Treatment, Part One

I started having symptoms of obsessive-compulsive disorder and depression when I was a young girl, around 8 or 9, but I didn’t get treatment for the disorders until I was 27.

Why the delay?

One reason was because my parents apparently didn’t recognize that their daughter had some major problems.

My mother in particular thought I was being “contrary” and disobedient because I ran the water too long when I washed my hands, took too long in the bathroom, wouldn’t finish a book for a class assignment, did everything slowly, etc.

I never tried to explain myself to my parents, because I thought I must be crazy, and I couldn’t admit that.

Do I blame my parents? As an adult, I have definitely carried some resentment because they didn’t try (to my knowledge) to find out what was wrong with me, or get me some help. But that discussion is for another day.

When I was a teenager, I read a magazine article about OCD (I don’t remember which magazine—Teen? Good Housekeeping?). I was shocked that there were other people who did many of the same strange things I did.

That new knowledge made me feel less like a crazy person but no less isolated. I was so embarrassed and worried about reactions from others that I never told anyone, not even my doctor.

At the end of my first year of college, I got very down and homesick. After my parents visited me at school one weekend, my mother wrote me and said how sorry she was that I was so depressed. That was the first time I thought of myself as depressed.

No one suggested that I see a doctor or therapist about my depression. There was a great stigma around anything that smacked of mental illness in the community I grew up in.

So I plugged along, believing that I was just a miserable, unlucky person.

My OCD symptoms became almost unbearable when I was in graduate school. I was far from home and lived by myself. I suffered from obsessions and compulsions that made my hands bleed, took me away from my studies, and made me think death must be a relief.

I was also depressed, which I thought was situational. I finally discussed that with a friend, and she suggested that I see a therapist at the counseling center on campus.

Oh, I could never go see a therapist, I remember saying.

Well, I see one, my friend said.

That surprised me, because my friend seemed to be the personification of sane. But her honesty with me provided the impetus for me to make an appointment to see a counselor.

That counselor, who was a PhD in psychology, probably saved my life. I spent a year talking about my childhood, my relationships, my sense of self and my negative and unhelpful thought processes.

My first foray into talk therapy—any kind of therapy—helped me to change my perspective: on my background, my past experiences, and the subsequent negative ways I thought of myself.

I began to think less negatively, and I began to recognize that the way I thought about things had direct, real effects on how I lived my life.

But after a year, but I wasn’t feeling better. And my OCD symptoms marched on.

Because I never once mentioned my OCD to the therapist.

In my next post, I’ll write about my first encounter with a psychiatrist.

Afraid of . . . an Advent wreath?

Let me begin this by saying that it’s not the wreath itself that I was afraid of, but lighting the candle in the wreath.

From the beginning: I go to a United Methodist church, and each year, we light a candle on the Advent wreath each Sunday leading up to Christmas.

Earlier this week, the church secretary called me. It seems that I was on the schedule to light the candle during the 9 a.m. service (we have two services) today, the first Sunday in Advent. The secretary didn’t have an updated email address for me, so I didn’t know I was scheduled for this until she told me.

“Are you going to be able to do this? Are you going to be in town?” she asked.

I told her yes.

We chatted a little more, and then I asked the most important question: “You said I would light a candle?”

“Yes,” the secretary said.

“I just don’t want to burn down the church,” I said.

I guess she thought I was joking, but I wasn’t, and the anxiety set in.

I don’t like fire. I don’t like matches. If you can believe it, I can’t even strike a match. I’m too afraid that I’ll do it wrong and burn myself or drop it and burn down a building.

When I used to burn candles, trying to use them to help me relax, the only way I was able to light them was to use a cigarette lighter or one of those long grill lighters

I finally stopped because of all the anxiety I had about the candles turning over or about me falling asleep and forgetting about them or not putting them out completely before I left the house or went to bed.

All this past week, I thought about it, and tried to remember how the wreath lighting had been done in the past. I hadn’t been at church during the Christmas season for a while. All I could remember was that people walked up and somehow lit the candle and read something aloud.

I really wasn’t nervous about standing up in front of people and speaking. I’m very introverted and shy, but my years of teaching and giving presentations at various jobs had moved me out of my comfort zone enough to be fairly used to it.

I was worried about getting that darn candle lit without looking like an idiot.

What if I fumbled with matches and the minister had to light the candle for me? Could I just ask the minister beforehand to light it for me? Would there be one of those lighter things to use?

Last night, I remembered. I remembered how the candles had been lit in years past. The long acolyte lighters were used to first draw a flame from the candles burning on the altar, and then to light the candle.

Oh, I could handle that, I thought.

When I walked into the sanctuary this morning, I panicked. The candles on the altar were unlit.

The Advent wreath was sitting on a stand up front, waiting for me to come up and burn it up. (OK, I’m being a little overly dramatic, but that’s what my fear does to me!)

The minister came over and reviewed with me what I would say and pray. And then he held up one of those acolyte lighters, which at that moment looked quite beautiful to me.

“I thought this would make the lighting easier,” he said. “I’ll light it from the altar candles and then bring it to you.”

Hooray! I thought.

“And you’ll light the altar candles?” I asked.

He said he would, since we use acolytes only during the 11 a.m. service (the more formal one).

Now all I had to worry about was transferring the flame from the lighter to a candle. I could relax a bit. There was even time to start worrying about tripping when I walked up front, or totally messing up the call to worship.

Everything went fine. There was a little glitch when the minister handed me the lighter. The wreath has a center candle, with four smaller ones around it, three purple and one pink. I knew not to light the middle candle or the pink one, but which of the purple ones?

“Which candle do I light?” I whispered.

“Any of them,” he said. “Do one of the ones in the front.”

I hope no one in the congregation heard our comments, because a live mic was around.

I lit the candle, handed the acolyte lighter to the minister and scooted on down to my seat.

Later today, I was thinking about my OCD fear of doing others harm and how that had been behind my fear of the candle. I had to laugh at myself. Years ago, I wouldn’t have been able to.

And I’m very excited about candles now. I just learned about battery-powered ones.

There's always something to worry about, but . . .

For the past few months, I’ve been working on “staying in the moment” instead of steeping myself in the past or worrying about the future.

The medications I’m on help, but they are not enough. I have to actively work on it, too, I’ve learned.

My efforts have included different forms of meditation, reciting poetry I love, self-talk and making mandalas.

The results have been mixed.

I have made headway in one area. One of the symptoms of OCD I manifest to different degrees is that I don’t think I should relax until everything is right. As I’ve written before, it’s not perfection I’m after, but feeling right.

I now can sometimes focus on my breath or mantra even when I am in the midst of anxious and racing thoughts. I just keep breathing or focusing on the words or sounds after reminding myself, repeatedly, that I can worry later.

It doesn’t always work, and I have to pull myself from my wandering thoughts time and again. It’s a start, though.

But isn’t it so much easier to deal with the everyday or familiar anxieties than it is with a new one?

We learned today that our 15-year-old cat, Samantha (Sam), has the beginnings of chronic renal insufficiency. That’s what eventually killed our two older cats, Waddles and Thunder Cat.

My husband and I stood in the examining room at the vet’s office, hearing the same things we’ve heard before. Try to get her to eat a renal diet. Watch her for certain signs and symptoms. Bring her back for more blood work.

Sam

We carried Sam back home, both of us quiet.

I started wondering how soon the kidney problems would start to noticeably affect Sam’s quality of life.

I pulled out Waddles’ medical records to find out when she was first diagnosed: Aug. 7, 2007. She lived for a little over four years after that. She was older than Sam when diagnosed.

Thunder Cat was diagnosed in December 2008 and died Feb. 12, 2009. He was also older than Sam is now. His disease seemed to progress quickly, though kidney disease can be silently present for a long time.

I started to worry (to myself, not out loud, because I didn’t want to upset my husband more than he was) about how long Sam would live, how long before she would fade away like her siblings. I was tense and depressed, fearing what was to come.

But some of what I learned from Waddles started to come back.

Enjoy the time we have with Sam. Don’t upset her with my anxiety and tears. Focus on her today and appreciate her.

If I waited to do those things until I felt “right” about her illness, I would never be able to do it, because it will never be right. There is no cure for chronic renal insufficiency. You can try to slow it down, but it’s never going to disappear.

It is so difficult to do the things I’m writing about, to focus on the time we have with Sam right now, while doing the things we can do to hopefully slow down the disease’s progress. I can only manage the “in the moment” attitude for short periods.

There’s always something to worry about, but I can try deal with the worry by being in the moment.

How do you best deal with your anxiety?

I am thankful

Thanksgiving is tomorrow, and I am going to try to be very consciously thankful for all the blessings I have. So many times I forget about gratitude. The holiday reminds me how many things I have to be grateful for.

My life isn’t perfect, but no one’s life is. We all have our burdens to carry. Mine seem too heavy to bear at times, but I have found that remembering what I am thankful for gives me a better perspective.

I am thankful for my husband. I am thankful for his generosity, companionship and friendship. I am thankful for his forgiving nature. He is a good husband to me.

I am thankful for our cats, Samantha (Sam) and Chase Bird. I am thankful for their companionship, their affection, their funny antics and their presence.

I am thankful for our cats that have crossed the Rainbow Bridge, Waddles and Thunder Cat. I am thankful for all they taught me and for making my life better.

I am for my husband’s daughter and her husband and children. I am thankful for his relatives.

I am thankful for my extended family and relatives, the good, bad and the ugly. I have learned from them even in difficult circumstances.

I am thankful that I have enough to eat. I don’t worry about where my next meal is coming from. I am thankful that I have access to healthful, safe food.

I am thankful that I have a home. I can stay warm in winter and cool in summer, and I sleep in comfort.

I am thankful that I have a job, and that it lets me do what I love to do—find out stuff and write about it.

I am thankful that I have health insurance, which allows me to get the medical treatment and medications that I need.

I am thankful that there are a variety of ways to treat OCD, anxiety and depression. I am thankful for my physician and for all those working to help those of us with these disorders.

I am thankful that Sam just pulled me away from writing this post to play a game of “swat that ball.”

I am thankful for music.

I am thankful that I am able to walk and run and move around. I am thankful for meditation and yoga.

I am thankful for books, beautiful books. I am thankful that I have access to so many.

I am thankful for my love of writing.

I am thankful for animals. I am thankful for trees and flowers and mountains and rivers.

I am thankful that I started blogging and have made connections to people who understand the whole OCD thing.

I am thankful for the spirit that connects all of creation.

To those who celebrate Thanksgiving, have a wonderful holiday. To those who don’t, enjoy your day too. I am thankful for all of you.

Counting: one, two, three

I think counting was my first manifestation of OCD. I practiced it mostly as a child. It was only as an adult that I recognized it as OCD. As a child, I thought I was being quite creative at keeping my mind busy while I waited somewhere.

I did a lot of waiting when I was a little girl. One of my brothers was sick a lot, and I spent a lot of time in hospital waiting rooms and doctors’ offices.

I must have been around seven or eight years old when I became obsessed with the number three, especially when it related to counting letters on signs, billboards, breakfast cereal boxes, anything.

Silently, never aloud, I counted every letter of a sign or whatever, hoping to make it turn out right. It was right if the letters ended up on the count of three with the last letter. In other words, the total number of letters was divisible by three.

Without thinking, I began to automatically break down sentences, phrases, or just words into threes, any time, anywhere.

I didn’t tell anyone about this game I played. I didn’t know that I was obsessively thinking of the number three and compulsively counting letters and punctuation marks. I didn’t know that I was compulsively counting to relieve the anxiety and fear I felt.

And it seems to be a practice that I still sometimes fall back on without thinking. Some months ago, I had an upsetting call on my cell phone while my husband and I were having lunch in a restaurant. After I got off the phone, I looked out the window and started counting the windows in a building across the street. It took me a minute to realize what I was doing.

It’s difficult to stop the racing thoughts, whether it’s numbers or something else. Meditation is hard for me, but I’m working on it.

I don’t know if it’s a good thing or a bad thing or in between—the way we sometimes develop compulsions to relieve our anxiety. We are trying to comfort ourselves. That seems to be a good thing. But the process goes haywire. What are you thoughts on this?

As an example, my counting ritual went something like this:

I am in the waiting room at the hospital. On the wall beside the swinging doors that lead to the real part of the hospital, there is a sign. It says, “No visitors under age 12 allowed past these doors.”

I am under twelve, so I’m sitting on one of the green leather sofas waiting for Mama and Daddy to come down from my brother’s room..

I look around. I don’t feel like reading my book anymore. I look at the sign by the swinging doors. Wonder if I can make it turn out?

I go through all the letters and numbers: N-o-v, i-s-i, t-o-r, s-u-n, d-e-r, a-g-e, 1-2-a, l-l-o, w-e-d, p-a-s, t-t-h, e-s-e, d-o-o, r-s. It doesn’t work. Two left over.

I include the spaces between the words and numbers: n-o-space, v-i-s, i-t-o, r-s-space, u-n-d, e-r-space, a-g-e, space-1-2, space-a-l, l-o-w, e-d-space, p-a-s, t-space-t, h-e-s, e space-d, o-o-o, r-s. One left over.

But, there’s that period at the end. If I add that to the r and s of “doors,” it works out. But the period is not the only dot on the sign. There are the dots over the letters “i” in visitors. Aren’t they part of it all? Do I have to count them?

If I do, how else can I make it turn out right? There aren’t any pictures on the sign. No lines underneath the words. No exclamation marks. No commas. Even if I change “12” to “twelve,” it doesn’t work.

I go over and over the sign, seeing if I made a mistake counting by three’s. No mistake. It will work out only if I count the period and not the dots over “visitors.”

Okay. That’s what I’ll do. I won’t count the dots over “visitors.” I’ll consider them to be part of the letter i. That makes sense. The letter i wouldn’t really be an i if it didn’t have that dot over it, unless it was a capital i.

Now I go over the sign a couple of more times. It works out perfectly. One-two-three, one-two-three. Kind of like a waltz. Perfect. I’m a little proud of myself. If there’s a way to make it work out, I can usually find it.

Can you imagine this kind of thinking in a child?

Tell me everything is going to be all right

It’s easier to give reassurance than to be the one who needs reassurance.

My husband is something of a checker. It happens mostly when he’s getting ready to leave the house. Even though he’s very careful and responsible, he sometimes has the need to recheck that he turned off the ceiling fan, the lights or the dryer. Even if he’s running late, he will take the time to check one more time, even unlocking the door he just locked to go back inside.

I’m glad he’s careful. I’m glad he cares enough about our home and family to check again.

But I still get impatient with him sometimes for the amount of time he takes to double check. You turned off the fan, I say. I know you turned off everything.

I can say those things because I don’t doubt that he did what he was supposed to do.

It’s easy for me to reassure him.

And yet I understand his doubts. I have doubts like that. I doubt myself very often and to an intense degree. I doubt that I turned off the stove. I doubt that I turned off the lights in the bathroom. I doubt that I heard the dryer shut off.

I cannot offer myself the same reassurance that I give my husband. I tell myself over and over that the light fixture is dark, there’s no light shining. But that doesn’t reassure me. Rather, the frenzy of my thoughts and the repetitiveness of my words make me anxious.

I can reassure others, but not myself. How can I learn to do for myself what I can do for others?

A couple of notes:

In my first post, I said I planned to post on Monday, Wednesday and Friday. That’s three times a week. This week I posted Monday, Wednesday and late Thursday. I think I’ll be writing every other day.

Also, please comment on the blog. I really want to hear from you. Thank you!

Update later: Technorati claim token FP8HHWMWZSNK

Waddles

I didn’t plan to write about this tonight. But I’ve cried a lot today and felt like I needed to tell you what is heavy on my heart.

My cat died five weeks ago today. Waddles was 21 years old, a black and white half-Persian beauty. I was blessed to have her for eleven-and-a-half years.

I still cannot write much about her. I can’t express in words how much I miss her.

For the last year or so, when her health was gradually worsening, I tried to be very deliberate about being mindful of and grateful for her presence.

When she lay down beside me with her head on my arm, I tried to memorize the feeling of having her close to me and listening to her breathing.

Waddles lifted me into a new perspective on life. With OCD, I was always afraid to be responsible for taking care of any creature, because I feared doing something wrong or forgetting something important.

I feared that I would begin to have new and even worse obsessions about hurting someone, and that would trigger more compulsions.

And then there were the concerns about germs and dirt in the house from another creature.

She was my mother’s cat first. After my father died, my niece encouraged her to get a cat to keep her company. My mother didn’t like cats much, but a dog was too much for her physically to take care of. So she adopted Waddles, whose original person had died.

The first time I met Waddles was when I visited my mother, and she walked into the living room where we were sitting. She looked at me, then jumped up on my mother’s long couch. I was sitting on the other end.

Waddles made her way to me, placed her front paws on my leg and began to purr.

I said, “I’m sorry, but I don’t like cats.”

That didn’t stop her. She kept purring.

The man who is now my husband said she picked me because she knew I would love her and take care of her.

I soon moved in with my mother for nine months, and I grew very close to Waddles. I loved her so much, but it was still reassuring to me that I was not fully responsible for her.

That changed when my mother gave her up for adoption about 18 months later, after I had moved out.

I went to the shelter and adopted her myself. I was afraid to do it, but my husband encouraged me. When I worried aloud that I didn’t know how to take care of cats, he said, “She’ll teach you.”

The first night with her at home, she hid a lot. But in the middle of the night, I woke up hearing her crunching her dry food in the kitchen. It didn’t freak me out. I didn’t jump up to make sure there was no food on the floor. I just smiled and went back to sleep.

Taking care of Waddles showed me how wonderful it can be to be responsible for a creature that you love. Any worries were just part of the relationship.

I loved taking care of her, watching over her and making sure she had good food to eat. I loved trying to find fun toys for her and creating comfortable spaces around the house for her. I loved holding her and talking to her and just being with her.

And cleaning up after her didn’t trouble me like I had feared. It was part of taking care of her.

Loving her, and then my husband’s cats, Thunder Cat and Sam, broadened my views about animals, turning me into an advocate for them.

I am so thankful for her. I thank God for her every day, for the wonderful cat she was and for what she meant to me and did for me.

I am grieving now, and I will never “get over” the loss. But I would not have missed having her for anything.

My OCD looks like this

I want to tell you how obsessive-compulsive disorder has manifested in my life.

I go through periods when certain symptoms rear their ugly heads and I have to deal with them again. Then they change. But vestiges of all of them remain even as I grow older.

You may see yourself in this list. It still blows my mind that other people have had the same obsessions and compulsions that I have had. I used to think I was uniquely weird and wrong.

You will also see that the underlying anxiety in a lot of these symptoms is a need to get things right. Not perfect, but right. And only a feeling of rightness will alleviate the anxiety and the compulsive actions.

Here are some of the symptoms I have experienced at some point in my life since I was a little girl. There are more, but this is an overview to give you a picture of what my OCD looks like.

• Obsessed with sins I committed and the need for forgiveness from God. Along with that, obsessed about being “saved” in the fundamentalist Christian way. Compulsively prayed over and over to be forgiven and saved, then doubted that I got the prayer right.
• Obsessed with germs that might be on me and with the chance that I could spread them to others and hurt them. Compulsively washed my hands until they were red and raw, not wanting to touch doorknobs, not wanting my lips to touch a fork or spoon that someone else had washed.
• Obsessed with counting. Compulsively counted the letters on signs, the steps on staircases, other objects, trying to make the count come out in threes.
• Obsessed with the cleanliness of bathrooms. Compulsively cleaned, taking hours sometimes to clean a small bathroom. I didn’t want anyone else to use my bathroom.
• Obsessed that I hadn’t read, with attention, the whole page in a book. Compulsively read and reread the page before I could turn to another page.
• Obsessed that I had hit someone with my car. Compulsively drove back and forth on the street, looking for a possible body.
• Obsessed that the stove was still on after cooking something. Compulsively turned the knobs on and off and stared at them, for hours, until I felt right about them being off.
• Obsessed with objects I saw lying on the ground that might harm someone else walking by. Compulsively picked up bent wires, sticks, paper clips, rocks, etc. as I walked along.
• Obsessed with responsibilities I had and the fear that I could cause harm if I didn’t do things right. Compulsively steered clear of responsibilities to others.
• Obsessed that I left the lights on in the closet or bathroom, that they might get too hot and cause a fire. Compulsively checked, staring at light bulbs and lampshades until I knew they were dark, not lit.

Does any of this sound familiar?

Welcome to my blog!

I am 48 years old and have been living with obsessive-compulsive disorder since I was a child. I was officially diagnosed when I was 27 and have run the gamut of medications for not only OCD, but anxiety and depression too. I’m under the care of a doctor for all three.

I live in a small town in Virginia with my husband and cats. I have degrees in English, and I work as a newspaper reporter for a weekly paper.

When I was first diagnosed with OCD, my doctor told me that I would probably be on medication the rest of my life, but the symptoms should become milder as I aged into my 40s.

My symptoms are nowhere near as bad as they were when I was first diagnosed. But I’m in my late 40s and still struggle daily with OCD.

I am currently going through a phase of checking, but I also have issues with germs, especially regarding bathrooms. I obsess about things I may or may not have done that could cause harm to others. I still try to assuage my anxiety with certain repeated words and prayers.

OCD is exhausting, as I am sure anyone who suffers with it knows. But the older I get, the more demoralized with OCD I become. I wonder what my life would have been like without it. I think about what I may have accomplished if I hadn’t had OCD, or if I had not allowed OCD to affect my life so much.

I have never talked a lot to others about my OCD, at least not specifically. With this blog, I hope to finally be truthful about the effects of OCD on me and on those around me.

I also want to use this blog to consider the questions I ask myself about OCD. I hope by writing and especially by receiving comments from you, I will gain some understanding.

I plan to write about my past and my present struggles and triumphs with OCD, anxiety and depression. I will share news I learn about the conditions.

My posts will include references to my husband, who is supportive of me even though he doesn’t fully grasp the frenzies I experience when I am deeply into an OCD episode. He has seen me at my worst and still loves me.

My cats will also be present in my posts. They have been instrumental in making my OCD, and my life, better, and they are very dear to me.

My plans are to write three times a week, on Monday, Wednesday and Friday.

I am not an expert on OCD, depression or anxiety. I just know what it’s like to suffer from them. I urge you to seek the help of doctors if you suffer symptoms of these conditions.

I hope you will comment, because I definitely want to hear from you. I ask that you not use insulting or vulgar language.

So here I go! I hope you enjoy the blog and will share your insights.