World Mental Health Day 2020
Today (October 10, 2020) is World Mental Health Day - a day dedicated to raising awareness and education around the globe for mental illness, and for promoting advocacy for those suffering from any form of mental disorder whether it be OCD, anxiety, depression, or anything else. You are not alone.
Since this is an OCD-focused blog, I wanted to hone in on Obsessive Compulsive Disorder. According to these statistics from the Anxiety and Depression Association of America, OCD affects about “2.2 million adults, or 1.0% of the U.S. population.” That may seem like quite a large number, but when compared to other more common disorders such as PTSD (est. 7.7 million US adults) or Depression (est. 16 million people), OCD is actually a fairly niche topic - which makes it that much harder to diagnose and treat.
Indeed, my experience is that many people suffering from OCD aren’t even aware they have it, and that many therapists and psychologists who are otherwise qualified to treat generalized anxiety disorders struggle to diagnose and treat OCD. This isn’t helped by the fact that OCD, whenever it is portrayed in mass media or popular culture, often gets stereotyped as a disorder that makes someone obsess about cleanliness and order… which only confuses people who suffer from OCD but don’t have the stereotypical compulsions around cleaning or hand washing.
In my blog post on September 19th, I wrote about the importance of “Knowing Your Enemy” - that is, in order to recover from OCD, you must first understand what it is and how it works. I won’t repeat the contents of that post verbatim, but the gist of it is:
Understand that OCD compulsions and intrusive thoughts can take many different forms. They are not just limited to the stereotypes of washing your hands excessively or having to arrange everything in your house in an orderly fashion. So don’t feel like your particular “brand” of obsessions & compulsions are something special or unique to you - they are still OCD and they can still be treated by things like Exposure Response Prevention (ERP) and Acceptance Commitment Therapy (ACT).
You (as the OCD sufferer) often have unique insight into how this mental disorder works - oftentimes even more so than trained psychologists and therapists. I believe that unless someone has actually suffered from OCD firsthand, it’s extremely difficult to treat others with this disorder. Oftentimes, therapists and psychologists (though well-meaning) will make your recovery worse by doing techniques like reassurance which only feeds OCD. It’s important to find an OCD specialist and not just a general therapist.
Your OCD recovery progress is completely in your hands. It can be as slow or as fast as you like. Doing ERP is tough - by refusing compulsions, you are depriving your brain of its favorite drug (the feeling of reassurance it gets when you perform those compulsions). And naturally, when your brain has been used to this for so long, when you start cutting out compulsions, you go through a period of withdrawal (feelings of anxiety, doubt, uncertainty, and fear). It’s very similar to an alcoholic going through withdrawal during recovery. It’s just an unfortunate fact - there is no easy or pain free way to recover. I get the sense that many people are scared of ERP because they don’t want to tolerate any feeling of discomfort or anxiety - they just want a magical pill that will make everything disappear. The hard truth is that there is no magic solution, and no easy way out. ERP works, but you have to be willing to grit your teeth and go through it and accept the short term struggle, because the long-term payoff of being free from OCD is worth it.
OCD is, fundamentally, a cognitive disorder in the sense that you have “conditioned” your brain to behave like that. Whenever an obsession or intrusive thought pops up, your brain fires off an alarm bell, thinking it is something to be afraid of (it’s our natural fight or flight response that originally evolved to make our ancestors be afraid of things like saber toothed tigers or hot fires). When you respond with compulsions (to make the sense of anxiety and fear go away), you are essentially telling your brain: “Yes, this is a valid fear to be concerned about” and as a result, your brain will then fire off feelings of anxiety and fear whenever that trigger occurs again in the future. The problem is, OCD thoughts and obsessions are not valid fears - they are completely irrational - but by engaging in this behavior, you are teaching your brain to ring the alarm bell every time they occur. Recovering from OCD requires you to break this cycle by refusing compulsions, which gradually teaches your brain that these are not valid fears. However, this process takes time. If you have been doing compulsions and normalizing this behavior for years, it will take time (not years, but maybe months) to “retrain” your brain. The good news is - your brain is an amazingly flexible and pliable muscle. You can teach it new behaviors and reshape your neural pathways through the correct conditioning and mental exercises. That is how OCD works, and that is why ERP is so effective in treating it.
So if you are suffering from OCD, I hope that helps contextualize this disorder and helps you to understand that although it can be a burden, OCD is definitely something that you can recover from with the right therapy techniques. In fact, you don’t even need to see a trained psychologist or therapist - you can start practicing Cognitive Behavioral Therapy techniques like ERP and ACT on your own with a little bit of research (see my Helpful Resources section for some good resources). I recovered from OCD on my own, without seeing a professional therapist or psychologist, and you can too! (but of course, a trained OCD specialist can be an invaluable resource for those who are able and willing to see one)
So today on World Mental Health Day 2020, I just wanted to write this blog post to let you know: suffering from OCD is difficult and painful, but you can recover from it. You have all the tools you need to start the recovery process today, by yourself, if needed. You are not alone - there are so many people in this world suffering from OCD, but also many people who have suffered from it and recovered completely. There are so many great resources online to help guide you through your recovery journey, including this blog (and I am always happy to answer questions sent to me).
Today, if you are reading this post, I am asking you to commit to OCD recovery, for your own sake. Research ERP and start cutting out compulsions, and even if the anxiety feels overwhelming, refuse to give in to the desire to ruminate or check or do any other form of compulsion. Grit your teeth and tell yourself “I will do this as long as I need to, because suffering in the short term is infinitely better than a life of being OCD’s slave.” And even when you feel miserable, or anxious, or wrought with fear, do things that you value and live your life. Go do your favorite hobby, mindfully cook a meal and savor the taste, go outside and just pay attention to everything you can see, feel, hear, and smell. Stay engaged in the present moment and not with the intrusive thoughts in your mind. You will come to realize that you can separate your actions from your OCD thoughts. Even if you are feeling anxious, OCD cannot stop you from actually doing things which add value to your life. And when you shift your focus to actions, rather than getting wrapped up on the thoughts and obsessions in your head, that is when you start to break free from OCD.
And lastly - be kind to yourself. OCD recovery is not a linear journey. Some days will be harder than others. Sometimes it might feel like you’re taking two steps forward and one step back. Or even one step forward and two steps back. That’s OK. We are not perfect. If you have a good week of ignoring compulsions and then suddenly give in and do a bunch of compulsions on one day, don’t feel like you’ve relapsed and ruined all your progress. Just commit to moving forward and refusing compulsions the next time you are triggered, and remind yourself that you are dealing with something that would break many other “normal” people. You are a warrior and you are fighting (literally) for your life. So don’t give up and don’t get discouraged. As Winston Churchill once famously said, “If you’re going through hell, keep going.” And you will find that if you stick with OCD recovery techniques like ERP and ACT, it will get easier and easier to refuse compulsions the more you practice and the more you habituate yourself to feelings of anxiety.
I hope you have a wonderful day, wherever you are reading this, and remember to treat yourself kindly today and whole heartedly commit to your own OCD recovery.
Eric