Peaceful Co-Existence

    When I was first learning to live with mental illness after my diagnosis, I thought of my OCD and panic disorder as things I needed to control in order to become and then to maintain my wellness. My mindset when it came to my mental health conditions was, "I will fight you, and I will win. I won't let you interfere with my life." I viewed my OCD and panic disorder as some unruly creature that I had to keep on a tight leash, lest it have too much wiggle room and ruin everything I had worked for.

    This "control" approach left me feeling exhausted, hopeless, and miserable more often than not. I was basically just surviving instead of truly thriving and growing because I was constantly on guard, worried that my mental illness was going to break through my carefully held control and undo every little bit of progress I was making. I was never not worried about what my mental illness was doing. (Spoiler: This whole "control" idea I had was really giving my mental illness more control over me and not the other way around.) By always being worried that my control of my mental illness would lapse and result in disaster, I was pretty much consumed by my conditions. This didn't leave enough space for me to nurture my actual self, the person who existed separate from the mental illness that forms who I am as a person with a healthier brain. (Hint: You can't truly heal if you don't nurture your actual self that is separate from the mental illness along with managing the mental illness itself.)

    The thing I realized a little bit later than I should have is that mental illness can't be controlled. None of us can control whether or not we live with mental illness, or whether or not it interferes with our lives from time to time, even with medication. We can, however, control how we interact with our mental illness. This realization prompted a change to a healthier, more accurate way of thinking about and living with my mental health conditions.  

    These days, instead of control, I strive for peaceful co-existence with my OCD and panic disorder. My mindset now is, "You're here. I'm here. Neither of us is going anywhere, so let's figure out how we can have a healthy balance within this space we share." (The shared space is my mind and body.) I allow my anxiety to take up an amount of space that I don't feel is frightening or overwhelming (because your mental illness is going to take up space whether you want it to or not) while I exist and function alongside the mental illness in enough space that allows me to thrive and to grow so that healing can happen. 

    With peaceful co-existence my focus is no longer my mental illness and how it can wreak havoc. My focus now is how I can help myself can feel balanced and "human" all the time, even on a day when I'm experiencing symptoms of my mental health condition. It's a much gentler and kinder way of dealing with my OCD and panic disorder, and it leaves me the space and time I need to learn about my actual self as I heal and grow.

    I'll end with this: When we strive to control our mental illness, the thought seems to be, "This can't be here," which isn't healthy, realistic or kind to ourselves. Life with a mental health condition is hard enough, and we don't need to make it harder by trying to control a thing that isn't controllable. Shifting our thinking so that we strive for peaceful co-existence, where the focus is, "Let's figure out how to find a balance between our actual self and the mental health condition in this shared mind and body," is healthier, more realistic, and kinder to ourselves. 

But...That's Not Real

    Part of living with OCD is dealing with intrusive thoughts and the irrational fears that those intrusive thoughts can cause. And I have a few: demonic possession from the years before I was diagnosed; the whole death by cleaning products issue that I mentioned in a previous post; unknowingly and accidently being the cause of someone's death; and most recently, since we've been living through a major health crisis, contamination. (I'm sure I have more, but let's not go down that rabbit hole today.)

    The pattern is always the same: I have an intrusive thought that is triggered by something, like a situation, a person, an event, or something else external. The intrusive thought leads to an irrational (meaning not based in reality) fear of the thing from the intrusive thoughts. The irrational fear leads to a physical response (AKA my anxiety and panic attacks). Then I'm left in a battle between trying to maintain my healthy patterns or reverting back to old, unhealthy patterns that involve compulsions to make the fear and the physical response stop.

    All the while that I'm experiencing the irrational fear and the anxiety that was caused by my irrational fear, I know it's not rational. I know I don't logically need to be afraid of the thing that I'm afraid of. While my anxiety is building up, even all the way to the tipping point, and sometimes even during a panic attack, I know I don't need to have such fear of the thing. I also know, logically, that I don't need to be anxious about the the thing that I'm anxious about. I am fully aware the whole time I'm lost in the land of irrationality that I'm being irrational, and I hate it. I hate that the fear and the anxiety keep happening anyway even though I know it's not a "real" fear.

    I was talking to my therapist about this very thing in my last phone session with her. I was telling her how much it bothered me to be anxious about a thing, and to know, logically, that I was being irrational while still being unable to stop the anxiety. 

    My therapist was quick to stop me from being too harsh with myself. She explained to me that the brain hasn't yet evolved enough in its most primal areas to be able to tell the difference between a real fear and an imagined fear. The brain just recognizes fear, and then it sounds the alarm so my survival instincts kick in. Then, because I can't run away from or fight my irrational OCD fears, I'm left with anxiety since the extra adrenaline, tense muscles, and all the things that go into the fight or flight response aren't actually put to use.

    So, *I* know my fear is irrational and not a thing that is really likely to happen. My brain, however, does not, and my brain, since it controls what chemicals get released into my body, wins a lot of the time. I can desensitize myself to the fear and lessen the emotional response over time with exposure and response prevention therapy, though, but even with ERP it'll take time for my emotional brain to catch up with my logical brain.

    I'll end with this: Just because somebody knows a fear is irrational doesn't mean that they can just stop having an anxiety response to that fear. A person can be fully aware they're being irrational, and yet they won't be able to stop the fear and the anxiety because the brain doesn't know the difference between a rational (real) and an irrational (not real) fear. The brain only has one blanket response when it comes to fear, and that setting is, "DANGER! DANGER! RUN FOR YOUR LIFE!" So, it doesn't matter if the fear isn't actually a "real" thing because the brain treats every fear as real, which can leave a great many of us left to battle anxiety and panic attacks when we can't run from or fight those fears that live inside our heads until we work to desensitize ourselves.

The Child Inside the Grown Up

     Let me start by explaining something about myself. As a child, I had an irrational fear of "chemicals", specifically things like Lysol, Bleach, SOS scrubber pads, floor cleaners, carpet cleaners, toilet cleaners...anything that you would use to clean something besides soap and water or rubbing alcohol or a non-toxic wipe. I was TERRIFIED of them. If I ever accidently stepped on a freshly mopped floor, a freshly shampooed carpet, or touched a freshly bleached dish or countertop, I just knew that was the end of me. I just knew that "chemical" was going to somehow get absorbed into my body through my skin, and that shortly after, I was going to die. (I could even die by showering or bathing in a freshly, chemically-cleaned bathtub because, what if it wasn't rinsed properly, and what if the steam from the hot water made me inhale some toxic fumes from the cleaning products?!) My mom had to rinse our tub multiple times before I would get into it after she cleaned it. 

    (Looking back at things like this, I can see how I may have developed OCD as an adult...)

    Fast-forward to the present, when I decided to be a "real adult" and clean my bathtub myself, with actual cleaning products instead of asking my mom to do it. (My mom knew I had this irrational fear of death by "chemicals" and so was always willing to do it.) Had I grown out of my irrational fear of being exposed to "chemicals"? Apparently not, my friends. I even had gloves on, but that didn't stop the panic that welled up inside me as soon as I was wrist-deep in blue SOS-colored water, trying to scrub my bathtub. I JUST KNEW that "chemical" was going to somehow absorb through my gloves, through my skin, and I was going to die because I had touched it.

    That fear sounds so child-like doesn't it? I never hear of adults being so afraid of things like Lysol, Bleach, SOS scrubber pads, and other cleaning products that they have a panic attack when forced to touch them. I brought that up with my therapist in our phone session this weekend. 

    My therapist was quick to point out that my fear didn't make me childish. She explained that my fear of the cleaning "chemicals" had resulted in traumatic experiences during childhood in which I was sure I was going to die.  As a result of that trauma, the fear part of my brain had sort of unpacked and lived in that young age in which the trauma had occurred. The part that held this fear hadn't grown up along with the rest of me, so to speak, which is often how trauma and fear work inside our minds. So, during this process of cleaning my bathtub, that fear piece of my brain from childhood resurfaced, and I experienced it all over again. 

    Adult me had to meet child me as I completed my triggering task. I had to be kind and understanding with that child self still living inside the adult if I wanted to be able to process my fear. Believing you're going to fall over dead because you accidently got something on your skin is a traumatic experience for anyone, but especially for a child. I made sure not to think to myself that the fear was silly or stupid. (Although I did acknowledge that it was an irrational fear.) I acknowledged that felt like the real fear that my childhood self was sure it was, but then I told myself, "I'm an adult now, and I even have gloves on. I've touched this accidently before and survived. I'll survive this time, too. I don't have to be terrified. I just have to be careful. I've seen my mother use these very cleaning products for years WITHOUT GLOVES, and she's not dead. So, I can be okay."

    I had to meet the fear on it's own level, and then treat it like the developmental age it was frozen in without judgement. Once I did that, and I talked myself through it, I was able to complete the task. By the time I finished, I had stopped crying, at least, and I no longer thought I was going to die. I was still anxious, but I wasn't having a full-on panic attack.

    I'll end with this: As adults, we often judge ourselves for the fears that resulted from trauma (both "small" and "big" traumas) that we experienced as children, especially if that fear plays a part in a mental illness that develops later. We often feel silly or embarrassed if something happens that triggers the memory of that childhood traumatic experience and the fear in our adult lives, and we try to dismiss it. (I felt embarrassed crying into my bathtub as I battled with the fear that I was going to die because of the cleaning products I was using. I felt even worse when I linked the obsessive way I used to worry about that to my OCD diagnosis from adulthood.) Dismissing it won't heal that child-like fear inside us, though. To heal that child-like fear, we have to meet it at the development level it lives in, and we have to be kind to it, to lend it that feeling of adult-like safety before it can heal.

Right Now

     I have never been a person that could say, "I'll cross that bridge when I get to it," and mean it. Even before my anxiety symptoms appeared, I was what my mom and my grandmother called "a worrier". If there is a situation, my default setting is to worry about every single aspect and every single possible outcome of that situation all at once until I'm overwhelmed and exhausted, even if I don't need to worry about an aspect or outcome of said situation. 

    With the current health crisis, with all the other things that have happened so far this year, and with all the changes I have implemented so far, I've been worried about a lot of things. Week after week, I was taking these worries to my therapist in our bi-weekly phone sessions and telling her that I was anxious and then also exhausted from being anxious. It seemed to be a constant stream of, "What if X, Y, or Z happens, then this, this, and this could happen. And then..."

    My therapist, time and again, has had to remind me not to focus on the future in this way. She's told me over and over, "Just focus on THIS moment. The one you're in right now." She'd follow that up with the questions that I needed to ask myself to pull myself into the present moment. Questions like, "What are you doing right now? What do you have to deal with right this second? Is everything okay in just this moment? Are you okay RIGHT NOW, in just this second?"

    Usually, as I answer those questions, I'm able to say, "Right this very moment all I have to deal with is this phone therapy session. Everything is okay in this moment. I am okay in this moment." Then I'm out of the future and all the possibilities that something bad could happen, and I'm firmly in the present, where I don't have to worry about anything except my current reality. 

    It's super easy to do that while I'm on the phone with my therapist, when everything actually feels fine. It's between the phone sessions that I have trouble stopping myself once that ball of worry starts rolling around in my mind and getting bigger and bigger, like a rubber band ball, as it collects more and more worries that are littering my brain at any given moment. It takes considerably more effort for me to stop myself and ask, "What do I have to deal with, right now, in just this moment?" And, "Am I okay right now?" But...once I can break myself out of the future-centered worries and realize that, in the current moment, I am actually okay, my anxiety tends to drop.

    After being a worrier for my whole life, learning to stop myself when that ball starts rolling around in my brain is taking a lot of practice, but I can eventually get there. I still forget to do it sometimes, but learning to use new coping strategies always takes time. The point is that I'm working on it. 

    I'll end with this: Learning to focus on only the present moment when our anxiety constantly wants to take us into the future isn't easy. However, asking certain questions to pull yourself back to the present can make it less difficult. Asking yourself, "What do I have to deal with right now, in this moment?" and "Am I okay RIGHT NOW?" can be helpful ways to get yourself to a calmer, present-focused place.

Feeling All the Feelings

    Since I've been in therapy, I've slowly gotten more and more comfortable with showing emotions that aren't always positive. I've had to re-teach myself to just feel all my feelings without trying to bury them like I did for years. In the process of re-teaching myself how to actually be okay with feeling all my feelings and expressing them, I've learned that I'm a person that cries easily. If I get sad, frustrated, angry, stressed, too happy, too sentimental, or too overwhelmed, I'm more than likely going to cry. Apparently, that's just who I am as a person. 

    After I started to more openly express the emotions that aren't typically perceived as positive emotions, I noticed something about the way that people tend to think about people with mental illness. In a way, people with mental illness almost seem like they aren't allowed to express unpleasant emotions without some kind of extra judgement. The extra judgement usually falls into one of two categories. One: we're having a mental health crisis because we're expressing "negative" emotions, and our loved ones are VERY concerned. Or, two: our negative emotions are dismissed as less "real" emotions because we have a mental illness and therefore our "negative" emotions are just a symptom of that condition. Both judgments typically come with a "You need to take your medications" kind of statement.

    Recently, I felt a whole mixture of emotions because of an external situation that I have no control over. I was feeling grief. I was feeling frustration. I was feeling a deep, burning anger akin to rage, but quieter. I was feeling a deep sadness that was separate from the grief. I was also feeling a bit hopeless. And, yes, I was crying. Of course, I was crying. How could I feel all those things and not cry?

    As I was upset and crying, someone suggested that I needed to take my anti-anxiety medications. That wasn't helpful...or healthy. One of the the only things I WASN'T feeling at the time was anxious. I was a mess of emotions, yes, but anxiety wasn't part of the mess. 

    The emotions I was experiencing had nothing to do with my panic disorder or OCD and everything to do with the fact that I was a human in an unpleasant situation that I had no control over and that I couldn't change. I didn't need medication. I needed to feel what I felt and to be allowed to cry it out in order to process it, to feel better, and move on.

    Mentally ill people still have access to the full emotional spectrum, right? People with mental health conditions can experience unpleasant feelings that have nothing to do with their actual mental health condition. Our mental illness doesn't somehow make us incapable of feeling the things everybody else could feel in any given situation. Not everything we feel and think is pathological. Some of it is really just "normal" human, feeling our feelings stuff, like everybody else that doesn't have a mental health condition.

    It's also completely okay that people with mental illness (appropriately) feel unpleasant emotions. It's good. It's healthy to feel all the feelings. It doesn't mean that we're headed for some kind of break down. It also doesn't mean that we need to hurry up and take medication to make the feeling go away. It just means that we're human. People with mental illness deserve the "luxury" of being able to feel all their feelings without the assumption being automatically made that it's related to our mental stability or having the feelings dismissed.

    Here's the thing with that whole "You should take your meds" attitude that is often expressed by loved ones when someone with a mental illness expresses unpleasant emotions: the medication treats a mental health condition, it doesn't stop us from feeling. (And if it does, that might means the medication needs to be changed.) A psychotropic medication won't stop us from appropriately feeling grief, sadness, heartbreak, anger, frustration, and all the other emotions along the spectrum that other people are allowed to feel without the extra layer of judgement, and it shouldn't. 

     If we weren't living with a mental health condition, our negative emotions would be viewed and handled differently. Instead of just assuming it's part of the mental illness, which is either cause for concern or dismissal, the feelings would be legitimately addressed. Our loved ones would say, "What's going on?" And then some kind of statement like, "Okay. Do you want to do X, Y, Z until you feel better?" Instead of, "You need to take your medication." Can you see how, when mental illness isn't a factor, the response is kinder and healthier because the emotions are actually acknowledged and allowed to be felt?

    I'll end with this: Feeling all of your feelings, even the unpleasant, "negative" emotions is healthy. It's good to appropriately feel those things. Appropriate emotional responses to life and its ups and downs don't end when someone is diagnosed with a mental health condition, and all of a person's emotions don't suddenly become the symptoms of their mental illness. Saying, "You need to take your meds" when your loved one is expressing an emotion that is unpleasant isn't helpful. It can actually be hurtful.

But What If it Works Out?

     As I've previously mentioned, I've had a lot of changes in my life so far in 2021. As a person with OCD, those changes have caused me a lot of anxiety, even though I wanted the changes and even though the changes are good things. Since I graduated with my certificate, I've been filled with anxiety. 

    All these worries kept piling on. What if this certificate course was a waste of money that we didn't have to waste? What if this certificate course didn't teach me enough to be prepared for the job I wanted to do? What if nobody wanted to hire me because I had "just a certificate" instead of the more acceptable associates degree or even a bachelor's degree in this new field? What if I did get hired, but then it turned out I actually had no idea what I was doing? What if I made too many mistakes and got fired? What if I got hired, but then it turned out that the job was so stressful that I started regularly having panic attacks again? What if getting this certificate and the job I wanted wasn't the step in the right direction that I thought it was? I was spiraling, my friends. 

    My brain kept taking me to the worst case scenario automatically, and then I would unpack and live there. At one point during my first week on the job, I was so anxious that I cried in the car. I just knew I was going to screw up so badly that my boss would fire me before I had the chance to even correct my mistakes. (That didn't actually happen. My boss is nice and understanding.)

    Again and again I brought these worries to my bi-weekly phone sessions with my therapist. Again and again, she would ask me for evidence that I had to support my worries that I wouldn't do well in my new job. I never had any evidence. In fact, I only ever had evidence to the contrary. So she would always say something like, "Stop that anxiety-inducing thought before it gets too far. Stop it and say: But what if this bad thing doesn't happen? What if it works out?"

    WHAT IF IT WORKS OUT?! What if it WORKS OUT? Asking that question felt like I was daring the universe to make it not work out just because for a moment, I'd had the audacity to think it possibly could work out. Asking that question felt like I was too confident, and too much confidence is never a good thing, is it? So, of course I said to her, "But, it might not work out." To which she replied, "But what if it does?"

    So, for the past few weeks, I've basically had to train myself to stop when I feel the anxiety rising because I'm living in the land of the worst case scenario and ask "But...what if this works out?" My anxiety doesn't really know what to do with that question, it doesn't know what to do with the little bit of confidence that question brings. After I ask that question, I feel my anxiety leveling off as the worst case scenario is replaced by images of things going well, or at least not going terribly wrong. That little breakdown in the spiral gives me the minute I need to be able to get to a calmer place so I can logically realize that everything isn't as drastic as I originally felt like it was. 

    I'll end with this: It's so easy to spiral into the land of the worst case scenario. It easy to get so lost there that we can't possibly see how our worst case scenario isn't the only option for how something will go. All it takes is a second to challenge that thought. Surprisingly, simply asking, "But what if this works out?" has been a thing pulls me back out of the worst case scenario to a more realistic place. 

The Medication Misconception

    People tend to feel one of two ways about medications for mental illness. (1) They hate them and think they turn people into "zombies" or addicts. Or, (2) They think they're magical, fast-acting, simple cures for mental illness. In a recent conversation, I encountered the latter. Someone recently said to me, "There has to be a medication for that," in a tone that suggested I should just take whatever medication is offered up to treat my OCD and panic disorder and be finished with the whole unpleasant ordeal of having mental illness. The person seemed genuinely surprised that getting the right medication to "fix" my mental health conditions wasn't as simple and easy as they originally thought. (And no, your family doctor really shouldn't be prescribing you psychotropic medications. They should actually be referring you to a psychiatrist for that prescription.)

    Yes, there is medication to treat my OCD. It didn't work with my brain chemistry. Technically, there is another medication I could have tried, but, since it's one of the older medications, my therapist warned that it was hard for people to tolerate because of the side effects. I had also been warned previously that, once I go off the medication, the symptoms might come back for a bit, meaning I could relapse, once the medication that was chemically re-wiring my brain was taken away. So, to me, the risks outweighed the benefits at the time, and the risks still currently outweigh the benefits. 

    A lot of people think about psychotropic medications (AKA medications that help a person achieve the right levels of brain chemicals so that illnesses like depression and anxiety are less severe) the same way this person did. Many people view psychotropic medications as these magical cures for mental health conditions. Many people think that, as long as a person is taking the medications, then they no longer really have to manage or even deal with the symptoms of their mental illness, and that the medication is the only treatment the person needs. That actually isn't how these medications work.

    Even when a person is prescribed medications for their mental health condition, that person is still a person living with a mental illness. The mental health condition isn't going to go away, but the whole point of the medication is to get to the point that the mental illness is no longer debilitating all the time. Symptoms and bad days will still occur even with the medication. That's why medication is prescribed (usually) as part of a treatment plan that still requires a person to attend sessions with a therapist and have regular evaluations by a psychiatrist. Therapy and medication work together to make the most effective treatment plan for the person.

    These kinds of medications also don't work for everyone. If two people have the same exact mental health condition, with the same exact symptoms, the medication commonly used to treat that condition might not help both people. Each person's brain chemistry is different and reacts differently to medications. Some people can even have medication-resistant types of mental health conditions. 

    Another thing that people don't tend to understand about these medications is that you can't just pop a pill and feel better that same day, unless you're prescribed something like Ativan or Xanax, which are addictive and not prescribed as often by mental health professionals as they were in the past. Most psychotropic medications need to build up in a person's system to become effective, and this can take at least two weeks. Then dosage and time of medication get tweaked until a person finds the dose and the time each day to take the medication that is most helpful. Then if medications need to be switched or if a combination of medications is needed, the process of finding relief is longer.

    When treating mental illness, there is no magical finger snap moment that suddenly makes everything better. Treatment, even with medication, is a slow, and sometimes painful process. There also is no medication (to my knowledge) that can permanently "cure" a mental health condition. 

    I'll end with this: A lot of people, especially if they haven't experienced mental illness themselves, view the medications that treat mental illness as a quick and easy cure for those illnesses that is easily obtained and effective for everyone. There isn't a cure for most mental health conditions, there is only treatment and then management over a person's lifetime. Psychotropic medications are treatments, not miracle drugs. The point of these medications isn't even to "cure" a mental illness, but to treat the mental illness so that it is no longer debilitating.