As her condition started to derail her life, Jemima Thackray had to discover how to take back control of her mind.
I'm at the doctor again. There's pressure in my head, behind my eyes – perhaps it's a tumour, ” I tell the poor young GP, who takes one look at my medical notes and then tries to find the most sensitive way to tell me these symptoms are, yet again, a figment of my imagination. He doesn't even examine me. He doesn't need to: I'm a completely healthy 21-year-old. Yet there is something growing in my head: the invasive thoughts of obsessive-compulsive disorder (OCD).
About three per cent of people will develop OCD at some time in their lives. This is a conservative estimate -many people suffer in silence because they're too embarrassed or don't realise they have a problem recognised by the medical profession. You'll identify the common manifestations of OCD from the TV. Most people think of the constant rituals. We flippantly say people who are super tidy are a bit OCD” But that's not me. I don't wash my hands a hundred times a day. I don't hoard stuff or make sure everything is arranged in straight lines or endlessly lock doors. I have what psychotherapists sometimes call Pure O – my only compulsion is to dig deeper and deeper into an anxiety-inducing thought. The process is known as checking” – returning repeatedly to a fearful thought to check it isn't true.
What's that flutter? A palpitation? ” I'd think. Perhaps my heart is failing. Come on, it's fine, you've had your heart tested and it's fine. I'll just check though, just to be safe, because there might actually be a problem this time. ” Then the floodgates would open. The moment I checked” the fear would take root – by giving the idea credence it would start to propagate. Because that test was a month ago now. What if something has changed since then? Oh God, what if I die? What will happen to me? What if my body dies but my mind lives on, just wandering around in oblivion?”
The vicious cycle of symptom-thought-check would continue throughout the day, whirring inside my head as I tried to get on with normal life, like background music on loop that I would keep tuning in and out of, get distracted from and return to. It was exhausting. My obsession was that at any moment I might drop dead from an undiagnosed illness a rather introspective preoccupation, perhaps typical of a middle-class girl with no real problems.
At the height of my OCD, I would think about death and what might be wrong with my body every hour of the day. Every physical sensation was analysed and could trigger a barrage of overwhelming thoughts. It didn't help that the resulting anxiety did in fact give me physical symptoms – tight chest, dizziness, numbness in my extremities – which would further convince me I was seriously ill.
In hindsight, I realise my need to check” had been a feature of my thoughts for years. Short haircuts for young women From childhood I had the habit of searching back through my mind for worrying thoughts I'd forgotten, just to be safe; I would re-read lines in books to check” I had taken everything in. But the trigger for my period of full-blown OCD was a university summer holiday spent working in Uganda in 2004, aged 20. (The twenties is the most common time for women to develop OCD, while men tend to succumb during their late teens. )
I woke up one morning with a fever I remember shivering uncontrollably even though I was wearing three coats in the heat of the day. A local doctor pricked my finger, smeared the blood on a dirty piece of glass and announced I had malaria (I later found out, malaria” was a catch-all term for flulike symptoms). A private doctor in the city said the cause was more likely an amoeba. Whatever it was, I took some drugs and was fine within a few days.
For someone whose worst illness was previously a bad cold, the experience of being diagnosed with a potentially life-threatening infection while on my own in Africa was a trauma that my OCD-prone mind could not cope with. I returned to university for my final year, but over the following months I became increasingly preoccupied with my health. The fact that my English degree involved only seven hours in class a week meant I had even more time to obsess and the problem quickly snowballed out of control. Instead of reading, I would spend hours googling imaginary symptoms, convincing myself I had every type of cancer, HIV (a common preoccupation for OCD sufferers, I would later learn), a heart defect… the list was endless.
After several medical investigations copious blood tests, a referral to a specialist and an electrocardiogram to check for heart abnormalities – one perceptive GP realised my illness was mental rather than physical. Hearing him say my mind, not my body, was the problem produced mixed emotions. There was relief (a diagnosis at last, even if it wasn't the one I was expecting), but also shame about how catastrophically my rational faculties had let me down.
I was so distracted that I was finding it hard to cope with everyday social situations. Normal conversation was almost impossible – even my friends were becoming increasingly exasperated spending time with me and would seem frustrated each time my sentence trailed off and my eyes glazed over. I think they felt powerless to help me as I began taking my pulse for the umpteenth time; their words of reassurance weren't getting through.
Fortunately, my boyfriend (now husband) had endless patience and learned ways to distract me. He used to call these episodes of paralysis my schemozzles” a word from his Jewish upbringing describing my state of fear and confusion. We had known each other from school, so were already good friends when we got together. Without this foundation, I'm not sure we would have made it: OCD can take its toll on relationships because it makes the sufferer turn in on themselves in a way that can seem selfish and self-indulgent to the outside world.
By the time I was midway through my final year at university, I could barely concentrate on studying. So the GP and my university department came up with a plan to allow me to finish my degree from home. Back in my parents' house, Mum would bring me cups of tea and we'd talk for hours, trying to figure out what had gone wrong with my head. But it was only when I was referred for cognitive behaviour therapy (CBT) that I began to notice the first signs of improvement.
CBT is known to be the most effective treatment for OCD due to its focus on thought control. Although I was desperate for help, I was sceptical at first: What do you mean, don't think my thoughts? They just come into my mind; they're who I am! ” But what I initially wrote off as insensitive advice from an overly rational clinician, who.
I felt was failing to understand someone as finely tuned as me, actually turned out to be the key to my recovery.
The principles of thought control in CBT have helped me and thousands of others see that we are not, after all, the product of our musings; that everyone has weird, intrusive stuff come into their heads. Some know instinctively how to push these thoughts away, while others, like me, may have to learn how to do this with the help of a few mental tools. My mental tool was to categorise my thoughts into truths and lies, sorting them into piles as soon as they entered my head, putting all the negative thoughts on a rubbish pile that I wasn't to touch.
At first I might only manage to throw away” one thought, then spend the rest of the day obsessing. It felt like the tiniest of victories when I had a whole war to fight; it was hard not to get discouraged. But progress soon became rapid and within a few months a year since the OCD had started, and just a few months after I had graduated I had gained enough control to start my first postgraduate job.
It's now been 10 years and I can honestly say it's like I've had my brain rewired. I spent much of my twenties putting CBT principles into practice and now, not only do I bat away fear-driven thoughts almost automatically, but I also mentor women who are going through the same thing. I don't feel regretful or ashamed, because I've learned our thoughts are changeable and fluid and certainly not the last word on who we are. But nor are they merely the by-product of randomly firing neurons: they are a fragile and beautiful part of being human.
For more information about OCD, visit beyondblue.org. Au.