“You have one of the worst cases of OCD we’ve seen in a while.”
My therapist said this after I finished explaining to her how and why I thought my OCD was getting better.
But as I sat there contemplating my day of full bladders, cracked hands, plastic utensils, “safe foods,” and magical thinking, I realized my concept of “better” is based on having fewer compulsions even if those compulsions are just as pervasive as the ones of which I rid myself four years ago.
The compulsions I’ve kept are the more “logical” ones. The counting, fear of certain colors, and bad connotations with certain times/days/months are mostly gone. The food, germs, and ritualized washing compulsions remain because they seem more “reality based.” Germs, dirt, and food really do cause sickness, but once again, I take the fear to the extreme.
My therapist asked me what it feels like to try to resist a compulsion, and I was just like, “it’s called a compulsion for a reason. There is no resisting.” It’s like anxiety takes over the motor cortex in my brain, and I go and do exactly what it tells me to go and do. Otherwise, I can’t move at all. At this point, though, everything is so ingrained that I don’t have to think about it. I just do my compulsions out of habit, so I only realize how much I use them as an irrational security blanket when I’m faced with a situation in which doing them is much more difficult.
She went on to tell me that I need to see a specialist because OCD is something I need to be working on every day instead of something I seek treatment for when the depression lets up and I remember how that sudden energy surplus gives OCD a foothold. As someone constantly battling the void, however, fighting OCD takes a lot of energy. Thinking about it transports me back to 2012 when I started CBT for the first time. Combatting OCD is hard. It takes more energy than simply giving in to it. The moment I get sucked back into the depressive black hole, I know I won’t be able to do my exposure therapy “homework.” (You know, like touching things and not washing my hands for fifteen minutes.)
My OCD and depression are opposing forces that, at times, paralyze me. When one is better, the other is worse, but OCD particularly keeps me going in the midst of depression. The feeling that I will die a painful death if I don’t do my morning ritual of coffee and yogurt and if I don’t eat at least one healthy thing each day at least forces me to do things that depression tells me don’t matter. But all the food obsessions/compulsions start to resemble body dysmorphia, and then I’m just like, “OH NO! Am I doing this because of OCD or BDD or both or neither oh my god?!?”
So in the spirit of restarting some exposure therapy, I need to make a list of my fears from least to greatest, but it turns out that’s a lot more convoluted than you’d think. For instance, if I use a public restroom and get to do the full 21 pumps of soap, I can go about my day as normal. If I can only do 17, I can touch stuff, but I can’t eat. 14, and I can’t touch things or eat. 12, and I can’t touch things, eat, and I go about the day with an overarching sense of impending doom. 5, and I have to go home and take a shower. (21, 17, 14, 12, and 5 are my new numbers.) So yeah, my fears are not at all straightforward. Plus, just typing that out makes me realize that I do still count. It might not be as restrictive as it once was, but I definitely still do it. Anyway, all my obsessions work like this. If I don’t carry them out in full, I can still function but in varying degrees depending on how fully I was able to carry them out. It’s more of a mind map of fears than a list.
It’s so frustrating to come to terms with the fact that I’m just experiencing a new manifestation of OCD with the same severity. New medications are in the works, and CBT just adds a whole new variety of tasks to my to-do list. Ultimately, I guess this stuff is supposed to make things easier, but that’s taking my sledgehammer moods out of the equation. They can derail all progress, and maybe that’s pessimistic but it wouldn’t be the first time that’s happened.
I am in a rut dug by my feelings of being overwhelmed by all the things I have to juggle at once to manage my different anxiety and mood disorders. It’s enough to send me into a panicked cold-sweat because I start to go down the whole “I’m going to be like this forever” rabbit hole. If I only work on one thing at a time, one of the other things gains a foothold. It’s like my disorders are climbing over each other trying to get on top of the dog pile they’ve made in my head. The prevailing one just sticks a flag in my brain and is like “victory.” And I’m like, “ow, that’s my brain.”
It’s such a tangled web that it’s even overwhelming to try to detangle. I think that’s why my therapist wants me to see a specialist because saying “wow, that’s a lot going on at once” after every single session isn’t too productive.
I’m a believer in talk therapy. It’s worked well for me in the past. I’m a believer in trying talk therapy before jumping on the medication train, but unfortunately, I can’t start to disentangle my disorders until medication alleviates some of the instabilities. Also unfortunately, my OCD makes me paranoid to pile on the medications.
WHEN WILL THE CONTRADICTIONS END?
I am tired still.