Imagine if your brain rebooted every two seconds, and every time it rebooted it meant what you just looked at became hard to remember accurately. So, for example, you check if you locked the door, turn around, your brain reboots and makes it hard to remember if you did lock the door, so you have to turn around and check it again. And imagine if every reboot makes the memory fainter and fainter until you find it completely impossible to remember whether you locked the door no matter how many times you turn around to check it and end up having a huge anxiety attack. This is what having Obsessive Compulsive Disorder is like, or at least one type.
Imagine if you were incredibly vulnerable to disease and any bacteria or virus could kill you instantly so you had to avoid, at all costs, any form of contamination with anything and there was no way for you to know what was contaminated. So absolutely everything around you is potentially contaminated and a massive threat to you. You would have to live a life of cleaning your hands all the time and ensuring your environment was as free of contamination as possible because otherwise you could die at any moment. This is what having contamination OCD is like.
Imagine if all day every day a small voice in your head fed you intrusive thoughts telling you that you had done something horrific. You are walking down the street and meet someone and as you walk away your brain tells you that you did or said something offensive or illegal. You don’t remember doing this horrific thing, but the voice is so convincing that you start to believe it and spend your day looking for any possible evidence you can find to disprove what this voice is saying. But the more you try to find evidence, the stronger the intrusive thought gets and this goes on all day every day so you spend your life thinking constantly that you have done something terrible.
There are, of course, various strands of OCD. Some people have an obsessive compulsion to have their things organised in very specific ways and if that order and organisation is changed they become incredibly anxious and need to immediately correct it. I don’t, but I have had the above three to various different levels throughout different periods of my life.
OCD is one of those terms that is thrown about a lot and misinterpreted or misunderstood and the condition is often brushed off as not that debilitating as a result. Many people say that they have OCD because perhaps they like to have their homes tidy and clean, or they sometimes wonder if they did turn the oven off. But the question to ask is whether NOT having their house tidy and clean would trigger an anxiety attack and make life impossible. Would not being able to go back and look at the oven make them horrifically anxious and unable to focus on anything else and then picture their house burnt down until they get there to check it’s OK? We all exist with habits and quirks, but it is when the absence of a routine or an impossibility to trust your perceptions or touching something dirty triggers an anxiety attack and makes life debilitating that you fall into the category of having OCD. It is an absolutely devastating and exhausting condition to have. It can destroy your life, your relationships and push people right over the edge.
And as with so many invisible illnesses, it is almost impossible to understand or empathise with unless you have been there.
OCD develops as a coping mechanism to what one may perceive as chaos in their life. Anxiety or feeling like you cannot control your surroundings. When I was 21, in my final year at university, I developed the first type of OCD mentioned above - an obsessive compulsion to check absolutely everything in the house that could be turned on or off, opened or closed. Lights, taps, doors, ovens, windows, switches, the whole house was a potential catastrophe if I left anything on or open when I left. It didn’t appear overnight, but rather crept up on me very slowly. It started with me having to get out of bed at night to just double check I had shut the fridge. I would turn around and think I had not paid attention and do it again. Before I knew it, leaving the house was becoming excruciatingly difficult for me. I had to go around the entire house checking and rechecking everything, working myself into a state of anxiety and fear because I couldn’t remember despite having just looked at something whether it was on or off or open or shut. Eventually leaving the house became impossible unless there was someone else there.
I knew that I couldn’t remain housebound, however, so I started to use my camera to help me leave alone. I would walk around the house taking photographs of things as reference so that I could check while out that I had in fact turned things off or closed them. Short term this was very effective, but it was not a cure.
The way I managed to overcome it (to the extent that I could lead a “normal” life, because I honestly believe that once you develop OCD, you have it for life to some extent) was through CBT (Cognitive Behavioural Therapy). It is an incredibly powerful and effective tool, when used correctly and regularly, to overcome the intrusive thoughts that lead to these compulsive behaviours. Put in basic terms, you ask yourself questions to force your brain to use reason to override the intrusive thought. You use facts to override the fictional beliefs your mind is creating. So if you are having an anxiety attack about whether or not you locked the door, you ask yourself what you would instinctively reply to someone who accused you of not having locked the door. You ask yourself how someone who has OCD and compulsively checks everything anyway could possibly not have checked the door. And you ask yourself what the worst case scenario anyway would be had you not locked the door. There is nothing rational about OCD. But you can use reason to override it - it just takes a lot of time and effort to get there.
It was through CBT that I managed to get to where I am now - I can leave the house generally with no issue. I check things once. On anxious days I may still take the odd photograph. But I can live a normal life, and that is what matters.
It wasn’t until pregnancy that out of the blue and literally over night I developed contamination OCD. I was terrified of touching something contaminated, putting my hand near my mouth (or any other part of my body that could be contaminated like eyes or ears, cuts, etc) and contaminating my growing baby. All of a sudden the whole world became a threat to me and I could not live a day without debilitating anxiety that made it really hard to cope. I washed my hands constantly to the point that they were bleeding and cracked, which of course was ironically exposing me to more contamination. I spent nine months terrified daily of everything. Everything I put in my mouth, every time I used a toilet, showering, brushing my teeth, drinking water, every time someone touched me, even getting dressed gave me anxiety. We had a cat and I lived in fear daily of toxoplasmosis, a parasite that can exist in cat feces and potentially cause catastrophic harm to a foetus. I could not even kiss my then husband out of fear that his mouth was contaminated due to his nail biting habit. I stopped leaving the house because it was just too much for me to cope with. Germs, bacteria, parasites, viruses were absolutely everywhere waiting to harm my baby and I felt it was safest to stay at home. But even at home I didn’t feel safe because anybody who entered it would bring the outside world in on the soles of their shoes…
I was lucky that it disappeared almost as fast as it came once my son was born. But there are people who live with this all the time throughout their lives and no amount of photos will prove that this threat is just not real. I cannot imagine what that must be like as there is no way I could go through it again.
The other form of OCD I had has fortunately also gone but I spent years with intrusive thoughts telling me that I had done horrific things, normally offensive or sexual things, that I had in reality not done. This is the hardest form of OCD to explain and the one that requires the most CBT because you just cannot ask someone if you kissed them or insulted them when you saw them without then triggering anxiety at feeling like they think you are mad. You sound crazy, and you feel crazy. For me, this one was the hardest OCD to have because it just makes you feel like you are losing touch with reality. I hated having to leave messages on voicemail because as soon as I had hung up the phone I would have an almighty anxiety attack thinking that I had said something offensive and was unable to check. It made working in any environment quite hard as I was always worried that I was going to get into some sort of trouble for having done something terrible. I found bumping into people in the street really hard because I would spend hours or days afterwards anxiously going over and over the conversation, terrified I had done or said something bad. But try explaining this to someone without sounding completely mad because surely you should know whether or not you did. But, like checking OCD, your brain wipes the memory and the intrusive thought takes over.
Living with OCD is hard. It is exhausting. Not only for the person who has it, but for people who live with them. But please have empathy for someone with it - it is so hard to overcome and takes over you life. And if it is you who has OCD, do not think it is a life sentence. CBT is an incredible tool and there are some wonderful therapists out there who can help you learn how to use it. Do not despair, do not give up and don’t let yourself live with it because you simply do not have to. OCD is a psychological issue - not psychiatric - and therefore can be overcome. If I did, anyone can.