Dealing with OCD Health Anxiety and Preventive Screenings

I had a week in January with my annual screening mammogram, followed by my diagnostic colonoscopy for chronic anemia. I am proud of myself for getting through it all in spite of anxiety.

The mammogram center had moved to a new office and actually had a radiologist there to read the results while I waited, and the results were normal. My mind did its usual "what ifs" but I did feel a flash of relief.

The colonoscopy prep was not how I would like to spend a day, but it also wasn't awful, and it is encouraging that I can deal with something uncomfortable. There was a small benign polyp but not the cause of my anemia. I am in that borderland of being old enough that the gastroenterologist wanted to "make sure" even as he reassured me that nothing was probably wrong at the initial consult in November.

Medical screening and testing stirs up my health anxiety, and I am learning to accept that, and keep going. I did not do any web research. I did see my therapist when my anxiety was high in September, as I wrote about in a previous post. I am learning to expect the surge in anxiety and not launch int ruminating about why it is back, why the OCD anxiety shows up. This defuses my panic, and my "oh no!" response.

Pharmacological Treatment of OCD: DVD's Available of Dr. Steven Poskar's Presentation at OCDNJ

I subscribe to the newsletter of OCD New Jersey and recently they had a Dr. Steven Poskar of OCDNY as their guest speaker.

Dr. Allen Weg, VP of OCDNJ, sent out this note after the presentation about DVD's, and I thought I would pass it on, because it sounds like a useful resource: 

. . . if you were not at our meeting last night (and, actually, even if you were), and you are interested in the latest in medication options for OCD, you should consider ordering a DVD of Dr. Steven Poskar's presentation.  It was an incredibly thorough and exhaustive review of what is out there, including some of the newest avenues of research.  If interested, call OCDNJ President Ina Spero at 732-828-0099. 

Dr. Steven Poskar is a certified Diplomate in Psychiatry by the American Board of Psychiatry and Neurology. He specializes in psychopharmacology and cognitive behavioral therapy at the Spectrum Neuroscience and Treatment Institute in New York City.

Dr. Poskar is a co-founder and current Vice President of OCDNY, the NY affiliate of International OCD Foundation. He is a member of the International OCD Foundation’s Body Dysmorphic Disorder, Hoarding and Autism Spectrum Disorder Special Interest Group.

Dr., Poskar’s presentation is entitled, “Pharmacological Treatment of OCD: The very latest developments in exploring options.” This presentation is an exhaustive review of the many medication options now available for those struggling with OCD and those treating them, including the very latest information on approaching the psychopharmacological treatment of OCD, not only by targeting serotonin and dopamine sites, but glutamate abnormalities as well.

Living With Me and My OCD: Check out the Trailer for Claire Watkinson's Documentary

In the summer, I recorded my story about having OCD for Claire Watkinson's documentary film Living with Me and My OCD.  I'm sharing the trailer here and Claire's introduction to the project, which is set for release in 2013.  I am excited that she has taken on this project to share stories of living with OCD.

My name is Claire Watkinson, I am a freelance filmmaker and a sufferer of OCD. Living With Me And My OCD is a personal documentary about OCD that I started filming in January. The feature is set for release in 2013. It will include interviews with sufferers of OCD, diary entries from myself, the Bupa Race, OCD UK and many more exciting organisations.

I am so happy by the amount of support and comments this documentary has recieved. I am touched and means so much. Please join this campaign. I need more interviews, people and interest. Get in touch, share this page and lets get OCD more talked about!

Claire Watkinson's Twitter for Living With Me and My OCD

Buy Living with Me and My OCD Wristbands

Check out the trailer:

Fear of Being a Bad Patient: Health Anxiety and Self-Worth

Problem for me is I also have social anxiety. Dealing with doctors is just as anxiety provoking as worrying about illness. My symptoms and test results seem just worrying enough to warrant monitoring the situation but I'm constantly worried the doctor will think I'm just being a hypochondriac.

I actually looked through some books on hypocondria, but they all focused on worrying about something that has been ruled out. Which isn't the case for me. I'm working on establishing a format of when to call a doctor, which symptoms or tests should be followed up on and which need not. I'm finding this helps me to let it all go and enjoy things more, particularly when I am having low symptom period. I've got a ways to go, though. :)

I've been thinking about this comment by MinM on my post Hypochondria and Health Anxiety OCD.  The social anxiety of dealing with doctors complicates my health anxiety, as well as cultural stereotypes of women as oversensitive, and my perfectionism which demands I pre-diagnose myself and get it right before I even go to the doctor.

I spent many years at my old job listening to medical residents do their rounds, and anything to do with the mind and emotions and human complications was a struggle for them in the midst of all the technical, diagnostic work they were doing.  There was a staff psychologist who would sit in at times, and I was glad to have her there providing some perspective.  Also, some residents were much more able to deal with anxious patients than others.

OCD is still an enigma to many people, professional or not, and health fears are often labeled hypochondria, even though health anxiety OCD has a significant component of dealing with uncertainty and rituals to try and undo the fear, such as repeated calls to doctors, web searching symptoms and monitoring and checking body symptoms in a similar way to those who check locks, stove burners and light switches.

My latest challenge was a physical in October with my family doctor, who was concerned about my low iron levels and said since I was "close enough to 50" that she was going to refer me for a colonoscopy.  Getting older adds another layer to health anxiety.  I'm still a few years away from 50 and I felt a surge of panic that I was going to choose the wrong thing, do the wrong thing.

Ironically, my doctor was not "certain" about this.  She even went and talked to a colleague to see if she sounded "crazy."  Here was her thought process: My iron levels could be due to being female, but she's seen too many cases of patients in their 40's who turned out to have colon cancer, and while she doubts that there is something seriously wrong with me, she wanted to play it safe, and have me consult with a gastroenterologist.

Does this sound omnipotent or certain?  No.  Do I deal well with uncertainty?  Well. . .I hadn't seen Leonard, my exposure therapist, in 5 months, so I made an appointment to sort this out with him.  I didn't look up colonoscopies in the meantime, which is huge for me.  Leonard made me laugh by saying the sedative is fabulous with a colonoscopy. . .he'd also heard that the guidelines might be changed to start a screening colonoscopy at 40 rather than 50.  

For him, it didn't trigger a big emergency because his self-worth was not at stake, as opposed to my perfectionism, which decreed I'd better get this right or prove my defectiveness.  Leonard asked if I really believed that there is a way for someone to prove I'm defective as a person by looking at my colon.  I made the appointment with the gastroenterologist and saw him a couple weeks ago.  He basically said the same thing as my family doctor, about wanting to err on the side of caution.  I scheduled the colonoscopy for January.  

If you are a reader tempted to write me a treatise about the dangers of overtesting, and other sociological factors about suburban US medicine, please be assured I've already thought about all of this, and I've taken my best guess.  Does this scare me?  Yes, it does, because I'd prefer to make a perfect omniscient choice, but ritualizing to give myself the illusion of being able to make a perfect choice has stolen many years from me already.

Some of what I've learned over the years of dealing with my OCD with Exposure Therapy:

• It's important for me to trust and respect my doctors, and be able to honestly say when I'm struggling with the OCD.  The anxiety of figuring out how to indirectly get my questions answered was exhausting when dealing with doctors who had little patience for anxiety.

• Even people without OCD have a difficult time gauging when to go to the doctor.  There will be uncertainty.   I may be wrong.  This doesn't say anything about me as a person.

• Self-Monitoring and vigilance will not magically protect me from illness and disease, as evidenced in my experiences: Skin Cancer Anxiety: Fear, Vigilance and All or Nothing Thinking and Skin Checks and OCD: Never Enough.

Relationship OCD: Two Hard Things at Once

The post on Exposing OCD with the most comments and reader resonance is Relationship OCD and Fear of Choosing the Wrong Person or Gender.  I wrote it over 2 years ago, and it still gets comments.  There is a thread of pain throughout the comments, which I find sobering.  

I am not a professional.  I am not a therapist.  I am someone sharing my story and my experience.  If there's any lesson, it's not that my readers need to marry the one they are with, or not marry the one they are with, or find another gender, but that OCD latches onto what is important to us, such as love or connection, or a particular person, or imagined ideal person.  

Relationship struggles are hard enough without OCD, and there's nothing magical about OCD treatment that will make relationships struggle-free, but it can give you the chance to choose to live your life, and choose who you love.  

OCD is offering a false promise that you can banish all fears and doubts, all unwanted thoughts, all gnawing anxiety, if you just come up with the right ritual of analysis, research, checking, double checking, monitoring feelings or repeating certain phrases.  

When I married my husband 20 years ago, I could've made the wrong choice.  Many marriages end in divorce.  The brave part was making a choice, without having absolute omniscient knowledge of the future, which of course no human gets.   Getting married didn't make my OCD go away, but I did have the victory of choosing what I wanted(or rather, my best guess of what I wanted).    

Professional help and OCD support groups are about making an investment in your future, an investment in your life, in facing the disorder that barrages you with thoughts that go against the core of your being, and yet the more you wrestle with them, the more they cling.

Fear of Thoughts Getting Stuck: The Challenge of Reading OCD Self-Help Books

I had several responses to my review of J.J. Keeler's I Hardly Ever Wash My Hands: The Other Side of OCD, expressing fears that reading the book would give them ideas or cause anxiety.  I've been mulling this over, because it's a challenge to respond.

The simplest answer is that I don't know if J.J. Keeler's account of her OCD, and the specific things she worries about, will "stick" in your mind or create new OCD obsessions.

This is the nature of OCD that one person's trigger can seem completely harmless to someone else with a different form OCD; it's not only those without OCD who think that a particular obsession is incomprehensible.  There is a tendency to assume that other people's obsessions are easier to bear.  Conversely, if we suspect that a person's obsessions might be similar to ours, then there can be a desire to quarantine them, and not get anywhere near, as if the fears were contagious.  Or we are afraid of adding a whole new category of obsessing, and again, stay away.

This is OCD's mode of operation, to convince you that you can avoid the contagion of life, if you just screen out all things that might set you off, and enlist those around you to help in this task.   I know this from the inside.  Public health campaigns to raise awareness about various illnesses seemed designed by very cruel folks to torment me.  I was already highly aware of things that could go wrong, and I didn't want to know of any additional ways to monitor and worry about.  When I was a kid there was no internet but there were posters on the bus, public service ads on tv, special episodes of programs where someone had a disease, and magazine articles.  Women's magazines were the worst, and my mood would plummet if I was in a waiting room, reading one(which I picked up because I was anxious to be in the waiting room to begin with).

In college I was doing fairly well for awhile, avoiding obsessing about moles, until a classmate opened up his datebook, and I could see he'd written in an appointment for a mole removal.  I couldn't have predicted this.  Now, it might seem that you could at least keep yourself safe by avoiding what seems obvious, like Keeler's book or other OCD self-help books, or my blog, or the OCD Yahoo Group, or OCD support groups, but what is your definition of safe?  Avoiding all possibilities of help is not safety.  OCD would have you believe that it is possible to maintain complete quarantine, but triggers are part of life.

The irony is that when I was in an anxiety spike, I would then search out articles about whatever symptom was catching my attention, in order to reassure myself that I didn't have something serious.  There would be an initial calming effect if my symptoms didn't match, but then as I'd keep reading, I'd find something that again put doubt into my mind, or introduced an even more scary possibility.

I am not minimizing the abject fear of being seized by an OCD obsession.  I've been there.
But getting help for OCD is where the true hope of living beyond your obsessions resides.  OCD wants to maintain the status quo.  Don't get help.  Don't learn about how other people have coped.  Don't risk new pain.  

If you can't read a self-help book or OCD memoir because it's too terrifying, then this is a signal to find an exposure therapist, or a self-help group, where other people can help you.  I understand the irony in this.  I was once incredibly shy and my therapist suggested group therapy, and I was appalled.  How could I go to a group for help if I was terrified of groups??  But eventually, I realized that I didn't want to go on the way I was going:  the cost of my fear was too much, I was missing my life.

Keeler, in the preface to her book, writes of having severe fears of harming someone while at Disneyland, and self-loathing for what kind of person she must be, when a toddler ran over and hugged her leg.

It felt like she was telling me I wasn't what I feared.

I have no idea who this toddler was and I never saw her again.

But she saved part of me that day.  

Hopefully, this book can save part of someone else. 

 

 

Intrusive Thoughts and Harming Fears: A Review of I Hardly Ever Wash my Hands: The Other Side of OCD by J.J. Keeler

TLC Book Tours contacted me about reviewing J.J. Keeler's I Hardly Ever Wash My Hands: The Other Side of OCD, and I was intrigued by the title because my OCD doesn't manifest in handwashing rituals, and this is the short-cut metaphor for OCD much of the time.  After reading the book, I felt like I'd found an OCD-Soul-Sister and although I am never glad that someone else has OCD, and I am glad when they can write about it in an articulate and insightful way.  

I had to laugh when J.J. Keeler describes how her twin sister had hypochondria with fear of many diseases(a type of OCD I am very familiar with), but the author had only "had" one disease: AIDS.  In the irony of OCD, in elementary school she is triggered into worrying about AIDS when her parents mention a blood transfusion she had, but what her OCD latches onto is the risk of "dirty needles" which in her young mind means thumbtacks, staples, pine needles, with dirt on them.  Humor is a major component of Keeler's account of OCD, grabbing the edge of ridiculousness about OCD fears and pulling the whole thing apart, so that the sufferer can catch a glimpse of OCD's game of generating endless scenarios and holding life hostage.  

The second chapter, The Bomb in my Teddy Bear, is a marvel of encapsulating the experience of morphing OCD thoughts.  When she was 8 years old, neighbor gives her a teddy bear at a yard sale, and a chain of fears links itself around her.  She started getting a weird feeling about the bear, and wondered why a relative stranger would give her a teddy bear for free.  Then it came to her, "The reason was obvious.  There was a bomb in the teddy bear."  Keeler agonized over how to dispose of the bear, without harming anyone else, and then when it didn't explode, wondered if the neighbor would come back to finish the job.  Her rituals to keep the anxiety from exploding were a constant stream of "figuring out" and "analyzing" combined with tin cans at the door to let her know if there was an intruder, and plotting how she could take the bear on one of her father's fishing trips and throw the bomb overboard.

Eventually, OCD moves onto other topics in Keeler's life, but the same corrosive fear and desperate maneuvers to make the fear go away.  In addition to fears about AIDS(and calling the testing center before her test was even received, to check, check, check), she feared causing harm to others after being deluged with intrusive thoughts.  If you suffer from this very painful form of OCD, please read this book.  Keeler has known the despair that made her consider suicide, because she didn't want to harm anyone and yet these images would pop into her head, and she has survived, and now thrives.  

The most difficult part of reviewing I Hardly Ever Wash My Hands: The Other Side of OCD, is that I want to quote everything, but it would be better for my readers to go find a copy of this book and read it for themselves.  

Read J.J.Keeler's Introduction to Harming Obsessions on her blog.  

Find J.J. Keeler on Twitter

Related Post:

Fear of Thoughts Getting Stuck: The Challenge of Self Help Books for OCD

http://tlcbooktours.com/