OCD

Today is my last day of disability leave from work, unless I recertify. That will all depend on how I respond to the new dosage in Abilify, which will go up to 5mg from 2mg tonight. I'm thinking I won't be much use to anyone this weekend.

The main reason I'm posting is that, a few days ago, I posted the diagnosis codes from my... I'll call it a receipt, though it's more like a summary page of what was done that day and what I paid. I was actually shocked to see OCD listed as one of my primary diagnoses. I guess it's because I don't count or wash or check things compulsively that that diagnosis struck me as odd. So, as I do, I set about doing some research. And there, it all becomes clear. PubMed's very first line of the OCD page states: "Obsessive-compulsive disorder is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions)." There's an OR! You don't have to have weird compulsions like hoarding, counting, etc. to have OCD, and I never knew that before.

So, why does the doctor think I have OCD? None of my other doctors really ever mentioned it as a possibility, and I wasn't ever prescribed any of the traditional OCD meds (Anafranil being the most common). Jumping over to the NIMH page, the first symptom listed is "People with OCD generally have repeated thoughts or images about many different things [...and] can't control the unwanted thoughts and behaviors." Wikipedia (sadly one of the better web resources on mental illness) further explains that not everyone with OCD has compulsions, and that the most common type of OCD is "pure O", meaning only obsessive thoughts. And that's where it starts to make sense...

You see, starting at around 12, I started having lots of thoughts I couldn't control. The first thing that I had obsessive, intrusive thoughts about was skiing. I used to be an avid skiier, and was pretty good. I could slalom with the best of them. But as I was skiing, I would have these thoughts of falling and injuring myself. They weren't just thoughts, either. They came along with imagery. Vivid, disturbing imagery. I couldn't shake these visualizations of what it would be like to hit a tree or tumble head over feet. I could almost feel my bones breaking, that's how real those thoughts were to me. So, even though I started skiing at age 2 (yes, literally), I started to stick to the bunny slopes. My dad hated it, and couldn't understand why I was so afraid of something I'd been doing for so long. He criticized me and made fun of me for being scared. But I literally could not help it. It got worse and worse until I quit skiing altogether at around 15... and I'm pretty sure my skiis are still in the garage at my parents' house.

But it's not just skiing. Starting at around 17 I started to have the same problem when driving, when I would see, in my mind's eye, what it would be like if the car were to malfunction in any number of ways... even in ways that weren't possible. As an example, I would be driving along, and have this horrible flash of my wheel completely disconnecting from the axel (how!?!) and the car lurching to the side, screeching and emitting sparks as it dragged on the asphalt, flipping over and crushing me down like I was stuck in a sardine tin. Totally impossible, not at all logical... but I could not help having those intense, intrusive thoughts and fears. To this day, when I'm not on medication, I have these intrusive thoughts while driving, walking up or down stairs, jogging or doing other physical activity... it is enough to make anyone completely nuts.

Luckily, when I had a regular therapist, I worked on controlling those thoughts and finding ways to ignore them or redirect them. Being on the citalopram definitely has the major benefit of making the intrusive thoughts very rare these days, which I'm grateful for. But I never, ever knew that what I was experiencing was OCD.

Sometimes I feel a little embarrassed by all my numerous diagnoses. I like to think that I come off as maybe a little bit neurotic or overbearing, but mostly normal. Inside, I'm anything but normal, but I work hard at it. That's part of why everything takes so much effort for me - having a day pass by without thinking about dying (by my own hand or in a nigh-impossible accident) takes a lot of energy.

In any event, it's time to go for lunch now. I'm glad I got this OCD thing off my chest, it was really bothering me. More to come on this topic...