Tuesday, July 31, 2018

"So, what's your OCD thing?"

We're not just switch flippers.
You tell someone that you have OCD, and often that person's response is, "Oh, so what do you OCD about?" 

Please stop casually asking this question.

Don't feel bad if you have done it before... it seriously happens all the time.  I get it actually, and it's kind of sweet in a way.

Based on a basic understanding of OCD, you think I'm a little quirky.  Expecting that my answer will be related to hand washing or checking the toaster three times, why not ask? 

What you don't realize is that based on the reality of OCD what you have really just asked me is, "What are your biggest and most shameful worries and fears and how are you irrationally coping with them?"

Compulsions like hand-washing are performed in response to obsessions - major worries and fears that incessantly taunt their victims.  Some people with OCD do not even have observable compulsions and are mainly plagued by the obsessive thought aspect.  These issues do not make for light, casual conversation.

The "What's your OCD thing?" question reveals how little the average person knows about what OCD really is.  To be fair to the average person, even doctors don't always know.  Yesterday at my annual physical when I mentioned OCD to my new doctor she asked a similar question.  This is an educated woman with a degree in medicine, and her question showed me how surface-level psych training must be for family doctors. 

It's a tragedy that there is so little general knowledge on OCD, but there are still ways to be supportive to someone who reveals this part of their mental health history to you.  Here are four quick tips:

1.  If a coworker or acquaintance mentions that his OCD is bothering him, try asking how you can support him. 

2.  If a good friend tells you that she has OCD in private, admit that you do not know much about it but that you are there to listen to whatever she wants to share.  Try to let her control the conversation and what she reveals.

3.  In serious discussions of mental health with anyone, try to respond intentionally without casually brushing it off, making assumptions or cracking jokes.

4. Remember that it is okay to realize that you are in over your head.  Even therapists aren't experts on every mental health problem!  If a friend reveals something to you that you think may be a sign that this person is losing control and could be in danger or dangerous, admit that you are not an expert and try to get help from someone who is!

Monday, July 16, 2018

A Letter on How Not to Break Up With Someone With Anxiety

To Whom it May Concern:
Here's my Dear John letter...
Dating and relationships are hard.  When one of the partners has a mental illness, it can complicate things even further.

Just because the person you're seeing has anxiety does not mean that you have to stay with that partner for the rest of your life.  However, it does mean that there are certain moves you should absolutely avoid during the breakup process.  

Here are my top four tips of what NOT to do when breaking things off with a person who has anxiety.  (Please note that these apply whether you are dating men or women, but just so I can stay grammatically correct without repeating "him or her," I'm just going to refer to the anxious person as her.  I am a lady after all!)

1. Do not ghost the person.  Ghosting is when you just stop replying to someone with no explanation rather than break things off.  To avoid an uncomfortable discussion, you just go AWOL.  This is cruel and selfish to do to anyone, but it is especially horrible to do to an anxious person.  One of the worst parts of having anxiety is the worrying about uncertain outcomes.  It may seem silly, but the pain and discomfort of worrying can be ten times worse than just knowing the worst is true!  Don't let her sit there restlessly waiting for a text, holding on to smaller and smaller slivers of hope as the time passes...Just let her down gently.  It's not that she wouldn't ultimately connect the dots, it's that you are prolonging the suffering.

2. Do not tell the person it is because of the anxiety. I am sure it took a lot for this person to share this aspect of life you.  If you bring it up in the breakup, it means you either completely lack sympathy or have not even taken the time to consider the implications.  You literally just gave someone who you already feel is too anxious one more thing to be anxious about.  Stop and think!  When you say this you are also basically admitting to breaking up with someone for an illness, so you are making yourself sound terrible.

3. Do not postpone the breakup while insisting everything is fine.  More likely than not, your partner knows that your feelings have changed and can sense that something is different.  She likely struggles with differentiating between her own intuition and her anxiety, and she may be particularly sensitive to changes in behavior as she is prone to considering worst case scenarios.  This lady often suspects the worst when it isn't there, so don't let her feel "crazy" for a time when she's actually right.

4. Do not tell everyone your ex was "nuts" or "crazy".  Most mental health struggles are very personal and likely did not really harm you in any major way, so there is no need to try and trash her name when she is just trying her best to work through her own stuff.  She shared personal details with you that should neither be ridiculed or gossiped about.  Now, if she tried to burn down your house or get you fired from your job... I'm not going to blame you for needing to talk and handle that.  However, even in these rare, severe cases, it is better to phrase the issues with empathy, recognizing that she was unstable and really needed help, rather than summing her up as a "lunatic."  

The breakup part of dating is often very painful, and remembering to treat other people with respect in the process is critical.  It is actually kind to follow these four tips even when your partner doesn't have anxiety.  Whatever that person's struggle, while you are breaking a heart try your best not to pour salt in the wound.  Avoid carelessness and choose compassion.



Tuesday, July 3, 2018

Poetry & Mental Health

As an English major, I always enjoyed poetry - the way wordplay and rhythm can come together to make you smile, hurt, laugh and cry. Poetry often focuses on emotion, giving it a natural connection to mental health. Poems are such a unique way to connect with the experiences of the poet, and they can articulate feelings you may have trouble expressing yourself.  It can also be cathartic for the authors, as writing poetry becomes a type of therapy. (For more information on the therapeutic benefits of writing, check out this article from the American Psychological Association.)  

Recently, I came across two poetry books by Cleveland authors that delve into the gamut of human emotions: Angeline Walsh's Bad Psychiatry: and Other Aptly Themed Poems and Eric Dettelbach's Lyrics for Lucid Dreamers.  As a disclaimer, I am not being paid by either author to discuss these books.

Walsh is a young woman who contacted me after finding my OCD blog on Facebook.  Many of her poems touch on the pain of mental illness, but she also has poems that focus on hope and happiness.  Written over years (she told me that one of my favorite pieces, "Weathering it All," was written when she was just seventeen), her poems reflect the ups and downs of life.  While some were clearly written from a dark place, others reflect a joy of spirit.  

Dettelbach's book is not directly focused on mental health, but like Walsh's touches on the emotional highs and lows that come with moving through life.  He is actually a coworker of mine, and I helped him type up years of notes to put together his book.  It was interesting to see the different tones from poem to poem, again ranging from despair to delight.  His focus on relationships - from romantic encounters to the experience of adopting a dog - highlighted just how much our connections with others can impact how we feel and who we become.

Though these authors lead very different lives (different genders, ages, marital statuses), they share so much.  It's easy when we are going through a tough time or having a mental health issue to feel so alone.  I'm so glad there are writers out there putting their feelings into words and sharing these experiences that show how alike we all are.  We see their pain, but we also see their perseverance and growth.

Publishing a book - especially a collection of personal poems - takes guts. Letting yourself be vulnerable isn't easy, and I applaud them both for the triumph of putting themselves out there. 

Monday, June 18, 2018

OCD Raccoon

Anxious Face
I tend to anthropomorphize, but it is well documented that animals exhibit OCD and anxiety similar to humans (To read more about this from professionals, you can see this described by National Geographic in 2013 and The New York Times in 2014).  

I have previously described how my own dog, Gus, battles anxiety. However, last week I actually witnessed an animal performing compulsions like someone in the throes of OCD.

My family and I were in Nassau at Blue Lagoon Island.  We crossed an item off of my bucket list and met a sea lion.  After our sea lion encounter was over, we walked around the island and that was when we saw a very special native: A Raccoon.

This Bahamian was in a cage.  We approached hoping not to scare him, and he started performing a very interesting behavior.   He was on a platform and was repeatedly walking from one end to the other.  When he got to the end, he would touch it with his hand and go back to the other side.  He would then touch that side and go back to the first.  He did this over and over and over again.

My heart broke for this little guy.  He was all alone and exhibiting this behavior that made no sense - something that I myself have done to cope with stress.  Even though I did not know what was going on in his mind, I knew that he was not at peace.

Animals are so like us: It is beautiful when we can connect with their joy and tragic when we can relate to their pain.  Our similarities can also help us help each other.  Tel Aviv University did research in 2009 on animal OCD behavior and captivity, and what they found revealed another way to approach OCD treatment for humans.  In a similar way, I'm sure Fluoxetine was originally created to help humans, but now it is the pill my dog is on for his anxiety (You can read more about fluoxetine - trademark name Prozac - in this article on the National Center for Biomedical Technology website).

I hope that the owners of this raccoon, whoever they are, ultimately speak with a behaviorist and try to investigate what is going on and how they can help him lead a better life.  Although animals do have similarities to us, they also have many different needs that should be respected.   

When you take on a role of animal owner, you also take on responsibility for that animal's health - both physical AND mental.  In addition to taking the time to thoroughly research the best way to care for the animals they own, owners also have to recognize when a problem is beyond their depth and they need to appeal to a professional with more education and experience.

Just like in the human world, we need to start taking mental health more seriously for animals as well.  They are more than just cute faces, they have full lives that we must respect and nurture.

Sunday, June 3, 2018

A Perfect Wedding Weekend

Guest's-Eye View.
May 19, 2018 was the day I had waited for my whole life: Wedding Day.

Naturally, as someone with anxiety and OCD, I spent a lot of time leading up to the wedding worried about all of the things that could go wrong.  

Well, the Saturday of the wedding a lot of those worries came true and then some.  For example, it POURED after I decided that we should get married outside (because surely the rain would hold out).  The chuppah and multiple floral arrangements were completely destroyed and my hair had significantly fallen by the time of the service from the humidity.  During the ceremony, the rabbi read the wrong traditional vows (not the ones we had chosen) and a baby babbled throughout, distracting me from our personalized vows.  The cake looked nothing like the picture, and the DJ started our choreographed dance before we were ready so we started off balance. 

But guess what?  Even though many of my fears were realized, it was still a perfect weekend.

I am not going to lie to you and say that I did not get upset when some of these things occurred.  I felt so many things that weekend...  Happiness.  Nostalgia.  Lucky. Angry.  Amused.  Sad.  Overwhelmed.  Excited. Grateful.  Anxious.  

But the overarching feeling was love: love for Nathan, love for family, and love for friends.  Even as the blunders piled up, nothing could ultimately overtake the overwhelming joy at the significance of the day.

My OCD and anxiety crept in of course, especially on Sunday.  My anxious brain was doing what it normally does and I found myself very focused on the negative.  I was frustrated and angry at myself for choices I had made that caused problems (like not calling for an indoor ceremony).  I was also feeling guilt and self-loathing at the anger and frustration I had experienced on what was supposed to be the happiest day of my life.  

My sister Linda (the maid of honor) really helped calm me down.  With OCD, it is common to judge and doubt yourself for your thoughts and feelings.  She reminded me that my feelings were all very natural and that overall the day was wonderful.  She suggested that I make a list of all the fun, wonderful details from the day so that I would not forget them.  

Watching the Royal Wedding early in the morning with my Mom, sister, and bridesmaid Katie... Being surprised by morning chocolate strawberries Nathan sent to the suite... eating chicken nuggets with my bridesmaids while we were all in curlers getting ready at the hotel... entering the ceremony with my dad and seeing everyone I love watching me walk down the aisle... Nathan and I getting our footing back and nailing our tango... Dancing with my sorority sisters.... Eating cake back in the suite with Nathan after the party.  All of these moments are mine forever.  (I also got some fun details I had missed by asking friends and relatives to share their favorite moments with me.  I recommend all brides collect their own lists!)

Nathan with his new wife, bro-in-law, and sis-in-law.
I pulled myself together ultimately, and that Sunday afternoon was a continuation of a wonderful weekend.  My family, Nathan and I got dressed up again and my bridesmaid Megan took family pictures of us with our dog Gus.  Then, Megan continued to lead mom, Nathan and I on a photoshoot around Cleveland in the perfect Sunday weather.  We captured a lot of photos we never would have gotten otherwise, including shots on the rocks in Lake Erie (Now that the wedding was over, I did not have to worry about the dress getting wet!).

The spot we said our vows on Pearl Island.
In terms of the rabbi reading the wrong vows, Linda also came up with the great idea of privately reading our chosen traditional vows to each other while we were on our honeymoon in the Bahamas.  We made our intended promises on top of a lighthouse on Pearl Island in Nassau... a spot so perfect, another young man proposed to his girlfriend up there that same day. 

My advice to anxious brides is to remember that when the people you love are there, nothing can ruin your wedding.  Enjoy every second of your wedding weekend.  Love is the ultimate triumph.  When you are marrying the right person, you get your fairytale.  The logistics of the weekend will work out.  

Focus on the positive and remember that some of those "errors" can ultimately lead to more beautiful memories.  After all, if the rabbi had not read the wrong vows, we never would have had our moment on top of the lighthouse.

Monday, May 7, 2018

Bridal Neuroticism

No veil can hold back all these feelings.
My wedding is less than two weeks away, and I am in a feeling frenzy.

By this I mean that I am experiencing all of the feelings.  All of them.

My new therapist said from our first meeting that she hates weddings because they cause so much stress and conflict.  I have been lucky in that my mom has taken on most of this stress through planning the rehearsal dinner, wedding, and out-of-towner brunch.  We haven't faced any crazy levels of conflict either... but a wedding is a wedding.

Nobody can save me from the emotional significance of my wedding day.

My anxiety disorder has compounded with the natural anxiety of being a bride. This has lead to an experience of intense volatility, and I am moving through the whole gamut of human emotions hour by hour: from elation, to despair, to anger, to amusement, to frustration, to excitement, to irritation, to anxiety, to contentment.  It is not about cold feet or doubt as to whether the marriage is the right thing; it is like marriage has initiated some kind of emotional existential crisis.

My thought processes move like this:

It will be lovely to move into a new house with my new husband.

We get to really start building our own family!

I love my fiancé, he is so handsome and kind.

My fiancé and I get to spend the rest of our lives together.

I can't wait for my wedding!

I wish I could stay focused on the positive and joyful pieces of the now, but when you have anxiety, the darker thoughts always find a way to mix in somehow.  You are often worried about the future or upset about the past.  Having OCD can make this hard as well, as thoughts that you don't want to have seem to stick the worst.  Therapists will recommend mindfulness techniques, but it can be very hard not to get caught up in your fears.

Now, I am the first to admit that a high level of irrationality has taken hold. This was proven to me the other day when I called the auto-body shop to cancel an appointment.  I was mid-major crying breakdown as I dialed (functional even mid-frenzy).  I was so hysterical on the phone that the worker let me know that I could still come there if I needed to talk to someone.  You know you have reached maximum-crazy-woman-potential when the man at the car shop is offering you emotional support.

I have strong logic skills, so my irrationality is always interestingly tempered by some understanding that I'm being irrational.  For example, yesterday when we went to get our Ketubah (the Jewish marriage contract) framed, the woman was curt and dismissive of us, and I was very perturbed. I refused to go anywhere else that day to handle the errand.  

I was irrationally upset, and all I wanted to do was call customer service and rant, but I also didn't want anyone to lose their jobs or be punished.  I mean, this woman was probably being paid minimum wage which isn't enough to care about anything really.  I realized the call would be useless, consisting of me saying that I was wronged but refusing to say when or by who.  

I played out what I would say in my head, but I never calledI took a nap instead.  Lucky for Michael's customer service line, I am not good at lashing out.  Truthfully, I think the world would be a much happier place if more people took naps instead of calling customer service.

After that nap, I woke up and through the rest of the day and night continued to move up and down through the emotions.  Today has been exactly the same.  It's fascinating to experience (if understandably somewhat frightening to spectators).  I'm just trying to move through and hopefully not cause too much collateral damage. 

The wedding is now 11 days away.  I'm lucky enough to get to marry the man of my dreams, and if it takes an emotional rollercoaster to get to the alter... at this point I just need to laugh and enjoy the ride.  Getting to have him as my husband at the end of the day will be the ultimate triumph.

Wednesday, April 11, 2018

I lost 10 pounds in two months! Ask me how!

At the beginning of March:
Goal achieved... but at what cost?
Chronic Stress and Anxiety!

Not the answer you were expecting?

Women in modern American society are constantly reminded that thin is the ideal.  

Thin = Pretty
Thin = Desirable
Thin = Good  

People who lose weight quickly and keep it off are considered success stories.  We all want to know their secrets... How can we be thinner too?  

What people forget is that weight loss isn't always a positive sign.  I could be a considered a weight loss success story, but my experience is not something you want to emulate.

When I bought my wedding dress back in October, I told the seamstress I wouldn't be losing any weight.  I've tried losing weight many times and trying to diet never seems to work, so why would it now?  I have blogged about dieting in the past, along with the OCD struggles that come with it, and I am well aware that I suck at dieting effectively.  The last thing I wanted was to buy a dress that wouldn't zip on the big day.  I decided to watch what I ate and maybe if I was lucky I would lose a pound or two.

What I didn't account for was that between working two jobs, taking tutoring clients for my own business, house hunting, and wedding planning, I wouldn't even have to try to lose weight - the insane amount of stress and the ensuing anxiety flair-ups that followed would do the work for me.  

Some people reach for food when times get tough, but I stress starve. When I feel like I'm drowning in responsibilities and struggling to find time for basic needs, food is the first thing to go.  If I start to panic as to what to tackle when, a meal is an easy thing to cut while prioritizing - an unnecessary time suck that can always be postponed. 10 more minutes of sleep vs. breakfast? Sleep always wins.  

On top of that, if the anxiety gets too extreme, I often do not even want food.  I start to feel disgusted at the mere idea of it.  Keep food away from me and let me take a nap.

I know this is not healthy.  My weight has not been this low since I was 22 and had an OCD/mental health breakdown while trying to figure out what to do with my life.  I know that in these extreme circumstances I need to find a better way to balance getting nutrition and fulfilling my obligations.  The real tragedy here though is all of the positive reinforcement I have been getting for these unhealthy behaviors.  Because thin is the goal, once the weight started to fall off, the compliments started to pour in.  

I do not have an eating disorder, but this experience has given me more of an idea of the seductive nature of the process.  I have bought clothes in sizes I never dreamed possible, and I couldn't help but feel like I had accomplished something when they fit.  

But perhaps the craziest part is that I still do not really feel thin. My weight high was 142 pounds and I always thought if I could just get down to the teens again, I would be happy.  At the beginning of March, when I hit 119 (23 pounds less), it didn't even feel that different.  So what weight would be low enough?  Is there a weight that would make me satisfied? 

At my final wedding dress fitting last week, I was warned that I need to maintain my current size - any more weight loss and the dress will not fit.  I have been hovering around 118-119 for the past month, my weight maintenance supported by some lovely dinners out and a decadent Vegas bachelorette weekend of indulgent eating.  

During this final countdown, I know I need to schedule meals and jump on to the self-care movement to stop my weight from slipping any further.... but part of me still can't help wanting to be thinner.  I have to work hard to fight against ingrained cultural beauty standards that value image over health.  

If this experience has taught me anything, it is to be very careful when dishing out weight loss compliments.  Sometimes weight loss is a sign of illness.  For example, my grandmother wanted to be thin her whole life and ultimately only reached her goal when she contracted pancreatic cancer.  Then there are the stress and anxiety situations like mine where mental health imbalances are manifesting physically.  One of my friends lost a lot of weight before her wedding because the stress of wedding planning on top of her intense grad school program actually gave her an ulcer.

Next time you are feeling dissatisfied with your weight, remember to practice gratitude. Having an appetite is a blessing, and enjoying a good meal is one of life's great pleasures.  If you are at a healthy weight and you feel good, there is no need to make yourself miserable trying to "lose those last 10 pounds."  Take it from someone who lost them - you may not even notice that they are gone.