Progress, feelings, summer

Where do I begin? I've made a bit of progress recently: I'm staying out of the house until 4:25, eating more of what I want for dinner, and exercising. I went to a party for the first time since January. Fridays have been hard for me, as my anxiety is very peaked on this particular day, but I've been trying to get out of the house and socialize on anyway. Last Friday I had lunch with Tekla and Amanda, and this Friday Rachel and I went to The Omelettery on Burnet.

I think I've mentioned that  my OCD makes me distrust things, events, or circumstances that I view as "good." Recently, I did some positive things for myself, like buying some really cute shoes and upgrading  to the new iPhone 4S (it's so fancy!).

Lots of this stuff feels really great. I totally enjoy getting my life back, even if it is going slowly. But alongside this pride that I feel for standing up to my disorder, I kind of see myself as a freak. A malaise sinks in when I think about dating again or having to tell people about my compulsions. If my recovery continues the way it's been going, I will eventually be totally healthy. But, I know that it's possible for the disorder to relapse again. How would I even start to explain to a new boyfriend that I have this potentially debilitating illness? And, let's face it, no mater how much I criticize U.S. culture for stigmatizing mental illness, I still feel some level of embarrassment about my compulsions.

On the bright side, I have amazing friends, excellent doctors, and work that I care about passionately. I'm teaching a new class in the fall, and the course planning is lots of fun. Plus, summer is already here.

Hi, blog world. I've neglected writing for a few weeks now, but I'm not apologizing for my web absence. I realized that I haven't much felt like thinking, or writing about, my OCD recently. There was a while where I checked this blog regularly, read other OCD bloggers' stories eagerly, and actively recorded my feelings here.

I just haven't wanted to think about any of that. I needed a break.

Sometimes the work of getting better is slow. Sometimes it goes fast. At times I feel very proud of everything I've accomplished, but I also feel this nagging weariness as the recovery period drags on. I've gotten so much support from my friends, and I'm going to need lots of love and good thoughts going forward.

I keep a progress log of all the exposures I do and the steps forward that I make. If I'm feeling low, I like to look back a month ago and see where I was then. Looking at then and now I see big changes, but it's often hard to remember that. In the last month, I've gotten a lot back:

Working on my dissertation, working in general, wearing jewelry, wearing makeup, wearing whatever skirts and shirts I want, being out 'til 4:21, exercising, adjusting my dosage of Sertraline for the final time, painting my nails, eating new foods at dinner, subtracting "safe" foods from dinner, doing laundry, getting my hair cut...

My YBOCS score is also down to 20. This is all good! I'm just ready to be better now.

Lists

As of yesterday, I've been on my own for a week. Mom left last Monday, and it's good to be self-sufficient again. Even though my rituals still keep me very limited, I don't feel like the helpless lump that I was about a month ago. There's quite a lot I want to write about in this post, and I think the content would be best facilitated by creating some lists.

I've accomplished some new (and exciting!) progress working against my OCD rituals. In the past week or so, I've achieved the following:

• Staying out of the house until 4:16
• Beginning to work on my dissertation again
• Eating more sweets (my OCD objected to candy, unfortunately)
• Completely taking care of myself, without help from Mom or Dad
• Feeling more comfortable putting effort into my appearance (wearing the clothes/jewelry/makeup that I want to)

Additionally, friends and family have offered tons of support. Did you know that my friends make up a small army of super-caring, ultra-generous, swift-acting, helper-people? Things I've received (whether tangible or intangible) include: 

• Tons of hugs, good thoughts, emails, calls, etc.
• Incredibly thoughtful cards from Kerry, Amanda, Stephanie, Lauren, Meg, Pamela and Nikki (seriously, I teared up when reading these)
• A gift from my Etsy wish list, courtesy of Lauren, that I'm anticipating with bated breath
• Coloring books (!!) from Meg
• Steven has offered Alaskan salmon that he caught
• A puzzle from Tekla
• Awesome lunch dates with Dustin, Stephanie, Amanda, and many more upcoming plans on my calendar to look forward to

Now that I'm more open about my OCD, many acquaintances and co-workers inquire about my improvement. My standard response usually alludes to how surreal things have felt, but I've been telling so many people how lucky I am to have such loving friends in my life. I, truly, would not be in such good shape and making such swift progress if it weren't for all of you. 

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.

FAQ

My mom has been staying with me recently, and though she has a first-hand glimpse of what I've been going through, she (understandably) has questions about the manifestation of OCD. The disorder isn't realistically represented in popular culture, so there are a lot of misconceptions about it. I thought I'd write a little bit of information for anyone who might be reading this journal that has questions.

• OCD is an anxiety disorder arising because of neurological malfunctioning. Anxiety is your brain's warning system, but if you have OCD, the warning system doesn't work correctly. Therefore, you experience the sensation of danger even when you know everything's fine.
• Individuals living with OCD usually understand that their obsessions and compulsions are irrational and excessive. In TV shows and movies, OCD individuals are often portrayed as enjoying perfection, order, or cleanliness. Someone who enjoys excessive perfection or cleanliness might have Obsessive-Compulsive Personality Disorder. With OCD, however, the individual knows that their fears are irrational, but can't stop feeling afraid. They also won't enjoy performing compulsions: the only reason they do the compulsions is to relieve anxiety. 
• OCD isn't primarily about cleanliness. True, some sufferers do fear germs or dirt, and this variety of the disorder is called contamination OCD. However, other iterations of the condition might make the person fear causing or receiving harm, breaking moral codes, or getting rid of personal possessions. 
• Finally, it's often not easy to identify a person that has OCD. Frequently, when I tell someone about my disorder, they'll say "I would have never known!" or "You seem so put together!" The reality of OCD, however, is that about 2-3 million adults and 500,000 children experience the illness at any given time. Most people with OCD hide the disorder out of embarrassment. In fact, OCD has been linked to above average intelligence and high achievement. 

If you google image search "OCD brain" you can see pictures that show how an OC individual's brain works differently than those who don't have the disorder. I'm very open to answering questions from friends or family, since it's important to me to raise awareness about the realities of the illness. 

Fun Home(work)

I met with Dr. M again today for my second-ever visit with AustinOCD. We talked about my progress last week, which consisted of just "poking" at little rituals and habits that I have. He said I'm in great shape and am going at a good recovery pace. That was nice to hear because it's kind of hard to tell if I'm taking on enough. Most notably, I made it out of the house 'til 4:15 (yay!) and ate some foods that are "off limits."

I've officially discontinued the Ativan - big relief! No more medication adjustments for a while.

My homework for this week  involves two things:

• Keep "poking" at my rituals and habits (but don't try to take on too much right now).
• Find ways to be purposefully imperfect. Dr. M said that OCD tends to make you want to do things perfectly, and that going out of my way to make errors, mistakes, and slip-ups will help my recovery. He suggested things like: including typos in emails, not doing all of my makeup, or leaving out dirty dishes. 

Also, I learned that Dr. M is familiar with Alison Bechdel, one of my favorite authors. I mentioned her book Fun Home in our meeting today, and he said the name was familiar to him. Apparently, he's read her comic strip Dykes to Watch Out For. Exciting!

Optimism

I've recently discovered that securing treating for OCD is almost as challenging as battling the disorder. In the last few days I've made some progress with my rituals, but have mostly been trying to make sure all the odds and ends with my new doctors are sorted out.

Insurance. The new treatment center I'm working with is "out of network" for my health insurance. This means that Blue Cross/Blue Shield will only cover part of my medical expenses. However, the people at AustinOCD suggested I try to get an exception granted to me since they're the only real specialists in town who treat OCD. I made lots of phone calls to BC/BS, and after speaking to many corporate bureaucrats, I've created an official request for them to cover my treatment costs. The people I spoke with said that there was a good chance for me to get coverage, so I'm optimistic.

Medication. I'm in the process of making my last medication adjustment. Two weeks ago I reduced my Ativan dosage by half, and right now I'm stepping off the medication entirely. Because of the difficulty of all my previous medication adjustments, I was very (very) nervous about this final one. I've also been informed that the withdrawal from this type of chemical, called a benzodiazepine, can be particularly hard.  I really don't want to lose any of the progress I've made, so I was bracing for impact with this med cessation. My anxiety has definitely been higher than usual, but I'm staying strong to get through this last withdrawal period.

Here are some things I'm looking forward to:

• My body chemistry being in balance again so I can start working on CBT/ERP with full force
• Getting to work again on my dissertation
• Watching Dancing with the Stars tonight with my mom (she's a big fan). 
• Spring