Coping with Existential OCD / fear of going crazy.
May 3, 2019 11:26 PM   Subscribe

I'm going through an extended bout of Existential OCD, and having a hard time navigating my way through. Looking to hear some success stories for people who have successfully managed or learned to live with this particular strand of the disorder.

In terms of defining my experience, I'd say this is the closest I've found to a clear explanation. There's some crossover with more traditional depersonalisation/derealisation as well.

I've suffered from GAD since I was a teen (currently in my late 30s) triggered from too much pot use, and when things get to a certain point, I immediately slip into these existential ruminations that can last for weeks and months - trying to intellectually drill down into totally unanswerable questions that go nowhere, which end up just increasing my baseline anxiety/arousal and then having knock on effects into other areas of my life like sleep, family, work etc.

I'm at a particular annoying spot at the moment where I get these really strange thoughts/sensations which I can only describe as a 'rush' of consciousness. These split second realisations that I am an embodied being with thoughts and feelings, and the sheer impossibility of being something rather than nothing.

Rather than being able to feel a sense of awe or wonder though, this triggers off a real primal fear which drives the compulsive thoughts to try to 'figure it all out' even though I know I can't logically, that my questions are unanswerable. When I manage to re-engage with normal activities/thoughts, I have this compulsion to actively seek out these disturbing thoughts like it's an itch I can't stop scratching, and the whole cycle just perpetuates from there. It's nothing disabling or crippling now, but it doesn't feel good to say the least. Again, lots of bog standard anxiety stuff here, but the existential flavour of it is what throws me for a loop and has me convinced these thoughts are Very Important To Think.

I've been on SSRI's which have managed this before by the sheer nature of just lowering my baseline anxiety state, however medication is not an option right now, and I'm not so hot on supplements like herbs/amino acids.

I have a very active mindfulness practice spanning 20 years, and have a particular interest in Tibetan Buddhism which covers some of these 'big questions' in a way that I can engage with, but I haven't really been able to break through in a way that has been meaningful off the cushion. I also have long term therapist who I see weekly who is helping me through this.

From an intellectual level, I've found the philosophies and ideas behind ACT therapy very grounding, but when it comes to practical purposes I just find it impossible to put into practice. Even with my longstanding mindfulness practice, the actual reality of being able to step back from my thoughts and give things space just doesn't seem to happen for me.

Like most others who suffer from anxiety disorders, things on the surface are fine. I run a successful business, play team sports, have a healthy family etc. Inside my head though it's another story, and the content and frequency of these thoughts and feelings trigger these typical anxiety fears of going crazy / losing ones mind. Even though I've been grappling with this stuff for years, and nothing bad has ever happened, it's almost a bit like being in Groundhog Day where each time it happens you just forget all that and it feels just as raw and awful each time it comes up.

So yeah, that's the long and short of it. I know I'm not alone here because so much has been written about this, but like everything else on the internet it's easy to find horror stories, and harder to find actual examples of people who have lived with this which I feel would be really helpful for me at this juncture.

I know this is not something I can make go away - I know the desire to make it go away makes it worse. I know that I'll have to live with this - but I'm just not sure what that means or how to do it. If any of this resonates with you, I'd love to hear any strategies or resources that you found helpful :)

Please note - I'm not looking for alternative diagnoses or anything like that. I can get really triggered by that kind of stuff, especially on the green, so please only reply if this condition/pattern is something that you have first-hand experience with, and can offer constructive comments or suggestions. Thank you!
posted by anonymous to Health & Fitness (6 answers total) 4 users marked this as a favorite
 
OCD is a really crappy disorder and almost impossible to treat without highly qualified help. Talk therapy can make it worse. Meditation makes it worse. Meds alone won't cut it.

I do have first-hand experience and the most constructive advice I can give you is that you need intensive treatment at a place that specializes in OCD, like McLean OCD Institute outside Boston. The OCDI specializes in exposure and response therapy--this is impossible to do on your own--as well as acceptance and commitment therapy.

Before you or others say that's dramatic, I can tell you I have years of experience with OCD and the OCD Institute and it is consistently the only program I have ever seen taken people with OCD and give them tools to live. Check their website and you'll see their program specifically speaks to your symptoms.

You mention mindfulness but what you're not seeing is that right now, your practice is the thing that's making you worse. You're ruminating and obsessing in the name of Buddhism and need to learn how stop. You will learn how to end rabbitholes. You will learn how to tell your obsessive thoughts that they are not Very Important Ideas that must be followed and considered. You will learn that flooding feelings of Big Ideas are just feelings and now it's time for lunch, nothing more.

You know from your question that this is not a sustainable way of living. I also think, like most people with OCD, you may resist treatment. That's okay. But you need to know it's out there, and that further rumination and meditation and discussion without therapeutic exposure techniques in place are not helpful. And you can feel better.

Your note at the end is so classic for a person with OCD I an sending you a virtual hug if you want one.
posted by yes I said yes I will Yes at 3:41 AM on May 4, 2019 [8 favorites]


This part here

I'm at a particular annoying spot at the moment where I get these really strange thoughts/sensations which I can only describe as a 'rush' of consciousness. These split second realisations that I am an embodied being with thoughts and feelings, and the sheer impossibility of being something rather than nothing.

Rather than being able to feel a sense of awe or wonder though, this triggers off a real primal fear which drives the compulsive thoughts to try to 'figure it all out'


Strikes me as a cycle of: thought -> adrenal response (cortisone) -> heightened bodily awareness & realization that we are all alive and thus ultimately susceptible to death at any moment-> fear -> pop into your head to avoid the fear

Can I suggest to try to stay out of your head and in the sensation of fear itself? There is nothing to figure out. It’s the primal fear of being alive. On the other side is great peace and (ultimately) an open heart / universal love / enlightenment if you can just walk through the valley of that terror. (This is what the monk I studied with told me when I had a panic attack similar to what you describe.) Buddhists work really hard to get past the illusion and feel the aliveness you describe. That is closer to ultimate truth that Buddha taught but you have to make peace with the fear.

As a fellow “what does it all mean” person, I have found great solace in Tibetan Buddhism, been practicing weekly at temple with a study group for 10 years now. Feel free to pm me and maybe I can suggest stuff in your area.

Then when the existential terror hits, I do refuge practice (Mahayana Buddhism) in conjunction with bodily presence as described above. It deepens my practice.

Try to stay out of your head as much as possible. You can totally transform this.

Hugs.
posted by St. Peepsburg at 12:53 PM on May 4, 2019


Congrats! You've identified an OCD thought pattern/behavior that is negativity impacting your life. You've also realized the fruitlessness of trying to "solve" the intrusive thought through spending more time/effort on it. To me, that means you're now much closer to a path of recovery. :)

While intensive treatment might be necessary, once I recognized that "yes, this is OCD & it needs to be addressed as such" instead of therapy or meditation or whatever so solve my OCD related intrusive thoughts), I was able to shift the direction of therapy & personal coping skills into a more productive path.

For me, this meant focusing on my behavior around a trigger thought, instead of the concern. OCD is easier to recognize and (probably) discuss if there's a concrete obsession and compulsive behavior, say, like: someone who has a fear of spoons, and doesn't eat soup or cereal or have spoons, including measuring spoons in their house and whatever...

What helped me to talk about it and get help was to use the following script:

"whenever I have this thought, I feel an intense fear and a strong need to..." sentiment above, and then added "so, I decided the next time I had the thought, I wouldn't act on it. 5 minutes later [I felt] 10 minutes after that [this happened] , and at 20min I gave in and attended to the thought. The trigger happened again [days/hours] later & delaying caused the following things." I think my concerns about [the thought] might actually be OCD. Can we explore that?
posted by bindr at 1:09 PM on May 4, 2019 [1 favorite]


I don't have OCD, but I have researched it, and have an article published in a top journal that you might find it helpful if you are seeking more insight. The main take home point is that there's a 'uncertainty signal' in your brain that's hyper-active for you. It's likely that your philosophical questions are a kind of rationalisation of that signal for you (that is, your uncertainty isn't caused by the philosophical issues, the philosophical issues are a post-hoc way to explain why you're feeling so uncertain). Other people rationalise that signal with other ocd-themes- they all tend to be doubts that are hard to confirm (what if there are invisible germs? What if God is judging me? what if my memory is bad?). What you are ultimately aiming for in your therapy (short of a drug that can turn that signal off) is a way to look at it and go 'oh that signal is playing up again'.

As a professional philosopher- it is striking to hear one's day to day profession described as a pathology. Still, I get that what's going on with you is different. Just on the philosophy, I can add that I sometime experience (mild pangs of) depersonalisation when considering deep philosophical issues. I've always thought of it as like vertigo, a kind of dizziness when you 'look down' at the foundations of the universe and they seem so unstable (i.e. we can't see what makes our universe necessary, where to be necessary is to be 'solid'). Anyway, the point is that those feelings may be relatively 'normal' in the context of philosophical anxiety.
posted by leibniz at 6:28 PM on May 4, 2019 [3 favorites]


I'm someone who is on SSRIs for anxiety. Before I went on them I was so bad I couldn't function. It was absolute hell.
One thing I have realised is that I cannot meditate. It makes everything much worse. It is an absolute lie that all anxious people should meditate - when I used to do it it took me to a similar horrible, existential place to the one you describe. I never want to go back there - and since I stopped meditating I haven't been back.
If you start doing a bit of googling you'll find heaps of anecdotal evidence for the same. Stop meditating. Instead, you could listen to rain sounds, white noise, sounds of nature etc. Those things help me.
posted by thereader at 7:13 PM on May 5, 2019 [3 favorites]


Also, I did acceptance and commitment therapy for anxiety and it was far, far better than CBT (which I have also done). I would definitely recommend that too.
Another one is to get out of your head and into your body, using your senses (what can i see, what can I hear, what can I feel etc.)
posted by thereader at 7:17 PM on May 5, 2019 [1 favorite]


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