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!

Happy Sunday, blog world. This weekend has been pretty good. Mostly, my homework involved socializing. Dr. D encouraged me pretty strongly spend lots of time with my friends and family. They're my support system and also help me feel tons better.

Friday afternoon my aunt, cousin, and her two little children came into town and we had a long afternoon lunch. I was nervous because it was a Friday - recently, the weekends have been making me nervous because it's a long stretch of time where I can't get into contact with my doctors if I need to. However, I think this weekend I was less anxious than the previous weekend. This anxiousness about weekends is new for me, and quite frankly it sucks.

Yesterday was a big step because I went out and socialized on my own, without Mom! I didn't rely on Mom to drive or pay at all. I went out to lunch with my friend Tekla and ate a massive burrito. We bummed around a little bit and then I took her home. Later, I went to Target to buy this pretty vase I've been coveting. So, I guess I allowed myself to have a good thing. I rewarded myself - this is good.

Also, I went two whole days without crying. This isn't necessarily an accomplishment, per se, but an indicator of my mood stabilizing and my body adapting to the new medications. Dr. E said that my regular crying jags were probably being produced by the medication swap and my body/hormones adjusting. I didn't cry at all on Thursday or Friday. Yesterday I did get upset, though.

Sometimes I get really frustrated with the fact that I have OCD. I start to ask lots of unproductive questions like "Why did this have to happen to me?" or try to tell the universe that it's not fair for me to have this stupid illness. I suppose I'm grieving - from what I understand this kind of anger and sadness is normal. I'm just trying to let myself feel my feelings, whatever they are.

My "homework" has been going well so far. I commonly feel two conflicting things now that the medication is starting to kick in: 1) Realization that the things I worry about are irrational, but 2) A simultaneous fear and need to perform my rituals in order to make myself feel better.

Maybe it would help if I explained my rituals a little bit. I remember reading about OCD in Alison Bechdel's graphic novel Fun Home. The protagonist, Alison, begins experiencing childhood OCD symptoms around age 10. Though each case of OCD is different, one of the compulsions she experiences reminded me of my own case:

If my day went well, I tried to duplicate as many of its conditions as possible. And if it didn't I made small adjustments to my regimen. Life had become a laborious round of chores. At the end of the day, if I undressed in the wrong order, I had to put my clothes back on and start again.

This is very similar to my experience with OCD. Repeating trusted behaviors is a variety of OCD (some others include checking, counting, or washing) and it's how my condition manifests. As much as I love Bechdel's novel, it's a little frustrating for me, as an OCD sufferer, to watch her recover all by herself. She describes her OCD as a "spell" - just a brief period of her life where she's OC (of course, this really isn't accurate, and a close reader of the novel can see OC symptoms well into her adulthood). I guess what I do want is for there to be more awareness in the general public about how debilitating OCD can be, and how necessary it is for patients to find treatment with trained doctors.

I guess I'm trying to wrestle with the fact that OCD is generally a chronic condition - it should persist my entire life. My doctors say that my recently worsened symptoms are probably a product of life stress, but even given my eventual recovery there's still going to loom the threat of relapse for, well, ever. Blerg.

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.