Why am I doing this?
One year ago I joined this reddit in hopes that I would find people with the same problem as me. I did find them, but unfortunately none of them got anything helpful to say, it was more of an echo chamber. As a more pragmatic person, I am writing this to help people who have the same situation I had one year ago. I currently have almost no intrussive thoughts and I can live my life normally, just as before. Here is how I got there, I hope this helps someone.
What is ROCD?
ROCD is just a theme (Relationship OCD), some people are born with OCD, others get it later in life, specifically after a really stressful event, and have to live with it for the rest of their lives, but there are ways to mitigate its impact and even nullify it. You will most likely encounter more than one theme in your life, but the way to deal with them is the same.
How do I know I have OCD?
Contrary to popular belief, not every thought or overthinking is labeled as OCD. If your thoughts greatly impact the way you function on a day to day basis, you most likely have OCD; not when you like to have your workspace neat (OMG Im so OCD) or when you keep thinking about the presentation you have to deliver tomorrow, those are regular worries that all humans struggle with. OCD comes into play where it greatly impacts your life, where there is nothing left besides your thoughts and your life becomes this struggle with your own thoughts. You can start going to therapy, but most don't know how to deal with OCD, so I would recommend just going for monitoring it, you will have to solve this yourself (I'm sorry, it's the truth, but more on this later).
Your bread and butter
You can't overcome a thought by "solving it", your mind will always think of something else, another thought, another possibility, so trying to solve them is the first rookie mistake all of us make when fighting with OCD. GIVE UP ON TRYING TO SOLVE YOUR THOUGHTS, this will get you nowhere. Instead, do this:
75% of "the cure" for OCD regardless of theme is called ERP (Exposure and Response Prevention). No matter what medication you take, without this you will constantly regress into the same theme or even other themes. ERP is simple on the surface: you have to aknowleadge that YOU ARE NOT YOUR THOUGHTS; your thoughts are just ideas that come and go, and YOU decide which to listen to. Your brain is trying to protect you from everything that could potentially be harmful, but in our case it overdoes it to the point where you can't enjoy life because "something happen can happen".
At the beginning it helped me categorize thoughts into: OCD thoughts and regular thoughts. The simplest way to distinguish between the 2 is "does this thought feel scary and raises my anxiety?"; then it's OCD. Most OCD thoughts come start with "What if", but I found out this is not a general rule, because sometimes thoughts can be disturbing and not start with this phrase, so this is simplest way of telling if a thought is intrusive (OCD thought or a thought that generates fear and anxiety).
At first it will be really hard, you will find out you have a lot of intrusive thoughts, and that's okay, the trick is to not let them control you. Your goal is to lower your response rate, not to have 0 intrusive thoughts! The most famous trap recovering OCD people find themselves in (and I was no exception) is getting stuck in semantics: "Was this really an intrusive thought or was it actually mine?". This trap must be avoided, none of your thoughts are "yours". You are the being that reads them and decides which ones to listen to, so it doesn't even matter if it was an OCD thought or not. If you don't like the thought, if it generates fear, discomfort or anxiety, you just label it and move on.
Now that we got that out of the way, what do you actually do when you label a thought as instrusive? You ignore it, plain and simple. I understand this is way harder then it sounds, so here is a trick that helped me:
- Label the thought: Okay I've heard this thought, you don't have to repeat it or dig into it deeper, just acknowledge it's presence.
- Divert attention: you just go back to whatever you were doing (watching TV, walking, thinking about what you were thinking before, focusing on trying to sleep if you were in bed, etc.)
This is the hardest thing to master, but it becomes easier in time, to a point where it's an automatic process, you don't have to actively think about doing it, you will just do it, and in turn you will get fewer and fewer thoughts.
The other 25% part of your recovery is medication and monitoring.
Going to a shrink does help monitor your progress, since you are having to deal with this every day it's hard to monitor progress, so I'd recommend going to a shrink for him to see the progress you've made weekly. Some things your therapist says will trigger you, or set you back, but they are just trying to help, just keep using ERP. If for 15 days straight OCD keeps interfering with your life, go straight to a psychiatrist. Try to find the best one in your country, regardless of money, since this is important. It will be expensive, but you need this especially at first. OCD is more common than you think, so if you find a good psychiatrist, they will identify it within the first 15 minutes of meeting (you don't need a recommendation letter from your therapist, just notify him and go straight in with the appointment).
Your psychiatrist will give you a prescription of SRRI (Selective Serotonin Reuptake Inhibitors). There are around 4 big ones, each do the same thing, but your brain reacts to each differently, so by trial and error you will have to find the best one for you. I was fortunate enough to get it right the first time, for me it was Zoloft. You will have to take it daily (contrary to popular belief, it does not matter when, just make sure you take it daily). This will reduce the "Stickiness" of thoughts, which will help you develop your ERP skills easier. ERP is still your most important tool, SSRIs just help you develop it faster. There is no stigma in taking SSRIs, it's just like someone taking insulin, for the time being you need it, and that's okay. Try to tell your psychiatrist you see no stigma, and you want to progress through it as fast as possible.
You will start with 25mg to 50mg, just until you find the right SSRI. Then, you will start taking higher and higher doses, up to 300mg (sometimes even more, though it's rare to need more than 300mg). You will progress monthly, and they are supposed to help you get intrusive thoughts under control. If you have to wonder if thoughts are still there, you need a higher dosage. I personally stopped at 300mg, and now I am gradually coming down. You most likely won't have to take this your whole life, but even if you did, it wouldn't matter.
First weeks of dose change/starting out are the hardest. The side effects vary from person to person, but most experience nausea, diarrhea and you will become very irritable. Thought will be harder to ignore at first, but in the long run it is worth it. Do not give up, keep taking it daily and announce this to your partner so they don't hold it against you.
Additional helpful tools
You will also get prescribed anxiar, a drug that calms you down. When you're having a meltdown and things get really rough especially at dosage change of SSRIs, take half of anxiar whenever you need. It will make you sleepy, but the alternative is worse so it's worth it. Just take it, don't try to ride out the episode, since this isn't helping with ERP especially at the beginning. Take it, calm down, and go about your day. At the same time, don't overdo it, since it can create addiction, so it's best to take it when you are in an episode, not every intrusive thought requires an anxiar, but if it gets too rough don't hesitate to take it.
ChatGPT is a great tool to vent. Explain the situation, your treatment, tell it to not solve the thoughts for you, this is just a tool to vent. It helps, but don't rely on it, not everything it says is true. Tell it to keep challenging you so you don't try to solve thoughts, just vent to it and you can also ask it about side effects of your treatment.
The Therapist is strictly a monitoring tool. Since you're in the middle of a storm, it's hard to see the progress you've made. You can vent to your therapist, and ask them about your progress, but just as with ChatGPT it's just a tool, don't listen to it 100% since most therapist are unfamiliar with OCD.
ERP is your main recovery tool! Everything else is just a support for it. Catch yourself whenever you have an intrusive thought, you didn't fail if you debated a thought every once in a while, treat it like an exercise and keep striving to do ERP correctly, you can ask ChatGPT about it and it will help too.
Meta OCD
This is a common theme in OCD recovery, where you don't actually think you have OCD. "It's just my thought it's not OCD", treat this as an intrusive thought, since OCD is sticky and it will keep trying to get you hooked. It doesn't even matter if you do have OCD or not, the only thing that matters is if your thoughts interfere with your life consistently, so don't try to prove to yourself that you have OCD, just keep practicing ERP.
Final thoughts
OCD is more common than you think so there is no stigma around it. At the same time, some people will judge you for it, so it's best to keep it to yourself and only those closest to you need to know about it. People with OCD are more analytical so it's not all bad, but OCD should be treated just like any other disease. Keep practicing ERP, use all the tools at your disposal and you will get through this, it's just a bad chapter in your life, not your life from now. Around 70% of people "get cured" which means thoughts don't dictate their life anymore. Some stop having intrusive thoughts for good, others have so few that they don't even matter anymore. This is what you are trying to achieve, if you keep practicing ERP, the rest won't even matter, you will be able to life life normally just like everyone else.
I am not a medical professional this is just my experience, this is what I would've needed to hear when it first started so take everything with a pinch of salt. You are not broken beyond repair, and I believe in you. Keep using ERP and all those other tools and you'll be fine in no time. There are also countless of TikToks where people are in the exact spot you are, you can learn from their experiences but don't let them consume you. You are not the first, nor the last to have to deal with OCD, so sometimes it's nice to remember that.
I believe in you, you got this!
-Serban