Mental Health Series: February –OCD

This is the second in my series of mental health posts that will be in 12 parts – one post per month for the full year – each focussing on a different aspect of mental health that I have experience with.

My hope is that these posts can provide words that will help others who struggle with these issues to find better ways of communicating how they feel, and provide insight for those seeking to understand these conditions.

January – Anxiety |February – OCD | March – Depression | April – Anger | May – Guilt | June – Lack of Motivation | July – Grief | August – Mental Effects of Physical Illness | September – Trauma | October – Fear | November – Loneliness | December – Impact on Relationships

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Up the Eildon Hills, Melrose, Scottish Borders (the image is mine but feel free to use it)

Most of you have probably heard of the term ‘OCD’. I hear it thrown around in casual conversation all the time. It’s often used to describe people who like to clean and keep things neat and tidy, who are very organised, or have a somewhat peculiar personality quirk like needing to keep their ornament collection arranged just so. I hear people remark, “oh, I’m so OCD about that”, when referring to their need to make their bed every morning or have their coffee at exactly 9 a.m. every day.

That’s not OCD. It’s not even close.

I’m certainly not suggesting that everyone who casually uses that phrase is being overtly insensitive or insulting. I’m sure it never even crosses their minds that it might be taken personally by those of us with actual experience of it. Unfortunately, whatever the intent behind it, that statement trivialises the severity of a condition that is so much more than just the desire to keep things neat and tidy.

If only OCD were that simple – or that benign.

Obsessive Compulsive Disorder is a mental illness that causes sufferers to experience unbreakable cycles of disturbing and negative thoughts that produce high levels of anxiety, usually accompanied by the compulsion to complete repetitive and sometimes bizarre rituals in order to cope. Often combined with other mental health conditions such as depression and suicidal thoughts, OCD traps sufferers into a pattern of behaviour that can cause them to believe that if they stop performing these rituals, or perform them incorrectly, something terrible will happen.

If you have OCD, it is genuinely possible for you to believe with absolute certainty that your family will die if you don’t check the soles of your shoes exactly 3 times as you walk down the street, and that it will all be your fault.

It can compel you to circle the perimeter of a room and touch objects in a specific sequence before you’re able to sit down.

It can force you to align objects at precisely right angles and get unreasonably angry if one gets knocked out of place.

It can leave you with chapped and dry hands because you feel the uncontrollable need to wash them over and over again to try and rid yourself of non-existent dirt and germs.

It can extend the length of your supermarket trips because you have to reshelve out of place products and straighten up the chewing gum displays.

It can mean that you feel so trapped in a room with closed doors and curtains that you have to repeatedly open and close them to prevent a panic attack.

In case you think these examples are exaggerated for effect, they’re not. Those rituals used to be mine. They are part of the rigid pattern of behaviour I was trapped in for over a year when I was 15 and severely mentally ill.

I recovered a long time ago, which is why I can now see them for what they really were and write about them objectively, but at the time, they formed the bars of a prison that meant I had to have home visits from two psychologists because I couldn’t manage the anxiety and all the rituals that would be required to get me from my living room couch to the treatment centre.

I can still remember how humiliating it was to have to walk around the house and show them all the bizarre and nonsensical rituals I was compelled to perform. They then had me sit on the couch with a piece of paper and a pen. When I felt the urge to perform one of the rituals, touching the mantelpiece with both hands at exactly right angles to the clock, for example, I had to draw a graph of my anxiety levels. When I wasn’t able to stand it any longer, I was allowed to perform the ritual, and then had to record how my anxiety levels dropped, and how quickly they began to rise again.

One of those graphs would have looked like this:

You can see a pattern here. A disturbing thought would enter my mind, triggering my anxiety. That anxiety would continue to build, and, lacking the ability to rationalise my feelings and deal with them, I would be compelled by my OCD to perform a ritual to calm the anxiety. I would experience only a brief reprieve before the anxiety would start building again, like a wave about to break on the shore (or the mantelpiece, in this case).

Eventually, I was able to attend regular sessions at a treatment centre specialising in adolescent mental health, where I was diagnosed with clinical depression and suicidal thoughts alongside the OCD. A challenging triad, to say the least.

With the help of my psychologists, I learned to process my traumatic childhood and address the underlying reasons behind my anxiety. I found that writing came naturally to me, and I personified my OCD into a monster that could be fought by Buffy the Vampire Slayer-style heroines who were really just idealised versions of myself.

The need to perform my rituals fell away over time, until I stopped performing them almost completely. I can definitely still see elements of OCD in the way I behave, particularly in my need to organise and clean, but I can live with those traits and have accepted them as part of who I am.

As I discussed in the first post in this series, I still have an anxiety disorder and I’ve needed further counselling since my original treatment but, over time, I have learned how to channel my anxiety in productive rather than restrictive ways. The mantelpiece that used to attract my hands like a magnet is now, thankfully, just a mantelpiece.

I’ve written about my anxiety several times before, and I freely talk about it, but I never talk about my history with OCD. Maybe it’s because it’s still difficult to admit that I used to walk around performing those bizarre rituals in a desperate attempt to master feelings I couldn’t control. After all, nobody wants to admit things that might make them sound crazy.

The crux of it is, as a society, we don’t talk about mental illness in the same way that we talk about physical illness. If, instead of OCD and compulsive behaviours, I had suffered from debilitating migraines that caused me to throw up a lot, would I still be embarrassed to talk about them? No, because, generally speaking, physical illness doesn’t carry the same stigma as mental illness does. One tends to invite sympathy, while the other invites incredulity. It’s easier to accept that someone is nauseated with migraines than to accept that someone could genuinely believe they would die if they didn’t turn a light switch on and off exactly 7 times before leaving a room.

If you know someone who you suspect is suffering from OCD, the best thing you can do is show them understanding and patience. If you observe them doing something that seems strange or unusual, try not to stare or question them. Be patient, even if their need to check all the doors are locked for the third time in a row is making you late for something. Try to remember that there’s a war waging inside their mind between the knowledge that their rituals make them look crazy and the uncompromising power of the OCD that compels them to perform them anyway. They need to know that they can trust you and that you’ll be there to listen if they feel able to talk about it.

Tempting as it may be, the worst thing you can do is try to prevent them from performing their rituals. That will only serve to heighten their anxiety to unbearable levels and make the situation worse, possibly resulting in a panic attack or an angry outburst. The only way to successfully treat OCD is to address the root cause and develop alternative ways to cope, and that will most likely involve professional help, time, and a lot of patience. But it is possible.

If you’re suffering with OCD yourself, hold on to the fact that you’re not crazy. You just have a more unusual way of coping with your anxiety. OCD, anxiety and depression all feed off each other, and hiding what you’re going through won’t make them go away. Maybe you’re worried that people, even medical professionals, will think you’re crazy and dismiss you out of hand. That’s understandable, but all I can say is that not one of the many doctors and psychologists who have treated me over the years ever judged me for my behaviour or made me doubt my sanity. OCD is a real, diagnosable condition that can be successfully treated.

The combination of my OCD and depression led me to plan my suicide one night 14 years ago. I wouldn’t be here now if I hadn’t gotten help, nor would I be building a life I’m proud of. So can you. Just don’t try to do it alone.