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I’ve recently been diagnosed with Premenstrual Dysphoric Disorder. It’s somewhat common in its form of PMS, but more severe. In my case, I only experience one kind of premenstrual symptom. No cramps or irritability for me. Instead, I am intensely, cripplingly hopeless and desperate for a week.
It’s a pattern I’ve been noticing for a year or two now, but hadn’t brought up to doctors meaningfully. I endure weeks in a row where I’m baseline depressed, anxious, traumatized, etcetera, but it’s all manageable. Then, one week out of the month, I lose my mind. I ruminate on death and double my medication just to keep myself from constantly crying. I read until my eyes drop to a close because if I put away my book prematurely, I may be left to my dangerous thoughts.
PMDD is a breeding ground for OCD symptoms, for me.
During this week, I feel utterly powerless in the face of my OCD. Obsessions race through my head, I’m writhing and twitching with compulsions, I’m either completely ignoring my friends or latching on too tight, and I’m impulsive.
Over the summer, I sustained a fair bit of trauma over a period of a couple of months. During this monthly week, ever since late August, I’ve gotten lost in it. All I can think about, at times, is what happened, and it’s pushing my head underwater, all I can see or breathe is what happened. Mantras like “it isn’t fair” run over and over, over and over about my head, and it rubs my brain raw.
I feel like this sometimes, too, when I’m not in the specific premenstrual week. OCD clings to all of the parts of my brain, and consumes every thought and action I have. I spent 5 years in DBT therapy, all to be told recently that I should have been in CBT the whole time, that OCD is my primary diagnosis and struggle and, somehow, that it’s lucky we caught it “so early.” It doesn’t feel early. It feels like I wasted 5 years of my life, languishing in the face of OCD, the unnamed and often invisible predator.
The cumulative effect of such a severe disorder is a sense of deep hopelessness and helplessness. I sometimes come off, on this blog, as if I’m completely recovered from everything. I’m recovered from most things, it’s true. But OCD is one I haven’t cracked. This is largely because it’s such a physical disorder. If intellectualizing a disorder was all it took to cure oneself of it, I’d have researched myself into the highest plane of existence long ago. Actually performing what I know to be the treatment for my affliction is another matter entirely, and it’s significantly harder than any other treatment I’ve ever been through.
I feel swallowed, sometimes. Smothered. OCD is behind almost every thought I have. Many of my thoughts are automatically snagged into repetitive loops, from which escape seems futile. Some days, I just can’t stop reliving traumatic events, I can’t stop picking my skin, I can’t stop pulling at my hair, I can’t stop muttering to myself or writhing or repeating phrases or looping, looping, looping.
My family is sometimes scared by the loops. They sound like insane mutterings. No one is more scared of them than me. I wish I could think normally, could let things breeze by me, could sit in uncertainty.
I know why I can’t. I understand the biological process. I’ve discussed it before, on this website, in detail. I know my fear response gets chemically stuck in my brain, replaying itself abnormally until treatment and exposure releases the loop.
My OCD is subject to change. If that’s true- and it is- then it follows that my OCD will get better. I was reading a book the other day called Freedom from Obsessive Compulsive Disorder by Jonathan Grayson, Ph.D. It was two in the morning, during my “hell week”, and my brain just wouldn’t stop. So I burned through a chapter on OCD cognitive distortions. Here is the list.
- Intolerance of uncertainty
- Black and white thinking
- Mind reading
- Thought-action fusion
- Excessive concern with controlling your thoughts(!)
- Inflated sense of responsibility
This list sums me up. For years, I was swimming in incorrect approaches to my treatment by well meaning and smart, though misguided treatment providers. I’m free of that, now. Things have changed, in my favor. My doctors understand me better than they ever have. Things are better. Things are better. Things are better.
There’s just a wall between my understanding these things about myself and actually practicing their solutions. And this early in treatment for OCD, when my skills aren’t what they could be, hopelessness and helplessness abound when it’s at its worst. Those are the two ingredients for suicidality, for me. Feeling stuck and unable, and with no hope of escaping.
It’s a trick my mind is playing on me, though. I know this because of PMDD, in part. OCD is all encompassing on a weekly basis, but its severity ranges. During one week of the month, its significantly worse. Everything feels hopeless. Then, the fog lifts. I can breathe, I wriggle out from under. Nothing has changed but my brain chemistry, but boy has it changed.
Knowing that it’s all a trick my mind is playing on me, that it’s a bunch of chemicals souring my outlook, is liberating. As I fall asleep, I know that the next day is liable to be much better than this night. Nights are when loops breed, and mornings are when they’re dormant. Different days, weeks, hours, are better and worse.
If I can keep in mind that my current state is not how it will always be, that OCD, unlike some illnesses I’ve discussed on this site, is very treatable, then I’ll be able to release myself from the cocktail of powerlessness that arises in varying degrees throughout my average month. Allowing oneself to be tentatively optimistic about the future releases a great deal of suffering.
When I was younger, fourteen and fifteen perhaps, I went through a sad breakup. It was hard for me to let go of what happened. I was physically distant from the boy, but I couldn’t stop thinking about everything that happened. I rambled on to my dear friends, who so patiently endured my babbling. I quite literally thought that I would never, ever be able to let go. I thought I was trapped for the rest of my life in this one mental relationship loop.
One day, it didn’t sting quite as much, what had happened. Soon after that, I truly let go of it.
I personally utilize this example all the time. I’m in a loop now, about what happened to me this summer. It feels like I’ll never escape it. But if common knowledge, therapy, and my past history have anything to say about it, my loops will cave, even if it feels like they never will. I just have to keep treading water until they inevitably do.