Here I go again..
Monday, 21 September 2015
Confusion

Obsessive–compulsive disorder (OCD) is a mental disorder where people feel the need to check things repeatedly, have certain thoughts repeatedly, or feel they need to perform certain routines repeatedly. People are unable to control either the thoughts or the activities. Common activities include hand washing, counting of things, and checking to see if a door is locked. Some may have difficulty throwing things out. These activities occur to such a degree that the person's daily life is negatively affected. Often they take up more than an hour a day. Most adults realize that the behaviors do not make sense. The condition is associated with tics, anxiety disorder, and an increased risk of suicide.

Wikipedia

I realised a while back that although I'd been in and out of therapy quite often over the last few years there was an aspect of my mental health issues that had remained somewhat overlooked and that is my tendency towards obsessive and/or compulsive behaviour. Usually it has been the depression and paranoia (amongst other issues) that have rightly taken centre stage but today I'd like to have a look at this slightly lesser problem (for me) from a purely personal perspective and see whether I can shed some light on it.

Before I go on I would like to point out that I've never been diagnosed with Obsessive-Compulsive Disorder (OCD) 1 but over the years I have come to realise that some of my behaviour is very reminiscent of what somebody with OCD might have to go through only milder and less debilitating.

This behaviour is also something that is relatively new to me. When I first presented my symptoms to a doctor and was told that I had depression (about 15 years ago) the behavioural issues that I'm going to describe were not present. I suppose I had a compulsion to handle all of life's problems with the application of huge amounts of alcohol but that's not quite the same thing. It's since I stopped drinking alcoholically that my behaviour has changed. To massively oversimplify, I think that some of the feelings that I previously suppressed by drinking are now effectively with me full-time and my brain has found new ways to manage them. I have come a long way in the last ten years, with the help of therapy, and generally my new ways of coping are much healthier; just not all the time.

A couple of days ago I found myself re-stacking the baskets by the check-out at my local Sainsbury's supermarket. There were two piles of baskets, both in disarray, with their handles at all angles, and I had a basket that I wanted to leave there. I neatly re-stacked one pile of baskets so that they all fitted together and even made sure that the pile was placed directly beneath and parallel with the end of the check-out. I then placed my own basket on top. Pleased with my handiwork I moved on to the next pile. Just before I did I had a “what the..?” moment, became suddenly self-conscious and stopped what I was doing, leaving the other pile as it was. Whilst waiting in the queue the only thing I could think of was this messy pile of baskets - I had an almost overwhelming desire to finish what I started because the mess that I'd left was somehow “wrong”.

The situation that I described above took place in a familiar environment but one which is nevertheless prone to elevating my stress levels. There were also far more people in the supermarket than usual for that time and day, certainly more than I was expecting - I have a bit of a problem with crowds. Whilst standing in the queue I had started to feel very uncomfortable. I then involuntarily focused on something to block or 'cope' with these feelings. As soon as I became aware of what I was doing I stopped it but couldn't quite suppress the urges involved. I needed to stop because the discomfort I was feeling would only have been magnified had I been discovered doing what I was doing. I needed to stop to get a grip on what was actually making me so unusually uncomfortable (maybe, I'll write about all the anxiety stuff at a later time).

There is also another factor at play here which may help explain why so many of my current coping mechanisms are based on tidiness. One of the things that went through my head when I started to tidy those baskets was: If someone came along behind me in the queue they might think that I was one of the people who had made the mess and they would think badly of me. I would need to go way back to my childhood to fully explain this and that's a bit out of scope here. But, let's just say for now that I was brought up to believe that tidiness and cleanliness are not just aspects of your character they are an integral part of being a better person 2.

I do not mean to say that this is a part of my normal thinking. I know that there are no value judgements that can be reasonably made from whether or not a person is tidy but nevertheless, deep down inside there is stern, censorious part of me looking out at certain parts of my behaviour, judging and mostly finding me wanting. It looks like my mother.

For some reason it's not the dirtiness of things that bothers me just the neatness or lack thereof, why that is I do not know. As I'm sitting here writing this I can see a layer of dust on the base of my monitor and although, I did just make a mental note to clean in here at some point, it's not bothering me particularly. But, if my desktop speakers were not at the “correct” angle for me to be at the sweet-spot for stereo listening or if my mouse mat were not correctly aligned with the side of my desk then I would probably start to feel bad and have to do some repositioning immediately (probably several times), I say probably because whether I do or not is largely dependant on how anxious I feel.

Ok, here is a scenario that happens at least twice a week. I am about to go out shopping and my stress level is normal - to me “normal” means I feel on edge, I'm tense and a little breathless, but I'm not so stressed that things feel overwhelming. Just before I go out I will have the most compelling need to tidy up and get things in order. Mostly this involves things like making sure that my pc is 'sleeping', all lights are turned off, heating is off and everything is in it's “right” place3 - whatever that means. I can usually keep myself from doing these things more than once but not always. The more repetitive my actions are the more frustrated I feel. As I'm checking that the door is locked for the third or fourth time I'm also usually telling myself what an idiot I am.

Let's say this time I'm going out to visit, the DWP, which happens on occasion. The Department of Work and Pensions, for a variety of reasons, are always prone to making me extra stressed. This time when I'm leaving my home I'm close to panic and being overwhelmed. All my little routines are repeated until I'm furious with myself. At times like these it takes a major effort of will to get out the door 4.

If you are wondering why it's so difficult to ignore the urge to behave in a certain way, why these compulsions are so powerful, I'll try to explain how it is for me. The behaviours that I have found to be compulsive are those that, at least initially, give me pleasure or comfort and, in a way, help me with the distraction that they provide. Why would I not want to do something that's pleasurable? But, I don't think this really describes the nature of a compulsion, after all, we are all capable of self-denial, of finding a time and place for our little comforts. They don't take us over. I suppose the nearest thing I can think of that has a similar sort of power are certain instinctive urges related to sex. I'm definitely not saying that tidying things gives me sexual pleasure, it doesn't, it's just that the urge to perform these little 'comforts' is nearer the level of an instinct than it is reasoned thought. They also have the added similarity in that once started they are quite often very difficult to push aside.

When you combine this instinct with the fact that so many of my actions are, on the face of it, quite logical then you have something that is very seductive indeed. After all, I do need to lock my door, I just don't need to do it more than once. It's good to save electricity, I'm by no means well off, but I don't really need to check every appliance multiple times before I leave my home. The actions I replay are very often sensible, adult ways of handling everyday stuff like keeping my home safe or not going over budget. I start these actions because I must, I continue because they feel good. Well, until they don't.

I have over the years become much better at noticing things about myself, I have seen these behavioural aberrations for what they are. At some point they ceased to provide comfort because of this and became an annoyance. Maybe annoyance is an understatement, when doing these things I start to feel like I'm completely lost, that all reason and logic has gone and that scares the hell out of me. Sometimes, I can recognise how I'm feeling and just not go there, sometimes I go there but the rising level of annoyance and fear triggers a moment where I have to say 'Stop. Now.'.

This self-awareness comes at a cost though; the energy needed to maintain it is significant. There is nearly always a part of me that is not involved with what I'm doing, a part that watches the how of things and maintains a constant vigilance for behaviour that might be, in my mind, thought of as destructive or aberrant.

I wish I didn't have to be like this, to maintain this watch, because, well, it feels like a cage, it feels almost as bad as giving in to the compulsion. But, for the moment, I need to be safe and, importantly, I need to be able to get things done and that has to take precedence.

Important note

If you're reading this and finding similarities with your own behaviour then I have some advice for you. Please go and see your GP and tell them you are having problems with obsessive and/or compulsive thoughts and behaviour. Do not leave until you get, at least, a referral to talk to a mental health professional.

Notes
  1. More information on OCD from OCD-UK.
  2. I don't mean that anyone actually sat me down and told me that. It's more the way I interpreted the actions of important people in my life when I was young. Messiness and dirtiness were almost always treated with censure, tidiness and cleanliness were acceptable although rarely praised. The former were somehow immoral, the latter, moral.
  3. And yes I have a thing about not wasting resources too, all fine and sensible, you might think. Not really. Not the way I do it.
  4. There is sometimes an added weirdness. Usually, before I go out I will have a bath, make sure I'm presentable, that sort of thing. Sometimes, I will be in the bath and suddenly feel a wave of sleep come over me, feel myself nod off even though prior to that I've been in full get-ready-to-go-out mode. This only ever happens when I am really not looking forward to whatever I am about to do. I can go from stressed to ready to sleep in seconds and it's completely involuntary. I'm on medication partially because of the fact that sleep is often difficult for me yet this happens? I have not recently given in to this strangeness but that in itself is wearing. Forcing myself away from sleep, feeling so tired yet at the same time really angry with myself and still having the near-panic that going out causes in me. Well, that's not a mix I would wish on anyone.
Categories:
  • Mental Health
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