OCD: The Reality, The Research, The Recovery -- Part One

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[00:00:46] [SPEAKER_03]: Welcome to our award-winning podcast, Mental Health, Hope and Recovery.

[00:00:51] [SPEAKER_03]: I'm Helen Sneed, and I'm Valerie Milburn.

[00:00:56] [SPEAKER_03]: We both have fought and overcome severe chronic mental illnesses.

[00:01:01] [SPEAKER_03]: Our podcast offers a unique approach to mental health conditions.

[00:01:04] [SPEAKER_03]: We use practical skills and inspirational true stories of recovery.

[00:01:10] [SPEAKER_03]: Our knowledge is upclosed and personal.

[00:01:13] [SPEAKER_02]: Helen and I are your peers.

[00:01:15] [SPEAKER_02]: We're not doctors, therapists or social workers.

[00:01:18] [SPEAKER_02]: We're not professionals but we are experts.

[00:01:21] [SPEAKER_02]: We are experts in our own lived experience with multiple mental health diagnoses and symptoms.

[00:01:28] [SPEAKER_02]: Please join us on our journey.

[00:01:31] [SPEAKER_03]: We live in recovery. So can you.

[00:01:35] [SPEAKER_02]: This podcast does not provide medical advice.

[00:01:38] [SPEAKER_02]: The information presented is not intended to be a substitute for or relied upon as medical advice, diagnosis or treatment.

[00:01:46] [SPEAKER_02]: The podcast is for informational purposes only.

[00:01:50] [SPEAKER_02]: Always seek the advice of your physician or qualified health providers with any health related questions you may have.

[00:01:58] [SPEAKER_02]: Welcome to episode 45, overcoming obsessive compulsive disorder.

[00:02:06] [SPEAKER_02]: Here we are taking on obsessive compulsive disorder.

[00:02:11] [SPEAKER_02]: OCD is our topic today and it's a first for us because you know Helen neither one of us has OCD.

[00:02:21] [SPEAKER_02]: And in all of our other episodes, one or both of us has fought the illness we've covered.

[00:02:28] [SPEAKER_02]: So this is really unprecedented and what we've discovered is this is a topic so vast and complex.

[00:02:35] [SPEAKER_02]: We have divided OCD into two episodes.

[00:02:40] [SPEAKER_03]: Two episodes are necessary for many critical reasons that our listeners will want to hear about.

[00:02:47] [SPEAKER_03]: And one of the things we always try to do first is to legitimize a mental disorder.

[00:02:54] [SPEAKER_03]: To promote understanding and empathy for those who have the illness.

[00:02:59] [SPEAKER_03]: No where I have decided is this more important than with OCD.

[00:03:04] [SPEAKER_03]: I often hear someone say, oh I have a touch of OCD.

[00:03:08] [SPEAKER_03]: No they don't.

[00:03:10] [SPEAKER_03]: People who don't understand it can trivialize it without meaning to.

[00:03:13] [SPEAKER_03]: When in fact, it's a very serious and debilitating illness.

[00:03:19] [SPEAKER_03]: To help us explain and enlighten us, we have some great experts on hand reports one and two.

[00:03:26] [SPEAKER_02]: Yes, we will have two guests to help us delve into this vast topic of OCD.

[00:03:32] [SPEAKER_02]: And both are indeed experts, one a professional and one a peer.

[00:03:38] [SPEAKER_02]: Dr. Jenny Fullerton will be joining us next month in part two and we'll bring us the professional perspective.

[00:03:46] [SPEAKER_02]: Today, we will join Mel on her journey and hear her peer perspective as Mel shares her lived experience with OCD.

[00:03:58] [SPEAKER_02]: Helen Mel will also be sharing her lovely British accent with us from London.

[00:04:02] [SPEAKER_02]: And I got to think, you know, I think our listeners will enjoy the break from my southern draw.

[00:04:11] [SPEAKER_03]: Well, in my mind, my niece Texas and so, you know, again we're just so grateful to have someone who sounds so cool.

[00:04:19] [SPEAKER_02]: See it. Oh man, her discussion with me yesterday is so amazingly insightful and I can't wait to share her comments.

[00:04:32] [SPEAKER_02]: She has been in recovery for alcoholism since she was 22 years old and is now 15 and a half years sober.

[00:04:39] [SPEAKER_02]: Mel has also been abstinent and recovering from binge eating disorder through over-readers anonymous for the past five years.

[00:04:46] [SPEAKER_02]: And Mel has a long history with obsessive compulsive disorder and her symptoms started very young around age five or six.

[00:04:54] [SPEAKER_02]: She has also struggled with the co-occurring conditions of tricatelomania, hair poline and dermatalomania skin picking.

[00:05:03] [SPEAKER_02]: Now it took a long time for her to find the appropriate help and support for OCD, but thankfully she has been in recovery with OCD for the past seven years now and has experienced a great deal of healing around the very debilitating condition of OCD.

[00:05:19] [SPEAKER_03]: As always, we like to just start with a little background and first of all, the definition. What is OCD? This is from the Mayo Clinic.

[00:05:29] [SPEAKER_03]: Obsessive compulsive disorder features a pattern of unwanted thoughts and fears known as obsessions.

[00:05:36] [SPEAKER_03]: The obsessions lead to doing repetitive behavior, also called compulsions.

[00:05:41] [SPEAKER_03]: And these obsessions and compulsions get in the way of daily activities, and he causes a great deal of distress.

[00:05:49] [SPEAKER_03]: Ultimately, the individual feels driven to do compulsive acts to ease mounting stress.

[00:05:56] [SPEAKER_03]: Even trying to ignore or get rid of bothersome thoughts or urges doesn't work. They keep coming back.

[00:06:03] [SPEAKER_03]: And this leads a person to act based on ritual. And this is the vicious cycle of OCD.

[00:06:10] [SPEAKER_03]: Now we found a basic formula that sort of sounds deceptively simple, but here's what it is. Obsessive thoughts, obsessions lead to repetitive behaviors compulsions.

[00:06:24] [SPEAKER_03]: So now let's hear from someone who actually has it.

[00:06:29] [SPEAKER_03]: We'll describe her definitions of OCD.

[00:06:33] [SPEAKER_00]: OCD is a bit like having your, if you can imagine your worst fear, whatever that might be.

[00:06:41] [SPEAKER_00]: Imagine that playing out on a repeat cycle in your mind at the forefront of your mind over and over and over again 20 or 7.

[00:06:50] [SPEAKER_00]: And not only is there a thought process that's obsessive, but it feels so real. So you know whatever the obsessive and true-sif thought is all the feelings that you would associate with that fear are present as well.

[00:07:08] [SPEAKER_00]: As if it were actually happening to you, and there's essentially what you feel is this urgency, this absolute urgency to find safety immediately.

[00:07:18] [SPEAKER_00]: And so that's the obsessive part. The compulsive part is the behaviors that we do to set our mind at ease for easing comfort really, you know, to get rid of the thoughts or the urges or the feelings or to prove them wrong in some way.

[00:07:35] [SPEAKER_00]: It's like walking around with your worst nightmare when I explain OCD to people often.

[00:07:42] [SPEAKER_00]: What doesn't get as much traction perhaps in the media, that is this idea of what actually are compulsions because people often know the kind of obvious compulsions outward external compulsions like checking locks or washing hands.

[00:07:58] [SPEAKER_00]: But a lot of OCD sufferers, the actual compulsions that they suffer with are often internal mental rituals that go on. So reassurance seeking is a massive one checking mentally checking things emotionally checking things, praying, researching, you know, reading things over and over again avoiding things.

[00:08:21] [SPEAKER_00]: So I like to when I talk about OCD to really make that distinction because there are lots of people that struggle with this type of issue, but they don't necessarily see it because they don't identify that what they're doing in their heads is a mental compulsion.

[00:08:38] [SPEAKER_03]: Now what are the symptoms of OCD?

[00:08:40] [SPEAKER_03]: The onset of symptoms begins gradually and varies throughout life. It usually begins in teen or young adult years and sometimes in childhood.

[00:08:51] [SPEAKER_03]: Now, mail described her early onset symptoms and what it was like for her.

[00:08:56] [SPEAKER_00]: I experienced symptoms very, very young. So I was about age five or six and I think the first obsessive thoughts that I grappled and struggled with was around death dying and going to hell.

[00:09:11] [SPEAKER_00]: And I would have reminations around that theme slightly later on when I was about 10, 11, 12.

[00:09:21] [SPEAKER_00]: I started to become very obsessed with the notion of contracting aids and getting a lot of irrational fears around that and around illness.

[00:09:31] [SPEAKER_00]: I would experience lots of sexual and trusive thoughts and I was really, really disturbed by it.

[00:09:39] [SPEAKER_00]: Of course, because I was so young, I didn't have an awareness that you know what I had was obsessions and what I was doing about it was compulsive but I had a whole bunch of compulsions from obsessive praying to push the thoughts away.

[00:09:57] [SPEAKER_00]: Lowes of remination. It also massively increased my sense of isolation because I had no one to talk to about it. I felt very weird the content of the thoughts felt very odd.

[00:10:11] [SPEAKER_00]: So essentially, I just felt like an alien really so those were my very early experiences with OCD and the impact at that age.

[00:10:20] [SPEAKER_03]: So right now, let's try to break down sort of the mechanics of OCD symptoms that could cause an effect and how OCD works.

[00:10:30] [SPEAKER_03]: All right, there are two kinds of symptoms, obsessions symptoms lasting and unwanted intrusive thoughts or urges that cause distress and anxiety.

[00:10:38] [SPEAKER_03]: And a person may try to get rid of them by acting based on ritual.

[00:10:45] [SPEAKER_03]: And then there are compulsion symptoms repetitive behaviors that you feel driven to do.

[00:10:51] [SPEAKER_03]: Now these are meant to reduce anxiety but bring no pleasure and offer only limited relief.

[00:10:57] [SPEAKER_03]: Compulsions can be beyond reason, and they often don't relate to the issue they're intended to fix so you can see how this can become rather misdefined.

[00:11:06] [SPEAKER_03]: Now here is just a couple of cause and effect. The sequence of obsessive thoughts created compulsive actions.

[00:11:14] [SPEAKER_03]: All right, so first off, a fear of contamination or dirt.

[00:11:19] [SPEAKER_03]: So the this leads to the obsessive thought of the fear of touching things that others have such as door knobs.

[00:11:26] [SPEAKER_03]: It leads to the action of hand washing, but it's going to be sometimes dozens of times a day.

[00:11:32] [SPEAKER_03]: Or avoiding situations that can trigger obsessions such as shaking hands, you can see how that would do the same thing.

[00:11:39] [SPEAKER_03]: All right, here is another obsessive thought that the person has not locked the door or turned off the stove.

[00:11:46] [SPEAKER_03]: And so the action becomes checking the doors and locks over and over checking the stove over and over.

[00:11:52] [SPEAKER_03]: This can leave a person unable to leave the house for hours if at all.

[00:11:57] [SPEAKER_03]: And here's one obsessive thought, needing things to be orderly and balanced.

[00:12:03] [SPEAKER_03]: And the action is counting and counting in certain patterns and such as it's counting you know quietly inside the heads such as the tiles on the bathroom floor.

[00:12:15] [SPEAKER_03]: How many people on the bus are wearing yellow.

[00:12:18] [SPEAKER_03]: The number of bristles on a hairbrush.

[00:12:21] [SPEAKER_03]: It just can go on and on and on.

[00:12:24] [SPEAKER_03]: Now, other obsessive thoughts can become very disturbing and aggressive thoughts about losing control or harming others.

[00:12:32] [SPEAKER_03]: And one, it thoughts of aggression, sexual or religious objects.

[00:12:37] [SPEAKER_03]: And these extreme obsessions can lead to suicidal ideation or behavior when compulsive actions don't allow the torment and fear.

[00:12:45] [SPEAKER_03]: JJ Healer said, OCD is not a disease that bothers.

[00:12:53] [SPEAKER_03]: It is a disease that tortures.

[00:12:57] [SPEAKER_03]: Now, the severity of symptoms varies over a lifetime.

[00:13:03] [SPEAKER_03]: Symptoms get worse in times of greater stress or transition, change, loss, trauma, even physiological changes such as effluxuation of hormones.

[00:13:14] [SPEAKER_03]: And if they're most severe, symptoms are extremely disabling.

[00:13:21] [SPEAKER_02]: There are a few subtypes of OCD and one hell in you and I learned about from Mel once of type of OCD is called ego-destonic,

[00:13:30] [SPEAKER_02]: which means that the thoughts and compulsions experienced or expressed are not consistent with the individual self perception and reflect the opposite of their values and desires.

[00:13:41] [SPEAKER_02]: Mel gave an wonderful explanation of this.

[00:13:45] [SPEAKER_00]: One of the things that I learned about OCD that was very helpful to me is that it is ego-destonic, meaning that OCD will find the thing that you value most in your life and you care about most in your life

[00:13:57] [SPEAKER_00]: and it will turn it against you and convince you that it will wallpip.

[00:14:02] [SPEAKER_00]: And so for example, you meet the love of your life.

[00:14:07] [SPEAKER_00]: You get relationship OCD which convinces you that you're not really in love and you have to leave them or you really value being protective if you loved ones

[00:14:15] [SPEAKER_00]: and looking after them and caring for them OCD will convince you that you have urges to harm them.

[00:14:20] [SPEAKER_03]: It's extraordinary to hear about that and it leads to another basic question.

[00:14:26] [SPEAKER_03]: What are the causes of OCD?

[00:14:28] [SPEAKER_03]: Well, there's biology, changes in chemistry or brain functions, genetics.

[00:14:36] [SPEAKER_03]: There's no specific gene of course but many people believe that there may be a cause for predisposition from relatives.

[00:14:45] [SPEAKER_03]: And finally, learning OCD can be learned from watching family members which is what makes me suspect that it can start so early in life.

[00:14:55] [SPEAKER_03]: What are the risk factors for developing OCD?

[00:14:58] [SPEAKER_03]: Family history, stressful life events and other mental health disorders.

[00:15:04] [SPEAKER_03]: Again, there's a real problem with comorbidity where the person's got more than one illness you imagine trying to sort through all those symptoms.

[00:15:14] [SPEAKER_03]: Now here are males, personal causes for OCD in her life.

[00:15:20] [SPEAKER_00]: Firstly, of course, I'm not a medical professional but I am an expert on myself.

[00:15:26] [SPEAKER_00]: I am an expert on my lived experience and for me, I believe that the word genetic factors in my family, there was likely a genetic load.

[00:15:37] [SPEAKER_00]: But I really think that trauma of early life experiences and dysfunction of early life experiences really shaped my brain in a particular way.

[00:15:47] [SPEAKER_00]: There was a tremendous amount of unsafety in my household growing up.

[00:15:53] [SPEAKER_00]: And I believe that my OCD was my brains attempt to try and look after me, to keep me safe, to give me a semblance of control.

[00:16:05] [SPEAKER_00]: I mean, really when you look at OCD, what is it about?

[00:16:08] [SPEAKER_00]: It's about not being able to live with and tolerate uncertainty.

[00:16:13] [SPEAKER_03]: We also want to look at the difficulties in diagnosis.

[00:16:17] [SPEAKER_03]: I mean, I think that this is something that male can be very specific about.

[00:16:21] [SPEAKER_03]: The symptoms can be very similar to anxiety, depression, schizophrenia.

[00:16:26] [SPEAKER_03]: And again, there is much comorbidity more than one illness or substance use disorder, all kinds of things to sort through.

[00:16:32] [SPEAKER_02]: Male had a long journey to treatment because of the comorbidity.

[00:16:37] [SPEAKER_02]: The multiple mental health conditions she was battling.

[00:16:40] [SPEAKER_02]: However, once she got to a therapist, her diagnosis was fast and correct.

[00:16:46] [SPEAKER_00]: When I was 22, I got sober in AA.

[00:16:51] [SPEAKER_00]: And I had had many, many themes of OCD up until this point that I had not recognized for what they were.

[00:17:00] [SPEAKER_00]: And I had been trying to stop drinking for basically since I started drinking, I've been trying to stop.

[00:17:07] [SPEAKER_00]: And I fell in love with AA. It absolutely changed my life.

[00:17:10] [SPEAKER_00]: But sadly, my OCD latched onto the theme of recovery.

[00:17:15] [SPEAKER_00]: And that's where it became really traumatic for me.

[00:17:17] [SPEAKER_00]: And I would use the 12-step programming very compulsive ways.

[00:17:22] [SPEAKER_00]: But essentially it got to the point where I think it was around nine years sober.

[00:17:29] [SPEAKER_00]: And I actually left, I left AA for a period of time and I became so frightened that I finally got over my fear and went to see a therapist.

[00:17:39] [SPEAKER_00]: When I met my therapist for the first time and she did a full assessment of me.

[00:17:45] [SPEAKER_00]: And it's very thorough. And she sent me through a lot of documentation to fill out before we even met.

[00:17:53] [SPEAKER_00]: She diagnosed me straight away.

[00:17:55] [SPEAKER_00]: I said, I feel like my brain is on fire and she said, that's because it is.

[00:17:58] [SPEAKER_00]: And she showed me pictures of brain scans.

[00:18:02] [SPEAKER_00]: There's a book called Brain Lock by Jeffrey Schwartz, which was very helpful for me.

[00:18:06] [SPEAKER_00]: And on the front cover is a picture of a neurotypical brain versus a no CD brain.

[00:18:14] [SPEAKER_00]: And the whole front of it is like red hot.

[00:18:17] [SPEAKER_00]: And I cried. I just cried because it was such validation for me to know that I wasn't insane.

[00:18:25] [SPEAKER_00]: I was, you know, this is real. What I was experiencing was real.

[00:18:29] [SPEAKER_02]: Now for some statistics on OCD first prevalence in the US about 1.2% of adults experience OCD symptoms in a given year and 2.3% experience it at some point in their lives.

[00:18:44] [SPEAKER_02]: Now that's over 5 million Americans or approximately 1 in 40 adults.

[00:18:52] [SPEAKER_02]: OCD affects females more than males with 1.8% of females and 0.5% of males experiencing OCD in the past year.

[00:19:02] [SPEAKER_02]: The International OCD Foundation estimates that 1 in 200 children and teens in the US or about 500,000 youth also have OCD.

[00:19:15] [SPEAKER_02]: OCD can appear at any age, but it usually first surfaces between the ages of 8 and 12 or in late teens and early adulthood.

[00:19:24] [SPEAKER_02]: Now here's a statistic that I found startling as Helen, I know you did too.

[00:19:30] [SPEAKER_02]: OCD is considered one of the top 10 leading causes of disability, including both medical and psychiatric conditions.

[00:19:41] [SPEAKER_03]: Well, that's simply an extraordinary concept and I think a very good reason for us to get on to treatment.

[00:19:48] [SPEAKER_03]: There is no cure but OCD has proven to be treatable up to 80% of people who receive treatment experience significant improvements in their symptoms.

[00:19:58] [SPEAKER_03]: So treatment can diminish symptoms so they don't rule a person's life.

[00:20:02] [SPEAKER_03]: Now in terms of effective treatment methods, first of course is individual therapy.

[00:20:10] [SPEAKER_03]: The therapeutic relationship is key to treating OCD.

[00:20:14] [SPEAKER_03]: This is one-on-one top therapy including cognitive behavioral therapy and medication.

[00:20:22] [SPEAKER_03]: Both are frequently recommended.

[00:20:25] [SPEAKER_02]: Yes, for some people with OCD, a combination of cognitive behavioral therapy and medication is the most effective treatment.

[00:20:33] [SPEAKER_02]: Now anti-depressants are often the first medications prescribed for OCD and it doesn't necessarily mean that depression is present.

[00:20:40] [SPEAKER_02]: It's just that anti-depressants also treat OCD.

[00:20:44] [SPEAKER_02]: And anti-anxiety drug is sometimes used to treat not only chronic anxiety but OCD as well.

[00:20:54] [SPEAKER_02]: And we know the decision to even begin taking medication can be very difficult for some of us who live with a mental health condition and we know everyone's experience with medication is different.

[00:21:05] [SPEAKER_00]: My initial first, maybe year if therapy, I refused to take medication and I was like, I can do this.

[00:21:12] [SPEAKER_00]: And I worked hard but I was really sick.

[00:21:18] [SPEAKER_00]: And you know when I eventually made the decision to take the meds, it was so that I could engage properly with my therapy because I just couldn't.

[00:21:27] [SPEAKER_00]: It was too scary exposing myself to my thoughts, was just too scary without you know help biological physical health.

[00:21:34] [SPEAKER_00]: From then taking the medication within three months I saw a huge reduction in symptoms and I remember being at a retreat center feeling so free.

[00:21:51] [SPEAKER_00]: And it was like I'd finally come home to myself for the first time in my life.

[00:21:56] [SPEAKER_00]: And I, yeah, like the things that I was worried about with medication, I was going to make me disconnect from myself.

[00:22:03] [SPEAKER_00]: It's going to make me dissociate. I experienced the opposite.

[00:22:06] [SPEAKER_00]: It was like, oh finally I'm here, I'm home.

[00:22:09] [SPEAKER_00]: And of course it hasn't stayed like that because it's EBS and FLOs.

[00:22:13] [SPEAKER_00]: Now let's look at some treatment methods and skills.

[00:22:19] [SPEAKER_03]: Cognitive behavioral therapy, I know we keep talking about it but it's really apparently so effective and that end medication are said to be the most effective treatments.

[00:22:32] [SPEAKER_03]: Now there's something called exposure and response prevention, ERP.

[00:22:37] [SPEAKER_03]: This is a type of cognitive behavioral therapy and what happens is it gradually exposes people to their fears and prevents compulsive behaviors.

[00:22:49] [SPEAKER_03]: And it's so effective that it is considered the gold standard treatment.

[00:22:53] [SPEAKER_03]: Now there are the methods of OCD treatment that include support groups, psychoeducation as we are constantly saying,

[00:22:59] [SPEAKER_03]: and it's going to be a hospitalization. And then a healthy lifestyle, you know, diet exercise and sleep, mindfulness meditation, yoga and other methods of self soothing are very important because so much of OCD is based on fear.

[00:23:15] [SPEAKER_03]: And now Mel will give us first hand knowledge through her own treatment journey.

[00:23:22] [SPEAKER_00]: Psychoeducation was so important for me and my first line of defense against my OCD was actually educating myself and read, I mean, I think one of my compulsions has become reading and researching mental, my mental illness.

[00:23:40] [SPEAKER_00]: And it became compulsive. However, within that I learned so much useful information that has honored me and helped me.

[00:23:53] [SPEAKER_00]: But that in and of itself, it wasn't enough. It was insufficient and I needed the help of a qualified specialist therapist who understood my conditions specifically.

[00:24:05] [SPEAKER_00]: So the gold standard of treatment for OCD is exposure response prevention and I have a great ERP therapist. And I've always needed a bit more of a holistic path, I guess.

[00:24:21] [SPEAKER_00]: So ERP was massively important to me. But I've also benefited greatly from mindfulness practices, from acceptance and commitment therapy practices.

[00:24:34] [SPEAKER_00]: You know, my bringing my 12 step philosophy into my therapy sessions has been hugely supportive.

[00:24:41] [SPEAKER_00]: Step three has been a really big part, step 11. My morning practice I spend pretty much an hour a day in morning practice of writing, journaling, meditation prayer, reading.

[00:24:59] [SPEAKER_00]: And those things greatly ground me.

[00:25:03] [SPEAKER_00]: And I, you know, how could I forget medication? It took me, you know, my journey towards medication was so fraught because I came off my meds at bad advice.

[00:25:16] [SPEAKER_00]: I got really ill to the point of nearly being hospitalized. And I took my meds, shaking and crying with my therapist on the call saying, you need to do this as an exposure right now and you need to do this with me on the call.

[00:25:31] [SPEAKER_00]: And what, and if this can be of help to anyone in 12 step community, what I realized was that me not taking medication was me in self will run riot.

[00:25:45] [SPEAKER_00]: Because I, you know, God has amply provided the world with doctors, medications help and what I was, it might my husband, my husband and my friends and my fellows in recovery, you know, have been, you know, really they are to put the list because they support me and hold me up.

[00:26:10] [SPEAKER_00]: You know, when I can't hold myself up and they are the absolute joys of my life really.

[00:26:19] [SPEAKER_00]: And sleep sleep is massive for me. I could write a whole book on the importance of sleep and consistently, wait cycle for me that has crazy effects on my mood. So yeah, those are just some of the things that have really helped.

[00:26:41] [SPEAKER_03]: And looking at treatment. We all we look at this sometimes, but it's very important to acknowledge what to do when there's a setback because believe me.

[00:26:53] [SPEAKER_03]: Valor and I can vouch for this, their setbacks throughout the whole process and I had several yesterday, but here I am today.

[00:27:01] [SPEAKER_00]: And so here is Mill dealing with person at Beck. Sometimes I handle setbacks in a model way and sometimes I handle them in really messy way and in a very humanly, I would say the first, the first thing that comes to mind is the cultivation of a compassionate attitude towards myself.

[00:27:27] [SPEAKER_00]: That has been so important, like learning to be my own best friend, learning to talk to me as if I were my own best friend.

[00:27:37] [SPEAKER_00]: And that has taken practice, that's a skill. It did not come naturally and I've had to cultivate it over many years.

[00:27:45] [SPEAKER_00]: Seeing my therapist, I still see my therapist regularly. You know, I've had breaks, I've had breaks over the years.

[00:27:50] [SPEAKER_00]: And then when things have been difficult, I've got backing contact for regular sessions. I see her once a month now.

[00:27:59] [SPEAKER_00]: It really helps me when I'm in a setback to kind of reconnect with the OCD community and my recovery to our set community, but which I'm always, you know,

[00:28:19] [SPEAKER_00]: there are people that I can listen to on YouTube. There are books that I can read. There are meetings that I, there are 12 set meetings that you can go to for OCD, specifically.

[00:28:31] [SPEAKER_00]: And just just talking to others and sharing what's going on.

[00:28:36] [SPEAKER_02]: I love what she had to say about self-compassion.

[00:28:39] [SPEAKER_02]: I know learning self-compassion was hard for me too and yet it was a real turning point in how I approached the setback.

[00:28:47] [SPEAKER_02]: And now I get to go into geek out mode, our listeners know and Helen, you know how much I love researching treatment breakthroughs.

[00:28:55] [SPEAKER_02]: And there are several new treatments for obsessive compulsive disorder that show promise.

[00:28:59] [SPEAKER_02]: One is non-invasive brain stimulation. Some say that this non-invasive personalized treatment that uses magnetic fields to stimulate brain specific brain regions is a groundbreaking advancement that could improve quality of life for people with OCD.

[00:29:16] [SPEAKER_02]: In fact, mindful health solutions reports that 50 to 60% of their patients who undergo this treatment see at least a 20% reduction in symptoms.

[00:29:28] [SPEAKER_02]: Now, there's another area of treatment research that shows promise for alleviation of OCD symptoms. And this research is on the neurotransmitters involved in OCD.

[00:29:40] [SPEAKER_02]: Neuro-transmitters are chemicals in the brain that help the body perform many functions, including psychological functions such as thoughts, emotions, fears, mood, pleasure, joy.

[00:29:52] [SPEAKER_02]: Now, the neurotransmitter serotonin is considered the central neurotransmitter involved in the occurrence of OCD.

[00:30:01] [SPEAKER_02]: But there's a high resistance rate to medications that focus on serotonin.

[00:30:09] [SPEAKER_02]: So here's the potential treatment breakthrough.

[00:30:12] [SPEAKER_02]: It is possible that there's an indirect route to facilitating higher levels of serotonin when that could be better targeted by medication.

[00:30:24] [SPEAKER_02]: Current research suggests that regulating a different neurotransmitter glutamate could possibly increase serotonin thereby enabling this decrease of OCD symptoms.

[00:30:35] [SPEAKER_02]: So this indirect route to OCD relief is considered a promising step toward more widespread alleviation of symptoms.

[00:30:46] [SPEAKER_03]: Well, it's all very encouraging and let's hope that they move swiftly.

[00:30:52] [SPEAKER_03]: Now, I would like to point out something that we always look at in any kind of treatment which is relationships because it's so significant in treatment and in recovery.

[00:31:03] [SPEAKER_03]: Now, it's probably become obvious by now that OCD can be extremely hard on relationships for both sides, you know, the individual with OCD and the various people in their lives.

[00:31:15] [SPEAKER_03]: The debilitating symptoms and behaviors can be mystifying, frustrating, and intrusive to people who don't have or understand the disorder.

[00:31:26] [SPEAKER_03]: And for the person suffering from OCD, the compulsive symptoms can destroy the possibility of friendship or close relationships of any kind.

[00:31:35] [SPEAKER_03]: Another obstacle is the shame for having the illness and performing such bizarre behaviors.

[00:31:41] [SPEAKER_03]: And then this whole business of the silent symptoms such as the counting can also be a real problem.

[00:31:47] [SPEAKER_03]: But nowhere is OCD more disruptive than within the family.

[00:31:51] [SPEAKER_02]: But Valerie, I do have some great information that I believe is going to be very helpful for family members and caregivers and education is the first step.

[00:32:03] [SPEAKER_02]: Education is so powerful for me in managing my mental health and the same goes for family members and caregivers.

[00:32:10] [SPEAKER_02]: The more you learn, the more you'll be able to understand and help the person with OCD.

[00:32:16] [SPEAKER_02]: And get started by learning about causes symptoms, treatments and excellent place to get educated is the International OCD Foundation website.

[00:32:28] [SPEAKER_02]: IOCDF.org.

[00:32:30] [SPEAKER_02]: That's international OCD Foundation, IOCDF.org, and that will be in our show notes.

[00:32:39] [SPEAKER_02]: There are also many excellent books on OCD.

[00:32:43] [SPEAKER_02]: Another thing you can do is help your family member find the right treatment and offer encouragement.

[00:32:50] [SPEAKER_02]: Tell the person that through the right treatment, most people have a significant decrease in their symptoms.

[00:32:57] [SPEAKER_02]: Tell them there's help that there are others with the same problems and suggests an OCD support group.

[00:33:05] [SPEAKER_02]: Also get support and help for yourself.

[00:33:08] [SPEAKER_02]: Seek professional advice, help from someone who knows OCD and talk to other family members so you can share your feelings.

[00:33:17] [SPEAKER_02]: Also, there are great support groups for family members.

[00:33:22] [SPEAKER_02]: No one of the most important things I learned as I did my research on information for family members and caregivers is something called family accommodation behaviors.

[00:33:32] [SPEAKER_02]: Learning to recognize and reduce these behaviors is one of the most powerful ways to support someone who is living with OCD.

[00:33:41] [SPEAKER_02]: Family accommodation behaviors are things families do that enable OCD symptoms.

[00:33:48] [SPEAKER_02]: Research shows that how a family response to OCD can help fuel OCD symptoms.

[00:33:55] [SPEAKER_02]: So the more that family members can learn about their responses to OCD and the impact they have on a person with OCD, the more the family becomes empowered to make a difference.

[00:34:07] [SPEAKER_02]: So here are some examples of these problems behaviors.

[00:34:11] [SPEAKER_02]: One is participating in the behavior and an example is you wash your hands whenever the person with OCD washes their hands.

[00:34:20] [SPEAKER_02]: Another problem behavior is assisting in avoiding.

[00:34:24] [SPEAKER_02]: For example, you help your family member avoid things that upset them.

[00:34:29] [SPEAKER_02]: An example is you do their laundry for them so that it is cleaned right.

[00:34:34] [SPEAKER_02]: Another example, a problem behaviors taking on additional responsibilities.

[00:34:39] [SPEAKER_02]: For example, you could go out of your way to drive them someplace when they could otherwise drive themselves.

[00:34:46] [SPEAKER_02]: One last example is maybe making changes in your job.

[00:34:51] [SPEAKER_02]: You could, you know, if you're cutting back on hours at your job in order to take care of your family member.

[00:34:57] [SPEAKER_02]: Now is both Helen and Mel have mentioned support from friends and loved ones can be essential in recovery from OCD and using these strategies and skills.

[00:35:07] [SPEAKER_02]: From education to encouragement and all those are reviewed can bring foundational change.

[00:35:12] [SPEAKER_02]: And now a final statistic. This one on recovery.

[00:35:16] [SPEAKER_02]: Now while OCD can be lifelong, the prognosis is better in children and adults among children and young adults 40% recover entirely by adulthood.

[00:35:28] [SPEAKER_02]: And as you said Helen with treatment 80% of people with OCD have a marked improvement in symptoms.

[00:35:36] [SPEAKER_03]: Valerie, this gives me hope for people everywhere who are fighting OCD.

[00:35:40] [SPEAKER_03]: There's so much evidence now that proves recovery is possible.

[00:35:46] [SPEAKER_03]: Now it's time reluctantly to bring the topic to a close or today we have so much gratitude for the amazing contributions of Mel.

[00:35:57] [SPEAKER_03]: Single-handedly she has helped all of us with her lived experience and expertise in both fighting and recovering from OCD.

[00:36:06] [SPEAKER_03]: She has contributed immensely to one of our chief goals for this episode.

[00:36:11] [SPEAKER_03]: Fostering understanding, compassion and hope for those who are struggling with OCD today.

[00:36:18] [SPEAKER_03]: And given her years of battle against OCD, let's give Mel the final words on hope.

[00:36:24] [SPEAKER_00]: I really thought that I would spend my life in this state.

[00:36:29] [SPEAKER_00]: Like that I would forever be just hopelessly anxious.

[00:36:38] [SPEAKER_00]: I couldn't perceive of a different reality.

[00:36:44] [SPEAKER_00]: And when I meet people today who are stuck in OCD and really frightened to get therapy,

[00:36:49] [SPEAKER_00]: I want to say, hey, come on it's I promise you it's worth it.

[00:36:54] [SPEAKER_00]: And there's a different way to live and I think what gives me hope is that there are so many more resources out there today.

[00:37:03] [SPEAKER_00]: You know, there is so much help out there.

[00:37:05] [SPEAKER_00]: The other thing to say is you can get to a place where you literally feel like the only option for you is to leave.

[00:37:12] [SPEAKER_00]: And that's the last thing that you ever wanted to do because that place is the most important place in your life.

[00:37:20] [SPEAKER_00]: And to be able to be in a state of mind that I know that I can remain even with hundreds of intrusive thoughts, you know, there are days where they're pelting me and I can remain in my community.

[00:37:35] [SPEAKER_00]: And I can discover an even richer and deeper relationship with that community even in spite of my interests of thoughts.

[00:37:46] [SPEAKER_00]: That for me is, you know, there's a great deal of hope in that.

[00:37:50] [SPEAKER_03]: And now we're going to change our direction a little bit.

[00:37:56] [SPEAKER_03]: And I have said that always has something to do with hope and that is to ask Valerie to lead us in a mindful exercise.

[00:38:02] [SPEAKER_02]: My full is ex I will be happy to yes we will close today's episode in our traditional way with a mindfulness exercise.

[00:38:11] [SPEAKER_02]: What is mindfulness? I always give a definition.

[00:38:15] [SPEAKER_02]: Mindfulness is a mental state achieved by focusing on awareness on the present moment, while calmly acknowledging and accepting ones feelings thoughts and bodily sensations without judgment.

[00:38:30] [SPEAKER_02]: Today's mindfulness exercise is called finding everyday joy.

[00:38:36] [SPEAKER_02]: You know, last night I stood in my kitchen eating cherries.

[00:38:41] [SPEAKER_02]: My husband has COVID right now.

[00:38:43] [SPEAKER_02]: I had just changed the towel stuffed under the refrigerator that is catching a water leak while we are waiting on the technician.

[00:38:52] [SPEAKER_02]: And I had learned something distressing a few hours earlier.

[00:38:57] [SPEAKER_02]: Yet I mindfully ate cherries, savoring every bite, flavor and sensation of my favorite fruit.

[00:39:05] [SPEAKER_02]: You know, it's the end of the cherry season and the cherries are finally coming from the hood river valley. These are my favorite cherries.

[00:39:14] [SPEAKER_02]: I joyfully ate those cherries. We can find joy in the small and unassuming

[00:39:20] [SPEAKER_02]: And bringing awareness to the many simple good moments we experience is not a denial of everything else that might be wrong.

[00:39:31] [SPEAKER_02]: Instead, it's an honest appraisal of what might be arising in that moment.

[00:39:37] [SPEAKER_02]: We may have to look for joy. So let's do it. Let's get mindful.

[00:39:44] [SPEAKER_02]: Close your eyes if you can.

[00:39:47] [SPEAKER_02]: Settle in and breathe.

[00:39:50] [SPEAKER_02]: As always, let's begin with a few diaphragmatic breaths.

[00:39:56] [SPEAKER_02]: Whether your eyes are open or closed, let's study our breathing with two diaphragmatic breaths.

[00:40:03] [SPEAKER_02]: When you do this on your own, take as many breaths as you need to become calm and centered.

[00:40:09] [SPEAKER_02]: Let's breathe.

[00:40:11] [SPEAKER_02]: Inhale through your nose, expanding and imaginary balloon and your stomach as you inhale.

[00:40:19] [SPEAKER_02]: Exhale through your mouth, pulling your stomach in as you do so.

[00:40:24] [SPEAKER_02]: Forcefully, exhale.

[00:40:26] [SPEAKER_02]: Drop your shoulders, inhale through your nose, expanding that balloon and your stomach as you inhale.

[00:40:38] [SPEAKER_02]: Exhale through your mouth, pulling your stomach all the way in.

[00:40:45] [SPEAKER_02]: Keep this slow, steady breath going.

[00:40:52] [SPEAKER_02]: Bring to mind small things that bring you joy.

[00:41:00] [SPEAKER_02]: Maybe it's a perfectly ripe peach.

[00:41:05] [SPEAKER_02]: The satisfaction after a long run or hard workout is it fresh flowers or the perfect parking place?

[00:41:17] [SPEAKER_02]: Maybe a well-written sentence or a lusciously-sensitive candle.

[00:41:25] [SPEAKER_02]: What small thing brings you joy?

[00:41:36] [SPEAKER_02]: Visualize that source of joy.

[00:41:40] [SPEAKER_02]: Can you see it or feel it or smell it?

[00:41:52] [SPEAKER_02]: Visualize a moment in your day spent savoring that small unassuming joy, soak in the peace and wonder of this moment.

[00:42:23] [SPEAKER_02]: You admit to finding these small moments of joy in your life.

[00:42:34] [SPEAKER_02]: If your eyes are closed, please open them and gently bring yourself back to the room.

[00:42:40] [SPEAKER_02]: Thank you for doing this mindfulness exercise with me.

[00:42:45] [SPEAKER_03]: Thank you, Valerie.

[00:42:46] [SPEAKER_03]: I think that the small joys of life are the greatest change for me and as I live in recovery is to enjoy them.

[00:42:53] [SPEAKER_03]: You can feel it at home.

[00:42:55] [SPEAKER_03]: A whole cargo full of these small beautiful things.

[00:42:59] [SPEAKER_03]: So thank you.

[00:43:01] [SPEAKER_03]: As we bring this first OCD episode to a close, we want to extend again our deepest gratitude to Mel for taking us on her remarkable journey and to all of our listeners around the world for traveling with us.

[00:43:16] [SPEAKER_03]: For our upcoming episode on OCD Part 2, we'll make a deep investigation into the therapist role with the consummate professional expert Dr. Jenny Fullerton.

[00:43:27] [SPEAKER_03]: Her vast comprehension and years of first-hand experience with researching and treating OCD, provide brilliant insights and an invaluable education about this complex yet treatable disorder.

[00:43:43] [SPEAKER_03]: Until then, I leave you with our favorite word, onward.