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

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.

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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