OCD
This is pretty long, so I've divided it up into several sections.
- Introduction
- Let me tell you a tale...
- Why?
- And so it begins...
- Cognitive Behavioral Therapy
- (Relatively) OCD-free
- ...And back to square one
- Abilify
- ...And back to square zero
- And end...
- ...And a beginning
- The rockiest bottom of them all
- A few months on
- One year on
Until my sophomore year of high school, at 15 years old, my OCD was more of a nuisance than something bad. Little obsessions would pop up now and again, but they would eventually wear themselves out. However, at 15, I began suffering from an obsession that would shape the next few years of my life.
Before I get into talking about the obsession and all that, I should explain how it has shaped my life. It has affected my life in both negative and positive ways. Suffering with it has been, obviously, a negative effect. But, my acknowledgement of my determination and strength in suffering with it and fighting it has been a positive effect. It has helped me to realize that my life isn't OCD, and OCD isn't my life. But it is a huge part of my life, so sometimes that distinction gets a bit blurred!
It's only very recently that I've felt comfortable discussing my particular obsession. With OCD, anything can be obsessed over. Anything can make you feel awful. My obsession is very common among OCD sufferers, but due to its easily misunderstood nature, we don't tend to go about shouting about it.
A sexual obsession that centers around the fear of being homosexual. Sometimes called Homosexual OCD and more commonly known as HOCD to sufferers. The constant questioning and ruminating over thoughts like "What if I'm gay? What if I actually like the same sex? What if everything I've known about my preference throughout my life has been a huge lie? What if I'm repressing desires? What if? What if? What if?".
You may read that and think, 'Closet case.' Or, 'Confused.'
'What's so bad about being gay? Just be who you are, it doesn't matter.' Have you thought that as well?
'Homophobe.' Did that run through your mind?
You would be right about all of these things, if in fact I were gay. If, in fact, the problem in question was sexual orientation, and not a disorder.
I've thought about all of those things too. I truly believe there's nothing wrong at all with being gay, and it's very important to embrace your sexuality and be proud of it. I think it's shameful to be homophobic. Thinking that people in the queer community are 'wrong' or 'bad' is like thinking that people with blue eyes are 'bad' - it's just stupid and kind of pointless.
What I just wrote was logical and reasonable. It made sense (I hope!). OCD takes no notice of logic or reason. It thrives on irrationality and implausibility.
I can remember this whole thing as a timeline. Right after the first Harry Potter movie came out (so, November 2001, to be precise). I wasn't really that mature yet - no, no, not that I was giddy and silly and all that, but emotionally... my hormones were really just starting to kick about. I saw HP and just completely fell for 'Professor Snape' (Alan Rickman). Fell way harder than I'd ever fallen for any guy before. Later, I realized that he was the first guy I was truly sexually attracted to. He made my hormones explode.
So after about a week or so after I saw the movie and had lost my heart to The Rickman, that initial feeling faded. I thought, 'Yep, I'll go back to not really caring like that about him sometime, like with other guys I liked before. Like I'm gay or something! *laughs* Oh. No. Gay?' Yeah, that's how it started. Did that make much sense to you?
Gradually, I became more and more obsessed with the 'am I a lesbian?' thing. I started having to do some rituals to ward off the thoughts about being gay (saying words in certain patterns, including 'I'm not gay, I'm straight, I'm not a lesbian...' ad infinitum), but they weren't interfering with life (yet).
I became more aware of my reactions around women (mostly women on TV and in magazines, but also 'out and about' - pun intended!) and men - who do I like looking at more? being around more? thinking about more? Over winter break, when we were decorating the Christmas tree, I was working on the computer for a minute. I opened a picture I had saved of 'Snape' for (and I didn't realize this at the time) reassurance that... here it comes... I wasn't gay. Then I couldn't close the damn thing. Open, close, open, close, open, close - ah, I had the 'right' thought, now I can go decorate the tree. Bugger. What if I was thinking something about being gay? Better open and close it again to make sure I'm not gay.
The more learned among you may have already seen how this obsession differs from a true sexuality crisis. My fear was (is) - what if I'm gay? Someone going through the process of coming out isn't obsessing about whether or not they're gay - they know that part already! One doesn't need to think too hard to know what one likes. OCD isn't about 'figuring out' your sexuality; it's about obsessing over the fear of being gay. What if I'm gay? What if I'm gay and don't know it? (That 'what if' is one of my specialties :) ).
Why that fear? I dunno. Why do some people with OCD have the fear of contamination? Why do other people with OCD have religious obsessions? It just is. For some reason, the idea of 'turning gay' or all of a sudden finding out that you're gay is the scariest thing ever to a person with that particular obsession. Who knows why?
It's not homophobia, honestly. To me, the basic, core fear with this obsession is that maybe you are something that you don't really believe you are. To understand that concept better, apply that description to, say, a contamination obsession. You know you aren't actually dirty. Deep down inside you know you're clean. But you have a contamination obsession, so you just can't be sure. For some reason, your obsession focuses on cleanliness. The 'what if I'm gay?' obsession focuses on your sexuality.
Some might read about this obsession and think: 'People with OCD obsess about things that they feel are unpleasant, wrong, or bad. By that definition, if one is obsessed with being gay, that means that they think 'gay' is an unpleasant, wrong, or bad thing. Therefore someone with the "gay obsession" is probably bigoted toward the gay community.' I can definitely see how it would be easy to think that, and I'm sure that there are people with this obsession who have bigoted views as well as OCD. For the great majority of us with this obsession, though, 'gay' is not a bad or unpleasant concept. What is bad and unpleasant is the fear of not really being who you think you are, which sort of twists itself into being a fear of being gay. What's more frightening than being wrong about something as integral to who you are as a part of your identity?
My obsession came to a head at my grandparent's house the day before New Year's Eve (a few months after HP). I 'spiked' - that is, I had an anxiety attack brought on by thoughts related to the obsession. That's when I realized I had an obsession.
The rest of the school year was... interesting. I mean, I was miserable, but I was able to function. I got excellent grades and kept up appearances, even though I was living in my head. That summer was awful. Among other difficult routines, I would try to get into bed, but I couldn't bring my feet up into the bed unless I was thinking of something not associated with my obsession. Images related to my obsession would come flooding into my mind when it knew that I just wanted to go to bed. I would lay there, half in bed, half out, watching TV for... well, maybe not hours, but it certainly felt that long. Then once I actually got into bed, all of me, not just my top half, I would start the nightly ruminations. I would force myself to imagine all manner of graphic 'stuff' with women and men and compare and analyze and analyze and analyze. Do I like that? What does this mean? Blah blah blah? I was a prisoner in my own mind, unable to let myself relax to fall asleep until I had reassured myself that I had 'counteracted' the obsessive thoughts. I can’t think back on those nights without wanting to cry. That wasn’t me. That was not me.
That fall, at 16, I started cognitive behavioral therapy sessions. I didn’t think it would help me. I thought I was doomed to live with my obsession for the rest of my life. The first half of my junior year was miserable. I still cannot understand how I was able to keep going. I had lost all hope in everything. I was just plain miserable. My obsession had consumed my life, had affected me in so many ways. I was weak, emotionally and physically. Mentally, I was exhausted. Something kept me going, kept me from just throwing up my hands and saying 'That’s it! I’ll just be miserable for the rest of my life! That’s all there is!'.
I went through a week of intensive therapy in February. I had to stay home from school that week in order for the therapy to work. I did everything (getting into bed, for example) that previously had been next to impossible to do without ritualizing while thinking about my obsession. By 'thinking', I mean that instead of avoiding the obsessive thoughts by ritualizing and ruminating, I confronted those thoughts and welcomed them. I walked all around the house, thinking about my obsession, relishing the obsession, forcing it to just try and stop me. I got my legs up into bed. I watched television without ritualizing. I lived.
It was scary at first, forcing myself to think about exactly what I had been trying to avoid all that time. But I knew by then that it was the only way to become me again. I was proud of myself. I had done it. I was no longer hampered by my thoughts, no longer compelled to ruminate, no longer a prisoner. I was free. It took the rest of my junior year, however, to recover, as well as the summer.
My senior year of high school was bliss. I was me again, and I had a fantastic year. My OCD was only there in the background, something to brush off if it dared try to bother me. After two years of hell, I relished just being able to look at men and women and not analyze. I particularly relished being able to look at men and simply adore them without thinking 'Well, you're just pretending, you're really gay.' I loved being able to look at women and think they were pretty without fearing that that meant that I was gay. I loved feeling confident about myself again - I had beaten the OCD into submission and I was back to being myself again.
So, I graduated in 2004. I steadily descended into depression over the summer and into the fall. During that time, I was not affected much by OCD, and didn’t expect to be. Then, the week before Christmas, I woke up and had an anxiety attack. That obsession I went through CBT to beat? Yeah, it was back.
This time around, it got so bad that I had to defer my first semester of college. I was truly suffering. I got back into therapy as soon as possible, but I was still in a very bad way. It’s a very, very scary thing to be frightened of your own mind, to be frightened of what next thought would cause an anxiety attack. I hit rock bottom during early 2005. I mean rock bottom. I was in such a bad way that I experienced depersonalization - '... a feeling of detachment or estrangement from one's self . The individual may feel like an automaton or as if he or she is living in a dream or a movie. There may be a sensation of being an outside observer of one's metal processes, one's body, or parts of one's body.' It's common as a full-fledged disorder, or as a one-off type thing, which is what I had. I have never felt anything as bizarre and frightening as that sensation.
I took a summer course to prepare myself for my first semester of college that fall. I was in therapy with my therapist until October, I think, which is when my parents made the decision to take me out of the therapy and take me in to see my psychiatrist.
I was not making any improvements despite doing my CBT techniques and exercises in earnest and with determination to heal. I hit rock bottom, again, when I fell asleep while ruminating in a bathroom stall for about an hour (I woke up in time for my next class, though). OCD ain't pretty, folks.
I was extremely irrational. My psychiatrist talked with me and heard the way I was thinking and how my thoughts were processing and told my parents, 'It's time for the big guns.'
I was started on Abilify (in laymen's terms, an anti-psychotic) that October. My psych gave me 'work' to do, techniques that were contrary to what my therapist had drilled into me. The strategies my therapist had been employing seemed to have exacerbated the obsession.
By some sort of miracle, and I mean that sincerely, the Abilify took effect within a month. I cannot tell you how amazingly better I began to feel. No more fearful thoughts plagued my mind. I was able to think rationally and logically, and I loved it.
That didn't last long. That spring, in March or maybe the beginning of April, I crashed again. My psychiatrist had taken me off my SSRI and the Abilify sometime during the last two months because of difficulties with side effects. So unsurprisingly, I didn't do so well without my medication. And though I've said it before, I hit yet another rock bottom.
I withdrew from all of my spring semester classes except one. I finished that one class with an A- (yay!) and a few shreds of sanity left. My psychiatrist tweaked my medications that summer and I struggled to get better. I cancelled my enrollment for the fall 2006 semester and planned to go back in the spring.
My parents began looking for a new psychiatrist for me at the beginning of the summer. There were a few concerns about some of the decisions my psych had made and we felt we needed a new perspective. My mother got a consult appointment with the head of an OCD clinic at Johns Hopkins University, but that appointment wasn't until the end of August.
That summer, I was put back on my meds and sort of just coasted along, not doing very well but not in a fetal position. I had an informative and helpful consult with a different therapist in the middle of the season and that lifted my spirits quite a bit. The end of August came and we went to Baltimore for my consult.
The consult lasted four hours as the psychiatrist took an exhaustive look at my history with OCD and my history in general. At the end of the session he confirmed that I was indeed suffering from a particularly bad bout of OCD and that it was very possible to recover and go on to have a wonderful life. He agreed to take me on as his patient and though I was still feeling pretty miserable, I was buoyed by the hope my new psychiatrist offered me.
We began building my SSRI up that fall and the months went by fairly uneventfully. I still had to withdraw from the spring 2007 semester due to some medication issues, but my healing continued... until I hit yet another big bump in the road.
The rockiest bottom of them all
Every time I hit 'rock bottom' before, I thought I'd never be so low ever again. February/March 2007 proved that I had been wrong.
I was doing relatively OK during the beginning of 2007. My psych, after talking with my internist, decided to take me off of Abilify as there were concerns that it was causing troubles with my heart. As I was coasting quite nicely, we thought that maybe I would do all right without the Abilify.
After I had been off the drug for about a month, I hit rock bottom again. This time, though, my obsession had 'morphed.' I was no longer worried about being gay. Oh no, that was out the window. I had a new fear.
This one is even more potentially offensive than the being gay one was/is, and so I won't go into it, because I have no idea how to explain it without starting some sort of a riot. I started having suicidal thoughts (not thoughts of actually doing it, but dark thoughts all the same) and was so damn depressed. I felt like hell and I thought it would never end. I mean, I was in a very dark state of mind that I had never experienced before. I felt, 'Why has this happened again? Why have I crashed again? How am I supposed to heal from this? I hurt so bad, I can't imagine ever feeling like myself again.' I felt numb.
I saw my psychiatrist, and he once again gave me hope. He asked me if I wanted to go to the hospital, because of the suicidal thoughts. I know there's nothing shameful about being hospitalized at all, but you only ever hear about people who are really struggling being hospitalized. It sort of hit me then just how ill I was. I said no, I didn't think I needed to go, and because of the rather mild nature of the thoughts he supported me in my decision. He talked with me and tried to get it through to me that it's all just OCD, that it will get better, that my new fears are still OCD and not, like I was convinced in my head, a 'real' thing to be concerned about. At the time it was hard for me to believe that things would improve because I just hurt so bad, but I was willing to believe my psychiatrist because he's a smart guy.
Now back on the Abilify, I have seen a great deal of improvement since my last appointment with my psych. That dark state of mind is gone. Those dark thoughts are gone. That hurting? Gone. I'm not better, I've still got quite a ways to go.
But this time, I really think I'm healing. I'm not just 'getting better' like I did the first few times. This time, I truly feel like I am recovering my mental health.
Those rocky bottoms never have to happen again. I don't have to feel that bad again. This time, I know that I can never truly get rid of my obsessions. You can't get rid of OCD. But I can learn to not be controlled by my disorder. I can own it. I can realize that my fears and worries are part of a disorder and that I don't have to pay attention to them, I don't have to spend time analyzing and ruminating.
I can, to put it simply, live.
Since "the rockiest bottom" last year, I have gone back to school - and enjoyed it, too! I've made "school friends." I love (well, perhaps love is exaggerating it a bit!) working on papers and coursework because with each assignment worked on and completed, I gain back a little bit more confidence in my abilities. I have a lot of hope and optimism about the future - both years from now and just hours from now. I enjoy things so much more and truly understand the meaning of "don't sweat the small stuff." My mantra is "Happiness is an option" (thanks, Pet Shop Boys!). I have my OCD pretty much under control - as under control as it can be. I've accepted and understand that I'll never really be free of OCD - but I also understand that doesn't mean I have to suffer.
Kudos to those of you who made it to the end of this. You win at teh internets.
