Being Me with OCD by Alison Dotson

BeingMeWithOCDI first connected with Alison Dotson through the International OCD Foundation blog, where we realized that we were both from Minneapolis and made plans to get coffee.  I can still remember that first in-person meeting at Dunn Bros, one of those lovely times between two obsessive-compulsives finding joy and relief in saying, “Me too, me too!”

Alison’s book– Being Me with OCD— is aimed toward teenagers and young adults, but I think its audience is much wider than that.  It’s incredibly well-written, chock full of helpful information, and– most importantly, I think– it’s like sitting down with a friend.  While reading it, I kept thinking of my first meeting with Alison.  Her comforting, empathetic voice comes through so strongly in the book that you feel like you have a friend, a cheerleader, right beside you.

The book is part-memoir, part self-help, and is sprinkled throughout with personal essays from teens and young adults who offer wonderful insight into a variety of areas.  OCD is a strange beast in that, while it works the same way for most people, it manifests itself differently for each person, and the personal essays help the book touch on areas that haven’t been a part of Alison’s own personal journey with OCD.

I deeply appreciated her approach to medication.  I also loved that she dedicated considerable time discussing exposure and response prevention, even though she never underwent ERP herself.  Alison also spends time talking about overcoming stigma.

All in all, a great book for teens, young adults, or any age!  The best part is finding someone who gets it,
someone brave enough to share, someone on your team.

Read an excerpt. Buy the book on Amazon. Follow Alison’s blog.

The Long Journey … to the Starting Line

"Cross That Line" by xLadyDaisyx on deviantArt

“Cross That Line” by xLadyDaisyx on deviantArt

It is SO HARD for OCD sufferers to be correctly diagnosed and then find the right treatment and a good cognitive-behavioral therapist.  In fact, it takes an average of 14-17 years for someone to access effective treatment.

That stat stings my heart.  I feel it deeply because of my own personal struggle.

I developed a sudden onset of OCD at the age of 7.  I wasn’t diagnosed with OCD until I was 22.  I started ERP (exposure and response prevention) therapy at 27.  That’s twenty years, folks– fifteen just till diagnosis alone.

Growing up, I just assumed that I “thought too much”– was an “overthinker” and especially sensitive to issues of morality. I didn’t understand that other people were also undergoing the same doubts as I was but were able to move past them with ease.  I, on the other hand, would get trapped.  The exit door to my brain was stuck shut, so all my thoughts just milled and churned and generated intense anxiety.  I didn’t know that others even had the same thoughts as I did, nor did I realize how it would be possible to let such thoughts come and go.

In childhood, I cried all the time.  In fact, I cried every single night for three years in a row.  I never told my parents about this.  I was so scared that they wouldn’t be able to “fix” me that I preferred to just rest in my own sadness, still clinging to the hope that *someday* I could be fixed.  As long as no one told me it was impossible, it still felt possible, and even thought I was terrifically sad, I kept that hope as my lifeline.

High school was a beast.  I got straight A’s (OCD drove me to perfectionism) and graduated at the top of my class.  I was a class clown, and I had some amazing friends.  But I battled intense spiritual doubts and lived in great fear.  My tenth grade year was one of the hardest of my whole life.  Only those closest to me knew it.

My doubts intensified in college.  They escalated to a whole new level.  Thankfully, I had a solid support system in my new friends (people who remain my support system to this day!).  And though they couldn’t understand what I was going through, they loved me.

After undergrad, things fell apart.  In a nutshell, I lost my grip on reality– my doubts had grown so large and out of control that I no longer knew if I could trust my friends or my own human experience.  Finally, for the first time in my lifesomeone used the words mental illness with me.  It felt shocking.

I was encouraged to meet with a therapist (unfortunately, a talk therapist– not effective for OCD), who also got me in to meet with a psychiatrist, and I was finally diagnosed with obsessive-compulsive disorder.  A diagnosis fifteen years in the making.

I spent about a year with that first talk therapist, and it was more damaging than anything else.  I finally “escaped” and never again set foot in that clinic.  Meanwhile, I was an SSRI lab rat, trying out a slew of various medications to treat my OCD.  I eventually went back to talk therapy– this time to a much better therapist, who was a true blessing, although she still didn’t truly understand OCD, and so my therapy included a lot of reassurances.  In other words, this kind, amazing woman who loved me was just reinforcing my compulsions.  Not good.  I also took a break from trying out medications after one stole all my energy and made me rapidly gain weight.  I was overweight for the first time in my life– all due to a medication– and have struggled with my weight ever since.

Five years after that initial diagnosis, my psychiatrist was out of ideas.  Literally.  She asked me what I thought we should do next.  I, of course, had no clue.  She referred me to an OCD specialist.

This incredible man– Dr. Suck Won Kim– changed my life.  He got me onto the right medication (almost immediately) and essentially required that I begin ERP, even giving me the name and contact information for the therapist who would ultimately allow me to bottle up my OCD and put a stopper in it.  Dr. Chris Donahue, to whom I’m forever indebted.

Twelve weeks was all it took.  In one sense.  In another, it took twenty years.

My life was a mix of depression, anxiety, compulsions, “bad” thoughts, and wrongness, and then twelve weeks later, I felt the burden of OCD lift from my shoulders.  I was giddy with freedom.  Five years later, I still am.

I hear from OCD sufferers every week who are in their 50’s, 60’s, or even older, who are still seeking appropriate treatment.  This absolutely breaks my heart.

On the flip side, I’ve had the incredible experience of meeting Maddie, 11, and her incredible parents, who leapt into action almost immediately and got her into ERP within months of her OCD onset.  In the same year, she developed OCD, was diagnosed, and was treated.  Marvelous!

That’s one of the reasons I blog about OCD.  To help people to understand earlier what they are dealing with and to encourage them to seek appropriate treatment (ERP, with or without medication).  It still just boggles my mind that in 2013, mental health practitioners still don’t know that ERP is the answer.  People get passed around from talk therapist to talk therapist, when the solution should be so ready, so available.

Just One Dose

I had such a hard day recently– my anxiety levels were higher than usual (“usual” being not too bad for the last four years– thanks, ERP!).  I felt this strange depression, a strong desire to sleep, and a hovering sadness that wouldn’t lift.  My blood pressure felt through the roof, and the stress took a very physical toll on my body: by the time I crawled into bed for the night, my shoulders felt like cement blocks and my arms were throbbing with pain.

I realized that– while racing out the door that morning– I had not taken my Effexor XR or my Prozac.

Just one dose missed, and it was so terribly evident.

I have acknowledged that I may be on medication for the rest of my life, and I’m okay with it.  In fact, I’m quite protective over my right to take medication.

I read this awesome related post on the OCD Foundation’s blog recently.  And it turned out that Alison, the blogger, lives in Minneapolis … so we got coffee.*  Love my OCD community!

* And since then, we’ve accepted new roles at the Twin Cities affiliate of the International OCD Foundation (I’ll be the communications director)  … and have an event planned in Minneapolis for OCD awareness week!  Exciting!

prozac morning

Will Treatment Change Me?

I recently had coffee with a lovely young college graduate, a writer who has been dealing with intense anxiety, anxiety that has latched onto her faith and forced her into a position of crisis.  We talked about medication and therapy, about how there is nothing to be ashamed of, about how even scripture can be twisted and used against us.

Then she said, “The way my mind goes so quickly?  That’s why I think I can write.  I’m scared that if I start taking medication, I’ll lose that.”

That’s a fear I could definitely relate to!

I told her, “I think just as quickly now as I did before treatment– only now, it’s productive.  Before, my brain was spinning its wheels.  I was thinking in circles, thinking all the time but never really getting anywhere.  Now I can think productively.  I can focus on things that are important.

“I still think deeply– in fact, more deeply in some areas, since I’m no longer terrified of thoughts.”

So, did treatment change me?

Yes, but for the better.

arms

Do I have OCD?

Before my diagnosis and, hence, before I’d done a lot of personal research on obsessive compulsive disorder, I thought of OCD as “that disorder where you wash your hands a lot” or “the one where people tap the doorknobs” or “when you’re a really big neat freak.”  In some ways, my diagnosis was a surprise to me because I didn’t do any of those things.  But on the other hand, just the term obsessive sounded so much like my situation that I was willing to listen.

Maybe a year or so into my original search for medication (I ended up taking a year-long hiatus from the search after Luvox stole all my energy), I suddenly started worrying (or maybe even obsessing) that what I had wasn’t really OCD.  I seem to talk to a fair amount of obsessive-compulsives who also reach this point, worrying that maybe someone has plastered a name on them that is incorrect.  The interesting thing about this is that the OC usually feels guilty about it– as if they are receiving compassion and medical advice and help from friends and family for nothing, or what they are worried is nothing.

Interestingly, such a huge worry and incredible guilt only point to OCD all the more.

The more I have learned about OCD, the easier it is for me to see it in others.  Though I am by no means a doctor, I now believe that OCD is pretty easy to diagnose.

birdcage2

 

It’s all in the name.

Obsessive-compulsive disorder.

 

1) Do you have obsessions?  Basically, do you have intrusive thoughts that you find ugly or disturbing but that you can’t seem to stop thinking about?  Common themes center around questioning your sexual orientation or if you really love your significant other, thoughts about harming yourself or others (even children), blasphemous or sinful thoughts, worries that you or people you love are going to die, sexual obsessions, intense fears about contracting a disease.  Ask yourself, do I have intrusive thoughts that cause me serious anxiety?

2) Do you have compulsions? The answer to this question might not come as easily, but what it is really asking is this: when I have those intrusive, anxiety-causing thoughts, what do I do to attempt to relieve that anxiety?  Maybe your fears about germs cause you to wash your hands, making you temporarily feel a bit of relief about that possibility.  Maybe your fear about harming a child means that you won’t allow yourself to hold your baby girl.  Maybe it even means that you avoid driving down the street where a lot of children play.  If you have blasphemous thoughts, perhaps you repeatedly ask God for forgiveness or you’ll ask other people if you think that means you are now going to hell.  Sometimes compulsions seem a little “magical” too– for example, you relieve the anxiety caused by your intrusive thought by tapping your foot a certain number of times or by avoiding stepping on cracks.  Even if it doesn’t logically make sense, it’s still something providing you some temporary relief.  Seeking reassurance is a huge compulsion for a lot of different kinds of obsessions: we glimpse relief when friends reassure us, No, you’re not gay.  No, you’re not going to get sick.  No, you would never hurt a child.  No, you’re not going to hell for that.

There is a third question to ask too, although this one may or may not be reached immediately, which is
3) Have your compulsions gotten out of control?
Most obsessive-compulsives reach a stage where the compulsions (that began as an anxiety-reliever) become too much and begin to add to the anxiety: you can’t stop washing your hands, you ask for reassurance so constantly that your friends are annoyed, you are driving a long way out of your way to avoid the street with children, you are tapping doorknobs and counting and repeating phrases in your head to the point that you’re starting to look a little silly.

Like I said, I’m no doctor, but when I talk to someone who wonders if they have OCD, these are the three simple questions I ask.  If you can answer yes to the first two, then you have OCD.  

So, what next?
1. Get an official diagnosis from someone who went to school for it. 🙂
2. Skip the talk therapy and go right for cognitive-behavioral therapy.  This is treatable.

 

 

Live OCD Free app: my review

I first learned of the Live OCD Free app when I was in Boston last October, attending an event hosted by the International OCD Foundation.  I was intrigued by the idea of a web app that could simulate or guide Exposure and Response Prevention, so I picked up some handouts to take back to my university, and that was that.

Until I had lunch with Faith, this incredible 9-year-old who is battling with OCD.

Somewhere in the back of my mind, I had stored the memory that this app had a children’s version to it, so I contacted the company and asked if I could have a free trial of the app so that– if I liked it– I could promote it on my blog.  I received a very kind email from Dr. Kristen Mulcahy, who also sent me a promo code.

Live OCD Free app

What it is: 
Billed as “your personal pocket therapist,” this web app allows you to undergo cognitive-behavioral therapy (CBT), specifically Exposure and Response Prevention (ERP), either on your own or with the help of a therapist.  With it, you create a hierarchy of exposures, practice your exposures, and record your progress.  You can even easily email your progress reports to your therapist!  There is an adult version and a child version (both available with just the one purchase).

Child version:
In the child version of the app, there is a video that shares the story of the “Worry Wizard” with the child– in the video, the Worry Wizard happens to be another person (a bad kid, ha!), which I kind of like.  It goes along with the idea of narrative therapy that YOU are NOT the problem, the PROBLEM is the PROBLEM.  By showing children that the Worry Wizard is a completely separate entity from themselves, they are able to treat OCD as the enemy and not themselves.

ERP is then made into a game of sorts.  Children (along with the help of an adult) create a list of exposures (with simple prompts to aid them).  They then can practice their exposure at the click of a button.  If there is a need for an imaginative exposure (creating a loop tape/recording), they can do that within this app as well.  There are also built-in timers to remind users to practice their exposures and to record their anxiety levels (for the progress reports).  It’s really easy to use, very self-explanatory.

Adult version:
The adult version is very similar to the child version except that it just tells it like it is. 🙂  

PROS:
The secret weapons (child version)/toolbox (adult version).

Oh my goodness, I absolutely loved this feature*.  When you choose to practice an exposure, you set the timer for how long you’d like to do it.  While you are practicing an exposure, you can access the secret weapons/toolbox area, which includes:

1. Reasons for fighting (both versions).  A place where you can review and record your reasons for fighting OCD/the Worry Wizard.
2. Uncertainty agreement (adult version).  Where you acknowledge that you cannot know things with certainty.  This records the date that you “signed on” for this!
3. Relaxation (both versions).  Listen to an exercise in muscle relaxation.
4. Motivational messages and inspirational quotes.  You can even add your own!
5. Tips from other kids fighting the Worry Wizard.  Obviously, this is in the children’s version.  Loved it.  The quotes were so good and meaningful and encouraging without being enabling at all.
6. Songs (child version).  This included two songs for children (although there is a whole CD available on iTunes).  I have to admit, one of the songs– “Worry Wizard”– made me cry listening to the lyrics.  It just breaks my heart that children have to deal with this crippling disorder.  They are so brave!

*When I was doing my own exposures, I was told to focus intently on them … I wonder how this toolbox jives with that, or if that was only my therapist’s method.

Live OCD Free User’s Guide
This is wonderfully written, very clear.  If someone is choosing to do ERP on their own and without the guidance of a therapist, this user’s guide will be critical to their success.  Since I have undergone CBT, I now find it fairly easy to recognize obsessions and compulsions– and to identify appropriate exposures.  However, I would not have been able to do this if I hadn’t gone through ERP myself already.  The prompts are very helpful (and OCs often know what things bring them the most anxiety), but this user’s guide will be a huge help in sorting through obsessions, compulsions, and exposures.  I emailed with Dr. Mulcahy, and she said that sometimes people will meet once or twice with a cognitive-behavioral therapist just to set up their exposure hierarchy before attacking the actual exposures on their own.  Even if you don’t have health insurance, I can see where this would be very helpful.  If not, the user’s guide will assist in that matter.

Progress reports
This app makes it easy to see your progress.  I love that.  A visual reminder of how far you’ve come can go such a long way!

CONS:
There are very, very few cons to this app.  The graphics in the video of the Worry Wizard were not my favorite, and (of course) being a writer, I thought the story could have used a little polishing, but all in all, this app is phenomenal.  

The cost is around $80, which at first seemed like a lot of money to me … but it’s really not.  Not for what you get.  An ERP experience for $80 is a bargain (even with awesome health insurance, I still probably paid about $300 out of pocket to meet with my cognitive-behavioral therapist).  And the freedom to be gained through this process is priceless.

I imagine that CBT without the guidance of a therapist would also be more difficult, especially as there is less accountability, but the truth of the matter is that CBT takes a lot of commitment, no matter what.  I have said it before and I will say it again, you know you are ready for CBT when the hell you’re experiencing daily is worse than the hell you’ll have to go through with CBT.

All said, I highly recommend this product.

I cannot say enough good about CBT/ERP and how it gave me back my life.  Whether someone chooses to go the traditional route of seeking out a cognitive-behavioral therapist (note: NOT a talk therapist) or chooses to use this web app … or chooses to use both in conjunction with one another … I am 110% for it.

The important thing is that you pursue CBT.

Live-OCD-Free_App_12

end of an era

Last week, I ventured to the Fairview Medical Center at the University of Minnesota to see my beloved psychiatrist Dr. Suck Won Kim for the last time before his retirement.  Dr. Kim is a skinny Korean man with salt-and-pepper eyebrows and sharply combed hair.  I met him first in 2008 when, after years of failed prescriptions, my old psychiatrist essentially threw in the towel and referred me to Dr. Kim, a national expert on OCD who has seen over 3,000 OCD patients.

The first time I met with Dr. Kim, he asked me about what meds I had tried.  And when I had told him, he resolutely said, “No more of that.  You are done with that.”  And he started me on Effexor XR, which I am on to this very day.  Dr. Kim spoke with such confidence that I had felt confident.  I remember thinking, I think this might actually work this time.

But Dr. Kim wasn’t done after he wrote out the prescription.  He turned to me and said, “Cognitive-behavioral therapy.  Tell me, have you heard of it?”

I had.  Horror stories.

“It’s the best treatment there is for OCD.  I’d like you to call Chris Donahue and get an appointment.”

“Okay.”

“It will be hell,” said Dr. Kim, telling me what to expect.

And it was– but it set me free from the reign of OCD.  And that is why I was feeling sentimental as I sat in the office of this OCD genius for the last time, feeling cheesy but needing to tell him that he was one of my heroes.

Medical or Spiritual?

Discovered a website this weekend that is very disturbing to me as a Christian obsessive-compulsive.

At GreatBibleStudy.com, you can read quotes like the following:

Obsessive Compulsive Disorder, commonly referred to as OCD, is not a mental disorder or disease… it is a spiritually rooted bondage in the person’s mind that needs to be uprooted.

Obsessive Compulsive Disorder (OCD) is basically demonic torment brought on by a person’s bondages to fear and shame.

These ‘voices’ or compulsive thoughts are NOT caused because of a chemical imbalance (which the secular world cannot explain anyways); they are there because of a spiritual bondage in the person’s life.

Now, don’t get me wrong!  I believe that obsessive-compulsive disorder has entered into this world due to SIN, yes, but to negate that OCD is caused by a chemical imbalance seems ridiculous to me.  As a Christian, I view ALL of life through a spiritual lens, but these quotes seem like the equivalent of saying, “Diabetes is not a problem with the pancreas– it’s a spiritual issue!!!”  To say that diabetes is not connected to the pancreas’s inability to produce insuliin would be silly, just as saying that OCD is not connected to a chemical inbalance (our bodies absorb serotonin too quickly … that’s why we take SSRIs [selective serotonin reuptake inhibitors … they SLOW DOWN the reuptake/reabsorbtion of serotonin]).

All issues are spiritual issues, but that does not mean that they are NOT also medical issues.  God is also the Author of Science and the Creator of our bodies.  To not combine the spiritual with the scientific is short-sighted, I believe.

What are your thoughts on these quotes?  I’d especially love to hear from obsessive-compulsive believers!

This is a repost of an earlier entry.

triple bypass

It’s been almost one year since my dad underwent triple bypass surgery.  Just this weekend, we were reminiscing, saying, “Remember what June was like last year?”  Oh man.  It was not an easy month.  Or summer.

But the surgery was the worst part.

The evening before, people from church had joined our family in the hospital to pray for a successful surgery.  It was so strange to be gathered there, Dad perfectly normal, in good spirits although nervous, and thinking, Tomorrow our world could change.  We knew that Dad needed the surgery; but it is a terrifying thing to undergo.

Dad stayed alone in the hospital that night, but we were back at 5:30 in the morning, saying goodbye and that we’d see him after surgery.  Mom went with him into the OR.  Kristin fell apart as they wheeled him away; I did too (but not as much as Kristin– she’s the over-reactor of the family.  For example, when she learned Dad needed surgery, she cried and said, “I don’t even know what songs to have at his funeral!!!”  Oh Kristin.).  Kevin was pretty well put together.

 

Mom came back to the waiting room in a while (it was a nice waiting room, and we had a private area of it!), and then the waiting game started.  There was a computer, so you could see what part of the surgery they were doing at which time.  Eventually the nurse came in and told us that he was on bypass now.

Do you know what that means?  I didn’t.  It meant that my dad’s heart was not beating but that a machine was doing that work for him while they operated.  It struck me then how crazy this surgery was.

It was a long day.  A long wait.  We were all on edge.

But he came out of it just fine, and when we went to see him in the ICU, I saw him lying there, swollen, ashen, chest tubes coming out of him, draining blood, and I about passed out.  Was not expecting that.

He had a marvelous recovery.  It was tough on him and on my mom, but they did it together, and they are both rockstars.  After you have heart surgery, you have a lot you need to cough up, but they break your sternum for the surgery, so it HURTS.  A LOT.  My poor daddy was in so much pain.  The nurse said the more he walked, the better he would feel.  At first, Dad’s walks were from the family room, into the kitchen, and around the table.  Just that would completely exhaust him.  But he kept working on it because he’s dynamite.

And six months later, we were on rides at Disney World!!!!  Oh, and P.S. I could not keep up with my dad.

medication is scary, part two

It took me approximately five years to get on the right medication.

Over the course of the five years, I experienced the following:

* rapid weight gain (30 pounds in one month)

* deep lethargy, during which air felt stale and I had to nap for 2+ hours every day after work

* mind vomit (a phrase I coined, meaning that taking the medication exacerbated my OCD, sending me into frenetic, panicked obsessions)

* a visible tremor

* drymouth, as stanch as if I were eating Saltines and peanut butter

* dizziness and vision loss, usually paired together (One time I had a whole conversation with someone without telling him I couldn’t actually see him … I hope I appeared to be looking him in the eyes.  The dizziness/vision loss combo happened so often that I actually got used to it, could continue walking across my apartment without even slowing my step.)

* Jello-legs, so terrible that I had to lean against the stairwell wall as I descended from my second-floor apartment

* excessive sweating

* lactation (you think I’m kidding, but I’m not)

* a spasm of pain in my back that once DROPPED me to the floor like I’d been tackled from behind

* an allergic reaction that nearly killed me (please, PLEASE do not take new meds unless you have Benadryl in your home!)

And then along came Dr. Suck-Won Kim, my sweet, wonderful expert psychiatrist, who got me onto my perfect dosage of Prozac, Effexor XR, and Risperdal.

And want to know what?

It was all worth it.