OCD is Down and Depression Steps In
So the good news is, I have been almost completely free of OCD symptoms since before my last appointment with my therapist. This is somewhere I never imagined I’d be even a year ago, and on that front, things are wonderful.
The bad news is, I had a mild brush with depression for a couple of weeks. It wasn’t as bad as it could have been, but it did sap me of all motivation and I lost track of time, so instead of the one week break from everything that I planned for, I was out of it for nearly three.
This is something a lot of you might have some experience with.
OCD and mood disorders — especially depression and bipolar disorder — tend to come together. One study found that a third of participants with OCD also dealt with some form of depression. Another study that spent three years monitoring OCD patients who had experienced episodic major depression found that more than half of them had comorbid bipolar disorder. According to Stanford Medicine, approximately 31 percent of OCD patients also experience some form of major depression.
So I guess it’s not really surprising that I would have a short stint of depression. There were a few contributing factors: The weather got warm here in California and I have no air conditioner, so my sleep has been terrible. I’ve been switching from one form of birth control to another, and I have always been very sensitive to medication shifts. I had three very busy weeks where I was working six days straight, with long hours (10-plus) on a few of those days. I think I bumped up against the bottom edge of hypomania a little, though I didn’t cross that line this time around — I even mentioned it to my therapist at my last session, just in case.
That was followed by a week that was nearly empty of work, and recovery turned into moping pointlessly and wishing for death. (I know that sounds melodramatic now, but at the time, I just wanted to not be bored anymore! Nothing I did seemed to relieve it or hold my attention for more than a few minutes at a time.)
What Should You Do If You Suspect You Have a Mood Disorder?
When I began treatment for OCD, my anxious, obsessive symptoms were covering up everything else. I’ve had symptoms of bipolar disorder for years, but they didn’t become clear until I began taking sertraline.
The SSRI relieved my OCD symptoms — and promptly kicked me into hypomania (or, more likely, kicked up the hypomania that had already been making my OCD symptoms, since I was sleeping maybe two hours a night for a few months before I began treatment and had a lot of “nervous energy”).
Getting me out of that hypomania kicked me down into a depression that lasted a few months before things evened back out. It wasn’t great. But with the help of my therapist, I learned how to monitor and assess my moods, how to cope with minor bumps into depression or elevated mood, and what warning signs indicate I need to let them know right away that things are not quite right. Having this kind of plan in place is important for any mental illness.
If you think you may have depression on top of your OCD, talk to your doctor. Take notes about how you’re feeling and when in the days leading up to your appointments. If you have worrying symptoms, make a note of those, too, even if you don’t feel them in the days before your appointment:
- Intrusive or obsessive thoughts about harming yourself, even if you don’t want to carry them out.
- A desire to hurt yourself — if you think you might be a danger to yourself, please tell them it is an emergency. You don’t deserve to feel that way.
- Feeling sad or intensely bored with no explanation for days at a time.
- Feeling worthless, guilty or helpless (though these can be OCD symptoms, too).
- Loss of motivation or interests in work or hobbies.
- Difficulty concentrating or problems with memory.
- Disrupted sleep. The big two for me are sleeping less than four hours a night without feeling tired, a clue I’m heading toward hypomania and need to give my therapist a heads’ up; and intensely vivid, usually disturbing dreams, which I tend to have whenever my mood is off kilter in either direction. Other common signs are insomnia (sleeping less but with feeling tired) or sleeping more than normal and still feeling tired.
- Or any of these other symptoms of depression or bipolar disorder.
Talk to your doctor (or therapist), find out if you have cause for concern, and come up with a plan so that you can nip depression in the bud.
Right now, my latest up-then-down spell seems to have passed. I’m hoping that once I’m used to the heat and my new birth control, I will level back out for a while. But even if I don’t, every time I sink into the pit or bump against the sky, it’s easier to grit my teeth, hang on, and know I’ll come out on the other side.
Photo by Ryan_M651
Cathey, K. (2016). OCD is Down and Depression Steps In. Psych Central. Retrieved on February 20, 2018, from https://blogs.psychcentral.com/overcoming-ocd/2016/06/ocd-is-down-and-depression-steps-in/