posted December 03, 1999 12:34 AM            

Thought I'd start a new thread about this since you seemed willing to talk about it.

Does your wife really think having OCD or an anxiety disorder makes her *crazy*? Funny, I thought i was *crazy* until I got the label, the assessment and the diagnosis, then I felt this enormous relief that I wasn't *crazy* but suffered with some neurobiological disorder.

That for me was the beginning of a very long journey (one I'm still on) about trying to decipher myself literally.

The anxiety disorders--the umbrella under which OCD falls--are truly biological in nature..and they are inherited...so chances are pretty good that if your wife's sister has dxed OCD, your wife might be suffering with it or a variant anxiety disorder.

But first things first: Does she truly dismiss the idea that something is awry? I often use the diabetes analogy when discussing these invisible disorders. No one would recognize a diabetic simply by looking at him/her. Yet, left undxed or untreated, that diabetic soon finds him/herself in a lot of physical trouble. The manifestations of untreated or out of control diabetes can present as intoxication. And thus might begin a downward spiral where the diabetic is not getting the help he/she needs but is being punished for his/her behaviour.

Once the diabetes is dxed, medications (in Type 2) like insulin help to regulate blood sugar levels...next come lifestyle changes to better manage the disease. But first, first must come the insulin.

Same with the anxiety disorders. Unless someone presents with what the popular media shows us is OCD (excessive handwashing, checking etc.) we don't often recognize OCD. It is so much more than it shows externally.

People with OCD or anxiety live inside their heads most of the time. We ruminate on everything almost endlessly and find living in the moment next to impossible. We spend time trying to avert every imagineable disaster, catastrophe in order to make plans to mitigate such disasters or catastrophes.

It's a vicious circle. We even worry about worrying! It's so insidious.

You say you are a logical thinker by nature: You are at once the perfect partner for her and the worst partner for her.

The perfect partner because once she is dxed (and I would strongly encourage her to be assessed and treated) you can calmly and rationally help her deal with her anxiety/OCD or whichever anxiety disorder it is that she has. (Medications such as the SSRI's--especially Luvox at high doses--work wonders, but adjunct cognitive therapy is strongly recommended as well! Remember the diabetes analogy--first you address the blood sugar imbalance and then you invoke lifestyle changes! Sadly, it doesn't work well the other way around).

You are also the worst partner for her while undxed or untreated because of your logic. OCD/anxiety has NOTHING to do with being rational or logical--it used to be called the Doubter's Disease and I think that name says it all! :-) Logic can be misconstrued on the part of an OCDer as an affront to his/her thinking. It can make the OCDer think he/she is being treated like a *moron* or that he/she is not being understood.

The trouble is without interventions we can never be truly sure of ourselves or our surroundings so we navigate through life trying to keep harm at bay--and that harm is perceived, not real.

One of the biggest *secrets* I kept from the world developed when my children were born. Since I have sufferd with OCD since I was five-six years old, since my core beliefs were-- and my parents reinforced in me --that I was unloveable and bad, I truly believed I was...and bad/evil people don't deserve good things in their lives.

When my children were born, the overwhelming love I felt for them was both wonderful yet scary. Scary because I felt as a *bad* person I did not deserve them...I felt God gave them to me only to have them taken away from me as a punishment of sorts. (This BTW is an intrusive thought!) I have lived with that overwhelming fear that my children would die since my daughter, now 11, was born. I have finally laid that intrusive thought to rest this year with a great deal of interventions, as you know.

But in the mean time, I was totally obsessed (in the clinical sense) with controlling their world, their environment to keep them safe! I was totally overprotective; did not want to spend even a night away from them; did not want to go out for an evening; would not let them play freely and naturally at parks and playgrounds even while I supervised; and hiking--a favorite family pastime--became a trigger for a panic attack thinking of all the dangers that lurked on hiking paths. In short, I made them prisoners of my disorders...which in turn fed their disorders!

How do you help your wife? By gently suggesting to her that she is far from *crazy*, by trying to get her to an assessment and supporting her in this.

How would I want to be treated? Well predx, I wanted reassurance ... about everything (this BTW is a checking compulsion) because remember I did not trust reality...only the intrusive thoughts in my head. But providing reassurance is actually, as you logically pointed out, feeding her o/c tendencies.

Right now, you are caught between a rock and a hard place. Getting help must be your wife's decision..and it's a toughie because it will mean confronting the most frightening of her fears...

But she deserves a better quality of life! And there is so much help available for her--pharmocologically or cognitively--both are best.

I understand too well, however, her reluctance to seek help. I did not until my son's dx...and then I fell apart...and even then, getting the help I needed was a long, long journey.

K, left unchecked, these anxiety disorders do not go away--they simply choke a person to death emotionally. They permeate into every aspect of her life--they feed depression and panic disorder. I really hope you can help her understand her quality of life could be so much better than it is right now.

Funny, my son's psychiatrist was the first to see the enormous distress I was in. And he offered me this insight. He said, Francis, life's not suppose to be so hard. It's suppose to be like driving as a passenger in a cab...you're enjoying the scenery and just peripherily aware of what lies immediately ahead. With OCD, it's like driving a bus, with no brakes down a steep hill--you see every little obstacle and you must work hard to avoid them. Life isn't suppose to be this way.

Those words just struct me ... they rang so true and clear to me...and thus began my own journey.

I hope she soon begins hers. Life is a lot easier these days--even given the enormous challenges of day to day living.

And while there is no cure for OCD or anxiety there is the hope of better management...and from someone who has suffered enormously because of OCD, better management is truly a gift from God.

posted December 03, 1999 09:33 AM            

I wonder if you caught the 20/20 episode last night (Thursday, Dec. 2). It featured a segnment on OCD.

I hope you did. Hope your wife did. It contained a lot of really great information.

posted December 03, 1999 10:13 AM            

I missed the 20/20 episode (although was it a rerun??). I had Noah at the doctors for an ear infection, and got back late (and went to bed soon after).

I really appreciate your post. I'll tackle it from top to bottom.

She doesn't dismiss the idea that something is wrong. She's not wild about treating it, but she will now acknowledge that maybe she should be thinking about it. The only thing I don't like about your diabetic analogy is that there's no simple blood test for most mental (invisible) disorders. PET scanning isn't the most routine diagnosis tool, and that's about the only way to do brain chemistry imaging (although MRI's have made some inroads). Our son is ADHD, and some of my wife's symptoms also share those components. And she's recently self-medicated with his ritilin (naughty...), and found that it's helped. That may encourage her to get to her doctor.

I completely identify with the following:

quote:

---

People with OCD or anxiety live inside their heads most of the time. We ruminate on everything almost endlessly and find living in the moment next to impossible. We spend time trying to avert every imagineable disaster, catastrophe in order to make plans to mitigate such disasters or catastrophes.

---

That's her. Not all the time, but enough. Noah had an abrasion (actually, a burn) on his belly that I also had the doc look at. But for my wife, it was certainly the start of "flesh eating StrepA". You know how that goes.

And I hear you for how I can be the "worse partner" for her. The "Disrespectful Judgement" lovebusters were the worse for her---and they were the hardest for me to do something about, because they were never intentional. I'm a logical, analytic teacher (and lecturer... ). What a disaster those behaviors were to my wife. It's so hard for me---I completely understand about how she feels (in my logical way), but I have a hard time empathizing because I've never been there.

I do understand that my primary goal is to gently help her to get to a professional and have this checked out. And I think I'm doing a much better job of it than I was several years ago (I believe my tactic was "You're nuts for feeling like this!!!!"---D'oh!). I will probably offer her access to this thread; I think it might help her to get a view from someone who's been there.

posted December 03, 1999 01:51 PM            

Yes, I think the 20/20 segment was a repeat--though the original was pre-empted in my neck of the woods.

I'll tackle your post from top to bottom too--seems logical :-)

I'm happy to know that your wife is at least considering that all is not well in her brain.

That she's "not wild about treating it" is understandable. I resisted treatment for such a long time for what I thought was only depression--significant as it was. It really did take my son's crisis and my subsequent breakdown to get me inside a doctor's office for all that was wrong inside my brain. For her sake, I pray she doesn't wait for a crisis to befall her! It's a rough journey back from a mental health crisis.

Pharmacological treatment BTW for anxiety disorders most often involves SSRI's...and if she doesn't need them, if she in fact is not OCD or have any anxiety disorders, with few minor side-effects that last only a couple of weeks (dry mouth, etc), the SSRI's will not harm her! :-) They will simply do nothing!

I accept the diabetic analogy as flawed--but closest I could come!--because there are not, as you pointed out and must know with your son's ADHD, blood tests to confirm whether a person has an anxiety disorder (or ADHD for that matter!)

I recognize too that PET scanning isn't readily available as a diagnostic tool, and I merely offered it as a means of demonstrating that this invisible disorder is really not invisible...ya just gotta have the tools. (BTW, have you ever seen The HOly Spirit? Or God? Or Jesus? But yet you both believe, right?)

That having been said however, there are observational-diagnostic tools available to determine whether a person suffers with an anxiety disorder; which disorder it is and how severe it is and whether interventions are warranted. Most are long questionnaires and are recommended by the DSM-IV, and thus are accepted as diagnostic tools across N. America.

I've done four or five of them in the past 18 months and it's amazing how each one has differed the more I learned about this disorder. Questions like, "Do you seek constant reassurance"...I firstly answer, "No" (what I meant to say was, Get lost! As if!) but as time crawled on, those questions haunted me (oh, yeah, totally OCD here!) and on sober second, third, fourth....thought, I recognized not only that I am a reassurance seeker but how I ultimately became paralyzed without reassurance! (My daughter is the same BTW and she's 11).

The first questionainaire I answered, BTW, immediately uncovered the OCD--subsequent ones--(in conjunction with ADHD and TS testing--also questionnaires) just unmasked how sigificantly it presented in me.

You must be aware of these questionnaires, especially given your son is ADHD. The questionnaires for ADHD are pretty short compared to OCD because IMHO OCD/anxiety is so insidious and so easy to hide! Not so for ADHD esecially hyperactivity. The questionnaires need to be lengthy to help unmask the disorder.

Interesting too that your son has ADHD and that you see some similarities between your wife's behaviours and those of your son. Most of these disorders do not often appear alone--and that is cutting edge info there BTW. In fact, a significant number of people with these invisible disorders have multiple disorders--for instance OCD, ADHD, depression etc. And the more disorders, the more difficult treatment becomes. (Most BTW are never properly treated--most will only be treated for the most significant symptom. The mental health system is flawed that way because often the most immediate and apparent symptom is not the primary disorder!)

Most people presenting with multiple brain disorders will finally seek help for their most problematic symptoms--at first for me, it was depression. I did very poorly on the initial SSRI I was on because the depression was just the tip of the iceberg for me. I was also on a very low dose...and high doses are needed to even begin to *touch* the anxiety disorders.

It was only through learning as much as I could--yes in an obsessive way LOL--about Tourette Syndrome that it became clear to me I was dealing with more than one disorder in myself. (Never mind the abuse issues stemming from childhood!) It was also clear that anxiety/OCD/panic disorder were the biggest challenges I faced....second was the depression.

Getting the right assessment from the right doctor was a nightmare for me! I don't know where you live, but if and when your wife decides she wants to further pursue an assessment, I strongly urge both of you to learn as much as you can about these disorders and find a clinician who specializes in it--don't settle for any old doctor or psychiatrist or psychologist!

Believe me, the wrong one will without doubt do more harm than good! (I'd hate to see that happen to anyone--thus was borne my new career path!)

I'd also like to point out that while your wife may suffer with multiple disorders--she also might not! (Though her trial of Ritalin does suggest ADHD is in her alphabetic brain mix because Ritalin in an un-ADHD brain does nothing!) The reason I mention that she may not have multiple disorders is that so many of these disorders share commonalities ...there is much overlap between OCD and ADHD for instance. OCDers, for example, ruminate and obsess (and them compulse to relieve the anxiety caused by the obsession) but ADHDers can also hyperfocus when interested or concerned about an issue/matter.Hyperfocussing and obsessing can appear to be one and the same thing! (Thinking of the burn on your son here!)

ADHD, as I'm sure you are aware, (or at least the ADD part) is not an inability to concentrate. Rather it is the inconsistent ability to concentrate--which means an ADDer can be off in lala land or hyperfocussed ... many times throughout a day!

Confused? Yeah, it's difficult to tease these disorders apart...that's why I so strongly recommend professional assessment with a clinician who specializes in these disorders. And even he/she will have some difficulty determining which symptom comes from which disorder.

In my own case, OCD is primarily the demon in my life--unchecked that fed my depression and certainly exacerbated my ADHD (I tend to be very disorganized unless I'm hyperfocussing! Argh!)

But what a good psychiatrist/psychologist CAN do is help determine which symptoms are causing your wife the greatest difficulties in life. And then treat accordingly.Even if the initial symptoms are not her primary dx, with treatment, her primary dx will become more obvious.

My ADHD, for instance, is unmedicated. So is my Tourettes. Same with my daughter.

My son, on the other hand, is on medication for TS (neuroleptic that caused the horrible reaction last week), and an SSRI for his OCD. (We did a trial of Ritalin in the summer and it had the opposite effect on him--made his ADHD and tics worse than ever, which BTW may be a marker for bipolar disorder down the road in life. Psych. doubts it though--since bipolar disorder appears not to be in our gene pool--thank God!)

When you suggest that your wife ruminates and catastrophizes "not all the time, but enough"--can you be more definitive? Does this happen daily for instance? If so, how much time would you guess she spends ruminating about disasters? Does she take what is obviously some minor injury and work it through in her mind until it has the potential to become a disaster?

I'd also be interested in knowing how she manages planning events--the holidays for instance. Entertainment, going out, etc. Does she go on and on and on with plans, wanting everything to be *just so* or *perfect*. Does this worry actually take away the fun or enjoyment of such events?

That's another big trigger for those of us with anxiety disoders. We cannot live in the moment--the moment is here and it is safe--it's the next minute, day, week, month, year...(you get the picture) that feeds our anxiety and compulsions.

K wrote: "The Disrespectful Judgement lovebusters were the worst for her--and they were the hardest for me to do something about, because they were never intentional."

They never are, K--because you didn't know, nor did she, what you were deaing with. The "logical, analytic teacher and lecturer" had no idea he was dealing with someone with a brain disorder...she probably didn't either.

Don't be too hard on yourself--you're human :-) Just keep learning! (I think a wise person on this forum told me it's not the mistakes that matter, it's what we do with them that counts.)

As I mentioned, I am STILL learning how my ocd creeps into my life--after all this study and treatment!!! So many revelations are still unfolding. It is truly amazing--the difference today is that we (both H and I) are beginning to see the OCD, to recognize when I'm obsessing or compulsing and that puts EVERYTHING into a different perspective. It's like putting on a pair of reading glasses after years of reading blurred material. Everything becomes clearer with a proper assessment, even if treatment is not pursued.

K wrote: "What a disaster those behaviours were to my wife."

And her's to you...And mine to my husband... :-) And his to me!

K wrote: "It's so hard for me--I completely understand about how she feels (in my logical way)..."

Uh, sorry, my friend, but you don't because there is nothing logical in this Doubter's Disease. You cannot understand, no more than the best OCD specialist in the world could completely understand it unless he lives with it. Ya gots to live with it--and fortunately you don't. You are to be congratulated, however, for your desire to want to understand how she feels....You're doing so well, K!!!!

K wrote: "But I have a hard time empathisizng because I've never been there!"

Bingo! But I strongly suspect that you would be an amazing help for her should she seek assessment and a dx...because of that logical brain of yours. (See how God works in mysterious ways? :-) You will be an immeasurable help to her in combatting the dragon.

Your "primary goal is to gently help her to get to a professional and have this checked out".

Bingo again! But ultimately the decision is hers. I really pray she does though--her life, and by extension your's and your family's--will be so much better, funner..(ohmygosh, did I say funner?)

Anyway, with apologies for the length of this little novelette, I sincerley hope to see K's Wife on this thread soon...or at least know she is further giving thought to getting help! :-)

posted December 03, 1999 02:07 PM            

My head is killing me right this second, plus, I'm at work, so longs posts are difficult, at best... just wanted you to know that you both are SO INTELLIGENT and INSIGHTFUL. I live in the same type of situation as both of you, the OCD, the ADHD... all of it.

I did see the 20/20 segment last night. Very good! The one mother was the "worse case" type of OCD, wanting to harm her children.

Anyhow, gotta run... just know I'm thinking of you, and hope I'm not intruding...

~Sheryl

posted December 04, 1999 03:13 AM            

You're not intruding at all...in these issues, often the more people involved, the greater the perspective and understanding.

Hope your headache is gone by the time you get this!