My safe place.

Today, I am feeling overwhelmed with gratitude for my husband.

I read an article (excellent and highly-recommended) about a man caring for his wife through the throes of psychosis. For this couple, mental illness didn't hit until they were already married, but he has stood by his wife in the terrible and complicated ways that her condition mandated. Her illness has changed her, yet he does not simply mourn the loss of parts of her personality, he seeks to treasure and nurture the woman his wife is becoming through her struggles. He is the one who made the choice to check her into a psych ward--twice. He is the one making her take her pills. He is the one forcing her to sleep. He is the one loving her through it as best as he can manage.

Now, don't misunderstand me. I am fully aware that my situation and that of the young woman in the article are very different. Psychotic depression and OCD manifest is extremely different ways and present a myriad of different struggles. I have not entertained suicidal ideations,  nor have I been checked into a psychiatric unit. In fact, I still have not actually seen a psychiatrist (my psychologist and primary care MD work together when medication is needed).
Yet, I cannot help but see glimpses of our marriage in their story.

Dan and I met in college, fell in love, dealt with cancer, dealt with nursing school, got married, dealt with loans/bills/grown-up life, and planned for the future throughout. He knew I had a history of mental illness, but I imagine he didn't expect it to become such a large part of our lives. Then, I began working as an RN and the anxiety grew out-of-control. He encouraged me to see a counselor, and then, when the talk-therapy stopped working, he supported me in trying medication.

You see, I have been blessed with a large support network of family and friends and church communities. I appreciate each person who has come alongside me in the struggle. I must, however, give credit where credit is due: to my husband.

Dan has heard the frantic fears that border on insanity. He has talked me down from countless panic attacks. He has physically pulled me away from my compulsions (washing my hands, checking things, calling work to check on my charting, etc.). He has logically unfurled my crazed notions of reality. He has made me take my medications and assured me that I have not already taken them. He has forced me to eat when my fears about listeria and food-poisoning have made me make poor choices. He has dealt with my anger when his true view of reality clashes with my distorted one. He has defended my needs to my family members without regard to the irritation it may cause them. Dan has loved me in very concrete and frustrating ways through the last few years of my struggle with OCD.

I pray that my ability to cope with my mental illness will improve with time and that this current struggle with OCD will again dissipate after I deliver our little girl. I never want Dan to have to choose to have me committed to protect my well-being or that of our family. However, I have utmost faith and trust in his love for me--to the point that I know I am safe with him. His love is my safe place in the midst of mental illness. Aside from my salvation, there is no greater gift that God has given to me than that of my husband's love and commitment.

This is not meant to be embarrass Dan or super-inflate his ego. This is simply meant to praise a humble and kind husband for the care and devotion he has shown me in my darkest moments.
He will probably rather I baked him a cake than cry my way through writing this...

All I can say is this: thank you, Dan, for loving me so well.

A Scratch and a Surrender

I went to Target today as part of errands. Things went fine despite a meltdown from the boy having to try on new shoes. We were almost done when I remembered that I needed a couple hair clips, as mine have been broken by a rambunctious toddler. I reached down to pull the package off of the rack and scratched myself on the plastic price tag on the front. I might have gotten two scratches.
At first, I reacted pretty well. Grabbed a wipe from the diaper bag to clean off the scratch. No big deal. Then, I thought, what if there was something on the plastic that scratched me? Used another wipe to clean off the scratch and moved on.

By the time we checked out and we got to the car, I was beginning to think too much. Someone else could have scratched themselves on that tag. That someone else could have HIV. Put those thoughts together: I'm scared I caught HIV from a plastic tag on a Target hair clip rack. Scared enough to rub hand sanitizer into the scratch several times until we got home, and then to wash my hands over and over once at home and the baby was asleep. Scared enough to Google the question: "Can I get HIV from scratching myself on a plastic tag/shelf in a store?" (No definitive answer was found.)

Before jumping to the comment section to offer reassurances to the very unintelligent or confused woman writing this (aka: me), please understand something. I am a nurse. I have a Bachelor's of Science. I have done my research. I KNOW THAT THE ODDS ARE EXTREMELY LOW. What I do not know is whether it is impossible. Thus, my brain is churning. The warning light has been activated, and there is no turning it off. I am remaining somewhat calm while the baby sleeps, which is actually pretty astounding considering Dan isn't here to make me stop googling or worrying.

The facts are being pressed up against each other in my mind as I try to come to one conclusion: I did not get HIV today. You see, if I cannot reach that conclusion, other conclusions will step in: The new baby will get HIV from me. Dan will get HIV from me, and because of his liver function he won't be able to take the anti-retroviral drugs, and therefore, will die. Then, when I'm a widow, no one will want to be with me because I have HIV. One thought process has assured me that I will now be raising two young children alone while dealing with an incurable disease that I caught at Target.

I am writing this out to try to manage my thoughts and panic. Tears are flowing, but so far the panic attack is being held at bay. What do I do now? Read a few Scriptures from my "emergency card", try not to bother Dan at work, try to sleep during the baby's nap. In time, (a day? a few hours? a week?) this panicky event will subside and be mostly forgotten. Realistically speaking, though, it won't be the last time.

Just like in my first pregnancy, my OCD is beginning to take over my thoughts and actions. My hands are cracked from washing them so much. I'm not gaining much weight because I'm so afraid of most foods. I'm nervous that many of my actions (mostly the ones involving being happy) will cause me to lose the new baby. I'm exhausted. I've tried hard to stay off the meds this time around, but I am acknowledging defeat. I need help. I surrender.

Hopefully, my doctors (different from the last pregnancy) will be encouraging and helpful. My OB seems to think that my OCD is simply keeping things organized and worrying a bit much. My GP said she could help if my OB won't. My last doctor ordered serial HIV tests for me to keep my nerves down, but I'm not sure this one will do that. I truly, truly hate being the crazy patient. Alas, here I am.

Beyond using this as a form of therapy, I am also writing this to ask for help from those who love me. If I got diagnosed with cancer/diabetes, I would ask for prayers and support. Accordingly, I am doing the same now. My body is healthy, but my mind is broken.

Please pray for me:
Pray that my medical team will be understanding and patient with me.
Pray that my body adjusts well to being back on medication.
Pray that the new baby experiences no harm from my panicking or the meds.
Pray that Dan would have strength and endurance as he walks through this with me.
Pray that I can brush off the comments of those who don't think this is real.
Pray that God will provide the "peace that surpasses all understanding" to "guard my heart."
Pray that I will have endurance to keep taking care of Dan and the little man. 

Boston and Bizarre Thoughts

My family of 3 joined my dad's much larger family in Boston this past weekend for a family reunion. While it was wonderful to see historic sites and have fun with family members that I rarely get to see, traveling always make my OCD worse. Going through the airport full of hurried people, flying with the germs of hundreds of other people, sleeping in a hotel room in sheets that are hopefully clean, showering in shared bathrooms, etc. Ah, the germaphobia got such a joyride this weekend.

While attempting to decompress after the teething toddler stopped crying (poor baby), I read an extremely interesting and helpful article. Written by psychologist Stacey Kuhl-Wochner from Southern California, it detailed the bizarre thoughts that she encountered throughout the course of her day. The catch? She doesn't have OCD. Her point was that everyone has strange thoughts and that it is possible to move past them. For people with OCD this is still possible, though obviously more difficult. Rather than reiterate everything that she wrote, I recommend reading the article in its entirety. If you are suffering from OCD, it will probably be very encouraging. If you know or love someone with OCD, it will certainly be illuminating.

Bizarre Thoughts and OCD

One of the most troubling parts of living with OCD is often the interactions that occur with family members or friends. Regardless of how much people may care for me, my struggle with OCD is still often seen as unnecessary quirkiness or me "being difficult or overly sensitive".
Please, please understand something: how I behave in response to my environment is in direct response to how well my OCD is under control.

My anxiety level is almost always in an elevated status, therefore, it is unwise (and unkind) to tease me about how I am attempting to keep the panic from bubbling over.

Also, I cannot actually change how my brain works in relation to OCD. I feel that I have made major strides in developing coping mechanisms and the ability to swallow the acid of panic before it ruins situations around me. Rather than chastising me for my inability to "get over it" or "just deal with it", perhaps offer some encouragement in the positive changes you have noticed.

I am not trying to make anyone's life more difficult by my behaviors or irrational fears. Having OCD has made working as a nurse incredibly difficult, has made being a mother downright terrifying (though I have heard that most parents spend much of their parenting career in mild terror), and has made relationships quite complicated at times.

Mental illness is often an invisible criminal, stealing away portions of lives that may never be returned.

There are people struggling with mental illnesses that are actually incapacitated and unable to live productive lives. On the other side of the spectrum, there are people living with mental illness that only deal with issues in very specific situations that they can avoid easily. I do not take it for granted that I am able to live life abundantly.

However, OCD has a constant and loud voice. A voice that I am sometimes victorious in ignoring. When I fall prey to the threats and lies of OCD, please do not take my actions personally or abandon our relationship.

There is one piece of certainty that OCD has not been able to discredit: love is powerful.

Stand beside me, forgive me, love me, encourage me and help me to move forward when I cannot take steps by myself.

Coping Mechanisms: Allies Against the Enemy

 Here's the scene: the baby has woken up to eat in the middle of the night. While I nurse him in the glider in the nursery, my mind begins to go over my to-do list for the coming day. When I come to plans for cooking a casserole for our community group, my old frenemy wakes up. You see, I need to dice and cook chicken for this casserole. OCD reminds me that raw chicken can be contaminated with salmonella, which could get on the counters and my clothes, which could then get on the baby, which could invade his blood stream and give him a massive infection, which could ultimately hospitalize or kill him. Ugh.

My peaceful session of nursing my sweet boy has been overtaken by an anxiety attack. My heart is racing, my mind cannot grasp onto any calming thoughts, my breathing is too fast. Typically, my hubby can help me through an attack, but he's asleep and has work in the morning. What can I do now?

Between nursing school and counseling, the importance of coping mechanisms has been thoroughly impressed upon me. Without strong coping mechanisms, people cannot effectively navigate crises. It has taken me my whole life to come up with a set of skills that can keep an anxious moment from turning into a full-blown panic attack.


Some coping mechanisms are common to all anxiety/OCD sufferers. Some, however, are personal to each person. In my opinion, everyone needs a few things that are unique to them to help them stop the speeding panic wagon from pulling them over the cliff. Here are some of mine:

1. Laundry.

 Yes, laundry. Sorting it out, washing it, drying it, folding it. The clean smell. The warmth. Taking a disorderly pile of clothes and making neat piles. It is so very calming and distracting. Good thing we have a laundry room now and a near-toddler to make LOTS of laundry for me to do.




2. Hot mugs of goodness. 

Whether it is coffee, tea, cider, cocoa, or even hot water, holding a warm mug in my hands helps me to breathe and relax. A fun mug can even draw a smile.

3. Gardening.
This is a new one for me. My thumbs are not green by any stretch of the imagination. However, having little plants to take care of forces me into the sunshine and out of my jammies in the morning. 







4. My "emergency card".
This idea came from my previous counselor. It is simply a laminated card with encouraging Bible verses on it. I can carry it anywhere and anytime. Just forcing myself to read through all the verses can sometimes pull my mind off the panic wagon.






5. My catfaces.
I am not recommending that anyone who has anxiety issues go out and get a cat. In reality, cats (or any pets) come along with responsibilities and triggers of their own. For me, though, my hubby and I adopted our first catface, Toulouse, when we graduated from college. We raised him from a tiny kitten, and he became a constant source of entertainment and cuddling and consternation. He was later joined by little Fleur.

When I was pregnant, neither or them would leave my side when I was on bedrest. Basically, my cats are a source of distraction and non-judgmental comfort. Even now that we've moved them to being outside cats, they still come around to snuggle or meow or run with me whenever I'm outside.

6. Running.
I was ran track in high school and have maintained a deep love of the freedom that comes from a good run. Working my muscles, clearing my mind, new scenery, the high afterward. Not to mention the serotonin running releases in my mind. Add in a running buddy like Toulouse...so good to kick my frenemy in the butt.






7. Sleeping and my bedroom.
I love sleep more than my cats love sleep. I certainly love naps more than my son loves naps. When a panic attack gets near, sometimes, curling up under a blanket and letting my brain rest can help. This only works if I catch the anxiety early enough. Otherwise, the rising panic will keep me awake.
Also, my bedroom is a source of sanctuary for me. Sunlight, a reminder to approach God with my worries and often, my hubby.











The last two "items" on this list are not really coping mechanisms. One, Christ, is a lifeline and the other, Zoloft, is a necessary evil.


8. My faith in Jesus Christ as my Savior

 OCD and other mental illnesses (and physical illnesses) are a result of the Fall. We are currently living in an unfair world, which will eventually be redeemed by the Second Coming of Jesus. Until then, knowing that He knows my heart and mind intimately helps me to trust Him with my anxieties. Mental illnesses cannot be simply prayed away or blamed upon spiritual warfare (except for certain occasions). However, prayer and maintaining my relationship with Jesus as Lord of my life, does help me to refocus away from the things that cause panic.

9. Zoloft
I fought against medication for years. As a nurse, I knew the side effects. I also knew that most meds were not compatible with childbearing. Eventually, though, therapy reached a plateau and my OCD was preventing me from being a good nurse and even wife. My physician was incredibly patient and took the time to research the best medication for OCD that was also safe for breastfeeding if I became pregnant. Though, I have successfully weaned myself off of Zoloft twice (once while going through fertility treatment and once during pregnancy), I'm not sure if I can come off of it any time soon. I hate the stigma associated with being on a mood-stabilizer. I hate not being able to be a productive person more. For now, I'll just make sure to take my "little blue pill" and keep trying to kick panic's butt.

Meatloaf

My hubby's birthday was this past Monday. When asked what he wanted for his birthday dinner, he quickly responded: meatloaf and mashed potatoes. He is a wonderfully easy-to-please man!

Now, meatloaf is a very simple meal to make. Grab a bowl, mix up egg, ground beef, bread crumbs, spices and onions. Put in loaf pan. Bake in oven. Voila! Yummy dinner and happy husband.

Oh, wait. I forgot about the E. coli. What is cooking with ground beef if you forget the absolute probability that you will be spreading E. coli everywhere?

Just wash your hands and the countertop, you might say.

My response: How many times? With what bacteria-killing chemical?

This should really be a simple task for me. I can cook well, but my germaphobia gets in the way of enjoying it. As a pre-requisite for nursing school, I took (and aced) microbiology. I know where bacteria and viruses can lurk, what illnesses they can cause and how susceptible to cleaning agents they are. Does it matter that my logical brain knows that a Clorox wipe will kill off any stray E. coli buggies that might land on my counter? Nope.

My OCD brain takes over and says, "Not only will the E. coli survive, it will invade your skin and clothes, make you sick and transfer itself onto the baby. Oh, and by the way, those Clorox wipes will leave traces on your skin that will poison the baby. So pick one: E. coli sickness or Clorox poisoning. Happy cooking!"

Luckily, my husband came to my rescue as a panic attack began to rise up. He sent me away to wash my hands in the bathroom while he washed the meatloaf mixing bowl. Then, he allowed me to wipe off the counters (only once) and then calmed me down when I realized that I had to hold the baby with chemically hands.

Amazingly, all three of us are still alive! No symptoms of E. coli or chemical poisoning to be noted.

I really do hate OCD. Such a ridiculously mean disorder.

Praise the LORD for a patient husband, a kid with a good immune system (knock on wood), and SSRIs that are safe during breastfeeding.

Sunshine and Shaking Hands

I hate shaking hands with people.

No, it's not hatred really. It's more like a visceral loathing that makes me cling to things that can fill my hands.
If my hands are full, be it of a baby or a bag or my husband's hand, I cannot shake hands.
If my hands are empty, I am thrust into an uncomfortable, slowly rising panic while I decide which is worse: to offend someone by not shaking their hand or welcome thousands of tiny particles of germs, dirt and fecal matter onto my hand.
If I have chosen not to offend, I am now trying to act normally while I plan the most expedient path to the nearest sink or dig into the recesses of the diaper bag to find hand sanitizer. In the time before I can wash my hands, my base level of anxiety is climbing.
My ears are ringing, my mouth is dry, my mind cannot focus, my breathing is shaky and my heart is racing. I can literally feel the bacteria and viruses on my trembling hands multiplying and making their way through some portal of entry to attack my immune system.
Luckily, the panic subsides as soon as the water begins to flow. As I count to 20 (the number of seconds recommended by the CDC for proper hand hygiene, if you must know), calm overtakes fear. By the time my hands are dry, my composure has been regained.
Within my clean, scrubbed hands I am now holding the greatest delusion of all: I am in control.

I have obsessive-compulsive disorder and a generalized anxiety disorder. These diagnoses became official in the Fall of 2011, but they are not new.

I was always a nervous child, a perfectionist, a worry-wort, tightly-wound, and so on.

I can remember panicking on the first day of Christmas vacation in 5th grade because I realized that I misspelled 'maintenance' on a spelling test--this mistake would surely cost me entrance into a good college.

During middle school, there would be entire nights in which sleep evaded me as I wandered down convoluted paths in the game of 'What If?"

I developed my first ritual in 7th grade: kissing my fingertips, touching a picture on my wall, praying the exact same prayer every night, kissing my fingertips, touching the picture again, flipping the light switch, closing my eyes. Forgetting a step meant starting over. Period.

By high school, the OCD was moved to the back burner as my anxieties welcomed a new friend to the crazy table: anorexia nervosa. Though a different beast, anorexia was simply my newest ritual of control. Instead of light switches, I was turning off my hunger. Anorexia also brought me to therapy for the first time. I'll never be cured, but my faith and my family eventually brought me back to a healthy body and a healthier mind.

The newness of college seemed to breathe fresh air into my mind. I was focused, stable, out-going. Of course I had anxieties and a few mild panic attacks--who doesn't panic over piles of papers and daunting exams? A change was coming, though.

I wish I could pinpoint when OCD took back control of my mind.  Was it in nursing school as I became a bonafide germaphobe? Was it when my boyfriend developed cancer and his care needed to be impeccable? Was it when I needed to score well on exams so I developed new rituals and checking behaviors? All I know is that by the time I graduated and began working, something was different.

I worked as a nurse for three years in an oncology department and an outpatient clinic. God has called me to be a nurse. I love caring for patients, healing hurts, putting together pathophysiological puzzles. I loved so much of my work...except the fear.  I began praying the same prayer everyday on the way to work and if I deviated, I was sure that something bad was going to happen. Over the three years, my anxiety reached a new level in which handling needles became tantamount to torture. My mind was literally re-writing my memories to make me believe that I was getting needle sticks and deadly diseases. Even writing about needles makes me breathe a little unsteadily.

Finally, I swallowed my pride and sought counseling. I was drowning in fear. My anxieties were sucking the color and vitality from my life. At first, the therapist focused on my needle and blood-borne pathogens phobia. Then, she moved on to my moderately high level of constant anxiety. Eventually, though, we had a breakthrough. I had failed to mention (to anyone) that I had developed rituals throughout my life to help me cope with burdensome thoughts. As I described the treacherous ways my mind seemed to work, my therapist walked me through an official diagnosis of OCD.

It may seem strange, but that diagnosis was a relief. My therapist described it as faulty wiring in my brain's warning system. Something (a chemical imbalance, probably) told my brain that something bad was going on all the time. The warning signal that we have been designed with never turned off for me.

We worked through cognitive-behavioral therapy for a while, but I plateaued. Despite my extreme reluctance to try medication, it became my only option. I wouldn't say that the drug has made a night-and-day difference, but it helps. I was able to keep working as a nurse, able to enjoy life with my husband again, able to plan for a future. I was able to breathe.

I stayed on the medication until my husband and I began trying to have a baby. I tapered off the drug successfully, and by the grace of God, I got pregnant in the Fall of 2012. At first, I thought my nervousness was normal for a first-time pregnant lady. Doesn't everyone worry about miscarriage or birth defects? Doesn't everyone choose their meals carefully? Doesn't everyone assume that as soon as they feel happy about having a baby that the baby will die? When I shared that last question with my husband, he helped me to see that something was wrong.

Unfortunately, OCD can be triggered by the hormones of pregnancy. With my history, the anxiety and intrusive thoughts became deafening. I never wanted to take drugs during pregnancy, but my doctors helped me to understand that my mental health would have a greater impact on the health of my child than the small risk of side effects of the drug. I stayed on the medication throughout the 2nd trimester and then tapered off for the 3rd trimester to prevent any withdrawal symptoms in the baby. My husband and I welcomed our son into the world in May 2013. He was born before lunchtime and by dinnertime, I was back on my medications. My doctors have suggested that I remain on my medication until my son is a year old to prevent any combination of post-partum depression and OCD wreaking havoc on my exhausted baby brain.

All that to say, I am a new mom, and I have OCD and an anxiety disorder. The support I receive from my family and friends is remarkable, though I do not share this aspect of my life with everyone.  When I do mention that I have OCD, most people assume I mean the colloquial meaning of "a quirky desire to keep their desk items in perfect order" or "the need to not step on sidewalk cracks." Usually, I let it slide.

Lately, though, I have felt the familiar tentacles of intrusive thoughts reaching for my sanity. Of course, I have coping mechanisms, and little rituals have snuck back into my day to help me keep breathing. However, more is required of me than just breathing now. I am responsible for a little life. Thus, this blog has come into existence.

Getting my fears and anxieties into the open helps me to decipher which ones are real and which are OCD. There is an old saying that says, "sunlight is the best disinfectant." In other words, bad things have a harder time staying hidden and powerful when exposed to the bright light of day. Between prayer, sharing with my husband and loved ones, and writing these words, I am truly blasting these intrusive thoughts with sunlight.

This brings me to the beginning of this (regrettably-long) post: shaking hands. A simple action that causes chaos in my mind. A greeting that literally causes my hands to tremble and shake long after the introduction is complete. It's time I start shaking hands in the light of day.