Symptom or Syndrome?

Monday, October 14, 2013
In my life I have made it a point to be open and honest with other people. I have done this for many reasons (the least of which is to help keep myself accountable) and often times it is extremely cathartic to share some of the deeper sides of my "self". While I often times publicly share my happiest moments on social media and the like, I have many deep personal demons that I don't share. Strangely it frightens me to think that I might one day die without people knowing my full true self. (Is this weird? Am I alone in this or do others have this same worry? I would think that my openness polity makes me more unique in this way… but I digress…)

Tonight I speak on another of my personal demons, something that (to my recollection) I have never shared with anyone before. Now, if you have read my blog post announcing my pornography addiction or maybe my post on the moral arguments for/against masturbation, you may be thinking that I might be sharing something sensational, something that would make good gossip around the water cooler.

Well you would be wrong! (I *do* have some personal demons that would make great gossip, and I hope to share those some day… just not now!)

Tonight's revelation isn't sensational, but it nevertheless does speak deeply about my "self", and I pray that it will be cathartic for me to share it. Here goes...

I have OCD.

There, I said it. *whew* I feel so much better now!

Well, now that I said that… to say "I have OCD" isn't entirely true… maybe it might be better to say "I often suffer from symptoms of OCD."

So… what is the difference between having OCD and suffering from its symptoms?

(Note: The following is *my* understanding of the topic thanks to internet research and shouldn't be interpreted as actual medical advice.)

OCD (obsessive-compulsive disorder) is a medical anomaly. We know it exists, but we don't know *why* it exists or even what causes it. Doctors over the years have sought to understand the condition better but the cause of the condition has eluded them, so they simply group a bunch of symptoms together and say "If you suffer from these symptoms then you may have OCD." The exact same thing can describe some other medical conditions like Autism. The definition of Autism is "people that suffer from this list of symptoms."

So what are the symptoms of OCD? Some of the symptoms are well known, but many others lie hidden from the public's eye. The National Institute of Mental Health says that people with OCD generally:
  • Have repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; acts of violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly tidy
  • Do the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again
  • Can't control the unwanted thoughts and behaviors
  • Don't get pleasure when performing the behaviors or rituals, but get brief relief from the anxiety the thoughts cause
  • Spend at least 1 hour a day on the thoughts and rituals, which cause distress and get in the way of daily life
See, OCD manifests itself very differently in different people. Some people have "rituals" like closing and opening doors so many times, some people like to keep things at right angles, some people have to wash their hands much more than is needed. Symptoms like these are visual which leads to TV shows like "Monk" (where Tony Shalhoub plays a police detective that struggles with many visual OCD symptoms). Because they are visual, these types of symptoms are often times what people think about when they think OCD.

I exhibit many of these "visual" symptoms of OCD. For example I often times like things at right angles to each other; I like to keep things overly tidy; I have a strong attention to detail. I even have symmetrical symptoms, IE: if I am walking down the sidewalk and I step on a crack with my left foot, I feel a deep urge to step on a crack with my right foot.

So does this mean I have OCD? Not at all! In fact, most "normal" people exhibit *some* level of OCD symptoms. It is not at all uncommon to like things at right angles or to feel better after you double check that your front door is locked. In fact it takes a lot to be diagnosed with OCD. The key to being diagnosed with OCD is the last bullet point from above:
  • Spend at least 1 hour a day on the thoughts and rituals, which cause distress and get in the way of daily life
A diagnoses with OCD has little to do with which symptoms you suffer from or even how strong they are; it has everything to do with how much it affects your life. You could keep every pencil on your desk sharpened to a perfect point, but if you can live a "normal" life while doing it, you will never be diagnosed with OCD. On the flip side there might be someone who struggles with unwanted thoughts of hurting their family, a completely non-physical/visual symptom, yet if they can't keep a job because they can't control their own mind, they are much more likely to be diagnosed with OCD.

That is why I say that, specifically speaking, I probably don't have OCD, I simply suffer from some of the symptoms of OCD.

Now, I started this post off by talking about how I was going to reveal some personal secret and you may be thinking "But Matthew, we already knew you have a strong attention to detail…" Well yes, but tonight I am going to share a personal struggle that no one knows about:

I have gone through bouts in my life where I suffer from compulsive prayer.

Compulsive prayer is a relatively common OCD symptom. Much like someone may feel the deep need to keep things at right angles or to wash their hands four times an hour, a compulsive prayer is compelled to pray constantly. It is much like an itch that you have that never goes away, it simply temporarily recedes after you scratch the itch, always to return.

When I am suffering from this I practically constantly feel the desire to pray. When it is as its worst I am saying a prayer literally every 10 seconds, all day long. If praying were a video game I would be on the High Score Leaderboard!

Thankfully I don't always struggle with compulsive prayer. In fact it has only manifested itself twice in my life, but both times it lasted for several years.

The first time was when I was in middle school. Going through puberty I found a problem that I thought was abnormal, so being a "religious" person I started to pray about it. For a few weeks I was so worried about this issue that I would pray about it every time I thought about it, many times a day. As it turns out this "issue" was like so many issues that kids have during puberty: it is a perfectly common condition, nothing to worry about… but the damage was done. Even after I stopped praying about that issue, I constantly found myself feeling the desire to pray. All through high school I would pray dozens of times throughout the day, even when there was nothing to pray about. The prayers were often short, something like "God, please be with me today. I pray this in your name, amen." And that would be it, I would scratch the "itch" and thus be relieved of the burden… but 5 or 10 minutes later, I would feel the itch again, and I would have to pray again.

Towards the end of high school the compulsion to pray slowly died out until one day I realized that I didn't do it any more. It is like looking in the mirror one day and saying "Wow, I look different than I used to!" I simply had the realization one day that it was gone, and that was that.

That is, until I was in college. One day towards the end of my college years I worked a double shift at work, part of which required that I work with a group of people that I normally didn't work with. Being a warehouse job many of the people working there weren't the top of society, so to speak. So, in addition to working a 16 hour day in an incredibly physically demanding job, I was surrounded by young people who thought it was cool to share every sexist joke they knew and to do it while inserting as many profanities as humanly possible.

Needless to say, I did some praying that day, if only to keep my mind away from the bad influences surrounding me.

The next day, I found myself still praying, and once again the prayers didn't stop for many years.

This time it got much worse than it had been in high school. See, OCD symptoms ebb and flow, they come and go. Often times they are at their worst when the person is stressed; the more stressed a person is, the stronger their OCD symptoms. As it turns out I was more stressed in college than I was in high school! I found myself praying not once every 5 minutes but once every minute, or 30 seconds, or 10 seconds. The need to scratch that itch was ever present, in everything I did. I even found that it was less about the prayer and more about the end of the prayer, specifically the word "Amen." I found that I could say the word "Amen" and it would satisfy the itch. Often forming the word in my mouth helped to dampen the desire, if only for a few seconds.

So there was a stage in my life where I was saying the word "Amen" every 10-15 seconds all day long, and no one knew about it. It was my little secret.

And that right there is why I will never be medially diagnosed with OCD. Remember that to be diagnosed with OCD the symptoms have to affect your life, they have to bother you so much that you can't carry on a "normal" life without being interrupted by your compulsion. My compulsion doesn't affect my every day life, so while I suffer from the symptom, I won't be diagnosed with OCD.

So… so what? If I can carry on a conversation while praying every 15 seconds, it must not be something I "struggle" with, right?

Wrong! It is something that creates a deep struggle in my life. I have to manage this compulsion, I have to constantly be monitoring the tiny voice in the back of my head, pushing it down only for it to return hours, minutes, seconds later. When I am in a bout of OCD I can't live a minute without the thought of "Amen" going through my head.

And, probably worse yet, it leads me to spiritual questions. "Are my prayers not good enough?" "If most of my prayers as 'dummy prayers,' does that cheapen my real prayers?" In light of my symptom being a medical condition these questions are kind of silly… but that doesn't keep me from having them!

Having to manage the compulsion along with the worries of the religious implications add a level of stress and worry on top of everything else which just makes the situation worse!

Well, just like the bout of compulsive prayer I had in high school, the compulsion in my college years eventually died out. Thankfully I have been compulsive prayer free for roughly six years.

So why write all of this now? Because I worry that it is back.

See, 10 days ago something happened at my job that was a good thing but it added a lot of stress on my plate, and so I prayed about it. I prayed that God would be in the situation and that God would guide and lead me though this uncertain time. 10 days later the situation is resolved, so the need for my prayers is gone… and yet I still find myself praying.

That small voice in the back of my head that I managed for so many years, I can hear echoes, growing very slowly louder, more constant, more present. Of course my first inclination is to pray that God would take this symptom way from me, but… wouldn't that just make the symptoms worse???

So you can see where I am tonight, between a rock and a hard place. I pray that God would relieve me of this all-the-while knowing that the prayers themselves could be making things worse.

So, as I close out this long blog post (2,075 words and counting), I ask for your prayers tonight and going forward, that God would remove this struggle from me, that my worries would be calmed, that peace would invade my life, and that my faith would reign over any physical struggles that I have.