I am all of the above. Not a hypochondriac (I've enough friends who’ve bookmarked WebMD) – but rather the person who cries wolf – someone who falls back on a slightly elaborate report of ill health where and when it suits me.
However, when I started to develop an anxiety disorder – one characterised by a non-stop barrage of violent thoughts – I didn’t know how to articulate it. Here was an actual invisible illness, and one that was too difficult to put words to; a type of OCD whereby the obsession took place in my head.
The thoughts started about a year ago. I began to feel worried for no reason, and became terse. I lost the ability to truly be present in a situation. And for the first time, friends and family became vocal about my neuroticism; they said I was acting out of character – more manic than usual.
As my anxiety started to build, there grew an ever-widening chasm between the worlds outside and inside of my head. Mostly, I was racked with the question of causality: What was making me feel like this?
As my anxiety started to build, there grew an ever-widening chasm between the worlds outside and inside of my head. Mostly, I was racked with the question of causality: What was making me feel like this? Was I actually unhappy in my job and my relationship? Or was this rapidly advancing feeling of anxiety disturbing peace?
Then, things took a bit of a dive. One morning I woke up and – I can’t remember the first time (because there were to be so many) – a violent image came into my mind. It was the image of female genital mutilation. As someone who lacks the capacity to watch a horror film in case I see something too gory, this gave me a gut wrench. ‘Ugh’, I thought, and shook the image out of my mind.
Only, it came right back, again and again. It wasn't a photographic image, but an abstract one, a visual fear of something unknown. It was a thought, but it triggered a physical reaction each time, before a feeling of alarm about why that thought had occurred.
I should say at this juncture that I have never had a direct experience of female genital mutilation, I have only read about it, and have never considered it a phobia before. Immediately I was flooded with guilt and confusion: How could I, someone living in a social and cultural bubble that is safe from the threat of FGM, be indulgent enough to feel pain from this thought?
But soon, what exactly the thought was became totally irrelevant, and said guilt and confusion became eclipsed by the inability to think about anything other than it happening. Upwards, I’d say, of a thousand times a day. Every thirty seconds.
I remember being worried that I’d never have total control of my brain again; that this uninvited thought would never go away.
For those first few days, I would slip out of the office every few hours, walk around the corner, sit on some steps, furiously smoke cigarettes and cry. I'd slap myself out of pure frustration. When I wasn’t at work, I would drink a lot, in an attempt to overrule the thoughts and relax my mind.
I remember being worried that I’d never have total control of my brain again; that this uninvited thought would never go away. As an extension of that, I worried that I’d lose my job and relationship, because the terrier twitch and the drinking and the sheer amount of crying would give the game away that I was, truly, losing my shit over something totally implausible.
I didn’t tell anyone what was going on for about a week, because how do you tell someone that all you can think about all day is female castration? And I felt underserving of sympathy or treatment, not only because I’m the kind of crap person who doesn’t go to friends’ birthday dinners, but because I felt that nothing bad enough had ever happened to me to warrant this brain malfunction. ‘Therapy’, I thought, ‘is a privilege that should be reserved for people who actually need it.’
Eventually, I cracked. I tried to get on the train to work one morning and could barely think about anything beyond scissors and knives. I was aware that I was freaking out and crying a lot and people were staring, so I got off at the next station and went home. I called my boss and told him that I thought I was losing my mind which, in hindsight, must have sounded quite melodramatic. Then I called my Dad, who very patiently said, “Okay, call the doctor”. So I called the doctor, who asked me whether I thought I might hurt myself.
I can honestly say at that point I thought I might. I was so tired with obsessing – with what felt like hallucinating – that I was no longer sure what was real and what wasn’t.
“Yes,” I said, “I do want to hurt myself.”
Do you think you might do what you’ve been thinking about to yourself?” he asked.
"Maybe." I didn't really know anymore.
The doctor told me I had 'intrusive thought OCD', and instructed me to go straight to a surgery. There, they put me on diazepam (Valium) and Fluoxetine (Prozac), and after a consultation, I went home and passed out in bed for a really, really long time. When I woke up, the obsessive thoughts were still there, but they were bothering me less frequently. I went for a run for the first time in years, despite feeling a tad high off of the valium. I found it soothing.
In the following weeks, I reluctantly bought my first self-help book, Mindfulness, and reluctantly enrolled in CBT (I lasted about two sessions but it was helpful). I continue to exercise when I feel like I need to calm down, and have been on the anti-anxiety drugs for nearly a year. I now rarely have the intrusive thought at all – maybe once or twice a day. When I do, I have learned not to freak out, but to let it pass out of my mind in its own time. That way, I don’t get caught up in the cycle of panic.
Research on why people experience intrusive thought OCD is inconclusive, although I've found mine to be exacerbated by stress. There are also no accurate statistics of how many people have it. The disorder is characterised by a recurring thought that gives you a sense of guilt, so a lot of people keep their suffering a secret. Common thoughts often involve paedophilia, incest, or hurting a family member – thoughts that you’d naturally be ashamed to give voice to.
It’s important to remember that this is not your thinking, but rather, your mind conjuring the thing most abhorrent to you. From my own experience, I learned that acknowledging your illness – despite the fact it's not one that you can see – is the first step to getting better. Telling people about intrusive thought OCD lifts the shame and reduces the sense of anxiety. When people don’t judge you as you assumed they would, you realise that what you’re going through is clinical, and as such, that it probably has a cure.
If you are experiencing intrusive thoughts visit OCD UK for more information or speak to your doctor.