OCD keeps you down with fear. It sneaks into your mind and convinces you that you are it, that it’s fears are yours. So how do you fight something that feels so completely to be you? This is how we fight back. You are not your OCD.

The treatment for any illness is never easy and OCD is no exception. Even I, who has successfully made it through treatment before OCD regained it’s power. Even I who can acknowledge it’s effectiveness, even I who can see how dark and unhappy I have become once again under OCD’s grasp. Even I find it extremely difficult to drag myself to treatment, to commit to the fight.

I wish there were some magical pill to cure OCD. But there isn’t. Many people have asked me what treatment looks like. And while it can be hard to explain, when I am able to find the right words, not only does it help them understand the process, but also to understand and respect the illness itself.

I am no expert, but I will do my best to put into words how we fight this debilitating illness.

To understand the treatment, we must first understand at least a very basic picture of how an OCD brain functions. I personally struggle with Contamination OCD, so I will be using that as a framework for my examples, but please keep in mind that there are many types of OCD.

Let’s start with someone who is not battling OCD. If they touch something that is dirty, whether it just be dirt, or a mild chemical of some sort, their brain has a process, or pathway to handle that. First they touch the contaminate and their brain says “That’s dirty, should wash hands”, which sends the signal further down the pathway and instructs the person to wash their hands. The person does so, which then sends the signal to the brain that their hands are now clean, and finally signals the person that they are safe, and can move on with their day. A linear, cause-and-effect pathway.

For someone with OCD, that pathway becomes stuck on a loop, feeding back into the original signal of “dirty, contaminated, etc.” and magnifying it to a signal of “extreme danger”. In this case, I would touch the contaminate and my brain says “That’s dirty, should wash hands”, which sends the signal to my hands to wash. I do so, but instead of sending the “clean” signal, my brain says “Wow, whatever you touched was so dangerous that you had to wash your hands, so you should wash again just to be safe.” So the normal response of washing hands further validated and intensified the original signal of “dirty”, rather than produce the normal response of “clean”. And the next time I wash my hands the signal will again get looped back, most likely adding to the list of suggested safety behaviors.

“Better wash your hands again just to be safe” becomes “Wash your hands, also you touched the faucet to turn the water on, so wash that too” becomes “wash your hands and what else could you have POSSIBLY touched on your way from first coming into contact with the contaminate and making your way to the sink”, and so on and so on, deeper down the spiral.

Every time I give in to another safety behavior I am magnifying that fear, getting stuck in a never ending cycle, never reaching that final stage of “Clean”. It’s like running with all your might, but never moving an inch.

So the way we fight this is by retraining our brain. Retraining it to have the proper amount of fear, and only require the proper safety procedures. But retraining your brain is not easy. Especially when your brain is sending you signals of “DANGER” and you are in the habit of believing your own brain. It is very frustrating to say the least, to have someone tell you that you can no longer believe what your mind is telling you, that you must go against those very real feelings of danger. That doesn’t come naturally and it is very distressing. Not only must you stop doing the multitude of safety behaviors you have been performing, but in order to successfully retrain your brain, you actually have to go above and beyond the normal. Deliberately go past gross, go past scary, so that you can come back to the “normal” and not feel any fear. Until “normal” is boring again.

This process is called Exposure-Response Prevention (ERP). I must purposefully and deliberately EXPOSE myself to the contaminate that I fear, and then PREVENT the RESPONSE for as long as possible. In doing so I can hopefully retrain my brain that those responses (safety behaviors), are not necessary to be safe.

Basically, when I or anyone else is asking me to go to treatment or to fight my OCD, they are asking me to do the thing I am most afraid of. Do the thing that my brain, the brain I have trusted my entire life, has told me could mean life or death.

I feel like even this far in the description, it is hard for someone without OCD to truly grasp the magnitude of this process; the sheer amount of willpower and strength it takes to battle this illness head on, simply because it can be very hard to wrap your mind around an OCD fear. Because OCD usually takes something minor, something the rest of the world doesn’t necessarily associate with that amount of fear, and turns it into a monster. So if you can’t see or understand what I am afraid of, if it looks to you like I am afraid of the invisible, then this will be hard for you to grasp.

So what are you most afraid of? Spiders, snakes, the ocean, sharks, heights? Whatever it is, picture that. We’ll use snakes in this example, specifically non-poisonous, harmless snakes. Because your therapist, while they will encourage you to face your fear, they will never tell you to do something that would actually put you in harms way.

Picture that you are living in a world where snakes are as common of a siting as dogs. Currently your fear of snakes has become so severe that it prevents you from leaving the house in case you might encounter one. Now someone presents you with a deep, dark pit of snakes, and tells you that the only way to get over your fear is to stick your arm in it (remember, deliberately go past normal so you can come back). And if you don’t stick your arm in, then your fear of snakes will intensify to include objects that look like snakes, including hoses, cords and headphones, shadows that move like snakes, a whisper or a plastic bag blowing in the breeze that sounds like a snake. You will be afraid of things that may have touched snakes, until you can no longer let people into your house without a grueling process to protect you from what they may have touched outside your house in the real world. You will be afraid of the color green, so much so that you flinch when green passes by your peripheral vision. You will be afraid of small green crumbs and pieces of plant life, for the chance that it could have come off of a snake. Your mind will convince you of the presence of invisible, ethereal snakes that float around in your home. You won’t be able to see them but you will be sure of their phantom touches, as real to you as if a 6-foot boa constrictor brushed passed your head. What began as a fear of snakes will be magnified to a fear of almost everything.

And while you are standing there with your biggest fear staring back at you out of that pit, you are going to tell yourself that it’s not worth the risk. That you may be limited by your fear of snakes right now, but that you’ve still got your house, and being stuck in there is not so bad. Much better than the possible alternative if you were to stick your hand in that pit. But what you are not seeing is that your house will soon turn into just a single room, and that room will turn into a chair, and you will be afraid to blink.

So you start with something small. You’ll simply sit and deliberately imagine snakes. You will do this until your spike of fear begins to subside, you will do this until you are bored of thinking about snakes. Then you will open your blinds and look outside, watching for snakes, again doing so until you are bored. And will continue to increase the magnitude of these exposures, until it’s time for you to step outside. Until you find yourself in front of that pit again. Now truly imagine yourself standing in front of a pit containing what you fear most. It will not be an easy decision to put your arm in. Every fiber of your body will be fighting against any movement towards that pit. It will feel like someone is playing tug-of-war with your arm.

Even so, you eventually bring yourself to do the unimaginable. You’ve decided that the chance of freedom from this crippling fear is worth the risk.

You did it! And after weeks of distress, unbelievable willpower and effort, you can now… finally… plug in the lamp because you are no longer afraid of the cord.

And this is the moment that you realize you will have to continue facing your deepest fear again and again in order to fully regain your independence. You have a long way to go. But you did just take a giant step towards freedom. One you thought impossible, but now know to be possible.

This is what treatment looks like for someone battling OCD. This is a daily battle, you don’t get breaks; OCD won’t give them to you, and if you get tired and slip back into old safety behaviors, you’ll feed the fear. It’s crucial to build a support team for yourself; family, friends, a therapist you can trust to walk next to you through the fear. While they cannot fight it for me, I have found at least, that I cannot fight it without them.

Keep in mind that once one fear is conquered, a person still must continue to maintain it, as it will always be right behind the veil trying to find a way back in. And on top of that, OCD is now like a hurt little bully, who had it’s toy taken away. So while you are maintaining your control over the fear, OCD is waiting on the sidelines looking for a new trigger to turn into a monster. And this time OCD has learned the same tools that you have during treatment, and it has adapted. So you must do so too, again and again.

I don’t paint this picture to seem hopeless, although it can feel that way, and it will certainly be a long battle. But I do so in the hopes that someone will pause when they see someone struggling to conquer their mental illness and it may appear that they are doing nothing. In truth they are doing quite the opposite; they are fighting the monster in their brain, the monster you can’t see. Because this it what they are asking themselves to do. What they are trying to muster up the courage to commit to, all while OCD lives in their brain gleefully playing whack-a-mole with every bit of courage that pops up.

“My wiring has gotten all mixed up.”

My life with OCD is like a game of operation. You know the one, with the tweezers and the inaccurately-sized organs and the overly-loud buzzer that lets you know every time you have failed. Except my buzzer is broken and instead of reaching for little plastic organs, I’m reaching for goals, loved ones, basic necessities. My buzzer goes off constantly whether I’ve touched something or not, an incessant alarm going off in my mind warning me of a non-existent danger. It’s loud; much louder than you or me.

My wiring has gotten all mixed up. And while your buzzer only goes off when necessary, mine goes off always, a constant impending loss or risk. Unlike the game, there are no laughs or do-overs when the buzzer goes off. No longer a game.

Though you cannot hear my broken buzzer, I can. It has become my reality; the world I live in. Though you cannot see the danger or feel the fear. I do. I feel it all too much and too convincingly. But I do feel it. It is just as real as your buzzer.

From the outside it might look like a silly and trivial excuse. To you it’s a game. But to me it’s real life. Life with a broken buzzer. Life with OCD.

“These fears are not my fears; they’re just a stranger’s thoughts that have snuck in and I need to show them the way out.”

An evil person has possessed my body, taken over my life and effectively convinced all of my loved ones that I’m still me and that I’m not actually missing. And while this person is living my life and speaking my voice, I can see and hear everything from behind this mask that looks exactly like me, but I can’t speak and I can’t move. I’m back there screaming, hoping that just one person will notice that it’s not me, that I’m gone, that I need rescuing.

It started small, with just someone else’s thoughts invading my mind. These little evil thoughts of fear and anger that I didn’t recognize. They snuck into my mind and stuck there, gaining more and more power as I gave them more of my attention. Then these stranger’s thoughts became actions and beliefs. And then this stranger became me.

So that I no longer feel like a human. I am just the host to a little scared monster that compensates for its fear by dragging me in and making their fear mine. Their actions mine.

Fear is a powerful tool and OCD is masterful at wielding it. It’s hard to explain how completely OCD can take over not just your mind but your body as well. Yet another way that it takes away your power, by making it almost impossible to put into words what you are experiencing. How life literally feels like a nightmare that you have no control over. And no one really hears you because you’re just a figment of your imagination. Because you no longer truly exist as you once did. Instead you are OCD’s puppet. A shell of who you once were. You now see through its eyes, eyes that used to be yours. And through them you see how your loved ones look back at you. Slightly confused as to why you seem different or if you’re even still there. They recognize you as you on the surface, but you’re not you anymore and they can’t figure out why, because what they can’t see is the stranger who has taken over.

And as OCD pushes you further back into the dark recesses of your mind, it becomes easier for it to convince you that what you think, feel, touch and see, is false. Until you can look down at your hands and not recognize them as your own anymore. They seem as disconnected to you as someone else’s hands. So now you can’t trust your own senses, but you can’t trust your captor’s; effectively isolating you from any sense of reality.

This is what I mean when I say that OCD has taken over my life. Not that it’s greatly affecting it, but that it has actually taken it. Every time my hands are washed, I scream and yell because I don’t want to be doing that. I didn’t tell my hands to wash. I know that I don’t need to be doing that, but they’re not my hands anymore. And not even I can hear the yelling anymore, not even I can see me fighting back anymore.

There have been times in my two year battle with OCD that I have been louder than the fear. And there are times when I’m not louder but neither is it. And even during this time when it seems like I will never be heard again, I have my moments when I am able to fight back. When I am able to feel present in my own life. But those moments take a lot out of me and I’m getting tired.

An evil, scared little monster has taken over my body. And the only way to fight back is to beat it at its own game. With fear. Scare it away, do the thing that it’s most scared of over and over until it’s lost all power over me. But to do that, I first have to convince myself that its fears are not my fears. They’re just a stranger’s thoughts that have snuck in and I need to show them the way out.

Fear is fear. My fear may be different than yours, but we fight it just the same.

Living with OCD is living with constant fear pulling at your mind. And I want to be clear, it is real fear, I chose that word purposefully. I did not say discomfort. I did not say annoyance. I did not say worry. I said fear. Try to imagine the absolute terror you would feel if you suddenly woke up in a dark cave. You don’t know how you got there. You don’t know how long you’ve been there. And now that you think of it, you don’t even know that it is a cave. You don’t know who or what else is in there with you. You don’t know what is going to happen next. And worse of all, you don’t even know what is reality anymore. It is that level of uncertainty and fear that is always with someone living with OCD. Constantly. And I truly mean constantly.

“OCD takes that window of uncertainty and runs with it.”

With every movement I make, I have at least ten what-if’s running through my mind. What do you think about when you’re walking to your car to go run some errands? Probably your grocery list, what you want for lunch, what so-and-so’s new Facebook status said. Did you consciously think about every step you took to get to the door? Did you think about every object you passed and whether you may or may not have touched them? Probably not. You most likely walk that path every day without a second thought. I walk to the door and each and every one of my steps is slow and deliberate so that I can know without a doubt what I’ve stepped on. And while I’m painstakingly monitoring the path of my feet, I am also trying to keep track of my elbows and my hands, making sure that they don’t touch something that my OCD has labeled as life-threatening. And while I am tracking my feet, elbows and hands, I am also trying to keep track of just how much I move my head in case the hair piled up into a messy bun might also touch something dangerous. And while tracking my feet, elbows, hands, head and hair, I am also looking ahead and trying to plan every step and every movement that will get me from point A to point B while avoiding all of the OCD traps. Now if you have ever tried this, you probably very quickly determined that it is not possible for your mind to actually track all of these things. At least not to the level of detail that the little OCD-brain-monster requires. So inevitably, before you can get to the door, you probably focused too closely on your left elbow, took a step, and then realized that within that step, you have no idea where your right elbow was! (Although if OCD wasn’t warping your reality, you very well know where your right elbow was. It’s attached to your arm and you have spatial awareness as well as a sense of touch, although OCD would like you to forget that). So now OCD takes this window of uncertainty and runs with it. Convincing you that since you were not painfully aware of where your right elbow was in space, you have no way of knowing what it touched. Therefore it could have touched something dangerous. So by the time you get to the car, if you ever do get to the car, you had to go wash your elbow, but let’s face it, what starts as just washing an elbow will most likely turn into a full-body shower. Because the fear you feel is as real and paralyzing as the fear you would feel if you woke up in that dark cave.

“It is amazing that you got out of bed today.”

If you have the tools and the support, you can fight this fear and OCD. But that’s easier said than done and some days are harder than others. Everyone battling their OCD will have their ups and downs. But sometimes it is that hard just to walk through your house. At this point in my fight it is that hard for me. So I am trying to change my definition of success. And as someone who used to be very driven and hold very high standards for myself, this is a very real struggle for me. This is why it is so crucial for people struggling with any type of mental illness to have someone in their life who is able to recognize and celebrate the small, yet not so small achievements. It is amazing that you got out of bed today. It is amazing that you got dressed. You won’t be able to do everything in one day. But don’t let the many little set backs take away from that one big stride forward.