I had a hard day today, both in general and with OCD. I had an 8:00 am doctor's appointment and was sure the office would be running on time since I was the first patient of the day. Well, I was wrong. I didn't get seen by the doctor until 8:45. I was establishing primary care, so we went through a family history, talked about my health, and reviewed my prescriptions.
Doctor's appointments can be hard for me. One of my major topics for obsessing and agonizing is my health. Health is something over which we have little control. We can make good decisions: don't smoke, eat healthy foods, wash our hands. But ultimately most of the diseases that will kill us will have causes that are at least partly environmental or genetic. My husband's grandfather is in his late seventies and smoked from ages eight to sixty. Not surprisingly, he was recently diagnosed with lung cancer. However, very surprisingly, the cancer in his lungs was in no way caused by his smoking. Instead a genetic predisposition to skin cancer and his love for golf were the major causes of the baseball-sized tumor in his lung.
The lack of control over my health--and the health of my family and friends--is part of what makes me anxious. I have no way of knowing if a killer amoeba is eating my brain or a malignant tumor is growing in my dad's pancreas. On the other hand, there are some diseases linked directly to personal actions. Hepatitis, cirrhosis of the liver, and HIV are all linked to behaviors--behaviors stigmatized by American culture.
It is this odd combination of unpredictability and ability to place blame that makes me fixate on the possibility of being infected with HIV. It is one of my deepest and most disturbing fears. It is a uniquely well-suited tool my brain uses to make me worried, depressed, and irrational. If I had HIV I wouldn't know; it would be my fault; it would harm my husband both physically and mentally; it would cause my family distress; I would be judged and shunned; it would be catastrophic. So when the doctor brought up the CDC's recommendations for HIV testing in young people, a switch was once again flipped in my brain. I began obsessing.
This obsession has come and gone since high school. It is at times intense and tormenting. I wouldn't wish it on my worst enemy. Imagine being convinced that you've given yourself and the person you love most in the world a death sentence. Horrifying! What a monster you'd be! Or at least that's what my brain tells me.
I've been tested for HIV. A year ago I finally broke down one after weeks of feeling intense pain and guilt every time I looked at my husband and felt like I'd killed him. I went to my local health department and got an oral swab test. It was negative. Part of me knew it would be. I haven't engaged in any behaviors considered "high-risk" and my husband and I had been together for seven years at that point. But the OCD part of me didn't care about reason or odds or even facts.
After the test I was able to move on from the obsession for about a year. Today it cropped up, hopefully temporarily. I told the doctor I'd been tested using the oral swab, which I was assured was accurate. I asked her if that satisfied the guidelines and if the test was indeed accurate as I'd been told. She shrugged a little and tilted her hand back and forth in a so-so motion. That's when my stomach tightened up. She said it would satisfy the requirements and she'd put it in my chart. But the damage had been done. Her doubt in the test was enough to fuel my obsessions and my brain began to churn with the well-worn thoughts from a year ago.
It's a horrible feeling. Miserable. Helpless. Frustrated. Angry with yourself, with the disease, with the trigger. OCD turns your brain against you. The things you love become the targets of terrible things that are your fault. You want to be happy. You want to look at your family and feel, above anything else, love. But that's not what I feel; I feel fear. I fear that I have or will hurt them in some way, inadvertently but through my actions all the same.
When I obsess over HIV infection my compulsion is online research. I do research to reassure myself that I have a very low risk of infection and that the test I took was accurate. A few minutes ago I was anxious for my husband to leave the room so I could research. I was so angry at myself for thinking that.
I did okay at managing my anxiety and obsessive thoughts today. I acknowledged them and redirected my attention. I took deep breaths and was aware of the tension I held in my body. But tonight, sitting on my couch unable to enjoy being alive, happy, healthy, I am so frustrated. The Prozac is a huge help--I would be paralyzed with fear right now if I'd not been taking my medicine. But at the end of the day, I want my brain to be on my side. I want it to leave me alone, let me be happy.
I had a hard day and am ready for sleep. Tomorrow is a new start.
A
