The waking nightmare of life in the grip of OCD

aramIS articles
  • Experts believe more than one million people in the UK suffer from OCD
  • Average person can have 4,000 thoughts a day – not all rational or relevent
  • David Adam has written book detailing his experience of living with illness

By
David Adam


Published:

19:35 EST, 24 April 2014


|
Updated:

08:06 EST, 25 April 2014

OCD sufferer David Adam, pictured with his daughter Lara, has written a book about his condition

OCD sufferer David Adam, pictured with his daughter Lara, has written a book about his condition

The girl was pretty, with long, black hair that she had to push back from her eyes as we kissed. ‘Shall we go upstairs?’ she asked. It was the winter of 1990 and I was a carefree college student.

Real life was on hold and time was a string of fun nights and daytime lectures. I was 18 and wasn’t thinking beyond the next day. Upstairs sounded good.

‘Did you have sex with that girl?’ asked my friend Noel the following evening.

‘Yes,’ I lied.

‘Did you use a condom?’

‘No.’

‘You could have Aids.’

‘Don’t be daft.’

I re-ran the conversation in my mind as I sipped my pint. Had I had sex with that girl? No. I had been lying to show off to my friend. So, could I have caught Aids? Don’t be daft.

Still, an echo of our conversation — you could have Aids — floated back into my mind from time to time over the next few months.

Each time, I could muster the mental puff to blow it out. Until one hot night in the August of 1991, I suddenly couldn’t. Like a snowflake falling from a summer sky, my obsessive compulsive disorder began.

For some people, it’s washing their hands or keeping their homes impeccably tidy. For me, it was a sudden, inexplicable, irrational fear of this killer disease.

(These were the days, I should remind you, when those fearsome tombstone government TV adverts reminding us not to ‘die of ignorance’ were still fresh in people’s minds.Though it’s now known to be a fragile virus that can’t survive for long  outside the body, back then Aids was presented as a death sentence with no treatment — a hideous consequence, it seemed, for a moment of carelessness.)

As I tried to brush away the thought — the snowflake — it squirmed from my mental grasp and settled.

Quickly it was joined by another, then another, then another. The blizzard that followed blew the snow into every corner of my mind and laid down a blanket that muffled every surface.

Why me? I was so frightened that the tips of my fingers tingled. As I went to bed that night, I told myself that everything would be fine the next morning.

It wasn’t. The thought was still there. I went downstairs to the kitchen the following morning and had breakfast in the new world I would inhabit from that day onwards — the first of the rest of my life.

An average person can have 4,000 thoughts a day, not all of them useful or rational. Among them are those occasional random and unprompted ideas that seem to emerge from nowhere and stun us because they are disgusting, sickening — or weird.

The seductive question, for example, ‘what if’? What if I were to jump in front of that bus? What if I were to punch that woman?

Most people have these kinds of strange thoughts. Most shake them off. But some can’t, and don’t. I am one of those people.

As recently as the Eighties, psychiatrists thought clinical obsessions (unwanted, intrusive, irrational thoughts that won’t go away) and compulsions (an irresistible urge to act in a way that is irrational, to perform a meaningless ritual) were extremely rare.

But they now believe that between two and three per cent of us — more than a million people in Britain — suffer from OCD at some point in our life.

Put simply, most people with OCD develop their compulsions as a way to make their unwanted intrusive thoughts go away. They can feel compelled to tap surfaces, count or say secret words to themselves to ‘undo’ the imagined consequences of an intrusive thought — for example, that their best friend will die in a road accident.

Obsessive washing of hands is a common symptom of OCD (Obsessive Compulsive Disorder) - a chronic and recurring neurotic condition

Obsessive washing of hands is a common symptom of OCD (Obsessive Compulsive Disorder) – a chronic and recurring neurotic condition

Even though there is no conceivable link between the two, the compulsion makes the obsessive thought go  away — briefly.

The tragedy for sufferers is that an intrusive thought silenced with a compulsive act comes straight back. And it comes back hard.

From that day on, I was obsessed with ways I could catch Aids. I saw it everywhere. It lurked on toothbrushes and towels, taps and telephones.

I wiped cups and bottles, hated sharing drinks and covered every graze with multiple plasters. I even checked train seats for syringes.

My rational self knew these fears were ridiculous. I knew I couldn’t catch a disease in those situations. But still the anxiety kept coming.

I started spending a lot of time on the phone to the National Aids Helpline. Was there a risk when I played football and scraped my knee? Someone could have left a smear of infected blood in the exact spot. No, they responded, the risk is very low.

I believed them — for just as long as it took to replace the handset in the phone box near my student house.

But wait. Very low? So there was a risk? I’d call them back, just to confirm. I dialled the number dozens of times a day.

When I thought they’d started to recognise my voice, I put on different regional accents. Even after the kind people at the other end gently suggested I should talk to a psychiatrist rather than them, I wouldn’t admit I needed help.


 Put simply, most people with OCD develop
their compulsions as a way to make their unwanted intrusive thoughts go
away.

It was not for another three or four years that I finally gave in and saw a specialist. He gave me a red rubber band and told me to wear it on my wrist and snap it against my skin whenever I had an intrusive thought I didn’t want.

Twenty years ago, this was the treatment for OCD. It was called thought-stopping — and it was useless. My band lasted a few hours. The next one survived a day.

I went to a budget stationery shop and asked for the biggest bag of rubber bands they had. I tried it for a few more days, then I gave up.

Instead, I taught myself to avoid the situations that would prompt the unwanted thoughts and urges and worked out ways to avoid them.

If I was unsure whether someone else had drunk from my glass, I didn’t finish it. If an opponent on the astroturf football pitch shredded his knee, I would avoid him.

I had good days and bad days – though more bad days. When things became dire, when a thought just would not budge, I’d take myself off to give blood. That way I would be tested for HIV and they would reassure me I was all right.

It wasn’t that I couldn’t function or that I couldn’t think or do anything else. I did well in exams, I had friends and girlfriends and held down some decent jobs. It’s just that I was thinking about something else at the time.

I was on autopilot. I looked the part and smiled at the passengers, but something else was flying the plane.

My baby daughter was six months old when I noticed the blood on her leg. It was a hot day in 2010 and she was wearing a pair of shorts as we played on the swings in the park. There, above her knee, was a dull smear of red.

There was no obvious cut or graze. Where had it come from? Was it my blood? I checked my hand and, sure enough, there was a small scratch.

Click. My mind delivered another scenario. It could be someone else’s blood. And it could be infected.

I couldn’t see any blood on the swing nor on the grass underneath — even though I returned to that playground at least a dozen times that day.

Experts believe that between two and three per cent of British people - more than a million people in UK - suffer from OCD at some point in their life

Experts believe that between two and three per cent of British people – more than a million people in UK – suffer from OCD at some point in their life

I still couldn’t see any when I came back with a torch to have another search that evening.

I was 38. It was almost 19 years to the day since that first summer night when I discovered that I could not ignore my intrusive thought.

You could have Aids. She could have Aids.

Before that momentous afternoon four years ago, I had settled for a life with OCD. I reversed that decision the day I made my baby daughter an accomplice.

I phoned my local doctor the next morning to make an appointment. It stopped here. It stopped with me.

The staff at my local psychiatry unit told me to report back for group therapy. There were no guarantees, they said, but they thought they could help.

If you were to have peered through the window of those group therapy sessions during the late summer of 2010, you’d have spotted nothing unusual. A group of middle-aged people sitting in a circle.

No one washing their hands or trying not to. We could have been learning a foreign language, so civilised did it seem.

Between us, we ticked most of the boxes — contamination and checking fears, long-standing symptoms, distress and reduced quality of life. 

Probably because we had all been young during the era of those infamous tombstone adverts, two of the others had obsessions and compulsions linked to Aids.

We swapped stories and tried not to swap irrational fears. We learned how the compulsions are a short-cut that helps relieve anxiety, but only for a short while.

We started to identify the dysfunctional beliefs and cognitive errors in ourselves. We started to diagnose them in each other.

This was cognitive behavioural therapy (CBT), but it didn’t feel like the type of treatment we’d expected. It was mild. We suspected that worse was to come.

We were right. I was told to go home and smear my daughter in my own blood.

Shocking though this sounds, it was part of a treatment for OCD known as exposure and response prevention. It works like this.

Get the person anxious by stimulating them with the object of their obsession, and then let the anxiety peak and plateau of its own accord. In time, it has nowhere to go but down.

Once the patient feels their anxiety go away by itself, without the need for compulsions, they will lose their fear and start to recover.

Because I feared, probably more than anything else in the world, to touch my daughter with blood on my hands, I was told that the next time I scratched myself or cut myself shaving, I was to seek her out and daub her face, her head, her exposed arms and legs.

 An average person can have 4,000 thoughts a day, not all of them useful or rational.

The anxiety would peak. But then, in time, it would come down.

Strangely, even the thought of this helped me. And the reason? Because someone else was offering to take responsibility for my actions. ‘I have a good job and I get paid a lot of money,’ the therapist had told us. ‘If I tell you to do something, and something bad happens as a result, then you can blame me.

‘I will get sacked. Do you think I would ask you to do something that will get me sacked?’

If I had blood on my fingers, touched my daughter and gave her Aids, then it wasn’t my fault. It was his. He’d told me to do it.

The end result would be the same. My daughter would still have the virus. But that didn’t seem to matter as much if it was his job to stop it and not mine.

Somehow, it just didn’t seem as likely to happen any more.

Suddenly, I had a sense of perspective. My consciousness soared above my fears, as a camera draws out from a single house on a map to show the street, the town and then the surrounding countryside.

Previously, my OCD interfered with this process. No matter how much I tried to make the camera pan out, the irrational fear stayed in view, like a dirty smudge on the lens. Suddenly, the risk of contracting a disease from all those unlikely routes shrank as I rose above to see them in their proper context.

Psychologists call this moment of clarity ‘the helicopter view’. We see the landscape in its proper scale.

From 10,000ft up, the gap between very low risk and zero risk — so visible and so important to my OCD — is hard to distinguish.

David Adam tried cognitive behavioural therapy (CBT) to help treat his OCD (picture posed by models)

David Adam tried cognitive behavioural therapy (CBT) to help treat his OCD (picture posed by models)

It can be hard to access good CBT and I will always be profoundly grateful that I did. It worked for me. And no, I never did smear blood on my daughter.

Four years on, I feel much better now. But I will probably always have OCD.

For most people it’s like being a recovering alcoholic. You are always only a certain number of days past your most recent obsessive- compulsive episode.

One of the first things they did at that OCD clinic was put me on drugs.

Sertraline hydrochloride is what chemists call a psychotropic medication. I call it a lifeline, a route back to the light from the darkest regions inside my head.

How long will I take it for? I don’t know. I’m afraid to stop: rapid relapse among those who do is common, apparently. But I don’t see a downside.

My OCD rarely causes me distress now. The snowflakes still tumble from the summer sky. But I have learned to make them melt away again.

  • Extracted from The Man Who Could Not Stop: OCD And The True Story Of A Life Lost In Thought by David Adam (Picador, £16.99). © 2014 David Adam. To order a copy for £14.99 (including PP), tel: 0844 472 4157.


Comments (247)

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The comments below have been moderated in advance.

garyhaywardcom,

UK, United Kingdom,

1 day ago

For some teenage years, I had OCD really bad. Not just bad thoughts and washing hands; the worst was ending up having to get out of bed ‘the right way’, ‘perfectly’, but according to an additional criterion of doing so on multiples of three, six, then nine–imagine having to get in and out of bed eighty-one times (nine times nine). I sat in despair at my ‘failings’ and from sheer mental and physical exhaustion; occasionally, thinking I might as well be dead. I was even offered an in-patient place at a local mental hospital; I declined: I had, and knew it, a perfectly well functioning, reasoning mind; it was just the urges–compulsions–felt so strong and not carrying them out, so bad. It all ended when I walked into the living room one morning and saw my mother in despair, head in hands over it all; literally, at that moment, I just ‘took control’ of myself and that was that. A big, but tolerable, sacrifice–the thought I should go on as before quietly tugging at the back of my mind.

Kitty,

Kittybox, United Kingdom,

1 day ago

I have seen a man the other day who was having a whole ritual while locking his car, then checking that it was locked over and over again, then counting the doors of his car, it took him a while before he was happy that he can now leave the car and go his own way – it must be really awful living with this kind of disorder and I truly feel sorry for those suffering from this.

sephryclub87,

bristol, United Kingdom,

1 day ago

OCD is merely people attempting to control everything in their lives……………….some things are just out of our control and we need to accept that

Johhanes,

Glasgow, United Kingdom,

1 day ago

The French called OCD the doubting disease and it is a nightmare when it spins out of control. People with OCD hate uncertainty and it is the fear they have done something or could do something that fuels the obsessions. They do compulsions to avoid the anxiety but this only beings temporary relief from them. It has also been shown by neurologists that people with OCD’s brain scans show differences compared to people without the illness.

Mike,

London,

1 day ago

How do they know we have 4000 thoughts a day?

Dean,

Ottawa, Canada,

1 day ago

I’m living proof that OCD can be beaten without professional help. It wasn’t until my friends told me one day that some people had said they’d seen me walking home and stumbling all over the place, they thought maybe i was drunk. I wasn’t drunk, i had to touch every drain cover on the pavement with both my feet therwise i just didn’t feel right.

MartinD32,

BluegrassCity, United States,

1 day ago

My first boyfriend had OCD. He sprayed everything with Windex and would buy about 20 bottles of Wet Ones (Baby Wipes) and go through them in a week. Sometimes my feet couldn’t touch the floor, I’d have to stand on one foot while he cleaned the floor or my shoes. One time he put money and my bra in the microwave to decontaminate it and they caught on fire. Yeah, that was miserable…I don’t wish OCD on anyone.

Kay,

England, United Kingdom,

1 day ago

I cannot believe some people are so nasty. Those commenting on this awful condition, but have never experienced it, should go and do some research. I wouldn’t wish it on my worst enemy. I had/have OCD to the point where I scrub my hands raw, occasionally they bleed. I smashed a lidded tin up completely yesterday, with my bare hands because I saw it had a crumb, from the contents, on the lid. Previous to this episode I hadn’t done anything of this nature for over a year. Why? Because I had practically been drinking opiates to block that, and other things, out. Now I’ve stopped taking the opiates, now the OCD has reared it’s ugly head. Wonderful.

Deena,

London,

1 day ago

Having OCD, I understand him. I always worry I might have HIV or AIDS. I know I dont have it, but my mind keeps telling me I might have it. It use to be worse, I washed so much my skin was red and often bled. I use to shower 5/6 times a days and couldn’t stop. I now only was once (maybe twice if im having a bad day) a day.

earlybirdmel,

Surrey,

1 day ago

My homeopath focuses entirely on the mental issues with her treatment. She is a classical homeopath and the remedies prescribed heal right to the core of the individual – the mental/emotional symptoms. I have been on medication for anxiety depression OCD and panic attacks due to Lyme disease for the last five years. A year of 12 homeopathic appointments and I have no negative mental symptoms. I came off my antidepressants within four weeks of starting treatment. I realise it costs money but if you can afford it and want to try a natural drug free approach to healing I can’t recommend classical homeopathy highly enough for issues like OCD.

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