Natalie Amo

@natalie-amo93 | contributor
My hope is to share my experiences living with Obsessive Compulsive Disorder and Depression, and to be a part of changing the dialogue about mental illness in our society. OCD is greatly misunderstood and misrepresented, and as someone who lives with it every day, it is very important to me to change the way we talk about it and understand it.
Natalie Amo

8 Common Symptoms of OCD We Don't Talk About

Obsessive-compulsive disorder (OCD) is not commonly discussed, and when it is, it’s more often than not misrepresented as a synonym for “neatness,” “quirk,” or “preference.” However, OCD is a serious, life-altering mental illness. It’s an illness that can completely take over life, and make its inflicted feel like a prisoner in their own mind and body. And while OCD is misconstrued as the desire for cleanliness, in reality, it is a vastly varied illness that can manifest in many ways, making it difficult to create a succinct list of symptoms. But here are a few of the symptoms I believe stretch across the many types of OCD, and that I have experienced throughout my battle with this debilitating mental illness. 1. Feeling an overwhelming sense of responsibility. Obsessive-compulsive disorder has taken my innate desire to make others feel safe and happy, and it has cranked it up to an extreme. Every OCD fear that invades my mind, every safety behavior that I perform, from washing, to avoidance behavior, to seeking assurance, is anchored by the belief that I somehow control the fate of those around me. That my actions, my mistakes, can make or break someone else’s happiness. Not only does OCD make us internalize this crushing sense of responsibility for our actions, but it also often exaggerates a sense of guilt for the simple fact that we have a mental illness, and for the effects that illness has on those around us, as if we somehow have control. Try as I might to remind myself I am not my OCD, I am not my illness, it becomes extremely difficult to separate my identity from the illness and the pain that it causes. OCD distorts my sense of responsibility and even weaponizes it, using my goodwill towards others as a tool to create anxiety, uncertainty, and guilt, all of which fuel my illness in a self-perpetuating cycle. Of course no one holds that much power over anyone else’s happiness, so OCD is simply setting me up for failure after failure, as all of my efforts to control the future and protect those around me fall short. And while OCD tells me that I will continue to fail, it simultaneously convinces me that it is my duty to keep trying. And the more I try, the worse my OCD gets, the more I feed it. To counteract this cycle, I must do something that is so contrary to my nature and that my OCD will fight against with all its might: Stop taking responsibility for the health and happiness of others. In doing so, I will begin to heal, and with that healing, gain the ability to care for others in a healthy and productive way that does not harm myself in the process. 2. OCD resulting in physical pain. I believe many of us battling OCD have become very skilled at being uncomfortable. I, for one, have a new baseline of discomfort, one that many would most likely find appalling. Not only mental discomfort — to put it mildly — but physical as well. I am sure this physical pain manifests differently for each of us depending on the type of OCD we endure, but such constant mental distress is bound to have an effect on the body. I have washed my hands until they were cracked and bleeding; but OCD doesn’t care about your pain, and even though washing my hands again causes searing pain, OCD tells me I must, or I threaten the health and safety of those around me. Once again playing on my sense of responsibility, it convinces me I must sacrifice my own well-being for the sake of others. I have stood, barefoot on a tiled floor for over 10 hours straight, despite the feeling that each one of the bones in my feet were breaking, my knees felt as though they would buckle, and despite the sensation that my spine was collapsing on itself. All I had to do to stop the pain was to simply sit down. That’s the power OCD can hold over you. I felt like the fate of the world depended on me to keep standing. So I stood. I have sat in one place for hours, in a particularly uncomfortable position, ignoring the feeling of my hips and spine being jammed into place, my tailbone bruising, and my shoulders so stiff I felt like I would be frozen like this forever. Frozen still as if one wrong touch from me and the world would come crumbling down. And as if my head is protesting the invasion of OCD fears, I get mind-numbing, debilitating headaches that can last for hours. Anxiety, depression, and fear are time-consuming, exhausting emotions that take a toll on your mind. My mind gets tired just like my feet, just like my back, and it hurts. 3. Experiencing suicidal thoughts due to OCD. OCD is often represented in mainstream media as a little quirk, a preference, someone simply being high maintenance. “I’m a little OCD” rolls off of the tongue as easily as “I like my closet organized by color;” a simple preference, one that if not heeded may cause some small amount of annoyance. Far from it, obsessive-compulsive disorder, as implied by the term itself, is a debilitating disorder. And in no small part due to its misrepresentation, OCD is isolating to those who endure it and the weight of it can feel crushing. It took me quite some time to acknowledge the reality of my own suicidal thoughts. I was afraid to admit them for many reasons. I thought if I didn’t, they wouldn’t become reality. I thought if I did, I would be laughed at because, “What’s the big deal? So I’ve got OCD,” so many think they’re “a little OCD.” This is not an easy subject to approach, but it’s important to acknowledge the reality of living with a mental illness. Battling OCD can feel endless; it’s hard, it’s terrifying, and it’s exhausting. I often feel as if I am left trying to hold the world together, all the while I am unraveling. It feels desperate. And on top of the fact that OCD can be a life-threatening illness in and of itself, the simple fact it is so misunderstood can leave us feeling even more alone, unsure of how to ask for help. Unlike what I was led to believe while growing up, that OCD is no big deal, in reality it takes up so much of your life. The distress is relentless, and it is no small feat to overcome it, but it can be done. I for one am learning not to be ashamed of my suicidal thoughts, but instead to be proud of overcoming them. Even so, they are often a reality of living with a mental illness, and I think it is about time that we acknowledge them. Acknowledge them for what they are — another battle we must fight, not a dirty little secret. Acknowledge that we are not something to be hidden, we are something to be proud of. 4. Realizing how much time has been lost. OCD is a time-consuming disorder. The severity of a person’s OCD is often measured by how many hours per day that obsessive thoughts consume them, and how many hours per day they perform safety behaviors (or compulsions). Even if all I do one day is sit, I will look up at the clock and realize hours have passed since I thought of anything other than the last trigger that consumed my mind. In my five years of battling this illness, I can look back and recognize the months of time I have lost to OCD. The time I wasn’t fully present for my life. The time OCD and its fears consumed me so greatly I missed out on the gatherings, the laughs, the hobbies. I can feel my 20s flying by while I play a game of catch up. OCD and OCD treatment take time. A lot of time. 5. Losing relationships because of OCD. While OCD consumes your time, it can also consume a little bit of you. You spend your energy every day fighting this battle, and you have less and less left over to share. The longer I’ve been in this fight, the more I have seen a growing distance between me and all of those I care about. Different things feed that distance. OCD is confusing even from the inside, so it can seem absolutely foreign to those on the outside. I have less to give, and I have withdrawn from the life I used to live due to fear. With that impossible sense of responsibility that OCD hands you, it convinces you to keep your distance, convinces you that mistakes and misfortune follow you like a shadow. Unlike time, these losses are not permanent, those who love you will be waiting for you to come back to them. It just takes more time and a lot of willpower. 6. Feeling a loss of independence or sense of self. Think about a moment when you have been terrified; how did you get through it? When we’re scared, it’s often instinct to reach out to someone we trust to help us through it. So when you’re living with OCD, living with constant fear, you can become incredibly codependent. A very common safety behavior across the varied types of OCD is that of seeking assurance. OCD can convince our minds that we can no longer determine right from wrong, safe from danger, and therefore we can come to depend on someone else to determine that for us by seeking their assurance. With the constant fear, the need for assurance, and the fact that compulsions can be so incredibly debilitating, it can feel as though your independence and the things that made you who you are, are being swept away. Before being diagnosed with OCD, I was my own person. A complete person with hobbies, jobs, friends, school, a career plan. But not too long ago, I was lucky if I made it out of the house at least once a week. And those short excursions out into the world took a lot of effort and a lot of help from my partner, often resulting in an incredible amount of distress on both our parts. Before being diagnosed with OCD, I was a partner. I was an equal in a relationship; I could support as much as I was supported. But there was a long period of time where that relationship transformed into one between caretaker and patient, rather than one between loving partners. I had lost the independence required to create an equal partnership. The simple truth is that OCD can consume you at times, and when it does it can feel like you completely lose yourself. That’s the battle we face, finding our way out of OCD’s shadow. We may never be able to completely get rid of OCD, but we can make it just that, a shadow. 7. Experiencing a poor quality of life as a result of mental illness. Anxiety and depression greatly affect a person’s quality of life, and when you add debilitating obsessive thoughts and compulsions, your world can become very small. My OCD has visibly hurt my quality of life, from mental and physical health, to outward appearance, to social engagement. People will see these changes in their lives differently depending on their depression or their type of OCD, but no matter your battle, there is no denying the draining effects that mental illness has on a person’s life. Many people who suffer from depression and/or OCD will find themselves unable to gather the willpower to perform basic self-care, such as brushing teeth, brushing hair, showering, doing laundry. In my case, this manifests as showering a harmful amount, unable to keep up on laundry, and a difficult time feeding myself. OCD affects all of these tasks in different ways, but each barrier I run into can be traced back to OCD compulsions, fear, and avoidance. I have showered until my skin was raw, gone long periods of time without eating, subsisted on two hours of sleep per night due to avoidance and anxiety. And when I do eat, junk food is easier and faster than healthy food, and when I do sleep, I sleep too much. This all takes a toll on the body, it feeds the exhaustion which then continues the cycle. And it’s certainly a hard cycle to break. You’ll often find yourself feeling sick, tired, undesirable, and you’re left with an unkempt and uncomfortable home. But due to your illness it can feel like you have no way out. Because the way out is going to the doctor, but that means leaving your house. The way out is taking your medication, but that’s simply another task you must add to the list of tasks you are too depressed to perform. There are an overwhelming number of barriers to improving your quality of life. You’ll most likely need help digging your way out of this hole you’ve moved into, which will add to your sense of dependence, but I am living proof that it can be done. 8. Feeling angry at OCD. OCD is incredibly debilitating and life-altering, so it follows many feel a fair amount of anger. I went from being an independent, determined, intelligent person — a hardworking person, trudging her way through grad school — to a person so drained by fear and anxiety, that I couldn’t hold down a job and I relied on someone else to help me get through every single day. My challenges used to be passing vet med exams and studying until the sun came up; I liked those challenges. Then my challenges became getting out of bed, eating, surviving. And I’m angry about that. Incredibly angry. I often find myself thinking it’s unfair, and I’m confused as to what exactly happened to get me from there to here. I’m angry that I feel so much responsibility, sometimes wanting nothing more than to not care. I’m angry that I hurt all the time, and that my mental illness just makes that worse. I’m so incredibly angry that I allow suicidal thoughts to enter my mind, and I’m angry about the guilt that follows those thoughts. I’m angry that I feel as though I’m missing out on my 20s because of this illness, and that I have distanced myself from those I care about. And I’m angry this illness not only seeps into every aspect of my life, but my partner’s as well. And the hardest thing about that anger is I don’t know where to place it. We’re told that we are not our OCD, we are even told to try to imagine our OCD as a separate being, even give it a name. But whoever my OCD is, it lives within me, I’ve been hosting it, listening to it, inviting it into our home. So most of this anger just gets placed back onto me. One more thing that weighs heavily on my shoulders. It’s valid to feel angry. You’re right, it’s not fair, and OCD is one of the most effective bullies you will ever encounter. So be angry at it. Let that anger drive your path forward, instead of letting that anger weigh you down. I’m sure this list could go on and on, and each person with OCD would describe their symptoms a little differently. But I hope it gives you a little insight into what OCD really is, and what it looks like for me. I hope it makes you pause and I hope it makes you question. I hope it makes you look more critically at the way the media represents OCD and mental illnesses in general. These days, each one of these symptoms is affecting me less and less as I start to come out on top of this battle. But there’s always the possibility and the fearful anticipation of another trigger. I come across them daily, but am better able to forge on. It’s not always easy, some days are better than others, some days are a little step backward. But my hope for anyone out there in the midst of their own battle, is that some day those little steps backward are easier to overcome, that they don’t make you feel defeated. Because they will happen, but they don’t make you a failure. They make you a warrior. A version of this article was originally published on the author’s blog Obsessive Compulsive Diary.

Natalie Amo

8 Common Symptoms of OCD We Don't Talk About

Obsessive-compulsive disorder (OCD) is not commonly discussed, and when it is, it’s more often than not misrepresented as a synonym for “neatness,” “quirk,” or “preference.” However, OCD is a serious, life-altering mental illness. It’s an illness that can completely take over life, and make its inflicted feel like a prisoner in their own mind and body. And while OCD is misconstrued as the desire for cleanliness, in reality, it is a vastly varied illness that can manifest in many ways, making it difficult to create a succinct list of symptoms. But here are a few of the symptoms I believe stretch across the many types of OCD, and that I have experienced throughout my battle with this debilitating mental illness. 1. Feeling an overwhelming sense of responsibility. Obsessive-compulsive disorder has taken my innate desire to make others feel safe and happy, and it has cranked it up to an extreme. Every OCD fear that invades my mind, every safety behavior that I perform, from washing, to avoidance behavior, to seeking assurance, is anchored by the belief that I somehow control the fate of those around me. That my actions, my mistakes, can make or break someone else’s happiness. Not only does OCD make us internalize this crushing sense of responsibility for our actions, but it also often exaggerates a sense of guilt for the simple fact that we have a mental illness, and for the effects that illness has on those around us, as if we somehow have control. Try as I might to remind myself I am not my OCD, I am not my illness, it becomes extremely difficult to separate my identity from the illness and the pain that it causes. OCD distorts my sense of responsibility and even weaponizes it, using my goodwill towards others as a tool to create anxiety, uncertainty, and guilt, all of which fuel my illness in a self-perpetuating cycle. Of course no one holds that much power over anyone else’s happiness, so OCD is simply setting me up for failure after failure, as all of my efforts to control the future and protect those around me fall short. And while OCD tells me that I will continue to fail, it simultaneously convinces me that it is my duty to keep trying. And the more I try, the worse my OCD gets, the more I feed it. To counteract this cycle, I must do something that is so contrary to my nature and that my OCD will fight against with all its might: Stop taking responsibility for the health and happiness of others. In doing so, I will begin to heal, and with that healing, gain the ability to care for others in a healthy and productive way that does not harm myself in the process. 2. OCD resulting in physical pain. I believe many of us battling OCD have become very skilled at being uncomfortable. I, for one, have a new baseline of discomfort, one that many would most likely find appalling. Not only mental discomfort — to put it mildly — but physical as well. I am sure this physical pain manifests differently for each of us depending on the type of OCD we endure, but such constant mental distress is bound to have an effect on the body. I have washed my hands until they were cracked and bleeding; but OCD doesn’t care about your pain, and even though washing my hands again causes searing pain, OCD tells me I must, or I threaten the health and safety of those around me. Once again playing on my sense of responsibility, it convinces me I must sacrifice my own well-being for the sake of others. I have stood, barefoot on a tiled floor for over 10 hours straight, despite the feeling that each one of the bones in my feet were breaking, my knees felt as though they would buckle, and despite the sensation that my spine was collapsing on itself. All I had to do to stop the pain was to simply sit down. That’s the power OCD can hold over you. I felt like the fate of the world depended on me to keep standing. So I stood. I have sat in one place for hours, in a particularly uncomfortable position, ignoring the feeling of my hips and spine being jammed into place, my tailbone bruising, and my shoulders so stiff I felt like I would be frozen like this forever. Frozen still as if one wrong touch from me and the world would come crumbling down. And as if my head is protesting the invasion of OCD fears, I get mind-numbing, debilitating headaches that can last for hours. Anxiety, depression, and fear are time-consuming, exhausting emotions that take a toll on your mind. My mind gets tired just like my feet, just like my back, and it hurts. 3. Experiencing suicidal thoughts due to OCD. OCD is often represented in mainstream media as a little quirk, a preference, someone simply being high maintenance. “I’m a little OCD” rolls off of the tongue as easily as “I like my closet organized by color;” a simple preference, one that if not heeded may cause some small amount of annoyance. Far from it, obsessive-compulsive disorder, as implied by the term itself, is a debilitating disorder. And in no small part due to its misrepresentation, OCD is isolating to those who endure it and the weight of it can feel crushing. It took me quite some time to acknowledge the reality of my own suicidal thoughts. I was afraid to admit them for many reasons. I thought if I didn’t, they wouldn’t become reality. I thought if I did, I would be laughed at because, “What’s the big deal? So I’ve got OCD,” so many think they’re “a little OCD.” This is not an easy subject to approach, but it’s important to acknowledge the reality of living with a mental illness. Battling OCD can feel endless; it’s hard, it’s terrifying, and it’s exhausting. I often feel as if I am left trying to hold the world together, all the while I am unraveling. It feels desperate. And on top of the fact that OCD can be a life-threatening illness in and of itself, the simple fact it is so misunderstood can leave us feeling even more alone, unsure of how to ask for help. Unlike what I was led to believe while growing up, that OCD is no big deal, in reality it takes up so much of your life. The distress is relentless, and it is no small feat to overcome it, but it can be done. I for one am learning not to be ashamed of my suicidal thoughts, but instead to be proud of overcoming them. Even so, they are often a reality of living with a mental illness, and I think it is about time that we acknowledge them. Acknowledge them for what they are — another battle we must fight, not a dirty little secret. Acknowledge that we are not something to be hidden, we are something to be proud of. 4. Realizing how much time has been lost. OCD is a time-consuming disorder. The severity of a person’s OCD is often measured by how many hours per day that obsessive thoughts consume them, and how many hours per day they perform safety behaviors (or compulsions). Even if all I do one day is sit, I will look up at the clock and realize hours have passed since I thought of anything other than the last trigger that consumed my mind. In my five years of battling this illness, I can look back and recognize the months of time I have lost to OCD. The time I wasn’t fully present for my life. The time OCD and its fears consumed me so greatly I missed out on the gatherings, the laughs, the hobbies. I can feel my 20s flying by while I play a game of catch up. OCD and OCD treatment take time. A lot of time. 5. Losing relationships because of OCD. While OCD consumes your time, it can also consume a little bit of you. You spend your energy every day fighting this battle, and you have less and less left over to share. The longer I’ve been in this fight, the more I have seen a growing distance between me and all of those I care about. Different things feed that distance. OCD is confusing even from the inside, so it can seem absolutely foreign to those on the outside. I have less to give, and I have withdrawn from the life I used to live due to fear. With that impossible sense of responsibility that OCD hands you, it convinces you to keep your distance, convinces you that mistakes and misfortune follow you like a shadow. Unlike time, these losses are not permanent, those who love you will be waiting for you to come back to them. It just takes more time and a lot of willpower. 6. Feeling a loss of independence or sense of self. Think about a moment when you have been terrified; how did you get through it? When we’re scared, it’s often instinct to reach out to someone we trust to help us through it. So when you’re living with OCD, living with constant fear, you can become incredibly codependent. A very common safety behavior across the varied types of OCD is that of seeking assurance. OCD can convince our minds that we can no longer determine right from wrong, safe from danger, and therefore we can come to depend on someone else to determine that for us by seeking their assurance. With the constant fear, the need for assurance, and the fact that compulsions can be so incredibly debilitating, it can feel as though your independence and the things that made you who you are, are being swept away. Before being diagnosed with OCD, I was my own person. A complete person with hobbies, jobs, friends, school, a career plan. But not too long ago, I was lucky if I made it out of the house at least once a week. And those short excursions out into the world took a lot of effort and a lot of help from my partner, often resulting in an incredible amount of distress on both our parts. Before being diagnosed with OCD, I was a partner. I was an equal in a relationship; I could support as much as I was supported. But there was a long period of time where that relationship transformed into one between caretaker and patient, rather than one between loving partners. I had lost the independence required to create an equal partnership. The simple truth is that OCD can consume you at times, and when it does it can feel like you completely lose yourself. That’s the battle we face, finding our way out of OCD’s shadow. We may never be able to completely get rid of OCD, but we can make it just that, a shadow. 7. Experiencing a poor quality of life as a result of mental illness. Anxiety and depression greatly affect a person’s quality of life, and when you add debilitating obsessive thoughts and compulsions, your world can become very small. My OCD has visibly hurt my quality of life, from mental and physical health, to outward appearance, to social engagement. People will see these changes in their lives differently depending on their depression or their type of OCD, but no matter your battle, there is no denying the draining effects that mental illness has on a person’s life. Many people who suffer from depression and/or OCD will find themselves unable to gather the willpower to perform basic self-care, such as brushing teeth, brushing hair, showering, doing laundry. In my case, this manifests as showering a harmful amount, unable to keep up on laundry, and a difficult time feeding myself. OCD affects all of these tasks in different ways, but each barrier I run into can be traced back to OCD compulsions, fear, and avoidance. I have showered until my skin was raw, gone long periods of time without eating, subsisted on two hours of sleep per night due to avoidance and anxiety. And when I do eat, junk food is easier and faster than healthy food, and when I do sleep, I sleep too much. This all takes a toll on the body, it feeds the exhaustion which then continues the cycle. And it’s certainly a hard cycle to break. You’ll often find yourself feeling sick, tired, undesirable, and you’re left with an unkempt and uncomfortable home. But due to your illness it can feel like you have no way out. Because the way out is going to the doctor, but that means leaving your house. The way out is taking your medication, but that’s simply another task you must add to the list of tasks you are too depressed to perform. There are an overwhelming number of barriers to improving your quality of life. You’ll most likely need help digging your way out of this hole you’ve moved into, which will add to your sense of dependence, but I am living proof that it can be done. 8. Feeling angry at OCD. OCD is incredibly debilitating and life-altering, so it follows many feel a fair amount of anger. I went from being an independent, determined, intelligent person — a hardworking person, trudging her way through grad school — to a person so drained by fear and anxiety, that I couldn’t hold down a job and I relied on someone else to help me get through every single day. My challenges used to be passing vet med exams and studying until the sun came up; I liked those challenges. Then my challenges became getting out of bed, eating, surviving. And I’m angry about that. Incredibly angry. I often find myself thinking it’s unfair, and I’m confused as to what exactly happened to get me from there to here. I’m angry that I feel so much responsibility, sometimes wanting nothing more than to not care. I’m angry that I hurt all the time, and that my mental illness just makes that worse. I’m so incredibly angry that I allow suicidal thoughts to enter my mind, and I’m angry about the guilt that follows those thoughts. I’m angry that I feel as though I’m missing out on my 20s because of this illness, and that I have distanced myself from those I care about. And I’m angry this illness not only seeps into every aspect of my life, but my partner’s as well. And the hardest thing about that anger is I don’t know where to place it. We’re told that we are not our OCD, we are even told to try to imagine our OCD as a separate being, even give it a name. But whoever my OCD is, it lives within me, I’ve been hosting it, listening to it, inviting it into our home. So most of this anger just gets placed back onto me. One more thing that weighs heavily on my shoulders. It’s valid to feel angry. You’re right, it’s not fair, and OCD is one of the most effective bullies you will ever encounter. So be angry at it. Let that anger drive your path forward, instead of letting that anger weigh you down. I’m sure this list could go on and on, and each person with OCD would describe their symptoms a little differently. But I hope it gives you a little insight into what OCD really is, and what it looks like for me. I hope it makes you pause and I hope it makes you question. I hope it makes you look more critically at the way the media represents OCD and mental illnesses in general. These days, each one of these symptoms is affecting me less and less as I start to come out on top of this battle. But there’s always the possibility and the fearful anticipation of another trigger. I come across them daily, but am better able to forge on. It’s not always easy, some days are better than others, some days are a little step backward. But my hope for anyone out there in the midst of their own battle, is that some day those little steps backward are easier to overcome, that they don’t make you feel defeated. Because they will happen, but they don’t make you a failure. They make you a warrior. A version of this article was originally published on the author’s blog Obsessive Compulsive Diary.

Natalie Amo

What Is OCD Treatment Like?

Obsessive-compulsive disorder (OCD) keeps you down with fear. It sneaks into your mind and convinces you that you are it, that its fears are yours. So how do you fight something that feels so completely to be you? This is how we fight back. You are not your OCD. The treatment for any illness is never easy and OCD is no exception. Even I, who has successfully made it through treatment before OCD regained its power; even I, who can acknowledge its effectiveness; even I, who can see how dark and unhappy I have become once again under OCD’s grasp. Even I find it extremely difficult to drag myself to treatment, to commit to the fight. I wish there were some magical pill to cure OCD, but there isn’t. Many people have asked me what treatment looks like. And while it can be hard to explain, when I am able to find the right words, not only does it help them understand the process, but also to understand and respect the illness itself. I am no expert, but I will do my best to put into words how we fight this debilitating illness. To understand the treatment, we must first understand at least a very basic picture of how an OCD brain functions. I personally struggle with contamination OCD, so I will be using that as a framework for my examples, but please keep in mind there are many types of OCD. Let’s start with someone who is not battling OCD. If they touch something dirty, whether it just be dirt or a mild chemical of some sort, their brain has a process or pathway to handle that. First, they touch the contaminate and their brain says, “That’s dirty, should wash hands,” which sends the signal further down the pathway and instructs the person to wash their hands. The person does so, which then sends the signal to the brain that their hands are now clean, and finally signals the person that they are safe, and can move on with their day. A linear, cause-and-effect pathway. For someone with OCD, that pathway becomes stuck on a loop, feeding back into the original signal of “dirty, contaminated, etc.” and magnifying it to a signal of “extreme danger.” In this case, I would touch the contaminate and my brain says, “That’s dirty, should wash hands,” which sends the signal to my hands to wash. I do so, but instead of sending the “clean” signal, my brain says, “Wow, whatever you touched was so dangerous you had to wash your hands, so you should wash again just to be safe.” So the normal response of washing hands further validated and intensified the original signal of “dirty,” rather than produce the normal response of “clean.” And the next time I wash my hands, the signal will again get looped back, most likely adding to the list of suggested safety behaviors. “Better wash your hands again just to be safe,” becomes “Wash your hands, also you touched the faucet to turn the water on, so wash that too,” becomes “wash your hands and what else could you have possibly touched on your way from first coming into contact with the contaminate and making your way to the sink,” and so on and so on, deeper down the spiral. Every time I give in to another safety behavior, I am magnifying that fear, getting stuck in a never-ending cycle, never reaching that final stage of “clean.” It’s like running with all your might, but never moving an inch. So the way we fight this is by retraining our brain. Retraining it to have the proper amount of fear, and only require the proper safety procedures. But retraining your brain is not easy, especially when your brain is sending you signals of “danger” and you are in the habit of believing your own brain. It is very frustrating, to say the least, to have someone tell you that you can no longer believe what your mind is telling you, that you must go against those very real feelings of danger. That doesn’t come naturally and it is very distressing. Not only must you stop doing the multitude of safety behaviors you have been performing, but in order to successfully retrain your brain, you actually have to go above and beyond the normal — deliberately go past gross, go past scary, so that you can come back to the “normal” and not feel any fear. Until “normal” is boring again. This process is called exposure and response prevention (ERP). I must purposefully and deliberately expose myself to the contaminate I fear and then prevent the response for as long as possible. In doing so, I can hopefully retrain my brain that those responses (safety behaviors) are not necessary to be safe. Basically, when I or anyone else is asking me to go to treatment or to fight my OCD, they are asking me to do the thing I am most afraid of. Do the thing my brain — the brain I have trusted my entire life — has told me could mean life or death. I feel like even this far in the description, it is hard for someone without OCD to truly grasp the magnitude of this process — the sheer amount of willpower and strength it takes to battle this illness head-on, simply because it can be very hard to wrap your mind around an OCD fear. OCD usually takes something minor, something the rest of the world doesn’t necessarily associate with that amount of fear and turns it into a monster. So, if you can’t see or understand what I am afraid of — if it looks to you like I am afraid of the invisible — then this will be hard for you to grasp. So, what are you most afraid of? Spiders, snakes, the ocean, sharks, heights? Whatever it is, picture that. We’ll use snakes in this example — specifically non-poisonous, harmless snakes. Because your therapist, while they will encourage you to face your fear, they will never tell you to do something that would actually put you in harm’s way. Picture that you are living in a world where snakes are as common a sighting as dogs. Currently, your fear of snakes has become so severe it prevents you from leaving the house in case you might encounter one. Now someone presents you with a deep, dark pit of snakes, and tells you the only way to get over your fear is to stick your arm in it (remember, deliberately go past normal so you can come back). And if you don’t stick your arm in, then your fear of snakes will intensify to include objects that look like snakes, including hoses, cords and headphones, shadows that move like snakes, a whisper or a plastic bag blowing in the breeze that sounds like a snake. You will be afraid of things that may have touched snakes until you can no longer let people into your house without a grueling process to protect you from what they may have touched outside your house in the real world. You will be afraid of the color green, so much so you flinch when green passes by your peripheral vision. You will be afraid of small green crumbs and pieces of plant life, for the chance it could have come off a snake. Your mind will convince you of the presence of invisible, ethereal snakes that float around in your home. You won’t be able to see them but you will be sure of their phantom touches, as real to you as if a 6-foot boa constrictor brushed passed your head. What began as a fear of snakes will be magnified to fear of almost everything. And while you are standing there with your biggest fear staring back at you out of that pit, you are going to tell yourself it’s not worth the risk. That you may be limited by your fear of snakes right now, but you’ve still got your house, and being stuck in there is not so bad. Much better than the possible alternative if you were to stick your hand in that pit. But what you are not seeing is that your house will soon turn into just a single room, and that room will turn into a chair, and you will be afraid to blink. So you start with something small. You’ll simply sit and deliberately imagine snakes. You will do this until your spike of fear begins to subside, you will do this until you are bored of thinking about snakes. Then you will open your blinds and look outside, watching for snakes, again doing so until you are bored. And will continue to increase the magnitude of these exposures, until it’s time for you to step outside. Until you find yourself in front of that pit again. Now truly imagine yourself standing in front of a pit containing what you fear most. It will not be an easy decision to put your arm in. Every fiber of your body will be fighting against any movement toward that pit. It will feel like someone is playing tug-of-war with your arm. Even so, you eventually bring yourself to do the unimaginable. You’ve decided the chance of freedom from this debilitating fear is worth the risk. You did it! And after weeks of distress, unbelievable willpower and effort, you can now… finally… plug in the lamp because you are no longer afraid of the cord. And this is the moment you realize you will have to continue facing your deepest fear again and again in order to fully regain your independence. You have a long way to go. But you did just take a giant step towards freedom — one you thought impossible, but now know to be possible. This is what treatment looks like for someone battling OCD. This is a daily battle. You don’t get breaks; OCD won’t give them to you, and if you get tired and slip back into old safety behaviors, you’ll feed the fear. It’s crucial to build a support team for yourself; family, friends, a therapist you can trust to walk next to you through the fear. While they cannot fight it for me, I have found, at least, I cannot fight it without them. Keep in mind that once one fear is conquered, a person still must continue to maintain it, as it will always be right behind the veil trying to find a way back in. And on top of that, OCD is now like a hurt little bully who had their toy taken away. So, while you are maintaining your control over the fear, OCD is waiting on the sidelines looking for a new trigger to turn into a monster. And this time, OCD has learned the same tools you have during treatment, and it has adapted. So you must do so too, again and again. I don’t paint this picture to seem hopeless, although it can feel that way, and it will certainly be a long battle. But I do so in the hopes someone will pause when they see someone struggling to conquer their mental illness and it may appear they are doing nothing. In truth, they are doing quite the opposite; they are fighting the monster in their brain, the monster you can’t see. Because this is what they are asking themselves to do. What they are trying to muster up the courage to commit to, all while OCD lives in their brain gleefully playing whack-a-mole with every bit of courage that pops up. A version of this article was previously published on the author’s blog.

Natalie Amo

What Is OCD Treatment Like?

Obsessive-compulsive disorder (OCD) keeps you down with fear. It sneaks into your mind and convinces you that you are it, that its fears are yours. So how do you fight something that feels so completely to be you? This is how we fight back. You are not your OCD. The treatment for any illness is never easy and OCD is no exception. Even I, who has successfully made it through treatment before OCD regained its power; even I, who can acknowledge its effectiveness; even I, who can see how dark and unhappy I have become once again under OCD’s grasp. Even I find it extremely difficult to drag myself to treatment, to commit to the fight. I wish there were some magical pill to cure OCD, but there isn’t. Many people have asked me what treatment looks like. And while it can be hard to explain, when I am able to find the right words, not only does it help them understand the process, but also to understand and respect the illness itself. I am no expert, but I will do my best to put into words how we fight this debilitating illness. To understand the treatment, we must first understand at least a very basic picture of how an OCD brain functions. I personally struggle with contamination OCD, so I will be using that as a framework for my examples, but please keep in mind there are many types of OCD. Let’s start with someone who is not battling OCD. If they touch something dirty, whether it just be dirt or a mild chemical of some sort, their brain has a process or pathway to handle that. First, they touch the contaminate and their brain says, “That’s dirty, should wash hands,” which sends the signal further down the pathway and instructs the person to wash their hands. The person does so, which then sends the signal to the brain that their hands are now clean, and finally signals the person that they are safe, and can move on with their day. A linear, cause-and-effect pathway. For someone with OCD, that pathway becomes stuck on a loop, feeding back into the original signal of “dirty, contaminated, etc.” and magnifying it to a signal of “extreme danger.” In this case, I would touch the contaminate and my brain says, “That’s dirty, should wash hands,” which sends the signal to my hands to wash. I do so, but instead of sending the “clean” signal, my brain says, “Wow, whatever you touched was so dangerous you had to wash your hands, so you should wash again just to be safe.” So the normal response of washing hands further validated and intensified the original signal of “dirty,” rather than produce the normal response of “clean.” And the next time I wash my hands, the signal will again get looped back, most likely adding to the list of suggested safety behaviors. “Better wash your hands again just to be safe,” becomes “Wash your hands, also you touched the faucet to turn the water on, so wash that too,” becomes “wash your hands and what else could you have possibly touched on your way from first coming into contact with the contaminate and making your way to the sink,” and so on and so on, deeper down the spiral. Every time I give in to another safety behavior, I am magnifying that fear, getting stuck in a never-ending cycle, never reaching that final stage of “clean.” It’s like running with all your might, but never moving an inch. So the way we fight this is by retraining our brain. Retraining it to have the proper amount of fear, and only require the proper safety procedures. But retraining your brain is not easy, especially when your brain is sending you signals of “danger” and you are in the habit of believing your own brain. It is very frustrating, to say the least, to have someone tell you that you can no longer believe what your mind is telling you, that you must go against those very real feelings of danger. That doesn’t come naturally and it is very distressing. Not only must you stop doing the multitude of safety behaviors you have been performing, but in order to successfully retrain your brain, you actually have to go above and beyond the normal — deliberately go past gross, go past scary, so that you can come back to the “normal” and not feel any fear. Until “normal” is boring again. This process is called exposure and response prevention (ERP). I must purposefully and deliberately expose myself to the contaminate I fear and then prevent the response for as long as possible. In doing so, I can hopefully retrain my brain that those responses (safety behaviors) are not necessary to be safe. Basically, when I or anyone else is asking me to go to treatment or to fight my OCD, they are asking me to do the thing I am most afraid of. Do the thing my brain — the brain I have trusted my entire life — has told me could mean life or death. I feel like even this far in the description, it is hard for someone without OCD to truly grasp the magnitude of this process — the sheer amount of willpower and strength it takes to battle this illness head-on, simply because it can be very hard to wrap your mind around an OCD fear. OCD usually takes something minor, something the rest of the world doesn’t necessarily associate with that amount of fear and turns it into a monster. So, if you can’t see or understand what I am afraid of — if it looks to you like I am afraid of the invisible — then this will be hard for you to grasp. So, what are you most afraid of? Spiders, snakes, the ocean, sharks, heights? Whatever it is, picture that. We’ll use snakes in this example — specifically non-poisonous, harmless snakes. Because your therapist, while they will encourage you to face your fear, they will never tell you to do something that would actually put you in harm’s way. Picture that you are living in a world where snakes are as common a sighting as dogs. Currently, your fear of snakes has become so severe it prevents you from leaving the house in case you might encounter one. Now someone presents you with a deep, dark pit of snakes, and tells you the only way to get over your fear is to stick your arm in it (remember, deliberately go past normal so you can come back). And if you don’t stick your arm in, then your fear of snakes will intensify to include objects that look like snakes, including hoses, cords and headphones, shadows that move like snakes, a whisper or a plastic bag blowing in the breeze that sounds like a snake. You will be afraid of things that may have touched snakes until you can no longer let people into your house without a grueling process to protect you from what they may have touched outside your house in the real world. You will be afraid of the color green, so much so you flinch when green passes by your peripheral vision. You will be afraid of small green crumbs and pieces of plant life, for the chance it could have come off a snake. Your mind will convince you of the presence of invisible, ethereal snakes that float around in your home. You won’t be able to see them but you will be sure of their phantom touches, as real to you as if a 6-foot boa constrictor brushed passed your head. What began as a fear of snakes will be magnified to fear of almost everything. And while you are standing there with your biggest fear staring back at you out of that pit, you are going to tell yourself it’s not worth the risk. That you may be limited by your fear of snakes right now, but you’ve still got your house, and being stuck in there is not so bad. Much better than the possible alternative if you were to stick your hand in that pit. But what you are not seeing is that your house will soon turn into just a single room, and that room will turn into a chair, and you will be afraid to blink. So you start with something small. You’ll simply sit and deliberately imagine snakes. You will do this until your spike of fear begins to subside, you will do this until you are bored of thinking about snakes. Then you will open your blinds and look outside, watching for snakes, again doing so until you are bored. And will continue to increase the magnitude of these exposures, until it’s time for you to step outside. Until you find yourself in front of that pit again. Now truly imagine yourself standing in front of a pit containing what you fear most. It will not be an easy decision to put your arm in. Every fiber of your body will be fighting against any movement toward that pit. It will feel like someone is playing tug-of-war with your arm. Even so, you eventually bring yourself to do the unimaginable. You’ve decided the chance of freedom from this debilitating fear is worth the risk. You did it! And after weeks of distress, unbelievable willpower and effort, you can now… finally… plug in the lamp because you are no longer afraid of the cord. And this is the moment you realize you will have to continue facing your deepest fear again and again in order to fully regain your independence. You have a long way to go. But you did just take a giant step towards freedom — one you thought impossible, but now know to be possible. This is what treatment looks like for someone battling OCD. This is a daily battle. You don’t get breaks; OCD won’t give them to you, and if you get tired and slip back into old safety behaviors, you’ll feed the fear. It’s crucial to build a support team for yourself; family, friends, a therapist you can trust to walk next to you through the fear. While they cannot fight it for me, I have found, at least, I cannot fight it without them. Keep in mind that once one fear is conquered, a person still must continue to maintain it, as it will always be right behind the veil trying to find a way back in. And on top of that, OCD is now like a hurt little bully who had their toy taken away. So, while you are maintaining your control over the fear, OCD is waiting on the sidelines looking for a new trigger to turn into a monster. And this time, OCD has learned the same tools you have during treatment, and it has adapted. So you must do so too, again and again. I don’t paint this picture to seem hopeless, although it can feel that way, and it will certainly be a long battle. But I do so in the hopes someone will pause when they see someone struggling to conquer their mental illness and it may appear they are doing nothing. In truth, they are doing quite the opposite; they are fighting the monster in their brain, the monster you can’t see. Because this is what they are asking themselves to do. What they are trying to muster up the courage to commit to, all while OCD lives in their brain gleefully playing whack-a-mole with every bit of courage that pops up. A version of this article was previously published on the author’s blog.

Community Voices

Fear is Fear

Living with OCD is living with constant fear pulling at your mind. And I want to be clear, it is real fear, I chose that word purposefully. I did not say discomfort. I did not say annoyance. I did not say worry. I said fear. Try to imagine the absolute terror you would feel if you suddenly woke up in a dark cave. You don’t know how you got there. You don’t know how long you’ve been there. And now that you think of it, you don’t even know that it is a cave. You don’t know who or what else is in there with you. You don’t know what is going to happen next. And worse of all, you don’t even know what is reality anymore. It is that level of uncertainty and fear that is always with someone living with OCD. Constantly. And I truly mean constantly.

With every movement I make, I have at least ten what-if’s running through my mind. What do you think about when you’re walking to your car to go run some errands? Probably your grocery list, what you want for lunch, what so-and-so’s new Facebook status said. Did you consciously think about every step you took to get to the door? Did you think about every object you passed and whether you may or may not have touched them? Probably not. You most likely walk that path every day without a second thought. I walk to the door and each and every one of my steps is slow and deliberate so that I can know without a doubt what I’ve stepped on. And while I’m painstakingly monitoring the path of my feet, I am also trying to keep track of my elbows and my hands, making sure that they don’t touch something that my OCD has labeled as life-threatening. And while I am tracking my feet, elbows and hands, I am also trying to keep track of just how much I move my head in case the hair piled up into a messy bun might also touch something dangerous. And while tracking my feet, elbows, hands, head and hair, I am also looking ahead and trying to plan every step and every movement that will get me from point A to point B while avoiding all of the OCD traps. Now if you have ever tried this, you probably very quickly determined that it is not possible for your mind to actually track all of these things. At least not to the level of detail that the little OCD-brain-monster requires. So inevitably, before you can get to the door, you probably focused too closely on your left elbow, took a step, and then realized that within that step, you have no idea where your right elbow was! (Although if OCD wasn’t warping your reality, you very well know where your right elbow was. It’s attached to your arm and you have spatial awareness as well as a sense of touch, although OCD would like you to forget that). So now OCD takes this window of uncertainty and runs with it. Convincing you that since you were not painfully aware of where your right elbow was in space, you have no way of knowing what it touched. Therefore it could have touched something dangerous. So by the time you get to the car, if you ever do get to the car, you had to go wash your elbow, but let’s face it, what starts as just washing an elbow will most likely turn into a full-body shower. Because the fear you feel is as real and paralyzing as the fear you would feel if you woke up in that dark cave.

If you have the tools and the support, you can fight this fear and OCD. But that’s easier said than done and some days are harder than others. Everyone battling their OCD will have their ups and downs. But sometimes is that hard just to walk through your house. At this point in my fight it is that hard for me. So I am trying to change my definition of success. And as someone who used to be very driven and hold very high standards for myself, this is a very real struggle for me. This is why it is so crucial for people struggling with any type of mental illness to have someone in their life who is able to recognize and celebrate the small, yet not so small achievements. It is amazing that you got out of bed today. It is amazing that you got dressed. You won’t be able to do everything in one day. But don’t let the many little set backs take away from that one big stride forward.

Community Voices

My OCD - The Lava Monster

Remember when you were a kid and at recess you played a game called lava monster? The ground was lava, and the people on the ground were lava monsters. And if you touched the ground or got tagged, you became a lava monster too. The winner was the last one standing. I remember playing that game and while everyone else was running and screaming and having fun, I was actually scared. I had fun, but the fun was tinged with real panic whenever a lava monster got close. It was always the same when I would play tag with my sister; I didn’t like the suspense of not knowing when the “monster” was going to reach out and touch you.

My OCD is a lava monster. The ground is the lava, and anything that the lava monster touches also becomes a lava monster. I am the last one standing. But in this real life version, the game doesn’t end. I am living in constant suspense, not knowing when or what the lava monster is going to reach out and touch. I navigate my house like I navigated that playground when I was a kid. But this time the fear and the danger feel so much more real. I can’t yell “time out” or say that I’m done playing and then get to walk on home. Because my home is the lava, and the lava monster lives inside of me. I can’t touch the ground or things that have touched the ground. Chairs become lava monsters that I must dodge; a whole room can become enveloped with lava.

No one else can see the lava, just me. I’m the only one playing OCD’s game. tricked me into signing up, telling me that this was the only way to survive. It finds joy in playing games with my mind. I can feel it taunting me; every time I start to feel safe, the lava monster will reach out and touch something unexpected and I’ll have to start running again. And because the lava monster lives inside of me, it’s as if my shadow has become the lava, dragging my fear behind me wherever I go.

I don’t want to play anymore. I spend my days trying to stop myself from running away from my little lava monster. If I could just stop running, it would stop chasing me; the game would be over and I would truly be the last one standing.

Community Voices

Who hides behind your “I’m fine”?

<p>Who hides behind your “I’m fine”?</p>
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Natalie Amo

OCD Makes Me Feel Like I'm Possessed by a Monster

An evil person has possessed my body, taken over my life and effectively convinced all of my loved ones that I’m still me and I’m not actually missing. And while this person is living my life and speaking my voice, I can see and hear everything from behind this mask that looks exactly like me, but I can’t speak and I can’t move. I’m back there screaming, hoping just one person will notice it’s not me, that I’m gone, that I need rescuing. It started small, with just someone else’s thoughts invading my mind — these little evil thoughts of fear and anger that I didn’t recognize. They snuck into my mind and stuck there, gaining more and more power as I gave them more of my attention. Then this stranger’s thoughts became beliefs. And then this stranger became me. I no longer feel like a human. I am just the host to a scared little monster that compensates for its fear by dragging me in and making their fear mine. Fear is a powerful tool and obsessive-compulsive disorder (OCD) is masterful at wielding it. It’s hard to explain how completely OCD can take over not just your mind but your body as well. Yet another way it takes away your power: by making it almost impossible to put into words what you are experiencing. How life literally feels like a nightmare you have no control over, and no one really hears you because you’re just a figment of your imagination. Because you no longer truly exist as you once did. Instead, you are OCD’s puppet. A shell of who you once were. You now see through its eyes, eyes that used to be yours. And through them, you see how your loved ones look back at you — slightly confused as to why you seem different or if you’re even still there. They recognize you as you on the surface, but you’re not you anymore and they can’t figure out why, because what they can’t see is the stranger who has taken over. And as OCD pushes you further back into the dark recesses of your mind, it becomes easier for it to convince you that what you think, feel, touch and see is false. Until you can look down at your hands and not recognize them as your own anymore. They seem as disconnected to you as someone else’s hands. So now, you can’t trust your own senses, but you can’t trust your captor’s, effectively isolating you from any sense of reality. This is what I mean when I say OCD has taken over my life. Not that it’s greatly affecting it, but that it has actually taken it. Every time my hands are washed, I scream and yell because I don’t want to be doing that. I didn’t tell my hands to wash. I know I don’t need to be doing that, but they’re not my hands anymore. And not even I can hear the yelling anymore; not even I can see me fighting back anymore. There have been times in my two-year battle with OCD that I have been louder than the fear. And there are times when I’m not louder but neither is it. And even during this time when it seems like I will never be heard again, I have my moments when I am able to fight back, when I am able to feel present in my own life. But those moments take a lot out of me and I’m getting tired. An evil, scared little monster has taken over my body, and the only way to fight back is to beat it at its own game. With fear. Scare it away; do the thing it’s most scared of over and over until it’s lost all power over me. But to do that, I first have to convince myself that its fears are not my fears. They’re just a stranger’s thoughts that have snuck in and I need to show them the way out. A version of this article was previously published on the author’s blog.

Community Voices
Community Voices

Living with Contamination OCD #obsessivethoughts #OCDTips

It's like living with a shadow of fear and guilt following you wherever you go. The fear of tracking something dangerous into your life and the lives of your loved ones. Your mind convinces you that you have power over things you cannot possibly control. I try to set small daily goals for myself, and most importantly, try to give myself a break when I don't meet those goals.

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