A thank you letter

To the psychiatric ward staff who check in on me when I’m struggling.

To the staff who don’t give up even when I don’t verbally respond.

To the staff who listen when I talk.

To the staff who check for the yellow/red cards in my door’s window to see whether I’m ok, or too anxious to ask for help.

To my care coordinator who’s always on my side, even when getting me sectioned (not sure how that works, but it does).

To the staff who try to help again even if I won’t always (be able to) accept it.

To the staff who ask me what’s wrong when I act oddly rather than assume I want trouble.

To the staff who do their best to avoid me having another meltdown.

P.S. I know not everyone has a good experience, and it isn’t rainbows, sometimes they mess up, or do something normal that triggers me badly. Moving my stuff for any reason, but they know not to do that now, and avoid it. Being on a ward isn’t a good experience, but I do appreciate the staff who help me cope.

P.P.S. The staff won’t get to read this, but I just wanted to write it out anyway.

When OCD crosses the line, by a million miles

OCD is, simplified, obsessive thoughts and compulsive behaviours (rituals) that are done to get the obsessive thoughts to fade.

For me, the rituals were only time consuming, irritating and got somewhat in the way of functioning like an average person…

However, what happens when the rituals themselves generate so much distress from the fear of not doing them correctly that I avoid doing them? I shutdown and stop functioning 😢

Things just don’t get done, including eating and drinking (don’t get me wrong, I do, just not as often, healthily or regularly) as they require a clean surface or tap to do.

I end up spending potentially hours in bed when I’ve already woken up just avoiding getting up and facing down the rituals.

I end up putting off having a shower because the rituals involved make it take five HOURS!

My flat ends up a mess as the anxiety of carrying a contaminated item over to the dustbin exceeds my threshold for acceptable distress.

Walking through a door becomes an exercise in avoiding bumping into the doorframe.

Just opening a door becomes stressful as the handle isn’t clean, so am I going to face down opening it even with gloves? Now, in 30 minutes, or in 2 hours…?

Using gloves or wipes becomes a guilt trip for the sensation of wasting them to avoid touching or clean something that doesn’t need it.

Sitting at my desk becomes avoiding raising my kneecap so high that it hits the underside of the desk, which I haven’t cleaned, yet, from a day or more ago.

Going to sleep becomes “will I be too contaminated to function when I wake up?”. So how about staying up a bit longer, like until 4am…

Being on the bus becomes will I brush against anyone? So if the bus is crowded I’ll wait an unlimited amount of time for a less busy one.

Putting my coat on becomes did it get contaminated because I was careless taking it off?

Putting pyjamas on becomes will pulling my shirt over my head to change contaminate my face? So I sleep in my clothes.

Resting my head on my arms becomes contaminating my head with whatever might be on the floor as my elbows brush against stuff. So it doesn’t happen, no matter how relaxing…

I just shutdown, stop doing anything, and try to work up the courage and energy to get up and face down another task until there is no longer a day to face down and life becomes just pointlessly existing.

I feel so guilty expressing my distress that I get even more distressed and become unable to form words. My mind simply prohibits it, making not speaking the compulsion.

P.S. About the title, it’s a reference to how unreasonable OCD is. The line being minimal impact on life. The distance past is how impactful it becomes. I love playing on common sayings to say something awkward. Although as I find myself explaining them a lot, maybe they get a bit confusing 😛, hopefully this one isn’t…

P.P.S. I even feel guilty about writing about my OCD, knowing that someone might spend time reading it, and so I feel compelled to thank you for getting this far. Thank you 🐭

Life on a ward, with severe OCD

I do not want to be on a ward. Who does? I guess me less than some as I’m sectioned. Although somehow I went onto a ward voluntarily in the past!

I’m here because my OCD has become so distressing and disruptive that I managed to concern my local CMHT a lot.

My daily routine, so far is:

  • Wake up in the morning, then not get up as I don’t want to feel any contamination anxiety.
  • Say I don’t want breakfast (08:15) when a member of staff asks (I do, just can’t face down the anxiety of getting stuff off a shared food trolley, contamination).
  • Get up when a nurse comes along with meds, and take them (10:00-ish).
  • Wash my hands, and partway up my arms.
  • Clean my teeth.
  • Ask a staff member for my phone – it’s been on charge in the locked office overnight, for those who don’t know, possession of cables is prohibited as they are high risk items.
  • Do stuff on my phone until about 11:45, or 15 minutes before lunch time.
  • Hang around the dining area to try and get my cutlery before anyone else, and get to the front of the lunch queue. Fail? Not having a hot lunch, maybe sandwiches instead, the staff seem to notice and supply them so I have something…
  • Water? Do I have an uncontaminated cup and can face down using a shared sink. Spoiler: nope.
  • More phone stuff.
  • Now I’m fed up with my phone, at approx. 15:00 and ask (and get) escorted leave to the hospital shop (getting a sandwich, bottled water and a chocolate bar) and a short walk.
  • Water? Yep, got a nice clean bottle 😁
  • Next mealtime, same as before, waiting from 16:45. If I can’t get desert before my anxiety (contamination and noise) overwhelms me, I’ll just skip it. So “wait 5 minutes until everyone else is served” is the equivalent to telling me no!
  • More playing on my phone, and possibly taking a nap as there isn’t anything better to do.
  • More meds (I do have meds in the middle of the day, but can’t remember when).
  • Sleep, I finally knock off sometime between 09:50 and 11:30.
  • Flashlight through the window of the door in my room, staff checks, which never, ever, wake me up 😛

Don’t have a change of clothes on me. Was not planning to get sectioned when the home treatment team (part of the mental health crisis team) assessed me on Wednesday (it’s Sunday as I’m writing). Fingers crossed I’ll get unescorted leave, or at least longer escorted leave, to visit my flat tomorrow and get some. I’m not a fan of having other people go into my flat to get stuff. Don’t know why…

Oh, and I haven’t told my parents I’m here – it feels too embarrassing to be in hospital for anxiety. Trying to kill yourself is easier to explain.

I’m on medication again technically voluntarily, but more because I don’t want to see if they’ll inject me if I refuse. I am aware that I’m struggling with my OCD, a lot. Having memories of agitation and feeling suicidal from a past med that I took for all of 36 hours is making me want to avoid medication, can’t any longer though.

Bye for now. Sleep incoming… Unless there’s something pointless I can do on my phone instead, got 2% left. Sleep it is, probably, I’ve still got 2% 📱

Fake, fake and another fake

When making sense of my OCD I create jargon to summarise the various facets. The term “fake” means that it feels like I was contaminated, my mind (if asked) says, “yep, you’re contaminated right now”, but I’m not.

Some fakes aren’t a problem can be brushed off in seconds as it is overwhelmingly clear that I wasn’t anywhere near, anywhere from 20cm to 2m, the object that I was supposed to have made contact with and had it contaminate me. The most common example is going near a surface that isn’t clean enough to use on the way to doing something else.

This evening however the fakes were about hitting items in the bathroom, where cleaning off the contamination would generate needing to have a shower immediately (which normally takes 4 hours, on a good day, without any special contamination) if not cleaned by other methods. I was aware that I probably didn’t hit anything, and every time I repeated an action that supposedly hit something I could see that I didn’t actually hit anything.

That didn’t prevent spending 40 minutes dousing clothing and my hands with disinfectant in a desperate attempt to remove enough contamination to avoid suffering through a 4 hour shower.

Eventually, well and truly fed up with the procedure, and safe in the knowledge that from any “normal” person’s perspective I’d have obliterated, multiple times, any biological or other material that could potentially cause harm I decided that “I hadn’t actually hit anything” and stopped there. Deciding that I had been hit would have required more cleaning, and a more intense version of what I had just done.

I use the phrase “a hit” to describe becoming contaminated which something as a result of impacting a contaminant or a contaminated item.

When I manage to avoid actually hitting anything, my mind seems so determined for a cleaning procedure to take place that it creates fake hits that I’m “required” to clean, unless I can show that they didn’t happen. Figuring out that I could avoid the cleaning by showing that it didn’t happened wasn’t what happened initially though, so lots of stuff got cleaned pointlessly (or even more pointlessly, as OCD isn’t solving a real problem).

I can temporarily distract myself and avoid cleaning a hit, but minutes, hours, days, or even weeks later the memory of the hit can impacts me at which point I’m compelled to clean everything I can to obliterate the memory of the hit – the logic being that by virtue of not cleaning the original hit the contamination has spread a lot.

The experience of having a hit overcome me long after its actually happened is what drives me to clean even when I feel that the hit maybe, probably, sort of didn’t happen, as getting past my anxiety to convince myself that not cleaning is OK feels impossible. So far I’m only able to bypass my mind when I can reason that the hit isn’t bad enough to require cleaning.

This brings me to more jargon I use. A “bypass” is when a hit that would normally require cleaning occurs, but I’m trapped in an important (for me) social situation, or deadline, basically something else is stressing me, a lot. This means that so long as I can vaguely reason that the hit “isn’t that bad” I will skip the cleaning is possible. The threshold for “badness” is low, so hitting the floor or shaking hands usually the worst I can bypass.

When trying to deal with everyday hits that no-one else is bothered by its sometimes possible to create a “skip” or a “cheat”, basically a rule that says that “in this situation, with this hit, it doesn’t count”. The rule is created after analysing previous stuff I’ve done, what other people do, so using logic to “skip” my OCD ritual. These usually require a trivial hit (knives and forks, say from a café) and won’t work when my anxiety level is too high and I lack the energy to enforce the “skip” as valid.

There is some overlap between a “skip” and a “bypass” as both provide practical advantages. However a bypass is created by sufficient stress overwhelming the distress created by my OCD, and a “skip” is created by using logic to work around my OCD, without actually beating it. As a “skip” doesn’t actually beat my OCD its also cheating in a way, as I’m not beating my OCD by overcoming it, just by side-stepping, hence the fact that I sometimes call it a “cheat.

P.S. Its been a while since my last post, a couple of instances of superficial cuts, but nothing since September, but my OCD has become worse and more overwhelming. My psychiatrist is referring me to a specialist OCD unit in London though, so that’s hopefully going to make a big difference.

Just talk :)

I’ve self-harmed and needed to go to A&E again (see last post).

However, on the plus side I’ve been reminded, again and again, by various people that I can just talk to people about how I am, and that they’d prefer to know, no matter how bad it is.

I love having people around me who feel that way, they’re the best kind of people.

I am sad that I forgot that they were there to talk to, as it has been so long since I’ve had an incident like that, that I just forgot.

Just wanted to say, people are there, and some even want you to talk to them 🙂

House flies

As if it wasn’t difficult enough keeping things clean, now I have tiny insects contaminating everything they touch, mostly.

Looking this up, this appears to be a “benefit” of warmer weather. As this is my first summer in my own flat, I guess I’m noticing this for the first time now.

All the flies that rest for more than 5s on a surface find themselves dowsed with disinfectant spray, conveniently eliminating the fly, and cleaning the surface they landed on.

Usually my flat is a safe space, but these little insects damage even that. Kinda stuck on how to resolve it, beyond eliminate any flies, secure any areas that attract them, and leave doors closed behind me.

For now, I just have to wait for the current wave to pass, and any eggs they’ve left behind…

I’m not feeling great anyway. Got an assessment for CMHT support the day after tomorrow.

Time to “soldier on”. For me this means, continue trying to cope, no matter how unpleasant it becomes…

Coping with sleep

My number one coping strategy is getting enough sleep. Should I fail to get enough sleep for long enough I will end up too exhausted to use any other coping strategies.

I forgot to get my repeat prescription on time this week, and as I usually rely on the sedative effect of quetiapine to get me to sleep, I had a few bad nights – when waking up the trouble of trying to get back to sleep made it feel like I was struggling to breathe. I don’t think that was the case, but my mind gave the illusion of it, probably because it had trouble expressing the feeling of being unable to sleep.

Historically a week with sleep disruption results in me acting implusively, not always dangerously, but always in a way that I regret.

Luckily this time around it was “just” two days, so I’m OK, and feeling, safe now, even if the feeling of fear when I try to go to sleep hasn’t faded yet.

Somehow, although it defies explanation I have found myself with too many things to do (programming, new series on Prime Video, and fitting in video games). That’s good, as it leaves me safe.

Bye for now.

Winning, sort of

For me this is

  • Getting up and showered, within 2 hours (that’s the best for now)
  • Getting a decontamination procedure done that’s stressing me out big time
  • Going to sleep without being afraid of what my mind might consider
  • Leaving my flat each and every single day
  • Keeping my (excessive) cleaning product consumption from increasing
  • Playing a new game or reading a new book
  • Writing a blog post

I haven’t posted in the last couple of days, and have been focussing on just getting the basics completed. I’ve managed to “win” so to speak.

Coping Mechanisms

Video games

Just shooting or destroying items on screen is cathartic. I play Overwatch (https://playoverwatch.com), and this week have withstood the anxiety of starting a new game and started one called Hades (http://playhades.com).

This game is about the son of the Greek god of death trying to escape the underworld. Which is a dark, miserable place where any occupants are trapped (including everyone who has died). Unlike most of the occupants the son of the god of death is alive, and reincarnates upon death again, and again, with no escape from his dismal reality. His only way out is to battle through all the levels of the underworld.

This makes a good analogy to recovery and restarting live after multiple suicide attempts. Life goes on, and the only rational way out, is to fight on, through a living hell.

This wasn’t what I had in my mind when I got the game, but I like the comparison. At the time I just liked the combat.

Walking

Walking just consumes time, with the end goal being that my mind will have sorted out whatever it is thinking about by the time the walk finishes.

This doesn’t always work, sometimes I break into running to vent stress – which helps. Going out in cold air is the most effective way to get my mind to “reset” (which is just clearing it of any impulses) and keep me safe.

Blogging/Diary (I have both)

Expressing how I feel is helpful. When something is written down it is much less scary as it is clearly acknowledged, as opposed to only inside my head.

Music

Listening to music provides a something for my mind to focus on. I like to call this providing the second track for my mind. The first track is whatever I’m doing at the moment. This avoids any ruminating, which I don’t want.

Onwards

I’ll keep fighting to win tomorrow. And the day after. To the future…

Motivation for self-harm, and alternatives

Trigger Warning: This post discusses self-harm, and references feeling suicidal.

This post’s focus is the often invisible self-harm that happens without people noticing it, normally. I explore the causes of myself having self-harmed in the past.

See here for help on minimising the harm you do to yourself. Some techniques I’ve found useful are snapping an elastic band against yourself, punching a pillow or sofa or running. Distracting yourself is a good option as it lets the emotions dissipate so you don’t end up harming yourself (see this post). I often count from 1-8 again and again when feeling anxious.

Should you ever want to kill yourself call someone you trust, a service like Samaritans 116 123, your local CRHT (if you have the number), or just 999. If you don’t live in the UK the numbers you have access to will be different.

Punishment

Self-punishment is a way of trying to cope with some “crime” you feel has been committed by you. It only emphasises the “crime”, and the goal is to make you feel worse as the punishment.

The crime could be an unwanted intrusive thought, or something like forgetting a chore. The action can be tiny, with no-one else aware of it, but to you it feels significant. A rational response would be to acknowledge that it happened, and move on, which is what you have to do in the end.

As the least extreme example (and not in the self-harm category) you could say not watch a series you like on Netflix, or make yourself go to bed early. This just emphasises that you were unhappy with the action, but, as I’ve found, isn’t any good at preventing it in future, as I just obsess over the mistake more.

At the other end of the spectrum you could feel you deserve to die for the action, and take some steps to do that.

Inbetween the two extremes are superficial cuts (where the cut draws blood, but doesn’t need treatment), serious cuts (which need treatment or leave very nasty scars), and burning. Any self-harm can leave a mark.

The main effect of the self-harm is it’s shock value as I find I am now well and truly distracted as I’ve done something worse that the original problem!

This gets out of control for me. As a tolerance develops to the mild self harm, so more extreme self harm is used to get the same shock again. This escalates quickly and is dangerous. I (back when it was a major issue) ended up taking it too far, and ending up in A&E, which persuaded me to stop it for a while, although not forever, the cycle repeated a few times.

It’s not an issue for me at the moment though. After seeing a psychologist I’ve found it easier to accept that I’m OK and that I mess up, but it isn’t such a big deal.

Venting emotion

When suffering a mental illness the distress felt can feel like it is inexpressible. So damaging yourself is viewed as an option.

The type of self-harm used and how extreme it is varies between people. I’ve found I tend to ramp up how severe it it is quickly, as I use it as a last resort to vent, and then next last resort is always worse than the previous one. I do know people self-harm regularly, every day a consistent amount without it getting worse over time.

Hitting something soft or smashing ice cubes is a safe way to vent aggressive emotions as it doesn’t cause any damage.

If you’re unbearably sad cozying up in a blanket is a good way to make yourself feel better.

Obsessing over self-harm

Sometimes I find my mind obsessing over self-harm, and I think about a specific way to hurt myself, again, and again, and again; which gets exhasting to just not hurt myself despite my mind thinking about it. For me, at least, this is part of suffering from OCD; what you obsess over can vary massively between different people with OCD, so some people may not even consider it.

Exhasting to just not hurt myself

Me

After several days of my mind obsessing over it it can feel easiest to just harm myself to get rid of the thoughts. That’s pretty much what happened today when I cut myself, the worst incident in a while.

Conclusion

The thoughts behind the self harm vary a lot, but the results appear the same, and none of it is ideal. Professionals refer to it as a maladaptive behaviour, as opposed to an adaptive, healthy response.

It can feel like you’re cheating by distracting yourself, or minimising the distress by not self-harming. You’re really not, you’re just coping differently in a way that will last and be usable forever.