What OCD is Not

OCD’s unusual in that a lot of people who don’t have it, think they do. We’ve all heard someone describe themselves as being “so OCD.” Maybe you’ve said it yourself. You’d never hear someone who doesn’t have cancer claim to have cancer, yet that’s kind of what people are doing whenever they equate their fastidiousness with having a debilitating mental disorder. I know, I know: it’s not exactly the same and language evolves and blah blah blah. But it’s also illustrative of how we diminish mental illness, like when people claim they’re depressed after their favourite team loses.

OCD isn’t about being fastidious. Allow me to illustrate:

  • Person A: “I like being organized! Organization makes me feel calm and in control. I don’t do well amidst chaos.”
  • Person B: “I have to be organized, because if I don’t arrange things just so my family’s going to die in a fire.”

Spot the difference? To be sure, some people who do have OCD like being organized, just like some people who have OCD are left-handed or eat a pescatarian diet or listen to Blue Rodeo. Some people have OCD and couldn’t care less about being organized; I am one of these people. But don’t think I’m exaggerating about Person B: that’s an actual example of an obsessive thought, the kind that get stuck in a loop inside our brains and make OCD so debilitating. I’ve never had that particular thought, but it wouldn’t take long to find someone who has.

I think it’s also important to mention that OCDers don’t necessarily have comorbid (or simultaneously occurring) depression. Some do; I’m among the lucky ones who don’t, or at least hasn’t yet. It’s easy to say “choose optimism,” and I know that’s a tough thing for some people to do. But if you can then cling to it: optimism can be a powerful recovery tool.

So OCD isn’t depression, and it’s not a quirk either. One thing OCD is, at least in my case? A positive thing. I’ll explain in my next entry.

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Gratefull

My OCD’s at a point where it hardly ever affects me: I haven’t had a flare-up since last October, if not last July, and while that doesn’t mean I’m “cured” or anything (since there is no cure) it’s still a wonderful development.

I wrote that on Thursday, May 18, shortly after learning that Chris Cornell had killed himself. A few hours later I was in the initial throes of what’d turn out to be the worst OCD lapse I’ve had in years – if not ever.

Cornell’s death was the the triggering incident – the McGuffin, if you will – but the real culprits were me messing around with my medication and, more broadly, becoming complacent with my recovery. I hadn’t had obsessive thoughts in so long I was starting to let myself think that maybe, just maybe, I’d kicked OCD once and for all. Which is difficult to do, if not quite impossible: OCD’s a chronic illness, and even if it’s been dormant for a long time it’s liable to rear its head at a moment’s notice (like, for instance, when your favourite singer dies by suicide). Moreover, I’d been doing great on 15 mg of Trintellix, which is the antidepressant I’ve been taking since January. It seemed logical therefore that I’d do even better on 10 mg. My doctor agreed. Of course, neither of us could’ve anticipated the McGuffin.

So that’s how the lapse began. But something else happened, too: I got pissed. How dare OCD force its way back into my life? How fucking dare it? And so I got pissed, and then I started fighting back.

This is part one of what’ll be a series of entries about my latest recovery from OCD. It might not be the last recovery – but two months in I’m feeling (and I don’t think I’m exaggerating) better than I’ve felt before.

Like, ever. I feel better than I’ve ever felt before. There have literally been times this week where I’ve sat back and marveled at just how good I’m feeling. (I am now knocking furiously on wood.)

I’m also working harder at my recovery than I’ve worked at almost anything. It’s been all-encompassing and my commitment’s been total. And each day the work starts as soon as I wake up and doesn’t end till right before I fall asleep with things called gratitude meditations. (This is the earth-y part of the process.) They’re a great way of starting and ending each day; plus, gratitude’s been shown to stimulate serotonin, which is also what antidepressants do.

Gratitude meditations are short and simple. In the morning I give thanks for…

  • My bed
  • My senses
  • The rest of my body, including my brain
  • Sam
  • My family
  • My friends; this’ll often expand to incorporate my broader community, including neighbours and co-workers

At night, meanwhile, I give thanks for three things. Sometimes they’re big (my fiancée!). Sometimes they’re not (dark roast coffee!…scratch that, dark roast coffee’s the best; once, though, I gave thanks for an aircraft that’d passed overhead earlier that evening, and while I do love to fly that one particular plane wasn’t especially meaningful to me). By enumerating things I’m grateful for at night I’ve begun finding all sorts of things to be thankful for during the day. Cumulatively, gratitude meditations have turned into a simple technique for appreciating my everyday life and being more aware of all the awesome in the world. Because when you’re looking for it, you’ll find it almost everywhere – sometimes, even, in mental health recovery.

This morning I’m grateful for light roast coffee, the British Open on TV, deliberately adding a second “l” to words, and the chance to share my recovery strategies with you. Have a gratefull day, everyone.

On Last Night’s Bike Ride

Last week I slashed my antidepressant dosage by a third, from 15mg a day to 10. My OCD’s at a point where it hardly ever affects me: I haven’t had a flare-up since last October, if not last July, and while that doesn’t mean I’m “cured” or anything (since there is no cure) it’s still a wonderful development.

But. Psychotropic drugs are meant to mess with your body, and any sort of adjustment, big or small, is going to have an impact. I’ve felt “off” since last week, and yesterday I was so lethargic I could hardly sit upright, let alone stand. Nonetheless, after work I came home, hopped on the bike, and went for a ride. We’re just a little over three weeks out from the Ride to Conquer Cancer; I need to get my miles in, withdrawal symptoms be damned. On my way back, riding alongside Lake Ontario into a brilliant early-evening sunset, I passed the Molson Amphitheatre, whose new corporate name I refuse to use.

I started thinking about some of the shows I’d seen there. Weezer. Aerosmith. Oasis and Pearl Jam twice each. Tom Petty. Robert Plant. Black Sabbath. And then another thought occurred to me: in spite of all I’ve seen there I’d never seen a truly transcendent Amphitheatre show. It’s my least-favourite major venue in Toronto. I don’t like the amphitheatre-style setup to begin with; the chore of entering and (especially) exiting the venue puts a damper on pre-show anticipation and gnaws away at any lingering post-concert bliss. It’s a tough room.

And then I realized: “Hey, this is where I saw Soundgarden for the first time!” It was one of the most special nights in my life as a music fan, the thing I dreamed would one day happen but that didn’t seem possible until I was actually down in the pit looking up at Kim Thayil, Ben Shepherd, Matt Cameron, and Chris Cornell. Isn’t Soundgarden playing Detroit tonight? I thought to myself. Sherkin and I had talked about getting tickets, but neither of us was sure if we’d be able to make it and then let the subject go.

And so I biked home, ate dinner, and went to bed. When I woke up, Chris Cornell had died of suicide, aged 52.

Your Bell Let’s Talk Challenge

I have a Bell Let’s Talk challenge for you:

Stop saying “I’m so OCD.”

Lots of people do, but speaking as someone who actually has OCD I have an important message. You’re not OCD. And you almost certainly don’t have OCD, either, because if you did you’d never describe yourself as being “so OCD.” (Unless you were being ironic. And even then.)

OCD isn’t something you are. It’s not a quirk, a transient personality trait, or a general appreciation of fastidiousness (regardless of what Monica Geller taught you). It’s a mental illness, and it ruins lives. OCD traps people inside their own worse nightmares and makes escape virtually impossible. It takes, on average, seventeen years to be diagnosed. And it increases risk of suicide by a factor of ten.

I’ve written a lot about OCD over the years. I’m subclinical these days, meaning OCD’s essentially a non-factor in my everyday life. I haven’t had a flare-up since July. These are very good things! But I’ll never stop advocating for mental health. Today, while you’re trying to bankrupt Bell Canada, challenge yourself to change the way you talk about mental health. Stop using OCD as an adjective. You are not OCD.

Lapse Into Now

I haven’t brain-blogged in ages, which is a good thing: it used to be the more I blogged about OCD, the worse it was (and, conversely, the worst it was making me feel). Prior to Sunday I’d been symptom-free for months. Like, completely symptom-free. It was glorious.

And then, on Sunday, I lapsed.

What happened? A bunch of things, actually. Consider this:

  1. I got engaged. It was pretty much the greatest day of my life; it was also the culmination of over six months’ planning, none of which Sam had an inkling about until the morning we left for Calgary. Hey, speaking of Calgary…
  2. I went back to Calgary for the first time since moving away. The weirdest part is how it didn’t feel weird at all.
  3. I’ve been going non-stop since April. Since April 7 I’ve flown around the world; gone to Nashville for a bachelor party; seen Pearl Jam three times, including once as part of a weekend in Ottawa; planned a surprise anniversary party for my parents; stood up for my cousin at his wedding; finished the Ride to Conquer Cancer; gotten engaged; and, just this past weekend, gone to Stratford and Buffalo.
  4. I didn’t sleep well Saturday.
  5. I gorged on sugar candy last week.

Et voila!

A lapse isn’t the same thing as a relapse, which can happen when a OC sufferer lapses and immediately discounts all the gains they’d been making. I don’t think I’m at risk of doing that…but that knowledge doesn’t make me feel better right now, which of course is what I want.

And so now I’m taking evasive action, starting with two of the pillars of any successful recovery: I’m going to bed earlier* and eating better. (* – this will absolutely not apply Saturday when I see Guns N’ Roses.) I’m also aware I’ve been slacking in the personal fitness department since crossing the finish line in Niagara Falls, and so it’s back on a regime of biking (and biking to work, if the TTC could deign to reopen the College bike lanes) and running with Sam. (I’m going to fail spectacularly at my goal of running a half-marathon this year; I’m willing to blame my knees for one more year, and in fairness they still do get sore really quickly after I run.) And I’m going to write. I don’t know what I’m going to write about: music? Mental health? Wedding planning? (God help me.) It’s therapeutic. And it’s something I realize now I need to make time for, as opposed to just sitting back and waiting for inspiration to hit. I’m chasing after inspiration now–chasing after it for its own sake, but also because it makes me feel a lot better during times like these.

Quack

I just got back from Eugene, Oregon, where I was attending an international recruiter conference with which some of you are doubtlessly familiar. The wrap-up was held at Autzen Stadium, home of the Oregon Ducks football team; imagine my delight when I discovered they’d opened the field for conference attendees, and I spent an hour playing catch and shanking field goal attempts in front of 54,000 mostly empty seats.

Anyway: ducks, quack, bad doctor story! As I mentioned, I started taking medication again a couple weeks ago. (I’ve since stopped, albeit temporarily; that’s another story, however.) The new psychiatrist, who we’ll refer to as Psychiatrist #1a, was perfectly alright. But it took almost a year, and possibly longer, to get a referral, so when a second one came in shortly thereafter I decided to take it, figuring I’d compare the two doctors before picking one to move forward with. So last week, after an especially productive (and necessary) visit with Doc Awesome, I met Psychiatrist #2b.

Quack.

First, the good: nice office, nice vibe, nice receptionist, and (if I’m being honest) nice doctor. Next, the weird: Psychiatrist #2b stayed seated when I walked into the room, then indicated a seat from which I couldn’t quite see him because his gigantic computer monitor was blocking my view. Lastly, the ugly: he misdiagnosed me. I’m not saying I think he misdiagnosed me: he straight-up misdiagnosed me, a suspicion that Doc Awesome later confirmed. I have something called Pure Obsessional OCD, which is a well-established condition. Or so I thought. Psychiatrist #2b diagnosed it as–drumroll, please–borderline delusion. His reasoning? OCD compels someone to act…so, for instance, the well-known stereotype of the chronic hand-washer. But in my case, he said, I wasn’t acting, but rather thinking, which suggested to him a second, concomitant cause. According to WebMD, delusional disorder is “a type of serious mental illness called a ‘psychosis’ in which a person cannot tell what is real from what is imagined.” That’s as similar to Pure O OCD as an apple is to an A380 jet. They’re both “things,” but that’s effectively where the similarities end. Not to Psychiatrist #2b, who diagnosed me with both OCD and borderline delusional disorder. He then prescribed me an antipsychotic. I listened to his diagnosis trying not to let my jaw drop to the floor. Doc Awesome’s assessment was wonderfully succinct: “I take it you will not be continuing with him.” She’s got that one right.

This points to the exact same problem I once encountered with Dr. No: specialists making fundamental mistakes. I don’t think I know more than either of these two men. But I do think they’ve got gaps in their knowledge, and that in both cases the results could’ve compromised my mental health. Dr. No, you may recall, once finished an appointment by laying me face-down on his office couch and running a magnet up my spine. Psychiatrist #2b didn’t go to such overt extremes. His mistake was much more covert–kind of like how Pure O OCD’s an internal disorder, not an external one. Maybe he’s the one who’s borderline delusional.

This is Your Brain Off Drugs

I went off antidepressants October 3. It’d been a long-standing goal of mine, not because there’s anything wrong with taking them–quite the contrary, in fact–but because I thought, or at least hoped, I’d gotten to a point where I no longer needed them.

I’d like to say this story has a happy ending, and maybe it does–but not yet. Maybe that’s because, in the eight weeks since going off antidepressants, I haven’t stopped moving, and I think I need some actual downtime in order for my brain to fully finish resetting. Or maybe it’s because I shouldn’t have gone off them; maybe I’ll need to be on antidepressants, at least in some form, for the rest of my life. I’ve been grappling with that possibility lately.

Here’s how we got to this point.

I started taking antidepressants in 2007, and together with cognitive behaviour therapy they’ve formed one of my first lines of defense against OCD. Earlier this year my friend Graham introduced me to a company called USANA, whose products had an immediate galvanizing effect on my mental health: within days my anxiety symptoms were completely gone. I was also eating better than ever, an unexpected benefit of dating a vegetarian. I’d been toying with the idea of halving my dosages by the end of 2014, but these twin developments convinced me to push further, that total withdrawal from antidepressants was within reach. I began tapering my dosage in mid-June under the watchful eye of my psychiatrist, who told me to monitor my symptoms for three months and then, if I was still feeling good, to stop completely. By early October I was feeling great, and when a long weekend cropped up during a work trip to Toronto I decided to go for it.

Day one was fine. Day two was okay. Day three was bad. Day four? Day four was hellish. Day four was when the withdrawal symptoms really kicked in. Strangely enough I hadn’t really anticipated the possibility of negative side effects, yet they were myriad and surprisingly aggressive. I figured insomnia would be one of them, since one of my antidepressants was a sleeping aid, and it was. But what I didn’t reckon for was the nausea, dizziness, obsessive thoughts, or general sense of dread (not to mention some of the weirder side effects, like the inability to eat dairy or an itchy scalp; no, the latter wasn’t actually dandruff). I think I was so focused on the end goal I never really stopped to consider the potential pitfalls. It took the better part of two weeks for the worst symptoms to abate. All the while I was working full-time, planning a three-week international work trip, and spending as much time as possible with Sam who, in case you didn’t know, lives in Toronto.

I was fine in the Middle East, which surprised me given I worked over a hundred hours’ overtime in less than three weeks. But then, when I landed in Canada, I started to experience anxiety for the first time in months. These symptoms have likely been exacerbated by jetlag: I’ve been back for two weeks and I’m still waking up at all hours of the night. Or maybe–likely, even–they’re happening because I stopped taking medication. Maybe my body’s still adjusting.

Maybe I shouldn’t have stopped. Maybe I’ll have to reverse course; maybe I’ll be on antidepressants forever. In truth, I don’t know what’ll happen next.

But here’s what I do know: I’m giving myself til April–six months–to see if I can get back to where I was in October. If, at that point, I’m not feeling markedly better I’ll consider going back on medication. I’ve fought too hard to reverse course after a few rough weeks. But I’m not going to be an idiot about it, either. As ever with OCD–as ever with life, really–it’s all about taking things one day at a time.