I am surrounded. There is no escape – no light at the end of the tunnel. Hopelessness is so thick it’s suffocating. I am forever falling down a never-ending pit of doubt, anxiety, and paralyzing fear. Bent on making my life miserable, my captors refuse to leave. Try as I might, I cannot escape. I am being held hostage by my own brain.
This is what OCD, or obsessive-compulsive disorder, feels like.
By all outward appearances, there is nothing dysfunctional about me. One has to delve into the innermost regions of my mind before realizing that I am a far cry from normal. My life has been filled with paralyzing phobias, vivid worst-case scenarios, anxiety, and stress. Tremendous amounts of stress. I have OCD, a disorder that causes me to experience severe anxiety and irrational fears.
What makes the normal, everyday anxieties that most people encounter different from the severe anxiety experienced by people with OCD is time frame and irrationality. A normal individual’s anxiety will typically vanish after minutes, while a person with OCD will be plagued by fear for hours or even days. These anxieties seem harmless to an outsider and may sound illogical or ridiculous, but to the OCD sufferer they are all too real.
A large component of my OCD is the fear of fire. My biggest fear is my house burning down. This has morphed into an immense phobia of fire alarms, and, in particular, school fire drills. My phobia made its first appearance in elementary school, when almost every fire drill would find me in tears. Each drill presented me with crippling anxiety and the belief that it was real. Sick with worry, my siblings were usually my first concern: How are they? Did they make it out? Are they scared? In my mind’s eye I could see them trapped inside the burning school. To this day, I still experience an internal panic attack whenever I hear the words “fire drill.” Even the thought of the shrill and unexpected screech of a smoke alarm terrifies me. Fireworks, tornadoes, earthquakes, and even emergency preparedness kits also cause me intense anxiety and fear. To others, my fears likely seem ridiculous and irrational, but to my OCD-infested mind, the risks feel very real.
Structures of the brain that contribute to OCD symptoms include the cortico-thalamic loop and the basal ganglia. The cortico-thalamic loop allows an individual to consciously review their thought process and resulting actions. Because of it, humans can analyze their thoughts and decisions. The basal ganglia receives thought and motor information and then arranges that information into a step-by-step plan that is presented to the other structures of the brain to be carried out. This process is conducted unconsciously. Under normal circumstances, the basal ganglia produces a plan that agrees with the conclusions drawn by the cortico-thalamic loop. According to Matthew Williams, author of “The Neuroscience of Obsessive-Compulsive Disorder,” OCD obsessions and compulsions are produced when the cortico-thalamic loop and basal ganglia do not agree with one another. If an individual with a normally functioning brain is worried about having accidentally punctured themselves with a used hypodermic needle, the basal ganglia will probably arrange thought processes and actions in the following order: recalling the visual experience of the needle brushing against their glove; having the thought,“I may have punctured my skin with a bloody needle;” reviewing the memory of the needle brushing past the glove; checking the glove for a puncture wound; checking the skin for a puncture wound; and finally, concluding that there is not a puncture wound. Relief is provided because the cortico-thalamic loop and the basal ganglia have reached the same conclusion; there is no puncture wound and therefore nothing to worry about.
Under the influence of obsessive-compulsive disorder, the basal ganglia scrambles thought processes and may arrange them into a sequence of: concluding that there is not a puncture wound; checking the skin for a puncture wound; recalling the visual experience of the needle brushing too close to the glove; reviewing the memory of the needle brushing past the glove; thinking, “I may have punctured my skin with a bloody needle;” and concluding with checking the glove for a puncture wound. Because no logical plan of action has been produced, the thought pattern is cycled through the brain again with the hope that it will be interpreted clearly the second time. When there is still no plan of action produced, the sequence repeats. This results in the cortico-thalamic loop logically concluding that there is nothing to worry about while the basal ganglia continually screams of danger.
Worst-case scenarios were especially troublesome for me. Going to sleep became difficult. What if I forgot to check if the front door was locked and someone breaks in? What about that laundry basket that I didn’t take off the hot air vent? What if it heats up so much it catches on fire? What if the house burns down and it’s all my fault? What if the part of my blanket that’s touching the outlet catches on fire? Thoughts like these ran through my mind endlessly. Hopelessness slowly built up inside me. It seemed I would never escape the cycle of anxiety and fear. I was miserable.
The disagreement between the cortico-thalamic loop and the basal ganglia is what contributes to anxiety and typical OCD compulsions. Logically, there is nothing to worry about, but at the same time, the basal ganglia shouts that something is wrong. An individual acts, hoping to make the anxiety go away, but ultimately the worry will return as the basal ganglia continually cycles the thought process, attempting to interpret it. Therefore, the individual feels the need to perform the action over and over again, in order to counteract an anxiety that will only reoccur. It doesn’t take long before the actions become a compulsion. Around the age of 12 I started giving into compulsions as a way to combat my anxiety. Every night before I went to bed I would check all the doors to the house to ensure they were locked. I checked the vents to make sure there was nothing on top of them. I even checked every electrical outlet in my room and made sure that whatever was plugged in was pushed in completely and not hanging out of the socket even the tiniest bit. Those rituals only provided temporary relief, however, for as soon as I was done checking everything I became fearful that I hadn’t checked well enough, that despite my best efforts something catastrophic might still occur.
Treatment for OCD comes in a variety of forms, but medication and therapy are the most common. Cognitive therapy focuses on teaching patients how to deal with their anxieties in a healthy way, while exposure and response therapy involves exposing patients to their anxieties and making them refrain from completing the associated compulsion. There are also many things that individuals with OCD can do on their own to help them cope with their day-to-day struggles. Some examples are writing down anxieties, relaxing, exercising, eating healthy, getting enough sleep, and focusing on something besides the anxiety.
Therapy. That’s what ultimately saved me. My first therapist literally changed my life. He taught me how to cope with worries when they appeared. Distractions helped me focus on things other than my anxiety. However, progress was slow. Sometimes my anxiety would fall upon me so heavily I felt like there was no other way to deal with it but to let it consume me. When this happened, my parents, not knowing what to do, would get upset with me and say I wasn’t trying hard enough to manage my anxiety using techniques I had been taught. My siblings became annoyed with my constant fretting and double-checking of everything. It was obvious that my obsessions and constant need for reassurance were extremely irritating. But I couldn’t help it. I felt broken and like a burden. There seemed to be no light at the end of the tunnel, no escape from my misery.
Therapy, hard work, perseverance, and medication can work wonders. They did for me. After a four-year struggle, my OCD no longer controls my life as fully as it once did. In the past, I was embarrassed of myself and ashamed to admit that I had OCD. Now, I am more open about my disorder. I used to think OCD defined and limited me. I have come to realize that instead, OCD has shaped me into the person I am today. If there’s one thing I have learned through my ongoing battle with OCD, it is that I can’t change or eliminate the struggles I face. What I can, and must, do is love and accept myself for who I am.
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This piece has been published in Teen Ink’s monthly print magazine.