Obsessive Compulsive Disorder (OCD) February 15, 2013Posted by Crazy Mermaid in Anxiety, Mental Hospital.
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Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry; by repetitive behaviors aimed at reducing the associated anxiety; or by a combination of such obsessions and compulsions. Symptoms of the disorder include excessive washing or cleaning; repeated checking; extreme hoarding; preoccupation with sexual, violent or religious thoughts; relationship-related obsessions; aversion to particular numbers; and nervous rituals, such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms can be alienating and time-consuming, and often cause severe emotional and financial distress. The acts of those who have OCD may appear paranoid and potentially psychotic. However, OCD sufferers generally recognize their obsessions and compulsions as irrational, and may become further distressed by this realization.
Obsessive–compulsive disorder affects children and adolescents as well as adults. Roughly one third to one half of adults with OCD report a childhood onset of the disorder, suggesting the continuum of anxiety disorders across the life span. The phrase obsessive–compulsive has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is excessively meticulous, perfectionistic, absorbed, or otherwise fixated.
Despite the irrational behaviour, OCD is sometimes associated with above-average intelligence. Its sufferers commonly share personality traits such as high attention to detail, avoidance of risk, careful planning, exaggerated sense of responsibility and a tendency to take time in making decisions.
OCD occurs in two to five percent of the population, and is the fourth most common psychiatric diagnosis. The majority of OCD patients who have not experienced symptom relief may have not received adequate trials of appropriate medication and/or behavioral therapy. The remainder typically do not respond because of poor treatment compliance, unrecognized cognitive impairment, co-occuring psychiatric illness or poor understanding of treatment. Adequate treatment for OCD often requires that medication trials be longer than those for other psychiatric illnesses. Additionally, behavioral interventions are time- and labor-intensive, frequently requiring close supervision and support.
Located in Belmont, MA, the OCD Institute at McLean Hospital is a national and regional center dedicated to the advancement of clinical care, teaching and research of obsessive compulsive disorders. The program provides partial hospital and intensive residential care for individuals age 16 and older who suffer from severe or treatment resistant OCD. It offers an innovative combination of somatic, behavioral and milieu treatments not found in other programs. It takes Medicare and Medicaid among other insurance plans, and comes highly recommended by a friend who completed the 8 week program in September 2012.
(Reprinted from Wikipedia and The McLean Institute)
Mental Illness and Smoking November 16, 2012Posted by Crazy Mermaid in Anxiety, Involuntary Committment, Smoking and Mental Illness.
Tags: Anxiety, Involuntary Committment
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Not a smoker myself, I had the luxury of watching the etiquette of cigarette smoking unveiled right before my very eyes as I roamed the small courtyard at our 15 minute cigarette breaks during my three week stay at the mental hospital.
Without the luxury of time afforded their rich brethren with their ready-made cigarettes like Camel and Virginia Slims, the homeless patients- who comprised more than half the mental hospital population- managed to use their ingenuity and creativity to make cigarette rolling into an art form, combining speed and efficiency. It was fascinating to watch a patient impress his rolling technique with his own personality. Some rollers – mostly men- fancied thick, squatty joint-looking rolls. Others- mostly women- preferred thinner, more ladylike cigarettes. Each cigarette had its own distinct look. It was amazing how much variety could be squeezed out of the same ingredients. Who knew that tobacco and rolling paper could be formed into so many individual shapes while still retaining their purpose?
As a nonsmoker, I was initially offended by this dichotomy: serving cancer sticks to the ill seemed morally bankrupt. Later on, I came to understand the stabilizing influence of tobacco. Its anti-anxiety effect became crystal clear to me as I watched the nicotine-deprived mentally ill patients visibly calm down after the administration of a cigarette or two. Forcing a psychotic patient to suddenly stop smoking was not good medicine, I came to realize. Besides, if the nicotine was looked upon as an anti-anxiety drug, then its administration to a suicidal patient became an action similar to administration of morphine to a cancer patient. Side effects, in other words, are relative.
Watching the daily calming influence of nicotine became a siren call for me to take up smoking, much to my husband’s chagrin. His daily visits, usually during smoke breaks, were spent watching me learn to roll cigarettes, and then having to listen to my explanation of why I was going to start smoking. To his credit, he neither discouraged nor encouraged me, sensing that any direction whatsoever to a psychotic mentally ill person- especially his wife- would be useless and even counter-productive.
My announcement to the nursing staff of my intention to start smoking was met with less than enthusiasm. The nursing staff, viewing my intentions as simply another manifestation of my mental illness, did everything they could think of to discourage me from lighting up. But the reality was that the same tobacco and rolling paper the homeless used was also available to anyone who wanted to start smoking. Even me.
My anxiety, from the medications as well as the illness, was enormous. Unbearable, even. It was so awful that I would do anything, try anything, to alleviate as much anxiety as I could. The prospect of dying of lung cancer paled compared to the anxiety of desperately wanting to crawl out of my skin. If smoking would relieve even a small portion of that horrible anxiety, I reasoned, then the price was more than worth it.
While not outrightly engaging in any sort of discriminatory behavior, the nursing staff nevertheless managed to communicate their dislike of smoking, stopping short of suggesting to the smokers that it might be a good time to quit. They realized the very strong stabilizing effect of tobacco on their charges’ psyche. But while they didn’t actively engage in trying to get people to stop smoking, Hell was going to freeze over before they were going to allow a non-smoking patient to take up smoking.
Their first line of defense was to try to reason with me. Didn’t I realize that the reason the drug (tobacco) calmed people down was because it was a “fix” from the habit of smoking? That it really didn’t alleviate anxiety like the anti-anxiety pills did?
But I wasn’t buying any of their bullshit. They were lying to me. I was convinced the drug really was like an extra dose of the anti-anxiety pills. Besides, the doctors limited the number of those pills we could take, but not the number of cigarettes we could smoke. It was, I believed, like getting an extra dose of Klonopin. Besides, all my new friends smoked.
In the end, I couldn’t make my mind up whether to start before I was discharged from the hospital. Once out of the smoking environment, I totally forgot about my desire to take up smoking. Besides, the tools- the tobacco, paper, and rolling machine- were no longer at my fingertips.
M medication is stabilized and I no longer have that incredible surge of anxiety through my system…most of the time. Although I am glad that I never took the habit up, I no longer pass judgment on the smokers of the world.
Mental Illness and Disability Insurance December 28, 2009Posted by Crazy Mermaid in Anxiety, Delusions, Disability Claim, Hearing Voices, mental illness.
Tags: Disability Claim, Hearing Voices, mental illness
I finally, after some soul-searching, decided to apply for Social Security Disability. There were over-arching problems that prevented me from applying for that disability until very recently.
The primary problem was that my core being would have to acknowledge in a very public forum that I have an illness so debilitating that I could no longer work. The months of waiting for the return to normalcy so I could return to my job as project manager would have to be officially suspended. Not necessarily forever, but for the forseeable future. In applying for SSDI, I would be admitting to the world at large that the disability is in fact significant and permanent.
The second problem was with the process itself. The point of the application is that I don’t handle stress well. Unlike me, whose disability actually gets worse under the application process itself, someone missing a leg can’t lose more of his leg simply by going through the application process. But I, because of the nature of my illness, had to be prepared for an increase in my “qualifying symptom”. Back-sliding was to be expected during the application process.
Would it be worth hearing voices for the ability to bring in at least a little income? I had to wait until the answer was “yes” before proceeding with the actual intake process.
The third problem was the enormous sense of guilt and worthlessness that acceptance by Social Security as disabled would entail. Guilt because I’d feel like I’m stealing money from society at large. Worthlessness because I would be getting something (money) for nothing. Nothing, that is, except losing my mind.
The emotional kick in the stomach started with an in-person interview at our local Social Security office. Because I was concerned about what the stress of my interview would do to my mind, I asked my sister to accompany me (and drive) to the interview. I was glad she did.
The interviewer, after learning that I was applying for disability for a mental illness, was very kind. I burst out in tears as I delineated the specifics of my disability to the world at large and to the government in particular. I “bled” all over the floor, in other words. My sister, having a better grasp of the reality of the situation, reminded me (and the intake specialist) of symptoms that I had forgotten about. Or maybe just wanted to forget about.
After clearing the “intake” hurdle, the next step was sending all of my medical records in to the government for their official analysis. My mental hospital records, my psychiatrist’s records, and of course my therapist’s records- all of these private, personal records became a matter of public record.
After the government reviewed my records, they still had enough questions about my purported disability that they insisted on an independent psychiatric evaluation. They arranged for a perfect stranger, a local psychologist who knew neither my psychiatrist, my therapist, nor me, to poke and prod around in my mind to find out how bad things were. Was I really mentally ill? If so, how mentally ill was I? Too ill to hold down a job?
Not surprisingly, the anticipation of that horrible exam brought on a severe case of stress which, of course, brought on the voices. The worst case, in fact, that I’d had since my discharge from the mental hospital.
Unlike the nightmare that I had constructed in my mind, the psychologist was very kind yet thorough during my exam. I had been warned from my psychiatrist that he would be looking for any possible substance abuse problems ( which I don’t have), since it’s fairly common for drug users to try to get disability in order to finance their habits. Having survived the psychologist’s 2 hour examination, I can bear witness to the difficulty any substance abuser would have getting disability- at least if they had to go through that guy.
When the psychologist told me at the conclusion of the exam that I was not employable, it was still a kick in the stomach. I didn’t really expect it would hurt that bad. His assessment confirmed my suspicion that the return to my former profession was not in the cards- at least not yet. But he did hold out hope that this assessment didn’t condemn me to a life of forever on the “dole”. He explained that just because I’m sick enough now to qualify for disability doesn’t mean I’ll always be sick enough. But the bottom line is that, at least for now, an independent third party just confirmed my worst nightmare: I’m no longer employable.
The Job that Took My Mind Part 2 November 6, 2009Posted by Crazy Mermaid in Anxiety, Delusions, Disability Claim, Hearing Voices, mental illness, Psychotic.
Tags: Delusions, Hearing Voices, Insanity, mental illness
As I began to take over the nightmare job, I quickly learned that:
- All subcontractors had been working by the hour and the superintendent had been afraid to turn in their invoices because he thought he would be fired. So he had been hoarding their invoices. By the time I found out about them, the stack was about 6 inches high;
- Not paid for their work, subcontractors were threatening to leave the job (understandably);
- The owner hadn’t paid M Construction since the first month they’d started the job (3 months prior);
- Matt had started work on the only floor without any plans;
- Normal procedure is for the contractor to finish a room and tell the architect he’s done with the work. At that point the architect looks the room over and creates a list of unfinished work (called a “punch list”) before the owner can move into the room. But at the hotel, the hotel manager was in charge. When he thought the work was close to being done, he called the architect for the inspection, even as the subcontractors and carpenters were still installing the work. Then, even as the workers were still in the room, the owner would bring in the bed, dressers, drapes, towels, sheets, etc. and quickly get the room back into the rental pool. M Construction was in effect thrown out of the room before they were done, and then denied access to the room to finish the work on the punch list. It was absolutely the most insane and out-of-control job I had ever seen in my 25 years of managing projects.
As project manager of record, I was responsible for rectifying each and every one of the problems listed above, despite the fact that I was the 3rd project manager in 4 months brought in to complete the project.
After I grasped the magnitude of the challenges, I asked my boss, Mark, to be relieved of the job, believing that the skills required to complete the project were far beyond my capabilities. He denied my request, citing a shortage of qualified project managers company-wide, and expressing confidence in my ability to successfully accomplish the job. When I asked Mark for a project engineer to help me, he denied my requesting, citing the company-wide shortage of project engineers at that point in time.
As the project dragged on though the end of 2007, Mark disassembled the Special Projects Division that I worked for and moved on as Construction Manager of another job. Despite my restricted access to him, I continued to keep Mark abreast of my progress, believing that he was still my boss because nobody else had been assigned to supervise me. At my request, Mark met periodically with me, assisting me in my efforts to obtain a signed contract with the Owner and subcontractors.
After the project was physically completed, I was assigned to build a construction claim against Kimpton for the additional scope and lack of access to the jobsite (guest rooms) in order to complete the punch list. I again asked Mark for the assistance of a project engineer. This time a young pregnant woman project engineer was assigned to assist me during the few months prior to the birth of her baby.
Anxiety September 8, 2009Posted by Crazy Mermaid in Anxiety, Involuntary Committment, Psych Ward.
Tags: Anxiety, Involuntary Committment
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The primary purpose of hospitalization is to administer powerful drugs in a controlled environment. As the drugs begin to take effect, anxiety builds. Most of the drugs, including antipsychotics and mood stabilizers, have anxiety as a side effect. The resulting synergy from each medication’s anxiety side effect produces an incredible surge of anxiety, unlike anything most of us have every known.
So the secondary reason for hospitalization is to learn to control the anxiety. Learning to control that anxiety, as it builds up higher and higher with each passing day as the medications take effect, is how patients spend their time. We take classes on it, we do exercises on it, we learn various coping methods for it. And in the end, we take medication for it. But the medication is never enough, and we are limited in the amount that we can take. So we have to learn how to handle it ourselves, to the best of our ability.
Although some people live with anxiety their whole lives, in general anxiety is not on most people’s radar. They have absolutely no concept about what anxiety is and how debilitating it can be. It’s difficult to put into words what anxiety feels like, but I’ll try: Stand up straight, legs slightly apart. Now, tighten every muscle in your body. Ball up your fists. Next, try sitting down. Can you do it? Imagine feeling like this all of the time, 24/7. You can’t relax, no matter how hard you try. If you sit down, the muscles in your legs are still tight. The muscles in your entire body remain tight. You can bend your limbs in the right direction, but those muscles don’t relax- ever. Your whole body, though not rigid, can’t relax. You clench your teeth. It’s exhausting. When the anxiety gets too high, it feels like you want to crawl out of your skin.
One of the most common outlets for handling anxiety in a mental hospital is to pace the halls. Those of us with severe cases of anxiety would walk up and down the halls, over and over again, trying to work out some of that anxiety. We couldn’t stop walking for very long, because the anxiety would come back in full force if we stopped walking. And so we continued to walk the hallways, over and over again. We walked miles every day, one foot in front of the other, up and down those carpeted hallways.
Everything that we did there was structured to teach us how to cope with that anxiety. Group therapy sessions discussed and sometimes actually showed us how to handle stress and anxiety. There were physical steps we could take with our bodies- everything from squeezing the flap of skin between our thumb and index finger to massaging our finger of choice to controlled breathing. Then there were steps we could take that weren’t direct acts on our bodies. We could blow bubbles, color in coloring books or on blank white sheets of paper, watercolor, or do jigsaw puzzles. There was also aromatherapy. Lavendar was the favorite. But walking the halls was the single most valuable outlet for handling anxiety.
Unfortunately, the building’s psych ward wasn’t built with our anxiety side effect in mind. The hallways were about 10 feet wide and about 50 feet long. So only a few of us could fit comfortably at a time. Sometimes it got a little crowded with all the people pacing. But when you’re that anxiety-riddled, pacing is your only option and crowded hallways are the least of your worries.
I seriously considered taking up smoking at the hospital because I heard from some of the other patients that it would help me with my anxiety. My mental hospital was the only one in the state to allow smoking, even supplying the tobacco and rolling paper for the homeless people who had no money to buy cigarettes. Anyway, once I became convinced that smoking would help my anxiety, I actively tried to take up smoking, but my nurse/guard did everything she could to discourage me. In the end, because she made it almost impossible for me to start smoking, I didn’t take it up. I’m eternally grateful to her.
Before my breakdown, I would go to sleep the minute my head hit the pillow. But with all the medication I was taking, sleep just wouldn’t come. The anxiety was just too powerful. Sleeping pills were discouraged long-term because they’re so addictive. So the access to them was very restricted.
When I was released from the hospital in the care of my psychiatrist, he started right in trying to treat my anxiety so I could sleep. He pointed out that lack of sleep would put me back in a manic stage and I would have to return to the hospital. Understandably, I became extremely anxious about trying to get enough sleep. So anxious that it effected my ability to sleep. I would lay awake until 2 am, knowing that if I didn’t get to sleep I would get manic.
The anxiety was so bad that I would lay in bed trying to get to sleep, my teeth clenched so tightly that my jaws hurt. So we (my psychiatrist and I) worked on finding a way to get me to sleep and keeping me asleep. Over a period spanning several months, we went through about 6 different drugs looking for one that worked. I would buy one drug and take it for a few weeks and then buy another drug and take it for a few weeks. On and on, racking up hundreds of dollars for drugs that didn’t work. Finally, we found Seroquel. It’s an anti-anxiety drug for me, and I can take up to 300 mg of it if I have to. Although I take just 100 mg of seroquel, just knowing that I can take up to 300 mg makes getting to sleep much easier.
Fortunately for me, I didn’t become addicted to sleeping pills or start smoking. I’m learning other ways to handle my anxiety.