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Sunday, October 11, 2009

The Dark Side of OCD

I want to call this “Learning to Love the Voodoo,” but I also want the title to show up if someone’s hunting for OCD, so. . . .

It’s one of those posts that people go, “Do you really think you ought to write about that? Really?” and the answer is, gee, probably not. But sometimes I imagine someone out there, someone young, maybe, or someone who doesn’t have anyone to talk to, and they’re thinking they’re absolutely nuts, just batshit crazy, you know? And I think maybe I have something to say to them. Maybe not, but. . . .

[And as I do the search for links to this, I find out that this week--October 11th-18th--is OCD Awareness Week—and isn’t that the oddest coincidence? (NO: it’s NOT ironic:  coincidence does not equal irony!) Whoa. Imagine my surprise.]

In the last decade or so, we’ve learned a lot about obsessive compulsive disorder, haven’t we? We’ve had Jack Nicholson in As Good As It Gets, and we’ve had The Fabulous Monk, and so we know everything we need to know. And isn’t OCD a hoot, anyway? People are always saying, “Oh, I have a little OCD myself,” or “That’s so OCD,” or whatever. And I just smile and smile at them and, to myself, shake my head.

OCD is not cute. I can laugh about it and make jokes about it and poke fun at myself, but let me tell you:  it’s not what you see on tv and in the movies, and it’s not that cute little tendency to double-count the change from your half-caf double shot extra-hot soy latte.

The quirks and checking and counting are just one part of it. The thoughts are something else entirely, and that’s the part you don’t see in the movies or hear about from your I-have-it-too friends.

The thoughts are ugly. They’re ugly and scary and completely confusing. For instance:  we keep an ice pick in the freezer for chipping the ice when it clumps together. I use the ice pick, but I hate the ice pick. I never, ever see the ice pick without the thought going through my brain about how easy it would be to take that ice pick and stab one of the cats with it.

I’m serious. This is not funny at all. Now, y’all know how I feel about cats, about how I like them better than people, about how they run my life, and about how I’m perfectly happy with that. My normal, rational brain can’t imagine doing anything to hurt them. But there’s that other part. . . .it’s the part that, if you see someone up on a ladder, says, “I hope they fall,” never mind that Your Real Brain is thinking, “Be careful up there, whoever you are!”

This other part of your brain, sends constant little thoughts about things, “I hope they trip,” “I hope she sings a wrong note,” “I hope he slips/crashes/drowns.”

I’ll pause here while you’re thinking how utterly horrible that is, about how I am, indeed, crazy as a loon, how no one else thinks this way and it’s just me.

It’s not. These are called “intrusive thoughts,” or unwanted thoughts. They’re the other, un-cute side of the brain chemistry imbalance that is thought to cause OCD (although they’re not sure—it feels right to me, but I’m not an expert). When I was young, I thought these thoughts were proof that I was a horrible, terrible person, evil and beyond help.  This seems so very sad now, looking back, and I wonder how many other children are where I used to be. I can look back and see it clearly now, but I had no idea then.

Used to, they thought OCD was really rare. I read once that there was really no way to treat it successfully short of institutionalization. They know better now—they know many more people have chemical imbalances that lead to all sorts of anxiety-related disorders. Latest studies report that there are up to 4 million people with OCD in the US alone. But I’m betting there are still many, many people who think they are truly, truly evil, possessed by something they can’t control and don’t understand. I’m guessing there’s a lot of religiosity tied in with this—people believing they’re receiving unbidden thoughts from the devil, perhaps. Or, on the other hand, receiving unwanted thoughts from the aliens, who implanted them with a chip during an abduction.

Because we have to understand our world, esp. ourselves. If there’s something we don’t understand, we have to figure out an explanation for it. And if we’re generally kind and non-aggressive and gentle people, yet we have these horrible thoughts about wanting calamity and death and disaster to befall other creatures, why, it must mean that there’s Something Out There causing those. Right?

Nope. It’s not Out There. But that’s even scarier, because that means it’s In Here, right in here with us, and we can’t blame it on anything else.

Scary, indeed, huh?

I do not at all understand the chemical process by which a lack of serotonin in my brain leads to my issues with The Ice Pick, but I’ve learned to trust that it does. I’ve learned, over the course of my life, to trust that the thoughts that pop up aren’t about me and don’t have anything to do with how I behave. I don’t worry that I’m going to hurt anyone because I have no inclination to do harm.I’m a pretty gentle person not at all given to acts of violence.

[If, however, you DO have that inclination , if you find yourself actually wanting to follow through on these thoughts and do harm to others, that’s a whole nother thing, and you must get help right away. Go now and make the call to your local mental health organization. Or click here for a doctor in your area.)

Here is the link to the International Obsessive Compulsive Disorder Foundation, where you can find tons of useful information. As with any disorder, this information is presented by people who do not actually have the disorder, so some of it may seem a little weird to you. But there’s plenty here that will have you nodding your head, going, “Yep, that’s true.”

For me, the biggest help in dealing with The Dark Side of OCD has been learning to meditate. It’s not meditation that helps so much as practicing and developing the ability to stand back and watch your thoughts. In mediation, you watch thoughts arise and flow past and subside. You learn, in essence, to watch your brain work. This is really wonderful when you’re dealing with moods. When you’re 15 and suddenly feel unhappy, you think the day is ruined. You’re unhappy/angry/depressed/bored, and it’s going to be like that all day long. Once you learn to watch things arise and float away, you can see that mood arrive and think, “Oh, a moment of not-so-great-feeling. I’ll be glad when that passes.” Conversely, it helps you appreciate the good moods and happiness:  you feel happy, you realize, “I’ll feel sad again at some point, so I’d better enjoy this right now.” You can do the same with Bad Thoughts.

This isn’t exactly the way the Buddhists would have you approach this, but, hey:  I’m not a Buddhist. Mindfulness in this way works for me, and it works for OCD:  you can watch the thoughts arise—“I hope he falls and dies”—and know they don’t mean anything, that they’re not about who you are as a person and that they don’t mean you’re bad. You can, over time, learn to recognize the conditions that make the thoughts more frequent (stress, rushing, being generally frazzled, perhaps) and the conditions that make them less intrusive—meditation, calm self-awareness, mindfulness, perhaps.

I have never taken any kind of medication for any of this, but there are new drugs being created all the time that can help make life so much less scary and stressful. If you’re suffering, please find someone familiar with OCD who can help—the link to the OCD foundation provides not only contact info for professionals but also a list of things you should look for to make sure your health care provider understands the most successful treatments. And if the first one you try doesn’t work, don’t give up—it takes most people several attempts to find good help.

I take St. John’s Wort, which seems to be a big help for me. Exercise and diet are important, as well. The biggest difference, I think, is self-awareness, which perhaps is partly a function of age:  it’s much easier to see what’s going on in your brain if you’ve been living with it a long, long time. It’s so much harder when you haven’t known each other all that long.

If you know a child you think might have OCD, please do whatever you can to get help for them. It’s a crappy way to spend your childhood. And if you’re an adolescent for whom this sounds familiar, find someone to talk to. And if they don’t have a clue, find someone else. There should be no shame about OCD. None.

There are on-line support groups, and those may be useful, but be careful:  I think the groups where people keep talking about their obsessions and compulsions, often as if they’re badges of honor (“Look how much worse mine are than yours!”) are very, very dangerous. OCD doesn’t need to be glamorized. There’s no benefit to anyone in out-OCD-ing someone else. The goal is finding a way to live peacefully and happily with your brain, both the Zen Side and the Voodoo Side, and making your life a joy to you and those who care about you.




Kathy said...

I've read this twice and I'm still trying to be articulate in my response. So much of our daily language has taken on a flippant, probably unaware use of reference to real and/or tragic afflictions, events, goes on. You hear kids say "that's so gay" (there's nothing tragic about being gay, until it's used as a weapon against you), we laugh at what we see as a comical OCD behavior, we comment on stereotypically ethnic behavior, we pretend to shoot ourselves when we have a bad day. Sometimes we smile and shake our heads as you do when you can. Now when I witness the last example, I am stopped in my tracks and virtually beg the person never to do that, because those intrusive thoughts that so many of us have (you should hear what goes through a new mother's head) may well have been what caused my equivalent of the EGE to actually pull that trigger two years ago. I have no way of knowing why or how, but I know that we need to examine the lexicon that allows us to find humor in an experience we know nothing about.
Not articulate, probably disjointed, but it's a rough time right now.
Thank you for this post - and for not listening to your voices.

Warty Mammal said...

Big, non-creepy internet hug: ((( ))).

Thank you for writing about this. Somebody will find it and it will help. It has helped me.

I asked my stepmother about some similar stuff when I was young. Not dark thoughts, happily, and maybe not OCD, but some compulsions. Did other people experience this? Why did I? Her response was "because you're weird."

Kudos to you for being self-aware and in touch with your brain.

Chris F said...

I applaud you for talking about this. I take things like OCD very seriously since I sometimes have students for whom this is an issue. (Certain OCD behaviors and autism seem to go together a lot) But although I recognize behavior which gets parodied on television (MONK) I guess I'm confused. Doesn't everyone have intrusive thoughts from time to time? I never thought about this being something more than my brain having too much time to overwork itself. You've given me something to think about.

Chris F said...

I applaud you for talking about this. I take things like OCD very seriously since I sometimes have students for whom this is an issue. (Certain OCD behaviors and autism seem to go together a lot) But although I recognize behavior which gets parodied on television (MONK) I guess I'm confused. Doesn't everyone have intrusive thoughts from time to time? I never thought about this being something more than my brain having too much TIME without meaningful occupation. You've given me something to think about.

Ricë said...

kathy, i'm so, so sorry to hear about your loss. what a horrible burden for you.

one of the things the OCD foundation website does is help understand what is and isn't OCD, and that's a good thing in starting to look for help. hearing what seem to be voices--outside the self--isn't connected with OCD--we know that those thoughts are our own.

chris, that's a good question--i don't know what other people experience. my husband, who is pretty much the epitome of mental health, is all i have to go on. he doesn't have intrusive thoughts. but maybe lots of non-OCD people do. good question--let me know what you think/find out/discover. brain function is endlessly fascinating, isn't it?

Velma said...

great post, rice, and from the outside, ie, those of us who live/work/love people with OCD, is it good to name it and restate that the others' obsession is just that? how does it feel on your end (the receiver's) of that kind of communication?

have you read audrey niffenegger's new book (her fearful symmetry)? i'm not done, but there is an important character who has OCD. i can't wait to see his story play out.

Ricë said...

i bought the book and put it in The Queue, meaning it has to wait until i finish all these other 9,635 books. grrrrr. got a ton of reading i need to do--

Kathy said...

Ricë (umlaut in correct spot!),
I probably should have used quotes for "voices", because I was meaning thoughts. I think many of us have those thoughts - I know I do. Of course, I'm no poster child for mental health much of the time. And I have no whys for what happened - just the questions - and a pervasive need (compulsive?) to think "maybe that's what it was".

Sydney said...

Thanks Rice for the information about OCD. I had no idea about the intrusive thoughts.

This also came at a good time. I've been dealing with a family crisis this weekend and while the information and links may or may not apply, it did lead me to some information that probably does apply.

Holly said...

thank you so much for posting this.

Lise said...

Rice, Just about a year ago I wason my way to Whole Foods to pick up some St. Johns Wort to stave off the SAD which seems to decend about Dec.1st around here. I first stopped at Kaiser to refil a blood pressure prescrip. and asked the sweet boy at the pharm. desk to check on interactions and lo-and-behold, st johns wort has the potential to render one of the bp meds inactive...well, glad I asked.
Thank you for sharing "intrusive thoughts". I had no idea there was a name for it. that helps.

ReticentPurple said...

I also have intrusive thoughts from time to time, sometimes violent, sometimes not. But I don't know that they're to the point where they would qualify as OCD behavior. I do things that people would jokingly call "OCD", but how compelled I actually am to perform the action can vary a lot. I used to compulsively count my steps when I was little, and when I was older I would fall back into the habit when I was stressed out. I've always wondered if this was very mild OCD, or just weird habits of mine.

In any case, I think this post was great, and it really made me think both about OCD, and the way it gets treated.

Anonymous said...

Oh wow. I have lived with those icky thoughts my whole life, and worked very hard to suppress them. I haven't noticed them so much in the past several years, and figured it was because a) I sobered up and b) because I take antidepressants and am not so miserable that I want to throw my kids off the roof anymore. Drinking kept the thoughts away, but they were doubly bad "the day after".

So now I have a daughter who 'worries' about things. She hates to ride in the car with the windows down because she's afraid she might throw something out. Oh boy.

Thank you for sharing that.

Terry said...

That was really good stuff, Ricë. Really good - and important.

I had a minor quibble with just one little aspect of it, but then, considering that we fought the only other time my sister led me to your blog, I think maybe it's better to let it go.

It's old stuff, but it's the kind that needs repeating regularly and never gets tired. And of course, for many, it's brand new and encouraging to read such things - I tend to forget about them, which is a big, big mistake on my part.

Whatever, I must give you credit for being so refreshingly open and honest about yourself. Big time! Kudos to you!

I'm glad I read it. And, especially, that you wrote it - and wrote it extremely well, I might add.

Jennifer Mehlman said...

Oh Rice, you are brave for talking about the intrusive thoughts part of OCD. It happens with other mental misfirings like Post-Partum Depression too.

I was once watching my (then 4 year old) daughter in the tub, and it was hot, and all of a sudden I had an overwhelming thought of throwing a fan into the tub with her (knowing what the effect would be.) I was on the phone in tears to my therapist, ready to to the police, or have myself committed, and give up custody of my beautiful, wonderful, "wish" child because I was absolutely convinced, that I was the most horrible, horrible human being that ever existed for even having such thoughts.

Luckily, therapist calmed me down, and reminded me that if have these thoughts it is one thing. But if I feel like acting on them, then we have another problem altogether. That it was an intrustive thought rearing it's ugly head, and with time and medication, it would get better. And it did.

But sometimes they lurk.... but I know and have the strength not to listen to them. But thank you, thank you for bringing it out in the open on your blog.