distress

How am I?

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I’m alone.

I can access support if needed to avoid self-harm. My CMHT (community mental health team) is supportive.

My family speak to me (and meet up, I’m in a support bubble).

I feel broken.

How can I recover from OCD when I feel like a fraud – I’m not sure how to feel unwell when I’m not in incapacitating distress.

All my routines feel so ingrained and optimised to avoid any OCD triggers that it seems impossible to change them further. I can’t see how to ever add working into the mix – and if I can’t get to working, how can I ever feel recovered.

I consume 800 disposable gloves a month to avoid touching (and hence handwashing), so the time taken up by my OCD is reduced, but its impact isn’t removed.

CBT is intense as we’ve eliminated all the easy topics, so we’re looking at core beliefs. They drive my behaviour, but are distressing to identify. Exposure response prevention feels ineffective as it doesn’t generate as much distress as it needs to work. Imaginary exposure drags up memories of when my OCD prevented me from functioning, which I really really want to avoid – I felt trapped in darkness and couldn’t see a way out – and can trigger me feeling unable to speak.

There’s a secret blacklist of things that I can’t ever do. Speech occasionally gets on the list when my distress spikes. There are times when trying to distract myself feels wrong and sleep is the only way to cope.

I can zone out and go into “objective mode” which lets me do virtually anything, at the expense of feeling in control of my actions. Zoning out is also how I unlock the ability to seriously self-harm; which terrifies me.

I think that’s everything for now.

I don’t feel OK, but I can’t pick any one thing that makes it so.

I do trust you [care coordinator]…

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…but my past experiences haunt me.

I always plan an escape route upon entering an area. I’m not going to be trapped with or by people.

I can’t agree to going onto a ward. I did before and on one occasion it was extremely unpleasant.

I can’t focus on the positives. The negatives feel overwhelming. Times when I have I’ve felt so awful that it wasn’t worth it to try again.

P.S. I’m not feeling that positive at the moment.

Why do I go on?

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I don’t know.

I used to though? The plan was to go to a unit in London for treatment.

Now I’m scared the unit will refuse to treat me because distress still causes thoughts of self harm.

A unit near where I live that is rehabilitation accommodation refused me partly because of the self harm thoughts, and partly because I was “complex”.

I feel lost.

I may be experiencing short term side effects of my latest medication.

I’m not sure it matters if the feelings are the medication, they feel real to me.

Back to the original question, why do I go on?

I still don’t know, and that scares me.

What is real right now?

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Trigger Warning: this post discusses thoughts of suicide and self harm

Definitely real (at 23:49)

  • I’m anxious
  • I’m awake

Possibly imagined (as of 23:53)

  • I’m too anxious to sleep
  • I felt suicidal
  • That the red card (meltdown/crisis indicator) I put on my ward room door earlier was justified

What I think, on my anxiety level

I’m feeling lost in my mind. I feel that my anxieties about the impact the Covid-19 are real, but I don’t know if they’re any worse than everyone else’s.

For (high anxiety)

  • I inflicted pain on myself
  • Cut skin on my arms with my teeth (not that effective though).
  • Had suicide present as a real option to resolve a problem.
  • Being unable to go for a long walk removed an significant coping strategy

Against (normal anxiety)

  • When talking to my care coordinator earlier we got disconnected, and she didn’t ring back, presumably because she felt I was repeating the same anxieties as on the last call to them 2 days ago.
  • Ward staff waited 3 hours to respond to my crisis indicator (suggesting that they thought my feelings would be transient)

What I think, of crisis response

That it appears the ward staff have decided the best course of action in the event I am anxious is to ignore it, hoping that it dissipates. If it doesn’t, then offer me PRN and suggestions of coping strategies I’ve already exhausted, before finishing with that I need to talk to them so they can help, despite the indicator showing that means that I feel unable to talk.

For (me)

  • Leave any anxious person alone long enough (say 4 hours) and the anxiety will fade, even if it’s unpleasant for the anxious person.
  • They did ignore my red indicator, and remarked that I should have gone to the office (I did, but froze and turned back – too anxious to wait).
  • I was so anxious that relaxing made me cry (crying was suppressed as I was frozen up)

Against (me)

  • I did eventually fall asleep, however briefly 4 hours later, so maybe and crisis wasn’t a “real crisis” (remark by nurse on duty)
  • I seem to have upset every staff member I’ve come in contact with today

What I think, of me being alive

If I’m dead I can’t spread the Covid-19 disease, so why not end it all? I’ve got an untested plan for killing myself on the ward, but haven’t used it as if I get caught before completion I probably won’t get another chance.

For (do it)

  • If I’m dead, I really can’t infect anyone else (at least not in a way that’s my fault)
  • The staff used PPE (gloves, surgical mask and flimsy plastic apron) when dispensing medication this evening, suggesting that I am a real contamination threat.
  • The staff don’t know I felt suicidal earlier, so they can’t mitigate what they don’t know about. I don’t even want to tell them after how dismissive they’ve been of the anxiety.

Against (don’t do it)

  • Everyone else will still be alive and infecting each other.
  • Everyone is a threat, not just me, I’m just lost in trying to comprehend how big (or not) of a threat I am compared to everyone else.

What I think, of remaining on the ward

I can see the perks, food, reasonable clean facilities, and I won’t be left with an escalating mess in my room, but the loss of freedom is a big deal, I really want to go for long walks to deal with anxiety.

Don’t need a for/against. I’ve already done it in my thoughts.

Conclusion

I’m losing confidence in my ability to assess my anxiety level, with the reactions of staff, and the general population’s anxiety level impacting my assessment.

A thank you letter

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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

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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 🐭