If I knew what it was, I might know how to fix it

February 25, 2009 2:42 PM

I have some kind of mental health issue along the lines of OCD and/or OCPD and I need some help fleshing it out. (Long)

I have seen doctors and other specialists and will continue to do so, but right now I am making use of this excellent resource that is the hive mind: A coupe of years ago I posted this question about feeling like I was messing up my mind/brain from kind of forcefully and obsessively trying to solve certain philosophical problems, and fast forward to today, this problem is fully blown and I get it all of the time from thinking about anything, and the closest thing I can relate it to is OCD and/or OCPD. Essentially what happens is that I have trained myself to be so completely productivity oriented that if I am not ‘doing’ something, checking something off of my to-do list in some way, I become very uncomfortable. And when there is a problem to solve, I just can’t get it out of my head. Even sometimes after the problem has been dealt with I still can’t stop ruminating on it. And with problems that have kind of thwarted my attempts to solve them in the past, even the mere thought of it sends me mentally right back into that psychologically unbalanced state that I get into when I am trying to figure something out relentlessly from every possible angle.
From my book on OCD with a little blurb on OCPD: People with Obsessive Compulsive Personality Disorder tend to:
- be excessively dedicated to work and productivity (I am majorly hell-bent on productivity to the point where it is 'obsessive' and unhealthy)
- be perfectionists (not really)
- be preoccupied with control (not really)
- be self-righteous (not really)
- demonstrate excessive frugality and fear of spending money (i am willing to spend a lot on something worthwhile, but otherwise I am excessively frugal. all of my possessions i consider to be tools and if it doesn't 'do' something, its in the garbage.)
- exhibit rigid, rule-bound thinking (no)
- have a reduced need for friendships and leisure versus work (i by choice have no social life so i can be more productive, and i don't really do 'leisure', i just 'take breaks' and ride myself to get back to being productive)
- have an excessive need for orderliness and rules (i dont care about rules, but i do keep things pretty organized but i don't consider it to be OCD levels of organization)

And for OCD, my book dinstinguishes between obsessions, compulsions and preoccupations. ‘An obsession is a persistent, unwanted thought, image, doubt, or urge that intrudes into your mind…’ ‘Preoccupation means being absorbed with something troubling that’s on your mind. Preoccupations are usually the result of you frequently focusing your attention on an idea or doubt that is distressing to you.’
So I don’t identify at all with obsessions or compulsions as described with regards to OCD but preoccupations hits the nail on the head. However I can’t find any reference to preoccupations anywhere outside this (CBT for dummies) book. It’s obsessive compulsive disorder after all, not obsessive compulsive and preoccupation disorder. So as you can imagine my OCD for dummies book had nothing that could help me as I do not suffer from intruding thoughts of doing harm to others or compulsions to wash my hands over and over.
So I think in the name of productivity I re-shaped the way I think towards something unbeknownst to me as resembling some kind of thinking pattern that has to do with OCD / OCPD. But only perhaps a specific kind of those afflictions so I am having a really hard time figuring this out. I understand that treatment is probably the same regardless: antidepressants, CBT, mindfulness, meditation, etc. But damnit if I don’t want to know exactly what I have and whether other people have the same type of thing and how they dealt with it.

posted by dino terror to Health & Fitness (18 answers total)

I think trying to diagnose yourself is not going to help you as much as getting a diagnosis from an excellent psychologist or psychiatrists. It was the only thing that really helped me deal with issues very similar to the ones you are facing.

I just want to point out a couple of things that don't seem to jive within your post which might help you think through these points some more.

You say: - be perfectionists (not really)
However, in the preceding paragraph you say: And with problems that have kind of thwarted my attempts to solve them in the past, even the mere thought of it sends me mentally right back into that psychologically unbalanced state
- That sounds a hell of a lot like perfectionism to me- you didn't do the task perfectly and so it's still bothering you so much that you can't move on.

Also you say: - be preoccupied with control (not really)
However, you also say: Essentially what happens is that I have trained myself to be so completely productivity oriented that if I am not ‘doing’ something, checking something off of my to-do list in some way, I become very uncomfortable.
-Being in this kind of productivity mode is a form of control for your own life. When you are unable to keep control (you can't get your work done or you can't figure out the solution to a problem) you feel terrible and have a further compulsion to work harder and do better.

You say that your mental health has deteriorated in the past few years as this has gotten out of control. Attempting to self-diagnose and coming here for help is (I suspect) procrastination in action- and procrastination as a coping mechanism doesn't work forever. It may also be an attempt to control the situation and put it in a nice neat little box. I don't know- only a professional will be able to help you understand your situation. I'm still in awe at the shit I've learned about myself the past few years- and understanding myself has been the tool for my recovery. Hugs! and Good luck working through this!

P.S.- I can't recommend The Now Habit more as a book for learning about being productive and enjoying leisure time with friends and family too. Just browsing through it at a bookstore might be useful to you.
posted by Mouse Army at 3:15 PM on February 25, 2009

I had OCD as a kid. I stopped the hand-washing and such but I still sometimes have what I call "sticky brain." I keep thinking and thinking about a problem or question, past the point of usefulness, or I keep calling up painful thoughts that serve no purpose. So if you want a label, OCD might work.

Back when I had a Panax prescription, one dose would turn the tail-chasing right off, like flipping a switch. That helped me understand that much of the problem was chemical. I eventually quit the Panax and was able to step outside my hyperactive brain and say, "It's just the OCD kicking in. I don't really have to resolve that train of thought right this very minute."

What helps me: physical exercise (rigorous, preferably outdoors), a timer on my computer that takes over the computer and forces me to stop working (TimeOut), a healthy diet with few refined carbs, and pseudo-Buddhism. If sticky brain kicks in, I do crazy Bollywood dancing, hit the treadmill, or go outside and split wood.

I'm also a big fan of Irresponsibility Day. It's a day on which I do whatever I want to do, not things I should do. It helps turn off the incessant thought "You should be doing something on your to-do list!" because whenever that thought pops up I can say, "Hah! Not today! Today is Irresponsibility Day!" It also helps me become more aware of the "you should..." pressure in general and recognize when it's becoming unhealthy.

Good luck!
posted by PatoPata at 3:15 PM on February 25, 2009 [2 favorites]

Sorry, that Panax should be Xanax.
posted by PatoPata at 3:17 PM on February 25, 2009 [1 favorite]

Self-diagnosis is a near-impossible task, for we see ourselves through a biased lens. We may be unaware of dysfunctional thought patterns and behaviors; conversely, we may worry needlessly about perfectly normal, harmless personality quirks. Therefore, even if you were to plumb the DSM-IV for an apt diagnosis, you'd still be analyzing your personality from a biased (and non-professional) perspective, and would not likely achieve a conclusive result.

Rather than frustrate yourself further with this question, why not visit a psychotherapist, clinical psychologist, or psychiatrist who can answer this question for you?
posted by terranova at 3:25 PM on February 25, 2009

‘An obsession is a persistent, unwanted thought, image, doubt, or urge that intrudes into your mind…’

I have zero training or credentials, but from this armchair, it seems like your persistent worries that you have changed or damaged your brain by thinking too hard or in the wrong way meets the definition of "obsession" pretty handily. Books and exercises can be incredibly helpful for some people - and maybe they'll be helpful for you - but we are generally the worst judges of our own mental and emotional health. I know you disclaimer'd that you "have seen" doctors - but we've all "seen doctors". Have you obtained a referral to a psychiatrist? Are you currently being seen by a psychiatrist? I think that's where you should be putting your energy right now - not in self-diagnosis and self-treatment.
posted by moxiedoll at 3:27 PM on February 25, 2009 [2 favorites]

The title of your post is, "if I knew what it was, I might know how to fix it."

"It" is, from your description, probably a mental health issue. It's incredibly tempting to try to apply willpower to mental health issues, but that is not the way to "fix" them. There are some things you can't fix by yourself. If you knew you had pneumonia, you would know that you could not fix it. A doctor, however, could. The longer you tried to solve the problem on your own, the worse it would get.

You are concerned about your mental processes. The fix for that is the expertise of someone with an advanced degree. "I have seen doctors and other specialists" does not sound like "I have found a psychiatrist/psychologist whom I trust and whom I am seeing regularly."
posted by prefpara at 3:37 PM on February 25, 2009

Sorry to double-post, but another thought:

"right now I am making use of this excellent resource that is the hive mind"

You've been "making use" of AskMeFi to deal with your fear of overstraining your brain since 2005. You also asked in 2006. You're asking again today. So this resource has not helped you in the past. Your previous posts have given me the impression that you're not giving your doctors the kind of detailed picture of the problem that you're giving us. Your 2006 question doesn't mention doctors at all.

If I were you, I would print out these three questions and take them to a therapist to discuss them with him. If your statement that "i by choice have no social life" is not hyperbolic, then you will likely benefit enormously from stable, regular interaction with another human being who can give you objective perspective from outside your head.
posted by prefpara at 3:50 PM on February 25, 2009 [1 favorite]

Response by poster: prefpara: the first one resulted me realizing that I was giving myself tension headaches and I successfully overcame that problem. The second one was dealing with some problems that were sporadic but now looking back they were the first warning signs of what is now fully blown OCD. This question I am now trying to make sense of any guidance I can get about differing between OCD and OCPD. I know it is safe and easy to say 'see a doctor' but believe me: it is really really hard to get any help from anyone beyond getting a prescription for antidepressants. Right now I am in the phase of trying to talk with people who may have experienced things along similar lines ie. OCD support group except that I haven't exactly found a good online OCD support group / message board thing yet, and hey, Ask Mefi is the bee's knee's, so I thought I might risk using it.
posted by dino terror at 3:58 PM on February 25, 2009

dino: then it sounds like you should ask, "It is really really hard to get any help from anyone beyond getting a prescription for antidepressants. How do I get the professional help I need?"

Don't give up! If you disclose your location, you will likely get some useful specific recommendations tailored to the resources available in your area.
posted by prefpara at 4:15 PM on February 25, 2009

Response by poster: Anyway as unproductive as I find it to nitpick about why I am trying to do certain things and not other things (at least I am trying to do something) I do personally consider diagnosis important because when this initially started after what was essentially a mental breakdown I had so much stress and anxiety that for months I (and every doctor and specialist I saw) thought we were dealing with generalized anxiety disorder. I no longer have anxiety for no reason, and eventually I had a complete paradigm shift if you will that OCD made a lot more sense. It never occurred to me for so long since I don't fit into this classic OCD what with the hand washing and unwanted thoughts of harming babies and molesting people and whatnot.
posted by dino terror at 4:16 PM on February 25, 2009

Look, no one here is going to diagnose you. There are tens of thousands of mental disorders all with different levels. There are also thousands of physical problems that can cause this. I assume you have had blood work done for typical things like hyperthyroidism, liver disease, diabetes, etc.

From your style of writing and description you at least sound like an incredibly unrelaxed person. You sound like you cannot put down an idea or stop working. This is a seriously unhealthy thing to do. This is a -classic- workaholic/stressful mindset. Some people are compulsive about knowing or doing things. You might not be addicted to your job, but working things out in your head constantly and being "majorly hell-bent on productivity" is a problem. Why are you accepting a life that's majorly hell-bent on anything?

I get this way sometimes and I really dislike it. It took me a few years to even realize I was doing it. In retrospect I become like this overly focused robot. I thought it was a gift. Its really a curse. Nowadays Ive made holistic changes in my life so I dont feel the need to do this. I have enough self-esteem to know that I dont need to be a 'superhero' 24/7 to impress people. My identity shouldnt have anything to do with my accomplishments. My happiness shouldnt be determined by competition and I shouldnt see everyone as a potential competitor. I added meditation and other relaxation techniques to my life. I take valerian root when I feel wound up and melatonin when I need to sleep. I added a bit of spirituality to my life and am not as materialistic. I eat better. I get a little exercise. I sleep better and longer (very important). I accept the fact that I wont be able to do most things in life and will never know the answers to everything. I listen to more down-tempo music. I drink very little caffeine, usually in the form of green tea or a diet coke, never coffee drinks. I dont do all of these things perfectly but a little does go a long way. Its also good to get out more, be more social, more human, outside of your comfort zone, take up a 'soft skill' like art, etc.

I really suggest you start taking relaxation seriously. You cant beat up your mind and body past a certain point. You can try the exercises in this book. You can learn very basic meditation techniques designed to stop your thinking and open the doors to calmness.

You should try these things. You should also remove the idea from your head that there's a magic diagnosis for you and a magic pill which fixes everything. There might be, but chances are you'll need to do a lot of this stuff regardless. There's a chance that your obsessive mentality is now obsessing over itself. Give yourself permission to relax and let things go. Understand that being attached to thoughts on this level is unhealthy and take responsibility for your mind. Stop beating yourself up. Start loving yourself instead. If you must have an addiction then get addiction to calmness and relaxation. Find what works for you. Good luck!
posted by damn dirty ape at 5:15 PM on February 25, 2009 [1 favorite]

Dino Terror,

I don't really believe in self-diagnosis, and think that previous posters have it right when they say "ask a doctor". But I will bring up one key point that has not been mentioned:

The major difference between OCD and OCPD hinges on ego-syntonicity. That is to say, the degree to which the ego (or rational self) either enjoys or is distressed by the thoughts that pass through his head.

OCD involves obsessions that are strongly ego-dystonic. The obsessions are described as "unwanted", "distressing", "anxiety provoking", and the compulsions develop as a form of relief. OCPD, by contrast, is ego-syntonic. Someone with OCPD does not find his obsessions stressful, but rather enjoys them, alongside the ensuing compulsions.

That being said, it sounds from your posts that you have been to many different doctors and specialists. Have you considered long-term, regular sessions with an experienced psychologist? From personal experience, the most effective progress against anxiety disorders comes from regular therapy, at least for awhile. Because progress involves actually changing your thought patterns, and this does not happen in a single sit down.
posted by HabeasCorpus at 5:18 PM on February 25, 2009

If only you could step outside of yourself, and read both your post and your circular justifications that are coded as answers. If you could, you'd realize that discerning the difference between OCD and OCPD isn't where you need to be spending your energy.

Right now you're hyper-focusing on this difference, and how you can find the answer alone, and you're trying to find the exact right online group (after you do these three other things), and justifying why you can't talk to anyone about this, and why they're wrong anyway, and look, here are all these charts you've made of various degrees of symptoms (or their absences), and now you know what that P means, and maybe now you can start to figure out why it mattered in the first place.

Those are all symptoms of the underlying issue. They are not the issue.

I'd highly suggest committing yourself to finding a team of people who can untangle this mess for you. The answer isn't in that elusive 'P.'

Print out these three posts. Take them to your next psychiatrist appointment. Which means making one if you haven't already.

Good luck. I know it's never a good time. But that kinda, inversely, means it's always a good time, ya know?
posted by barnone at 5:44 PM on February 25, 2009 [2 favorites]

If you're still in Ontario:
- Ontario OCD Network with a listing of psychiatrists and doctors and groups
- CBT Associates in Toronto

Two good places to start.
posted by barnone at 5:54 PM on February 25, 2009

In the thread associated with your original question, about your headaches, ikkyu2 said a feeling of pulsing or pressure inside the eye socket is pretty typical of migraine, and not of the other sorts of headache that have been mentioned so far-- after you called him patronizing (rather amusingly, in retrospect, for anyone who remembers how excoriating he could be when he chose).

And now you report symptoms of OCD. There are many pages out there claiming a significantly high correlation exists between migraine and OCD tendencies. Here's one I chose because it stated the conclusion felicitously:

Serotonergic dysfunction may underlie the observed
association between migraine headache, depressive symptoms, and
obsessive-compulsive phenomena.

I think it's possible for migraines to develop into OCD. I would like to see you go to a neurologist at a good clinic and be thoroughly evaluated. Good luck.
posted by jamjam at 6:48 PM on February 25, 2009

Response by poster: Interesting jamjam, I definitely to feel physical sensations although I don't know if I would call them migraines, but that would be the first I've ever heard of the physical discomfort accompanying the mental discomfort with regards to OCD which validates what I am experiencing. The first in this apparent trilogy however was about me furrowing my brow when I think which turned out to be giving me tension headaches that have stopped since I started making a conscious effort not to furrow my brow. For the record, nothing to do with parts 2 and 3 of the trilogy for anyone keeping score.
posted by dino terror at 8:48 PM on February 25, 2009

FYI, OCPD is not the same as OCD and it's unfortunate that their labels are so similar because they tend to get conflated. I can't advise on OCD, but having OCPD is kind of like being a perpetual backseat driver. You get very agitated if things aren't done the 'right' way (the right way of doing something is not subjective to the afflicted - e.g. all the shirts hanging in the closet need to be facing the same direction or the world will end), to the point of being fixated on doing it properly. Rage also play a large role in the diagnosis - if you thought everyone around you purposely wasn't acting correctly, you'd certainly be angry and hateful all the time.
posted by Burritos Inc. at 1:45 AM on February 26, 2009

Response by poster: Thanks for your input everyone... One of the things that is so great about AskMe is that everything is right there for you to go back and look at 5 years from now if you want to...
posted by dino terror at 6:46 PM on February 26, 2009