Wednesday, April 1, 2015

Obsessive-Compulsive Disorder (OCD)

Photo by Matt Kelly

Name: Lisa Walter
Location: Ontario, Canada
Occupation: Visual artist, educator, and advocate for those with mental illnesses
Age: 46

Tell us a little bit about your early battle with mental illness.
I’ve had mental illness on and off through my life, mostly depression and anxiety. As a kid, my family went through a lot of stress and turmoil, and I was bullied very badly in school. I became very depressed and anxious in my teens, and started to cut myself to help control my feelings. I started to see a psychologist when I became suicidal, and she was very helpful. I got back on my feet and graduated from high school with honours.

Did anyone else besides a therapist help you during that time?
My family was very creative and nurtured my interests in acting and in visual art, which helped to propel my life forward. 

Were there any instances in your life that acted as triggers for your anxiety and depression? 
When I was a child,  I was molested by a neighbour. One of my brothers committed suicide when he was 29 and I was 24, which plunged me into some very difficult times. Again I got professional help, and I pulled out and moved on to some very rewarding work.
In my late thirties I was laid off from my job and became depressed again. This time, though, I developed a lot of other problems as well. I became extremely anxious. I had flashbacks of having been molested. Worst of all, I started to worry about some weird thoughts that I’d always had, and which I’d never bothered to think about before. (I’ve since learned that research shows everyone has random intrusive thoughts – weird ideas that flash into a person’s mind that really go against what they believe in. Like, “I could push that guy off the subway platform,” “I might stab my dog,” or, “What if I drove my car off the bridge?” For the most part, no one pays attention to them because they know that they’d never do such a thing.) But I had had thoughts of hurting children since I myself was a child. I’d never thought about them before, but for some reason, I now became really concerned about them. I wondered why I would have these kinds of thoughts if I would never do them. I wanted to stop having the thoughts, and as a result, they actually came more frequently. I did more and more things to avoid anything that reminded me of children. It was like quicksand; the more I tried, the harder it all became.

How did your active resistance of your scary thoughts and feelings affect you?
I became convinced that I was an evil monster for having those thoughts, and that I posed a serious risk to the safety of children – even though the very idea horrified me. I became horribly ashamed of myself, and I couldn’t bring myself to tell anyone about what was going on in my head. 
I started to cut myself again, which I hadn’t done for a long time. I felt that I had to punish myself for being evil. My life really went downhill, and I became suicidal. Even after I told my doctors what was really going on in my head, they failed to recognize that my symptoms were actually a version of obsessive-compulsive disorder. I didn’t have any of the obvious behaviours people think of when they think of OCD, but I had all kinds of coping behaviours going on inside my head. For example, trying to “erase” bad thoughts; spending long periods of time lost in my thoughts; and doing anything I could to keep myself from thinking about children. This last thing, especially, became a huge problem, to the point where the only way I could leave my house was if I took elaborate steps to prevent myself from being aware if any children were in my vicinity. I wore a jacket with the hood up, a baseball cap with the brim pulled low over my face, and I always had my music player going. This way, I could only see a few inches of the ground in front of me when I walked, and I couldn’t hear any sounds that might make me think of children. 

How did it affect your life?
During this time, I alienated some of my friends and lost touch with most of them. My spouse broke up with me, and I had to find a new home. I had to go on disability. I tried to kill myself twice. Both times, I was discovered by a fluke and rushed to the hospital, where I was in intensive care for days, unconscious and unable to breathe on my own. For my parents and the few friends I had left, this was very painful. My parents suffered particularly, because they’d already lost one child to suicide.

What was your darkest day with depression and anxiety? Do you remember what  your thoughts and emotions were like?
The worst day I can remember was one time a few summers ago; a friend of mine had stopped by my place briefly while she was babysitting a little girl. As she was getting ready to leave again, her car somehow locked itself with the keys still in the ignition. The toddler was strapped in her car seat. While we waited for an emergency service worker to arrive and open the door, it was getting hotter and hotter in the car. The poor girl was crying and screaming, and my OCD was telling me that it was my fault she was in so much distress, that I must have done something terrible to her. Everything worked out fine, but afterward, I couldn't stop having flashbacks of the girl screaming. That was when I decided I had to get rid of myself, because this incident was "proof" that I posed a terrible risk to kids. I started planning my suicide and three weeks later, gave it a go. The memory of those three weeks still makes me feel shaky and upset. They were a torment.

Did you ever try medication? If so, what are your thoughts on drug use for OCD?
After a couple of years, I was diagnosed with OCD. I tried different medications, most of which made no difference, a couple of which helped a little, and some of which made things much, much worse. 
It's a bit of a blur now, but I remember that they [medications] made me feel more anxious – much more anxious. I never usually experienced strong physical symptoms of anxiety, but on these medications, my hands and legs would shake, I felt out of breath, and I was wet from sweating. It was impossible to sit still. I also became afraid to take short-term anxiety medication, because I learned that it can be disinhibiting – that is, it can make you more likely to do things on impulse that you normally have to sense not to do. So sometimes when I was so anxious that I was almost hysterical, I would refuse medication because I was afraid it would make me more impulsive and therefore more dangerous to children. I really did feel like I was losing my mind.

When did you get help? What did you do/where did you go to find it? What was your therapy like?
After the second suicide attempt, my psychiatrist referred me to a specialized treatment centre for OCD in Boston. I spent three months in intensive treatment there, learning to see my horrible intrusive thoughts as just meaningless thoughts that come and go. I also had to learn to tolerate my pain and shame without hurting myself, which was very difficult in itself.
Those three months were perhaps the hardest thing I’ve ever had to go through, but I managed to make huge improvements. When I got home, I still had a lot of residual anxiety but I worked hard to keep going with ERP and therapy, and I’m glad now that I did.
Exposure and Response Prevention (ERP) is a kind of treatment that's used to help people with anxiety learn to tolerate things that terrify them. It involves confronting (or "exposing" yourself to) the triggering object or situation and then experiencing the anxiety as it gets worse and then gradually eases off again. For example, I had to expose myself to things that made me think of children – writing the words, "boy," "girl," "kid," etc.; looking at pictures of kids; walking by a childcare centre and listening to the children playing outside. These situations brought the intrusive thoughts rushing into my mind. Normally, I would kind of panic and I reacted by running away, hiding in my room, trying to undo my bad thoughts or punishing myself for having had them. In ERP, I had to learn to adapt and cope with how the thoughts made me feel, without doing any of those "rituals" which made me feel better. I had to just carry on with life "as usual." It was very hard at first, but it turned out to be incredibly helpful, as I learned that I could in fact tolerate what was going on. 

How are you coping now?
Since then, my life has improved dramatically. I’m going to graduate from university this spring; I’m being trained in how to provide peer support; and I’m doing a fair bit of public speaking, talking about my experiences and helping to debunk stereotypes about mental illness. Most importantly, I’m writing and illustrating a graphic memoir about my life while I was ill, and how I found my way from that terrifying place. Life is pretty groovy right now, and I feel incredibly fortunate to be alive and able to appreciate it!

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