Relapse

I haven’t posted in so long…

Around Christmas time my OCD (particularly my Relationship OCD) relapsed pretty bad so it has been a struggle.  I am two weeks into therapy again and it is hard but I am fighting to accept that I don’t get to know some things. I’m fighting to accept uncertainty.

Relationship OCD targets the very thing that is most important to me.  I read a study recently which speculated that people with Relationship OCD tend to get a lot of their self worth from their relationships.  Not having a good relationship feels like the worst thing to me so naturally my OCD attacks it.

It makes me question my boyfriend’s love for me, it makes me question my love for him, it makes me question the “rightness” of our relationship.  It targets our most special moments and it breaks my heart.

But at the end of the day I am choosing to trust that it is my OCD and not that we really aren’t right for each other and I am working to accept that I don’t get to know if that is the truth or not.

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Magical Thinking

I’d like to take this opportunity to explain how OCD made me think that I was psychic because of a closed gate….

 

This post is about OCD Magical Thinking. It essentially fools us into thinking that we have control over things which we do not, or that we are somehow able to predict things that we cannot.

 

Yesterday as I was leaving work the thought popped into my head that it had been a while since the gate to the parking lot was closed early (forcing me to go out a different entrance and take the long way around to the highway). I then had the overwhelming feeling that the gate would be closed that evening, which of course as I got closer I saw that it was indeed closed.

 

My mind immediately jumped into panic mode telling me that I do in fact have psychic powers and that when I get overwhelming feelings about my OCD fears they also must be true.

 

In the back of my mind was a little voice telling me that this is probably not true and that the gate thing was either a coincidence or that I subconsciously registered the closed gate out of my peripheral vision when I first left the office. But the little voice was swiftly silenced by the much more boisterous voice of my OCD telling me all my worst fears and feelings are true and that I should pay extra attention to them.

 

In the light of day I am able to mostly silence that OCD voice which was so loud last night, but it is still there. It will probably always be there, and I have to just accept that because the more I try to eradicate it the louder it seems to get. So alas, I will allow OCD to be there without giving it as much weight as it thinks it deserves.

Eye Fishing Syndrome

Here is a weird one for you.  Eye Fishing Syndrome (aka Mucus Fishing Syndrome).  It may sound TOTALLY unrelated to OCD, however it is actually linked to the disorder.

Eye Fishing Syndrome is marked by an obsessive need to remove those mucus-y strings that can form in your eyes using your finger, a tissue, the inside of your shirt etc.  If anyone has ever touched the inside corner of their eye and come away with a long string of goo they know what I’m talking about.  To the rest of you…this probably sounds pretty gross.

It becomes Eye Fishing Syndrome when you feel a repetitive need to try and clear the eyes of mucus, even when they are already clear.  It is linked to OCD much in the same way that trichotillomania or skin picking disorders are linked to OCD.  It is almost like the message in the brain never gets sent that the eye is clear. So the brain gets stuck, like a broken record, sending a signal that you should clear out your eye.

It may sound silly or just quirky, but it can be really distracting and potentially even dangerous to your vision.  People may not think much the first time that you pull the inside of your shirt up to your eye, but they do tend to notice the 6^th, 7^th, and 8^th times.  It is also not very good to be constantly touching your eye with dirty fingers, or with the inside of a fuzzy sweater which can leave behind fuzz (perpetuating the problem of clearing out your eyes).  But despite these warnings if someone has Eye Fishing Syndrome it becomes very difficult to break the pattern, just like any other compulsion.

I am always learning new things that can be linked to OCD and continue to be fascinated by the intricacies of this disorder.

I am always learning new things that can be linked to OCD and continue to be fascinated by the intricacies of this disorder.

OCD About OCD

Sometimes OCD makes you worry about the most ironic things.  I remember when I first started with an Exposure Response Prevention (ERP) group I was worried that I wasn’t OCD-enough.  I had already had a consultation session with the therapist running the group but yet I still worried that I wasn’t supposed to be there.  Not in an I-Don’t-Want-To-Be-Crazy-Enough-To-Be-In-This-Group sort of way, but in a What-If-I’m-Fooling-Everyone-And-I-Don’t-Actually-Have-OCD way.  Which makes no sense. My OCD was essentially making me worry that I wouldn’t be “cool” enough to fit in at OCD group therapy.

Another odd one I encountered was toward the end of my time attending the group.  I started to notice improvements, and notice that I was able to catch myself early if I started new obsessions.  You would think I would be elated and feel so free.  Now don’t get me wrong, I am so thankful for that group, it changed my life!  But for some reason I kept noticing an odd desire to hold on to a little bit of my OCD.  It was almost like I didn’t know who I was without it.  I worried that my OCD would completely go away (HAH!) and I would be a totally different person.  And even though OCD can be very difficult and very isolating, here I was bonding with people over it and feeling like I fit in somewhere (and who doesn’t like to fit in?).

Point being: OCD makes you worry about OCD *le sigh*

What are some ironic worries that OCD has caused you to have?

Relationship OCD (rOCD)

Relationship OCD. Have you heard of it? Most people haven’t (including my first three therapists). I first noticed the symptoms when I was in high school but it would take another 8-9 years before I would be properly diagnosed.

Relationship OCD (rOCD) follows the typical pattern of OCD: Intrusive thought -> Anxiety -> compulsion to counteract the anxiety. With rOCD though, the theme of the intrusive thoughts center around one’s relationship.

Most people experience it as Type I, in the form of intrusive thoughts regarding their own feelings toward their partner. But occasionally someone may experience it as Type II, intrusive thoughts about their partner’s feelings toward them.

The first type would have you obsessing about your significant other’s flaws (partner focused) or fearing that you have fallen out of love (relationship focused). For example you might become obsessed with a particular flaw that you view it completely out of proportion to reality, convincing yourself that your partner is not attractive enough, or smart enough etc. Or you may be so hyper-aware of your feelings toward your partner that you become alarmed any time you feel annoyed or angry with them, convincing yourself that because you don’t feel completely 100% in love at all times that you are not with the right person. This can put a heavy strain on a relationship if the other person senses a distance, or starts to feel as if they are constantly under a microscope.

The second type typically involves the need to repeatedly check that your partner still loves you. For example you may be obsessed with the idea that your partner is attracted to someone else or that they are just pretending to be in love with you. The idea that you cannot guarantee your partner’s feelings causes a constant level of uncertainty and fear. This can also put a strain on the relationships as the other person begins to feel that no amount of reassurance will be enough. Or as John Mayer puts it “I adore you, but there’s a hole in the cup that should hold my love”.

With rOCD some of the common compulsions can be:

• Seeking reassurance (either from friends and family or from your partner directly)
• Avoiding movies, songs, or other couples who trigger intrusive thoughts
• Spending a lot of time on the internet researching relationships
• Mentally reviewing past relationships to compare them
• Mentally comparing the relationship to those of friends, family, or even characters in a story
• Checking to see if you still “feel” in love
• Checking to see if you feel more attracted to someone else
• Checking to see how often you think of your partner

The thoughts are always intrusive and unwanted, going against what the person truly feels and believes.  The desire to be “sure”, especially in an area of life where most people are taught to believe there is one true soul-mate, takes over.

But just like other forms of OCD, allowing the thoughts to be there without needing to do anything about them is the best treatment for rOCD.

rOCD is heartbreaking because it attacks one of the very things that is supposed to be a source of comfort.. Sometimes you just have to take it one day at a time and say to yourself “OCD will not control this. I make my own decisions and right now at this point in my life I am choosing this relationship and this person and this love”.

10 OCD Sub-Types You’ve Probably Never Heard Of

OCD is a very complicated disorder.  There are many sub-types that even some psychological professionals aren’t aware of.  It breaks my heart to think of the people suffering who aren’t receiving proper treatment simply because there isn’t enough awareness of these sub-types.  Please check out this article (or “listicle” as they are sometimes called…???) that I put together on Buzzfeed:

10 OCD Sub-Types You’ve Probably Never Heard Of

Memory Hoarding

I am constantly discovering how different habits or aspect of my personality are related to my OCD.  It is both fascinating and unnerving.

For example, as a little girl I used to keep a journal.  When I would write in it I felt a lot of pressure to make sure I recorded every minute detail (after seeing the film I once wrote out the ENTIRE plot to The Princess Diaries…).  I couldn’t really pin down the source of the anxiety but I knew that I wasn’t writing in such excruciating detail because I wanted to, but more because I felt anxiety if I didn’t.

I recently learned about Memory Hoarding, a sub-type of OCD where the sufferer over-attends to memories.  They view memories almost like objects that need to be gathered or collected.  One might spend time replaying a memory, over and over, in order to ensure that it is able to be recalled accurately, and the thought of not being able to revisit that memory at a later time causes a lot of anxiety.  Or one may focus too much on “appreciating the moment” which in and of itself causes someone to not fully appreciate that moment.

For me it works like this; I will be having a good time or sharing a special day, and feeling particularly happy.  Then I have the intrusive thought that it could all be snatched away from me and this time next year I will be aching for this exact moment, unable to accurately recall it.  The compulsion is to look around and take mental pictures, to pay extra close attention to my emotions and my surroundings, and to truly appreciate and savor everything – or else something terrible will happen. For most people taking time to savor the moment is a good thing, a healthy thing. But for someone with OCD this over attention to detail is fueled by anxiety and can have the opposite effect, pulling them out of the moment completely.

It makes sense why this is one of the ways in which my OCD manifests.  My core fear has always been losing someone I love and as a kid I remember hearing people talk about how someone didn’t appreciate something until they lost it, or how you don’t know what you’ve got until its gone.  My OCD brain then decided that if I could just make sure to appreciate things while I have them then I won’t lose them.

As I got older I grew out of the need to write every trivial detail in my journal but it manifested itself in other ways.  For example, if I know it is the last time I am going to be somewhere (such as an apartment I’m moving out of, or a job I’m leaving) I will take an excessive amount of photos with my iphone.  I feel that I must capture everything, from every angle, so that I can later recall exactly what it felt like to be in that room, or sit in that chair, or walk on that floor.  The idea that I will look back and have forgotten details (which I am aware is an inevitable part of life) gives me a lot of anxiety.

If something, maybe a song or a scent for example, triggers a memory from my past I will have to sit and really delve into that memory recalling as much detail as possible.  I can’t stop thinking about it until I really feel like I am back in that moment and can be sure that the memory is still safely stored in my mind.

Another way I experience memory hoarding is when I am walking away from a good moment or a person that I love.  For example if I am standing and happily watching the sunset and it is time to go back to the car I will continue looking over my shoulder, again and again, trying to get the last “perfect” image to tie to those happy emotions.  Once the image feels right, I can’t look at the sunset again or else I’ll have to start over.  I experience this most intensely when saying goodbye to my family at the airport.  I feel like I have to have a perfect mental image of them or something bad will happen, so I look back over my shoulder dozens of times as my family is waving to me.

But now that I am aware that this is part of my OCD I can work to combat it.  I can purposely looking away from the sunset when it doesn’t feel “right” and just allow the anxiety to be with me.  I can wait as the anxiety slowly dissipates and remind myself that this fear is just a construct of the faulty wiring in my brain and that, as hard as it is, it doesn’t need to control me.

Half The Battle

Gun control is only half the battle in this type of shooting. Acknowledging the mental health aspect of these tragedies isn’t meant to take the blame away or lessen the horror, it is to prevent it from happening again! If someone shows warning signs of a physical illness we encourage them to go to the doctor but mental health is viewed as a luxury instead of a necessity. In addition to passing gun control laws let’s please also advocate for better, and more easily accessible mental health care. Let’s educate people (especially parents and school professionals) on ALL the warning signs of mental illness and make it more acceptable to talk to someone about seeking treatment.

High’s and Low’s

It is always amazing to me how much my opinion on my relationships, career, and even music can change depending on my mood.  If I am depressed and feeling negative I will think my boyfriend isn’t right for me, I have ruined my career, and that music just doesn’t matter to me anymore (!?!?!). If I am feeling particularly good suddenly I am dating my soul mate, my career will fall into place, and music speaks to my soul.

It is important to always keep in mind that we are constantly viewing the world through a lens made out of whatever chemicals are present in our brain at that moment. And while there is something to be said for positive thinking sometimes all we can do is say “things look bad because I’m feeling down today, I’ll revisit this when the lens is made of different chemicals”, then simply wait it out.

The yo-yo effect can be draining, you may ask how you are supposed to know how you really feel if you brain’s chemicals are dictating all of your opinions. But there is no certain way that you really feel, they are all just emotions. The best you can do is vow not to make big decisions when you are too high nor too low.

“We’re all at war with ourselves; that’s what it means to be human.”

——Sylar from Heroes

Crazy Pills

Ever wondered how your anxiety meds actually do what they do?

See, I think I may need to go back on medication. This is an agonizing decision for me because even though I know Prozac lifts the heavy weight that sits on my shoulders, it also comes with a slew of side effects that affect my quality of life in a different way. It is pretty much just trading one type of mental anguish for another.

I have been on (and off) several medications, Prozac being the most effective, but the side effects of each has led me to do a lot of research on the types of medication that are available to anxiety sufferers. This is what I have learned in my research:

First of all there are these little things floating around in your brain/body called neurotransmitters. And they, well…they transmit. They travel from receptor site to receptor site passing along information about what you’re feeling at that time. There are different ones and they all convey different bits of information. Anxiety deals with a few different neurotransmitters.

THE KEY PLAYERS (NEUROTRANSMITTERS)

Serotonin (my favorite, also the chemical compound shown in the upper corner of my blog): Key word here is HAPPINESS. Like when you have had a wonderful day at the beach.

Gamma-Aminobutyric Acid (or GABA, my second favorite): key words here are RELAXATION and CALM. Like when you take a warm bath.

Dopamine: key word here is REWARDS. Like when you get a pay raise!

Norpinephrine/Epinephrine: key word here is ADRENALINE. Like when the fire alarm goes off while you’re in the shower…

So I’m sure there are more, and those are super basic explanations but it helps to know them when understanding how the different meds work.

You have your SSRIs (Prozac, Zoloft, Celexa, Lexapro, Paxil, Luvox): Basically you have little nubs in your brain that suck up the neurotransmitters from another nub in your brain (I think the nubs are actually nerve cells but all the pictures make them look like nubs).

When they’re not working right the initial nerve cell sends neurotransmitters over to another nerve cell and then is like JUST KIDDING, and reabsorbs them. This causes a shortage of that neurotransmitter. So what SSRIs (Serotonin Re-uptake Inhibitors) do is they bind to where the Serotonin is coming out and block it from going back into the nerve cell that it came out of (they Inhibit the Re-uptake). SSRIs are like those spikes in parking lots that allow you to leave but won’t let you back up. This keeps enough serotonin floatin’ around in your brain and therefore helps decrease anxiety and depression. These work the best for OCD because Serotonin plays a big role in the Obsession and Compulsion process.

Then there are SNRIs (Cymbalta, Effexor): These are essentially the same thing but they block the reuptake of Norepinephrine instead of Serotonin. This is so interesting to me because a Serotonin issue might cause one person’s anxiety, while a Norepinephrine issue might cause another’s. Or some unlucky people might even have an issue with both. This is why certain medications work for some people and not others.

Next up are the Benzos (Benzodiazepines) (Xanax, Klonopin, Valium, Ativan): These are my favorites but they can be super dangerous. They make you feel great, almost instantly calm, but they are incredibly addictive if you’re not careful and have some of the most dangerous withdrawals. I know for some of us that is something to obsess over but those warnings are in place for the people who need them so don’t freak out, just be aware. These work by binding to the sites that are receiving the GABA neurotransmitter and boosting the function of GABA. The little GABAs latch on and open a channel into the nerve cell, said channel allows chloride ions to enter. Once they enter the cell they sort of numb the cell to keep the other neurotransmitters that make you all worked up at bay (essentially keeping you calm).

GABA: holds the door open “Hey Chloride Ion! Welcome to the party, Adrenaline is already here!”

Cloride Ion: “YAYYYY” hugs Adrenaline really tight and won’t let go

Adrenaline: can’t do its job

Buspirone: This one is in a class of its own. I recently started looking into it because it doesn’t seem to have the side effects that I was experiencing with Prozac. However, my doctor does not want to prescribe it because of the rare but permanent side effect of developing a movement disorder such as a twitch. This would be permanent even once going off the medication, which is very scary. However it supposedly works very well for Generalized Anxiety Disorder. Buspirone is something called a selective serotonin subtype 1A (5-HT1A) partial agonist. But that sounds super confusing so basically it increases the release of Serotonin and Dopamine but in a more controlled manner than say a FULL agonist drug (such as morphine) would. It is like when you only partially open the vents in your car because you’re kinda cold but its too hot with the air off…

Gabapentin (Neurontin): This has been the most recent one I have researched because my doctor just wrote me a prescription for it last week. I have chosen not to take it because of people online saying it caused weight gain. Since that is the biggest reason I’m not going back on Prozac I don’t think it’s the right choice for me. It does seem that it can be effective for people though which is weird because it is primarily an anticonvulsant (used to treat seizures). It seems that they’re not too sure why it can work on anxiety but oddly enough it doesn’t seem to work on the GABA receptors, despite the name.

So to reiterate:

SSRIs- Keep Serotonin from being reabsorbed by the nerve cells that release it

SSNIs- Keep Norepinephrine from being reabsorbed by the nerve cells that release it

Benzos- Help GABA to do its job of making you numb to stress

Buspirone: Increases Serotonin and Dopamine in a controlled way

Gabapentin: No one seems to know…

This is obviously not everything that can be prescribed for anxiety, but these are the ones I have looked in to.

Are any of you on other types of anxiety medications? Or does anyone wish you could find a simpler explanation of a medication you’re taking?