Wednesday, August 31, 2016

The Reality of Recovery

     During my most recent bout of extremely high anxiety, my mom and I continued to discuss my mental health. A few of our conversations brought up my recovery from my Primarily Obsessional OCD. We both agree that I have made progress. Yet, sometimes I still am not doing as well as my mom and I both wish. I still have really bad days during which I am either hysterical, medicated, or sleeping with no moments of naturally occurring peace in sight.
     Sometimes, when I'm really struggling, my mom will say something like, "I can't wait until you don't have these thoughts anymore." She may also say something like, "There has to be a way to get better faster." I think the same things sometimes, especially on my bad days. It would be great to just suddenly not have my intrusive thoughts, and it would be great to change the way my brain functions more quickly. I have discovered that those are not realistic ideas or expectations.
     These ideas are pretty common in our society. I know when I went to my intake appointment these were my expectations, even though I studied psychology in college. I assumed the recovery process was going to be moderately quick and moderately painless. I assumed that recovery meant that I would no longer have intrusive thoughts, and that I would no longer experience symptoms of OCD or anxiety. I assumed therapy and medication could be this quick and magical cure.
     The reality of my recovery from OCD is that, according to my research, I could be in therapy for around 2 years, and even then my OCD won't be cured because OCD doesn't have a cure. I will probably always have anxiety symptoms and intrusive thoughts. The goal of treatment isn't even to eliminate intrusive thoughts but to change the way I react to them. The goal is to accept the thoughts and not to become anxiety-riddled, hysterical, and to not get sucked into ruminating on the thoughts. The goal is to treat intrusive thoughts the way I treat other random thoughts, like the non-OCD population does when they have the same thoughts. (Some days I can do that now. Other days I can't.)
     The reality of recovery from any chronic illness, like a mental health condition, is that symptoms may always be present, but managing the symptoms can become easier. There is no quick fix for something like anxiety disorders or depression or eating disorders or PTSD. Recovery takes time because it's actually hard work full of learning, homework, lifestyle changes, and changes to our very thought patterns that we have to intentionally implement. Medication can help if you choose medication as part of your treatment, but the reality of medication is that it is a trial and error process until you and your doctor find the one that works best for you. The process is completely worth it when you find something that enables you to function at your desired level, though.
     The reality of being recovered is that being recovered doesn't mean that I'll be done with therapy (or medication if you choose medication). I may need to go back to therapy throughout my life to maintain my recovery, just like any person dealing with a chronic physical illness continues doctor visits to maintain wellness. (Medication may always be part of maintaining wellness as well, and that is okay.) I may also still have some bad days after being considered recovered, but (hopefully) the way I manage the bad days will make them feel less severe so I can shake them off sooner. (Sometimes I'm in a place where the bad days can be shortened to a bad few hours or something like that, but not always.)
     The reality of my recovery looks a lot different from the ideas I had about recovery when I first had my intake appointment. I can't say that I wasn't disappointed by the reality check my therapist served up, but I can say that I am much better at working toward recovery because of that reality check. I have a better picture of what recovery from my mental health condition looks like, and I think that makes it easier to recognize progress. I also think the idea of recovery that I have now has done a lot to help me not be so hard on myself  during my journey toward wellness and recovery.
     I'll end with this: Recovery from any chronic condition, especially mental health conditions, takes a lot of time and effort, and the process looks different for everyone. Recovery may not look the way that you pictured in your mind in the beginning, but that's okay. You wouldn't expect someone with asthma to never have asthma symptoms just because they were being treated for their asthma, so you shouldn't expect yourself to never have symptoms of whatever mental health condition is part of your life.

Wednesday, August 24, 2016

No One is a Lost Cause

     My mom and I were talking about my mental health recently. My mom usually says something like, "I wish you would have told me that you thought you needed a doctor." Or, "I wish you would have told me what was happening instead of hiding it so I could have gotten you counseling." She seems to not understand how deeply terrified I was of my own mind at the time it all started and for years after. Looking back, I wish I would have just told her what was happening because if I had, I would be in a completely different place mentally than I am right now.
     I know it doesn't make sense that I wouldn't seek help to most people who have been to therapy for something or who have never struggled with a mental health condition. I also know I only did more damage to myself by not seeking help. I had always been pro-counseling. I even suggested that other people get counseling when they felt like something wasn't quite right.
     When it came to myself and the type of OCD I was (unknowingly) dealing with and the thoughts I kept hearing in my mind, I just couldn't seek help. I felt like no one could help me. I thought whatever was happening inside my mind was my fault, like I had opened the door and let the bad things in, and that no form of modern medicine or therapy would be able to silence the demons I had accidently welcomed into my life. I didn't even think my problem was a mental one. I thought it was a soul problem.
     My mom, throughout my repeated episodes of the worst of the Pure O, asked me, "Why don't you let me make you an appointment for counseling?" She even asked that in my 2015 episode, and I rejected the idea. My primary care physician mentioned therapy for the panic attacks, and I struggled with the idea of therapy for weeks before I finally gave in. (I still have no idea what my mom picked up on to make her realize that something was wrong because I thought I was hiding it pretty well.)
     So, why didn't I just wise up and go sooner? Because I thought I needed an exorcism instead of therapy. My second worst fear regarding asking for help was that I would just be locked away somewhere because I was too dark and evil to be among the rest of humanity. I literally went to my intake appointment at the community mental health organization sure the therapist would turn me away or use some sort of code phrase to signal that I should be taken somewhere without even getting to say goodbye to my mom and my cat, because the therapist wouldn't know how to help someone in my position.
     I felt like I was unable to be helped or saved. I felt like no one in the world would be able to make me less broken or to fix me. I was even pretty sure whatever demon had attached itself to my soul wouldn't be touched by the exorcism because maybe I didn't have enough faith to be able to shake it (since no amount of prayer, hymn singing, church attendance, or Bible reading had taken away the bad thoughts). If I was insane (which I also thought was a reasonable assumption), I thought I was so far gone down the path of insanity that no amount of therapy or medication would be able to bring me back to myself. I thought I was a lost cause, and I was afraid that asking for help would only validate that idea for me.
     When I finally opened up, I was shocked that my mom didn't recoil in horror or disgust. She just basically said, "It's anxiety. Sometimes stuff like that happens to me, too. You just need some medication and/or therapy." My primary care physician had nearly the same reaction as my mother. Then my therapist was completely un-phased by the things I told her. She basically said, "You are definitely not the worst case I have seen, and I can totally treat you as an outpatient. This is a real mental health condition, and it is treatable." She even promised that no one would perform an exorcism, as did my priest, because no one thought I was evil or possessed.
     All the ideas and the fear that I felt kept me from seeking help were also just part of the disorder I was dealing with. They were also due in large part to the fact that I didn't understand anything that was happening (which would have been cleared up if I had just talked to my mom). I did a lot of research (and I still do lots of research) just to understand more about therapy, things that help, and my own disorder. It also turned out that I wasn't a lost cause. That realization brought me tears of joy.
     I'll end with this: No matter what kind of mental health condition you are dealing with, be it OCD or any of the OCD subtypes, Anxiety Disorders, Depression, PTSD, Bipolar Disorder, Schizophrenia,  Eating Disorders, or Personality Disorders, or anything in between YOU ARE NOT A LOST CAUSE. YOU ARE NEVER A LOST CAUSE. It is never too late to seek help. The right kind of help for whatever is happening in your mind is out there (whether you choose a free App for your phone, the clergy, a crisis line, or face-to-face counseling...it's out there). I repeat: NO ONE IS EVER A LOST CAUSE.

Wednesday, August 17, 2016

The Two People in My Mind

     I've said the same thing over and over again since I've been battling Primarily Obsessional OCD. I've said to both of my therapists and my mother that it feels like two extremely different people live in my mind. At this point, I have even affectionately named them Anxious Annie and Logical Lucy.
     Anxious Annie personifies the OCD. She is irrationally driven by fear of every thought I have. She freaks out at the slightest thing she labels as abnormal or bad (and she thinks almost everything that isn't sunshine and rainbows is bad). Then when Logical Lucy tries to step in and calm Anxious Annie, Anxious Annie attacks her. (And let me tell you that Anxious Annie is like a trained UFC Fighter.)
     Logical Lucy personifies the rational part of my mind. She knows the whole time that Anxious Annie is being irrational. She is like the calm therapist that tries to talk Anxious Annie out of her anxious tirade. She tries to explain to Anxious Annie that she really doesn't need to be so anxious, and she occasionally has to talk Anxious Annie down from the precipice of a panic attack.
     Almost every day I feel like both of the people that live inside my mind are trying to claim my attention. At the same time I am worrying about something and falling into an obsessive thought spiral, I'm logically myself, too. That means I know the things I'm worrying about and thinking are irrational, but I am powerless to stop myself from doing those things. Knowing something is irrational and silly just makes me feel like a crazy person because, even though I know it's irrational, I can't stop thinking about it.
     Also, as a result of the two parts of my mind being at war, I also feel like I am a non-crazy person being held captive by a crazy person. I realize I am thinking or behaving in a way that my OCD is in control of the situation. I realize that my anxiety has gotten the best of me at times. It feels like Logical Lucy got handcuffed and thrown in jail while Anxious Annie got away with armed robbery of my sanity.
     How do I try to bring Logical Lucy to the front of my mind instead of Anxious Annie? I label my thoughts and practice Mindfulness. If something pops into my mind and it just keeps rolling around so that I have to keep thinking about it, I label it as an OCD thought. Then I try to objectively observe that thought until it stops happening. I may have to do that every few minutes for a while, but my brain eventually lands on something else to think about. It gets easier over time, and then I feel in control again.
     I'll end with this: Sometimes it can feel like your life is controlled by your mental health condition, and that sucks. I still feel like that sometimes after months of weekly therapy visits. It can be scary when it feels like your mind is holding you prisoner. Mindfulness practice helps me greatly. If you haven't tried it, I encourage you to research it and see what you think.

Wednesday, August 10, 2016

The Anxiety Override Coping Mechanism

     My therapist brought up something in my session last week, and this week I realized that she was absolutely right. She asked me something last week when I told her that my anxiety was still pretty high and my intrusive thoughts were still super frequent. She asked me, "What is your anxiety distracting you from that you don't really want to think about?" I had no answer for her because I was sure that my anxiety was the real problem and not something I didn't want to deal with.
     Then later, after discussion on another topic about being a high sensitive person and feeling too many things, she said something else that stuck in my mind. She said, "You know, anxiety is fear...fear of feelings." I thought I was past that since I had been using mindfulness to work through my feelings and improve my distress tolerance.
     I've been reading online about this idea presented to me by my therapist at the end of last week and the beginning of this week. Many, many people, particularly in Pure O forums and groups said in posts that their Pure OCD spiked when they worried about something or when they were under emotional stress (like dealing with feelings that were overwhelming). I even saw it referred to as some sort of coping mechanism to distract them from whatever it was that was too stressful to deal with. That sounded like an extremely twisted coping mechanism to me.
     I started to wonder how something could be so stressful that the intrusive thoughts, the anxiety, the shame, and the guilt were preferable to the something that was so stressful that our brains would just spin out of control just to keep us from thinking about it. Most mental health conditions will be exacerbated by any stress, but this was a slightly different idea. This was the idea that the anxiety took the place of whatever was actually happening to cause the emotional stress (the strong, overwhelming feelings) so that our brains could just slowly back away from that thing (like a person slowly backing away from a rabid animal in the hopes that it doesn't attack.)
     Then I got first hand experience with the very thing that I previously hadn't understood. My family experienced a loss, and the grief that I felt was so overwhelming and so consuming that I felt like I was drowning in it. One minute I was so devastated that I just wanted to curl into a ball and sob, and the next minute I was so angry that I hated everyone and everything and I wanted to destroy anything I could get my hands on. Too many emotions, all of them happening too quickly, can be a frightening experience.
     So, what happened? My intrusive thoughts (all 3 current categories) flooded my mind, and I could only focus on them. Then I realized that my Pure O was only trying to distract me from the grief (the rabid animal I was apparently too terrified to face). When I realized what was happening so I could mindfully observe the thoughts without focusing on them, more intrusive thoughts in categories I had never experienced rushed into my mind. I was even terrified of going to bed at night and dying in my sleep. I would get so wrapped up in focusing on the intrusive thoughts and mentally checking for them that I wouldn't feel my grief anymore. My anxiety had taken over so that I didn't have to feel the things that were so terrifying to me, and the anxiety almost felt like a relief sometimes, compared to the intense sense of loss that I've been terrified will never go away.
     I'll end with this: Feelings are scary, but I've learned the hard way that I can't hide from them or bury them forever. I have to remind myself every day at the moment that my therapist told me that all feelings eventually pass, even when it feels like I'll be stuck in a certain place forever. I also have to force myself to put more effort into my mindfulness practice at the moment to recognize, accept, and just feel my feelings. Then I just have to keep swimming until I reach a place where the current my grief and other feelings (including my anxiety) isn't trying to drag me under anymore. With grief it's hard to say when I'll reach that place, but I'll get there.

Wednesday, August 3, 2016

Settling for Okay

     Perfectionism (defined by the Merriam-Webster Dictionary online): a disposition to regard anything short of perfection as unacceptable (or as I like to call it, one of the many things that contributes greatly to my anxiety). I've always had this personality trait, and it never seemed like a big deal. It kept me out of trouble, helped me push myself to get good grades, and all the other things people usually strive for. This perfectionist personality trait also had some consequences, though, like the fact that when I didn't do as well as I wanted to on something, anxiety set in. If I made a mistake I would dwell on it for what felt like forever and feel terrible.
     Then the OCD set in, and it seemed to amplify my perfectionist personality trait. I had intrusive thoughts that I couldn't control, that I was sure only bad people had. I started to think that maybe to make up for those thoughts, if I just didn't do anything else wrong, if I didn't commit any other sins, maybe those thoughts could be overlooked in light of all the good things I had tried to do. In other words, if I could be morally perfect in every other way, the thoughts might not count as much. Talk about high standards...
     Striving for moral perfection became an obsession. (I still struggle with it a lot). I felt like I had to be 100% honest all the time, 100% selfless all the time, and 100% compassionate and understanding all the time. Anything less than that meant that I was a terrible person, and being a terrible person made me live a guilt-riddled existence. The problem is that no one is capable of achieving any of those standards I set for myself, and I knew no one else could possibly do that. Sounds irrational, then, doesn't it? Logically I know my ideas aren't rational, but logic doesn't always help my anxiety.
     My therapist likes to point out that the things I was trying to achieve were impossibly high standards because I'm only human, and humans are imperfect. (She likes to say that to me a whole lot.) She also asked me what my idea of a bad person was, and I realized that the definition of a bad person that I gave her didn't match anything that I had ever done. That doesn't really get rid of my guilt for my perceived moral infractions, no matter how small they are in reality, though.
     For weeks now, my therapist and I have been working on changing my faulty thought patterns. I've tried to shrug things off, and say, "So what? In the past I made mistakes, but the past doesn't matter as much as the present moment and the future. Everyone makes mistakes." I've also tried to wrap my anxious brain around the idea of settling for being an okay, mostly good, or at the least, an okay, not bad, human. Changing my perfectionist tendencies and my faulty thought patterns is a very difficult thing to do, but I'm trying to be more compassionate with myself than I have been in the past.
     I'll end with this: If you wouldn't hold someone else that you love to such high standards, why do you hold yourself to such standards? You don't have to be perfect to be a good person. Trying your best and being "okay" is perfectly acceptable. Being perfect is impossible. It doesn't mean that anyone is a failure or a bad person for being just an "okay", average human who has bad days, bad moods, and makes mistakes.