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Coping Skills

The Most Important (and Neglected) Item On Your To Do List

Life is tough.

Our schedules are jam packed; we have work obligations, child care commitments, and -- Junior, stop that shrieking --hardly a moment to unwind from the inexorable daily grind.

For parents (thankfully, which I am not), the grind must seem particularly indefatigable. I can hear the weariness --bordering on utter exhaustion -- when I chat with my parent friends.

With life coming in hot, how many of us consistently attend to our mental health needs?

I suspect that many of us don’t feel we have enough time (or money) to engage in mental health maintenance. The result: we put mental health on the back burner -- somewhere between cleaning out the garage and repairing that malfunctioning lawn mower.

I was the same way -- until, that is, my mental health issues floored me.

From adolescence to adulthood, I have battled mental health issues. During my freshman year of college, I was officially diagnosed with OCD -- although there were telltale signs during my teen years. Following my diagnosis, I met with a counselor every week in college. And, in part, because of the counselor’s direction/friendship, I thrived -- steadying myself after OCD threatened my equilibrium.

When I attended (and stumbled) my way through law school, I had a weekly appointment with a trusted counselor. Law school provides enough mental anguish; I didn’t need my OCD and depression compounding matters. With a giant assist to Dr. Gullickson, I survived and, with a begrudging admittance, even semi-enjoyed law school’s tribalistic rituals. I can do without the Socratic method though.



Coping Skills

New Year; New (and Hopeful) Letter

For many of us, the New Year represents a rebirth--an opportunity to reflect on the previous year’s disappointments and, in some case, repair lingering hurt. In my case, my estranged relationship with my immediate family has been a perpetual source of consternation (and, at times, unending frustration). For those that struggle with family conflict, I am sure you can relate and, I hope, empathize with my broiling family turmoil.

Dear Family,

I want to wish you a belated Happy New Year.

Our relationship is undeniably strained; we haven’t communicated since 2014. Most of our conversations are accusatory--armed with icy threats and recriminations. There have been belligerent phone calls and taunting emails--and that’s when we do communicate.

Your lawsuit against me, of course, generated ill will (the property dispute, I believe, could have been resolved with a couple of phone conversations). That said, a reservoir of discontent has long stained our relationship.

And, truthfully, I am not exactly sure why. Since Mom’s passing, we should be on the same page--working together to collectively heal our wounds (instead of brooding over slights--real or perceived).

More than revisiting past hurts, I would like to take a moment to address the elephant in the room: my mental health. For you, mental health has been a perpetual source of tension and unease. You don’t know how to talk about mental health--and I suspect there has been confusion--even bewilderment--about my mental health diagnoses. This confusion has manifested itself in pejorative labels.

These labels are hurtful--verbal grenades designed to demean.



Living with OCD

Don’t Be a (Cold) Turkey: Avoiding Medication Withdrawals

“Damn it--this feels worse than my initial diagnosis,” I groaned before composing my latest email to Dr. Neumaier. “I feel off--like something is really wrong with me.”

As I composed the latest email, I wondered what was going on. I understand depressive thoughts--and their, at times, permagrip on my psyche. I am all too familiar with OCD--and its, at times, stranglehold on my mind. But this felt different--a medley of panic, smoldering anxiety, and darkness threatening to torpedo my harried mind.

As the sense of helplessness cresconded, I pulled over on the side of the interstate and clicked send on the panicked email. “Here’s hoping I can finally find some relief,” I lamented--before cursing Abilify’s name. Again.

For years (strike that--decades), I have played medication roulette--shuffling from one medication to another. The overwhelming majority of medications have had potent--even debilitating---side effects (dry mouth, insomnia, marathon-like fatigue). But more than the aforementioned side effects, weaning myself off a particular medication has been the most difficult--and, at times, crippling side effect.

Insert image of me hunched over the steering wheel wordsmithing the latest missive to Dr. Neumaier (We need to schedule that appointment ASAP!)

The back story: Taking 1 mg of Abilify for the preceding month, I quickly tired of the medication’s corresponding lethargy. Fumbling over words, my mind felt like it was in verbal quicksand. I felt off--a strange mixture of passivity and detachment. While I had hoped Abilify would dull Wellbutrin’s sharp edges, my hope was descending into concern--even despair.



General

Indecision 2018: More Waffling Than Your Local Pol

“How do you decide?” I probe my close friend.

“Well, I just listen to my gut,” she responds matter of factly.

I slowly nod--borderline incredulous. Who knew that making a decision could be so, well, easy?

For OCD sufferers, decision making is an exercise in agony, indecisiveness, and self-doubt. If you don’t want to take my word for it, take the esteemed authors of Decision-Making Under Certainty in Obsessive-Compulsive Disorder.

These authors chronicle--in painstaking detail--the chronic indecisiveness characterizing OCD sufferers. Referring to OCD as “the madness of doubt,” the authors state that “individuals with OCD often exhibit indecisiveness, pathological doubt, and avoidance of uncertainty.”

Sorry---you may have just heard me grimace in that knowing, half smirk way. As any OCD sufferer knows, doubt--and the attendant anxiety--are willful, ravenous creatures. If the smoldering doubt doesn’t consume you, the swirling pit of anxiety will.

In my case, I have watched indecision nearly paralyze me. In school, I would agonize over every last word of a a homework assignment. The writing process, painful during the best of days, would become agonizing. A 30 minute homework assignment would devolve into a three hour torture session--replete with frustrated sighs and guttural groans.

Careers and relationships have also stagnated, if not suffered, because of indecision. Opting for law school (of course, on the last possible day of enrollment), my career has meandered from one unfulfilling career path to another. It has been a continual and, at times, fruitless search for something more meaningful than typical law firm tedium.

Family and friends have expressed frustration--even exasperation--with my chronic indecisiveness. “Matt, just pick something,” they bellow. I suspect they view my indecisiveness as manipulative--something straight out of the passive-aggressive playbook. But as I mull over my options, there is an overriding concern: What if I make the wrong decision? In some cases--most notably when the OCD is at its shrieking histrionic worst, it seems easier to delegate than make an all-important decision.



General

Mental Health: The Most Common Extracurricular

Two parent family? Check.

Highly regarded public school? Check.

Excellent student? Check.

Involved in extracurricular activities? Check.

Mentally ill? Check (nods sheepishly).

I grew up in Des Moines, Iowa--more Americana than apple pie. We had our own basketball court and a sprawling yard in a quiet, tree-lined neighborhood. There were family vacations to Colorado; Spring Break trips to Mexico. There was the the annual Thanksgiving extravaganza, where my aunts and uncles would descend on our cozy, brick home. In short, I had every advantage--involved parents (most notably, a caring mother), supportive aunts and uncles, and a rigorous academic environment.

But OCD or, quite frankly, any mental illness doesn’t give a damn about your family pedigree, upscale neighborhood, or academic credentials. It just doesn’t.

OCD first emerged during my teenage years. I remember the agony of turning in a seventh grade assignment--as I tossed one aborted draft after another into the wastepaper basket. The content, I am sure, was fine but I was obsessed about my handwriting. “It has to be perfect,” my mind implored. And it had to be; I remember my neverending frustration when I couldn’t meet my insatiable handwriting demands.

Yes, handwriting. Insert head shake.

My obsessional handwriting thoughts would soon metastasize into obsessional everything. On a family vacation to Florida in ninth grade, my OCD flared its ugly nostrils. The horrific thoughts besieged me; I felt defenseless as my mind staged a bloodless coup.



Coping Skills

The Doubtin’ Disorder: Paralysis By Analysis (and Legal Pads)

Did I commit that horrible crime? Did I hit that innocent pedestrian? Did I cheat on that exam?

The answer, of course, is no. But as OCD sufferers, our minds are equal parts creative and callous. As my OCD mind churns out the latest falsehood, that nagging sense of doubt remains.

In reality, OCD stands for obsessive compulsive doubt. The doubt--that second guessing--fuels our disorder. At times--and in a somewhat amusing twist, I have even doubted my OCD diagnosis (somehow that feels appropriate).

For decades, I have struggled with doubt. As the latest OCD thought gurgles in my overtaxed mind, my OCD mind goads, “Matt--maybe, just maybe this thought is real.” And as any OCD sufferer knows, the thoughts feel real--often painfully so.

And so the vicious cycle begins.

As OCD tickles my mind, it pulls me back into its ether. With a furrowed brow and an array of legal pads, I would endlessly debate the latest distressing thought. The goal: to “figure out” OCD and, in turn, extinguish the all consuming doubt.

A hard-learned lesson: a furrowed brow and army of legal pads cannot extinguish doubt and those accompanying pangs of anxiety (trust me, I have tried).

Here’s the thing: Intellectually, I understand that certainty is an illusion. Doubt is a fundamental part of everyday existence. From our biggest philosophical questions (Does God exist?) to everyday minutiae (Did I lock the garage door?), doubt pervades our lives. And, truthfully, doubt can even be a positive, prompting us to be more careful when completing tasks. Case in point: Doubting my math abilities, I am much more careful when completing any task involving numbers. Carry the one, Matt.



Coping Skills

The Longest Game: OCDecades, Not Years

“What if the exposures don’t work?” I said--cringing as I contemplated the possibility of more mental anguish.

Sensing my trepidation, the St. Louis-based counselors assured me that the exposures would, indeed, work. These exposures, she reassured (yes, I know that is loaded word) me, would temper my OCD.

Grudgingly, I acquiesced. As the counselors watched, I exposed myself to my most dreaded fears: the horrifying thoughts; the jarring physical sensations; the pulsating anxiety. With each additional exposure, the objective was to ratchet up the anxiety to increasingly unbearable levels. In time--and through these all too vivid exposures, the scary thoughts wouldn’t seem so terrifying.

Or so I thought.

As I preserved through these daunting exposures, I hoped for--even anticipated--that long awaited OCD breakthrough. My mind, unfortunately, had other ideas. Spanning ethical dilemmas to sexual concerns to tingling physical sensations to whatever else my mind could concoct, OCD proved too skillful--too experienced at tormenting me--to habituate to any of the ready-made exposures.



Coping Skills

(Im)Passion(ed): Finding Your Career Calling

“So you want to find something you are passionate about,” my father sneered at me--his tone dripping with condescension.

Yes. Yes, I do.

During my teenage and early adult years, we would argue--often heatedly--about my career aspirations. Pledging fealty to the almighty dollar, he disparaged my “passion play” as something between naive and irresponsible.

“You can never have enough money,” he would insist. “You’ll want to keep up with the Joneses--you’ll understand when you are older.”

While I understood his money obsession (less his infatuation with keeping up with those mysterious Joneses), it struck me as empty. Who would languish--willingly, I might add--in an unfulfilling career for some extra Benjamins? Kids and student loans, (somewhat) duly noted.

Now batting an eye toward 38, I am reexamining my “passion play”--and whether I am well-served to prioritize passion over profit. My official conclusion: Yes. Yes, I am.



Coping Skills

One Man’s Trash…Is Another Man’s Trash

“Are you going to throw away my notebooks? Really?” I lamented. “This seems totally unnecessary.”

The counselors solemnly nodded their heads--and then proceeded to toss my yellow pad notebooks into the nearest trash receptacle.

I was aghast, although I concealed my bubbling emotions with a thin, plastic smile. You see, I toted my yellow pad notebooks everywhere; they were the adult equivalent of my favorite blanket. On my yellow pad notebooks, I scribbled “answers” to my latest (and most feared) OCD thoughts.

These notes were indecipherable to everyone but yours truly. But for me, these yellow pads were critically important--providing “answers” to my daily OCD riddles. I would spend hours digging into my mind’s recesses and then jotting down notes to recall/recreate the troublesome OCD thought.

My thinking: If I could just “figure out” these distressing thoughts, I could eliminate the paralyzing doubt boiling inside me.

Despite the trusted supply of yellow pad notebooks (and endless hours analyzing my obsessive thoughts), the doubt lingered--an ever-present reminder of OCD’s stranglehold. I couldn’t “figure out” my obsessive thoughts--despite my unwavering desire to unlock their seemingly important meaning.

A hard truth: I was chained to my notebooks, devoting countless hours to “logic out” the illogical.

When the counselors casually tossed my notebooks away, I was worried--if not panicked. “These notebooks have important information--the type of information that helps me with these irresistible OCD thoughts,” I stewed. “What am I going to do now?”



Living with OCD

Cop Out: Policing Your Thoughts

“How will I know if--or when--I defeat this thing?”

As my mind ruminates about recovery, I almost have to laugh. If there is one thing to get “stuck on,” it might as well be recovery right?

That said, I think it is a fair--even compelling--question: What is recovery?

As I have previously discussed, OCD waxes and wanes. It pummels for a week or month, spewing ugly taunts (and, we fear, truths). And, then, the sinister thoughts seemingly disappear--providing a respite from our churning mind and racing heartbeat. There is a hopefulness in our step, “Maybe we have--finally--defeated this thing.”

Sorry to be the bearer of bad news but we haven’t--and, somewhat ironically, recognizing our very own futility is a sign of recovery. Let me explain further.

There is a common misperception that you can defeat OCD--that through a cocktail of perseverance and stubbornness, you can vanquish OCD’s running monologue. “I don’t have to think about you--you are just an intrusive thought,” you counter to the latest (and greatest) nagging thought. And as you attempt to stomp out that OCD thought, another noxious OCD thought invades your mind. And when you attempt to stomp out that thought, another OCD weed sprouts up. Your steely determination has met its match--an OCD machine that is smarter, savvier, and (more) sinister.