Monday, May 19, 2014

Meddling Medication

I, well my doctor, recently made a change to some of the prescriptions that I take and it got me thinking about psychiatric medications again. It’s usually something that I think about for a few days, it kind of bothers me a little, but then it eventually fades away until next time. So, I thought this would be a good forum to voice some of my thoughts and maybe get some of your opinions too.

I’ve come up against this topic many times in recent months. Sometimes it’s just a fleeting thought when I take my pills in the morning. Other times it lingers and I do some heavy thinking on the subject. But it always feels like the cycle is the same. If you’ve ever taken medications for anxiety, depression, or any other mental illness, you might be familiar with the feeling. You reach for the bottle of pills to take your daily dose and a pang of uncertainty crosses your mind. Should I really be taking these? What does it mean that I take medicine that messes with my brain? I guess the core of it is that something about taking psychiatric drugs feels wrong. I have asthma. Every morning I take two puffs of my inhaler before brushing my teeth, and then I move on to a day of easy breathing. I have no problems taking the medicine, and I simply see it as a way to fix a basic problem. No big deal. But when I reach for the anti-depressants (some anti-depressants are standard prescriptions for OCD) I get this lingering, questioning uncertainty.

Now, logically, I feel like there shouldn’t be any difference. OCD is a physical, biological disorder just like asthma. If I can take a prescription for one, I should be able to for the other as well. But somehow, the knowledge that the medicine will affect the way I think changes the picture. I find that my line of thinking follows a lot of what our society has to say about mental illness. Somehow, it just seems different. Again, I know it shouldn’t be, and I wish my gut instincts would reflect that. But for some reason, they don’t.

If I take medication that changes how I think or what I think about or how I feel, am I somehow messing with who I am? If I automatically think in a way that is somehow deficient, should I change that at the risk of changing something more central about myself? I feel like this is the point at which my therapist would step in and ask me to identify the distortions in my thinking, but I don’t want to be objective today. I want to wonder about why my instincts tell me to back away from something that ultimately makes me better and healthier. Why is that I am ok with medicine messing with all the parts of my body except for my brain? I think it’s because it’s so hard to see a dividing line between my brain and my mind. Are they one in the same? Western ideology certainly says so. “I think, therefore I am.” But is it true? Maybe I should explore some eastern psychology on the topic.

Thank you for listening to my rant. I’d love to hear what you think about the topic, whether you speak from experience or just personal opinion!

The Facts about OCD

OCD affects between 2 and 3 percent of the general population. That’s between 6 and 9 million Americans.

1 in 40 adults will suffer from OCD at some point in their lives.

OCD affects men and women equally.

The most common age for onset of OCD is 18-24, although it is possible for symptoms to begin at any age.

Many people with OCD also suffer from a co-existing, or comorbid, mental illness such as depression or another anxiety disorder.

Evidence suggests that OCD has some genetic component and can be inherited in families.

About 80% of OCD sufferers have both obsessions and compulsions. About 20% suffer from only obsessions or only compulsions.

Research suggests that those who have OCD have brains that function differently from those who do not have OCD. Hyperactivity in the frontal lobe, cingulate gyrus, and striatum has been observed in those with OCD.

OCD can be treated with medication, Cognitive Behavioral Therapy (CBT), or a combination of the two.

For those with OCD it takes, on average, 7 years between the onset of symptoms and reaching successful management of symptoms through treatment.

Tuesday, May 13, 2014

20 Unexpected Lessons

I stumbled upon this page and I think it has a lot to say to those with mental illnesses too, not just physical ones. I’ve listed some of the more poignant ones below.

“2. Laughing is really important. It brings us back to the moment and reminds us to exhale, and to use up less of our moments worrying about the future or grieving over the past. But it’s okay to cry sometimes. That’s important too.

One of the best decisions I made in treating my OCD was to join a local support group. Sure it’s a great place to share stories and get advice but, most importantly, it’s a place to laugh at yourself with others who understand what you’re going through. If you’re struggling with any kind of mental illness, I highly suggest looking up support groups in your area.

“5. If you want something to work, the first thing that you have to do is believe in it. The second step is to trust it, and the third is to commit to it until what you believed would happen becomes a truth.

Nothing truer could be said about my time in therapy. It takes 100% commitment if you want to make change in your life. This also ties in with number 6:

“6. A doctor, a teacher, a mentor or a healer can show you how to do it, but they can’t do it for you. You have to meet your guide halfway. It’s up to you to do the work.

There’s only so much you can be talked at. Eventually you have to start taking on responsibility for what you’re hearing and actually apply it in your life.

“14. Stop looking for the “right answer.” Pause for a moment, breathe, and let it come to you. The further you go searching for what may not be yours, the farther you get from what’s actually meant for you.

The right answer is what’s right for you, not for anybody else. Sit with it and let what feels right come to you. Don’t hold yourself to other people’s definitions of what’s right or good.

“19. Asking the question “Why me?” just proves to the Universe that you haven’t learned the answer yet, and nothing goes away until it teaches us what we need to know.

The truest way to find happiness, I believe, is to be content with the lot you’ve been given. Don’t just accept what’s happening to you. Find a way to see the good in it and let it change you for the better.

Monday, May 12, 2014

Coping Strategies vs. Compulsions

I was at an OCD support group meeting when the topic of coping strategies came up. We all have coping strategies for dealing with stress, anxiety, and depression. This article talks about the habits we foster throughout our lives. Whether it’s that early morning run or the glass of wine after dinner, we all have habits, good and bad, that run our schedules. But when does it go too far? When do our coping strategies turn into compulsions?

As far as OCD goes, I don’t think I’m a particularly compulsive person. My symptoms tend to linger on the obsessive side of the scale. That being said, there are definitely things I’m picky about. The way I fold my laundry, my bedtime rituals, things of that nature. But it’s a slippery slope for all of us. It’s when you get into the habit of doing something in response to something else that it becomes a problem. You have a lousy day so you have a glass or two of wine when you get home from work. You have a couple more lousy days and you do the same. Pretty soon, you’re having a few glasses every day no matter how your day went. And that’s the cycle of addiction that happens, but there’s more to it than that. If you started drinking because you felt down, you’re likely to get more depressed each time you drink. That’s exactly how Obsessive Compulsive Disorder works. You convince yourself that the only way to relieve your anxiety is to keep performing your compulsions. And it feels like it works at first. But the truth is, every time you do that compulsion, you increase the likelihood that you’ll feel anxious and need to do it again. Every time you have a drink, you increase the likelihood that you’ll feel crappy the next day and need a drink again.

Maybe your habits seem better adjusted than my example. Maybe instead of a glass of wine after your bad day, you go out for a run. Endorphins are released, adrenaline surges, and you feel a little better. But then you do it again and again and pretty soon you can’t go a day without a run. Sure, running is good for you, but when it becomes crippling, addicting, compulsive – that’s when you know it’s a problem.

Unfortunately, I don’t have a solution to this one. Habits are a part of human nature. We all have them, and it’s hard to imagine a life without some habits. Maybe the solution is just awareness. If you’re aware of your habits and you notice if and how they control you, maybe you can step in and stop yourself before things get out of control. Maybe the only thing that really separates people with OCD from people without it is the inability to stop habits from raging out of control. (Of course, there’s the obsessive side of it too. We seem to get stuck on more things that require a habitual response than the average person.) Maybe the solution is, like this article suggests, is to just make a small modification. Maybe instead of a glass of wine when you get home, you change it up. Maybe sometimes it’s a smoothie or a milkshake. Or instead of a run, maybe you mix it up with some yoga or a bike ride. Keep the routine and the benefits without the repetitiveness that can cause a compulsion.

What destructive habits or compulsive behaviors are you holding on to? What changes can you make to give yourself a little freedom from your habits today?

Wednesday, April 30, 2014

White Bears and Other Unwanted Thoughts - Book Review

In White Bears and Other Unwanted Thoughts, Daniel Wegner explores the topics of consciousness, obsession, suppression, and mental control. This is an insightful read for anyone interested in general psychology, not just those suffering from OCD or some other mental disorder (although I did find much of the material particularly applicable to OCD). If you’ve ever been plagued by a disturbing image, had trouble dieting, or even just had a song stuck in your head, this book has something to say to you.

The core of Wegner’s theory is that we are plagued by obsessive thoughts, that is, we have unwanted thoughts that keep coming back to us, because we actively try to suppress them. Attempting to suppress a thought actually increases the frequency with which it will reoccur later. Clearly this has a lot to do with what happens with OCD. The core of the disorder is that we get stuck on a thought (the obsessive part), primarily a disturbing or distressing one, and can’t get away from it no matter how hard we try (the compulsive part). But this is relevant for everyone. If you’ve ever tried to quit drinking or smoking, or even lose weight, you are familiar with this cycle. You set strict rules for yourself and promise to stick to them. But, inevitably, you are reminded of alcohol, nicotine, or carbs wherever you go. You see someone eating a delicious-looking bowl of pasta, or you go to a party and everyone is drinking and lighting up. Even when there appears to be no obvious trigger, you feel the craving. Arguably, there is a lot of chemical craving going on too, but the chemicals are just as active in your brain and nervous system. It seems like no matter how hard you try, the reminders are just too much and you eventually give in.

This is where White Bears comes into play. Wegner argues, with convincing evidence, that when this happens, we shouldn’t keep looking for distractions or put all our energies into suppressing the unwanted thought, which is what we naturally tend to do. Instead, we should sit with the thought and let ourselves habituate, or get used to it. The book gets its title from a famous series of experiments you might have heard of. If you tell someone not to think about a white bear, what are they going to do? Think about white bears of course. The act of trying to suppress a thought automatically brings that thought to mind. It is the same with any unwanted thought. When we stop telling ourselves to not think about something, we give our minds room to let go of the thought naturally. Rather than constantly being on guard against the thought, we can discard it in time like a child discards a toy they got tired of. This theory bares striking resemblance to the theories about mindfulness, which promotes the same concept of sitting with our thoughts in order to let go of them.

I would definitely recommend this book to anyone suffering from OCD or any other type of anxiety disorder, as well as anyone else who just has an interest in this type of cognitive psychology. It well definitely make you think twice about the way you think               !

Saturday, April 26, 2014

A Sense of Control

Today I was clicking through the pages of Psychology Today when I came across this short but thought-provoking article entitled “The Importance of Feeling in Control.” It discusses our intense need for a sense of control and the impact it can have on our physical and mental health. Most interestingly, however, it discusses the way in which we find control in times of turmoil, even if none actually exists.

In reading this article I turned to think of a recent change in my life. It would be an understatement to say that my life is a little depressing at the moment. I am currently unemployed and about to have surgery that will keep me immobile for a month. That means that the relatively small pool of activities I have to occupy my time is about to be severely diminished by my inability to get around after surgery. But for the past couple of days I have taken to making lists of things to do with my time. I’m not actually doing anything that I wasn’t doing before – reading various books, watching movies, taking trips to the library and grocery store – but I have found that by making lists and checking items off as I go through the day, I am much happier with how I’m spending my time. I feel more productive and less like I’m wasting away in unemployment, even if only a little. This illusion of control seems to mirror what is discussed in this article.

In a time of great depression and emotional turmoil for me, I am finding some security in tricking myself into a sense of controlled productivity.

I have mixed feelings about this. On the one hand I am very grateful for the recent peak in my moods. Such a simple fix to a horrendous problem is surely to be praised! On the other hand, I am always suspicious of illusions, particularly of the kinds we play on ourselves. Isn’t it true that I AM being hugely unproductive at this time? Don’t I deserve to be reminded that I want to work and spend my days in a worthwhile manner? It seems like a slippery slope to me. One minute I’m happy at having watched a movie today and the next I’m content to ignore more important tasks in favor of mindless ones. As long as I get to check it off the list, right?

What are your thoughts on tricking ourselves to feel happier? Do we deserve to give ourselves a break? Or should we suffer through in the knowledge that it will bring better times once things sort themselves out? How does a sense of control play out in your mental life? Leave me a comment and share your ideas!

Overcoming Obsessive Thoughts - Book Review

This is a great first book to read if you are just starting to explore the world of OCD literature. It contains wonderful explanations of a lot of key concepts in the realm of OCD self-help. Unfortunately, it was not the first book on the subject that I read. By the time I read this book I had heard most of the information  before. That being said, I would still highly recommend this book for anyone suffering from OCD, particularly those who are relatively new to it and still have a lot to learn.

The book recommends a pacing guide totaling 8 weeks, to give adequate time to read the chapters, complete the exercises, and apply the findings. I would seriously encourage putting a great deal of effort into these exercises and taking them seriously. I have to admit that I did not successfully do this myself, mostly because I had already done many of them in other books and practices. But having done them all at some point or another, I can honestly say that they are very helpful and worthwhile, especially if you are using books as an alternative to actual therapy. David Clark and Christine Purdon do an excellent job of outlining and explaining a lot of the practices that I also covered with my therapist.

I think what makes Overcoming Obsessive Thoughts such a great work is that it does a fantastic job of exploring the many different ways in which OCD can present itself, while simultaneously highlighting the underlying trends and themes that all of the various presentations have in common. Many different examples of obsessions and compulsions are described, along with the thought distortions that underlie them. And then there are exercises that guide you in identifying your own obsessions, compulsions, and thought patterns. The book really gives you all of the guidance and information on OCD you could hope for from a therapist or shrink.

One word of caution I would offer is that this is not really a book for family members or friends of those with OCD who are trying to understand the disorder. There are certainly sections within the book that could provide useful information for these readers, but as a whole this work is clearly directed at those who actually have OCD. The exercises and follow-up readings would be very much lost on those who don’t have actual symptoms to observe. If you are a friend or family member looking for reading material, there are much better books to turn to before this one.

Overall, though, Overcoming Obsessive Thoughts is a great resource and guide. Happy reading!