Monthly Archives: June 2012

Wednesday Wishes: Number Four

Have you ever read one of those “Ten things your guy wished you knew” or “Ten things your mother-in-law would never tell you but thinks you should know” (though in many cases—unfortunately for you, there’s nothing your mother in law wouldn’t tell you). Well I wanted to create a lists of things that those of us who struggle with mental illness wished the rest of the world knew—and hopefully get insight from my support team about what they wish I knew!

Number Four: When I’m depressed or stressed, don’t tell me “It’s not that bad”.  First, it truly feels that bad to me. Second, I might recognize it can be worse—but there’s nothing I can do about feeling really low or anxious. That’s why it’s called an illness—the feelings are a result of my “broken” brain—not the external circumstances.

Just a personal opinion (as if this entire blog is not that!)—I don’t think you should use this phrase on anyone. I’ve never seen it fix anything, and normally just makes the person defensive. Try to relate to their feeling—not the situation.

Disclaimer: Not all of these thought will reflect all people, in the same way not all “Ten things your guy wished you knew” would relate to my husband—some will not even relate to me. They are thoughts/concerns/opinions I’ve heard when talking with fellow adventurers along the journey that is mental illness.

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My Personal OCD

Disclaimer: I would rate this post as PG-13

If I defined my relationship with OCD on facebook, the status would most definitely be “It’s complicated”. On one hand, it is the most manageable part of my mental illness. The medication prevents majority of the thoughts and the techniques I’ve learned manage the ones medication does not prevent. On the other hand, it can be the scariest and most disturbing part of my mental illness.

My struggle with OCD began at a very young age. I had several hamsters when I was younger. In true Nicole fashion, I liked the dwarf hamsters (the under dogs) and named them adorable things like Precious. I remember checking my hamster’s cage to make sure he had water several times before I would go to bed.  Then I’d lay awake waiting for my parents to go to sleep so I could get up and check it again. While lying in bed, all I could see was my poor hamster lying dead in his cage from dehydration.

I remember having disturbing thoughts of cutting myself as early as the age of 10. I have very vivid memories of thinking of cutting my legs, but more often my female parts. I never understood why I was cutting these parts, but now I’ve learned that this is “normal” since most OCD obsessions relate to violence and sexual perversion. The thoughts would appear without warning and plague me throughout the day. Even at night I could not escape them, as I would dream about harming myself.

As I got older and learned more about sexual acts and self-harm, the thoughts became more graphic and more frequent. [Side Note: The increase in frequency is a typical pattern of untreated OCD]. I told myself I was simply hearing voices—it was like the imaginary friend I had when I was younger. Except this friend was mean to me! Hearing voices is not particularly comforting, but it’s definitely more comforting than believing the horrible thoughts were my own.

I then started obsessing that I had been molested when I was younger—it got to the point that I had to quit volunteering with the church youth program because being around young children caused significant amounts of stress and anxiety. As the thoughts became more frequent I started avoiding certain people and situations that triggered the thoughts, or I believed had taken part in the abuse. While it would have been a great excuse if the situations were things like cleaning the bathroom or doing homework. But they weren’t. It was spending time with certain family and friends.

The thoughts continued to plague me. While on a road trip in college, hoping to restore the memory of the abuse, I   took a detour to South Carolina to see if I could find the house that I lived in when I was younger. Which if you know me is completely hilarious because sometimes I can’t even find my apartment now, let alone have a sense of direction for a house 15 years ago. I realized that, but the irrationality of the OCD thoughts had taken over.

I started to question if I was turned on when I taught young children swimming lessons, or took the Sunday school children to the bathroom.  Was I going to hurt one of them? Otherwise why would I be thinking these thoughts?!

I researched “repressed memories” and tried several techniques to bring those memories to life, hoping that remembering them would allow me to treat them—but I couldn’t because those memories did not exist. I was never abused.

It took me over a year of therapy to finally discuss the issue with Rick; by that time I had done enough research on OCD to know the thoughts were obsessions and not true. I bribed myself with slushies for a week before I finally brought it up. But his response was perfect; “First I’ll tell you what we’re not going to do—we’re not going to go back looking for memories that don’t exist.  What we are going to do is teach you how to handle/manage your OCD so it stops controlling your life.” I’ll discuss these techniques in a later post, but it was these sessions that finally freed me from the control of obsessions.

Opening up about my OCD is the scariest part of my illness. It makes me afraid that people will not want me around them or their children. Then I’ll have to turn into a crazy cat lady, and I don’t like cats nearly enough for that! I think it’s the one of the hardest mental illnesses to understand. After all, people without mental illness have feelings of intense sadness and stress, so on some level they can relate to depression and anxiety. But obsessions and compulsions are foreign to those who do not experience them.

Maybe at a later date I’ll share some of my journals when I was struggling with dark OCD thoughts…but the goal of this post was to provide an overview of my OCD experience.

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The way Einstein understands OCD

Part Two: The “academic” side of OCD

Earlier this week, I shared an experience I was having with OCD. That experience was relatively minor, and a bit humorous.  While annoying and intrusive, the experience was not disturbing.  Wanting white clean teeth is a normal feeling and desire that many people have—the difference is that no matter how hard I try, I’m just not able to let it go.

In this post I want to go into a bit more detail about the disease that affects 1.6% of American Adults: the symptoms, the diagnosis, medication, and  the research surrounding it.

Question One: So, what is OCD?

“Obsessions intrude suddenly into your mind and are unwanted, inappropriate, and distressing. Once an obsession occurs it captures your attention, and it is very difficult to think of anything else.  Even if you are able to distract yourself from the obsession, the relief is only momentary because obsession occur again and again. OCD obsessions refers to unwanted, unwelcome, recurring thoughts that happen against your will and that are about unpleasant topics.”
Source: Overcoming Obsessive Thoughts : Christine Purdon and David Clark

Question Two: And in English that means?

An average human tends to produce over 25,000 thoughts a day. It’s a bit like a slot machine. The numbers, signs, and symbols are constantly running through the machine, and then by an outside force (pulling the lever in this case) the numbers stop. Let’s say one symbol is an ax—the chemically balanced brain might see it and think “hm, I could hack the person next to me with that”.  Their next thought would likely be “that’s weird” and then they’d move on to spin the dial again.  An unbalanced brain could think the same initial thought, but the response is different. They are unable to spin the dial again. Instead, thoughts of harming someone with the ax continues to plague them. Then they might think, “Wow to think that must mean I have violent tendencies”, and they run from the machine in fear. Eventually they might start avoiding casinos all together to avoid having obsessive thoughts.

A compulsion is an act repeated in the exact same way every time in an effort to “neutralize” a disturbing obsession. A study found that 61 percent of their sample of individuals with OCD had checking compulsions, 50 percent had washing compulsions, 36 percent had counting rituals, 34 percent needed to ask or confess, 28 percent showed symmetry and precision behaviors, and 18 percent showed hoarding (Overcoming Obsessive Thoughts). Checking can include counting, checking/seeking reassurance from other that harm hasn’t occurred, or mental self-reassurance (ie: determining how well characteristics of known pedophiles to match your own characteristics).

Question Three: So I’m actually OCD when?

Like any mental illness, OCD is difficult to diagnosis because worries and anxieties are a normal and expected part of life.  However, OCD obsessions are more extreme than “normal” experiences. The American Psychiatric Association publishes the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) that is used by mental health professionals to diagnose mental illnesses. To be diagnoses with OCD:

  • You must have either obsessions or compulsions.
  • You must realize that your obsessions and compulsions are excessive or unreasonable.
  • Obsessions and compulsions significantly interfere with your daily routine.

Your obsessions must meet these specific criteria:

  • Recurrent and persistent thoughts, impulses or images are intrusive and cause distress.
  • The thoughts aren’t simply excessive worries about real problems in your life.
  • You try to ignore or suppress these thoughts, images or impulses.
  • You know that these thoughts, images and impulses are a product of your own mind.

Compulsions must meet these specific criteria:

  • Repetitive behavior that you feel driven to perform, such as hand washing, or repetitive mental acts, such as counting silently.
  • These behaviors or mental acts are meant to prevent or reduce distress about unrealistic obsessions.

Basically obsessions are having thoughts that are intrusive, unwanted, uncontrollable, uncharacteristic, and you are trying hard to resist them. The compulsions are acts you feel an urge to perform are intended cope with negative feelings or consequences. They are intentional, repetitive, excessive and make you feel a loss of control.

Source: Mayoclinic.com .

Question Four: So, my treatment options are?

The first drug class of choice tends to be SSRIs, such as Lexapro, Prozac, and Paxil. If that doesn’t work, another type of antidepressant called a tricyclic antidepressant such as Clomipramine, are available. These drugs are likely to have more side effects than SSRIs.

A combination of the two can also be prescribed. Like any mental illness, therapy (in combination with these medications) such as cognitive behavior therapy can be extremely effective. A licensed practitioner will likely employ some type of Exposure and Response Prevention. This treatment involves slowly exposing the individual to the distressing thought, and working on adapting the mental response to the external event. For example, if you struggle with thoughts on hitting people—you might work on patting someone on the back and identifying the false thoughts that you are a violent person.

These treatments can be very effective at managing the distress and intrusiveness caused by OCD. However, the longer it goes untreated the more disruptive to the individual’s life it can become. I’ll explore how this was the case for me in the next section.

For more good information on treatment, and OCD in general, visit: http://www.ocfoundation.org/index.aspx

Question Five: What are some examples?

I shared a less serious example of a OCD experience in the last post. However, obsessions are more often about more disturbing topics such as harming self or others, thoughts or urges of sexual acts you find personally disgusting, or blasphemous thoughts and actions.  The following two examples are from Overcoming Obsessive Thoughts:

Mario is a forty-three-year-old financial planner with two teenage daughters and a solid marriage that has just celebrated its twenty-second anniversary. He is a conscientious and hardworking university graduate who volunteers for a number of worth community causes, is well-like by neighbors and friends, and is admired for his determination and well-balanced approach to work, family, and community. And yet, Mario’s day is filled with unwanted thoughts of violence and aggression toward others; thoughts of kicking a pregnant woman who passes him on the street, of punching a colleague in the mouth for no apparent reason, or lunging toward his wife with the knife he is using to cut up vegetables. These unexpected and unwanted intrusive thoughts are extremely upsetting for Mario because they are totally against his character. After all, he is a fine, outstanding family man with strong moral values who is polite and gentle toward others. But here he is, plagued by violent and repulsive thoughts and images.

Cara is a twenty-four-year old mother of a four-year-old boy. She is a proud, loving parent who wants to provide the very best for her son. But shortly after arriving home with the infant, Cara, began having thoughts or doubts about whether she might sexually abuse the child. While changing her diaper or bathing her, she wondered if she felt sexually aroused. This doubt became so frequent and troubling that she avoided bathing or changing her daughter and relied on her husband or visiting friends to do so. Her days were fraught with high anxiety and fear.

Conclusions….

Hopefully, this gives you a bit of background about OCD…I eased you into OCD with the light post….a more academic understanding…and more intense one is to come…..

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Wednesday Wishes…number three

Have you ever read one of those “Ten things your guy wished you knew” or “Ten things your mother-in-law would never tell you but thinks you should know” (though in many cases—unfortunately for you, there’s nothing your mother in law wouldn’t tell you).  Well I wanted to create a lists of things that those of us who struggle with mental illness wished the rest of the world knew—and hopefully get insight from my support team about what they wish I knew! 

Number Three: I don’t expect you to understand what I’m going through, nor do I want you to.  No one should have to understand the constant feelings of anxiety, depression, or mood swings. But I need to know you believe its REAL. That you don’t think I’m weak, or lazy, or unwilling to change.  I need you to acknowledge that I am sick; that I have an illness; that you are here for me.

Disclaimer: Not all of these thought will reflect all people, in the same way not all “Ten things your guy wished you knew” would relate to my husband—some will not even relate to me.  They are thoughts/concerns/opinions I’ve heard when talking with fellow adventurers along the journey that is mental illness.

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It’s not that I’m so smart, it’s just that I stay with problems longer.
~ Albert Einstein

Now I’m no Einstein….but I have been able to learn the techniques to managing my mental illness.  But it is definitely true that diligence and determination go much farther in staying healthy than intelligence.

There’s hope even with a low IQ!

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Daily flossing can add up to 6.4 years to your life….

After today, I’m going to live forever.

I’ve flossed over 100 times in the last 2 hours.  Literally, I lost track at a 100.

What? I’m sure you’re scratching your head in confusion. Well, a few posts ago I talked about walking the balance of pretending things are ok and letting people know I’m struggling.  In the vein of trying to open up more, I thought I’d share an OCD struggle I’m having right now.

I went to the dentist this morning, and they asked if I was a coffee drinker because there was a small stain on one of my front teeth. I’m not. So they said, “oh no big deal, just make sure you floss in the C-pattern and it will go away”.  I’m sure anyone with OCD knows where this story is going.

Well one area I’ve always struggled with OCD is germs.  I think about them all the time.  My grandma once told my husband that I used to wash my hands until they were red and chapped when I was younger. Flying in airplanes is terrible for me.  I’m not scared of heights (my dad is a pilot), but instead I’m constantly picturing the germs I’m being exposed to and can literally feel them running all over my body (ok not literally, but it sure feels that way).

I’ve been obsessing about flossing since the appointment. Since I don’t drink coffee the stain must be germs taking over my mouth. And thanks to those tramatizing cartoons they showed me when I was younger (see example below) I have a very detailed image of what they look like. So,from the minute they mentioned it, my fingers have been itching to touch some floss. However, I know it’s not good for me to over floss.  So instead I’m sitting at my desk mentally flossing.  And not just thinking about flossing, but literally moving through my head and flossing around each tooth, paying particular attention to the one with the stain.  And when I finish, moving back to the beginning and doing it all again.

I’m obsessing about it so much that I can’t focus on work. I’m hard at work (hardly working really) on writing a training plan and all I can see in my head is an image of the spot where they told me had a small stain. And then starts the flossing….

I can’t remember any of my techniques for dealing with OCD right now because I’m so completely focused on the tooth with the stain….and flossing to remove it.

I have a card with my OCD tool set on it—but it’s sitting at home somewhere in the dungeons of my desk because I have not needed it in a while.  I’ll have to go home at lunch to find it; the time it will take to do that will be made up for in an increase in productivity in the afternoon.  I hope.

Now…back to adding years to my life

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Is being politically correct overrated?!

Note: This is not an angry rant post—read with a sense of humor, smile, and a laugh!  That’s the way it was intended.

Now onward….

I’ve always wanted to write a Top Ten list of Stupid S*** people say about mental illness.  It’d probably end up being longer though since I’ve heard so many.  But recently I’ve stopped noticing these types of things as much and been more surprised by the completely ignorant comments people make in passing.  That probably reads harsher than I mean it (I’m smiling as I type this), but there’s really no other word for it.  I’ve listed some of those comments in italics below, with my thoughts on why they are just totally inappropriate.

I’ve been so distracted today.  I’m just so ADD.
First, I know for a fact that you’re not.  Second, you’ve been running between a bunch of different projects which can definitely be exhausting or frustrating—but you’re a really successful employee who normally is pretty focused (I know—I’ve had to work with you!).  Third, are your levels of glutamate off balance (along with several other neurotransmitters)?

I had a panic attack this morning—I couldn’t find my car keys and I had looked everywhere.
I have a medically diagnosed panic disorder and I’ve spent more time looking for my keys than probably any other activity in my life (with the exception of maybe sleep!) and it has never caused a full blown panic attack. Now this did come from one of the most organized people I know, so I’m not discounting that she was probably pretty rattled. Because of their normal personality they likely even had one common symptom of a panic attack—feeling out of touch with reality!  However, they didn’t feel out of their body, short of breath, have chills and shakes, and an intense terror of some unknown.

It’s easy like therapy.  We just let them talk a lot, about the same thing week after week, and smile and nod a lot.
Therapy is exhausting! It’s a lot of work! And it’s way too expensive to talk about the same thing week after week! And if I wanted someone to smile and nod—I’d buy a bobble doll.  Oh! Probably one of someone really cute like Matt Bomer.

I’m OCD—I re-organized my entire closet by color yesterday and it made me feel so much better.
Awesome!  Want to come do mine tomorrow?  See I was so busy trying to convince myself not to go back into the bathroom to pick at my face for the fifth time in the last two hours, and having compulsive thoughts about cutting myself to even hang up my coat!           

I need to get my daughter a new roommate. I think hers is bipolar, and you can’t have a normal life living with a bipolar person!
No comments other than the comeback my mom could have given to her “yeah, my son-in-law is having a hard time with it too”.  Amazing!

To be honest, none of these comments actually offended me.  I was raised in a military household where being PC was highly overrated. I know I’ve made a few (or a lot) of my own non-PC comments and unknowingly offended some around me.  To them I apologize.  I didn’t mean to hurt you and it was out of ignorance not malice. But that’s no excuse.  My own condition has opened my eyes to how comments can affect those around me and that I never know who is listening. Hopefully, now that my eyes are opened I can be more careful and also find gentle non-offensive ways to help others understand how their flippant comments can be misunderstood.

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Wednesday Wishes….number two

So–I total fail on my part about posting to this collection.  Apparently there was nothing else I wanted the rest of the world to know…or too much to decide where to start.  But I’m hoping to do better this time….onto Number 2!

Have you ever read one of those “Ten things your guy wished you knew” or “Ten things your mother-in-law would never tell you but thinks you should know” (though in many cases—unfortunately for you, there’s nothing your mother in law wouldn’t tell you).  Well I wanted to create a lists of things that those of us who struggle with mental illness wished the rest of the world knew—and hopefully get insight from my support team about what they wish I knew! 

Number Two: I want to be able to tell you I want to die, wish I was hit by a bus crossing the street, and don’t believe life is worth living…and not be worried that you will put me on suicide watch.  I want you to understand there is a difference between wantingto die, and planning to die….

I am nervous about posting this one, because suicidal threats and talk of death should never be taken lightly. In some cases it is essential for family, friends, and healthcare professionals to recognize a suicidal intent or plan. Please do not think I’m discounting the seriousness of this issue.

But the point of this post refers to something different.  I know many fellow adventurers who would agree that there are many many times when they want to die and feel like life is pointless or not worth living. But they have no intention or plan of ending their life.  In fact, they are 100% certain they will not. In these moments, I want to be able to express my depression–but also know you are not secretly removing all dangerous items from my house.

Disclaimer: Not all of these thought will reflect all people, in the same way not all “Ten things your guy wished you knew” would relate to my husband—some will not even relate to me.  They are thoughts/concerns/opinions I’ve heard when talking with fellow adventurers along the journey that is mental illness.

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Rascal Flatts: Easy

Official music video of the Rascal Flatts song mentioned in the blog.

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How hard it is…to make it look so easy….

I’ve discovered a new favorite song.  Have you ever heard the song “Easy” by Rascal Flatts? Not only do they have amazing voices—the lyrics fit my feelings about my illness quite well.

It’s easy going out on Friday night
Easy every time I see her out
I can smile, live it up the way a single guy does
But what she, what she don’t know
Is how hard it is to make it look so easy”

Now—I realize this song applies to a breakup.  I can only wish that I had broken up with my illness (I’ve tried, but it just won’t accept it.  Restraining orders don’t work either—believe me, I’ve tried).

Anyways to the point–how it reminds me of my illness.  Until you get to know me really well, my disorder is often not visible. I make it look like I’m ok. I go out with friends to the bar, watch movies, make jokes, dance (not well or to the beat but dance none the less), and play games.  I’m often even the “life of the party”.  I make it look ‘so easy’.

And you’ll never know just how hard it is for me to make it look so easy.

It’s a balance I’m struggling to find. How much do I pretend? And when do I share how hard it is?

The case for pretending: One, I want people to think I’m normal (but really, who am I fooling? I doubt I’d be normal even without my disorder). Two, I don’t want to burden those around me. And three, alot of times I don’t know if they could do anything to make it better, so why share?

The case for sharing: One: those who care about me want to be involved in my life. Do I have the right to make that choice for them? Two: How can I fight the stigma of mental illness if I hide my experiences?

And three, most complicated of all, sometimes I fear that if I pretend so well and for so long, people won’t believe my disease is real.  When I do finally share, they’ll think I’m making it up.  That they won’t realize how hard being healthy, happy, and calm is for me EACH day.  And selfishly—I like some sympathy once in a while (preferably with some flowers, chocolate, or a slushie!)

It’s one of those questions related to my disorder I’m still working through.  I spent the first 22 years of my life on the extreme pretending section.  Now, I’m slowly learning to open up and let people in.

I’m sure I’ll figure it out, after all the song is being played about once an hour or so.

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