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 

Though Wednesday was pretty difficult, Thursday (yesterday) was better. I didn't cry, and my mood was a little bit perkier. I'm still suspicious of these days when I feel more upbeat, but Dr. E says that by next week I should be having more and more of them, and my good moods won't feel like a "fluke."

As for my homework, I did something very small, but it felt really good. I took care of cleaning up all of the dishes after dinner. I put away all the leftovers, and washed and scrubbed the plates in my sink. Up until now, Mom has been doing these kinds of things since I've been largely helpless. It felt really good to take back this little chore - I felt a bit more like myself, and I felt more capable.

Also, I got a very sweet phone call from my friend Kerry, and she offered lots of kind thoughts and advice. She said one thing that has stuck with me, which is to reward myself for doing all my hard work. She asked if I was treating myself in any way, and I realized I hadn't really been doing anything like that. In some way my freedom, in and of itself, is a reward. It's such a magical feeling to be able, little by little, to get my life back.

But Kerry's right - I do need to reward myself. Some ideas that spring to mind are:

- Buying myself little presents from my Etsy wish list
- A yummy dessert
- A date with a friend
- Pretty fabric from Calico Corners
- A bottle of Champagne (when I'm allowed to drink again)
- Flowers
- DVDs of my favorite TV shows
- Visiting a new restaurant

It was kind of hard to think of ways to reward myself. That says something important, yes? I'll work on this more.

Doctor #2

This morning I met with my counselor. She's a psychologist, who, for the purposes of this blog, I'll call Dr. D. Dr. D is another super-smart lady, and she runs marathons, and always wears these cute shoes that look like they came from J. Crew.

Anyway, I was talking to Dr. D today about my general malaise and how I've been feeling like my OCD really sucks and it's chronic and I'll have to deal with it for the rest of my life. Please excuse my use of a run-on sentence, but a long, smushed up list of bad feelings accurately describes my recent emotional state. She was very helpful in pointing out to me that OCD doesn't have to be chronic like other mental health issues such as Schizophrenia or Bipolar disorder. According to her, OCD can be treated and can go into remission. She reminded me that I am very high-functioning, and she hopes that my symptoms will, after I work at it, go into remission.

My homework for this week builds on the things I've been doing. 
Today: I'll be out of the house for 6 hours, stay out until 4:15.
Tomorrow: Take the bus to and from school, stay out of the house until 4:30 - 4:45.
Thursday I'll start doing the dishes again (Mom has been doing that).
Other homework includes hanging out with a friend at least once this week, and eating a yummy dessert after dinner (and allowing myself to enjoy it).

I also noticed that the leg jerking was kind of bad last night, but I'm assuming that was just because I increased my dosage of the Sertraline.

This is a blog about my recovery from OCD. I thought it might help for me to start of with some basic details about my condition, and how it has changed in the last month.

2009 - 2012

I was diagnosed with OCD in the spring of 2009. At that point the condition was very mild, and my rituals (physical things I do to reduce my anxiety) were not very intrusive in my life. I was put on a low dose of an SSRI (Lexapro) to manage the condition, and began work on Cognitive Behavioral Therapy (CBT). CBT is a type of therapy where patients gradually exposes themselves to anxiety-provoking scenarios. I was successful with the CBT and the medication. Though I had a few ups and downs, overall, I was improving steadily with my OCD recovery.

2012 - 

According to my doctors, OCD naturally waxes and wanes. This past January I had a series of panic attacks and experienced a sharp increase in my OCD symptoms. Basically, my anxiety and rituals both increased a lot. In order to manage my anxiety in the short term, I've been put on a heavier, temporary anti-anxiety medication (Ativan). My doctor wanted to see if my anxiety would stabilize and return to normal levels on its own. We waited for two weeks, and my anxiety levels had not improved. Therefore, my doctor decided I needed to be on a different medication, and on a much higher dose. So, about a week ago, I switched medications, and increased the amount I was taking. 

Details about my OCD

Rituals: OCD is a condition where an individual experiences distressing thoughts (obsessions) and tries to use rituals or physical acts (compulsions) in order to mitigate their anxiety. Right now, my rituals take up most of my evenings. I'm working on minimizing, little by little, the rituals that I perform. 

Medication: Right now I'm on two medications, a temporary anti-anxiety medication (that I mentioned above) and a long-term SSRI (Sertraline). The SSRI will take some time to kick in, so right now I'm waiting to start feeling the full effects of the medication. I have a meeting with my doctor next week to talk about reducing the temporary medication, and increasing my SSRI dosage. 

Complications: Adjusting to the new medication is a little tricky, and my body has been doing some wonky things during the transition period. I've been experiencing on-and-off nausea, intermittent crying jags, and some nocturnal myoclonic jerking. According to the doctor, these side-effects should wear off as I adjust to the medication. 

Prognosis: My counselor (psychologist), who specializes in anxiety-related disorders, has been having me do little pieces of "homework" every day. Basically, I try to do one thing each day that makes me anxious, such as breaking a small piece of a ritual. My doctor (psychiatrist) says that my ability to do this homework is a very good sign - most people going through medicine transitions aren't even able to do that.  So, it's very positive for my recovery that I'm able to tolerate the anxiety of working against my OCD, if only in small pieces.