OCD

What’s next?

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Last week of 2022 now.

Progress check

Positives

  • Want to be alive (except in a few instances, but haven’t done anything to progress dangerous thoughts)
  • Interacted with more people
    • DnD group
    • New care worker who works with my CPN
    • Social group for individuals who have self-harmed (at any point in their lives)
  • Completed an assessment for a unit to treat my OCD and been accepted, pending 1.5 years on a waiting list
  • Taking medication (the odd dose forgotten though)
  • Run a DnD group as the dungeon master online and play in person at a local group.

Still not happy with

  • Still get really anxious
  • OCD and associated distress and limitations to what I feel able to do.
  • Self-harm thoughts still play through my mind (most of the time they’re gone)
  • Negative scenarios playing out in my mind for interacting with psychiatric crisis ward staff – despite not having been near a ward all year.

Analysis

I feel there should be more on the positives listing. I know my CPN is happy with my progress.

I’m disappointed with the continued existence of the self-harm thoughts, and I would have hoped that the fear of a disastrous interaction with staff would have gone.

Looking forward. What do I want?

  • More friends
  • Seeing my sister
  • Able to enter a situation without my focus being avoiding contamination

Blank, blank, blank

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I had a stressful meeting with my CPN (community psychriatric nurse) this morning.

My CPN had to fill out a form for a OCD treatment referral to a unit, and the unit had requested more details.

As a result my CPN asked about whether I had any intrusive thoughts about harming other people.

The answer was yes. And I then spent about 15 minutes trying to express what they were, which was unpleasant as I really don’t like thinking about them.

After that my CPN also asked whether I had any intent to act upon them. The answer being no.

It just felt like I wasn’t trusted enough for my non-intention to be taken implicitly. Why did they have to ask? It made me feel awful.

How do I feel safe telling them thoughts in the future. If they’re intrusive with no intent I’ll still get challenged with questions about whether I plan to act on them. I don’t want to be treated as a possible threat – why can’t that be something agreed upon without extra questions.

Some of this might be irrational, but at the moment it feels too real to dismiss.

P.S. The title is a reference to how I wish my mind would just be blank so I didn’t have to feel any of the frustrated emotions.

What happens if I don’t qualify for an inpatient OCD treatment?

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Trigger Warning: This post contains feelings and thoughts about self-harm.

I really don’t want this to happen.

The last time it felt like support was unavailable when I was discharged from local CMHT (community mental health team) and it turned out that the referral for primary care had gotten lost, a couple of years ago. life seemed hopeless and I seriously self-harmed.

My parents have mentioned moving on with life and getting a job if the admission falls through. When asking my CPN what would happen if I didn’t qualify for the mental health inpatient admission it is that I’d have to do “something”, which could include getting a job (mentioned) or something else (left vague) and find a way to deal with my OCD in the community.

I don’t want that to be the case, as if its possible to manage my anxiety with a community intervention (and not an admission) it means that I am currently useless for not having managed it yet.

I’m scared of being in an environment with big deadlines when I can’t cope with them. I never want to feel that the only “exit strategy” is self-harm again. At the moment the promise of treatment feels like it makes self-harm unnecessary to coping as there’s always the promise of treatment and I have ongoing support.

There are bad memories of flunking out of university in the second year. This came from feeling unable to engage in academic work and deadlines, with an crippling anxiety about doing the “wrong thing”. Frustratingly I finished my first year with a score of approximately 80% – I can’t explain what then went so badly wrong that the second year ended with me not even passing.

Minor deadlines can leave me feeling too anxious to do the stuff necessary to complete them. I make slow progress – doing stuff intensively feels like way too much.

I don’t want to self-harm, but can’t help feeling worried that it could trigger in the future.

Discussing self-harm as a risk if I don’t get access to treatment feels too close to threatening to self-harm so I don’t want to bring it up with the CMHT. I’ve never been accused of threatening self-harm, however I am paranoid about being perceived to threaten self-harm. Second guessing people’s perception of how I’m behaving feels like an inhibitor to open discussion when my anxiety spikes.

All this risk could be resolved if I have a coping strategy that doesn’t revolve around the safety blanket of ongoing support. I don’t know how to build a better method yet; I’ll figure it out.

I’m feeling agitated this evening, so I’ve taken a sedative (lorezepam, 1mg, prescribed to me as PRN). I’ll shoud feel better tomorrow, as sleep usually helps.

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.

Let there be light

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I sucked in air with all my might

Like I was trying to light a fire in all my cells

Make your blood and sweat your sacrifice, desire your holy flame

And shout at full volume:

“Let there be light”

Intro song to Haikyu!! Season 3 (anime series about a volleyball team)

I’m still here. Still carrying on. Still dealing with OCD and anxiety. Still have days when I wonder if the effort is worth it.

I think it is. There is definitely light at the end of the tunnel.

After taking a break from running (I overdid it and hurt my knees), I’m trying again, but this time using the NHS “Couch to 5k” app to pace myself better, I’m on week 3, so far so good…

My care coordinator is changing jobs so I’ll have a new care coordinator (I’ve already been told who it will be, its a CPN I like). I’ll miss my old care coordinator.

I think that’s everything.

Running, again

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Is exhilarating.

Is freeing.

Is a release.

Is the best.

Recently my trainers started to fall apart, so my body ached too much to run in them, got new trainers and it feels like I’m running on air.

I’m back in my flat. Yay!

Getting the trainers was a unique experience, as normally going into a shop and trying on random items would be too contaminating for me to do. Not this time, being unable to run was so important that it was worth taking the risk. That, and I cheated a bit by using a sedative to make me less anxious.

I’m in a good mood 🙂 🙂 🙂

P.S. I’m not technically a runner, its more of a series of sprints rather than one long run.

Leaving the rehab unit

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I didn’t feel in control on the unit; was told by the staff to trust the staff and take the medication suggested, basically “take it”, and they then prescribed new medication after I said I didn’t want it. I’m already on medication, and haven’t even been on them long enough to know if my current meds are effective!

There is no way I was going to make myself endure another 7 days of isolation (no leave), so I left the premises, only to return 1.5 hours later and be told they had to search me and the isolation now had 14 days left (reset to the full time because I was off the premises).

I then left again, and slept in my flat overnight, before getting admitted to a psych ward because of my self-harm risk.

Leaving the unit gave me a sense of control that I had been missing from when I first arrived, however after returning to my flat I still felt that I didn’t have much control because of the lockdown making going out more stressful.

I don’t know how to restore the sense of control that I once had, but it feels like that is the only way to make me safe again.

Despondency

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When it feels like nothing matters, my OCD seems to go away.

If nothing matters then why am I trying to keep things clean?

When nothing matters I seem to alternate feeling high (some kind of euphoria) and low (depressed).

The highs feeling disconnected, or like I’m viewing the world through a different lens.

The lows feeling like doing nothing at all, just shutting down.

I mean, why would I run when there’s nowhere to go?

What’s there to fight for when you’re trapped and being trapped seems like your best option?

Context

I’ve recently changed to a different unit, which (for the first 14 days) has no leave. Initially I’ve been able to touch most stuff – as I’m trapped, what else is there to lose from touching it?

The unit has a “no visitors other than staff” policy for people in the 14 day isolation – I don’t have Covid-19 and, as far as I know, I haven’t been exposed to it. This seems to mean (at least to the staff here) that my care coordinator isn’t allowed to see me, which is something my care co. is trying to fix.

What’s the limit?

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Is it when I feel like I have nothing to do because the anxiety that I might be doing the wrong distraction prevents me from engaging in the distraction (Netflix in this case) to make myself feel better?

Is it when distractions feel pointless?

Is it when I feel uncomfortable and unsettled because my anxiety won’t settle down?

Is it trying medication that makes you more anxious temporarily?

Is it moving to a new location with restrictions on leave that will eventually be removed, but until then, despite not moving yet I’m still anxious?

Is it not being able to watch any of the TV shows my younger sister like because the number of sex references disrupt me trying to focus on the story (anxiety about anything sexual is a problem), even with 10s skips to get around the jokes I don’t like?

Or is it when I drop a book I initially liked (at least up to that point) because I didn’t want to trigger any intrusive sexual thoughts?

Is it when I start obsessing over meaningless small details, just so I have something to focus on?

Is it when I decide my anxiety is making my existence so unpleasant its worth using a sedative to calm down?

The short answer, nope, none of those reach the limit of what I have to tolerate just to exist. My anxiety can always get worse, and it feels like I have no choice but to endure it.

I always have to endure it though, and that doesn’t feel fair. Why me? Why can’t I escape the anxiety permanently?

There isn’t a good answer, it just is that way.

I just have to live for the moments inbetween when I feel alive and happy.

The moments when I speak with my little (aged 16) sister.

The moments when I chat with a friend.

The moments when someone else does something that makes my existence easier as I don’t need to worry about that thing now.

The moments when I’m running uphill and the physical exertion makes me feel alive.

The moments of intense focus when I’m lost in a fantasy world (books, video games, TV shows).

The moments I notice that my OCD is slightly less absorbing.

Every little victory matters, there’s no big moments, just lots of small ones that make me feel a little bit better, and they make it worth enduring the anxiety.

I can feel something else?

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My emotions are less intense now. My anxiety is still a factor though.

Tried running when I was on a “walk” the last few days, seems to generate the most intense feelings at the moment.

I’m not even sure what I’m feeling most of the time, just that something, anything, intense is felt when running.

Now my emotions are turned down it seems that I want another thing that’s intense, fortunately running (short bursts repeatedly) is a safe, and practical, thing to do.

If I had to make a comparison I’d say its like I’m 15 again (22 now) and running just for fun.

Other people seem to view it as “OK” and react a bit surprised (I think). Its a bit scary as I’m feeling stuff that hasn’t been felt for a long time, and I don’t know what will happen next.

I’d say this is progress, but I don’t want to jinx it.