Tuesday, July 25, 2017

Another Psychiatrist, Another Let Down

Blooms that meet my expectations.
*Sigh*

I've definitely had my fair share of bad experiences with psychiatrists.  I have even discussed it before on this blog.  So, it is very frustrating to me that a new psychiatrist has just let me down.

It's important to realize that at this point, I am like the dream patient for a psychiatrist.  I know that I have an OCD and anxiety diagnosis, I know what pills work, I am stable, and I just show up twice a year and basically confirm that everything is still going relatively smoothly.

Well, I started with a new woman last summer and maybe I should have known from the beginning it was going to be trouble.  She didn't accept like any insurance plans.  But fine, whatever, I'm on autopilot... how hard could this be?

We met and she seemed nice.  I met her again in January, confirmed things were good, and asked if I could just have some Xanax for emergencies.  I had them in the past, but didn't have them anymore.  She looked at me like I might be a drug addict.  She looked me up in her computer system, saw that I wasn't a pill shopper, and agreed to give me a prescription for 10 pills, but lectured that this wasn't the standard of care anymore and told me she would never give me a refill.  (Please note that since she prescribed them in January, I have taken a total of one.  I seriously only use them for extreme panic attacks.)

So I was kind of off put by that situation, but okay.  I see this woman twice a year.  She doesn't need to trust me.  Whatever.  

That brings us to last week. I get a bill in the mail for $125.  Underneath the date and total info was handwritten only, "missed appointment."  I didn't even recognize the name at the top of the invoice at first.  What even was this?

I was angry, but remembered that I had made an appointment with my psychiatrist back in January for July. It was 6 months ago that I made that appointment, so I had just forgotten the day. I've never had a doctor before who didn't do some kind of confirmation.  Email, text, call... even my manicurist confirms her appointments!  

I called in to figure out what to do and her receptionist basically said all she could do was take the money I owed, but if I wanted to make another appointment I'd have to leave the doctor a voicemail.  I paid and let the receptionist know I wouldn't be returning.

This whole situation had me fuming.  Regardless of the fact that this woman has no confirmation system, what I think the real tragedy is here is that this woman is a psychiatrist who had a patient not show up, who she has had no contact with for six months, and her only response was a bill with the handwritten note "missed appointment."

Luckily, I am stable.  But what if I wasn't?  Apparently she sees no need to confirm and remind patients of their appointments and believes they can remember them on their own.  Well, in that case, the fact that I missed the appointment should be even more disturbing.  What if I hadn't shown up to my appointment because I was in crisis?  A lot of these pills that are supposed to help mental health can sometimes lead to negative effects.  She's supposed to be a mental health professional... shouldn't she at least check in?

I talked to my friend about it who agreed it was ridiculous.  She said her therapist calls her if she's even 15 minutes late for an appointment just to make sure she isn't dead.  

I know most doctors don't check-in when you miss an appointment.  But, as a mental health professional I would hope psychiatrists would understand the importance of showing care and empathy to their patients.  Even if you tell me this woman has no time to send emails or make phone calls, if she had expanded her handwritten note to read, "Missed appointment.  Hope all is well, please check in,"  that would have been enough.

Maybe that's a good lesson for all of us:  Take the little extra step to show people you care.  It can mean a lot.


Wednesday, June 21, 2017

Reach for Your Dreams, OCD or Not

A beautiful day to ignore OCD 
For those who know me, it will come as no surprise that one of my aspirations in life was to work as a golf cart girl.  Spending the day in the sun, bouncing around in a golf car, handing out beer, with everyone happy to see you... What could be better?

Well my friends, last Saturday I had the opportunity to live that fantasy and I knew that I had to seize the day.  Only one problem: I'm OCD with money.

For those of you who are not OCD with money, or are OCD with money in their own way, let me explain what I mean.  I am terrified of stealing.  Petrified.  I tend to count and recount.  I doubt my numbers and even my honesty.  I worry that I took tips that I wasn't supposed to take or somehow cheated the employer or the customer.  I never feel safe around money, and my anxiety around cash is extremely high.  This fear and anxiety actually gave me the compulsion to give back a ton of tips at my old bartending job.  I would sneak them back into the cash register. I eventually quit because it was so overwhelming.

Knowing that I was going to deal with money at this event made me very nervous.  But I wasn't going to let OCD get in the way of my little golf cart girl dreams.  So I went anyway.

Did I worry about counting? Yes.  Did I worry about stealing?  Yes.  It was especially bad at one point when I pulled out my wallet to make change for a $20.  I handed the change over and took the $20 and put it in my wallet.

Sounds simple, right? But my OCD was only focused on the act of putting that $20 in the wallet.  

OCD doesn't care about context or reality.  OCD was just saying "Did you steal that $20?  I can remember you taking a $20 from a customer and putting it in your wallet."

But I wouldn't let myself get caught up in an argument with my OCD.  I said NO.  Not today, buddy. I moved on.  

I had a fantastic day and even made a little money.  I kept my tips and didn't return them.  I'm glad that I didn't let my OCD fears prevent me from taking the gig, because I would have missed out on a wonderful time.  

Sometimes you just have to put through.  Don't let OCD take your dreams away.  You are capable of triumph.


Wednesday, May 31, 2017

Birth Control Kind of Crazy

They look so innocuous!
Oh, birth control pills.  They can certainly be a beautiful thing.  Aside from preventing pregnancy (major pro), they can also help keep your skin clear.  Plus, it is certainly nice to be on a schedule and know when you're going to have a visit from Aunt Flow.

That being said, they certainly have their drawbacks.  People talk about how using these pills can lead to depression.  Messing with hormones can mess with mental health.  As someone with OCD and anxiety, I've experienced first hand how these pills can play into some of your weaknesses.  It's a unique feeling of imbalance that I wouldn't wish on anyone.
       
I was on a birth control pill for awhile which went through three different hormone levels over three consecutive weeks, followed by one week off.  I found that one week a month was particularly rough in terms of my mood.  I was extra anxious and cry-prone for that week (My boyfriend learned to tread carefully during this time). Call it PMS, call it whatever you want, it was a noticeable difference that I wasn't comfortable dealing with 25% of the time.

So, this past month I switched to a new kind of birth control pill that my Dr. informed me provides a steady level of hormones, rather than changing week to week. 

Sounded brilliant.  Sounded steady.

However, instead of balancing things in a positive way, now it feels like every week is the bad week!

I am feeling all the feelings.  The negative ones are especially strong.  Sadness. Irritability. Fear. Despair. Frustration.  I started sobbing watching the end of Big the other day.  I was crying just from catching the last like 20 minutes of a Tom Hanks' movie that I've already seen... with a happy ending.  

Feeling overwhelmed and anxious is the standard this month.  I'm going to try and give this pill one more month to see if this is merely a transition phase, but if not I have to explore other options.  

When you have mental health issues, you often have to make tough decisions between two less than ideal choices when it comes to medication (Ex.: Do I deal with the side effects of my OCD meds or do I deal with the intrusive thoughts, fears and anxiety that I experience without them?). My therapist has reminded me that there are other options for birth control if the pills are having too much of a negative impact on my life.  That being said, I like knowing I'm on them and what to expect month to month.  It doesn't seem fair to have to choose between that peace of mind and better mental stability.  

The tragedy is that I might just have to.  

Thursday, April 27, 2017

The Face of Anxiety and OCD

For my dog Gus, anxiety is a squirrel.
For whatever reason, your anxiety and OCD often pick a target.  What follows from exposure to whatever scares you are feelings of fear, dread, and often intrusive thoughts related to that topic.  Whether it's a fear of germs, a fear of harming yourself, or a fear of stepping on cracks... the anxiety takes hold.

What you have to remember though is that the face of anxiety is different for each individual person.

If you don't know someone well (and sometimes even if you do), you often have no idea what sets off his or her OCD and anxiety.  Few of us go around shouting our greatest fears from the rooftops, and our fears don't always follow logical rules.  

For example, someone with harm OCD, who fears they want to hurt others, might not be set off by the stereotypical exposure to dirt, but could be set off by seeing knives.  At a restaurant where most of us are completely carefree and oblivious to the silverware, this person might be close to a panic attack, or feel the need to do certain compulsions to avoid disaster.

The other thing is that a lot of us are pretty good at hiding our inner turmoil.  We try to maintain an image of cool, calm and collected.  When intrusive thoughts are too dark, too scary, or too embarrassing, we want them kept to ourselves and do our best to hide them from the public eye.

So what can you do to be supportive?  Two things stand out to me.

First, don't assume.  When your friend says they have OCD and anxiety, realize that it could mean many different things.  You won't just know what sets them off unless they share.  

Second, if your friend does share, try to refrain from judgement.  Think about your own idiosyncratic fears.  OCD or not, we all have them.  One of my non-OCD fears is that Diet Coke is poison. (Yes, some scientific studies have shown bad effects, but most of my concern with the artificial sweeteners is just based on feeling.)

Just as every person is unique, every manifestation of mental illness is unique.  There is no one face of anxiety and OCD, just like there is no one face of Bipolar Disorder or Schizophrenia.  Those with the same diagnosis share many common threads, but we are ultimately all our own blanket of crazy.  Keep an open mind and remember that you don't have to completely understand to empathize.

Wednesday, April 5, 2017

OCD: Not as Seen on TV

 The other day one of my tutoring clients who is aware of my OCD asked me a very sincere question.  Acknowledging his ignorance on the topic, he wondered, "Do you ever just not take your OCD meds one day if you know you have a major homework assignment or project to focus on?"
What you see on TV isn't always what you get.

Fascinating.  He saw my OCD as almost a kind of superpower that could be used for good... harnessed and directed at my will. HA! As if.
  
The truth is that OCD can't help me become a better student.  On the contrary, there have even been times that it has made it impossible to do the work that I needed to do.  Rather than a superpower that I can use to direct my focus and perfect my projects, OCD chooses the focus. It brings on anxiety that can slow or even halt progress.  For example, if I get into an OCD reading funk, I may feel the compulsion to reread sentences over and over and over.  Soon they lose their meaning.  

There are a lot of misunderstandings about mental health out there.  Just think about how many times people equate schizophrenia with multiple personality disorder, or how little people know about the varying symptoms of depression. Unfortunately, pop culture and the media generally take a very surface level exploration of the topic. They give people something easy to understand and digest. 

Since the overall media isn't educating the public, it becomes even more important that individuals who are able spread awareness when they can. When my student asked his question, as someone who is in a relatively stable place and felt safe to share, I seized it as a teachable moment.  

Many people get understandably angry and frustrated by the lack of knowledge that's out there.  However, instead of getting annoyed by this student's question, I just tried to explain the reality of the situation.  If the person is sincere in trying to understand, what good does it do to get mad?  It isn't his fault the only vision of OCD he had been exposed to was an incorrect caricature.

We can triumph by setting the record straight, even if we have to spread awareness one person at a time.

Thursday, March 16, 2017

When Anxiety Attacks

Anxiety can hit you like a blizzard.
Mondays are hard.

They are especially hard if you have an anxiety attack in the middle of the afternoon.

Monday morning, I was feeling pretty low.  I was driving home from visiting my boyfriend who lives in another city.  I was still upset about a small argument we had the night before (even though it was resolved.) Adele's "When We Were Young" played on the radio and I could feel the feelings starting to bubble up.

When I got home and was sitting on my favorite chair, all the negative feelings hit. Tragedy. Mom asked me what was wrong, and I couldn't pinpoint it, but soon I'm loudly sobbing in her arms.

Anxiety attacks can feel different to different people.  For me... it feels like my heart is crying.  And I'm crying.  And the whole world is overwhelming and there appears to be no good outcome in sight.

All sorts of negative doubts, questions, and considerations bombard you at once.  Here are just a few of mine from Monday (Trigger warning for those who are prone to anxious fits.):

- Maybe I'll never find a career I love.
- I'm a disappointment.
- I feel so physically blegh lately... Maybe it will always be this way.
- What if I never find someone who loves me enough to marry me?
- My parents will likely die before me and I'll have to live without them.
- I don't see a positive future where I'm happy.
- I should have made a lot of decisions differently.
- I'm getting old.
- There's not enough time.

In hindsight, when the attack is over, many of these concerns seem overblown. But while the attack is occurring, they are all very real.

Why Monday afternoon?  Was it because of where I was on my cycle of birth control pills (Varying hormone levels can lead to mood changes)?  Was it related to an exacerbation of OCD and anxiety?  Was it just a normal twenty-something freakout? Feelings are difficult enough to figure out without these other factors.

My advice to those facing an anxiety attack is to just let it happen.  Cry it out. Feel all the feelings.  Don't hide from it.  Take it from someone who has been there and back (and there and back and there and back....) You will come out on the other side.

Wednesday, February 22, 2017

Magic Germs

Recently, somebody I know with OCD was having some serious anxiety about getting sick.  The reason?  They were in the vicinity of someone who had thrown up.  Even though she knew she hadn't made contact with that person, she was still concerned that maybe she had been exposed.  What if she had been in contact with a person who had been in contact with that person?

  
What could be lurking on the sink handle?

Now this concern may seem outlandish to some, but for those of us with germ-related OCD fears it makes total sense.  Although I'm much better than I used to be, I know that at different times in my life I have determined that germs have amazing powers.

Powers to spread... powers to stick around. Powers to crawl over distances.  

Magic germs.

But I got to thinking this week... what do I know about germs?  

As far as actual facts go:  Not much.  

What even is a germ really?  As I'm writing this, I realize that I don't actually know, other than that it is something that is icky and can make you sick.

Most of my germ fears are not based on any real scientific knowledge.  They're based on false beliefs, and the tragedy is that I know sometimes there is no level of scientific reasoning that would get rid of the anxiety.

Obviously germs can spread through contact with people who are infected, but different diseases spread in different ways.  I just don't know how it all ultimately works.  There are those times you get a cold and you don't remember even coming into contact with someone who had a cold.  There are other times you know you made out with and snuggled your boyfriend all weekend, and then you don't catch his cold.  

Washing your hands before you eat or after you come into contact with a sick person is obviously a smart move, but over-washing or spending your time worrying about what you will catch will only give you dry skin on your hands and an unquiet mind.  

But I know what it's like to not be able to shake that feeling of contamination until you've washed your hands a certain extent.  My concerns have definitely lessened over the years, but I can still relate to the caricature of an OCD person: someone terrified of germs, washing and washing and washing.  

To those who still struggle, I hope you know it can get better.  With the right treatment, you'll see the real magic isn't the spread of germs, it's the power of your own mind to overcome your biggest fears.