
The terrible 'what if': how OCD makes every day a matter of life or death - pmcpinto
https://www.theguardian.com/us-news/2018/aug/01/living-with-ocd-survival-poison-contaminated-food
======
matthewwiese
I'm appreciative of somebody who also has OCD writing an article like this
detailing how the disorder isn't at all like the stereotype of a neat freak.
What's funny is, I myself am actually a terribly messy person with books and
papers always strewn about (among clothes not quite in the hamper, &c).

What's interesting to me from a personal history viewpoint is that one of my
earliest compulsions also centered around door knobs. However, in my case I
had to cover the whole surface area of the knob (hah!) with my hand and yank
it shut multiple times (the exact number was arbitrary; merely whatever "felt"
right) until I was sufficiently satisfied that the damn door was indeed
closed. I still do this when leaving my apartment.

Hell, reading this article and writing this comment has "caused" (ie,
compelled me to) do some of my own compulsions multiple times already because
_just thinking about doing them_ means I need to. Once I get into my head that
I "have" to do X, Y, or Z then it's much harder to ignore than if the trigger
(or what have you) came up in everyday life. I hope you HNers learned
something so me sitting here in my underpants counting powers of 2 and
repeatedly moving my head back and forth like a confused pigeon wasn't totally
for naught! :)

EDIT: For those more curious about this topic (all dozen of you) I wrote a
short piece on my blog attempting to better illustrate the painful bizarrity
of OCD through the vehicle of a fictional dialectic:
[https://salt.mattwie.se/essays/all-
mad.html](https://salt.mattwie.se/essays/all-mad.html)

~~~
Retric
Would it help if you had a webcam pointed at the door so you could remotely
verify it's closed and locked? Or do you need some the actual feeling of the
door being closed to end the fixation?

~~~
victorbojica
Really want to see an answer on this

~~~
stubish
I expect it would just move the goal posts, and you would end up staring at
the screen to confirm the door is closed or checking the camera to ensure it
is pointed at the correct door or some similar way of getting the 'hit' that
the door checking gives you.

------
classichasclass
I'm one of the "chronic checker" types. I used to be really bad about checking
and rechecking door locks, particularly, but also the fridge and the garage.
If I check absentmindedly and without intention, I'll have to do it all over
again.

What really helped me get out the door in the morning, and still does, is
actually to video myself doing it. When I got a Palm Zire 72, for the first
time I could actually leave within a normal interval because I had a
continuous, raw, time stamped record of everything I did from checking
everything was off and secure to leaving the apartment and driving away. I
refused to ditch the Zire until the iPhone 3GS because the 2G and 3G only did
stills. To this day I still do it with my Pixel when I'm flying solo.

Which brings me to the other thing that helped: my very patient wife, who
reminds me she saw me do it, you did it right, and get your butt in the car,
darling.

The damnable thing about OCD is that a _little_ is very valuable in my regular
line of work (medicine). Without it I wouldn't be as careful, I don't think.
It means it won't let me take shortcuts and it forces me to be thorough, and
that's a very _good_ thing in that business.

~~~
SmellyGeekBoy
> The damnable thing about OCD is that a little is very valuable in my regular
> line of work (medicine). Without it I wouldn't be as careful, I don't think.
> It means it won't let me take shortcuts and it forces me to be thorough, and
> that's a very good thing in that business.

That's a really interesting take on the positive aspects of OCD and one that's
not often discussed. Thanks for sharing. :)

~~~
majos
There are a few famous athletes who've said similar things. Ray Allen was an
NBA player known for having a beautiful, textbook-perfect jump shot and
eventually setting the NBA record for three-pointers. He credits a good
portion of this to his own OCD, which compelled him to repeatedly drill the
motion beyond reason.

------
meguest
Long time sufferer here.

There is still a _HUGE_ taboo around OCD and mental health in general. A lot
of people still think it's all make believe.

In the last couple of months I've starting receiving professional help for a
number of themes around OCD that have been traumatising me for most of my
life. It's certainly helping, but also very comforting to hear from a
professional the kind of issues his/her other clients might be facing.

Don't suffer in silence or try to fix it all by yourself. No matter how
bizarre, how dark or how ashamed you are of your OCD you should know you're
not alone. A professional therapist has probably heard it, or something very
close to it, many many times before.

Good luck!

------
pugworthy
Mine is earthquakes and tsunamis. I live in Oregon, where we are due for a big
one "some day", and I grew up on the Oregon coast, where there historically
have been major inundations in some areas.

Every time I drive 101 on the coast, I'm constantly scanning and planning what
driveway or what side road I'd go up to get away from a tsunami. "I could turn
around and go back to that one road - oh wait here's a new one. OK that one."

If I'm driving across the Willamette Valley and I'm on the other side of the
Willamette River from my home, I'm thinking, "OK if I make it across this
bridge and then there's an earthquake, I can make it home. But if not then it
might collapse and I'll have to figure out how to get across."

Ironically, I actually didn't develop this until I spent about 5 years working
for seismologists, so I suppose it's kind of a rational, scientifically driven
irrational behavior.

~~~
glenneroo
Do you commute a long way? Is it possible that it's just your mind keeping
busy/creative while you commute? I find my mind playing out similar doomsday
scenarios and solutions when I'm doing something repetitive for longer periods
of time.

~~~
pugworthy
It's about a 10 minute drive to work, 15 on my bicycle :)

This is more when on the coast for vacation or when traveling between cities
in the valley like on weekends.

That said I know what you mean - I do that when I'm biking with traffic,
thinking about what people MIGHT do to cut me off, etc. as opposed to what's
actually happening.

~~~
kirubakaran
> thinking about what people MIGHT do to cut me off

That's probably very useful. Keeps you out of trouble.

------
scarejunba
I was like ten years old when I had to even out things if I stepped on a crack
in the pavement. If I brushed by something on one side I had to even it out.
If I bumped into something, I'd have to go back and bump the other side
evenly.

One day I saw a TV show or a movie where someone was like that and people
treated them like they were retarded. So I tried really hard to stop it. Over
the next few years, I just got rid of the compulsion. I guess it was weak
enough.

Just lucky, I suppose. I still have one terrible one but it doesn't let me
talk about it or bad things will happen.

~~~
circlefavshape
I used to have little compulsions like this as a kid, and I know some others
who did. Perhaps it's not uncommon? Probably rather different to full-blown
adult OCD though

------
gator-io
I have had a close family member experience and recover from severe OCD. This
was at UCLA's child and adolescent OCD program (which was amazing). Let me
share what worked:

1) The program first prescribed SSRIs in order to reduce the child's anxiety
enough to do the difficult work required.

2) Intense ERP (exposure response prevention) solo and in a group setting. The
social aspect of being with fellow sufferers was critical.

3) Coming up with rewards for successful ERP sessions (not food related due to
potential overeating)

4) Starting treatment as soon as possible. OCD has a tendency to get worse and
harder to treat over time. I clearly saw the difference in treatment efficacy
based on how long it took for the child to start treatment.

The link to the program is [https://iocdf.org/clinics/ucla-child-adolescent-
ocd-intensiv...](https://iocdf.org/clinics/ucla-child-adolescent-ocd-
intensive-outpatient-treatment-program/)

------
Insanity
I've been dealing with OCD for about 2 decades now (I was around the same age
as the author when I got these compulsions).

A lot of it centers around health and death, it goes hand in hand with
hypochondria and thanatophobia (fear of dying). It's related to my stress for
sure, and I often get panic attacks because I can't let go of the thoughts of
having become ill or dying.

It does affect my daily life, I have 'repetitive thoughts' almost the whole
day. Not per se bad thoughts, sometimes just worrying about my eyes hurting
from wearing lenses - I keep thinking that until it starts hurting.

I have some kind of 'pattern' when it comes to thinking and if I move outside
of it, I start repeating myself. One of these is that, as a bilingual person,
when I mix up languages in my thoughts that is 'wrong' somehow and I need to
start the 'train of thought' again.

Sometimes - the moments I am most stressed - I end up in a cycle of causing
more OCD moments by having stress, which causes OCD, ..

At times it just depresses me that my thoughts aren't "normal", I know it's
not rational to keep repeating things to oneself, but if I don't do it I have
a nagging feeling that just pushes me to do it.

I also think that OCD is not something only the person who has it suffers
from, it surely does take a toll on the people around you at times -
especially when it makes you seem stressed out all the time and like you're on
"edge". At least from my experience.

------
djhworld
I have OCD, although it's not crippling.

My triggers tend to flare up most at night before I go to bed, or in the
morning when I leave for work. Did I checked the hob is off, is the fridge
closed, did I lock the door? Did I close the windows? What if I left the iron
on and it falls over and starts a fire the house burns down with me inside it?

It's amazing how the mind can "catastrophize" mundane situations.

I live alone which probably makes it worse, but it doesn't affect me too badly
during the day.

~~~
icebraining
Is that necessarily OCD? I do that sometimes, but I think it's just regular
worries coupled with a poor memory (and inattentiveness), that leaves me often
unsure if I really did something like lock the car door.

~~~
rectang
Wouldn't it make sense if all humans were along a continuum (possibly non-
linear) with regards to OCD symptoms? Pick a point somewhere on that
continuum; "normal" to the left, "OCD" to the right.

~~~
robbick
While this is somewhat true, it can easily lead to the idea that mental health
problems aren't serious because they are just further along a scale than me.

We all have kidneys that don't work perfectly, so we are all on a continuum of
kidney failure, however you'd describe some people as having kidney failure
and others not, only a few people would be 'borderline'.

I appreciate that may not have been what you meant, just that your argument
lies close to that kind of logic (though maybe by saying non-linear you mean
to avoid this trap).

~~~
SketchySeaBeast
Mental health is totally a (multidimensional) spectrum, and in mental health
it switches from normal to a "problem" if it's affecting your life. There are
a ton of medical conditions where we've drawn lines in where we think it goes
from normal to a problem (blood pressure, blood glucose) and I don't think
anyone is saying "oh, your blood glucose is just different than mine, you
don't have it that bad". We even have the term "prediabetic" to indicate that
they are getting to the bad end of the spectrum.

I think it's incredibly useful to realize that all of us experience symptoms
of anxiety and depression, intruding thoughts and compulsions, but those who
with the problems are just those further along the line. It's not diminishing
the issue, it's humanizing the sufferer. They aren't "crazy", they are
suffering from something we all can relate to, but just in a manner that's
unmanageable.

~~~
stephengillie
Too often the "spectrum" theory is used to humble-brag about one's own success
in the face of self-diagnosed shortcomings. Vocal patients with mild cases of
a disease can then receive more support and treatment than less-vocal patients
with more severe cases.

~~~
SketchySeaBeast
That always happens. It's people clearing out "toxins" with "cleanses".

------
cube2222
Couldn't get rid of all the compulsions for quite a long time (a few years
really), but after starting meditating every day I was able to nearly totally
get rid of them.

I'm basically finally able to just let go of the thoughts that once seemed
overwhelming.

EDIT: To quote the article "because deep down, the sufferer knows the thoughts
and compulsions are irrational. However, despite this knowledge, there always
remains a terrible “what if”.".

That's basically it, I'm able to finally rationally decide that letting go
won't have bad effects, so I'm able to let it go.

------
jcutrell
Trigger warning for health anxiety folks. Nothing to see here.

I will never forget one day I opened Hacker News, and the top story was about
a 30-year-old programmer named Jonathan (also my name, and I'm 29) who found
out about his terminal cancer spreading throughout his body. This was one of
many trigger moments in my life.

I struggle against health anxiety. Specifically, I am obsessed with dying
young from cancer.

I am not diagnosed with OCD, but health anxiety presents very similar
behaviors.

When I feel particularly vulnerable to a specific kind of cancer, I tend to
research and wrap my head around probabilities, prevention, and everything I
can to hedge myself against that cancer. I'm constantly checking in with small
pains in my body.

I have chronic back issues (partially because of my posture while working).
Pain exacerbates the anxiety.

For the first two months of this year, I couldn't hold my infant son without
ending up on the edge of tears, because I was emotionally convinced I would
die before I ever had the chance to see him grow up.

One understated effect of OCD and anxiety is the feeling of guilt you can
foster because of your own behavior.

My wife's father recently went through a battle with pancreatic cancer. It was
a complete rollercoaster. He ended up having the unlikely type, in a good way
- he is now cancer free. But one moment stands out to me: when she came to
tell me about what they had found. She started out by telling me, "I don't
want to trigger your anxiety..." This both broke my heart and made me feel
understood.

This is something that really has more influence on life than you expect. I
feel for those of you who struggle with OCD, anxiety, and any other mental
health issues. I don't have an answer, other than you are not alone. You're
not isolated. You aren't the first to experience this, and you can live your
life WITH the struggle, even if it feels impossible.

Seek help. Surround yourself with people who love you and want to understand
and help. Don't seek reassurance; seek acceptance.

------
anibalfernando
Hi. I have suffered from thinking about the future as something dangerous (a
question of life or death) that is determined from each decision I make. It
has helped me a lot: 1) The faith: what is going to happen, what should
happen. And that to receive it as learning. A spiritual conception has let me
not be so attached to life. Knowing that if death comes it has a meaning. And
that there is a transcendence. 2) Do not manipulate with the intention of
achieving my benefit. Giving meaning to the life of the common good. 3)
Communicate: Talk about what happens to my family and friends. Do not keep it
for me, expose me. 4) Put myself in the role that I should occupy: At work, as
an employee. In my family, as a brother, as a son. With the doctor, as a
patient ... This order helped me to a better social development and a greater
simplicity in my mind. At the beginning, it cost me a lot to respect the
treatment. I thought that I would not be able to develop professionally (I'm a
systems engineer), and that I would lose intelligence. But with family help,
with patience and learning to be more flexible, medication has been reduced to
a minimum. It's a process that has taken me years (and I'm still in process).
I appreciate everything that happened to me, because it has brought me many
learnings.

------
skytrue
It's interesting how contamination OCD seems to be one of the most relatable
forms of OCD to those who aren't sufferers. I'm glad articles like this are
being written (there are a few other good ones out there), but it's
unfortunate that this subset of the disorder is the only one that gets
attention.

There are hundreds of variations of OCD -- basically, a variation for each
thing you might have a fear over -- as fear and anxiety are at the root of the
behavior associated with OCD. If you can fear it, you can probably create an
obsession over it.

Much like the author, I also suffered a "nervous breakdown" in my 20s (and I'm
still in my 20s, so this wasn't that long ago...) and tried to get myself
hospitalized for the sake of my immediate family, as taking care of somebody
in that state is emotionally exhausting. Fortunately, I had terrible insurance
at the time that didn't allow for "non-critical" inpatient hospitalization, so
I ended up going back home. This ended up being the right decision, because as
mentioned in the article, exposure therapy is the best way to treat OCD.
Avoidance behaviors actually _reinforce_ the damn thing, only making you
worse.

I've thought about writing in more depth about my particular form of OCD,
which is a difficult one to treat as my compulsions are entirely mental
(compulsions are just reassurance seeking behavior, and you'd be surprised at
the mental gymnastics one can try to jump through to reassure themselves about
a situation). I consider myself very fortunate for having lived in a city with
one of the best OCD clinics in the country, as I went through a few months of
clinicians and psychiatrists not really understanding what was happening to
me, before ending up at the right place.

Writing about OCD is incredibly exhausting, because as many other people have
related in this thread, even reading about OCD tends to be triggering to
sufferers. Writing about it is basically saying, "hey, I don't mind exposing
myself to old and new anxieties over and over and over, with the potential to
make my next few weeks miserable", so the people that do it are admirable.
Probably healthier for it, too, given it's basically therapy.

I can't imagine what it's like to write a novel, like John Green did with
Turtles All The Way Down, while also being a sufferer. I'm sure medication
must help. ;)

~~~
Finbarr
I relate very keenly to this and found this resource really helpful:
[https://www.intrusivethoughts.org/ocd-symptoms/pure-
ocd/](https://www.intrusivethoughts.org/ocd-symptoms/pure-ocd/)

The main thing that has helped me has been meditation. I’ve also found
labelling of thoughts to be very powerful. If you can realize what’s going on
and label it as anxiety, it takes the sting out of it.

------
imlina
the fact that this article got upvoted so much probably also explains why
there are always paper towels available and a waste basket near every restroom
door in the bay area right?

I literally possess binary memory when it comes to "what is clean" and "what
isn't clean (touched the floor, public restroom, etc)" for most of my things.
Also used to have "San francisco shoes" and "South bay shoes"

~~~
cryoshon
>I literally possess binary memory when it comes to "what is clean" and "what
isn't clean (touched the floor, public restroom, etc)" for most of my things.

after working in tissue culture where sterility matters (to put it lightly) i
have developed a similar mentality. in the lab, it teaches you to be overly
careful with things because a lot of the time you have to throw them out if
they get dirty, and often the bar for "being dirty" can be as low as "was
exposed to air while uncovered". it causes a lot of very wasteful carryovers
into real life.

------
dm03514
This scene played out almost every night, except I learned to be quiet so no
one would know I couldn’t open the door because of a mysterious feeling that
if I didn’t do it “right” something horrible would happen.

I didn't quite realize it, but how many people suffering from OCD are
motivated by "something horrible" happening? Like I wonder how many people
have compulsions that aren't motivated by something bad happen?

~~~
DonaldPShimoda
For most OCD sufferers, it's the "do this or you'll die" thing (at least, from
what I've read).

> Like I wonder how many people have compulsions that aren't motivated by
> something bad happen?

I'm one. I have compulsions, and none of the obsessions involve me being
certain of impending death if they aren't carried out just so.

For me, it's an extremely intense feeling of _wrongness_. Not like morality;
just that there exists some "right" way to do certain things, and doing it any
other way is somehow inherently wrong or incorrect. Why would I willingly do
something the wrong way?

It makes my skin crawl if I do it wrong. Like there's a physical sensation of
"You've screwed up; go back and do it again until you do it right." My stomach
drops and I feel that one shiver you get when you're just a bit too cold.

Of course, I'm never compelled to do _useful_ things the right way. My go-to
example is from a few years ago. I eat cereal a lot, and historically have
mostly always eaten Smart Start and Raisin Nut Bran. Maybe four years ago, I
branched out and got some Cinnamon Life for the first time since I was a kid.
I ate the bowl of cereal and all was well. Then I tried to put the box back on
the shelf... and I couldn't. It was wrong. The box was printed wrong, and I
didn't know what to do. You know how there's those interleaving flaps on the
top? I like to put my boxes on the shelf such that the flap the goes on top is
on the left and the nutrition information faces out (that way I can pick it up
with my right hand and easily open the box and pour into the bowl — any other
way of doing it would be _wrong_ , somehow). But the Life box was printed such
that the flaps and the nutrition information were at odds. I had to make a
choice: either face out the nutrition information and have the flaps wrong, or
put the flaps correctly and have the wrong side of the box face outwards.

I debated the best compromise for some thirty minutes, until my roommate came
home and asked why I wasn't in class. I hastily shoved the box on the shelf
(flaps correct, nutrition information be damned) and made some excuse about
having missed my alarm. I was completely preoccupied with my decision for the
rest of the day, and haven't bought Life since because I can't deal with the
stomach-sinking feeling of having done something wrong.

------
nkzednan
An interesting podcast episode that talks a bit about OCD is
[https://www.npr.org/programs/invisibilia/375927143/the-
secre...](https://www.npr.org/programs/invisibilia/375927143/the-secret-
history-of-thoughts)

------
somebodythere
One of my obsessions is that objects aren't the "right temperature", even if I
intellectually know they should be.

This has led to many a burned hand throughout my youth as I would reach out
and touch a hot stove or incandescent light bulb to make sure they were really
hot like they should be.

------
SpouseThrowaway
I’m using a throwaway account and trying to keep personal details sparse to
keep this as anonymous as possible. Also, despite my frustration with the
situation, I’ll attempt to be as neutral as possible.

My significant other was always “germ conscious”; clean hands, no shoes in the
house, etc. Nothing over the top or alarming. However, over the years, there
have been huge shifts in behavior and routine in regards to keeping clean.
This person has made the house the “clean zone”. All attempts are made to
avoid contamination from the outside world.

The routines in the house start with the notion that you are dirty if you’ve
been outside. “Outside” isn’t inherently dirty, so things like yard work and
actual dirt are okay. Basically, if you’ve driven anywhere, you’re dirty.
Anything that you or your clothing touches (while dirty) must be cleaned. If
it’s the floor, it must be cleaned immediately to avoid tracking germs through
the house.

The dirty rules apply to everything. Anything brought into the house from
outside is dirty and must be cleaned before use.

Strictly speaking, the basement is dirty. Touching (nearly) anything means
that your hands are now dirty. Shoes or slippers must be worn before going
downstairs.

Shoes must be removed before coming in the house, but you can’t step where
your shoes have been...otherwise your feet are dirty also. Sandal wearers must
wear socks in the house.

We have guests over, but all walkways must be cleaned after they’ve left. Any
surfaces they touched or sat on are cleaned as well.

Work days must end with a shower and change of clothing after coming home. It
doesn’t have to happen immediately, but one can’t sit on furniture and should
be careful not to contaminate anything.

The furniture, floors, cabinets, handles and counters see regular cleaning
with either lysol wipes, alcohol wipes or lysol spray.

One larger issue stems from the fact that my spouse is a medical professional
and is fearful of transmission of things like MRSA. While there is a real
concern there, I’m of the opinion that the cleanliness routine is too extreme.
This person does not typically do not work in a hospital, but when they do,
they have a routine that must be followed.

\- The car must be sanitized

\- Shoes are removed outside and sanitized

\- Clothing is removed in the basement and put into the wash immediately

\- Person showers, which unfortunately means a naked stroll across the house
from the basement all the way to the bathroom.

\- Clothing is washed again

\- The washer is now washed

After drying on the line, the clothing is washed again and the line is
sanitized

All items on the person (jewelry, purse, bags, phone, pens, etc…) must be
sanitized

This behaviour has slowly gotten worse since we started living together. The
logic is consistent, but new behaviours are constantly being added. Where I’m
really beginning to become concerned is that we recently had a child. I’m
hopeful that this will encourage positive change, as some behaviors aren’t
sustainable with a antsy child. But, I’m concerned that they will get worse
and that the child will pick up on these behaviours.

Early signs of concern with the child: The showering rule applies to
everybody. So, somebody has to hold the baby while the other showers. You
can’t put the baby anywhere, because that would be dirty now as well. This has
already become problematic now that the baby is almost three. Basically,
somebody is stuck with a squirmy kid that you can’t put down for upwards of 20
minutes.

ANY attempt at discussing this has been met with extreme hostility, to the
point where I’m afraid to mention or question the germaphobia.

I try to be very patient, but I believe that I've enabled too much of this
behavior for fear of sacrificing a happy household.

~~~
cryoshon
this might be medically unadvisable, but i have found that education goes a
long way towards disarming the notion that anything can ever really be clean
if it is in your house. i helped one of my friends be _slightly_ less obsessed
with cleanliness this way.

let's say you bleach down a perfectly smooth countertop in your kitchen. okay,
it's clean, there's no bacteria there. for about two seconds. probably less,
in reality. we can't see microorganisms with our naked eyes, but they are as
much a part of our physical environment as the air.

put differently, you can't make them go away by cleaning compulsively. not
even for a moment. not in your home, at least. sure, if you see mold growing
on food, throw it out. but you aren't about to out-clean nature's ability to
survive.

remember, nature has been playing the game of "gotta inhabit every potential
niche, ESPECIALLY if nobody else is there, because then there will be more
room for me!" for a few billion years. a lifetime spent applying cleaning
products isn't about to make any headway, nor will it prevent disease beyond a
certain minimal level.

~~~
8xde0wcNwpslOw
The OCD notion of cleanliness doesn't always have really anything to do with
any real germs or other pathogens. "Dirtiness" is more an abstract concept
that varies and develops over time.

~~~
SpouseThrowaway
I think, in this case, it's the fear of the known that is the problem. "Dirty"
is the concept used to describe all the reasons to clean stuff. But, real-
world issues like MRSA are scary and the root of this slippery slope. Combined
with the fact that my spouse works in a highly contagious environment doesn't
help.

~~~
Starwatcher2001
What an awful situation for you both. Would a change of career be
possible/practical/helpful?

~~~
SpouseThrowaway
Possibly, but my partner finds the work extremely enriching. I'd hate to upset
that balance as well.

------
coldtea
> _Most people still think having OCD means you’re a neat freak or like your
> shoes precisely lined up in the closet. Come to my apartment; I’ll show you
> that’s not true. OCD is not a personality or preference. It’s a mental
> illness that can have devastating effects on how you live and interact with
> the world._

Well, yes, but it can also manifest in being a "neat freak" (and not just of
the mild kind).

------
vectorEQ
i used to be plagued by worries who some might relate to all kinds of stress
disorders or obsessive / compulsive disorders. Recently in my life i found
actually, that these things are stress, and that (i finally managed for a
short while to..) if i resolve this stress in my life, this whole background
noise of worries and negative thinking just goes away. like it's not even
actually my own thoughts or something...

Not trying to tell how the mind or psychology works, but after a few diagnoses
of incurable mental problems, i found that actually these were all wrong, and
the problem was just plain stress. it;'s very hard and painful to accept and
resolve these things, costs a lot of self-reflection and self-acceptance of
the dark side to put it simply, but i'd want to encourage anyone who suffers
from these things, to the point of being depressed for years and years on end,
that there is hope to grow beyong yourself, to places more calm and beautiful
than you can even imagine.

Keep up hope and positivity, and look into yourself for positivity and you
will find it.

~peace

------
fb03
I am not gonna post this as anonymous, because I need to put this out of my
chest: I am absolutely terrified of blood pressure being high/measuring it.

I was giggling (and almost crying) while reading the article, because putting
it out into words makes it sounds really ridiculous, stupid, and obvious, but
for us while we are following one of our 'mental stories', it feels very real.

I have the same stuff OP wrote about, but with blood pressure. I am absolutely
terrified of 'having high blood pressure' because of traumas of the past, and
stuff that was said to me that kinda stuck. I fear having my blood pressure
measured and having that makes it go up as I try to measure it. It sucks and
is really detrimental to my mental health.

I have anxiety and panic attacks. Whenever I feel uneasy or feel my heart beat
faster and/or stronger in my chest, I think: "what if my blood pressure is
severely high right now? that is why I am having these symptoms! what if...
what if... what if..."

I have measured my blood pressure probably a million times and usually at the
third reading it is fine (I need to measure 2-3 times because the first
reading is always a little high, because I panic - heart rate goes up, my
breathing gets strange). By the time I end my ritual, the blood pressure is
always fine at 11-12/7 or 12-13/8, and I get relief for some days or weeks
(the thought goes away).

I have also countless times doubted these good readings and thought 'what if
by the time I just got this good reading it got back to being high? I don't
know right now, it _could_ be high right now?'. These doubts made me do insane
things like measuring it all the time for some weeks (I'm past that phase,
thank goodness).

I have also made my wife measure it while I sleep "just to make sure I really
don't have high BP all the time" \-- turns out, because I am sleeping and
unaware I am about to be measured, my blood pressure readings (even the first
one) are always good. I still can't let go of it...

Almost every time I go to cardiologist or anything related to heart/blood
pressure, if the doctor approaches me to try to measure my BP, my anxiety goes
off. And the reading is usually a little high. On rare occasions, if the
doctor is understanding of my fear/condition and talks me out of it (and has
patience), I get a good reading and that brightens my day up more than earning
a million bucks.

Like I said, writing it out makes it sound _so_ ridiculous to me, almost like
a play. I just wish I wasn't cast to it...

'what if' is the true enemy.

PS: I jog 2km 5 times a week and swim 1.5km 3 times a week. I am still not
convinced I am healthy and strong - if i get any palpitations from strenuous
exercise "hey it could be my bp or my heart acting funny"

PS2: I have done multiple ekgs, dopplers, 24h ekgs, all fine. The only exam I
haven't done yet is the '24h blood pressure readings' because guess what --
terrified of having that stuff stuck to my arm for a whole day.

~~~
august9
Oh, this is so me. Except I'm constantly convinced I'm having a heart attack.
For some reason I associate a fast pulse with imminent death. Then I start to
panic and the adrenaline floods in and guess what? My pulse gets faster and
the cycle continues.

It usually comes up out of nowhere when I'm alone, like I'm convinced I'm
going to pass out and nobody is going to know and I'll die for lack of
treatment. My doctor actually laughed at me when I described taking a shower,
feeling my pulse go up, and imagining passing out, the hot water running out
and me dying of a combined heart attack / hypothermia / drowning situation
because it would be hours before anyone noticed I was missing. Don't get me
started on what goes through my head while driving alone on a highway or, the
horror, being out on a lake in a canoe.

I try to ride my bike at least 16km a day, and it does help condition me to
experiencing a high pulse without sudden death. EKG, stress test, heart
ultrasound all came back perfect save for the palpitations, which my doctor
described as "extremely, extremely benign." I feel better for a little while
after every test but it inevitably comes back, as if I constantly need a
medical professional to explain to me that I'm not dying.

Are you considering treatment? I'm certainly thinking about it at this point.

~~~
fb03
Reading your answer made me feel a little less crazy (thank you?). It is
actually reassuring to know there are people experiencing the same stuff and
doubts, and that i'm not alone.

We all should really talk about this with our friends, coworkers, etc. We
should let the word out. I don't know about you but I feel embarrassed of this
condition, like I'm a lesser person because of this. And not talking about it
makes me even more anxious... I don't like admitting it. When I talk about it
freely (like I am doing now, in a somewhat leap of confidence (hopelessness?
haah)) I feel way more relaxed and the monster becomes a little smaller.

We are probably fine bro! You certainly wouldn't be able to bike 16km with a
heart condition. It's all in our heads.

Also, there is a lot of it to being a perfectionist. I somewhere read that
having a low pulse is a good sign. When I'm really relaxed my pulse is like,
60-58bpm.... now picture this:

I am at work right now, sitting in my chair, typing this and juggling 10 other
tasks, I am definitely not relaxed. Just measured my pulse using a cellphone
app, I'm at 70bpm, which is quite good (since the normal range is 60-100).
BUT:

\- Why did I measure my HR in the first place just because I read about yours,
even tho I am not experiencing any kind of symptoms right now?

\- Having measured it, and seeing a pretty normal number, why am I not
satisfied? why am I apprehensive that it's not the 'best' number that could
come out, it's only a 'good' number? I would have had some reason to be
worried if i was sitting here feeling absolutely nothing and then I got a
reading of idk, 105bpm. So why everything has to be always perfect in my head?

We create these fantasies that things are/should be clear cut in real life,
but we know everything is chaotic and imperfect. As we cling more and more
into our 'perfect mental models' we suffer because it will always mismatch
with reality.

We should take a moment to stop and be grateful for what we have, instead of
suffering for not attaining the perfect unattainable pattern we strive for.

Answering your question: I have taken meds before (Xanax), and all symptoms
went away, and then my ocd kinda receded too, I had a phase I simply forgot
about all this and just __lived __.

I am off it now because my doctor said I am already experienced enough to
power through the panic attacks, and she knew I have a preference for not
being on meds if I can (which is where I am now - trying to be sane and
exercise and eat well and just power through).

My BP phobia is really hard on me but if I don't relapse to the 'measuring
everyday all day long' stage I am not going back to meds, nope. I want the
real thing.

Right now I am managing it quite okay, following the shrink's recommendation
to just NOT MEASURE IT. not even if i have symptoms, not even if i have
palpitations. The thought occurs to me and I try to acknowledge it and talk
myself out of it, much like starting to meditate.

Sorry for the huge answer but I felt 'at home' sharing this with you since it
looks like we are very similar in this regard. Hope this helps you and
everyone that reads this.

If you wanna reach out, I am here.

o/

~~~
august9
Well, reading yours made _me_ feel less crazy. I feel like you don't hear
about this aspect of mental illness that often. It's like a weird cross-
section between anxiety, hypochondria, and OCD (which I hadn't considered
before). My doctor referred to it as "hypervigilance" and it seems like there
is plenty of literature out there concerning it.

This study actually looks pretty interesting:
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862826/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862826/)

I stopped actually counting my pulse a while back. It wasn't exactly
willful... more like I just don't want to know because it's probably
artificially high and it's not like I've ever felt better after checking it
anyway.

I know I'm in good health, which is where the "I'm not dying, just a little
crazy" thoughts come in. When it gets really bad most of my energy is spent
remembering that I can do things like ride 16km and feel just fine, despite
feeling like I can't breathe and my heart is going to jump out of my chest and
my nerve endings feel like they're on fire. Xanax has been recommended to me
but I'm very reluctant to start down that road. I can't really justify why, it
just seems slightly scary or somehow unpleasant.

Also, you're right. I should communicate with those around me a little better.
It gets very awkward trying to explain an attack away.

Thanks for talking!

~~~
fb03
> Well, reading yours made _me_ feel less crazy.

Btw, I believe my wording made you think that somehow I said that you're
crazier than me ahhaah and I feel better because I know there are 'crazier
people than me'. English is not my first language, so sorry :-) What i really
meant is that it feels good to _know_ there are people going through the same
stuff, because usually when we are having these symptoms, we tend to feel
really alone ("why does this only occur to me?"), which is wrong -- there are
lots of people going through this.

Don't be scared of Xanax, I took it for two years and it really helped. It
won't cure you, but it will do better: if you're struggling too much (daily)
it will give you some time off to reorganize your thoughts and understand the
whole situation (when you're in panic you're not able to have a logical train
of thought, right?). And with better understanding comes better mental tools
to deal with it (reassurance, previous experience, etc).

Have a good one!

------
bengale
Doors are always unlocked for me, I have to go back and try it a few times. Or
the dog will 100% somehow get through the other doors in the way, pull the
handle, then run into the road. Also if I sleep with the bedroom window open
he'll 100% definitely jump out of the window when I'm asleep. Fun times.

------
m3mpp
To add to the comments here, it's also important to stay very humble about
those compulsions, knowing that they can appear anytime in life, when you have
kids, when they to go college, when you lose a parent etc, even sickness can
bring it.

------
HeadlessChild
I don't known if I have OCD or I'm just a over thinker. Most of the time I
must process the words I'm about to say to another person. I have a hard time
making spontaneous conversations.

------
RGamma
Not a sufferer of OCD, but anxiety and depression (and associated
neuroticism). One of the scary things to accept is that you have no control
over what you think, free will is a (darn good) illusion.

Since we have no idea why these obsessive and dark thoughts are occuring in
psychiatric patients, the best thing you can do, as a patient, is to get good
at identifying all the bullshit that's going through your head: "No, that
random crowd of people doesn't deeply despise you", "No, you don't have to
kill yourself because you can't finish your studies in regular time", "No, you
won't be laughed at because you're looking for an SO"

Precisely none of the fears I had have ever come to pass. I am, relative to
people I interact with, (by a huge margin) my largest critic, which can be
disabling, when every time you make some small trivial mistake you think "Oh
god, nobody will ever forgive me for this, what a stupid PoS you are". It's
all a fiction told by a disordered part of the mind.

On the bright side, things have been improving a ton for me since when it was
really bad a year ago, but it takes medication (not an option for everyone),
time and lots of patience.

One of the best things I came across on the web are the works of Robert
Sapolsky, biology and neurology professor at Stanford. Specifically his 25
part lecture series:
[https://www.youtube.com/playlist?list=PL150326949691B199](https://www.youtube.com/playlist?list=PL150326949691B199),
his talk on depression:
[https://www.youtube.com/watch?v=NOAgplgTxfc](https://www.youtube.com/watch?v=NOAgplgTxfc)
and his book "Behave" (there's more from him, just look around).

It's not that I learned some "magic fact" that suddenly frees me from all
nonsensical thoughts, but it has opened up the complex, nuanced world of human
biology and behavior and numerous interactions between genes and environment,
between mind and body or between different functional parts of the brain
(obviously a course like this can only give a broad overview).

There's so much hidden stuff happening that, without us being conscious of it,
influences who we are, and yet one doesn't have to be a plaything of one's
environment, because several of these factors can be influenced like which
experiences you seek and which you avoid, once you are aware that these things
can shape you. That said, a lot of stuff like your genetic predisposition,
prenatal environment, childhood, external stressors (e.g. death of close
relatives and friends) can not be changed, but it also matters _how_ you think
about them.

One will not become resistant to psychiatric illness no matter how fancy and
elaborate you think about it or yourself, but it takes off the edge of
thinking of oneself as this especially hopeless case. And equally importantly
Sapolsky's course/book shaped my thinking of others, made me much less
prejudicial (I sometimes catch myself with prejudice, but normally I notice),
much more aware that everyone else is also subject to the same rules and
phenomena that govern human thought and behavior and there's nothing "wrong"
with them (in the sense that they're just "an evil person" or somesuch thing).

------
homero
I never knew ocd had anxious thoughts to them. I thought they were thoughtless
compulsions.

~~~
gnode
It doesn't primarily manifest as anxiety, more of an intrusive thought
(obsession). E.g. until you have washed your hands, you are actively aware of
a feeling they are unclean and need to be washed. This can amount to
distractability and irritability, which is remedied by the compulsive act
(washing hands). Combined with the highly co-morbid condition of ADHD, the
intrusive thoughts can impair ability to manage attention.

------
RickJWagner
Ugh. What a terrible affliction to have.

------
aviau
I thought this was referring to XKCD's "What if".

------
stealthmodeclan
I've OCD and i was on a verge of complete failure.

Untill a friend recommended me to try Ashwgandha (Withania somnifera)

After that my life completely changed positively.

I've lost my anxiety since then. I usually take it with a glass of milk.

Now, I've very less stress.

~~~
cheeko1234
My preliminary research shows it's in the realm of homeopathy and folk
medicine. But still might be worth a shot if it can reduce anxiety.

Can you elaborate a bit on how to find it and how it changed you?

~~~
0x62c1b43e
[https://examine.com/supplements/ashwagandha/?PageSpeed=noscr...](https://examine.com/supplements/ashwagandha/?PageSpeed=noscript)

If you haven't encountered it, examine.com is a good resource; they curate
research on supplements.

In the Human Effect Matrix, in the Anxiety entry, you can see a link to 3
double-blind, placebo controlled studies examining the effects of ashwagandha
on anxiety:
[https://examine.com/rubric/effects/view/a42299063269c89b14ce...](https://examine.com/rubric/effects/view/a42299063269c89b14ced47e812decef/042f3f19742d86e6bbfa31ee9af3bfa6/all/?PageSpeed=noscript)

As far as sourcing, you could look at consumerlab (paid subscription; they do
independent testing of supplements).

------
baccheion
Memantine (5-10 mg) + selank.

Add a multivitamin, D + K, and chelated/TRAACS magnesium supplement. Like AOR
Ortho-Core (or Life Extension Two-per-day if too expensive), Life Extension D
+ K, and Doctor's Best High Absorption Magnesium.

Can also add Doctor's Best DHA 500 and Doctor's Best Real Krill.

Nutrient tests like NutrEval catch many deficiencies. And a comprehensive
hormone panel (include thyroid panel). And genetic testing.

~~~
tomhoward
I first tried this kind of thing over 10 years ago. In my experience, it gives
initial benefits, followed by a relapse to an even worse state of ill health.

Mental illnesses are not just physiological in origin and cannot be treated as
such.

They are a complex combination of physiological and emotional issues, and both
must be addressed in step with one another for complete healing to occur.

~~~
baccheion
Did you try what I mentioned or something else? The first stack, for example,
took effect quickly and continued to work.

------
bitblit87
I had OCD (compulsive hand washing, obsessive food hygiene beyond normal,
obsessive about which things touched my lips or hands)

It was tiring. Frustrating. Depressing. It felt like a disease that ruled my
life.

A change in circumstances distanced me from unrelated stresses in my life and
the OCD disappeared. It seemed that it was a manifestation of unrelated
stresses.

------
songzme
I seriously wonder if OCD could be is created because of our lifestyle in
society. Yesterday I went to a coffeeshop (creamery in SF) and there was this
crazy bathroom where I had to scan a QR code to get in. The door automatically
opened, I walked in, and it automatically closed behind me. When I washed my
hands, the water faucet detects motion and it has a built in air dryer as
well. When I'm done, I pushed a button and the door automatically opened.

Afterwards, I thought about why such a crazy bathroom was built and I realized
that my entire bathroom could be done without me touching anything so I could
keep myself clean. It made me think about all the germs in every bathroom door
handle and all the hands touching it. If I didn't consciously stop myself, I
could see myself becoming slight OCD.

At the same time, I wonder if someone who practiced true altruism would ever
develop OCD. If I'm only focused on helping others without thinking about
myself, would it be easier to let things go?

~~~
anonytrary
I'm one of those people who uses a paper towel to open public bathroom doors.
I get upset when:

1\. There's no trash can by the door for my auxiliary paper towel

2\. The door isn't _push_ on the inside (can't kick with my foot).

For the reason you mention. I'm sure it's mostly just conditioning. It's a
harmless preference and it probably saved me a few colds (although, perhaps
getting a virus would have helped me in the long term...).

~~~
augustk
Sometimes there is a trash can by the door but it has a lid (with a handle).
Even if the door needs to be pulled from the inside you simply grab the door
handle with a piece of paper and open the door, and then throw the paper in
the trash can.

~~~
anonytrary
Which is why I'm upset when I don't find one by the door. Wouldn't the lid
make it even more of a pain? I guess I didn't understand what you said.

