Imagine having to touch the oven knob 100 times before leaving the house. Washing your hands 200 times a day. Spending hours aligning everything perfectly and having to start all over again if you make a slight mistake.
The brain is a fascinating thing. It has the power to totally manipulate you, even when you know you are being manipulated. That is OCD for you.
What is OCD?
OCD, which stands for Obsessive Compulsive Disorder, is characterised as an anxiety disorder. The OCD sufferer often has intrusive thoughts (obsessions) such as 'My parents will die and I will be responsible', and then feels compelled to do a certain action (compulsion) to prevent that from happening.
OCD is still relatively unknown in Malta. When we do hear of it, the term is often used loosely; ‘Uwijja now I’ll clean up, you’re so OCD madoff’. Contrary to the common misconception, OCD is not about being a perfectionist, it is more about trying to avert disaster and trying to neutralise disturbing thoughts with a behavioral act.
'OCD is not about being a perfectionist.'
OCD as a manifestation of anxiety
Anxiety manifests itself in many ways. Most people experience anxiety as a combination of both mental and physical symptoms, wherein the sufferer may experience sweating, involuntary tensing of the muscles, a sense of unease. Some people complain of stomach aches when anxious, not to mention headaches and palpitations.
However, it goes one step further with chronic anxiety, which sometimes develops into a full-blown anxiety disorders such as eating disorders, panic disorder, social anxiety disorder and perhaps the lesser known, OCD.
Tina Anastasi from Lovin Malta speaks to a (quasi-ex) OCD sufferer.
When it all started…
I’ve had anxiety as long as I can remember, but I must’ve only had a mild form of OCD as a child. I clearly recall feeling the need to touch all four walls of every room I entered, as well as a compulsion to repeat certain words people said, in my head, and then mentally match them with a rhyming one. A few years later, I also remember having to chew the same number of times on either side of my mouth, and if I ate one chip on the right side, I’d then have to eat one using the left side. That's a typical example of a symmetry-related compulsion, often seen on TV and in movies.
However, I can’t remember it causing negative emotions back then, I was too young to understand and probably saw it as some kind of game.
'I clearly recall feeling the need to touch all four walls of every room I entered'
Then it became a problem...
I noticed I had a problem when I was in middle school. I remember compulsions like having to touch my pencil case a certain amount of times before putting it in my bag, without my classmates noticing. At home, while reading, I would have to read the same sentence over and over until it felt 'right'. Sometimes the frustration of it all would make me lose my breath and want to hit something.
However, it became a full-blown debilitating disorder when I was in college and university. Although there was no rational reason to be anxious, I couldn’t control the intense anxiety I felt doing simple tasks such as catching a bus or asking a question in class. I would feel a knot in my stomach, start perspiring for no apparent reason and my muscles would tense. As a result, I missed many lectures and couldn’t explain why. I felt stressed, lonely, insecure and gradually more and more depressed.
Looking at me, though, you could never have known this. In the eyes of society, everything was seemingly normal and I was a bright, functioning young adult. Inside, of course, was a different story altogether.
'Sometimes the frustration of it all would make me lose my breath and want to hit something.'
How did OCD manifest itself in your case?
The interesting thing is that many of my compulsions were temporary and would change and give way to new ones every few weeks or months. But whatever shape or form they took, I was never free of them.
For instance, I’d go through phases where whenever I touched something, I would have to touch the same object a certain amount of times with my other hand, to kind of ‘neutralise’ my action and make it more symmetrical. So 10 times with my right hand, 10 times with the left.
Other times, I’d have to enter a room with a specific foot, and then take a step back and do it over and over until it felt ‘right’. It’s a feeling that is impossible to explain to someone who hasn’t experienced OCD, but anyone who has will know exactly what I mean.
Another compulsion which drove me and everyone around me mad, was switching the lights on and off repeatedly. I would have to do so a specific number of times, which could even add up to a hundred times. If, at any point, I felt I hadn’t done it right – because, for instance, the pressure my finger had on the switch wasn’t enough, - I would have to start all over again.
I reached the point of desperation many times. I’d often already be exhausted and having to do the compulsions perfectly and for so long would totally drain me of the little energy I had left.
'If, at any point, I felt I hadn’t done it right – because, for instance, the pressure my finger had on the switch wasn’t enough, - I would have to start all over again.'
Did you ever try to fight your compulsions?
Yes of course, many times. OCD is a neurotic, not psychotic disorder, meaning you are fully aware of how irrational your thoughts and actions are. I knew what I was doing was ridiculous, but the anxiety I felt when I tried to fight the urge of carrying out whatever compulsion I had, was overwhelming. It’s as though there’s a very strong, invisible rope pulling you back to where you are meant to do your compulsion.
I knew what I was doing was ridiculous
It’s a vicious cycle; anxiety first causes you to do these compulsions and makes you unable to fight the urge to do them, so the only way to get rid of the anxious feeling is by acting on your compulsion. Completing a compulsive act only temporarily relieves the anxiety - until the next urge.
It’s as though there’s a very strong, invisible rope pulling you back to where you are meant to do your compulsion.'
I was put on SSRIs (Selective Serotonin Reuptake Inhibitors) an an anti-depressant as well as pills for my anxiety. I can’t explain the relief I felt almost immediately upon starting this course of treatment. As cliché as it may sound, a massive weight was lifted off my shoulders; I felt lighter, could breathe better and my muscles relaxed.
This played a crucial part in my psychological therapy. I did CBT (Cognitive-Behavioral Therapy), which, in an oversimplified explanation, focuses on the way we perceive things and works on modifying our thoughts, emotions and in turn, behaviour. The irrational fear I had of something bad happening to a family member and being responsible for it if I didn’t complete a compulsion was extreme. Through therapy, we worked on such intrusive, disturbing thoughts and a lot of the therapy focused on facing my fears and not giving in to the compulsion.
'I can’t explain the relief I felt almost immediately upon starting this course of treatment.'
So whenever I had the compulsion to touch something 20 times, for example, I had to fight hard to walk away slowly and not give in. I would rate my anxiety level on a scale of 0-10 and discuss how I felt at that moment, focus on breathing and self-reassuring. Words can’t do justice to how hard it was at first, but gradually, my anxiety levels decreased when I managed not to act on my compulsions.
Professional help is out there, and it is life-changing
Anyone who can relate to my story will probably have experienced some form of OCD, however, if it has got to the point where it is taking up a significant part of your day and making you feel unable to function normally, there are professionals who can help turn your life around completely, even if you cannot imagine a life without anxiety and OCD. Your anxiety will never completely vanish, but you will learn how to cope better and deal with OCD to the point where it is almost something in the background.