Saturday, June 30, 2007

A Neurobiological Disorder

The OCD Workbook by Hyman and Pedrick indicates that obsessive compulsive disorder is a neurobiological disorder. This definition jives with my psychiatrist's stance that OCD is organic in nature and, most likely, inherited.

The theory that OCD is inherited can be no better proven than to sit at my Mom's and Dad's dining room table during a mealtime chat. My Mom is a checker (like me) and my youngest brother is a checker (like me) and a hoarder (not like me). OK! OK! My Mom says that I'm a hoarder, too, but I disagree. Unlike my brother, I really do need all of the junk I collect. Just kidding!

My brother is 12 years younger than I am which puts him at 23 years of age right now. Like me, he is also an he has that working against mean going for him. He purchased a house a few months ago and Mom is pressuring him to move all of his hoarded belongings to his new home. If the move ever actually occurs, I think it may require several moving vans. My brother still has every toy, trading card, screw and fastener that he ever owned at any one time in his life. He has even purchased bags of smashed model car parts to store with his other toys and gadgets.

My family teases him a little about clutching all of these trinkets, but I feel sorry for him as well. I've finally entered a time in my life where I'm trying to unload some baggage (that at one time made me feel secure) and I hope he will be able to do the same in the future.

As far as inherited traits are concerned, this past week I found an uncanny resemblance in my family's obsession with checking locks. I had never personally witnessed my brother or my mother checking locks, but I'll be buggered if they don't report almost the same lock checking litany that I have performed in the past.

In my immediate family, I am the only one who has sought therapy. I am encouraging my family to encourage my brother to seek professional help now before his OCD becomes something worse than a nuisance.

Tuesday, June 19, 2007

OCD and Intrusive Thoughts

A less well-known symptom of OCD is the phenomenon that my psychiatrist calls "intrusive thoughts". In my own words, intrusive thoughts are uninvited disturbing thoughts that pop into one's brain and are difficult to get out. My intrusive thoughts were/are so disturbing that I did not divulge them to any of my therapists until I read that this could actually be a symptom of my OCD. I feared that if I told anyone about these thoughts that I would be locked away in a hospital or would have my child taken away.

My most disturbing thoughts were extremely painful and I felt very victimized by them. One of my therapists told me that I really was a victim of sorts. He also reassured me of my sanity by telling me that these thoughts had nothing to do with ME or my wishes and desires.

My most disturbing reoccurring intrusive thoughts are as follows:

  1. Knives - My husband and I loved to cook and we had an assortment of fancy knives. One day while I was washing one by hand, I could see in my mind the knife stabbing into a loved one as if drawn to their flesh like a magnet. My loved one would look down at the wound and then up at me with a look of "Now, why did you do that?" I never had any desire to stab someone or hurt anyone in anyway (even when my mother-in-law would stand in the kitchen and talk to me for hours at a time). Thereafter, the dreadful thought would reoccur whenever I touched a knife. I began to loath the thought of using or touching a knife at all.
  2. When my son was born, I began to have intrusive thoughts whenever he would cry. His cries would bring about thoughts of him being tortured and me being forced to listen to it either in person or on a tape recorder. These thoughts made me nauseous and upset to the point that I wanted to cut out the portion of my brain thinking these thoughts. (Yes, I realize that I just wrote "cut" (as in knife) but that is the only way I can describe it other than saying sever or slice.) The most curious thing about these thoughts is that I could feel disgust and relief at the same time. I was discus ted by the images and also relieved that my son was in my arms being protected and not being tortured.
  3. As a 12-13 year old I began having disturbing thoughts about sex. When at church, I would have thoughts about having sex with my priest. When at my grandparents house, I would have thoughts about having sex with my grandfather. (Needless to say, I desired neither.) These thoughts caused me great embarrassment and dismay. I often felt that others could hear my thoughts and, therefore, they knew that I was a sick and twisted pervert. I'm not sure if these thoughts are really OCD related or just puberty related.

I am happy to report that I have found a way to manage my intrusive thoughts. My therapist told me to think of something else in order to distract me. (He originally told me to think about a sexual fantasy, but I really thought that thinking about a sexual fantasy while holding my child was inappropriate.) Whenever I had thoughts about my child being tortured, I would think about people in my life that needed prayers and healing. I started thinking about other people's pain and problems instead of my own and that helped immensely coupled with the medication that helps me to stop my unending thinking patterns.

Friday, June 15, 2007

OCD and Due Diligence

I'm an engineer by training and, therefore, I'm well aware for the need for due diligence when making decisions and completing projects. My OCD, however, was causing me to take due diligence to an extreme. Rather than completing a satisfactory search for codes and design information I would perform an unending amount research. These checks and rechecks began to degrade my efficiency as well as my quality of life.

One weapon that I developed during cognitive therapy was to determine what a "normal" amount of checking would be and then adhere to the norm. One day my therapist asked, "When normal people write a letter, how often do you think they re-read it for edits?"

I was somewhat put-off by the term "normal people". In actuality, I would check a letter and then recheck a letter more than once, even if I never found anything to edit in the first place. I answered with, "I don't know what "normal people" do. Maybe they will check once?"

I now strive to fulfill the norm, but I still catch myself re-reading twice or more sometimes. I find that I am most successful (in terms of cutting down the number of rechecks) when paying very close attention during my first edit. If I expend a lot of effort and attention on the first check, my brain seems to be satisfied enough with that effort that I will not give into the temptation to read and re-read again.

Tuesday, June 12, 2007

Morphing Obsessions and Getting Needed Help

Even though OCD can be nauseatingly repetitive, it can also throw a few curve balls. The obsessions and compulsions are somewhat akin to mutating viruses...once the original virus/obsession becomes manageable it will morph into something completely new.

In my last post, I covered in depth the ritual I developed with checking locks and alarm clocks. Over the years, these obsessions and compulsions changed to include checking my parking brake, reopening and checking sealed letters, reopening and checking e-mails, checking to make sure that I hadn't run over someone with my car, going over past conversations to make sure that I hadn't said anything offensive, mentally repeating phrases, obsessing about events and decisions at work, the list goes on and on. I won't even go into intrusive thoughts at this time.

I was able to live with these things, even though I didn't know that my problem was OCD at the time. Eventually, however, my obsessions and compulsions became so pronounced and disturbing that they took over my life. I stopped eating and sleeping and ceased to function in a normal sense. At that point, I finally decided to seek help from a professional.

My first therapist visits were free through a corporate mental health program. This therapist felt that I had generalized anxiety and panic issues. He felt that in my case, medication would be helpful and pointed me toward a psychiatrist. My psychiatrist indicated that I had OCD and finally the pieces of my jigsaw life began to fall into place.

My medication (Paxil at the time) and cognitive therapy did wonders to help me learn to manage my issues. I will go into both medication and cognitive therapy in future posts.

I want to end with this post with two of the many important things that I learned about OCD from my psychiatrist.

1. OCD is like pressurized water that will seek out a crack (stress or anxiety) and leak through.

2. Traditional anxiety and depression medications (Paxil, Zoloft, Prozac) can and will be used to treat OCD, but often in higher dosages.

And now...the moral of the story: If you feel that you may have OCD, please seek professional help even if it is not causing unmanageable distress. Tame the cat when it is still a kitten and before it becomes a full-grown lion.

Monday, June 11, 2007

Back In The Day and Feeding Your OCD

OCD is sometimes called the "Doubter's Disorder" or "The Doubter's Disease". These phrases seem to sum up both the cause (in part) and the effects of OCD.

As a young person (and as an adult), I was riddled with self-doubt. I had very few friends and my self-esteem and self-confidence were very low. Once I became old enough for important responsibility my basement low self-confidence would bar me from ever believing I could perform a task without error. I had to do and redo simple tasks such as locking the front door or setting my alarm clock in order to convince myself that I had done them correctly. When my Mom noticed me doing these things she would say "Just don't do it anymore!" Why not! Shouldn't not relocking a door or not resetting an alarm clock be easy? I guess for normal people, it is.

For instance, this sadly humorous account of a bedtime ritual speaks for doubter's everywhere:

10:30 PM Arrive home late from play practice.

10:31 PM Lock the front door.

10:35 PM Go upstairs and get ready for bed.

11:00 PM Lay in bed and wonder if the door is really locked.

11:02 PM Go back downstairs and check to see if the door is locked.

11:03 PM See that the door is locked and proceed back upstairs to bed.

11:10 PM Lay in bed and worry that I really just unlocked the door when I checked the door the first time.

11:20 PM Proceed back downstairs to double check that the door is locked.

11:21 PM Unlock the door. Relock the door. Step back from the door and see that the door is locked.

11:23 PM Proceed back upstairs to bed.

11:30 PM Lay in bed and worry that the lock didn't entirely engage when I locked it the last time. Curse myself. Laugh a little at my weirdness.

11:35 PM Proceed back downstairs to triple check the door to make sure that it is locked.

11:36 PM Bend down and look that lock square in the eye. Check the space between the door and the frame to make sure that the bolt part of the lock engaged fully. Lock and relock the door a few more times watching the bolt traverse the space between the door and the door frame. Step back from the door, stand up and say "The door is now locked."

11:40 PM Go back upstairs to go to sleep.

11:45 PM Lay in bed and wonder if my alarm clock is set.......

You get the picture, right?

There are some parts to this scenario and the wiring of the human brain that make the above a very vicious circle.

1. Ever, ever, ever finding the door to be unlocked on a recheck became proof that the compulsion/ritual was required to make sure that the door would be locked at night.

2. Finding the door locked was always pleasing and my brain then gave me a little endorphin shot that my body became dependent on.

3. Either way...I was screwed.

OCD On A Stick: The Beginning

The National Institute of Mental Health reports that nearly 1% of Americans have some sort of Obsessive Compulsive Disorder (OCD). I always knew that I was special in some way.

I was diagnosed as having OCD (primarily an anxiety disorder) in my 20's, but I began exhibiting symptoms in my teens. Unlike the extremely sexy compulsions that we see on TV (obsessive counting and cleaning), I have more subtle symptoms like checking locks, checking clocks, and intrusive thoughts.

As harmless as these compulsions seem, OCD can be debilitating in the extreme if not managed properly and/or medicated correctly. It is even helpful for the sufferer if (on a good day) he or she can step back and have a good laugh at the worries and the ticks.

The course of these posts will be aimed at exposing the disorder, sharing what I have learned in terms of managing the disorder and also logging my progress and setbacks. I hope to have some feedback from my fellow sufferers (and others) so that we can all learn and grow together. Last, but not least, let's laugh at ourselves and those darned intrusive thoughts and compulsions.