Sunday, July 4, 2010

Built on Sinking Sand: The House of OCD and Health Anxiety

Sunk and askew

It was the summer of 2006 when I sank deeply into the OCD with a full scale health anxiety crisis. OCD thinking is like an elaborate structure built on sinking sand. It appears so real and solid and indisputable and all the while your life is collapsing underneath you, and the logic is built on inherently unstable ground. OCD is an entire industry of thinking with very little to do with the outside world, except for the grain of truth that it inevitably latches onto.

Even writing about this summer stirs up the OCD. Part of my compulsion to make the anxiety go away was to make detailed notes about my symptoms, in hopes that I accounted for every possible thing, so my impulse, when writing this blog post, is to include every detail. The anxiety began when I agreed to take a medication which might alleviate a symptom that I obsessed about frequently. I took the medication, and started obsessing that I was getting a bladder infection, which was another one of my health anxiety themes. After fixating on every bladder sensation, and agonizing about whether to call my doctor, I finally did and she got me in at the end of the day. It is common(though perhaps not recommended) to treat women empirically if they have bladder infection symptoms, so that's what she did--no urine test.

And that began an elaborate building of health fear, one level on top of another. Because I'd had a severe headache with one antibiotic in the past, I said I wanted a different one, and in dodging one fear I landed in another as I began to obsess about getting a yeast infection from the 2nd antibiotic, and called my doctor who prescribed meds over the phone. I was overwhelmed with a surge of anger at my doctor for not doing a urine test since I had several bladder infections that turned out not to be, and since strong feelings set off my OCD, I was on very shaky ground.

Over the next weeks the OCD was compounded and grew at an alarming rate. I went to a different gynecologist, who was near my house, who did a lab test and said I did not have a bladder infection, and gave me more meds for the supposed yeast infection. I still felt urgency in my bladder, and even more urgency in my OCD desire to know exactly what was going on in my body, and perfectionistic self-condemnation for not perfectly diagnosing myself or advocating for tests, or for calling a doctor in the first place. The OCD thoughts were all about my defectiveness, and my responsibility to make sure I didn't get a kidney infection, and the imperative that I never make a mistake, and that I would be haunted by the pain and discomfort in my body.

I was on a quest to get relief from my anxious imaginings and my fixation on painful sensations in my body. I found a new family doctor, who said if I still had bladder urgency that I probably did have an infection, and she wrote a script for antibiotics, and reluctantly did a urine test at my request, but when I panicked that I did not do the test sample correctly, she went into authoritarian mode and told me to not get myself worked up, to just calm down. Well, if I could do that, I think I would have already. . .I went and cried in my car.

So here I was trying to decide whether to take another antibiotic, without test results, and the OCD structure was growing, as I felt a surge of hyperresponsibility that if I got a kidney infection it would be all my fault, so I'd better take the antibiotic. By the end of that week, I couldn't sleep at night, and I went into the doctor on a Saturday. The doctor on call was much calmer and kinder, and she prescribed another antibiotic that would be less likely to cause insomnia, but this antibiotic wreaked havoc with my digestive system. I went back to the doctor on call who happened to have my test results, and once again it showed I didn't have a bladder infection but that I did have blood in my urine, and she wanted me to see a urologist.

By this time I was a mess. My therapist Molly was on vacation. I went to see the therapist on call, and told her how I couldn't get this right, couldn't figure out what was wrong with my body, that I needed to try harder. She sat quietly for a moment, and then said that it seemed I had been working incredibly hard to find out what was wrong, with multiple doctor visits and relentless researching on the computer. I was baffled by this. This did not make sense in my OCD world, where I was never good enough, never finished, never solved, never certain.

She wrote a few sentences on a scrap of paper, and gave it to me:

May I be filled with lovingkindness.

May I be safe from inner and outer dangers.

May I be well in body and mind.

May I be at ease and happy.


This was a glimmer from outside the windows of the house of OCD, the possibility of another way to view the world. Feeling body symptoms can be hard enough without the "inner dangers" of OCD. I was to descend further into my OCD, but I had a moment of reprieve.

*********************
Thinking about it now, this is part 7.5 of my Medication Series, since it was my first OCD crisis after ceasing to take my antidepressant.

Part 1: OCD and Medication Decisions
Part 2: Starting Medication while Struggling
Part 3: The Limits of Research in Medication Decisions
Part 4: My First Prescription for SSRI's
Part 5: Feeling it in the Jaw: Side Effects of Medication
Part 6: Being on Medication & OCD Weeping
Part 7: Wanting to Get off my Medication

11 comments:

  1. While reading about your health anxiety I was struck by how OCD can so easily latch on to one thing, while completely disregarding another. While there are times that I have started to feel that overwhelming fear about various bodily symptoms, fear that seemed irrational even to me and that appeared out of nowhere during times of a lot of stress, it never became a downward spiral for me. I somehow dodged that bullet when I think I could have easily gone down that road.

    Looking back to this time last year before my big contamination relapse, I can now see various ways OCD was trying all throughout the summer. I was under a lot of stress, and in retrospect it seems like OCD just kept trying different attacks, just waiting for one to take hold more permanently and wreak havoc on my life. Somehow I ended up with contamination issues, but I feel like it could have easily been one of the other routes of attack that OCD tried, including health anxiety. Contamination just happened to stick.

    Right now, I tend to have the opposite problem of what you had. I tend to avoid the doctor because of my contamination issues even though I know that I probably should go. I don't really worry about getting sick from others, but rather, getting caught in a situation where I feel like washing is imperative when I have no opportunity to do so.

    Anyways, your post reminded me that OCD often seems to take to the same pattern, demanding the same sort of perfection and absolute certainty whether it is in regards to health, cleanliness, or any of the other endless possibilities. It is the same villain dressed in different disguises for different people, or even for the same person, at different periods in their life. What frightens one might not be a problem for someone else, or what frightened someone in the past might not bother them at all now, but the insidious nature of the disorder is the same. Like you said, "OCD is an entire industry of thinking with very little to do with the outside world, except for the grain of truth that it inevitably latches onto." Which grain of truth OCD grasps onto can differ from from person to person and within the same person at different times, but the template for eroding the sufferer's life seems basically the same.

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  2. I also struggle with obsessive thinking. I don't have any compulsions but my mind is constantly thinking, all the time. One thing I have found helpful is to do a meditative technique and interrupt my thoughts. The key thing to recognize here is that the specific thought is not neccesary, it is the thinkingness that our minds crave. Any thought will do. Our true selves, or our higher mind, as some would say, is intuitive, not logical. Intuitive thinking is of a higher order. Here are a couple of sites you might find helpful.
    http://www.exercisenutrition.net/ and also
    check out http://todayshealthcounselor.com/default.aspx
    There is a section about negative emotions you might find helpful.

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  3. Fellow Sufferer--I love the sentence "the template for eroding the sufferer's life seems basically the same"--that rings very true!

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  4. Anonymous--thank you for commenting! The metaphor about keeping balance on a bicycle, from the website you mentioned, was very insightful--"Balance is achieved by regularly going off center and then coming back." I don't have a lot of practice with that because when I feel negative emotions I immediately want to make them go away and fall off the bike! I am taking time to practice the process of feeling the feelings and coming back to center.

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  5. I really like how you describe your ocd as an industry of thinking that has little to do with the outside world. I'm only now realizing now in my 40's that all my industrious thinking is not useful and kind of a problem.I love the way You articulate your thoughts on this!

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  6. I recently found your blog and so much resonates with me. I have read back through your archives. My mind is causing so much pain, it is a wonder to hear others who have traveled this road already and with such honesty. I adore the statement at the end, and it does give me a glimmer of that elusive world outside the OCD mind. Thank you.

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  7. flyingbird--I am glad that my blog resonates--that is truly one of the best things about writing this blog. If even one person catches a glimmer of hope, I will be grateful.

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  8. I can relate! The doubting disease is very sneaky and persistant! It tries so many themes to get you hooked, My therapist puts it like this. "Hey, pay attention!! These thoughts are important!!" I find though once you get the hang of it relapse goes away faster and faster. But on the other hand it selects things that you will never know the answer to.

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  9. Adam--I've found my ability is improving to recognize the desperate efforts of my thoughts to catch my attention with new and bizarre things--that it's part of it's mode of operation. But it sure is sneaky and frustrating!

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  10. I went through the same lever, same strength of OCD during my summer vacation in 2006....but for a very different reason. More existential OCD than the fear of having an illness. The one that thrives on doubt and the one that tries to gain more credibility based on ideas that can't be proven/disprove. The OCD that I have tries to repulse against the idea that I can't disprove anymore than the idea itself can be proved.

    It is actually stronger than ritualistic OCD because of it's "validity" and more deadlier. Almost leading me to suicide.

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  11. Pakistani--yes, trying to prove what can't be proved is one of the things that causes so much suffering in OCD! I hope you have found some treatment to help with this--it made a world of difference for me.

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