Wednesday, March 30, 2011

Disproportionate Frustration


Sometimes (like now), I find myself disproportionately angry with the world.  At times like this I feel like society, our culture, has set me up for disappointment.  I feel like I have been taught, indeed instilled with, certain beliefs that are later turned on their heads.  I feel lied to.  I feel betrayed.  I'm angry.  And then I have to watch and bear witness as others merrily go about their day, unaffected by these things that society promotes, blissfully unaware of any sort of duplicity that others might see and experience.  Or, if they are aware of the incongruent messages and actions of society as a whole, they remain somehow unfazed by the anomalies and can proceed with their lives unruffled by the discordance.

The particular subject of my anger today is a bit too personal for me to describe here.  (Yes, I know it is anonymous, but still, I already have a hard enough time talking about this particular thing with my therapists.  Putting it in writing for the world to see is a bit much for me at this point.)  However, I recognize that I am overly bitter.  I try to give things a chance.  I try to be mindful of my tendencies to catastrophize, and I try to let my thoughts and feelings come and go freely.  But somehow things still seem to lead to disappointment, which in turn ramps up my anger with the world for making it seem so easy, so natural, to be happy with this particular thing.  I have been brought up to believe that things are supposed to intrinsically be a certain way, and yet for me, that never seems to be true.  So I am angry.  I am disappointed.   I am frustrated.  Did I mention angry???

I realize that this post is probably hard to understand without giving more information about the particular subject I'm referring to.  But it's the best I can do right now.  I need an outlet for my frustration at this moment, and this seems like best option.

I feel broken, imprisoned, and betrayed by society AND my body.  Hopefully it won't always be that way.

Monday, March 28, 2011

Little Time Equals Little Writing

Life has been a bit crazy-making lately.  A few weeks ago I started to titrate down from my uber high dose of Zoloft (sertraline) so that I could try out Prozac.  And as I much as I feel like the Zoloft never really noticeably affected my thought patterns or my ability to fight my OCD, I have been hesitant to proceed in going down in dosage.  Meanwhile, my psychiatrist is out on leave, and I have been further hesitant to call the psychiatrist covering for her in her absence.  But I haven't proceeded with the schedule for decreasing medication dosage, and I should probably talk to someone about it.

Part of my hesitation to going down in dose is rooted in OCD, I believe.  OCD is probably also the reason I stayed on the Zoloft (and my super high dose) for so long.  It didn't seem to be harming me.  I WAS getting better, albeit ever so slowly, as I continued to move forward in CBT.  And if my ability to progress was, in fact, facilitated by the meds, I was reluctant to rock that boat, even if I wasn't seeing really clear signs that the medication was working.

Who knows, maybe it was working.  Maybe it still is.  Maybe it was for a while but has lost its effect on me.  But all the same, when my psychiatrist suggested we try something else or continue to go up on the Zoloft, I decided I was ready to go with something new.  And thus, the decrease in dosage process began.

And...stopped.

I went down one step and remained there.  I stalled and then stopped going down on the Zoloft for a number of reasons.  I was having a rather rocky time when the dosage change process began (but then, isn't it always rocky?  Maybe rocky isn't rocky at all but just the way life always is?  I can never tell...).  Anyways, I was having a rocky time and I missed a day here or there of taking my Zoloft and didn't want to go down in dosage immediately after having forgotten a day, and so on and so forth.  And after perpetuating this pattern for several days, I got cold feet and I stopped continuing the process of weaning off the Zoloft.  My dosage gave me some sort of feeling of security, most of which was probably NOT due to the effects of the drug itself but rather my attachment to the idea of it and the desire to maintain "sameness."

Meanwhile, I was feeling incredibly sleepy more frequently than usual.  I'm not sure if this was just the result of things I was dealing with that week, lack of sleep, decreased quality of sleep due to various things OCD, or the decrease in the Zoloft, but because of that sleepiness, I stopped taking the very very low dose of Seroquel I have been on.  The Seroquel has always seemed to counteract the sort of hyperactivity and inability to fall asleep that I've come to associate with the Zoloft, so when I found myself sleepier than usual the week I went down in Zoloft dosage, I was hesitant to make myself MORE sleepy by taking the Seroquel on top of everything.  And when I stop taking the Seroquel on a regular basis, my sleep schedule starts to drift (I don't work until the afternoon, so I don't have to get up early), I don't make enough time for sleep, don't get enough sleep, and at that point, I certainly don't want to resume taking the Seroquel, because if I take it too late at night, I oversleep.  Like a lot.  So on and on it goes, as the domino-like effect accelerates and makes problems worse.

I am beginning to get back on top of things again (one of those things was calling my back-up psychiatrist to report my medication issues), and I suspect the decrease in dosage regimen will begin again soon.  Such is the course in fighting OCD.  I fight.  I get tired.  Everything starts to catch up with me, and I can't seem to keep up.  I spend a few days in an abyss of just trying to keep up with my OCD.  But then, I regroup.  I get back on the horse and continue fighting.  And the cycle begins again.  Right now I'm in the getting back on the horse phase.  Or so I hope.  Not completely back on track yet.  But trying my best to get there.

Thursday, March 17, 2011

Little Compulsions and the Big Role They've Played

Sometimes I think I have a hard time seeing just how much OCD I have and have always had.  Today I was reading an article from my Winter 2011 IOCDF newsletter.  There was a personal account from a parent whose son had suddenly starting exhibiting OCD symptoms after apparently acquiring a strep infection (I still find the whole concept of PANDAS intriguing - in college, I did a fairly in depth project on a related neurological issue also caused by strep, Sydenham's chorea).  Anyways, when she mentions the things her son suddenly "convinced" himself he had to do, like twirl past his sister's room to prevent something bad from happening, the degree to which OCD has been part of my life for YEARS, since I was also a kid, becomes more apparent.

I'm caught off guard by accounts like this one, thinking, "Wait!  But doesn't everyone do that?"  My day is probably filled with all sorts of these little compulsions that hardly even register anymore because I am just so used to doing them.  Fidget with that until it feels just "right," do and redo this or that motion with the "right" thought, do this or that again just because you happened to have the thought that something might go wrong if you don't, and so on and so forth.  These sort of things have permeated my life over the years, and I am so used to just dealing with it, that I am always surprised when people point on these little intricacies.  Again, I think, "Wait, what?  You mean, everyone doesn't do that all the time?"

I actually do far fewer of these types of compulsions now that I have learned about my OCD and have been able to recognize many of these small compulsions for what they are.  Indeed, they have often been far easier for me to let go of than my major compulsions, because I largely did them just because I "felt" like I had to.  I had never really paused to consider what might ACTUALLY happen if I didn't.  I did what my OCD told me to, because I didn't know that, if I waited long enough, my mind would find its own equilibrium again.  I didn't have to force it there by performing compulsions.  So when I finally did learn about OCD and how it perpetuates itself, I was able to sit with the momentary discomfort and resist performing some of these smaller compulsions.

My larger compulsions have been much harder to fight, and I still have a ways to go.  And I think this is because, to a certain extent, I cling to the obsessions that drive these compulsions with excessive fervor.  I have a developed elaborate systems of thought, a maze of scaffolding, to justify the performance of my rituals.  And though we are deconstructing that framework piece by piece, I built it up strong and high and resist every step of the way, sometimes even building up a new type of compulsion to make up for those we are taking down.  It's a process.  It's a process that will probably always be in progress.

So, that said, I am always somewhat dumbfounded when I read observations and others' reports of OCD behaviors.  What stands out to me are the major flare-ups that have occurred off and on since I was a child, but when I pause to look at what was going on in between, I realize that my life was still rife with compulsive activity.  In fact, I think by the time I got to college, I had turned it into an elaborate art.  I had learned to adapt to a certain degree and despite my compulsions, so that no one, including myself, really knew any better.  I had learned to weave my compulsions into my daily routine so seamlessly that it was only when my last flare-up began that the long hidden monster suddenly became apparent to others and to myself.

Sometimes I get frustrated.  I think, "How did I manage to get better so fast before?  How did I manage to force myself to stop performing compulsions long enough to overcome my past flare-ups?"  And then I realize:  I never really fought my compulsions before.  All I did was push them around, slowing their assault in one area of my life by accommodating them in another area.  I was doing those "little" compulsions all the time, especially (ESPECIALLY!) when I was anxious about something.  (I still get twitchy when I'm super nervous.  When no one's around at times like this, I find myself jerking my head in a certain direction and in a certain way until it feels "right," or I find myself tensing this muscle or that in just the "right" way or the "right" number of times.  I probably look really funny, actually!)  Maybe it wasn't apparent to myself or to others that I was still feeding the OCD demon inside me, but I was.  I was constantly giving in to this compulsion or that, stoking the fire.

What I am attempting now is different from what I experienced when I "recovered" before.  This time I'm fighting it.  This time I'm not just trading one set of compulsions for another to appease this hungry disorder.  This time I'm depriving my OCD of the compulsions it needs to survive.  And it really, really doesn't like that.  It doesn't like that I've FINALLY discovered, after all these years, that I don't have to obey its every whim or justify my every move.  No, it doesn't like it at all.  And thus, I think this time around is harder because I am not just finding more covert ways to be compulsive; instead, I am outright trying to fight and eliminate my rituals.  And it may be more difficult, but hopefully, if I keep going, it will pay off in the end.

On a completely different (and completely geeky!!) note, the registration brochure for the 2011 IOCDF Annual Conference is out!!!  I am SO overly excited that I just had to mention it here.  I pretty much feel like a kid on Christmas morning right now.  So yeah, so nerdy, but SO cool!  For those who have never been to the IOCDF's Annual Conference, I would highly recommend it.  It's a bit pricey, but I had a sensational experience last year.  I not only attended several very informative lectures, but I also met other sufferers like myself, some of whom I have continued to keep in touch with.  Again, I would highly recommend it.

And now if you will excuse me, I will be starting the process of mapping out exactly which lectures and presentations I want to attend during each and every hour of the conference.  Not kidding - I wish I could attend them all!  So, yeah, excuse me while I plan out 3 days of my life that are still almost a half year away...

Friday, March 4, 2011

What I Want to Want

This is my life.  I live with OCD day in and day out and suspect that I always have.  And because I have lived with it for quite some time, I have a hard time seeing it and just how much it affects my life.  I forget the cost, the toll, of giving into OCD's wishes, because, frankly, I have grown used to the sacrifices.  Indeed, I'm not even sure I know what it's like to not make SOME sort of sacrifice to keep this disorder appeased.  The more I learn about myself and how OCD has wriggled its way into the nooks and crannies of my life, I begin to wonder - how many of my decisions, in the past and in the present, have been based on my attempts to quell OCD's insatiable need for certainty, for feeling "right"?

I have been a bit more reflective on these things this past week as I decided to take some time off from therapy.  I'm not giving up.  I'm certainly not done with treatment by any means, but I have been feeling, well, complacent, lately, and I felt like I needed a break from the never-ending assault on my OCD in order to regroup and re-solidify my will to fight back.

And there it is:  complacency.  I want to get better.  Yes, yes, yes.  And yet, as the compulsions become less severe, less pain-staking, less onerous, I lose my will to keep fighting back.  Before there seemed to be no choice.  I just couldn't continue on the path I was on.  It was awful.  I was imprisoned by the rules my mind developed and OCD's insistence that I follow those rules.  I couldn't keep going, so I had to fight back.  The alternative - just complying with OCD's every demand - was more than I could bear.  So, I fought back.

Now compulsions are still a regular part of my day, but they have been toned down to a point where they seem manageable.  Can I have the life I want while maintaining this level of engagement with OCD?  No, not at all.  But can I get by?  Can I face my days without wishing I never had to get out of bed in the first place?  Yes.  I most certainly can and continue to do so.  But somewhere in that transition from terribly unmanageable to manageable, my motivation, my reason to push forward in treatment, seems to have been subdued.  Before fighting back didn't really seem like a choice.  I just COULDN'T keep going like I was.  It was too hard.  The choices were fight back or dread every decision, every task of my day.

But I'm beyond that now.  I feel like I have far greater control over my decisions and the choice as to whether or not I will give in to a compulsion.  There is so much more flexibility.  Not performing a compulsion just seems uncomfortable, not utterly devastating.  I feel like, when I really have to, I can choose not to perform the compulsion and be okay.  I can make therapeutically helpful decisions without it resulting in a terrifying contagion of post-exposure compulsions that I just can't seem to resist. This is absolutely wonderful, but to a certain extent, it leaves me with a vaccuum of will power where my desire to fight back and control my disorder should be.  Before I was being propelled forward by the urgent need to free myself from the exhausting compulsions I was engaging in.  Now that the compulsions are not quite so exhausting (but still fairly inhibiting), that urgency has dissipated, and I feel like I have to reevaluate my reasons for committing to this process.  Because I'm reaching a point where the compulsions seem to provide a sense of peace more equivalent to the amount of effort put in - in other words, I don't have to go to nearly as much trouble as I used to for my compulsions to bring me some sense of peace.  Thus, compulsions have become a more attractive option as they have become less elaborate and less painful to endure.  Dire need to escape the hellish regimen of ritual can no longer be the driving force for my treatment.  Somehow, I need to find motivation that doesn't come from a desperate need to escape - because I no longer feel the absolute need to fight back just to keep my head above water.  I'm still stuck in the middle of the OCD ocean, but I'm not constantly on the verge of drowning anymore. 

Just to put things into perspective:  I still sleep on my floor sometimes when I feel too dirty to sleep in my bed.  I still don't cook or bake even though I now have time to.  I have largely subsisted on a strange combination of frozen foods that could be microwaved, sandwiches, other goods that don't have to be cooked, and eating out - certainly not the healthiest, most interesting, or most well-balanced diet.  I still avoid certain social situations or activities because I might have to use a public bathroom or might find myself in a position at odds with my OCD.  I still don't feel like I can even consider initiating another relationship (I broke up with my boyfriend of a few years when things really started going downhill a year and a half ago), because I can hardly tolerate the possibility of contaminating my environment myself - adding a whole other person to the equation seems preposterous (plus the avoidance of any sort of physical intimacy that began at the time of my big contamination "relapse" a year and a half ago just makes a relationship seem sort of unrealistic right now. Even if I did decide I wanted to date, this issue would soon become apparent and cause strife in any relationship I tried to start).  I still am not really able to keep my home environment clean or use it comfortably because of my OCD, and I still spend a certain portion of my day figuring out how I will work my life into the intricate dance of my OCD rituals.  Finally, I still deny myself opportunities and a number of things I would like to do because of OCD.  Because at this point, I have adjusted to all these sacrifices, to this modified way of existing.  So while the compulsions have become less harrowing, I have, at the same time, become accustomed to the sacrifices I make on a daily basis so that I am hardly able to recognize what it is that I actually am sacrificing.  Put these two trends together and you get complacency.  I may not be satisfied with this way of existing, yet as the pain of rituals and the desire to escape them lessens (and as I grow more and more used to my dysfunctional way of life), the drive to find a way out, a way to break free from OCD, also lessens.

As I told my therapist last week, before my little vacation from therapy began, I "want to want to get better."  I want to want it.  How do I find and maintain that desire to keep fighting back?  To keep improving so that one day I can live a fuller life again?

How do you continue, day in and day out, to fuel the desire to get better?  I would love to hear how others deal with this challenge as I am struggling with this at the moment!

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