OCD is Everywhere All the Time

The scary thing about getting treatment for OCD is that it shines a really bright light on a part of our lives that we tend to prefer keeping dark.  Before treatment, we can pretend like OCD is a small part of our lives, something that can be swept under the rug or hidden in a closet.  We can pretend like things are better than they are.

But it’s all pretend, and this kind of pretending is more dangerous than helpful.  When you start therapy, OCD gets bigger, a LOT bigger.  It seems like OCD is suddenly everywhere all the time.  The reality is that OCD has always been everywhere all the time, but you were ignoring it—sort of—really just pretending.  It has always been there, but now you’re shining a spotlight on it, and you can’t ignore it anymore.

And when you start to fight back, OCD seems scarier.  It’s like a bully: as long as you do what it says, it doesn’t make a huge fuss, but the moment you turn around and refuse its orders, OCD has to puff up its chest and be as intimidating as possible.  It wants to scare you back into submission.

But if you hold your ground, if you refuse to submit, if you throw a punch or two back, then that bully, OCD, will begin to shrink back, slowly, but it will.  When you assert your dominance, OCD begins to lose control; its grip on your life begins to loosen.

So therapy is scary at first.  I know.  I have spent the last year realizing just how crazy I am, and that has been super scary!  I tried to pretend otherwise for years.  It seems like OCD has suddenly become my life, but, really, it already controlled every aspect of my life.  It already influenced every decision in my life—no matter the size.  I just refused to see it before.

Now, it’s impossible to ignore it.  I see it everywhere.  Everywhere.  And that makes me mad, furious as hell.  That anger is a great motivator, though.  That anger spurs me to fight, to win.

School and OCD

I’m sorry that I have been such a blog-slacker lately.  This semester is in full swing which means my OCD is all kinds of amped up for destruction.  I have tons of obsessive thoughts running through my head these days that keep me from accomplishing much.  Papers, exams and class discussions provide OCD all of the potential-failure fuel it needs to make my life miserable.

Papers

It takes me a really long time to actually start a paper, because I spend a lot of time worrying whether or not I’ll have any smart, much less significant to say.  Or if I’ll fail the assignment.  Or if I’m really stupid and have just tricked everyone thus far and that when reading this paper, my professor is finally going to figure out what an idiot and what a fraud I am. I spend so much time worrying about needing to write perfectly that I can’t commit any words to paper for days.  I am usually unable to write until the deadline gets so close that I don’t have a choice and necessity takes over.  OCD continues to scream at me in the background with every word I type, though.  Every word must be perfect, must be the right choice.

Then I get to the point in writing when a normal person would print the essay and be done with it.  Not me, though.  I get to that point and I read it over and over and rearrange and reword and fret and worry some more about how the paper just doesn’t feel quite right it’s missing something and it’s not perfect.  And if it isn’t perfect, I’ll fail and my professor will figure out how stupid I am and it’ll be the end of my career.

Exams

Exams are stressful for just about everyone.  A lot of students get test anxiety.  I’m not really afraid of tests the way most people are.  I don’t study for them.  I don’t obsess about them days before they happen.  The anxiety creeps in somewhere in the middle of taking the test.  OCD starts to suggest that maybe I accidentally skipped a question or maybe I accidentally circled the wrong answer or maybe I didn’t read the question correctly, so I better go back and check every single question. Luckily with tests, I am usually able to ignore OCD’s suggestion that I check and recheck everything.  The urge is there, but I try to get up quickly upon answering the last question so that I have to just turn it in without checking anything.  This is one area that, thus far, I have remained stronger than OCD.

Class Discussions

Class discussions are problematic because they bring in a social element.  I get really anxious in some social situations, especially with strangers.  The worries are similar to my paper-related worries about being an idiot and people figuring it out.  This is especially frustrating because I’m not a quiet student.  I speak up frequently in class discussions.  This means more to worry about and over-analyze.  Every word that comes out of my mouth is met in my mind by harsh criticism.  By mid-semester, class discussions cease to cause me anxiety, because I have gotten comfortable with my professors and classmates.  It’s habituation at work.  Exposure really does reveal the scary monsters to be harmless.

Reality

It really is ridiculous how much time I spend worrying about failure.  I always get A’s on papers.  I have a 3.5 GPA.  I’m a good student.  I’m smart and my record shows that.  I see the evidence, trust me.  But OCD doesn’t care about evidence.  OCD makes you doubt yourself and your abilities and everything you know.  OCD finds all kinds of ways to make you distrust evidence.  The rational part of my brain knows that I’m crazy, but in the moment, the crazy side usually calls the shots anyway.

School is such a paradox for me.  It should be something of which I am proud.  Sometimes I am proud, but sometimes school pushes me into some serious self-loathing and self-doubt.

What fears, worries and doubts does school bring up for you?  What causes you anxiety?

OCD Misconceptions

One reason I don’t like telling people that I have OCD is that I frequently get this response: Oh my god me too!  I am such a neat freak!  I hate when my house gets cluttered!  My friends are always telling me that I’m OCD.

First off, no one is OCD.  People have OCD.  But that’s beside the point.

My point is that sometimes people think they have OCD just because they have a little quirk (like being a neat freak or liking things to be a certain way).  That isn’t OCD.  In some cases it could be OCPD (obsessive compulsive personality disorder), but I’ll cover that in a future post.  For a quick overview of OCPD, here’s some info.

OCD is an anxiety disorder.  It’s a mental illness.  People with OCD perform rituals because they feel huge amounts of anxiety and their compulsions calm their anxiety.  OCD sets off alarms–very loud alarms–in a person’s head for irrational reasons.

The Difference: An Example

There are two people who keep their homes very neat, very clean.  One has OCD and one does not.  The person who does not have OCD keeps her home neat just because she likes her home to be neat.  It makes her happy or relaxes her.  She just like it that way.  It’s a preference.

The person with OCD keeps her home neat because she has to, because she gets extremely anxious if something is even a little bit out of place.  This anxiety is the kind of anxiety a normal person feel when his or her life is threatened.  Some describe it as an apocalyptic-type dread.  It’s a fear that something really, really horrible will happen if things aren’t done a certain way.

Of course there is a lot more to OCD than needing things to be neat.  There are so many other symptoms.  This is just one example.

The DSM’s Definition of OCD

Since I don’t have a degree in psychology, here’s how the DSM defines OCD (taken from emedicine):

“OCD is classified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) as an anxiety disorder.1 It is characterized by distressing intrusive obsessive thoughts and/or repetitive compulsive actions (which may be physical or mental acts) that are clinically significant. The specific DSM-IV-TR criteria for OCD are as follows:

The individual expresses either obsessions or compulsions. Obsessions are defined by the following 4 criteria.

• Recurrent and persistent thoughts, impulses, or images are experienced at some time during the disturbance as intrusive and inappropriate and cause marked anxiety and distress. Those with this disorder recognize the craziness of these unwanted thoughts (such as fears of hurting their children) and would not act on them, but the thoughts are very disturbing and difficult to tell others about.
• The thoughts, impulses, or images are not simply excessive worries about real-life problems.
• The person attempts to suppress or ignore such thoughts, impulses, or images or to neutralize them with some other thought or action.
• The person recognizes that the obsessional thoughts, impulses, or images are a product of his/her own mind (not imposed from without, as in thought insertion).

Compulsions are defined by the following 2 criteria:

• The person performs repetitive behaviors (eg, hand washing, ordering, checking) or mental acts (eg, praying, counting, repeating words silently) in response to an obsession or according to rules that must be applied rigidly.
• The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are meant to neutralize or prevent or they are clearly excessive.

At some point during the course of the disorder, the person recognizes that the obsessions or compulsions are excessive or unreasonable. This does not apply to children.

The obsessions or compulsions cause marked distress; are time consuming (take >1 h/d); or significantly interfere with the person’s normal routine, occupational or academic functioning, or usual social activities or relationships.

If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it, such as preoccupation with food and weight in the presence of an eating disorder, hair pulling in the presence of trichotillomania, concern with appearance in body dysmorphic disorder, preoccupation with drugs in substance use disorder, preoccupation with having a serious illness in hypochondriasis, preoccupation with sexual urges in paraphilia, or guilty ruminations in the presence of major depressive disorder.

The disorder is not due to the direct physiologic effects of a substance or a general medical condition.

The additional specification of “with poor insight” is made if, for most of the current episode, the person does not recognize that the symptoms are excessive or unreasonable.”

Oh, OCD.  You drive me crazy!

So do you see why simply wanting things to be a certain way or being a little bit quirky does not mean a person has OCD?  I hope so.  I hope I was clear, but of course I have OCD so right now I am obsessing about whether or not I explained things clearly, whether or not I wrote at all coherently.  My mind won’t stop screaming that I didn’t get this just right, that if I post it, I’ll only screw everything up.  So because I’m supposed to be doing the opposite of what OCD wants, I’m going to post this even though it doesn’t feel “just right.”

Questions?

Do you have any questions about OCD that you’d like answered?  I’m not an expert and I don’t claim to have all of the answers, but I can promise to do my best to find answers.  I have been researching OCD for the past decade and have come across some great resources.  Plus I have a therapist and she is an expert.  She is more than used to me asking lots and lots of questions.