My OCD Story – Part 8: Sleep Specialist to OCD

In summer and fall of 2013, I still had difficulty with sleep. I would often have difficulty falling asleep, and I would often walk up early and not be able to fall back asleep. After I started meeting with the EMDR therapist on Bainbridge, she suggested I see a sleep specialist, so we found one in Seattle and I started meeting with her.

She suggested a handful of strategies to help with sleep. Most of these are strategies to wind down at the end of the day. She suggested:

1. Journaling a couple hours before bedtime. The idea is that journaling is a way to process what is going on any particular day and by writing about it and analyzing it before bedtime, your brain has already processed and will therefore be less active as you try to fall asleep.
2. Dimming the lights as bedtime approaches. Apparently there is research to suggest that brighter lights, particularly in the colder blue light spectrum encourage alertness, whereas dimmer lights in the warmer red spectrum are more calming and conducive to rest.
3. Listening to instrumental calming music before bed (also as a way of calming the mind).
4. Meditating before bed. Also, another way to calm the mind.
5. Basically take care of everything that could be a worry before going to bed.
6. Telling myself a story (the same story every evening) or counting as I laid in bed as a way of calming the mind.

What we didn’t take into account as we discussed strategies were my OCD tendencies. OCD latched onto these strategies as a foundation for all sorts of behaviors designed to protect sleep: take care of EVERYTHING before you go to bed so that there won’t be ANYTHING that could bother you and potentially keep you awake as you try to fall asleep. Did I get the mail from the mailbox? Were all the dishes put away? Was all the laundry folded? Was I packed and ready to go to work and then the gym the next day? It started with normal mundane tasks like this; making sure they were resolved before going to bed. But with time it evolved into more than that. OCD started playing with the “what if“ game, coming up with all sorts of things that could potentially be problematic and impact my sleep. What if I got thirsty during the night? Did I have a glass of water next to my bed ready to drink? What if I got a runny nose? Did I have tissue available? What if I got hungry in the middle of the night? Did I have a snack nearby? There’s a point where OCD transition from semi-reasonable things like this to some more far-fetched things. My car isn’t parked perfectly perpendicular to the wall. The plates in the cupboard aren’t stacked perfectly straight. My backpack fell over when I put it against the wall. I’ve gotta re-park the car, straighten the plates, stand the backpack upright before going to bed. Is the door REALLY locked? Are all appliances turned off? I started checking the heaters, the light switches, the door locks, the stove, etc. Particularly with this checking behavior, things started to feel “not right.” I know I already checked the stove five times, but is it REALLY off? How can I be certain it’s REALLY off? What if the knob is loose and falsely indicating that the stove is off? I better turn it on, and then off again just to be sure. Oh, but that didn’t “feel right” or like it actually turned the stove off. I better do it again. Eventually this evolved other things not feeling “right” and needing to correct for it. The key didn’t smoothly insert into the lock. Picking up the loaf of bread felt “off.” That step felt “funny.” I better re-insert the key, pick up the loaf again, retrace my steps. Because if I don’t fix it now it’s gonna bother me later and potentially impact my sleep. Eventually over the years all these behaviors would evolve into a vast routine that would essentially start everyday the minute I got home from work and last until the minute I went to bed.

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My OCD Story – Part 7: Bring it On

So, April, May, June of 2013 was the period of peak anxiety and depression for me. Initially, I didn’t know how to get out of the anxiety loop that I was in. I’d never experience that level of anxiety and depression. I started to wonder how I could make it end. Was there a way to stop it all? Those of you who have experienced severe anxiety or depression may be able to relate. You really don’t know how dark and desolate it is until you’ve been there.

So, what did actually help bring me out of the anxiety and depression? There were a handful of things.

1. “Bring it on!” In the deepest part of my anxiety and depression all I wanted was to go back and change what had happened to me. I wondered what I could have done differently to avoid the situation I was in. I questioned… how did this happen?… why me?… can’t I go back to the way life was before? After a couple months asking myself these questions, I hit an inflection point. I realized and accepted that I couldn’t change the past. I realized I had to face the anxiety and depression head on. I couldn’t keep running from the beast. I didn’t know how to do that yet, so every morning the minute my anxiety hit I would say to myself “bring it on,” as if to turn toward the beast and take my best offensive stance. “Bring it on.” That became my mantra. It was my way of saying to the anxiety and depression I will not run anymore, I will face you, and I will fight you.
2. Studio C. If you’re unfamiliar with Studio C, it’s a sketch comedy show that aired on BYUTV (the TV station at BYU)… perhaps the cleanest, and squeakiest, sketch comedy out there. I started watching their sketches on YouTube. This was the first thing that allowed me to escape the anxiety. The sketches were just long enough to divert my attention, make me laugh, and help me temporarily forget about the anxiety. Studio C, though, has now become a trigger for me as it reminds me of this time of my life.
3. Game of Thrones. Everybody was talking about Game of Thrones at the time. It was relatively new and I needed a distraction so I decided to give it a try. It was an interesting fantasy to get lost in and also gave me something new to distract from the anxiety. I would, however, learn that this probably wasn’t the best show for somebody with developing OCD to get watch. Game of Thrones is also now a trigger for my OCD.
4. Photography. I had dabbled in photography in the past and I decided pulling out my DSLR and getting back into photography would be another productive thing to distract from my anxiety. In July I took my camera to the Pioneer Day celebration (it’s a Mormon thing) back at the Boundy Farm on Bainbridge Island. The Boundys had a lovely cutting garden full of dahlias and other beautiful flowers. I spent nearly the whole time taking pictures of the dahlias (yes, I took the photo above… very proud of that particular shot). It was another great distraction to explore this creative hobby once again. Unfortunately, photography and dahlias are also now OCD triggers because they remind me of this time of my life.
5. Affirmation. Affirmation is a non-profit support organization for LGBTQ and allied Mormons. In the fall of 2012 I was introduced to Affirmation when they had their annual conference in Seattle. I had heard some not-so-great things about Affirmation, but since the conference was in my hometown I decided to drop in and check it out. There were about 60-70 people at the conference and I found them to be extremely welcoming, authentic, and well-intentioned for the most part. Affirmation was going through a sort of renaissance at the time. There was new leadership. A new board of directors. They were rebranding and really trying to become a big-tent organization for the intersection of LGBT issues and Mormonism. Because of the relationships I had made at the Seattle conference I was able to get connected with the leadership team. So, when I found myself looking for things to help me out of my anxiety and depression the next spring/summer, I called up the leadership team and asked for something to do. Turns out they needed a chair for their 2013 conference and I volunteered. I spent most of the summer planning and organizing. The leadership team had secured Steve Young (NFL hall of fame quarterback) as the keynote speaker and had done a great job promoting the event. Because of this we were seeing that registrations for the event were skyrocketing as compared to the previous year. I don’t know the exact count, but we had a few hundred registrations. All this to say that the event required a lot of time and effort to plan and put on and it also proved to be a great distraction from my anxiety and depression.
6. Targeted mental health treatment. I finally got targeted therapy for my anxiety, but not until several months after the most severe and depressing times. I can’t emphasize this enough… getting proper and appropriate mental health support is sooooo important. It wasn’t until I sought appropriate mental health services that I was able start to articulate and develop a vocabulary around what I was going through. But, again, it took several months to get anywhere close to what I needed. I often wonder how things would have played out if I had been able to get the right mental health resources right at the onset of the anxiety and depression. Could it have reduced the severity of what I went through?

The irony about many of these things that helped get me out of the anxiety and depression are now in and of themselves triggers for my OCD because they are connected to this time of my life.

An Update

Just thought I’d give a quick update on where I’m at. I recognize the need a week and a half ago for some pretty immediate relief from what I was experiencing so I messaged my therapist and basically told him to schedule as many appointments as he could. I had three appointments last week. I’ve already had two appointments this week and I’ve got a third one tomorrow. That’s been tremendous help in terms of getting on top of the OCD and bringing it back down to manageable levels.

The other thing that’s really helped has been this blog. I think telling my story and the way that I’ve been telling it has allowed me to approach my history and trauma from an intellectual perspective. What it’s allowing me to do is view my experiences not necessarily as bad, but as simply a part of my history.

This last weekend I spent a good chunk of time running errands and that felt mostly normal. Last week I took a good chunk of time off work to try to manage the OCD, but this week I’ve been working more regular hours. Things are getting closer and closer to being back to “normal.”

There’s still a lot to do and recent events have been a catalyst for moving into what I consider to be my next phase of OCD therapy. I’ve been putting this off for a long long time because I’ve been mostly functional, and because the next phase of therapy feels scary and difficult. I’ve built up OCD barriers to protect myself and keep all that scary stuff away. But recent events have caused that protective barrier to start to crumble on it’s own and there’s not much more I can do to keep the scary stuff out. So it’s time to face it head on and do the hard work.

My OCD Story – Part 6: The Beginnings of OCD

As already mentioned, in April and May of 2013 I constantly worried about whether or not I would be able to sleep. I would eventually be able to fall asleep on my own after switching from the Ambien to the Trazodone, but it was still difficult. I tried all sorts of things to distract myself at bed time. I tried listening to music. I tried watching movies or TV shows. I listened to books on tape. I played games on my phone. Anything to distract myself from the worry of whether or not I would be able to sleep. Sometimes I’d drift off, only to wake up in the early morning and toss and turn and not be able to get back to sleep. I would do this during the day as well; trying to keep my mind engaged in activity to try to distract from my anxiety about sleeping.

I remember one day in my bathroom I was looking at the tag on my towel and the thought that came to mind was “what if every time I look at this tag on my towel it reminds me about not being able to sleep. I don’t want that. Thinking about not sleeping is what is making me anxious. Being anxious is what’s keeping me from sleeping well. I need to not think about sleep. I need to now avoid the tag so it doesn’t remind me of not sleeping.” So I did. I started to avert my eyes to avoid looking at the tag. When I dried myself with my towel I would be careful not to touch the tag. To this day I still avoid touching tags on things.

I also started to have extreme reactions to other people talking about sleep. The simple question “how did you sleep?” would immediately pull me back into anxiety. The reaction, of course, was more extreme if the conversation was about not sleeping, or not sleeping well. I also started to make more and more connections to sleep and having more and more severe reactions to what others might consider relatively benign topics of conversation. I started to react to phrases like “good morning” or “good evening”. To words like “overnight” or “nightmare”. So, to manage the anxiety I started to engage in all sorts of activities to distract my mind and reduce my anxiety.

When I started meeting with the therapist on Bainbridge in the fall of 2013, she first started addressing my trauma because that’s what was at the forefront. We did EMDR treatment (Eye Movement Desensitization and Reprogramming). My experience with EMDR is perhaps best reserved for a post on it’s own. But to give a simple explanation, EMDR involves you discussing your trauma while watching a light on a display move back and forth. The theory, as I understand it, is that the eye movement mimics what happens during REM sleep which is when your brain sort of sorts, categorizes, and files away information. I found it to be surprisingly effective.

But after about a month of meeting with her and listening to what I was going through, she concluded that my experience and the behavior that I was describing to her were textbook OCD. My obsessional thoughts were clearly about sleep. My compulsive activities were all these other things I was trying to do to reduce my anxiety and distract myself from thinking about sleep. She explained to me that OCD was not necessarily her specialty but she knew enough to at least attempt some OCD therapy, which is exposure and response prevention. While we stayed primarily focused on the trauma and EMDR therapy (because that’s where she was comfortable as a therapist), she explained the basic concepts of OCD exposure and response prevention to me, and we dabbled into it in some of our sessions. I didn’t sense it at the time, but this was just the beginning of OCD. I didn’t realize the monster it would grow into.

My OCD Story – Part 5: Mounting Anxiety

The remainder of the month of April 2013 was hell. I continued to worry every night about whether or not I was going to be able to sleep. The only way I could sleep was by taking the Ambien. I started to have regular anxiety attacks. I was anxious about sleeping. I was anxious about work. I was anxious about my relationships. I was anxious about the fitness class. I started to get anxious about being anxious. If you’ve ever approached the edge of a cliff and felt that sudden rush of vertigo, that’s how I felt… all the time. There seemed to be no relief. The anxiety was the last thing I thought about before going to bed and it was the first thing I was aware of the next morning. I struggled to be present in any conversation. There were words coming out of my mouth but I was disconnected from them. I was hyper aware of my discomfort and anxiety in spite of any conversation that I was having. It’s like I was split in two. Half of me was going through the motions of life and trying to hold it together, but half of me was fully engrossed in the anxiety. I was in an anxiety loop that I couldn’t get out of. Literally, there wasn’t a minute that went by that I wasn’t hyper aware of it.

I started to question my sanity. I started to question if this was my new reality. I started to be afraid of the thoughts in my own mind. All I wanted was to go back to the way things were before, wishing that I hadn’t had this experience.

Finally, after talking to my father we agreed that it was a good idea for me to see a psychologist. This would be the first mental health professional I would see for any anxiety related issue. He happened to be on his way to retirement and I was one of the last patients he agreed to take so I only saw them for about a month or two. I knew that I had become reliant on the Ambien to be able to sleep, so I knew I needed to break that as soon as possible. I weaned myself off the Ambien. The psychiatrist prescribed trazodone instead, an anti-depressant that is sometimes used to help people sleep because it causes drowsiness. As we continue to have discussions, ultimately he diagnosed me with PTSD. But before we could really do any treatment it was time for him to retire.

I needed to find somebody else, so I talked to my father once again and he recommended a therapist on Bainbridge Island he had referred other patients to for PTSD. That is where I was finally able to start unpacking what had happened to me… a full three or four months after my initial trauma.

My OCD Story – Part 4: Sleep

In March/April of 2013 I had a new dating interest that I was pursuing, but it didn’t seem to be going that well. He showed initial interested, but started backing away. So I started questioning whether or not I was likable or actually able to pull off the relationship thing. Also, I had decided that it was a good idea to take on the added responsibility of teaching a fitness class at my gym (even though I was still dealing with the hip injury). I had decided it would be a fun way to earn some extra money and pursue something that I was passionate about so I approached my gym and they agreed to hire me. I didn’t think about the added stress of programming classes, or the responsibility of teaching people proper form so they don’t get injured. So I started mulling over the responsibilities as I waited to start teaching the classes. Lastly, I was working toward transitioning to a new project at work. When my coworkers found out I was being transferred to this new project basically everyone who walked by apologized. “I’m sorry you have to work on that project.” The project had a reputation for not being the best project to work on, not only because the project itself was struggling, but also because of the work environment. I would be co-located with the project team in the client’s office which was in a vast basement full of a sea of cubicles. No natural light. Basically the most depressing work environment you can think of. And it just so happened that I was scheduled to start this new project on the same day that I was scheduled to start teaching fitness classes.

The build up and stress culminated late one evening when I was looking at and lusting over pictures of attractive men online. When I was done I was wracked with guilt for having indulged and lusted and when I finally went to bed I just laid there. I tossed and turned, but I couldn’t fall asleep. This went on for hours until I finally drifted off in the early hours of the morning only to have to get up and go to work with only an hour or two of sleep. I managed to get through the day. But when I went to bed the next day, the same thing. I could fall asleep. My mind just started reeling for hours about all the stresses I was experiencing. Once again I didn’t fall asleep for several hours and again drifted off just before morning. Then the next day the same thing. Then the next.

This went on for about a week and a half before I decided that I needed to look for some help. My father is a doctor so I schedule an appointment with him to see if he could run some tests to see if there were some chemical imbalance. The only thing they found was a slight deficiency in vitamin D. So, my dad did what most doctors would do and decided to treat it with medication. He prescribed ambien. Initially he suggested a reduced dosage. So I tried it, but it didn’t help. I still had trouble sleeping for the next several nights.

Finally, on Easter Sunday I had my first real anxiety attack. It had been two weeks with very little sleep. I was exhausted. The next day was the day I was supposed to start both the new project and teaching the fitness classes. The pressure and stress I felt was overwhelming. I remember sitting at the dinner table. I was seated in the middle seat and there were conversations happing on both sides of me, but nobody was talking to me. I was just lost in my own anxiety. Would I be able to sleep that night? How would not sleeping impact my performance at both my regular job and in the new fitness job? After dinner I had to leave and headed out to the driveway. My father followed and I broke down in tears explaining to him what was happening. Again, as a doctor of medicine the way he could help was by prescribing medication. He told me to increase the ambien to a full dosage and prescribed a medication that was supposed to provide calming (I think clonazepam). Finally that evening the full dosage the ambien knocked me out after about half an hour.

My OCD Story – Part 3: The Build Up

In 2012 I had my second serious relationship. It lasted about 4 months, and at the end of four months I decided it wasn’t working for me. He was much younger than me and I felt a generational divide. I didn’t fully understand him and he didn’t fully understand me. So I ended it. I wasn’t prepared though for how much it would impact me. I definitely hurt him and it was a burden to be responsible for that much pain in another person. That was the beginning of a mildly depressive episode of my life.

Then in the fall of that same year I had what amounted to the worst experience of my professional career. I had been invited to a huge company conference in Vancouver. I was working for a very large company at the time and the meeting was the Who’s Who of the company. All of the top executives. And then me. I was the chair of a young professional group at the time and invited as a representative of that group. There were a couple other young professional representatives from other regions like Australia and Singapore, and we were asked to lead a team building activity. I had read the instructions for the activity from an iPad that had been issued to me for the duration of this work conference (Every single person had been issued an iPad with preloaded software for the event). After the activity some drunk jack ass came up to me and mocked me to my face for using the iPad. But the ultimate embarrassment came in the very last meeting of the conference. It was a breakout meeting with just the USA leader ship. Everything they were talking about was way over my head and I struggled to keep up. I was then put on the spot and asked a question by the area manager for my home office. I started to respond… and then started questioning what the hell I was saying, am I making sense, no I’m not making sense, and then just stopped talking in embarrassment without completing any coherent thought. The room was silent for several seconds before I heard someone behind me mutter under their breath “poor guy.” I drove home from Vancouver to Seattle playing that event over and over again in my mind. I started questioning my place At the company. What were the executives thinking of me? Had I just spoiled future development or promotional opportunities? did I really enjoy what I was doing? Was the company the right fit for me?

At this time in my life I was also heavily into fitness. I had a pretty regimented workout routine and was actually in really good shape. It was my primary stress relief. Well, that fall I had a hip injury that prevented me from being able to work out. So suddenly my primary stress relief activity wasn’t available to me.

I think all of these events contributed to what would happen in the next year.

One other thing to note about this time period. I was still in the process of coming out of the closet, but also still an active practicing Mormon. At the time I was not yet open with my family about my dating life. I think I was still on the fence about what my future looked like. In a way I was still wracked with turmoil about where I stood in the church. Were my choices at odds with what the church was telling me? I was still figuring it out.

My Private Hell

Recent events have led to a significant increase in OCD activity, to the point where it’s once again significantly impacting my daily life. The last few days in particular have been hellacious.

It started last Wednesday. My typical trip home from the office under normal circumstances it should take about 30 minutes (give or take depending on traffic). OCD rituals usually make my commute longer. The rituals that delay me are repeating rituals; re-walking the same path over and over again, retracing my steps, circling my driving routes back-and-forth, etc. On average OCD adds 15 to 20 minutes to the commute home. On a bad day I can add an hour or more. So, when I left the office last Wednesday I decided to try to break up the typical scenario by first driving to a project site that had recently completed construction to take a look at it. Everything was fine until it was time to head home. All it took was one OCD trigger and I started driving back-and-forth the same route, circling the blocks, getting on and off the freeway, and then finally after an hour and a half making it to the 520 bridge to got home. only once I got across the bridge, OCD wasn’t satisfied and so I turned around and drove back across the bridge, and then again, and then again. Finally I mustered up enough courage to push through and go home, three hours after leaving the office. I was home for about an hour and OCD wasn’t having it, so at about 10:00 I got back in my car and drove back out to the bridge and across the bridge again, and again, and again. I probably drove back and forth across the bridge 10 times in total. Finally at about 11:30, after hours of exhausting ritualizing I was able to get it to feel “right.”

Usually after a particularly bad OCD episode I’m able to recover rather quickly before I have another, but that wasn’t the case. Thursday after work I went to the gym, and after finishing my workout ran into a very high-level trigger as I was leaving the gym. Similar to the driving episode, I kept having to repeat my path. The entire walk home It was five steps forward, three steps back, Three steps forward, five steps back. What should be about a 10 minute walk, took me about 45 minutes. Then once I got home the ritualizing continued. Handwashing, over and over again. I couldn’t get my hands clean. I spent probably another half hour trying to do that.

Then Friday morning, OCD wouldn’t allow me to do the simple task of putting on shoes. From an OCD standpoint it was too risky. There were too many opportunities for additional triggers to happen and additional contamination to happen. I just sat there for about 20 minutes and broke down. OCD was once again preventing me from doing the most basic of daily tasks. After that emotional episode, I was able to pull it together enough to put on my shoes and have a mostly productive day.

Then Saturday was just as bad. I tried to run errands, but I couldn’t complete them. I couldn’t stop to buy food. Just hand washing again, and again, and again. Then on Saturday evening before I went to bed I decided to take a shower. when I got out of the shower there were triggers regarding my feet and I couldn’t get my feet clean. So I got back in the shower and rinsed them again, and again, and again. Then got out of the shower, but then they got contaminated again so I had to get back in the shower. Then again and again. It was about an hour of getting in and out of the shower, the whole while my anxiety, frustration, and anger building in building.

Sunday and Monday have been easier and have provided some relief. I’ve scheduled several meetings with my therapists to work through this.

Epiphany

I had an epiphany today regarding my OCD. So much of my OCD activity is my brain trying to ward off what it perceives as threats. This is evident when my OCD is triggered. Triggers typically have connection to really uncomfortable events in my life and any memory of that time or any thought that I might again experience what I experienced at that time is a threat. It’s uncomfortable. It’s bad. The epiphany is this… OCD will continue to be present as long as I continue to see those thoughts and memories as threats, as being bad. I believe my therapy needs to be focused on relearning that the memories and thoughts themselves are not threats.

My OCD Story – Part 2: Young Adulthood

To be honest, I don’t recall very much OCD activity in my teenage years. At most I avoided stepping on seams in the pavement. It wasn’t until young adulthood that I started seeing other signs of OCD. I started counting in my head while I was performing certain activities. I would count while filling up I my water glass at the water cooler at work. I did this so much that I knew exactly how many counts it took to fill up my glass. I would joke to colleagues that I could fill up my glass with my eyes close. I started counting while walking as well. Instead of just avoiding seams in the pavement, I would try to make sure that I stepped an even number of times on each sidewalk panel. I don’t know why. My brain just started doing it. Then I started checking the door lock when I left my apartment to go to work. Not once, not twice, but half a dozen times or more. None of these activities though truly consumed an inordinate amount of time. None of these behaviors impaired function in other parts of my life, so I saw no need to address them.