Double-Edged Sword

     Some months ago a good friend of mine added me to a couple of those Facebook OCD support groups and discussion pages. I left the groups as soon as I was added to them. Then I sort of felt like a snobby jerk for not wanting to be part of a group whose main purpose is to provide a support network for people just like me who live with OCD.
      I also avoid those online OCD discussion forums, unless I just want to check and make sure that someone else is dealing with the same weird new obsession that I may have developed, which isn't often these days. (I do that because if someone else is experiencing the same types of intrusive thoughts, that means it's more likely to be treatable than just a fluke that no one is going to know how to deal with.) After I find a post like that, I immediately leave the group, and I don't go back. I also avoid those sections of Tumblr and all the other social websites out there. (I have, in the past, browsed the stigma tags on Tumblr to find information for a couple of blog posts, but that is the only reason I checked the mental health side of Tumblr.)
     I'm not avoiding the online support groups and discussion forums because I'm a snobby jerk or because I'm a loner who doesn't think she needs a support system. I avoid online support groups and discussion forums because my only observable compulsions are confession and reassurance seeking. (I have stopped confessing and seeking reassurance, but I still have to put quite a bit of effort into it every time I'm troubled by intrusive thoughts.)
     In theory, I like online support groups and discussion forums. In theory, online support groups are a good place to share experiences and recovery stories or even tips and techniques you may have learned from therapy or self help books that other people might also find helpful. In practice, however, online support pages and discussion forums for mental health conditions like OCD can be a double-edged sword. Yes, the groups and discussion forums help people feel less alone and provide a distant support network. Those groups and forums also feed the OCD loop by providing some people with a way to confess and a pretty constant stream of reassurance that people often feel compelled to seek out. (I could so easily slip into being one of those people in an online support group or discussion forum.)
     Online support groups and online discussion forums can so quickly become a thing that feeds a person's reassurance seeking compulsion as well as the confession compulsion. I browsed a couple when I first got diagnosed with OCD, and pretty much all I saw were people pleading with the entire support group or discussion forum to reassure them that they weren't actually going to do whatever obsessive thing they were worried about or that their thoughts were only thoughts. No one likes to see their fellow humans suffer, so the people of the Internet would rush in with reassurance to make them feel better. The reassurance seeker might be fine for a few hours or a few days, but then they would come back asking for the same reassurances the group or forum provided before, which just feeds the OCD loop and made it worse.
      The people in the forums and the groups have no idea they're feeding someone's OCD loop when they provide reassurance, even if they have OCD themselves. They just want to help, like any decent human being that sees someone else suffering. So, I find it best to avoid those things altogether in order to maintain and continue my wellness.
    I used to do the same reassurance seeking with my mom (and anyone else I could get to talk to me whenever I was in the throes of OCD). When I figured out that the reassurance seeking was a compulsion I had to remind my mom over and over again not to give me any reassurance, and it was really hard for both of us because she didn't want to see me suffer like that. I had to just sit and deal with it, even if I had a panic attack. Eventually I was able to stop, but every time my intrusive thoughts get loud enough to bother me, I have to really work to not give in and call my mom at work to confess my intrusive thoughts and then get reassurance that I'm not an awful person.
      The problem with the online groups and discussion pages is that everyone on the Internet can just come in and make a post. You can't tell the whole Internet to stop giving you reassurance when you ask for it. Somebody is ALWAYS going to be online to feed that confession and reassurance compulsion, so the OCD loop is just going to keep circling and getting more and more severe as the OCD brain finds ways to out-logic the reassurances somebody just received from the group.
     I definitely don't want to discourage anyone from finding support in an online support group page or through an online discussion forum. I just want people to be wary of tumbling into a reassurance compulsion or of providing reassurance online and feeding someone else's OCD feedback loop. I know everyone (the OCD suffered and the reassurance provider) thinks that providing reassurance helps, but it honestly doesn't. It can make OCD  more severe in the long run.
     I'll end with this: Doing whatever you need to do to maintain and continue wellness isn't rude or snobby, and if that means avoiding certain people or websites/online chats that is okay. In theory online support groups and discussion forums are a great part of your support network, but in practice, we should all be more careful with how we use and sometimes abuse them. If you're one of those people that goes into the support pages/discussion forums seeking reassurance, I can agree with you that not getting the reassurance feels like the end of the world and it makes life hell for a while, but I can tell you that you can eventually get to a point where you can stop seeking reassurance if you work really hard at it over time. (Although, you might want to enlist the help of an OCD self help book, therapist, or a person you trust if you want to try that.)

Common Ground

     As many of us know, explaining a mental health condition to someone that doesn't have any experience dealing with a mental health condition can be difficult, and sometimes downright weird, especially if we don't know the person we're trying to explain something to very well. I encounter this problem when I have to explain my OCD to people that I'm not related to or that aren't my Facebook friend. Sometimes they get confused. Sometimes I get confused. Sometimes I make it sound way worse or way more "crazy" that it actually is, and then I end up backtracking and saying, "It's not as bad as I just made it sound, I swear."
     I can't refer everyone to my blog so they can read the way I have explained my mental health condition in writing. (I always write better than I speak.) I generally use lots of examples when I try to explain something, but with mental health conditions the examples can make it seem worse than it is or the examples can make people uncomfortable, if I deviate from the contamination OCD examples they see in the media (which I always do).
     I was discussing this issue with my therapist in my weekly session this week, and she suggested that I try to find common ground to make people understand my mental health condition when they ask. By that she meant, that I should make them think about some time they might have been preoccupied with thinking of an issue and unable to get it off their mind (maybe like a college student around the time of finals or someone worrying about a medical test result). Then explain to them how the obsessive part of my disorder is similar to that, but magnified to the extent that it can be debilitating. Then maybe they could understand without horrific examples that make them uncomfortable, and I wouldn't end up making it seem worse than I intended.
     I think the idea of trying to find common ground can also be applied if you're dealing with someone with a mental health condition when you don't have a mental health condition yourself. It gets rough. You don't understand what's happening. The other person can't find the words to explain what's happening. Look for common ground, and then try to empathize with the struggling person. You don't have to fix it, because a lot of the time, you can't fix it, but you can find common ground and empathize with them and then ask how you can help. The other person might appreciate the effort.
     I'll end with this: Explaining your mental health condition to someone is never easy. It also isn't easy to understand when someone tries to explain something like that to you when you don't have personal experience with a mental health condition. Find common ground with them instead of getting frustrated or angry because someone can't adequately explain or understand. Draw a similarity between a common human experience (whatever human experience is similar to life with your mental health condition) and go from there, so that you are meeting each other sort of at a ground zero of shared human experience.

Focusing on Love and Acceptance

     Since starting ERP again last week, my therapist and I have talked about the root of some of my religious obsessions, and a lot of the root of my problem seems to stem from the fact that my early religious training and religious dialogue were fear and guilt driven. My therapist has remarked time and time again that I carry around a lot of guilt for someone who is objectively considered to be a good person by most people. My other therapist called it the Catholic guilt, from my time in the Catholic Church. I don't care how you label it. All I care about is the fact that this guilt is heavy and that it plays a HUGE roll in the compulsive part of my disorder. I will do anything that I think might get that guilt off my chest so I can breathe. Hence, the compulsive praying for forgiveness and the reassurance seeking.
     My grandmother's main idea about her Baptist faith was that everything and pretty much everyone was bad on some level. Hellfire and brimstone everywhere all the time, throughout my formative years. Example: I was told I was going to send my soul to Hell around the age of 8 or so because an aunt had me repeat a curse word (to say that someone was pissing someone off), even though I was only doing as I was told by an older adult, even though I didn't mean the words. I was also told that certain sins were absolutely not forgivable. (My intrusive thoughts fell into that absolutely unforgivable category when I started to have intrusive thoughts.)
     In other words, my grandparents weren't big on the unconditional love idea and the idea that God accepts us as we are, in all our brokenness and darkness because God knows we are human and humans are far from perfect. As a result of that teaching, for years, I have carried around guilt about the idea that my OCD made me unacceptable and most definitely undeserving of unconditional love from God. I finally started to feel the guilt lessen when I started receiving treatment and I realized that I had a mental health condition that wasn't my fault, which also meant that the intrusive thoughts weren't my fault.
     Starting ERP has brought all those feelings back up. I knew that was a possibility, but I'm still surprised that it happened. I know that logically I am acceptable to God, but emotionally, I'm still in a place that is guilt-riddled, a place that still makes me feel unacceptable and undeserving. My therapist is actually having me work on that this week by visualizing that I am acceptable, and its more difficult than it sounds. I'm working it in to my meditation practice. I know my emotional brain will eventually catch up to the logical parts brain. I just have to redirect to focus on love and acceptance until that becomes the new pathway routed through my brain.
     I'll end with this: I never realized how much things from my early years could impact my mental health later in life. My early years planted the seeds for what would later turn out to be my first OCD obsession, so please, be mindful of the things you are saying to your children. I also didn't realize until today that I was still carrying around, buried somewhere, the feeling that my intrusive thoughts meant that I was probably the only person on the planet to which God's unconditional love and unfailing acceptance did not apply. I said it in my first post, and I'll say it again. If you're like me and you're worried that God doesn't love you because of something you've done, said, or thought, and you feel guilty, ashamed, and undeserving, please don't hold onto that. God's love is unconditional. God accepts us for who we are imperfect, broken, and all.

Exposure and Response Prevention

     For the past couple of weeks, I have been discussing exposure therapy with my therapist. I decided this week was the week that I wanted to dive into that part of my treatment. Diving in might not be the best way to describe it because I had to do some prep work before I could try it out again, but, to me, it felt like diving into the deep end when I did the exposure exercise.
     I mentioned before that therapy, especially something as potentially traumatic as exposure therapy, is taken at a baby steps pace. Before I could try out exposure exercises again, I had to make sure I remembered my relaxation techniques. I also had to make sure I had a place in my mind, like a safe area, that I could retreat to in distress. I actually had to construct a happy place in my mind. (I hadn't previously done that, so I had to do that the week before and practice going there.)
     I went into my weekly session this week with my preferred relaxation technique and my happy place at the ready. Near the end of my session, I had to rate my anxiety so we could have a baseline. Then I had to set a number that I thought would be okay for my anxiety to jump to. (Think of it like judging pain on one of those ER pain scales.) A two point jump is all my therapist will allow, and I'm totally fine with that.
     Then came the time for the exposure exercise. Since we are treating my religious obsession first, I had to do something that would deliberately trigger my blasphemous intrusive thoughts, and I couldn't do any compulsive prayer or anything to ward off any consequences of my bad thoughts. My time limit for the trigger was 5 minutes maximum, but I only made it a couple of seconds before my anxiety jumped from a 2 to a 4 and the guilt rushed in. I tried to listen to a Gospel song, and I backed out after at most 3 or 4 seconds of the song. Then I cried. Then I had to practice my relaxation technique and go to my happy place.
     I'm surprised. First, I'm surprised at the fact that I couldn't do the exercise for more than a few seconds. I had expected to get closer to the five minute maximum time limit. Second, I'm surprised at the sheer amount of guilt that came rushing in and caused my anxiety to spike even higher. I hadn't felt guilt like that in over a year, since my diagnosis. In less than 5 seconds, I was right back to feeling like I was such a bad person that I didn't belong in my church with all the good people.
     According to my therapist, you have to deal with leftover feelings doing ERP. I had to deal with guilt that was left over from all those years of sitting in church, with intrusive thoughts screaming in my mind, and then hiding the shame and guilt that came after those thoughts. I have a lot of guilt to deal with after nearly six years of hiding my mental health condition and thinking I was possessed.
     I only needed a couple of minutes to calm back down so I could be logical, and that was also surprising. I had stopped shaking and crying by the time I left her office. My feelings of guilt had also dropped significantly by the time I left her office.
     I had been terrified that doing exposure exercises would send me into a downward spiral that would put me back in a bad place in my recovery. That didn't happen. I was exhausted but fine even after I got home. I still carried around some guilt for the rest of the day, and I was a little bit more emotional after I got home. I did notice, though, that my intrusive thoughts weren't really more intense this time, as they had been the first time I tried out an exposure exercise some months ago.
     How do I feel now? I feel relieved. I feel like I jumped over a hurdle, and I managed to land on my feet instead of flat on my face. I faced a fear and then felt like I could even do it again. Although, knowing that the exposures will become more intense the longer I keep doing them as part of the desensitization to my intrusive thoughts makes me feel a little nervous.
     I'll end with this: Thinking about starting ERP is scary, but going through ERP is definitely a better course of action than avoiding ERP and being controlled by my OCD. ERP is not something to be taken lightly, and it does take some prep work before you can start exercises. I don't like doing the exposures, but I do them anyway because I know that is the way to get well again.

Roller Coaster

     Since I have been forced to deal with my anxiety for the past year, I have realized something. I have realized that living with anxiety isn't just about managing the anxiety symptoms day-to-day; it's also about managing the roller coaster of emotions and mood swings that come with living with anxiety.  I have even noticed (thanks to my mom for pointing it out and making me keep up with it) that my anxiety-induced emotional roller coaster tends to go in a specific pattern.
     My pattern is always the same as far as I have noticed. I get the really high anxiety for a few days or weeks, depending on a number of factors. Then, after the anxiety starts to drop, I get super emotional. I just want to cry, about anything and everything or for seemingly no reason at all, and that lasts for a day or two. Then, after the crying comes the low period. I just feel "blah" and mildly unhappy and exhausted. I just want to curl up and watch TV all day. The low only lasts for a few days or a week, like the really high anxiety, and then I go back to feeling more like myself. (I can go for weeks or even a month now, or this last time a couple of months, without high anxiety, and then the emotional roller coaster doesn't happen. I can feel like myself all the time.)
     Becoming depressed and suicidal is actually one of my Pure O obsessive worries, so you can imagine how much I freaked out when I realized that these low periods were becoming a regular part of my life with anxiety. Then the freak out just caused me more anxiety that would start the whole, overwhelming roller coaster ride all over again. I worried for a long time that I might have Bipolar Disorder because of the ups and downs I experience on a regular basis now. (My therapists both assured me that I don't have Bipolar Disorder, so I haven't been misdiagnosed a second time.)
     In other words, my anxiety can make me feel like I'm all over the place emotionally, and I didn't understand that or know what to do with it. All I knew was that it freaked me out and made me feel out of control. My therapist calls it something like my pattern of getting well (I think). Now that I know that this is a pattern I will likely always live with as long as I live with anxiety, I just ride the roller coaster and hope it doesn't take a long time before I can get off of it and back to myself.
     I can't really change the pattern or force myself not to have any low periods. So, I just cry when I need to cry. When that goes away I treat myself like I would treat someone else who was feeling low. I Pinterest and I watch my favorite movies. I rest. I also hang on to the fact that I know I will eventually feel better if I give myself the time I need to get there. (I also try not to give in to my obsessive worry that I'm getting depressed and I won't recover, but that is a little bit difficult.) It's apparently a pretty common thing for anxiety to directly cause mood swings or to cause so much distress that it indirectly causes mood swings, much like any other stress can make some people moody.
     I'll end with this: Living with anxiety is more than just managing anxiety symptoms day-to-day. Sometimes it feels like I'm unwillingly strapped into an emotional roller coaster. It's okay to cry and be exhausted. You can't force your emotions to always be under your control. Sometimes you just have to ride it out, and that's okay. Feeling like you're riding an emotional roller coaster when you live with anxiety doesn't mean you require a new clinical diagnosis, but if you feel like something else is to blame you should definitely talk to a therapist/your doctor. You won't always feel all over the place.

Hormones and Mental Health

     We all hear about how pregnancy can impact our mental health because of Postpartum Depression. We all hear about how menopause can impact our mental health because a lot of women experience clinical Depression after menopause. We all hear about Premenstrual Dysphoric Disorder (PMDD) and how rough the couple of weeks before periods can be for some women.
     The thing I don't see talked about a lot (outside of a couple women's discussion forums) is how normal monthly hormone fluctuations (your period, your lady's days, Aunt Flo, whatever you want to call it) impact an already existing mental health condition. I know that since I've been struggling with severe anxiety since last summer, my anxiety and my intrusive thoughts spike about a week, sometimes 2 weeks, before my period. I get normal PMS, and then my anxiety skyrockets on top of that. It seems like any little thing can trigger my anxiety around that time, too. I even started to wonder if I might have PMDD. I don't, but I was concerned about it until I figured out how common it was for most mental health conditions to be worse during monthly hormone fluctuations.
     I was curious about this because I never knew that my mental health condition could be so closely tied to my hormones. I talked about it with my therapist, and she said it was a common complaint among females with anxiety. I read in 2 discussion forums for women that most women felt like their OCD, Anxiety, or Depression was more severe a week or two before their periods, even when they didn't have Premenstrual Dysphoric Disorder.
     What can you do to help when your mental health condition is so closely tied to your hormones? Well, a large number of the ladies in the discussion forums with anxiety conditions said they chose to go on birth control just to level out their hormones. If Depression is the problem when your hormones fluctuate, my therapist mentioned that doctors will usually prescribe Prozac to help. You just have to talk to your gynecologist and/or your regular doctor. Since my problem is OCD, I just take L-theanine (200mg) that my therapist suggested when my anxiety gets higher than normal before my period.
     I also do some other things when my anxiety is high because of hormone fluctuations. I try to stay busy doing things I enjoy. I spend extra time practicing ukulele, and I watch people play songs on ukulele on YouTube. I talk to friends more. I try to write, even when I don't feel like writing because I'm exhausted. I read more. I watch funny shows like I Love Lucy on Hulu. (I also ate a whole bag of marshmallows over a period of a week and a half, which may be a bad thing...)
     My point is that during the 2 weeks before my period, I have to double my coping efforts. I have to cope with the PMS as well as the extra high anxiety. I can't give in to the all the cravings for the extra sugar and caffeine and the junk food like I used to because that would just negatively impact my anxiety. I also can't just give into the PMS fatigue because then my anxious brain gets bored and goes haywire, so I clean things in spurts of energy between rest periods.
     I'll end with this: I hadn't realized that my mental health condition could be impacted by the usual, monthly hormone fluctuations. PMS with an added mental health condition can be an overwhelming combination, and it's okay to talk to your doctor/gynecologist about something (like medication or some extra coping techniques) they think might help. It doesn't even mean that you have PMDD, but if you think you might you should talk to your doctor because PMDD has a specific treatment plan outside of your already diagnosed mental health condition.

Natural Remedies to Help Anxiety

     My therapist and I recently discussed medication, and we landed on my unwillingness to try them because of the side effects that come with certain medications (feeling suicidal, the possibility of worsened intrusive thoughts, more anxiety). I told her that if medications didn't have side effects like that I would be willing to try them. (As in, either the medication works or you don't get anything from it at all is similar to what I told my therapist.) This led her to bring up the topic of natural remedies that have proven effective in managing anxiety symptoms. She mentioned 1 supplement and 2 herbal remedies that could help me with no nasty side effects.

1. L-Theanine (particularly the kind made with Suntheanine): This is an herbal remedy. L-Theanine is found in green and black teas. I consider this one to be the safest because it doesn't have any negative side effects. I ordered myself a bottle of capsules from Amazon. 100mg isn't strong enough to lower my anxiety, so the next time I try it I'll try 200mg. It does make me groggy, but I can still function when I take it. (I also read a study that 200mg of L-Theanine worked better than Xanax. I'll provide a link to that information at the bottom.)

2. Valerian Root: This is also one of the herbal remedies that my therapist mentioned during our session. Valerian is a sedative, and it is often used to treat insomnia, but it can also reduce anxiety. (You shouldn't take it if you take other things that make you drowsy.) I haven't tried this one, and I don't intend to try it since it is a sedative. I need to function normally throughout the day to write.

3. GABA: GABA occurs naturally in our brains. L-Theanine (see above) boosts GABA in your brain, which makes you calmer. The results on taking a GABA supplement for anxiety are sort of sketchy. It's even suggested that it might be better to try L-Theanine or Magnesium, and some B vitamins to help with GABA without having to take a straight GABA supplement. (Link below, at the end of this post.)

     I know there are more natural remedies for anxiety floating around out there, and I would be interested to hear more about some of those if any of my readers have any experience with things I didn't list here. I listed these 3 because they were the ones that I discussed with my therapist and that we researched a little during my session.
     If you feel like you need some help managing anxiety symptoms, but you don't want to take any psychoactive drugs, these natural herbal remedies and supplements might be another great option. You should consult with your doctor and/or therapist and do plenty of research before you try any herbal remedy or supplement.
     I'll end with this: If you don't like the idea of taking medications just yet or you want to save that as a last resort, trying out some herbal remedies and supplements (with the approval of your therapist or doctor) might be an option to try. These remedies and supplements don't have the nasty side effects that make medications so hard to tolerate, but they may not help everyone. Everyone's brain and anxiety is different, and may respond differently to any of these alternative treatments.

Links:
1. L-Theanine: http://www.lifeextension.com/magazine/2007/8/report_stress_anxiety/page-02
2. GABA: http://overcomingyouranxiety.net/naturalanxietyremedies/gaba-for-anxiety/