Posted by: medicblog999 | July 21, 2009

OCD – Obsessive Compulsive Disorder

ocd_i_do_things_in_3s_mug_customized-p1689687923177639253gsa_400I was called to assist a man who was having “?Mental Problems” at a local large office complex.

I arrived on scene and was met by a man at the main entrance to the building who pointed to a man in the car park who was walking around and around his car, constantly checking his car doors. The caller seemed quite amused with the whole thing and the collection of staff looking out the window pointing and laughing also seemed to be having a good ol’ time watching the spectacle.

I could feel myself getting a little angry (with the on lookers and the caller, not the patient) so I said thanked him for calling and walked off towards the patient.

As I walked up to him, I could hear various mutterings and cursing

“Come on for Gods sake…….Its looked OK?……….Just walk away, its fine!………..Jesus Christ!!!!………..whats going on?”

I walked up, knowing exactly what to do.

M999: “Hello there, I’m Mark from the Ambulance Service. Whats your name?”

Pt: “Steve”

M999: Hi Steve, I can see you are having some bother there, shall I check that that all your doors are locked for you?”

Steve looked at me, tears in his eyes, and such a look of despair on his face.

Steve: “Yes…….yes please!”

I slowly walked around the car, exaggerating my checking of all the doors and windows, calling out “Locked” and “Windows Closed” as I went around each door. As I walked back to Steve I simply said “there you go, its all ok now, Ive checked it and its okay to walk away now”

Steve collapsed to the floor, sobbing like a child.

Steve “Its never been like this before, I just couldn’t walk away. What if something happened?”

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I have had another submission from a guest writer this morning which I am planning on posting on Saturday. The story is from a patients perspective and it is in regards to an acute psychiatric illness and the treatment and care she received from her local ambulance service as compared to the ER she was taken too.

The two things together have spurred me on to write this post. I have been meaning to do it for quite some time and have eluded to it previously, in my post ‘Psych ER’, so I thought I would finally get down to sharing it with you all. All I would ask is that you try and understand and don’t judge me or my patient that I have talked about at the top of the post.

—————————————————————————————-

The reason that I could help my patient so well was due to the fact that I knew far to well, the signs of someone suffering with OCD (Obsessive compulsive disorder). Looking back, I can now see that I started with signs of it back in 1996, but it became noticeable in 1999. The one thing I would like to put straight immediately is that it has NEVER had any effect on patient care, my colleagues have never been aware of it, until I decided to talk about it over the last couple of years, and I am now well and truly in control of it, and it hardly ever bothers me. So with that said, lets discuss how it manifested itself with me.

OCD can be split into various types. Mine came down to a very irrational and over inflated feeling of responsibility for everything and everyone around me. Now, you might think that doesn’t sound too bad, but believe me, it can take over various parts of your life before you even know it, and with me, it ended up controling me in certain cirumstances and times of the day.

Mine seemed to really kick in when my first son was born. I was all of a sudden was directly responsible for another life. I started to have irrational thought processes which resulted in me ‘Catastrophising’ scenarios. For example, what if I put my son to bed, then forgot to turn the oven off downstairs when I went to bed….maybe the house would explode and my son would die. Then it would be all my fault. Once that thought was in my head, it was there and there was no shaking it. At my worst times, once I had decided to go to bed, it would take me upwards of 90mins to actually be able to go upstairs and settle down to sleep. I would find myself stuck checking everything from plug sockets, to the oven, to the doors, the iron etc etc etc – 3 times each time!! . If there was something that could potentially cause harm to anyone, no matter how small the risk, it had to be checked. If I lost concentration half way through, I would have to start again, otherwise I may have missed something. And so it went on.

If my partner at the time was the last one up, then I could just say to her, “will you just check that everything is off when you come up”, and I could quite easily walk straight upstairs and go to bed, as it was now HER responsibility and not mine.

It started to move into other parts of my life. If I was driving to work, and I didn’t concentrate on every last thing on the way in, then I would have to turn back to the last thing I remembered ‘really’ noticing and start again from that point. After all what if i clipped someone with my car and didnt notice and the person died (I know it sounds truly mad!!) This resulted in me having to leave for work early, just so that I could manage some extra time into my journey to work.

The strangest thing though was that when I arrived at work, it wouldn’t bother me at all, except in one circumstance….the one thing I used to dread.

If we had a patient on the chair, stretcher or walking out to the ambulance, I would ALWAYS try and manoeuvre myself so that I was the one either pushing the chair, supporting the patient or carrying their bags. That way it would become my mates responsibility when the patient asked:

“will you just check my fire is off and lock up please”

If it worked out that it was my task, I used to hate it. I mean really hate it. I knew that I couldn’t do anything about it at all, and that I would be constantly worrying for the rest of the shift/night/day. After all, what if I hadn’t turned everything off right and the house caught fire and people died and it was all my fault…….You see where this is going??

But, no one at work ever knew about it. It was my own personal hell.

I finally decided to get help in 2001, and I was referred to a cognitive therapist who helped me work through why these things were happening to me and more importantly, explained the actual neurophysiology of what was going on. She told me that I had a ‘short circuit’ in my thought processes for various things, usually to do with issues that may cause some harm to others. My therapy was focused on breaking the habbit of always going to the worst possible conclusion for a certain circumstance, and instead, accepting reality and that you can only do so much to negate risks for others.

It took a few months and alot of hard work, but I soon noticed that things were getting better, and I soon went to only having ‘relapses’ every now and then.

It is still with me now, I don’t think I will ever get rid of it completely, but it doesn’t control me anymore.

I still have my bed time routine (if I am in my own house) which is just a quick once over (not 3 times!!). A normal night time check, but I still stop at the cooker and have to check everything three times. I look at the dials on the cooker and check they are all lined up to the off position.

Mrs 999 often hears me in the kitchen………

“Off, Off, Off…….Up, Up, Up………Off, Off, Off”

Then she comes in and turns one of the dials to the on position, just so I have to start again!!!!

But hey, at least we can laugh about it all now.

I talk about it openly at work now. I try and get others who have been fortunate not to have any personal psychiatric experience to empathise with the patients they deal with. When I explain how I used to be, people usually don’t believe me.

How could such a confident paramedic, ever have had trouble getting into bed or even driving to work??

Easily….It could happen to anyone.

What has amazed me is the amount of my colleagues who have suffered and are still battling certain elements of OCD. I don’t think any have been to the extent that I was, but who knows? Maybe it is a caring thing. If you want to commit your life to caring for others, then maybe it isn’t to far of a step to start worrying about your impact on others too (irrationally so).

I bet we all know a work mate who gives you an exact run down on what they have used during their shift and what they have restocked when you take over from them. Then you may get a phone call or a text from them 30 mins after they have left the station to tell you that they used a 100% mask out of the bag too. It all points to a degree of OCD.

So, going back to the start, I hope you can now see why I was getting angry at the bystanders laughing at Steve. I know the exact turmoil that was going on inside his head, and until you have been there, you will have no idea what it feels like to be trapped by a single irrational thought process. I hope Steve finally found some help to get him back to living a normal life, and I hope by reading this, I can show that mental illness can happen to anyone, and if it does, anyone can hopefully work their way through it.

I am not a looney though, and I hope you dont think less of me for disclosing this information. I know we all say that the stigma of mental illness has now gone, but believe me when I tell you it hasn’t.

Anyway, there it is…..Medic999….warts and all!

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Responses

  1. Sounds scarily familiar, 999 🙂 And yes, the stigma is still out there even though the talk is that it’s gone and that there’s no shame in getting help. Oh, and thanks for following my blog – much appreciated. As I am ridiculously new to all of this and have seen more than I ever bargained for in the past few months, it’s nice to be able to unload in cyberspace 🙂 Thanks, thanks, thanks!

  2. I too had a touch of organizational OCD, a touch that required things to be lined up or align with things around them. I would religiously align cups back in the water rings they left on the table. and that was the light stuff.

    I’ll elaborate in an email and see where we line up, but I think all EMS and Fire Dept folks have a bit of OCD.

  3. I always find I have an irrational fear of having left the front door open and worrying that the dog will get out and get run over. This involves frequent pushing of the door to ensure it’s shut and peering back several times etc. I’ve found a way to help is to find something individual to that specific door shutting to remind myself after I have walked/driven off that it was definitely shut, for example there was a leaf by the door or I could hear a certain noise etc so that when I later wondered whether I had shut the front door and could in my head picture it being shut, just to ensure it was a memory from today I could tell myself yes it was definitely shut because there was that leaf I saw just in front of it. There are still times however when I have to phone anyone who was at home at the time just to check or I spend my shift at work worrying about it!

    It is quite irrational because it’s very unlikely I would have left it open. I do think this sort of thing is very common especially in situations such as these where bad things could happen.

    The man in your post could so easily be any of us. Hopefully he will get the help he needs.

  4. Dear 999

    My son has OCD to a greater or lesser degree depending on other stresses in his life. He’s nearly 20 now and has left home but my word the angst that he and we went through when it was at it’s peak was truly terrible. There is very little help out there for young people suffering from this. Your post will help others searching for OCD related articles to see that no one is exempt and that even the most apparently gounded and much loved individuals can become sufferers. There shouldn’t be a stigma but sadly there still is as I know to my sons cost.

    Every blessing to you.

    Sharon xx

  5. Brave post 999. As Sharon says, there’s still a bit of stigma floating around. Being bloody-minded, I fight it head on by making no secret of the fact that I suffered from moderate/severe depression a while back. I don’t raise the fact every five minutes, just when it’s relevant (like here).

    I’ve always been a little inclinded to OCD, but only slightly. It did get worse when I was falling down the slough of despond, but it’s well under control now.

    With me too, it was a case of feeling responsible for everything even if it was nothing to do with me. Now I’ve climbed out the other side of the depression I can get obsessive stuff in perspective too.

  6. Must have taken a lot of guts to write this Mark, well done. I do agree that mental illness does have a stigma attached.

    As you know my Dad has vascular dementia and my Mam is caring for him at home. I have noticed that a lot of their friends are conspicuous by their absence. Maybe they just don’t know what to say. xxx

  7. I watched a TV show on OCD just last evening. If you don’t have it, it might be tempting to laugh at it, but this show taught me how debilitating it is for sufferers. It truly broke my heart to watch the woman agonizing if she could put a jug of milk in her fridge and wondering if that weight would make the fridge crash through the floor, causing her to fall through the floor and get impaled and die. Very irrational but very real to her.

  8. I am the one who will text my colleagues and tell them about the 100%er that I used! My obsession with checking the kit at least three times at the start of the shift is a standing joke! The horror that I felt when we ran out of ECG dots last week because I let my crewmate check we had some doesnt bear describing! And I always have an extra one of everything on the bus as well, drives everyone loopy!

  9. Good on you for outing yourself, but I had to laugh; I have to have even numbers, so your illustration greatly disturbed me!

  10. I enjoyed this courageous post. Even among those who work in medical fields, there is sometimes a disturbing lack of awareness in regard to mental health issues. This post will undoubtedly cause some to reconsider their perceptions of our most vulnerable patients.

  11. I’ve watched the movie aviator and it’s the disorder which Howard Hughes had. I just can’t imagine how painful his family had gone through.

  12. […] I had made a mistake, and in my mind this one was a big one. I ALWAYS own up when I do something wrong. Some may say that this is a character flaw; some may say this is a good thing. All I know is that I cannot cope with the guilt of knowing that I have done something wrong which may impact on someone else. (Looking back, I know that this was the final trigger in a sequence of life events that started me on the road to OCD, which I have written about before). […]


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