Crazy

 Feeling like your mind is not under your authority can make you feel crazy. 

There is a dangerous equation with mental health and attitude in our world. It is one of the most disheartening things I have encountered, having people tell me “change your mind--choose to be happy”. To be sent  “Let Go and Let God” memes, coached on having an “attitude of gratitude” and to “count my blessings”. 

Their hearts are in the right place, but I promise you--if I had a choice, this definitely would not be it. 

No one chooses to be this broken. To shower four to six times a day because you can’t stand the feeling that you might not be clean. Frankly, I’d rather save the water because it ain’t free. To make list after list after list, things that matter and things that don’t because it gives you momentary comfort to see  the structure, everything in its nice little place. Y’all. If I could go into a parking lot and just park….anywhere. Can you imagine the freedom, the power? Of not circling the lot for forty minutes before going into the store, just waiting because someone is in your spot and if you don’t park in one of your designated spots you won’t be able to find your car when you come out and that it will be unfixably, inexplicably bad so we can wait, wait for them to move. 

If could air lift my Checks(™) straight out of my day, could you imagine how much free time I would have? Picture this: you make a sandwich and you just...eat it. You don’t have to page through each ingredient to make sure there is nothing (mayonnaise) on your sandwich, then totally just skip rechecking each layer before each bite just in case. I mean, YOU made it; shouldn’t you know whats on it? Checking to make sure you locked the door, then driving back to make sure, and just once more because it never hurts to be extra cautious. Physically watching the kids go into the school to make sure they don’t get abducted (no, the crosswalk doesn’t count--you have to see them go through the gates to the school)...and then calling the nurse to make sure they made it in. 

After the bedbug trauma, I got my daily checks for them down to a clean (heh, pun) two hours-- take down all the curtains and bedding to wash, take a flashlight and comb the baseboards, the bedframes, the mattresses, the furniture. Every inch to make sure they isn’t a single trace of unwanted tenants. Search everything thoroughly before I sit on it or touch it. It didn’t matter that there hadn’t been any evidence at all of their reemergence, I had to be sure. 

If it was a matter of stubbornly bucking up and making the choice today to not have to, say, do or think things in multiples of fours, I rather think I’d jump on the opportunity. I won’t let you down, sir. Give me a chance to prove myself, because frankly I am a control freak. Such a cute way to put it, right? It speaks to a meticulousness, an attention to detail that will make you an exceptional employee. Instead of a person that cannot transition when plans change to such an intense degree that you just straight shut down. Where I keep such a tight rein on myself and my kids that none of us can breathe from it, a source of unending tension and conflict in the house because I can’t relinquish control of any situation. 

About a year ago (the time line is foggy but the landmarks clearer), having exhausted the limits of my primary care doctor’s attempts to medicate me through this, I met with a mental health professional to discuss a more targeted approach. I sat in that office, folding and refolding my tissue until it was a tidy little square, on the verge of tears because she was going to tell me it was all in my head, there was nothing wrong except my attitude. 

Or she was going to see someone so broken that I was an unfit mother and they would take my babies away. I had already tried so many prescriptions--citalopram, amitriptyline, zoloft, klonopin, wellbutrin, to name a few. I could go into the kitchen and check the Santa cookie jar of failed drug experiments waiting until Texas Tech center does a safe prescription disposal day, but the results were all the same: hopeful optimism, intolerable side effects, limited to nonexistent efficacy. What else was there left to try? Nothing had worked. Not years of counseling, yoga, meditation, prayer, clean diet and daily exercise. 

I had to fill out a questionnaire about how I was feeling that day. Afraid of the repercussions, I lied my sweet fanny off on it, minimizing and rose-tinting just about as hard as one person can. Brits got the stiff upper-lip; Americans have the jazz hands of distract and deny. Don’t worry about me because I am 👋 fine 👋.

Even through all of my bull, she saw the reality: a woman that was hurting so badly on a daily basis that death felt a welcoming alternative. 

Many doctors had given names to what I was struggling with: Postpartum depression, depression, anxiety, panic attacks. Each a piece of the puzzle they were trying to use chemicals to correct, each time failing because it wasn’t seeing the whole image. Like Akinator, her questions started out so gentle and broad as she took notes in the margins of my well-presented fiction, each one getting a little more honed in until you could tell that she had figured you out. Looking up at me from across the desk, she asked: 

“Have you heard of Obsessive Compulsive Disorder?” 

Immediately, I am skeptical, dismissive. Nah, can’t be that. Lots of people I know are the same as I am. It isn’t a mental disorder, I am just particular. 

Don’t you love how we go to professionals for answers just so we can disagree with their assessment?

She explains what the condition is, clinically and in such a way that made it apparent: the way I had been functioning for so many years until felt it felt normal to me was actually a dysfunction. Then she explains why all the medications I had tried had failed--they weren’t intended to treat the symptoms of OCD. She wrote me a prescription for a low dose of fluvoxamine and recommended I purchase a workbook that would help me understand and work through the symptoms. The dose I would eventually need to be on we would have to work our way up to so things were going to be slow and steady and I wouldn’t see a lot of progress at first, but I just needed to be patient and stick with it. 

Most of you have probably heard of OCD before but so we are all on the same page: Obsessive-Compulsive Disorder is a condition marked by excessive and irrational thoughts or fears (obsessions) that may or may not lead to repetitive/ritualistic behavior (compulsions). It usually follows an individual throughout their life and varies in severity at different points. 

The obsessions can take a lot of different forms--fear of germs and disorder is a big one that is portrayed often in media. Usually, the media will focus more on the compulsions as a visual cue for the obsessions; in this case, ritualistic straightening, intolerance for disorganization, excessive hand washing, things of that nature. 

A lot of people can relate to that and even use the condition as an adjective to describe themselves: “Sorry, I am just so OCD!!” There is, as always, a difference between a preferential quirk (tucking in someone’s shirt tag that is sticking out) and a mental disorder (changing your full set of clothes and showering multiple times a day because you feel like you can’t get clean). The defining line is: how long do your compulsions take you to complete a day? If it is in excess of one hour per day, then it is significantly impacting your life. You also can’t control your response for the compulsion, even though you are internally begging yourself to stop because you know it isn’t right, it isn’t healthy. And there is usually not any relief brought by acting on the impulse--it just stops the anxious thought, if only for a minute. 

Other obsessions I have, upon forced recollection through the workbook to identify, dealt with in the past are aggressive thoughts, unwanted or forbidden thoughts, and religiosity. 

Compulsions are the burning urge that you can’t resist until you feel better, kind of like the need to move when you have restless leg syndrome (I recently rediscovered). When I get supremely agitated, for example, I have to count to four. It started in high school when I would stroke down the length of each of my fingers as I counted until I was calm. As you could imagine, I rather loved common time signature in band. Multiples of four also work. Having four kids either worked out perfectly or was a bit more premeditated than I intended, but whenever I have them out in public you will see me doing a pinging head count. 

There are also the ones I mentioned up above, and some others that even I have the pride not to talk about much in a public setting. They can be humiliating, disheartening, crushing. Anything but quirky. 

So back to the story, I guess: we know what it is and that now I have reasonable suspicion that I have it. Now it is just slowly gaining the tools to fight back. 

I saw the doctor every two months as we eased up the dosage. At first, I didn’t notice feeling any better, a fact that actually encouraged her--she reminded me that I wasn’t going to feel better for a while, but the fact that I wasn’t any *worse* told her we were in the right direction. The workbook had me identifying when it first started, learning what the condition was and how I was going to regain control of it. It was two fold: 

1. Identifying my anxious thoughts and confronting them as irrational thoughts. This is tricky because your sneaky OCD brain wants to write these rebuffs to intrusive thoughts as a mantra ritual that eventually becomes a reassurance compulsion. It is kind of like a little talisman you wave to ward off bad luck when what you are really supposed to be doing is training your brain to stop bringing you these dead bird carcass of thoughts to you in the first place.

2. Recognize the compulsions for what they are--a damaging dysfunction--and rewriting your subroutine into healthier coping mechanisms through a process called ERP (Exposure/Response Prevention, not the other thing. Get your mind out of the gutter, gamers)

ERP is where you expose yourself to a stimuli that usually prompts a predictable trigger for you and gradually increase the time before you allow yourself to complete the compulsion. It is kind of like Plato’s  “Allegory of the Cave”--you can’t start out staring directly at the sun, you have start by seeing its reflection in the lake, its shadows on the wall. For me, one of the things I had to work on was laying on the floor for increasing periods of time without going to take a shower and change my clothes. Or drop Emerald off for school at the front of the building but not watch her walk in, then eventually drop her off at the crosswalk and let her walk in from there. 

I need you to know: I get that this was not rational. That at her age, Mom would have probably let me walk the same distance to school from my house, maybe not by myself but with a sibling. But knowing it wasn’t healthy or sane didn’t prevent me from having this reaction because I was unwell. 

So I made the ERP my new compulsion--along with the tenants of mental, physical, and spiritual health I strove toward every day, I built the scaffolding for a stable mental health. 

I saw them for a little less than a year. Each time an appointment would come up, I would ask them: do you have some sort of financial assistance? Is there anything I can do because this money we are budgeting for is coming directly out of our grocery money, our bills. Can we switch to a generic medication? That cost was for the generic, they told me, and couldn’t I just pay it this time, pay it this time and we’ll see what we can do in the future. We’ll look into your options. Finally last month when they called to confirm my appointment, I asked them to take me off of their patient load because I could not justify the cost anymore. I patiently explained one last time that this was outside my budget. The receptionist told me she would discuss it with the office and call me right back. A few minutes later, she does phone back and asks “Have you heard of the app GoodRX? That might help get your med cost down. Now! Are we ready to make that appointment?” I was so stunned at how truly obtuse her solution was--I told her no and to have a nice day. 

Michael and I sat down and discussed it. The medication alone was not my goal; I didn’t want to be on a med for the rest of my life and we hadn’t even gotten up to a dose that was strictly effective yet. (I shudder to think how the price would have skyrocketed at that amount). We were at a crossroads to decide if I wanted to pursue this path. If I chose to, we could make it work--financially, we have been much worse off and we can cut down costs to make sure I had my prescriptions and doctors visits. But to me, it was infinitely not worth it. Thus decided, I had to go through the painful discontinuation syndrome for the last few weeks. 

Discontinuation syndrome is withdrawal from a nonaddictive drug. Your body gets used to things being a certain way and it does not much care for sudden changes, dang it. My particular poison manifested at first in a swimming head--I was so dizzy, I couldn’t watch TV or play video games or be on my phone or anything involving a screen. Every time there was a sharp or loud noise, it grew significantly worse. My emotions were all over the map--I wanted to call the doctor's office and dress them down for being over glorified drug dealers. I wanted it to all end. Mike told me I was being rude nearly every conversation we had.

There were other symptoms like the zaps--electrical pulses like amped up static electricity inside your brain--, face tingling, painful restless leg syndrome, insomnia, nausea and repulsion toward food. But I made it through; I am currently on the other side. But it is the quiet before the storm, the moment when the meds are out of town and the OCD gets to throw a rager. I don't know how it is going to look, but I am gathering my forces to fight back.

This post is because it is Suicide Awareness Week and I wanted to share my experiences with mental health issues because sometimes it helps. Sometimes you have to read someone else going through it to recognize a dysfunction or disconnect in your life, the life of your loved ones. Where the Call of the Void is so strong and so welcoming that it is nearly impossible to ignore because being alive is so hard. Sometimes you don't know why you keep picking yourself up, trudging on ahead because if this is what life is, no thank you. You may not have all the answers yet, but you can't find them if you're not here. Talk to someone--reach out.

They may understand more than you realize.

<3 Andie