She called me high functioning: My first visit to a psychiatrist

Dear readers,

This is a very small excerpt from the book that I’m writing about my experiences with OCD and depression. It’s the story about my first visit to see my first psychiatrist when I was 26 years old.

I’d like you to read this not just to find out about that experience, but to also give me some feedback on how you think this would fit into a memoir. What would you like to learn more about? What needs to be fleshed out or clarified? Are you interested in reading more?

And please share your experiences as you feel comfortable. If you’ve been treated by a therapist or psychiatrist, what was that first visit like? If you were diagnosed with a mental illness, how did the diagnosis make you feel?

I always appreciate your comments and feedback. Thank you!

She called me high functioning.

What the psychiatrist actually said was something like, “I would consider you high functioning since you have managed to stay in school and do your work.”



Me at 26.



High functioning seemed to be more than generous, because I certainly didn’t think of myself that way.

I spent countless hours cleaning my small bathroom. If I cooked or even just cleaned the top of the stove, I spent several hours checking to make sure the stove was turned off. Any cooking, whether it was on the stove or in the microwave, produced repeated and careful washing of the countertops. My hands and wrists were red and chapped from my repeated washings to rid myself of any germs that might hurt others. I couldn’t walk up a sidewalk or path without starring at the ground, looking for sharp sticks or rocks that could possibly harm someone. My mind was full of prayers and chants to a God I couldn’t really talk to.

I didn’t consider myself to be high functioning.

I had never been to a psychiatrist’s office before. I was 26, and after a year of talk therapy, the psychologist had decided that my depression was not going away and I probably needed some medication.

I had also revealed to her my obsessive-compulsive disorder symptoms. That surprised her.

“All the time we’ve been talking, and you never mentioned it,” she said. “I would have never known.”

So perhaps to her, too, I was high functioning.

When I arrived at the psychiatrist’s office, which was located in a town north of the town I was living in while attending graduate school in northwest Ohio, I wasn’t sure what to expect.

Would I lie down on a couch? Would she ask me questions about my childhood that I wouldn’t want to answer? Would she judge everything I said through the lens of Freud?

I admit that I was glad her office was not in the same town that I lived in. I desperately wanted to keep this visit secret.

The waiting room looked like all the other doctors’ waiting rooms I had been it. Muted greens and blues. Semi-comfortable vinyl-covered furniture. Magazines.

I was embarrassed as I stood at the counter in the waiting room and paid for my visit. What was the receptionist thinking? That I was crazy? That something must be scarily wrong with me because I had an appointment with her boss, who was a head doctor?

When the psychiatrist called me back to her office, she had me sit down in a chair, directly across from where she sat behind her desk. There was a window behind her desk, shining light on me.

She then started with the business of the visit. She asked me a lot of questions, questions I’ve since been asked many times by any new counselor or psychiatrist.

Why are you here today? What problems are you having? Are you sleeping too little or too much? What are you eating habits? Do you get pleasure from daily activities? Do you feel hopeless? Have you ever considered suicide?

For the OCD, the questions were along the lines of, what do you obsess about? What kinds of things are you doing compulsively? How do they interfere with your life?

It was more like a job interview than a doctor’s visit.

Eventually, she diagnosed me with depression and OCD. I wasn’t surprised by what she said. I certainly felt hopeless, suicidal and dead inside. And I had read enough to know that my bizarre habits indicated I had OCD.

But hearing her say the words, officially diagnosing me, was an experience that I would now call life changing. Before, I could simply hypothesize that I had these disorders, especially the OCD. I could always imagine that I really didn’t have OCD. I was just a sinful, bad and weird person who wasted time, water and money, all in the name of my strange habits.

With the diagnosis, I had a stamp of officialdom on my habits. They were weird, yes, and wasteful, yes. But they were also symptoms of a disease, albeit a disease I felt humiliated for having.

The psychiatrist talked about a new drug that had just been approved by the FDA called Anafranil. It was the first medication that targeted OCD specifically. She had seen it used in drug trials, had seen its effectiveness.

But it had just been FDA-approved in December, and this was January. It wasn’t yet available to the general population, she said.

So she prescribed Prozac. It would help the depression, and it might help with the OCD. Time would tell.

I walked out of her office with some hope of help. But I also walked out with self-consciousness and a sense of shame.

Time to rethink this

I have an appointment with my psychiatrist on Friday, just a regular appointment. But I have a lot to discuss with him.

Some of you have shared your experiences with OCD on this blog, and we have found how many connections we have in the way the disorder affects us and manifests itself.

You have talked about cognitive behavioral therapy and exposure and response prevention therapy, and the successes that you have shared have me rethinking my own treatment plan.

I have been seeing my current psychiatrist for nearly two and a half years. Prior to that, it had been many years since I saw a psychiatrist. I relied on my family doctor to treat my depression and OCD.

Depression was my biggest concern. I feared it. I was haunted by the reality that even with medication, it could return.

My OCD was, I thought, less of an issue. If the antidepressant I was on happened to help the OCD, then that was fine. Otherwise, I thought I could handle the symptoms of OCD on my own. I thought getting older and wiser about the disorder had made it less of a threat and more of a nuisance.

About four years ago, I seemed to slide into a period of depression that was the worst I’d had for a while. I was on medication at the time and had been since I was 27. I sought help from my family doctor.

My doctor said he thought I might be bipolar, and started me on different medications. I really can’t remember if the new symptoms started before or during the time my doctor tried different drug combinations with me. I can’t say for sure if some of the medications I was on exacerbated certain tendencies towards anxiety.

I do know that I thought I was going to lose my mind.

I had taken a new job in a city an hour’s drive away. I started dreading the drive more and more. I felt like I didn’t have complete control over my driving and feared having a wreck.

I felt afraid. I didn’t know what I was afraid of. I remember lying in bed at night whispering to myself, I’m so afraid.

I was extremely tense and anxious. It was hard to focus and settle down on anything—hard to read, to work on the computer, hard to write out a sentence by hand, to keep my mind on any one thing.

I felt like I was watching what was going on around me, not participating in it.

I reached the point where I was too afraid to keep driving to and from work and quit my job to try to find something closer to my home. My husband did all the driving.

My doctor worked with me closely, and gradually the anxiety lessened enough to begin to feel comfortable driving again and go about daily activities. But I still didn’t feel on track.

A close friend urged me to see a psychiatrist. She even recommended one that she had met socially. I appreciated her concerns, but I didn’t think I needed a specialist, and I thought she was probably understandably biased towards psychiatrists because her father was one.

My family doctor had suggested it too. He said I might need to be on lithium, and he would want a specialist to do that. I resisted.

Finally, though, I realized that I needed help that maybe a specialist would know how to give me. My family doctor recommended a psychiatrist, and it was the same one my friend had urged me to see.

It was the best choice I could have made.

When I first met with the psychiatrist, he asked me a lot of questions, of course, including what medications I had been on. I couldn’t even remember all the ones I’d been on through the years. He had to name different ones, which jogged my memory.

As he took notes, he shook his head every now and then and said I should have never been on some of the meds.

He said he saw no signs at all that I was bipolar.

I was relieved, but also upset because I had been treated for nearly 18 months for a disease that I did not have.

He diagnosed me with depression and OCD—no surprise there. But he also diagnosed me with general anxiety disorder.

He made changes in my medications and, most importantly, gave me hope. He said I would start feeling better in a few weeks and a lot better in about 12 weeks.

And he was right.

It took a while to get the medications well balanced. In addition to the medication therapy, he offered insight and advice on dealing with my disorders in other ways.

My OCD started becoming an issue again, and he suggested setting me up with a therapist for cognitive behavioral therapy.

I told him no. I felt like I had had enough therapy over the years, and I just didn’t want to take the time or spend the money to do it.

However, I’m going to reevaluate my response and discuss my options with him Friday. I don’t want to be resistant again to change that I might need.

I’ll tell you what he says.

Treatment, Part Two

I was almost 27 the first time I saw a psychiatrist. I had been in talk therapy for a year, which I wrote about in my last post, and I had gained a lot of understanding about how my thought patterns and my reactions to the things I had experienced in life were affecting the quality of my life.

But I was still deeply depressed, and my sense of hopelessness and the almost continuous OCD rituals I performed made me decide many times that I didn’t want to live anymore.

Some sense of hope kept me going, some belief that help was available somewhere.

My talk therapist referred me to a psychiatrist and I went to see her with some trepidation.

At our first session, she asked me a lot of questions. Some were hard to answer, because I had never said aloud some of the things that I told her: the obsessions I had that no one else seemed to have and the compulsions I acted out that I figured she must think were ridiculous.

She didn’t seem surprised by anything I said. After I had answered all her questions, she told me I was clinically depressed and had obsessive-compulsive disorder.

I can’t say I was surprised. I knew I was depressed, and I had known for years that I had OCD. But hearing her words, her diagnosis, made it real.

The doctor told me about a drug that had received final approval from the FDA just the month before. It was Anafranil, the first medication that could be prescribed specifically for OCD. It was a tricyclic antidepressant.

She had seen the drug at work during clinical trials, and she believed it would help both of my problems.

But Anafranil wasn’t yet available in pharmacies. So she started me on Prozac, saying it would help with the depression and possibly the OCD.

At home, before I took the first pill, I sat down on my couch with the medicine bottle in my hand and cried. I felt ashamed that I had to rely on a pill to make me feel better. I felt like I now carried a label that no one else I knew carried.

It was a new road to walk on, and I was afraid. But I took the pill.

My next appointment with the psychiatrist was two or three weeks later. I had a vague sense that I was feeling better, but I didn’t feel as much hope about the Prozac as I did about the Anafranil. Since that medication was meant to treat OCD, I thought it would be my better chance at getting better.

My doctor didn’t think it would be in pharmacies yet, but she picked up her phone and called the pharmacy I used. It had Anafranil in stock. She wrote me a prescription.

I was the first person for whom she prescribed Anafranil, she told me.

I stopped the Prozac and started the Anafranil. About three months went by. I continued to see the psychiatrist and my talk therapist. I experienced some relief from my OCD symptoms, but the difference the medication was making became crystal clear one spring day.

I was out on my little patio outside my apartment.

Picture a woman with OCD, with intense issues about germs and dirt, putting her hands in soil and on a plant, putting the plant into a non-sterile flowerpot to then take into the apartment.

And the woman is humming.

That’s what I was doing. When I realized that I was focused on my task, not worrying about anything, feeling content, I knew the medication was helping me.

Please know that I am in no way saying that Anafranil and Prozac are suitable or not suitable for anyone else. I don’t take either drug now.

But at that time, Anafranil helped me more than I could have ever imagined a medication could.

A lot of years with a lot of treatment plans have gone by since then. As time goes on, I will write more about that.

How did you feel the first time you received treatment of any kind for your OCD and/or depression?