Medical matters

My intermittent health anxiety reared its ugly head again this summer when anti-inflammatories that I was taking for a bad back triggered excruciating indigestion. 

Initially I had no idea what was going on, having somehow never suffered from this very common complaint, and I immediately assumed the worst. Google provided some reassurance, in that every source I reviewed gave the same answer. My doctor confirmed my self-diagnosis and the problem resolved after a couple of days of his recommended treatment.

Unfortunately, the symptoms reappeared, and escalated, a month later. The constant gnawing, empty feeling left me unsure whether I was hungry or not, I could have won an Olympic medal for burping, and my stomach gurgled day and night, which kept me awake, just to add to my woes. My biggest concern, though, was that I could now feel food going down when I swallowed. 

I tried every treatment I'd read about - antacids, herbal remedies, eating earlier in the evening, avoiding trigger foods, elevating my sleeping position - yet nothing effected a complete cure. While my online research confirmed that the new symptoms could all be attributed to any number of relatively minor conditions, I was convinced I had something more serious. The fact that these symptoms came and went, and some days hardly troubled me at all, was irrelevant!

A few weeks on, a particularly bad flare-up on holiday finally forced me to abandon Dr Google in favour of going back to my doctor, who confirmed continuing indigestion. Even using its medical term, dyspepsia, there's no getting away from the fact that it's not serious - and I'm much better after a month or so of medication and severely restricting my diet.

Although I felt silly for letting a trivial medical matter concern me so much, perhaps it's reasonable to be scared by unfamiliar symptoms. Those people who conjure up completely non-existent illnesses undoubtedly have a much bigger problem. 

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A friend's brother, who is badly affected by health anxiety, became convinced that he had been exposed to asbestos through his work - there was a very slight, but unproven risk - and that he had developed a lung condition as a result. He had no symptoms, but underwent a private scan, which gave him the all-clear. Sadly, this still didn't put his mind at rest.

I've sometimes wondered about doing the same, to check for any lumps, bumps or other anomalies. The upside would be that if a scan did identify any problems, treatment could be carried out promptly and, therefore, more effectively. 

The downside - other than the cost - is that things can obviously still go wrong between these examinations. Any test is, after all, only proof of your medical status on the day that it's done.

For someone like my friend's brother, even a daily scan would be insufficient to quash their health fears. Only cognitive behaviour therapy, and developing a whole new way of thinking, can slay that particular dragon.

Sign your name

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Earlier this month, a major campaign was launched to try to persuade the government to increase investment in mental health services.

The Equality for Mental Health campaign is being led by MP Norman Lamb, whose son was diagnosed with OCD at the age of 15, and has the support of hundreds of high profile figures from all walks of life.

It's great to see mental health hitting the headlines again and also to see the growing momentum in the work being done to achieve 'parity of esteem' between mental and physical healthcare.

The campaign, described as 'cross-party and cross-society', highlights 10 of its concerns on its website. This list features some truly scandalous facts; the standout ones for me were:

• Only 15% of people who might benefit from talking therapy actually get this.
• Three-quarters of children and young people with mental health problems receive no treatment at all.
• Children are sometimes admitted to adult hospital wards, due to a shortage of beds.
• Until April this year, there was no maximum waiting time for treatment for mental ill health - this is now 18 weeks.

Just imagine applying any of the above to physical health problems. Suppose only 15% of people who needed heart surgery had it. Or those with kidney disease received no treatment whatsoever. Or children recovering from an operation had to share a ward with adults. Such situations would simply never be countenanced.

As Ruby Wax, comedian and mental health advocate, said: 'They [the government] don't comprehend that mental illness is a physical problem - it just happens to be your brain, which is another organ.'

The knock-on effect of not addressing mental health problems is significant, both on the individuals concerned and society as a whole, not least the impact on the NHS and employment figures. One of the most shocking points raised by this campaign is that people with long-term mental health conditions live on average 20 years less than the general population - suicide is presumably a contributory factor.

Following the list of key concerns is this plea: 'We urge the government to seize the opportunity to end this historic injustice and commit the investment that will lead to an economically and socially stronger Britain.'

If you're a UK resident, please sign the petition to lend your support ahead of the announcement of the 2015 Comprehensive Spending Review, on Wednesday. No doubt this particular battle will go on into the future and this petition is a chance for you to make your voice heard.

With 1 in 4 people suffering from a mental health condition, we all know somebody who is affected, and who might benefit from better investment in services. And you never know when you might become one of the 1 in 4 yourself.

No surrender

When news broke on Friday evening about the terrorist attacks in Paris, the scale of these was so shocking that it seemed unreal: the number of deaths at that stage was around 40. I went to bed upset, but determined to push it to the back of my mind - I had a big day ahead of me, with my first talk at a local library, and needed a good night's sleep.

However, when I turned on the radio first thing Saturday and heard that nearly 130 people had died, my stomach flipped and my heart began to race. As the day wore on, and I continued to monitor the news, my distress grew, along with my need to perform compulsions.

My OCD is exacerbated not only by bad news close to home, but also by upsetting events further afield that don't directly affect me. The more crazy and out of control the world becomes, the stronger the urge to order my environment: exerting even a little control eases my anxiety.

Over the years, all kinds of horrific incidents have triggered the same response, including the attack on the Charlie Hebdo offices in Paris earlier this year. Although natural disasters usually cause more deaths, it's the instances of human evil that disturb me the most.

I'd already had a difficult couple of weeks, with the sudden death of a friend's wife and a burglary at my boyfriend's flat. Factor in my rising anxiety about performing in public and I was in a pretty wobbly state. The Paris attacks were the final ingredient in a perfect storm of mental distress.

By early afternoon, when I had to leave for my talk, my compulsions were as bad as when my OCD was at its worst, 20 years ago: I was unable to leave my flat until everything was exactly where it should be. These days, I usually only find myself in that position when I'm going away for a prolonged period, not for an absence of a few hours.

On the news yesterday, countless people were saying we shouldn't be frightened and should go about our business as usual, or the terrorists would have won. I couldn't help being frightened, though, and as for carrying on as normal... 

Only days earlier, I'd been thinking of treating myself to a trip on the Eurostar to Paris. Now I was suddenly scared even to go into central London - into any big city. I just wanted to curl up in a ball in my flat, where I may not be immune to all harm, but would most likely be safe from terrorists.

Then it suddenly came to me: I could fight back, in spite of my fear, by reining in my now rampant compulsive behaviours. The terrorists may have wormed their way into my mind, but I wasn't going to let them take it over.

I began to work on reducing my compulsions to their usual mild level, but soon found myself taking this further, using exposure exercises (ie deliberately leaving things out of place) to tackle my most entrenched - and 'accepted' - habits.

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All day, I put stuff down without positioning it, thinking 'F**k you, terrorists': you may have frightened me, you may have temporarily terrorised me off this city's streets, but you will NOT terrorise me in my home. In my own small way, je suis Paris.

RIP to all the victims.

I spy

I began this blog with the intention of focussing on my experience of living with OCD, perfectionism and anxiety. Writing about these conditions has, however, prompted me to reflect on other of my behaviours and I've discovered a great deal about myself as a result.

In the process, I've also acquired yet more labels, including obsessive-compulsive personality disorder, spartanism, compulsive skin picking and misophonia*. Fortunately, I tend towards the milder end of the spectrum of symptoms for each of these.

While I sometimes wonder about the merit of labels, I do think it can help to know that a particular behaviour is attributable to a condition, that you're not the only one affected by it, and that treatment is available. So this week I'm appealing for help in naming a problem that the usually trusty Internet has so far failed to shed any definitive light on. 

The issue I struggle with is that I'm easily distracted by things in my peripheral vision, whether stationary or moving. I already know that I'm not alone in this, as a friend has described the same problem, but I hope that by talking about it here, somebody might be able to provide an explanation.

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At work last week, for example, a colleague sitting some distance away was zipping about between documents on screen and I was forced to adjust my seating position to block my view of this activity. Meanwhile, the friend I mentioned has created a wall of folders and large plants around the edge of his desk, so that he can't see colleagues moving about.

The situation is no easier elsewhere. When my boyfriend and I settle down to watch a film at his flat, I first have to check our surroundings for anything that might divert my attention. This could be the light on his iPod, a remote control on the coffee table or a greetings card standing on the floor beneath the television. While his living room is crammed with stuff, it's only certain items that catch my eye and have to be moved.

In my own flat, it's mainly the traffic that troubles me. My street has become increasingly busy and the flash, flash, flash of cars going past is unbearable. If I'm reading, writing or watching television in the living room, I have to draw the curtains - the nets have proved an inadequate shield.

And don't get me started on the ubiquitous phone screens that have, for me, ruined everything from going to the cinema to watching a fireworks' display...

The problem is exacerbated when the task I'm engaged in is difficult or requires particular concentration. I suspect, therefore, that it's more likely to be a psychological issue than a physiological one.

I'd love to hear from you if you've experienced this, too...especially if you know what it is and, more importantly, what I can do about it!


*You can use the 'Search this blog' facility (see right) to find related posts on each of these subjects.

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I do hope that some of my more local readers will be able to join me for my talk at Friern Barnet Community Library, this Saturday 14 November - full details here.

Parenthood

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Two scenes that I witnessed recently set me thinking about how I might have fared if I'd ever become a mother, in light of my OCD.

The first took place late at night in the waiting room of a railway station in Bristol. Amongst the other passengers were a couple of young mums whose two boys, aged about three, were happily playing together. 

Their game of choice was to lie down on the floor, roll across it, pick themselves up and do it all over again...and again and again. I shuddered at the sight. Whilst my contamination issues are secondary to my ordering compulsions, this was more than I could bear. I felt as if I could actually see them getting dirtier with every roll, turning themselves into walking, talking biological weapons. It made me feel dirty, too.

Less than a week later, I was in another waiting room, at my doctor's surgery, when I found my attention drawn by a man's voice repeatedly saying 'Don't do that; it's dirty.'

I looked up from my newspaper to see a man addressing a small boy standing in front of one of the fabric-covered chairs. The boy was bent at the waist, with his cheek touching the seat, which was evidently the cause of the man's concern; although he seemed calm, he was insistent that the boy stop doing this. 

Strangely, this child's action didn't make me uncomfortable, perhaps because people don't tend to stand on chairs with dirty shoes - although I'm sure the one he was leaning on was far from clean, given its location.

I imagine many parents would cringe if their child rolled on the floor in a public place and, equally, many would dismiss the idea of a chair being a hazard. I'm pretty sure that if I'd had children, I'd have been at the unduly protective end of the scale, as a result of both my OCD and my generalised anxiety. Incidentally, it wasn't these conditions that put me off parenthood; I just never felt the biological urge!

Of course, most parents want to shield their children from harm, but that natural instinct can escalate and trigger compulsions in people previously unaffected by them. And it's easy to see why: when you find yourself responsible for something more precious to you than life itself, the world must suddenly seem a very dangerous place.

Whether a person already has OCD, or only develops it when they become a parent, it's important not to drag children into the condition's miserable orbit. It's hard for anyone to resist complying with a sufferer's demands, but even more so for children, and their emotional wellbeing is likely to be at risk if, for example, they're forced to adhere to a parent's strict cleaning rituals. Such rituals may be designed to protect, but ultimately do more harm than good.

Whatever your particular situation, help is available from both OCD Action and OCD UK. This page, about pre and postnatal OCD, is especially useful, as is this leaflet about perinatal OCD, from the Royal College of Psychiatrists.