I’m not on medication because doctors told me I don’t need it. Around three years ago, I took Escitalopram for six months. It had no effect whatsoever. On the contrary, during those times, my anxiety turned into full-blown OCD. There’s no particular medication for obsessive-compulsive disorder; perhaps meds might be effective, but so far, antidepressants have proven useful only as far as depression and severe anxiety go. “Nowadays there’s a trend among therapists to stop referring their patients to psychiatrists”, a friend told me.
Why should I start taking pills if I don’t need them? However, this is not to say I wouldn’t take them, should it actually become necessary. In the past, obsessive-compulsive disorder was characterised as a sort of “religious melancholy” or “scruples”. There is no proven cure for this malady, besides therapy, which apparently seems to yield the highest rates of success.
It has been noted that behavioural-cognitive therapy has so far produced the best results in most cases, yet this isn’t a certain recipe for healing either. Based on my experience and that of others close to me, the surest way of “healing” such a disorder is to acknowledge it and experiment with various therapies until the sick mind finds a way of healing itself.
Someone close to me once told me, “you know, I’ve been diagnosed bipolar. Medically speaking, it’s incurable, since the disease is based on a chemical disequilibrium within one’s brain, which constantly makes you constantly alternate between mania and depression and the other way round, forever. In theory, you’re supposed to follow a lifelong treatment plan in order to handle it, yet look at me, I haven’t taken a pill in four years; I’m just in therapy.”
The obsessions of OCD sufferers take forms which are normally uncharacteristic to their personalities, precisely because the purpose of an obsession is to be the manifestation of an anxiety. Obsessions and worries within OCD are usually fairly similar, although each individual usually “finds” his customised sources of obsessive thought. The most common ones are related to infectious diseases, religion, sexuality and current cultural anxieties. For instance, OCD sufferers nowadays might develop obsessions related to terrorism or earthquakes.
To further explain the way an obsession works and how the mind “chooses” the most frightening topics, I’ll tell you how I might develop a sexual obsession. I haven’t chosen this example at random: I’ve actually never had a sexual obsession and suppose it will most likely happen sometime in the future. This supposition in itself is a sort of anticipation anxiety.
Most people’s sexual obsessions revolve around the “risk” of being gay. The questions they start asking themselves resemble those asked in the case of suicidal OCD: “What if I’m gay? I’m gay! Do I actually like people of the same sex? Have I always been gay? What if I’m actually gay and just don’t know it yet?” The questions they end up asking themselves are often related to a deeper existential anxiety.
As a part of compulsive rituals meant to combat obsession, patients begin asking the same questions to those around them, seeking support from family and close ones, usually in the form of reassurance that their obsession won’t come true, that it’s not real and they aren’t in imminent danger. What may at a first glance appear to be a bearable effort turns into a nightmare for those around the sufferer, as they can end up talking for hours and months on end about the same issue. Academic literature is rife with mentions of OCD sufferers whose significant others or families left them, as they eventually found it impossible to cope with their obsessions anymore.
As regards me, I’d never end up developing a sexual obsession of the “am I gay” sort, because the thought of actually being indeed gay or bisexual doesn’t worry me in the least; it’s not a possibility that frightens me. The chances of me turning obsessed with being gay are close to zero. Nevertheless, I might end up developing a terrifyingly torturous obsession named “am I a pedophile?”, which would surely end up chastising me for a very long time, after which I would eventually reach a conclusion regarding my sexuality, a conclusion that is already known to me, which would end up “passing” the OCD test.
It is precisely for this reason that OCD sufferers from the 17th century were thought of having “scruples”; the term refers to a doubt from afterwards, in which the patient questions that which they already know, which they fear, which plagues them over the course of their life with “what if” questions.
It’s like a veil setting over your psyche. That’s pretty much how an obsessive thinking episode feels: your mind sets itself to the parametres of the obsession and starts functioning according to the rules it imposes, instincts of perpetual questioning of everything and everyone and self-exploration bordering on schizophrenia in which you may end up asking yourself if you’re the same person as yourself. It’s a hell of a ride, a madly maddening trip leading to answers and conclusions that go beyond anything you’ve ever envisioned during your obsession.
Perhaps some people are simply meant to go through this.
The real me, the way I know myself, remains somehow barred within the depths of my psyche, like a child terrorized by an evil, dark adult. “At times I fear the big one will annihilate the small one”, I once told Cristi. “It’s not going to happen”, he replied. “Sometimes it is adults that are taken by the hand by children, and led to wherever they truly want to be.”
Will I ever be freed from OCD ? Who knows; I doubt it. I’ve currently reached this point of my journey. Or perhaps it is the OCD within me which replies that “I doubt it”, as it fears that one day, we’ll break up. The more I learn about it, the more it will know about me, that’s why odds are we’ll never break up. Nonetheless, as in every relationship, it’s highly likely we’ll end up getting bored of each other and in time, no longer acknowledge each other’s existence too much. “Don’t be so scared. Let it pass through you. Change your perspective. Try to do things for others”, is what Ioana tells me every day.
When I go out in the city, or go to work, generally when I am surrounded by people, they often perceive me as arrogant, self-content, lacking interest for others. Oftentimes, their perception of me is accurate; yet, while these impressions materialise within the minds of those around me, the most threatening fears, nightmares and worries uncontrollably play in the background of mine. And then I jump into conversations with those around me, and slowly, they fade away: “the demons of your childhood no longer exist, but your mind knows no way of functioning without them. Who’s going to come out from behind your drawer now to scare you? Your mind needs something more realistic to scare you now, precisely so that you can believe it. There’re no more monsters behind your drawer, the monsters are now part of your reality, taking different forms. But they’re still not real, and you know it”, Sorin told me.
At some point, one day, when you expect the fear to begin, you realise it’s actually not going to happen. I never actually know why, but it feels like it simply “can’t begin” anymore.
The obsession is replaced by positive thoughts about yourself and your future, streams of thoughts that flow naturally, and you begin to daydream, which then turns into plans and ideas you intend to follow; I’m thinking about the future, taking pictures, wondering what else to write about, who to meet, what to discuss.
I’m buying a bottle of Pepsi, open it, smell the drink and finally drink it without having to worry about turning restless because of the caffeine. I’m sitting someplace where I can admire the view, and keep gazing until the bottle is empty. Then I gather my positive thoughts and take them with me, to be shared with others, wherever life takes me.
Original Romanian version: casajurnalistului.ro/boala-indoielii
Mihnea Mihalache-Fiastru is licensed in Psychology, essay and fiction writer, author and contributor since 2001 for Hustler, Vice and many other publications and websites