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.

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.

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).

neurotransmitter-diagram

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.

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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.

tire_spikes

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…

vent_controller

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.

kristen stewart

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?

No Title

Are there actually people out there who are able to spend a nice day off completely at peace? I can’t remember what that would even feel like.

I spent the entire ride home from a nice day-trip out of town with a sense of dread. For me anxiety is felt primarily in both my stomach and my chest, therefore the whole drive home it felt like a fist was clenched securely around my heart. My mind was spinning between dreading the work-week (where I have too much time doing excel spreadsheets to think about my fears), thoughts about when the people I love most in this world might die, and looking back at things we drove past trying to get the last “perfect” image of them. That last one is one of my OCD compulsions which tends to get worse on days where I’m making really good memories. I start to feel like I MUST remember that good day/moment/feeling forever and so the last image I see of it has to feel “right”. According to my OCD if I don’t get that last perfect mental image then something bad will happen.

So for me sometimes even happy seemingly carefree moments aren’t carefree because all I can think about are all the different ways that happy moment may become a painful memory. For example today as I had this great day-trip with my boyfriend I was plagued by thoughts of us breaking up in a year and this day just being a reminder of how oblivious I was to the coming doom. Then to counteract the anxiety from that thought I had to get a perfect mental snapshot of the good moments; of the pretty views on our hike, of the clear blue sky over the pier, of the tropical drinks we had a lunch, of the sun setting over the pacific ocean on the way home.

I can’t just look at those things like a normal person. I have to blink a certain way, or stare for the right number of seconds, and then god forbid I accidentally look at it again and have to do it all over. Or worse I don’t get that perfect image before the spot of beach slides out of view from the car’s window and I have to sit with a dull gnawing anxiety until it passes.

I want to end this on a positive note or with some type of advice for lifting your spirits on the days when you just feel defeated and down, but I really can’t right now. Sometimes all you can do is let those feelings be there and trust that they will cycle through. In fact usually that is the best thing to do; let the bad feelings be there, don’t do anything about it, and watch them dissipate on their on. It is trying to do something about them that usually gets us in trouble anyway…

So like…..What’s Your Sign?

When your friend says aspects of your astrological chart don’t line up with aspects of your boyfriend’s astrological chart:

giphy

I have something called Relationship OCD (rOCD).  This particular brand of OCD is barely ever talked about and there is very little research on it, but its a real thing.  rOCD is when your obsessions and compulsions center around a significant other or someone you’re dating. It can take one (or both) of two forms. On the one hand you can obsess over the other person’s flaws and the “rightness” of the relationship and on the other hand you can obsess over if they really love you or their faithfulness to you. My rOCD tends to flip a little bit between both which is confusing for my poor boyfriend.

The compulsions associated with this can be anything of course but some examples are: mentally comparing your relationship with others, “checking” your feelings to see if you feel in love (and any moment where you don’t feel totally in love is a massive trigger), or seeking constant reassurance from your partner about their feelings for you.

This is hard for me to write about because even when I tell people about my OCD I usually leave this aspect of it out. I am aware that to the untrained eye it just appears that I’m your stereotypical CRAZY girlfriend. For example, when I studied abroad in college my roommates simply did not understand why I couldn’t enjoy my time abroad because I was bombarded with nearly constant obsessive, unwanted thoughts about my boyfriend cheating on me while I was gone. He didn’t understand it either. I didn’t even understand it. It would be another 3 years (and a period of us being broken up) before I would be able to put a name to what was going on in my head.

Luckily now we both understand it better and he knows to only give me reassurance once or twice before refusing to be an enabler in my compulsions. I understand what is happening now when a friend tells me that some aspects of our astrology don’t line up and it seems like the world screeches to a halt. I understand what is happening when I can’t focus on anything around me after that. I understand what is happening when I then feel the need to spend the next week compulsively learning about astrology to make sure our relationship isn’t “wrong”. I understand what is happening and so I will not be spending my week reading about astrology, but instead use my time to do things that will move me toward positive things in my life : )

Looking For The Lion

I have a tattoo of a lion on my ribs. A lot of people ask me if I’m a Leo because of it. I’m not, but I’m always really glad they ask.

I’m glad they ask because it gives me a reason to explain my tattoo.  I originally got it for me, as a reminder. But it turns out it also gives me a reason to open up the conversation about mental health with anyone who asks, something that I think is important if we’re going to change the way people view mental health.

This is my tattoo, done by the absolutely amazing Dr. Woo at Shamrock Social in Los Angeles (it was well worth the 3-month-in-advance appointment I had to make):

dr woo lion

So this is the spiel I typically give whenever anyone asks about the meaning behind it: When I was in high school I went to a therapist who told me a really great analogy for anxiety. She said that back in the caveman days the biological purpose of anxiety was so that if you saw a lion outside your cave you would feel anxious and therefore know to run, or protect your family etc. But when you have an anxiety disorder the process is flipped. Instead of

  1. See Lion
  2. Feel anxiety

its

  1. Feel anxiety
  2. Go-looking-for-the-lion-that-must-be-there!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

We’re always “looking for the lion”. In modern society however threats do not look the same, there are no actual lions waiting outside your apartment. That mechanism is still in place though and sometimes any little thing can set it off.

After hearing that analogy I knew I wanted a lion tattooed on me so that I didn’t need to go looking for the lion anymore. Now I know where it is.

Of course I still have my anxiety disorders (like the one telling me this post doesn’t “feel right” so I shouldn’t post it) ….but it sounds really poetic right?? ;p

The Book That Changed My Life

I’m feeling a bit down today which is making it hard to write, so I’m going to take this opportunity to talk about someone else’s writing. Terry Spencer Hesser’s writing. If anyone hasn’t read the book Kissing Doorknobs I’d say now is the time to go buy a copy. Because it changed my life.

Kissing Doorknobs

It is a very short book. Only 149 pages. And when I read it for the first time I was only 9 years old with no words to describe what I was experiencing.

I don’t really know what all I believe in and what I don’t because my anxiety makes me over analyze anything that could possibly be other-worldly. But I have to say, the story of how this book came into my life is pretty perfect.

I was in 3rd grade and I’d only heard the words “Obsessive Compulsive Disorder” once. When my dad found out I was bringing my own soap to school because the school’s soap was causing my hands to break out from using it so much. I think at the time he was joking but I remember feeling a connection with the words as I was grasping for an explanation for why I felt the need to make sure I used the bathroom EVERY time our class left the classroom out of fear that I would get stuck somewhere and not be able to go (totally irrational…it was a public elementary school, there were bathrooms everywhere).

My mom had a cabinet of books in the living room and I was a voracious reader so I would often go in there looking for a new read. One day I came across this slim book called Kissing Doorknobs. I flipped it over and read the back, freezing when I saw the sentence “She didn’t like behaving so oddly; she only knew she had to if she wanted to feel better.”    …………………………………………………. My little 9 year old mind was blown. Was I not alone?

All throughout the story I connected with 11 year old Tara, although we didn’t have all the same compulsions we shared a core fear of something happening to our parents. When I got to the end (I won’t spoil the book) it was essentially my first exposure (ha. ha. pun intended) to Exposure Response Prevention Therapy. The idea of just NOT doing the thing you felt you had to do and then sitting with the anxiety and allowing it to be there. I decided to give it a try. It was hard and I mostly failed, but I knew what it was. And I truly believe that learning about it that early on, even though it took almost 15 more years for me to be properly diagnosed, helped wire my mind to be open to that type of therapy.

To this day my mom doesn’t remember where that book came from, she thinks she must have just gotten it in a book trade or something. She never even read it until more recently when I asked her to. But all I know is that I’m very thankful that that book was in that cabinet that day.

So. If you haven’t read it yet. Do.

Scripting

Tonight I pulled out a tool that I learned in my Exposure-Response therapy over a year ago. I have been slacking on doing my exposures and it is time that I get back into practice.

“Scripting” isn’t writing a stage play (although you never know!). It is an exposure to your fears. Here are the steps:

1.) Choose your current fear/obsession

2.) Write out that worst fear in as much gruesome detail as you possibly can. It works best as a narrative, like you’re writing a story.  Here is an example (apologies if this triggers anyone): “I leave for work one morning and check the stove my normal 8 times. I feel really anxious still but I have to leave for work or I will be late and my boss has told me that if I’m late again he will fire me. The whole way to work I am anxious. Two hours into work I get a call from the fire department that my apartment has burned down with all of my belongings and my cat inside. My life falls apart, I have nowhere to go, and I have nothing. My worst fear has come true.”

cat ablaze

3.) By this time your anxiety should be through the (non-existant) roof. You. Must. Do. Nothing. Get up and do something non-compulsion related until your anxiety goes from a 10 to a 5, or lower.

4.) Re-read your story (and remind yourself that it is just that, a story. Nothing more) and again allow your anxiety to go up, then do something else until it comes down to a 5 or lower

5.) Re-read your story every day, focusing on the most anxiety provoking parts or words until eventually your anxiety only goes up to a 9, then an 8, then a 7 and so on (look at me ending on 7, one of my “bad” numbers. Woo-hoo!)

I know it sounds crazy to purposely raise your anxiety to a level 10, but that is the key to reclaiming your life and no longer being a slave to that story you created. The idea is to expose yourself to the story enough times that you start to become numb to it. That’s human nature! Just like on Thanksgiving when you’re allowed to eat an entire pumpkin pie (oh wait…you don’t do that?) and then suddenly 2 slices in it’s not as exciting anymore.

So this is what I did tonight. I “Scripted”. I sat down and wrote a full page story about how my choice to move and change careers came crashing down around me ending with me alone and depressed for the rest of my life. I used a lot of descriptive words and things that stirred fear and emotion. I was crying by the end of it. Now I have to be strong enough not to ask my boyfriend to read it and give me reassurance that the story won’t come true.

One of my biggest compulsions is reassurance-seeking, and I’ve gotten sly with it over the years. I will find ways to maneuver into a conversation that I’ve already had with someone a million times just to hear them give me the same reassurances that they’ve essentially already given me a million times. So not doing this will be difficult. But that is part of the process…

To Be or Not To Be….That Is The Question

Making decisions can be hard for anyone, but for someone with OCD and anxiety decisions can be an agonizing ordeal. It took me awhile to connect my difficulty making decisions with my OCD, I just figured it was a part of my personality (which I suppose it is). But one day I wondered if it might be connected to my anxiety disorder so I tried to observe my thought process when making decisions. I realized that I approach decisions with the same cyclical thinking process that I do my other obsessions.

I can’t simply make a decision.  If it is something seemingly unimportant, such as which box of cereal should I grab from the shelf at the store (no not which brand…literally which box…these are the things I worry about *sigh*), I go back and forth weighing my decision on the thoughts that might pop into my head or how “right” it feels.  Then if it is something very important, such as wondering if I should make a career change or not, I:

Compulsion 1: Spend hours Googling

Compulsion 2: Ask Mom/Dad/Boyfriend/Person-I-Just-Met for reassurance (multiple times)

Compulsion 3: Play out every possible outcome all the way to the end (multiple times)

Compulsion 4: Check my feelings as I think about options to see what feels “right”

On the surface these might not initially seem like compulsions, but they fit the definition. Things that I feel I must do in order to get rid of the anxiety I am having about the decision. I talked a little about the Googling compulsion in my previous post so I’ll talk briefly about the others I’ve mentioned.

Reassurance-seeking is a pretty common compulsion.  Again, most people like some reassurance about things that are making them anxious but the difference between someone without OCD and someone with OCD is that the person without OCD usually only needs to hear that reassurance once or twice. Then, even though they may still have anxiety about the decision they will not continue to ask for reassurance. Someone with OCD however will not only ask for the same reassurance over and over but possibly even the exact same words over and over. Its not that they forgot but more that the reassurance did not shut off the doubting thoughts replaying in their head so they will need to keep hearing it until it does.

Playing out possible outcomes over and over is another unhealthy anxiety-resolving behavior. The way it works for me is I have a bad thought such as “If I choose to go back to school for Psychology I will be miserable AND in debt”. So then I must picture myself and how it would feel to go through the entire process of going back to school and starting over in a career etc. This might be something anyone would do briefly but for me it feels like something I have to do in order to feel like I’m making the most informed decision and I cannot focus on anything else until I finish thinking through the whole process. I will do this one day and then the next day have the thought again and have to do it all over again.

Lastly, checking for that “right” feeling. Another pretty common compulsion that can be applied to anything from choosing the box of cereal or putting on a shirt in the morning to making big life decisions. It is something that is hard to explain to someone that doesn’t have OCD but this is the best way I can describe it: That feeling you get when you cross the last thing off your to-do list and you sit down on the couch to chill. It is when there are no negative thoughts or feelings tied to something. If you were to plop down on the couch while you still had things on your to-do list you might not feel quite right, you wouldn’t feel settled. Someone with OCD might put a shirt on in the morning and randomly have the thought that they will die in a car accident that day (because their brain knows it’ll get a strong reaction out of that one, so it likes to throw it out at random times throughout the day). They will then not feel quite right, not settled, and take the shirt off and put it on again (and possibly again and again and again until they can get one without any negative thoughts), rather than deal with that not-right feeling. For big decisions it is more anticipating and “checking” for that right feeling when thinking about different options.

Once I realized difficulty making decisions was another part of my OCD it became easier to notice when I was following those OCD patterns and try my best to break them.  Sometimes simply being and observer of your thoughts can do wonders for helping you overcome things (even if it is small steps at a time).