Wednesday, January 4, 2017

Wintertime Blues

     I typically love fall and winter, or at least, I used to love fall and winter. I like the chilly temperatures so I have an excuse to wear my favorite leather jacket and tights under my shorts, the color-changing leaves, and I even love a nice non-dangerous amount of snow. I also seemed to write more during fall and winter. These days, I don't love fall and winter so much.
     For the past couple of years, I've noticed that my mood changes during fall and winter. My mood is low, and I feel blah. I don't want to write as much or exercise as much. I basically just want to hang out in my room with my cat and binge watch Netflix or Hulu while I cram my face full of junk food. I wouldn't take it so far as to say that I feel depressed all the time, but I would say that I feel moderately unhappy for a great deal of the time during fall and winter these days.
     I mentioned this to my therapist, and she said it was a seasonal affective sort of thing. I learned about that in my Abnormal Psychology class in college as a mental health disorder. Cue a new freak out that something else wasn't quite right in my brain. Then my therapist explained that people that didn't have any diagnosis of a depressive disorder were also more likely to feel depressed during the fall and winter months because of the decreased amount of sunlight. So, people with healthy brains might also be feeling blah and unmotivated during fall and winter, too. I felt relieved after hearing that because, since one of my OCD obsessions is that I might become severely depressed and suicidal, I'm terrified that I'll be diagnosed with something that includes depression at some point.
     My therapist mentioned that some people even go on medication during fall and winter so they can feel better. She also mentioned that I could get this light machine that would simulate the sun rising while I was still sleeping, which would cut down on the depressing amount of dark I have to deal with while it's cold out. Both of those are good options.
     I thought about both of them. I decided against both. The medication is still a scary area for me that I'm not willing to dive back into just yet. Since my depressed feelings are mild, I also decided against the light for Seasonal Affective Disorder (they are available on Amazon). I thought the lights were too expensive while I could still cope on my own, but I might try one in the future. On Amazon, the lights are available for $60 to $150.
     So, instead, I am trying out the same extra coping efforts that I try out when my anxiety skyrockets the week before my period. I'm trying not to give in to the cravings for all the junk food, and instead I'm currently trying to clean up my diet (which isn't hard considering I like fruits, veggies, and all the other healthy things). I'm also trying to exercise more. Instead of three times a week or whenever I feel like it, I plan on doing my regular three-day workout and adding in going for a walk on the other two days of the week, so I'm doing something active five times a week. I'm also trying not to binge watch Netflix and Hulu, but I will let myself watch a few episodes of whatever show I'm into after dinner. (I'm working on the binge watching...)
     I'll end with this: The wintertime blues can hit anyone. If you have the money, I highly recommend trying out one of the Seasonal Affective Disorder lights for your bedroom because my therapist said they were quite effective. Exercise also helps, and it can be something as simple as going for a walk or a bicycle ride for twenty minutes. I even walk inside my house with a timer and my iPod when I don't want to go outside.

Wednesday, December 14, 2016

Just Stop Doing That

     Just stop doing that. Just don't think like that. You don't have to do that.  All those statements sound so simple and so easy to comply with. Of course, it's so simple to just stop doing an action or a task if you don't like that action or task or if it makes you feel ashamed or if it doesn't make any sense. I even say these things to myself when I realize I've done a compulsion, and I get frustrated with myself. It's easy to just stop doing a thing...unless you have OCD and the action or task is a compulsion.
     Something happened with me earlier this week that had become a rare occurrence. I was already having more trouble than usual with my intrusive thoughts, but I was dealing with that. I wasn't doing any of the thought neutralizing in my mind or behaviorally. I was just sitting with them, which is something I have grown used to since I've been in treatment. I have cut way done on the mental rituals to neutralize my thoughts, and that's been going well. Then my cat spilled nearly a whole cup of coffee on my bed by jumping up on my table, and I almost said a "bad" word, a particular curse word, and a word that frequently clangs around in my mind as an intrusive thought, which is something that hadn't really happened before.
     Cue the fear. I was terrified that some divine punishment was about to fall upon my head. I was afraid I was going to fall over dead and be sent straight to Hell. I was afraid our house would burn to the ground. I was afraid my mom was going to die in some accident as punishment because I love my mom. I was afraid something was going to happen to my cat because I love her. All because I almost said a certain curse word that was then repeatedly flitting through my mind as an intrusive thought.
     So, what did I do? I prayed about it, but not just the one time. I had to pray more because what if God was so angry with me for that one slip up that God wasn't listening to my prayers? What if God didn't think I was sorry enough because I didn't pray for forgiveness enough? I had to pray for forgiveness every single time I thought of the bad thing I had almost said. In other words, I had to do a compulsion to neutralize the fear caused by my actions and intrusive thoughts.
      I knew my thoughts and repeatedly praying for forgiveness didn't make a whole lot of sense, but I still couldn't stop until I got a grip on reality and realized it was OCD. I logically knew that after praying the first time and meaning that prayer in which I apologized, that I had been forgiven because that was what I learned from religious teaching, but I felt like I couldn't risk the certainty of being forgiven so I had to make sure God knew I was sorry by praying more. The OCD part of my brain had to be certain that I was forgiven to keep everyone, including myself, safe.
     After the third time I prayed for forgiveness in the first hour or so, it clicked in my mind that I was doing a compulsion and that the fears I had were OCD-related. So, after the third time I prayed, I said I wouldn't pray about that one instance anymore. But, it was hard. I was still afraid that something terrible would happen. So, I sat with that fear. I didn't medicate with my L-theanine or my Ativan. I sat, and I broke out in cold sweats. I felt sick. I wanted to cry. I felt like I might panic. It took all of my willpower not to pray and pray and pray about the one thing or to ask my friends or my mom for help (reassurances).
     I sat like that for around five or six hours. It was torture. I was sure bad things were going to happen, and those bad things were going to be my fault. Then I talked to my therapist in my weekly appointment, but by that time my anxiety had dissipated enough to be at my usual levels because I had spent so much time just sitting with it and habituating myself to it.
     So, why can't people with OCD stop doing compulsions, even though the compulsions don't make sense or cause feelings of guilt and shame? Because the stakes are too high and the fear is too great. The fear tells us that we are a bad person for not doing anything we can to protect our loved ones because we just know something will happen to them because of us. I felt like my own soul and the lives of my mom and my cat were at stake, and it was my responsibility to protect those loved ones with nearly constant prayers for forgiveness so God would know I was truly sorry and wouldn't hurt someone because I made a mistake.
     I'll end with this: People with OCD can't just stop doing compulsions. OCD can out-logic every logical argument your brain makes just to keep you doing the compulsions. The dangers that we need to do the compulsions to protect people (including us) from feel terrifyingly real. If you love someone with OCD, keep those things in mind instead of commanding that they stop without help. Stopping a compulsion can be terrifying, and it takes a lot of work that anyone that isn't a therapist or an OCD-sufferer might not understand. And yes, slip ups in which they still do compulsions are going to happen, even as they're working with a therapist to get well.

Wednesday, December 7, 2016

More Than Treating Symptoms

     Sometime, I go to my weekly therapy session, and we don't talk about my OCD or do any exposure exercises. Sometimes we talk about my writing and how stressful it can be for me. Sometimes we talk about my relationships with family or friends. Basically, in therapy we talk about life in general instead of only the one piece of my life that is OCD.
     I always feel a little guilty when therapy talk drifts away from my OCD. I feel guilty because any time spent in my session on my part, talking about something that isn't related to the mental health condition with which I was diagnosed feels like I'm wasting my therapist's valuable time. To me, it seemed the same as going to my primary care physician for a cold, but then telling them all about a sprained ankle instead of telling them the actual problem for which I made the appointment in the first place.
     I told my therapist about that idea this week in my session, and she said something like, "You know, therapy is about coping in general." What she meant by that was that therapy isn't just about treating the symptoms of a mental health condition. It's about learning coping skills that can make life a little easier to deal with as well as treating the mental health condition. That statement makes sense now that I've heard it spoken out loud.
     Stress can  make the symptoms of mental health conditions worse, so of course you have to learn coping skills for life's stress to improve life with your mental health condition. She also made a point to tell me that I wasn't wasting time. Therapy is also a place to process traumatic events like the death of a beloved pet or family member, or any other traumatic life event. She has even asked about the book I'm writing, which was definitely a more pleasant topic of conversation.
     I guess I still had an expectation for the way I thought therapy would be. I thought the only thing that I should talk about was the mental health condition that I had been diagnosed with. I thought my everyday life and struggles outside of what was impacted by my OCD weren't on the table for discussion. The truth is that everything about your life is on the table for discussion when you walk into a counseling session, even the fact that you might have made a spur of the moment change to your hair.
     I'll end with this: Therapy isn't just about dealing with the symptoms of a mental health condition. Therapy is also about  learning to cope and to process things so that after therapy we can maintain our wellness. Just because you aren't talking about your symptoms every single time you sit in the chair doesn't mean that you aren't working on getting well or that you're wasting time. Sometimes, therapy needs to be a place to process life in general, and that's okay.

Wednesday, November 23, 2016

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.)

Wednesday, November 16, 2016

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.

Wednesday, November 2, 2016

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.

Wednesday, October 26, 2016

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.