We're All Warriors

     My therapist said something a few weeks ago, and it sort of stuck with me. I mentioned that I felt like I was weak because I was having a hard time dealing with my anxiety. If I'm being honest, having a mental health condition made me feel like I was weak. I felt like the people that didn't have to deal with a mental health condition were stronger, or hardier, than me, like maybe if I was stronger, I would be better able to deal with my anxiety or I wouldn't have an anxiety disorder in the first place.
     Then my therapist looked at me, and she said, "You know, if you took the anxiety out of your brain and put it into someone else's brain, they wouldn't be able to deal with your level of anxiety. They just couldn't deal with it. So, I don't think you're weak. I think you're more like a warrior." I just had to sit there for a second and process that. I hadn't thought of it that way before. I was just thinking about the fact that I was feeling anxious and doing my best not to show it most days. I hadn't considered that, to someone else, my anxiety would be something they would experience as almost unbearable or crippling.
     I got home, and I was still thinking about what my therapist said. After I processed it, and I thought about it a little bit more, I realized that describing me as a warrior for dealing with my OCD and the high level of anxiety that comes with OCD was pretty accurate. I do have a steely determination to get myself better, and I fight for it every single day. It's like fighting a battle against an invisible enemy that knows all your weaknesses and uses them against you.
     I've felt tougher ever since I've been thinking about myself that way. My perception of my situation changed, and I haven't felt like a weakling anymore. I feel strong and tough, like a warrior. I like feeling strong and tough. That's actually why I work out, and why I wear a leather biker jacket. I also have purple in my hair because it makes me feel like a superhero, and superheroes are tough.
     I think anyone that deals with any kind of mental health condition every day is a warrior. We're dealing with something scary, and some days it can be debilitating,. Yet we put on a brave face each day, and we do our best to be high functioning, productive members of society anyway. Most of the time we don't even let people see us struggling. We just do our best to be fine, and we manage to survive another day on our internal battlefield.
     I'll end with this: Just because you have something like Bipolar Disorder, OCD, GAD, Panic Disorder, PTSD, or Depression doesn't mean you're weaker than anyone else. It just means you're human, like everyone else. When you're struggling, remember that you're a warrior, and that you can make it another day, even if you have to take that day hour by hour.

Different Strokes for Different Folks

     I mentioned that I switched from community mental health to a private therapist in previous posts. I have been seeing the private therapist since December, and I'm really noticing a difference in myself. I'm noticing that my anxiety is holding at low to moderate levels now instead of  the extreme highs that I was dealing with before. I also notice that I'm feeling more like my pre-diagnosis and pre-symptom self, and that was something I had been missing for the past 5 months since I'd been in treatment. (Yes, I've had OCD for over 6 years now, but things didn't get too terrible until this summer. I haven't really felt like myself since that time.)
     I'm noticing these changes now for a couple of reasons. The first reason is that I'm having therapy once a week now for an entire hour each session instead of 45 minutes every three weeks. (Again, that isn't the fault of the community mental health system. They were doing the best they could with the resources they have.) Now, I have time to deal with one issue at a time, as that issue comes up, instead of trying to cram as much as possible into the sessions, like we were doing in the community mental health agency. (As a result of cramming so much work into each session, my previous therapist had flooded me, too, which wasn't good.)
     The other major difference that is responsible for my drastic improvement is the change in the way my current therapist is treating my mental health condition. Both my previous and my current therapist are Cognitive Behavioral therapists (CBT), (which means they use an approach that identifies the unhelpful or messed up thinking patterns and beliefs and change behavior to be more in line with the new more positive and helpful thoughts and beliefs). However, the techniques they use are extremely different.
     My previous therapist tried to treat my OCD with Exposure and Response Prevention therapy (ERP), which is a type of CBT that is the recommended treatment for OCD, even the nontraditional type of OCD that I have. However, my previous therapist didn't have a whole lot of experience with OCD, and she told me that before we started. (ERP raises anxiety levels, and then the anxiety is supposed to slowly decrease over time as you get used to the thoughts and challenge them with behavioral activities.) This wasn't happening with me, and more and more intrusive thoughts were coming, spanning all kinds of terrifying areas. The sort of approach my previous therapist used didn't work for me. I'm not sure why. They had also previously tried a medication, and it made my OCD worse even though it worked wonders for everyone else that I read about taking the medication for their Pure O.
     My current therapist, also a Cognitive Behavioral therapist, uses a different approach to treat my OCD. So far, my current therapist seems to favor a more cognitive approach (which means she is focusing on changing my thought patterns and my faulty beliefs in regard to my OCD intrusive thoughts instead of stressing the ERP and behavioral changes). In other words, we're talking about my intrusive thoughts, my anxiety, and what I think and believe about all those things. I'm sure we'll get to some ERP activities, but we haven't so far in my treatment.
     My current therapist has also pointed me in the direction of some extra resources: workbooks. On the second visit with my new therapist, she suggested that I order an OCD workbook to work through, and I ordered a workbook that actually takes the same cognitive-focused approach instead of an exposure-heavy approach. (The workbook is called Break Free from OCD: Overcoming OCD with CBT by Dr. Fiona Challacombe, Dr. Victoria Oldfield, and Professor Paul Salkovskis, and it comes from somewhere in the UK.) This workbook has helped me tremendously in the short time that I've been reading it and doing the suggested writing activities (making my own charts and things like it shows in the book). The workbook does have some exposure therapy activities that involve bringing on the distressing thoughts on purpose, but I haven't worked up the nerve to dive into those on my own yet. I'll get there, though.
     I'm not saying that, objectively, one treatment is better than the other, and I'm not saying that a private therapist is better than a therapist at a community mental health agency. However, subjectively, I think the treatment I am receiving from a private therapist has been a better experience because I am responding better to the treatment used by a private therapist. Different things work for different people, and people respond differently to different treatments because everyone's brain works differently.
     I'll end with this: Treatment for mental health conditions isn't a one size fits all sort of thing. People respond differently to different types of treatment because everyone's brain is different. Sometimes, you just have to try different therapeutic approaches and different therapists until you find one that works for you and your brain. The approach that works best may also include medication, and that's alright, too. Just, please, don't give up on treatment because the first few techniques or therapists you try aren't helpful.

It Only Takes One Person

     I started this blog because I wanted to share my mental health journey with other people so that those other people might not feel so alone. For just over six years, I had felt alone with my mental health condition, and I was pretty miserable. I didn't want anyone else to feel that way. I really wasn't thinking about people reaching out to me so that I wouldn't feel alone, too.
     This past week, someone reached out to me. The person contacted me, and they told me that they read my blog and that they have OCD as well. The person just wanted to let me know that they could relate to my struggle.
     I was so grateful that someone had taken the time so say something like that to me. I hadn't really noticed, but up to that moment, I had been feeling alone with my OCD. Yes, I have a support system that I talk to regularly. Yes, the people in my support system try to understand all the OCD-related things, but sometimes, I feel like they just don't get it. It's easy to still feel alone when you feel like other people don't get what's going on with you.
     Talking to somebody who really understood what I was dealing with changed the way that I was thinking about the OCD. At that point in time, while we were chatting, I didn't have to feel awkward about my OCD or ashamed or guilty. I didn't feel like I was weird for talking about it. I wasn't afraid that my conversation partner was going to think I was asking for pity or sympathy, or playing the victim. I didn't have to do my best to say things (or type things) that made me appear to be as "normal" as possible. We were in the same boat. We were having a normal conversation about something that we both deal with every single day (like talking about how the weather effects shoe choices).
     I'll end with this: It's no fun feeling like you're alone, especially when you're dealing with the things going on inside your mind. It only takes one person talking about your shared experience with something to make you not feel alone. One person. So, if you're comfortable with it, it's okay to open up about things. It might be a relief to you or someone else, just to know that someone else is struggling with the same thing.

The Power of Information

     Before I started therapy I had no idea what was going on inside my mind. Then I went to therapy, and I came home with packets of information related to my then diagnosis. Even between therapy appointments, the therapist had me doing research to try to fill in the other pieces of the puzzle. That only filled in a few of my puzzle pieces. These things were helpful, but since I wasn't getting information about OCD, I still was pretty clueless. My other therapist also didn't discuss any of the biological causes for anything that I was dealing with, so I was still sort of thinking that the obsessions and the anxiety were my fault...maybe even some sort of divine punishment for some sin or wrong I had done without realizing it.
     Fast forward to my new therapist. She gives me a lot of information specific to OCD and my anxiety and the biology behind some of my symptoms. An example: I have a lot of anxiety first thing in the morning. I had chalked this up to the fact that I was a bad person, and I had managed to do something awful, possibly in my sleep. My therapist explained that this wasn't the case. She told  me that a lot of people have anxiety first thing in the morning because our body releases cortisol to get us up and going, and that sometimes, too much cortisol can be experienced as anxiety.
     That little bit of information changed the way I look at my mornings completely. My anxiety wasn't caused by divine punishment or anything like that. My anxiety was just a reaction to too much cortisol first thing in the morning. So, I wasn't sad and hopeless anymore when I woke up to anxiety. I was able to take a step back and say to myself that everything was fine because this was a normal biological process involving too much cortisol. My mornings, and even my days, started to get a whole lot better, just from the little bit of information from my therapist.
     Another example: I had a couple of bad days. I felt it had to be my fault, that I was somehow not doing something right to keep my OCD and anxiety managed. My therapist then explained the Recovery Spiral. Recovery from mental illness doesn't travel upward to wellness in a nice straight line. Recovery goes in a spiral toward wellness. That means that sometimes, symptoms will reappear, even if you've been doing great. That doesn't mean you're back at the bottom or beginning again. That just means you hit a place in your recovery spiral in which your symptoms have come back.
     Even that little bit of psychological information helped me to better understand what was going on. That changed the way I thought about the incident and that changed the way I can react to it now. I can realize that it isn't just  me making mistakes in my recovery. That's just the way recovery goes for everyone.
     Information is always important, but it is extremely important when you're dealing with any sort of health condition. Information changes the way that people think, and by changing the way someone thinks about something, you change the way they react to it.
     I'll end with this: If you're seeing a therapist, and they aren't giving you the information you need, ask them questions, or at least ask them how you can find the information you need on your own. If you have questions about why you're having any kind of symptoms or anything like that, it's okay to ask. If you're therapist can't answer that very moment, they are more than willing to do research to get you answers that you need.

Another Tough Decision

     So, you've already made the tough decision to actually seek treatment for your mental health condition. You've already gotten a diagnosis and a treatment plan, and maybe you've been in therapy for a bit. This is where I ran into a problem with my recovery. I was going to therapy every 3 weeks, and in the time between those appointments, I was really struggling. I was dealing with all of my intrusive thoughts and the rumination, and my anxiety was holding just below the point that tips me over the edge into a panic attack because as new things came up, I wasn't getting the help I needed to work through them.
     I had been in therapy for just over 3 months. My therapist and I had a great therapeutic relationship. I liked her. I trusted her. The only problem was that I was getting worse because of the time between my appointments. That was no one's fault. It was just the state of the community mental health system. My therapist was so busy that she didn't have time to see me as much as I needed to get better.
     This problem meant that I had to make another tough decision. I had to decide whether or not to find a different therapist that could see me every week. (To treat OCD, it's recommended that I attend therapy once a week for at least 6 months, possibly up to 12 months.) I didn't want to find another therapist. In fact, the whole idea of letting yet another stranger into the deepest, darkest parts of my mind caused me more anxiety.
     I was afraid to find another therapist for other reasons, too. I was afraid that maybe the new therapist wouldn't really understand me or that this one might think I was crazy. I was afraid that I would be a nuisance to a private therapist. I was afraid that the change would make my anxiety worse, and that the new therapist would really push medication. I had all kinds of fears that I ended up not having to worry about.
     At the urging of my mother and the advice of my therapist, I made the decision to look for another therapist. That was a process. I looked online, in mental health directories and Google, and I only found 3 therapists, 2 of them located a couple of counties over, and 1 in a different state that specified that they could treat OCD. They were private therapists that may or may not take my insurance. Those options didn't look like great options. Other than that, the only options I knew about were the other community mental health organizations in my county.
     Then a friend of mine recommended a private therapist that wasn't listed in the online directory I had searched. I had another option. I Googled the therapist and checked her reviews. Then I actually had to call to see if she could even treat my condition. Then I had to see if she took my insurance. Then I had to see if she was taking new patients and how long it would be before I could get an appointment. I tried to contact her a few times before I heard back.
     The next step in this process was to make an appointment with the therapist I started with. I had to see her to get her to sign a release so that my new therapist could call her and get my file. Then I was no longer considered a client of the community mental health system.
     I changed my therapist because I needed to have more frequent therapy appointments, but other people may need to find a new therapist for various reasons. They may not be a good fit as far as personality, so a therapeutic relationship may not work out. Maybe the therapist doesn't know how to adequately treat a disorder, and the patient notices that they aren't getting the help they need. Maybe the therapist just makes the patient uncomfortable for some reason. The list could go on.
     I'll end with this: If you don't mesh well with your therapist, if something about them makes you uncomfortable, or if you feel like you aren't getting the help you need, it's perfectly acceptable to ask for or seek a new therapist. You have a right to adequate mental health care.

Triggered

     I've experienced a few triggering events over the end of last week and the beginning of this week. I've experienced triggering things before, but a couple of these events were different because the events that stand out were intentional. I've never had to deal with someone, or in this case, a couple of people intentionally triggering the intrusive thoughts then the anxiety and guilt that accompanies those thoughts.
     In the first case I was talking about some of the things I had been working through in therapy. Jokes were made about it, and the person laughed. In the second case, I was teased about the anxiety I felt about ordering food over the phone, and then encouraged to give in to my OCD and call to check that they had taken my order down correctly. The result of both of these incidents was that I was lost in an OCD spiral of rumination, anxiety, guilt, and tears for four days. (The triggering events occurred within 48 hours, and they sort of built on each other.)
     For both of these triggering events I responded the same way. I asked the person to stop. I told them they were messing with my anxiety. Neither of them stopped whatever they were doing that was triggering for me. Both of the people that triggered me just sort of laughed it off and then continued the jokes and teasing.
      I sometimes read posts on Tumblr tagged under mental health, specifically those tagged under anxiety and OCD. These posts cover everything from daily struggles, symptoms, poetry, rants, educational topics like comorbid conditions, and then quite a few posts also talked about friends and other people triggering the poster's anxiety and intrusive thoughts and compulsive behavior. I always wondered how someone's friends could intentionally trigger another friend's horrible intrusive thoughts and compulsive behavior. 
     This pointed to a problem that I hadn't been very aware of up to this point. A lot of people still don't take mental health conditions seriously. Neither person took me seriously when I told them they were messing with my anxiety until the tears started to flow. I shouldn't have had to cry and get so anxious that I felt a panic attack looming for someone to believe that I was having trouble as a result of a diagnosed condition.
     I've seen things popping up on my Facebook occasionally mentioning invisible illnesses and the idea that other people that don't suffer from them really don't take those types of conditions as seriously as other illnesses, and I've seen things like this on Pinterest mental health advocacy boards. I just never had any experience with this sort of thing.
      I'll end with this: Obsessive-Compulsive Disorder (and any other mental health condition) might not be an illness that you can see written all over someone's body or face, but that doesn't mean they aren't serious conditions. It isn't funny to treat these conditions like silly quirks or funny personality characteristics that you can make jokes out of. If you know someone dealing with a mental health condition the best thing you can do is believe them and take their condition seriously.

Permission to Chill

     I've always been one of those people that was "on" constantly. I never took breaks from anything that I was working on whether it was stuff for school, writing, or any other goal that I could come up with to reach. I even pushed myself with my first novel, and I finished it in 4 months and 12 days. I felt lazy and then guilty for not pushing myself to constantly work on something if I tried to take a break. (I thought people that wanted to accomplish things couldn't take breaks.)
     I lived my life this way even after my issues with OCD started when I was nineteen. By then, staying busy was the way I coped. If I was busy doing homework or working on a novel, then I didn't have to think about the intrusive thoughts, and that also meant I was distracted from my anxiety. It worked pretty well over the years until I would go on breaks and run out of things to do. Then I just hoped and prayed that no one noticed that I was crazy, evil, or possessed or I lied about the cause of my anxiety and social withdrawal.
     I tried to continue staying busy and pushing myself even after my recurrence of severe symptoms in July. I went to the Emergency Department for a panic attack one day, and the next day, still loopy on Ativan, I attempted to get back to work planning my second novel. I refused to take any time to sort my mind out because not doing something made me feel lazy.
     Over time it got harder and harder to concentrate on my work. I couldn't settle on an idea to turn into a book. I'd pick something, and then I'd change it a few weeks later because working on it made my anxiety level rise. I had 2 single novels, a trilogy, and the beginning of a series planned out, and I couldn't concentrate enough to work on any of them. Not to mention the fact that most days I was so exhausted that all I wanted to do was curl up somewhere and take a nap. It was taking way more of my energy to fight off anxiety than I was willing to admit. (I never knew how exhausting mental illness was until this summer.)
     Then my therapists (my first therapist and the new private therapist that I currently work with) told me that I push myself too hard. The therapist told me that she sees that I push myself to accomplish twice as much as everyone else, and that I was pushing myself to make leaps and bounds when I should have just been glad I could take baby steps. Here's the problem with that: pushing myself to be as normal as possible and still as "on" as I had been before this recent upheaval was causing me more anxiety because I was failing at achieving what I thought I should be achieving every day. Here's the other problem with pushing myself as hard as I used to: my mind needs time to rest just as much as my body needs to rest, and when I don't take time to rest mentally, just like if I don't rest physically, symptoms get worse.
     To make me see the error of my ways my therapist likes to ask me, "If you were counseling someone, would you expect from them what you're expecting from yourself?" My answer is always, "Of course not!" So, one of my New Year's resolutions was to focus more on actually getting well. To do that, I realize now (after months and months), that I actually need to chill out a little bit so my mind can catch a break. I don't have to be so "on" all the time. Sure, I might not write another book in four months, but that doesn't mean I won't ever accomplish anything.
   In 2016, to get well, I'm giving myself permission to chill. I'm working on slowing down a bit. I keep reminding myself that just because I'm taking things a little more slowly these days doesn't mean that I'm lazy. It means I'm taking care of my mental health just like I take care of my physical health.
     I'm also trying not to put as much pressure on myself. I'm still planning a lot of the bits and pieces for the second novel that I have yet to actually start and focus on, but I'm not forcing myself to plan the whole thing in a day. I'm also not forcing myself to be as close as I can possibly be to perfect anymore. I'm realizing that doesn't work whether you have mental illness or not. So, I'm trying to relax my standards I set for myself because it's okay to not be okay some days. It's not humanly possible to be okay every single day.
     2016 is a whole new year, and I'm doing things I've never let myself do before. I'm actually picking shows that I like and watching them on Netflix or on TV instead of recording them and only letting myself watch them when I feel like I've accomplished enough that day. I'm taking time out of my day just to color because coloring relaxes me. I'm also taking whole days off from writing just to do something fun like watch some of my favorite movies or just to talk to other people on Facebook, through texts, or occasionally, phone calls. I try to find things that make me laugh because laughter does wonders for my anxiety. (I may or may not narrate my cat's daily life, with dialogue. I also may or may not spend time imagining my life as a romantic comedy with Chris Evans as the leading man.) I've also picked back up on reading before bed instead of just going and going until I tuck myself in at night.
     I'll end with this: Life can be exhausting and overwhelming, and it can feel even more exhausting and overwhelming when you're dealing with any kind of upheaval, like mental illness. Stress can exacerbate the symptoms of mental illness. You wouldn't expect someone still recovering from the flu to get up and run three miles every day like they did before the flu, so you shouldn't expect yourself to be able to keep up the same pre-mental illness pace of life all the time. It's okay to have days that all you get accomplished is breathing, eating a meal, and maybe even laughing at your favorite book, movie, TV show, or something funny your pet did. Everyone on Earth could really use a chill out day now and again, and we shouldn't feel guilty about it. No one should ever feel guilty for taking the time out to de-stress and take care of their mental health.