Ch-ch-ch-ch-changes

The more I watch the US sitcom The Big Bang Theory, the more I find myself relating to Dr Sheldon Cooper's quirks.

For those who aren't familiar with the show, it focusses on the lives of four scientist friends - including Sheldon - who are all afflicted by varying degrees of social inadequacy. Although his behaviours are never named, he displays not only obsessive-compulsive tendencies, but also traits common to those on the autistic spectrum.

One episode that I particularly identify with is The Werewolf Transformation, which is about his adherence to routine. This all unravels when his regular barber is taken ill and is unavailable to give him his scheduled haircut.

What upsets Sheldon most is that his routines are designed to prevent a descent into chaos, yet this disruption to his plans doesn't have any dire consequences. 

'I have spent my whole life trying to bring order to the universe, by carefully planning every moment of every day,' he tells his friend, Penny. Now, he fears, he has been wasting his time.

Photo: Peter Gettins Photography

To a degree, of course, we all find routines comforting and it can be unsettling when they break down, whether they were seemingly ordinary activities or something rather more special. 

My boyfriend and I used to celebrate Bonfire Night with the same friends every year, enjoying drinks, dinner and a firework display in their garden. Until the year we woke in the early hours of the following morning to find their neighbours' shed on fire. 

Although the neighbours blamed the electrics, our guilt-ridden hostess attributed the blaze to one of our rockets and swore never to light another firework - and that was it, the sudden death of a fun-filled tradition that I'd thought we would carry on forever.

It may not even be our own routines that we miss when they change. I've lived in my flat for 21 years and so have become accustomed to my neighbour's patterns of behaviour and have been quite upset when various people have moved on.

When the elderly couple opposite left, oh, how I missed their over-the-top Christmas lights that signalled the start of the festive season and welcomed me home like a beacon on dark December evenings. When the new residents, in turn, moved out, I missed their cat for weeks afterwards - I was so used to seeing it in the living room window.

There is still the comfort of the familiar all around, however, such the barking of a neighbour's excitable dog as she heads out for her evening walk and the jangle of the rag and bone man's bell as he drives down our street every Monday morning. 

And now I have a new neighbour across the road, who is a night owl like me - probably because he's an astrophysicist. We've never spoken, but I feel a strange companionship when I look over and see him working at his computer late at night. 

Perhaps, in the end, that's why these routines are so significant: they don't just provide stability in our lives, but also a connection to the world around us. Even those that seem mundane or peripheral to our existence play their part, though you may not realise how important they were until they're gone.

Little Miss Responsible

People with obsessive-compulsive disorder tend to feel an exaggerated sense of responsibility for ensuring harm doesn't occur to others. It's this that drives many compulsions, such as cleaning obsessively to eradicate germs or repeatedly checking that doors and windows are secure.

My own compulsions are less focussed: I don't order my belongings to prevent something bad happening, but to alleviate the anxiety that disorder provokes in me. I do, however, carry a sense of heightened responsibility out into the wider world. 

I once walked past a man lying on the pavement in my local high street, apparently fast asleep. Not an uncommon sight in London, but when I got home I began to fret. It was a very hot day and he wasn't wearing a shirt; he could easily suffer sunburn or heatstroke. What if he died and I could have prevented it? My anxiety drove me to call the emergency services and they despatched someone to check on him.

On a number of occasions, I've gone up to a child on their own and asked if they were all right. The idea that a youngster might be abducted and killed is far more worrying than the risk that I might, myself, be mistaken for an abductor.

While many people might walk on by in these situations, most would probably consider it reasonable for a community-spirited individual to intervene. However, I take this kind of intervention to a whole new - and possibly less reasonable - level.

I'm the sort of person who points out to a fellow driver that one of their headlights has blown...because they might have an accident and hurt somebody.

Or who tells a complete stranger that their shoelaces are undone...because they might fall over and break their arm.

Or who sees a letter left on the doorstep of a shop and wonders whether they should take it inside...because it might be important and its loss could have dire consequences.

Tackling OCD is all about learning to handle life's uncertainties, the constant 'what ifs' that can cause almost intolerable anxiety if you dwell on them. By interfering in others' lives, I'm trying to control some of those 'what ifs', even though they don't directly affect me. 

In Overcoming Obsessive Compulsive Disorder, authors Dr David Veale and Rob Willson talk about the need 'to assume an appropriate, flexible and non-extreme level of social responsibility'.

In extreme cases, OCD sufferers may, for example, retrace car journeys to be sure that they haven't knocked anybody over en route, or obsessively check the news for reports of accidents to reassure themselves.

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Veale and Willson go on to say 'The balance to strike is attending to the protection of others on the one hand, while on the other allowing yourself the usual rights to a life that is not plagued by anxiety and guilt.'

My approach is probably a little off balance, compared to most, but so far not to a detrimental extreme: for now, at least, my interventions still qualify as helpful, rather than obsessive.

Keep calm

The recent onset of heart palpitations has reminded me never to take any aspect of my physical health for granted.

These palpitations first manifested as 'ectopic beats' - premature or extra beats that thudded in my chest at least two to three times a minute. These stopped after a couple of weeks, only to be replaced by the intermittent sensation of being able to feel my heart beating: apparently also categorised as 'palpitations'.

This sensation is more noticeable if anything presses against my chest, for example, if I'm lying on my left side or if I have my arms crossed. It feels as though a small animal is head-butting my ribcage. Although this is a less disconcerting experience than the ectopics, it reminds me too much of the 'chestbuster' scene in Alien to be entirely comfortable.

Oh, how I long for the undetectable, rhythmic heartbeat that I'd never appreciated for one second before.

This problem has also made me aware that I'm often a lot more stressed than I realise.

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When the ectopics began, I tried to pinpoint exactly when they were happening; I didn't notice them when walking quickly and they eased if I sat still, but only vanished if I lay down and didn't move a muscle. The second I so much as turned over, thud-thud-thud, off they went again.

Then I noticed that the beating seemed more erratic when I was standing still. While running errands, I found myself having to wait in both the post office and at the supermarket checkout. My heart felt completely out of control - it was like having a family of mice running about inside me. Pitter patter, pitter patter.

It was only later that I realised the problem wasn't the standing, but the queuing.

I'd gone to the post office when I'd expected it to be quiet, only to see from my 'Counter Service' ticket that there were about 20 people ahead of me. And in the supermarket, the woman in front took ages to pay, with a fistful of vouchers and what appeared to be the contents of her loose change jar.

Although I was conscious of becoming irritated in both places, I didn't realise I was actually stressed. My wonky heart was the giveaway: stress may, or may not, have triggered the original palpitations, but it was certainly making them worse - and still does, in their most recent manifestation.

So what has it been doing to my body - unnoticed - up until now, when I didn't have this heightened physical awareness? We all know that stress is bad for us, but mostly disregard the warnings for lack of any real evidence...until it's too late and we develop high blood pressure, heart disease or any one of a number of other serious conditions. 

At least now I can tell immediately when I'm becoming uptight and can take steps to calm down, by deep breathing, or reminding myself that whatever's bothering me isn't that important. 

I'm trying to view this early warning system as the silver lining to this particular health issue, but I can't say I'll be sorry to see the back of those hyperactive mice!

Invisible wounds

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Ordering compulsions have always been the mainstay of my OCD, with contamination issues playing only a minor part. However, a couple of years ago, I realised that this latter element was having an increasing impact on my behaviour. 

My main difficulty had always been travelling on public transport - or, to be precise, using the seats - but then I became aware that I was trying to avoid physical contact with strangers. If my coat sleeve so much as brushed somebody else's, I found myself cringing. 

While this escalation hasn't stopped me going out, I do sometimes navigate the pavement as if I were dodging criss-crossing laser beams - swerving left and right and swivelling sideways to manoeuvre between people. Shopping trip turned Mission Impossible assignment.

And sometimes I find myself 'under threat' quite unexpectedly.

Last month, I went into my local job centre to sign on for the first time. A customer services' assistant directed me to the bank of seats closest to the advisor I was due to see and I settled down next to a man already waiting there. 

'Busy, isn't it?' he said. As we exchanged small talk, I became aware of an 'unwashed' smell. Not the throat-constricting, toe-curling kind, but sufficiently strong to indicate an abnormal level of dirtiness somewhere nearby.

Up until then, I hadn't looked closely at the man beside me, but now I registered the ingrained dirt on his coat cuffs and the stained patches on his jeans. His clothes were filthy, even if he wasn't.

It immediately struck me that somebody in a similar predicament might, at some point, have sat where I was. The thought made my skin crawl and I resigned myself to washing all of my outer clothes when I got home - a job usually reserved for when I've had to sit on a bus or train. 

We continued talking and it became apparent that, while he was possibly neither homeless nor jobless - he had accompanied a friend to the centre - he did have some significant problems. Not least that his ex-wife didn't allow him to see his children. 'She says I'm an alcoholic,' he told me. His too-bright eyes and unkempt appearance made me think she might be right.

Several minutes into what was becoming a friendly chat, I realised he was leaning in closer. I became convinced his sleeve was going to graze mine, or, worse, that he might touch my arm in some kind of gesture of solidarity. I went rigid in anticipation, bracing myself not to flinch.

In the midst of my rising anxiety, the thought popped into my head 'How strange that he has no idea what's going on in my mind. That, in my own way, I'm as tormented as he is.'

Just then, his friend reappeared and called him away. I tensed, fearing he might pat me on the arm or offer his hand in farewell.

He did neither, instead simply urging 'Take care of yourself', as he stood up. 'You, too,' I replied, suddenly feeling unaccountably sad for both of us.

Mind games

When you have an anxious or obsessive nature, it can be hard to escape the worries and thoughts that constantly whirl around your head, but I've always found reading to be great escapism.

The problem with this is that I prefer to read when I have at least a couple of hours at my disposal, so that I can really lose myself in a book, and such large chunks of free time are hard to come by.

Television might seem to be an alternative remedy, yet it doesn't work in the same way; it's simply not demanding enough. It rarely requires you to 'engage brain' fully and any unoccupied corner of my mind is just another space for worry to creep in.

Fortunately, over Christmas, I discovered two new forms of effective distraction - or, rather, rediscovered in one case. 

While staying at my sister's, I got drawn into helping her with a 1,000 piece jigsaw that she and my two nephews had been working on. Once I'd started, I found it as addictive as she did. Time after time, we'd say, 'I'm just going to do one more piece'... and then still be hunched over the table twenty minutes later.

I'd forgotten just how involving this apparently simple process can be. Although I had a lot on my mind, it was all forgotten as I hunted down piece after elusive piece.

Of course, I was compelled to apply my usual methodical approach to the pieces we had yet to place, first separating out all the odd-shaped ones, then sorting the rest by their dominant colour. My ever understanding sister left me to it, while she continued to plug the gaps in the picture.

My sister's latest completed jigsaw
Photo: Alison Barbour

I was reminded how, after my 'A' level exams, I spent weeks doing jigsaws while listening to ABC's Lexicon of Love album on a loop; the mental downshift was therapeutic after all the academic effort. The repetitive music was probably somewhat less therapeutic for my family.

On the train home from my sister's, the noise from fellow passengers drove me to abandon my magazine and seek an alternative diversion. In desperation, I resorted to my - very unsmart - phone, which has one solitary game on it: sudoku, the number puzzle.

I'd never played before and couldn't get the hang of it at first. Repeatedly making stupid mistakes, I had to re-start the same grid several times and still hadn't finished it when we pulled into Euston. Over the next few days, however, I got to grips with the concept and began to enjoy the challenge. 

Sudoku taps into my love of order and logic and is something I can continue with in my flat, where I don't have the space to lay out jigsaws.

Since then, my boyfriend has persuaded me to try adult colouring books (no, not that kind of 'adult'), with the promise 'If you buy the book, I'll buy the pencils. It'll be good for you.' 

I'm not sure whether colouring will prove sufficiently absorbing, and it doesn't have the 'right or wrong' element that I enjoy about puzzles, but I'll let you know how I get on.