healthmedicinet

• Experts believe more than one million people in the UK suffer from OCD
• Average person can have 4,000 thoughts a day – not all rational or relevent
  
• David Adam has written book detailing his experience of living with illness
  

By
David Adam

Published:

19:35 EST, 24 April 2014

|
Updated:

19:36 EST, 24 April 2014

OCD sufferer David Adam, pictured with his daughter Lara, has written a book about his condition

The girl was pretty, with long, black hair that she had to push back from her eyes as we kissed. ‘Shall we go upstairs?’ she asked. It was the winter of 1990 and I was a carefree college student.

Real life was on hold and time was a string of fun nights and daytime lectures. I was 18 and wasn’t thinking beyond the next day. Upstairs sounded good.

‘Did you have sex with that girl?’ asked my friend Noel the following evening.

‘Yes,’ I lied.

‘Did you use a condom?’

‘No.’

‘You could have Aids.’

‘Don’t be daft.’

I re-ran the conversation in my mind as I sipped my pint. Had I had sex with that girl? No. I had been lying to show off to my friend. So, could I have caught Aids? Don’t be daft.

Still, an echo of our conversation — you could have Aids — floated back into my mind from time to time over the next few months.

Each time, I could muster the mental puff to blow it out. Until one hot night in the August of 1991, I suddenly couldn’t. Like a snowflake falling from a summer sky, my obsessive compulsive disorder began.

For some people, it’s washing their hands or keeping their homes impeccably tidy. For me, it was a sudden, inexplicable, irrational fear of this killer disease.

(These were the days, I should remind you, when those fearsome tombstone government TV adverts reminding us not to ‘die of ignorance’ were still fresh in people’s minds.Though it’s now known to be a fragile virus that can’t survive for long  outside the body, back then Aids was presented as a death sentence with no treatment — a hideous consequence, it seemed, for a moment of carelessness.)

As I tried to brush away the thought — the snowflake — it squirmed from my mental grasp and settled.

Quickly it was joined by another, then another, then another. The blizzard that followed blew the snow into every corner of my mind and laid down a blanket that muffled every surface.

Why me? I was so frightened that the tips of my fingers tingled. As I went to bed that night, I told myself that everything would be fine the next morning.

It wasn’t. The thought was still there. I went downstairs to the kitchen the following morning and had breakfast in the new world I would inhabit from that day onwards — the first of the rest of my life.

An average person can have 4,000 thoughts a day, not all of them useful or rational. Among them are those occasional random and unprompted ideas that seem to emerge from nowhere and stun us because they are disgusting, sickening — or weird.

The seductive question, for example, ‘what if’? What if I were to jump in front of that bus? What if I were to punch that woman?

Most people have these kinds of strange thoughts. Most shake them off. But some can’t, and don’t. I am one of those people.

As recently as the Eighties, psychiatrists thought clinical obsessions (unwanted, intrusive, irrational thoughts that won’t go away) and compulsions (an irresistible urge to act in a way that is irrational, to perform a meaningless ritual) were extremely rare.

But they now believe that between two and three per cent of us — more than a million people in Britain — suffer from OCD at some point in our life.

Put simply, most people with OCD develop their compulsions as a way to make their unwanted intrusive thoughts go away. They can feel compelled to tap surfaces, count or say secret words to themselves to ‘undo’ the imagined consequences of an intrusive thought — for example, that their best friend will die in a road accident.

Obsessive washing of hands is a common symptom of OCD (Obsessive Compulsive Disorder) – a chronic and recurring neurotic condition

Even though there is no conceivable link between the two, the compulsion makes the obsessive thought go  away — briefly.

The tragedy for sufferers is that an intrusive thought silenced with a compulsive act comes straight back. And it comes back hard.

From that day on, I was obsessed with ways I could catch Aids. I saw it everywhere. It lurked on toothbrushes and towels, taps and telephones.

I wiped cups and bottles, hated sharing drinks and covered every graze with multiple plasters. I even checked train seats for syringes.

My rational self knew these fears were ridiculous. I knew I couldn’t catch a disease in those situations. But still the anxiety kept coming.

I started spending a lot of time on the phone to the National Aids Helpline. Was there a risk when I played football and scraped my knee? Someone could have left a smear of infected blood in the exact spot. No, they responded, the risk is very low.

I believed them — for just as long as it took to replace the handset in the phone box near my student house.

But wait. Very low? So there was a risk? I’d call them back, just to confirm. I dialled the number dozens of times a day.

When I thought they’d started to recognise my voice, I put on different regional accents. Even after the kind people at the other end gently suggested I should talk to a psychiatrist rather than them, I wouldn’t admit I needed help.

 Put simply, most people with OCD develop
their compulsions as a way to make their unwanted intrusive thoughts go
away.

It was not for another three or four years that I finally gave in and saw a specialist. He gave me a red rubber band and told me to wear it on my wrist and snap it against my skin whenever I had an intrusive thought I didn’t want.

Twenty years ago, this was the treatment for OCD. It was called thought-stopping — and it was useless. My band lasted a few hours. The next one survived a day.

I went to a budget stationery shop and asked for the biggest bag of rubber bands they had. I tried it for a few more days, then I gave up.

Instead, I taught myself to avoid the situations that would prompt the unwanted thoughts and urges and worked out ways to avoid them.

If I was unsure whether someone else had drunk from my glass, I didn’t finish it. If an opponent on the astroturf football pitch shredded his knee, I would avoid him.

I had good days and bad days – though more bad days. When things became dire, when a thought just would not budge, I’d take myself off to give blood. That way I would be tested for HIV and they would reassure me I was all right.

It wasn’t that I couldn’t function or that I couldn’t think or do anything else. I did well in exams, I had friends and girlfriends and held down some decent jobs. It’s just that I was thinking about something else at the time.

I was on autopilot. I looked the part and smiled at the passengers, but something else was flying the plane.

My baby daughter was six months old when I noticed the blood on her leg. It was a hot day in 2010 and she was wearing a pair of shorts as we played on the swings in the park. There, above her knee, was a dull smear of red.

There was no obvious cut or graze. Where had it come from? Was it my blood? I checked my hand and, sure enough, there was a small scratch.

Click. My mind delivered another scenario. It could be someone else’s blood. And it could be infected.

I couldn’t see any blood on the swing nor on the grass underneath — even though I returned to that playground at least a dozen times that day.

Experts believe that between two and three per cent of British people – more than a million people in UK – suffer from OCD at some point in their life

I still couldn’t see any when I came back with a torch to have another search that evening.

I was 38. It was almost 19 years to the day since that first summer night when I discovered that I could not ignore my intrusive thought.

You could have Aids. She could have Aids.

Before that momentous afternoon four years ago, I had settled for a life with OCD. I reversed that decision the day I made my baby daughter an accomplice.

I phoned my local doctor the next morning to make an appointment. It stopped here. It stopped with me.

The staff at my local psychiatry unit told me to report back for group therapy. There were no guarantees, they said, but they thought they could help.

If you were to have peered through the window of those group therapy sessions during the late summer of 2010, you’d have spotted nothing unusual. A group of middle-aged people sitting in a circle.

No one washing their hands or trying not to. We could have been learning a foreign language, so civilised did it seem.

Between us, we ticked most of the boxes — contamination and checking fears, long-standing symptoms, distress and reduced quality of life. 

Probably because we had all been young during the era of those infamous tombstone adverts, two of the others had obsessions and compulsions linked to Aids.

We swapped stories and tried not to swap irrational fears. We learned how the compulsions are a short-cut that helps relieve anxiety, but only for a short while.

We started to identify the dysfunctional beliefs and cognitive errors in ourselves. We started to diagnose them in each other.

This was cognitive behavioural therapy (CBT), but it didn’t feel like the type of treatment we’d expected. It was mild. We suspected that worse was to come.

We were right. I was told to go home and smear my daughter in my own blood.

Shocking though this sounds, it was part of a treatment for OCD known as exposure and response prevention. It works like this.

Get the person anxious by stimulating them with the object of their obsession, and then let the anxiety peak and plateau of its own accord. In time, it has nowhere to go but down.

Once the patient feels their anxiety go away by itself, without the need for compulsions, they will lose their fear and start to recover.

Because I feared, probably more than anything else in the world, to touch my daughter with blood on my hands, I was told that the next time I scratched myself or cut myself shaving, I was to seek her out and daub her face, her head, her exposed arms and legs.

 An average person can have 4,000 thoughts a day, not all of them useful or rational.

The anxiety would peak. But then, in time, it would come down.

Strangely, even the thought of this helped me. And the reason? Because someone else was offering to take responsibility for my actions. ‘I have a good job and I get paid a lot of money,’ the therapist had told us. ‘If I tell you to do something, and something bad happens as a result, then you can blame me.

‘I will get sacked. Do you think I would ask you to do something that will get me sacked?’

If I had blood on my fingers, touched my daughter and gave her Aids, then it wasn’t my fault. It was his. He’d told me to do it.

The end result would be the same. My daughter would still have the virus. But that didn’t seem to matter as much if it was his job to stop it and not mine.

Somehow, it just didn’t seem as likely to happen any more.

Suddenly, I had a sense of perspective. My consciousness soared above my fears, as a camera draws out from a single house on a map to show the street, the town and then the surrounding countryside.

Previously, my OCD interfered with this process. No matter how much I tried to make the camera pan out, the irrational fear stayed in view, like a dirty smudge on the lens. Suddenly, the risk of contracting a disease from all those unlikely routes shrank as I rose above to see them in their proper context.

Psychologists call this moment of clarity ‘the helicopter view’. We see the landscape in its proper scale.

From 10,000ft up, the gap between very low risk and zero risk — so visible and so important to my OCD — is hard to distinguish.

David Adam tried cognitive behavioural therapy (CBT) to help treat his OCD (picture posed by models)

It can be hard to access good CBT and I will always be profoundly grateful that I did. It worked for me. And no, I never did smear blood on my daughter.

Four years on, I feel much better now. But I will probably always have OCD.

For most people it’s like being a recovering alcoholic. You are always only a certain number of days past your most recent obsessive- compulsive episode.

One of the first things they did at that OCD clinic was put me on drugs.

Sertraline hydrochloride is what chemists call a psychotropic medication. I call it a lifeline, a route back to the light from the darkest regions inside my head.

How long will I take it for? I don’t know. I’m afraid to stop: rapid relapse among those who do is common, apparently. But I don’t see a downside.

My OCD rarely causes me distress now. The snowflakes still tumble from the summer sky. But I have learned to make them melt away again.

• Extracted from The Man Who Could Not Stop: OCD And The True Story Of A Life Lost In Thought by David Adam (Picador, £16.99). ©?2014 David Adam. To order a copy for £14.99 (including PP), tel: 0844 472 4157.

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Comments (132)

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The comments below have been moderated in advance.

jamesc111,

South, United Kingdom,

8 minutes ago

This is the 278th article you’ve written on OCD. It’s of average length compared to the others.

ScotsBuffoon,

Timbucktoo, United Kingdom,

14 minutes ago

I used to have OCD . . . but I was cured 4 years, 210 days, 16 hours and 49 seconds ago

Magic,

Far Far Away, United Kingdom,

18 minutes ago

The hardest thing with this kind of escalating mental illness in the UK is that they will not treat you until you are desperately unwell and living in misery. Early intervention would help so many people not to have their lives ruined. OCD is very similar to the way EDs work, and often you find people with an ED have many OCD traits, yet you have to be practically on death’s door for the NHS to help you, and there are not enough private facilities that are actually hospitals rather than rehab-type places. Unfortunately the NHS does give the best care in these situations, but it’s so hard to get it, and by the time you do your life has been dominated by the illness and it will take years to feel better, if you ever do.

John61,

Epsom,

19 minutes ago

I once had a client who had OCD and I spent many an hour listening to her crying down the phone. She used to scrub her legs and feet with a stiff brush and Dettol until the skin came off in flakes. It was soul destroying because there was nothing anyone could do to help her. She was locked solid into her own cycle of self abuse and yet she was a very educated woman and quite personable. It was all just so sad to see.

stranton,

Billingham, United Kingdom,

23 minutes ago

At last, a story depicting the real OCD, the OCD I gave lived with all of my life and the oCD that has caused by 15 year old daughter years of misery, the OCD that causes my 7 year old to seperate his food, the oCD that causes thoughts so revolting I sometimes feel I’m damaged, the oCD that caused me to walk away from several high paid jobs. OCD (unlike what TV depicts) is not all cleaning and organising your shampoo bottles and CD collection, its’ terrible and at 35 still causes me daily distress, thankfully my own experiences are helping me ensure that my children (who all display OCD) provide the support required.

ME,

Wiltshire, United Kingdom,

25 minutes ago

OCD is extreme anxiety really isn’t it.
In which case every human who has ever walked God ‘s earth has experienced it to one degree or another.

emmasamantha,

Rutland, United Kingdom,

27 minutes ago

Paul if you held a gun to my head at my worst I would have a panic attack if I couldn’t as you call it ‘indulge’ myself. You are very ignorant in yout views. My husband though the same as you about all mental health until he lived with me and realised it is a real thing (although it does annoy him at times my twerks).

mollypop94,

Mountain Ash,

30 minutes ago

”Put simply, most people with OCD develop their compulsions as a way to make their unwanted intrusive thoughts go away.”

The sad irony is that OCD is an unwanted, intrusive thought in itself…I’m greatful of the little things in life, and to not suffer with such a difficult mental illness, I hope to all that suffer that they find a way to control their trouble thoughts. There’s always a way out of your painful mind pattern, you just have to find it

mr_angry,

here and there, United Kingdom,

33 minutes ago

I’ve got various iterations of this horrendous bondage. Most of them are concerning benign things so people just laugh at me but the result is the same. TORMENT. I put it down to anxiety/depression brought on by loss of carefree childhood and becoming a resposible adult. Bottom line: I never wanted to grow up!

Imogen,

Sydney, Australia,

38 minutes ago

Thanks for this article finally something worth reading! when I was just a kid around 13 I use to have wash my hands and have things done a certain a way. It was frustrating like if someone had touched me during the day it usually meant I would have to shower later or at least wash my hands. A was borderline obsessed in being perfect! thankfully I got over that phase its somewhat an invisible mental illness you can be a genius or an average person and no one would know about your ocd

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