Medications, Me, and OCD

At the risk of potentially offending some people, and I sincerely hope I do not, I felt it time to address the issue of medication as it relates to me and my ocd and my beliefs. I emphasize my because I do not want people to think I am forming opinions of what they do, casting judgment on what works for them, doubting their success, or suggesting that anyone stop or avoid the use of medications for the treatment of ocd or any other psychiatric disorder. However, due to the frequency at which people are recommending I go get myself on some medications (every time I post), it's something I need to discuss.

First, I know the people who suggest this to be are doing so out of kindness and compassion, so I hesitate to even post on the topic because I do not want anyone to feel that I am being dismissive of their genuine, caring attempts to help me. I take these acts for what they are, as an attempt to offer me a beacon of light and some hope on this very dark journey through ocd. We know this road, we walk it together, and I believe we all only want the best for each other.

Second, I realize there are people for whom life would be unbearable without certain medications. Medications have their place, and undoubtedly there are situations in which they greatly improve lives and are a necessary tool in a person's quest for health and wellness. I would never try to convince anyone otherwise.

And finally, your life is not mine to live. I have no right to say what you should or should not do. These choices are your own, and I respect them - particularly when they are part of a desire to improve your life.

Now, with all of that said...

My stance on medications is that I will not use or try them unless I have completely exhausted every other option.

I do not like SSRI medication. I think they are profoundly over-prescribed. I think we, as a society, are far too over-medicated. I've had everyone from doctors to friends to strangers trying to shove SSRI medication down my throat for everything from anorexia to restless legs during my pregnancy to PMS and cramps ever since they gained major popularity back in the 1990s. But I have studied these drugs, I know what they do, and I realize that they are truly a last resort.

I have seen far too many people overuse and abuse medications. I also realize that the bottom line remains the same; at the end of the day, I will still have to do my exposures, feel the fear, and press on. Also, I have managed to get through, sans medications, everything that people have tried to cram SSRIs down my throat for. This does nothing to bolster their case.

All feelings aside, there is also the matter of my spiritual beliefs. I am a Buddhist. The fifth precept advises that we should abstain from intoxicants. Now, I do have an occasional drink. Clouding my mind for a mere few hours versus weeks or years on a medication is a huge deal-breaking difference for me. Alcohol also does not chemically restructure my brain. SSRIs do. I believe that my faith and the use of psychotropic medication are mutually exclusive in all but the most unavoidable cases. I'm not saying that good people who follow the Buddhist way of life cannot take necessary medications, I just find it far too difficult to take SSRIs seriously considering their copious overuse, the kickbacks received by the medical profession, the endless indiscretions of Big Pharma, and the fact that (as I stated before) I've been offered SSRI medication for so many things that I find it more than a little disconcerting. The lawsuits spawned by the prolific "popularity" of SSRI medications is enough to scare anyone to their bones. I encourage you to Google this, only for informative purposes. I believe many people are far too uninformed about what they ingest daily, be it medications or even genetically-modified food.

I hope that clears things up about where I stand on medications for me personally. As I said before, I do thank you for the concern and kindness. I realize these things come from a positive place. I hope you, too, will understand that we all think and do differently. This is the path I've chosen to go.

Onward

I am just getting back into the groove here, so forgive my if I haven't given your blog any attention just yet. I like to read them when I can take adequate time to consider the words you've written and respond.

Yesterday wasn't too bad. I realize much of this comes down to choices I make. Some of those choices are extremely scary and painful, but only until I adjust. The rewards are substantial. This journey must be taken one step at a time, as much as I would like to jump to the finish line and be done with it or refuse to acknowledge that this is a path I may be on for a lifetime - to one degree or another. Acceptance is crucial, I think, not of allowing ocd to ravage my life but of myself as someone who has ocd. Yes, I still struggle with that.

The Cold Pool of OCD

Why can't I just stop?

Can I just stop?

How do I stop?

I've come to a few realizations. One is that you can't just stop having ocd. The other is that you must just stop doing ocd. Habituation is jumping into a cold pool; at first, the shock to your body from the cold water is unpleasant. You might have the urge to jump right out of the chilly water and back into the warm air. However, you also probably want to swim and enjoy being in the pool. To get there, you have to wait. You have to allow habituation to occur. If you wait, you'll eventually realize that the water no longer feels uncomfortable. After a few minutes, the water will feel quite comfortable. You will no longer experience the urge to leap out of the pool for the sake of escaping the unpleasantness of the chill.

Now, the water temperature has not changed; the only difference is that habituation has occurred. The unpleasantness, the cues from your brain telling you, "Holy crap, this water is COLD!" have stopped coming. Again, nothing has changed about the situation, the water, or your physical self, per se. Nothing, that is, except habituation. You've "gotten used to" the pool water and you are now free to enjoy whatever activity you jumped into the pool for in the first place. Even if you get out of the pool, say to use the diving board, you will still feel acclimated to the water temperature. Unless you stay out of a few minutes, in which case you will habituate to the air temperature around you. Which is why it is important to keep going back into the pool.

Which is why it is important to keep going back into the places that scare you or make you feel uncomfortable. Avoiding jumping into the pool will not make the water any warmer, and avoiding contamination will not make something any less contaminated.

Habituation also happens much faster if you just jump right the hell into the pool. Easing your way in a little at a time just allows the process to last longer, your mind to consider the coolness of the water longer, your body to experience the unpleasantness longer. The person who jumped in at the same time you started tiptoeing in is already having fun and enjoying the water, while you're still standing there thigh-deep, re-experiencing the shock of the chilly water one step at a time. Whose experience of getting used to the water is likely to be more negative? Who is more likely to avoid the unpleasantness in the future? The tiptoer, of course.

And OCD is the same.

I have the power to either strengthen or take the wind right out of the sails of ocd. Every time I react to an obsessive or frightening thought (i.e. OMG, that red dot is blood!) by washing or performing some compulsion or ritual, I am telling my brain that it was correct in its assessment of the risk. In doing this, my brain takes my action as confirmation, and the compulsion is deemed "necessary" in the future. An unrelated pair of things becomes related, and OCD gains strength and validity. Now all red spots are dangerous and require a decontamination ritual - even if they're easily recognizable as simple polkadots in a pattern on a dress.

I went to sleep two nights in a row with no soap & water handwashing. None. I did briefly wipe my hands with a cloth, but that was it. Will this continue? Likely not quite yet. But I am hoping it will help me break the 4-hour handwashing ritual that nightmares are made of. Time will tell. And meanwhile, I will keep reminding myself of the cold pool.

Just a Quick Wash...

We've all been there (us ocd people); you feel you've touched something contaminated and you just want to do a "quick wash", or you think you heard something in the house and you just want to do a "quick check". Haha, right.

That "quick" wash starts out okay, until you realize you've splattered "dirty" soap water onto the floor. Then you have to clean it, so you dry your hands and grab the floor cleaner. Then you have to start over with the hand washing. But now you're running out of paper towels or hand towels, or you've contaminated what you've got and need fresh ones. So you go get what you need and start again. By now, you've washed so many times you forget if you got each part of your hands...and wait...did you really clean up after the soap splatter, or did you just know you had to? Shit. You need to do that again. Meanwhile, you think your hair touched the contaminated cleaner bottle, so you have to clean that part of your hair. And because of all of the contamination you've been in, you'll need to change your clothes.

Or maybe you went to check out a noise you heard. And you did, but when you got back to bed you couldn't remember if you checked the window lock. So you went back to check. And once you were back in bed, you weren't sure if you really checked it or if you just went into the room and thought you checked it but really looked at something else. So you check again. But wait...did you check on your child? What if there was a blanket wrapped around his or her neck? You run out of your bedroom and into theirs. The kid is fine. Lather, rinse, repeat. You finally get done with this "quick" wash or check about 3 hours later. You're so exhausted you're asleep before your head hits the pillow.

This is why I have come to realize that "just a quick..." never is, no matter what it is, when you have ocd. The epic tidal wave of anxiety and exhaustion that could potentially (and probably will) overtake me if I decide that I need to do just a quick wash or check is often far worse than just sitting with the anxiety of whatever it is I'm trying to avoid. In fact, the experts would recommend going a step further and sitting with the anxiety while simultaneously imagining my worst case scenario. Honestly, I don't do the latter most of the time. I did once, and the result was kind of funny. But usually, just sitting with it is enough.

For example, I have a thing about contaminated water. Sometimes, when I am filling my coffee or tea cup with water in the morning, my ocd says, "Stop! Where did that water come from!? Were you paying attention to the faucet? Did it come from there? Or did you pick up a soaking cup full of old coffee and who knows what else?" Of course, this is absurd, and it sounds even more absurd when I externalize it by speaking it or writing it (the reason I came back to blogging!). There are a number of things I could reassure myself with. But, as absurd as it is, ocd is a powerful naysayer who can dismiss any measure of comfort and destroy my peace of mind in seconds. So I've stopped listening about the water. Because I've decided that drinking junk water is going to be more pleasant in any circumstance (even if it did, in fact, sit overnight soaking in a cup) than listening to ocd tell me I have to refill my damn coffee cup countless times before it feels "right" and I am allowed to be fully convinced of the safety of the water. Sometimes I even say aloud, "F%ck you, ocd. I'm using this water. I'm putting it in the microwave. See? Right there. And you can kiss my ass." Of course, I only say this if I am alone, which I usually am in the early morning. I don't know why, but when I talk back to ocd aloud, I feel more powerful. Eh, and maybe a little crazy, but whatever.

ERP is awesome. Well, maybe not the E (exposure) part, which is why you might often see me say just RP or response prevention. My ocd, this episode, has been what I would consider severe. I was housebound for 6 months, and wore only one pair of shoes for 2 years. I washed my hands for sometimes 3 hours at a time, and could not touch laundry without plastic gloves on my hands at one point. So for me, and I'm guessing some of you, simply preventing the response part of my constant friggin' anxiety and stress is huge all by itself. I don't need to seek exposures; simply getting out of bed and going pee in the morning constitutes an exposure for me. Really. But anyhow...

Recently, I found what I think is the best book ever written on the topic of ocd. It is called Coping with OCD: Practical Strategies for Living Well with Obsessive-Compulsive Disorder, by Troy DuFrene and Bruce Hyman. This book is fantastic; it hits all of the important points, stresses the importance of maintenance, and gives practical advice anyone can use. In short, it basically affirms that you're not alone, that they "get it", and gives you some very easy-to-follow instructions on how to set yourself free. Or, as they put it, to quiet the "Doomsayer". And ocd is a doomsayer, yes? And a bitch. And a bully. And so many other things. I find metaphor to be helpful in explaining my struggle with those who are unfamiliar with ocd. I like to say I have a bully living in my head 24/7, who only shuts up when I sleep. And back in the day, not even then! The bully even made its way into my dreams! Not lately, though.

Anyhow, I highly recommend the book. I'm not paid or encouraged to say that, I don't make money from my blog, and I'm not here for anyone's benefit but my own. And, if I am blessed enough to make a difference in someone else's life, your benefit. If I help even one person, even a little, by sharing my own struggle, it's all been worth it. And I sincerely mean that. I truly wish all of you who suffer with ocd a life free of it, where you can be you again. I don't even know you, and I want that for you. No one deserves this. I hate bullies, and ocd is one of the worst.

So this week, my goal is to avoid (as many times as possible) the "quick" wash, or the "quick" check. Want to join me? I'll be happy to cheer you on! If you're reading along and have a blog, I'd love to read yours, too, so leave a link in my comments. I add my regular reads to my sidebar.

Best to all of you.

Acceptance

The jist of my former lost post was this:

The goal is not the absence of fear, but the acceptance that things can happen and that life goes on anyway.

Living my life in fear of what might happen is not living my life. These things may never come to fruition. Or they might. But either way, giving in to ocd means trading the possibility of something undesirable happening for guaranteed misery.

Acceptance. Not the absence of risk, but the healthy acceptance of healthy levels of risk. Yes, a few shitty things happened to me a couple of years ago. Some of them could not be prevented with any level of effort on my part. The things that could have been prevented required no extraordinary risk avoidance, I just failed to do the bare minimum. I put myself in a situation that was very likely to end up badly (not by ocd standards, but by actual standards). And considering the level of risk, what happened was pretty mild. The fallout was not, but that was all ocd.

Yes, my intellect works just fine. But the other part of my brain, the one which operates on more primal urges like fear, is having a much more difficult time catching on.

Acceptance. That is my mantra. Reasonable risk. Acceptance. Not absence of fear. Just acceptance.