Frankie Says Don't Worry About Your YBOCS Score

I went to see my doctor at AustinOCD today. Every time I go into the office, he asks me to fill out the Yale-Brown Obsessive-Compulsive Scale. Commonly known as YBOCS, the scale uses a 40-point, standardized questionnaire in order to diagnose the severity of one's OCD. A score of 40 indicates the most severe symptoms,  and 0 the least.

So, during every visit to the doctor's office I re-take the survey. At my first visit to AustinOCD, I scored a 29. During today's meeting, my doctor told me that my score had dropped with each visit. Last week I was at a 26, and this week I scored 24. Because the changes with OCD recovery are so small and incremental, it's sometimes hard to tell if I am, indeed, getting better. But my YBOCS score is going down little by little. And that's a really good sign.

After we talked about my improving YBOCS score, Dr. M pointed out that despite my quickening progress, he had recorded in his notes: "She's concerned she's not doing enough work to get better." I'm assuming that this mental self-flagellation is due in part to my training in graduate school. As an academic, there are no boundaries on when and where you're supposed to work, so I usually find myself thinking "I should be working right now" during most hours of the day. Apparently this all-work-and-no-play mentality has shifted to my health! I need to learn to relax.

New Doctors!

I just got back with my meeting with the director of AustinOCD, and overall I think the meeting went well. The director of the center is Dr. M and he kind of looks like Richard Attenborough from Jurassic Park. The meeting was mostly "patient education" about OCD and what happens in the brain with this specific disorder. Dr. M refers to it as a "neurological glitch." This glitch happens in your frontal cortex, so you perceive danger where there is none.

Here are some of the other relevant things I learned from the meeting:

Medication: Dr. M discussed the medication switch I went through recently, and said that because I had such a hard time when I was starting the new medication, it might actually indicate that this particular med is going to be a good fit with my brain. It's kind of complicated, but because of something called "downregulation," when an SSRI is a good fit with your brain, it floods your body with serotonin, and so (at first) you end up producing less and so feeling worse. In the long term, though, once I adjust, it might indicate that the particular chemical in the Sertraline will help me a lot.

Prognosis: I had been nervous because when I first spoke with Dr. M he had referred to my condition as "severe." That totally freaked me out. I mean, yes, things have worsened with my condition, but it's scary to hear someone say you have a "severe" illness. He addressed that today with me - he said it sounds like the anxiety/"suffering" I've been going through is severe. However, he says he's very optimistic about my treatment based on my history with OCD and current disposition.

Rituals: My homework this week is to "poke" at my OCD - just try to change little things in my rituals. I had been trying to tackle some ritual-changing on my own, and told him I started with trying to stay out of the house later because it was such a "big" ritual and so obnoxious. He asked why I'd started with something big and suggested I try to do small things instead. He emphasized I take on modest goals at first. Especially at the beginning of recovery, he said, it's a mistake to do too much.

Overall, I'm pretty positive about things right now, but it's soooo hard to just make slow, small gains. I am impatient and want to fix every problem right now.

March 20 Status Update

So, I haven't done a recap post in a while with pertinent info about my health stuff. Here's a quick update about where I'm at right now.

Rituals: I've been able, little by little, to start pushing back against my rituals. They start around 4pm in the afternoon, but I've been working on pushing that back. Yesterday I stayed out of the house 'til 4:06! I know that sounds like baby steps but any progress is good. There are a lot of "avoided activities" that I have. But, I am able to cook and clean for myself again, and I am going to work. For some reason, my OCD also made me feel afraid to eat certain foods, but I'm incorporating lots of new stuff into my diet and am eating more.

Medication: (Big knock on wood here) It seems like we've found a good combination of meds for me. I'm on a higher dose of an SSRI called Zoloft, and another drug that amplifies the SSRI called Seroquel XR. The crying jags seem to have stopped.

Complications: The new meds that I'm on are supposed to make me hungry, and they do. I'm pretty OK with this side effect, and I'm trying to eat as much as possible. I've also noticed some uncontrolled muscle movements in my legs (small muscle jerks) that I need to speak with my doctor about.

Treatment:  I'm going to start working with AustinOCD. I'm very hopeful about working with the people there, although I'm also nervous, because it will be hard work. Thankfully, my insurance will cover part of the cost, and my parents are going to help out.