26. OCD 101 & My Full OCD Story: Misdiagnosis, Evidence-Based Treatment, OCD Myth Busting, & Comorbidities

(upbeat music) - Hello and welcome to a chat with Uma, with me, your host, Uma R. Chatterjee. On this podcast, I bring together all of my roles as a neuroscientist, researcher, board certified mental health peer specialist, mental health advocate, community builder, and a survivor with lived experience to bring you honest and unfiltered conversations exploring our true human experiences in their fullest form. Every week, I'm bringing you conversations bridging the gap on all things neuroscience, psychology, mental health, lived experience, advocacy, psychedelics, and more. This is a space for raw unfiltered truth to truly explore ourselves for who we are and how we are. I cannot wait to connect with you, answer all of your questions and co-create this with you. Welcome to a chat with Uma. Hello, beautiful friends, and welcome back to another episode of a chat with Uma. I'm not gonna lie, this episode is probably the scariest and most difficult episode to record, which might be surprising to people who've read the title of this episode and know anything about me. And I guess I'll start with talking about what the episode is and then I'll tell you why it's so hard, but today's episode is all about obsessive compulsive disorder, OCD, titled OCD 101, at least in part, and my full OCD story. And it's obviously a long time coming. And I've definitely talked at length about my experience with OCD in the context of my full life story, my very long episodes on my mental health journey. And I have not shied at all away from talking about OCD, but whether I intended to or not, what I shared was my experience and journey with OCD more so than what OCD actually is. And there's a lot of people listening who probably already know what OCD is because you're probably part of the OCD community, but there's a lot of people who don't. And if you've listened to enough episodes or you consume my content, my research, any way that I show up in the world, you've definitely gotten bits and pieces of what OCD is as a byproduct of me talking about my work and my life story. But what I have not done, at least on the podcast and in the context of my own life is just do a whole OCD 101 primer in my words. And that's what is so scary about today's episode. And that's because in a very meta way, my OCD latches on to, what if I don't have OCD and gets extremely afraid of sharing anything wrong about OCD, not doing it justice, being incorrect about anything I say. And that in a nutshell is having obsessed a compulsive disorder, having extensive pathological doubt and hyper responsibility and engaging in compulsions like avoidance or remination or really anything, checking, seeking reassurance about things we care about and feeling deeply afraid of being wrong or doing something quote unquote bad. And so that whole last three minute introduction is all to say that this episode is an exposure for me. And if you don't know what an exposure is, you're going to through this episode. But that's why it's been a long time coming. Now also, it's kind of the most perfect time ever to do this episode because today on words is OCD Awareness Week 2023. And what better way to kick off OCD Awareness Week from my perspective through my advocacy in my world than to do a full episode on everything related to OCD, what real OCD is and my journey specifically with OCD, which again, I've talked about, but in the context of kind of everything else rather than its own isolated topic. And as you're going to hear in this episode, it does not exist in a vacuum, it's not isolated for sure. And also though, there's so much layered into the specific experience with obsessive compulsive disorder that it has needed a tone episode or more in my space and my podcast in my advocacy for a long, long time. Although I'm not just someone who talks about OCD, I talk about things that include OCD, but it's so important. It's so important and OCD Awareness Week is a testament to why that's so important. And I'm gonna say this now before we get into everything about OCD because I want people to understand why this advocacy, why talking about the specific disorder, the specific illness, the specific experience is so vastly important because I'm sure you may see the letters OCD a lot in my work. And if you don't have it or if you're on the community, you might wonder why that comes up so much and why there's such a community specifically for this disorder. And that's because all disorders, all mental, physical, psychiatric, chronic, all illnesses, all disorders, by definition, are debilitating, are painful, wreak havoc, and in theory, all take up an equal amount of space in needing awareness, importance, resources, right? But why OCD takes up so much more space by the people who live with it, as compared to maybe other disorders, is because it's not just the disorder that we're living with, it's all of the misunderstanding and stigma, confusion, misperception, and the ensuing lack of proper diagnosis, the extremely unnaturally high misdiagnosis rates and even beyond misdiagnosis, the mis-treatment, the incorrect harmful treatments people receive as a result of a lack of awareness and understanding of the disorder. And then on top of all of that, before we even get into misdiagnosis and mis-treatment, or I guess fueling largely the misdiagnosis and mis-treatment is the elephant in the room of the fact that OCD is not properly understood for what it is. It is wildly misrepresented. It is considered a character trait or quirk. It's used as an adjective in our society and maybe I'm getting ahead of myself as well part of the episode, but that I planned. But I just needed to say that people with OCD, don't just live with OCD, they live with the byproduct of the misrepresentation in society that causes a lack of awareness of what it is, which leads to delayed diagnosis, delayed treatment, incorrect treatment, and debilitation so severe that left untreated and undiagnosed leads people to die by suicide far more often than the average population. And untreated and undiagnosed, again, OCD is right in the top 10 most disabling conditions on planet Earth. And that's not just psychological conditions, that's all conditions. And we need to do something about it. We can't control at this point if OCD is gonna happen in people or not, maybe one day with research and magic. We'll get there, but if we can't get there, then what we can do is reduce the amount of unnecessary suffering and time wasted for patients and loved ones and sufferers who not only have to live with this monstrous disease, but also have to live far too long without treatment and have to live in shame and suffering and isolation due to the insidious nature of this disorder which we'll get into. And then have to live with the joke that is made of this illness that ends people's lives. And all of that has so much room to change and grow. And that is why people like me. and so many people in this community dedicate so much of their space and time to OCD advocacy and awareness. Not just because this is the illness that we decided to make our identity or we want something to make us feel like we're important or a victim or whatever people might be thinking if they see this advocacy so much. And I'm a testament of that, right? If you're familiar at all with my story and you can feel free to go back to many of the episodes that talk about my full story and perspective, I'll link them all in the show notes if you're new here. I live with a lot of different things. I have lived through cancer that has almost taken my life and metastasized. I have lived with chronic autoimmune diseases since I was a child on diagnosed for a long time. I have lived through severe abuse and trauma. I live with post-traumatic stress disorder. That's kind of treatment or refractory. I live with major depressive disorder, generalizing anxiety disorder, many body-focused, repetitive behaviors, so gerocytelomania, dermatillomania, or excursion disorder. Panic disorder, I mean, the list goes on and I'm not trying to sit here and make a list of just how much my life sucks. It's not that. My life is all that and it's also beautiful and full and I am so grateful to be here. But all of that to say, I have lived through and with many, many different things. I mean, I wasn't a religious cult. I mean, what more can you say, right? But why so much of my energy goes toward specifically OCD advocacy is because of what I just said before, because of how deeply misunderstood it is and how much worse the suffering is than just the disorder itself, because of everything surrounding it, because of the lack of awareness and resources people have. And if we can change that and people just have to deal with the disorder, but have proper understandings of what is have proper accessibility to resources and evidence based treatment and qualified practitioners as soon as humanly possible. So much suffering and could be lessened so much more life could be lived so many more lives could be saved. And that's why we're here doing this. That's why OCD awareness week is a thing. That is why that is one of my deepest passions in life to if nothing else turn my pain into purpose in this way that I choose. And also through my work as you have heard or will hear in other podcasts, I am a researcher. I am a neuroscientist and that is hugely driven because I want to understand this disorder that wreaks so much havoc in people's lives so that we can. So help people help people like me. So that is why we're doing this episode and without further ado, let's get into it. Before we get into the episode though real quick, I have to share some awesome events that are coming up really soon that I have the honor and privilege to be a part of. And there's especially a good number of events happening this week because of OCD awareness week like we just talked about. So if you're here in the current moment listening live, then you will be able to attend these live. And if not, these will all be recorded and available on my website and the respective websites as well. So definitely check them out even if you're listening to this episode later than they actually happened. But first and foremost, we are going live on today, Monday, April 9th at 8 p.m. Eastern with made of millions on their TikTok live to have a really awesome live stream conversation on what they call their OCD Socratic seminars. And our quote unquote Socratic seminar is going to be talking all about BIPOC representation in the OCD space by its lacking and what we can do about it. So join me and Esther who is the really awesome creator at made of millions on their live stream. And if you can't join live on TikTok, it will be uploaded to Instagram as well. Next up on Thursday, October 12th at 7 p.m. Eastern. I'm going to be going live with the International OCD foundation, the IOCDF on their live streams on all platforms for a panel presentation called diversity starts with us talking about exactly what the title suggests diversity in the OCD community and mental health. What is lacking why it is and what on earth we can do about it and it's going to be with my dear friend and fellow IOCDF advocate, Alexandra Reynolds as well as some really amazing panelists joining us. You do not want to miss it. I am so so thrilled for this. And again, if you cannot catch it live, the recording will be available everywhere on all platforms that it's streamed, which will be linked in the show notes. And it is also on my website always on the events repository. And then on Saturday, October 14th at 12 p.m. Eastern, I will be going live with the IOCDF on their Instagram for an IOCDF advocate Instagram live. And we're going to talk about OCD awareness week, what my journey has been like my advocacy, what this means to me and just anything that the IOCDF wants to ask. It's always really fun. It's very interactive. You can join in and you can share your questions and just talk like a person on this live stream. So definitely join us on IOCDF's Instagram live just by going to @IOCDF on Instagram. And again, that recording will also be available everywhere. And then my final event for OCD Awareness Week is also going to be on Saturday, October 14th. And this event is by OCD Game Changers and amazing OCD Advocacy Nonprofit that hosts events worldwide as well as virtually with advocates to share stories and raise awareness for this cause. And they are putting together this advocate extravaganza. And I call it that because there's over 40 advocates that are going to be presenting, which is amazing. So this event is going to be going on from 5 30 to 10 PM Eastern. And I will be hopping on around 7 30 Eastern and I will be sharing my story, my advocacy and how I show up in the world. So I'd love to have you join all of us. It's seriously going to be a virtual party and it's going to be streaming on the OCD Game Changers YouTube Live as well as Facebook Live. And of course the recordings will be available as well. So join us and this is all free, which is what a tree to have so many free rich events with so many people sharing themselves. And I'm just grateful and honored to be a part of all this. Okay, so just two more announcements for now. They're not about OCD Awareness Week, but they are about OCD and advocacy. So, okay, this one is really, really exciting and it's such an honor to share this. I will be co-presenting the keynote address at this year's online OCD conference hosted by the International OCD Foundation and OCD SoCal. So this is the virtual version of the OCD conference that happens annually to make this far more accessible and available to people worldwide. And I have the absolute honor of being one of the keynote presenters sharing my story with OCD and my journey of recovery, especially with my intersecting identities. And it's going to be with some amazing co-presenters and I would love to have you there. So come join us on October 21st and 22nd for the whole conference. Specifically, my keynote will be on October 21st, Saturday from 6 to 7 p.m. Eastern. And I would just love to have you for this really, really special and exciting time. And very last announcement I swear for this episode, but it's too exciting to not share, especially in line with the theme of this episode and everything we're doing. So, I have the absolute honor of being appointed the newest board member to the board of directors of OCD Wisconsin, which is Wisconsin's official IOCDF, the International OCD Foundation's affiliate. So the IOCDF is global and then they have local affiliates all over the world to serve communities in person. And the state of Wisconsin is OCD Wisconsin and I am now a part of the board of directors and I doubt live in Wisconsin obviously. So to be able to join the board and have such a profound way to serve the state and serve our community in a local way is such an honor and privilege to me to bring so much of my advocacy and my lived experience and my research and just the different parts of my identity together to be able to spearhead and further initiatives of access to treatment, awareness of what real OCD is, outreach to historically excluded communities, which is a huge cornerstone of everything I do because I am part of so many my Northeast groups that often get left in the shadows of advocacy in general and of being able to access life saving treatment and the awareness that is required for that. So my gosh, is it such a joy and honor to officially be a part of the board and start my term and I will be back. be talking far more about that in the future, but I just wanted to share this and I wanted to point you to OC Wisconsin's website and all of the things that are about to come, the things that we're going to create together and just really, really, really excited. I just wanted to give a shout out and I will link details in the show notes too if you want to check it out. But such amazing news and I'm so, so grateful and honored truly. Okay, so we are going there. I am officially initiating exposure. OCD, obsessive compulsive disorder, first and foremost, what the actual health is it? Well, I think it's easier because of the nature of OCD to talk about what it's not before we get into what it is because for anybody who is not familiar or who does not have it themselves truly, who does not have the diagnosis, who's not listening to this podcast because they've already gone through their own journey of discovery and understanding of what OCD is. And the average person really, to no fault of their own, what they think OCD is, is what I thought OCD was till I was 22 years old. I thought OCD was a love of being clean or perfect or, you know, things being even or just things being like in their place. You know, I didn't even conceptualize it as a disorder, even though OCD stands for obsessive compulsive disorder. We'll get into the grammar and syntax soon of just how absurd it is to use it as an adjective. But nonetheless, I grew up hearing and using OCD as an adjective. Like my mom, especially when I was a teenager, would go be annoying about me cleaning my room and would just harp on me all the time and then when I was gone, I would go through my stuff and clean my room. And I would just annoyingly tell her that she was just so OCD and needed to stop. And so I mean, I'm here telling you that I am just as guilty of it and guilty is not really the right word. But I am, I was just as susceptible to that as anyone else was because I didn't know any better. That is not a fault of us. That's a fault of society as a whole and just linguistically it getting out of hand and it taking on a life of its own. So there's, the way I see OCD misinformation and its misrepresentation is on a spectrum because there is the extreme of where OCD is just completely used as an adjective. It's seen as a quirk, you know, it's seen as a choice. It's very just flippantly used as a desirable trait or a term. Like I love being OCD about cleaning. My OCD is really helpful to me. Just talking about people who do things really well. And there's, so that's like in my perception, the most extreme misunderstanding of it. And then even when people do see versions of it as a disorder, like examples of celebrities or people in popular culture who have talked about their struggles with OCD, one who really comes to mind is how he meant L, who for anyone who doesn't know is a comedian and a judge on America's Got Talent. But you know, mainly a very successful and prolific comedian who has struggled with obsessive compulsive disorder for a very long time in a severe way. And that came out in history as he was a public figure and it kind of just came out. And for him, the way his OCD presented at least publicly in an outer facing way and on a surface level really because OCD's far more than just the perceived compulsion we see in people or the surface level fear is he had a really hard time with contamination and with being able to shake hands with people, being able to touch things with his open palm and just a massive, massive fear of contamination. And so when people conceptualize OCD as a disorder and they think if people like him as a disorder, what it becomes in their mind is, okay, maybe it's a disorder, like it's a weird thing where someone just like can't get over this like irrational fear and they, it's about handwashing or you know, oftentimes people think it's about locking doors over and over or checking stoves. And I share this not to dismiss those symptoms because that is very much a way that OCD can show up and big and that is a tiny piece of the pie of what OCD can look like in people which is also a form of misinformation because number one, it reduces the severity and implication and widespread nature of what OCD is by conceptualizing as such. And also it just excludes the vast majority of people who have OCD who have none of those symptoms or who have none of those presentations. And it's also in the grand scheme of what OCD can look like and the debilitation that it can wreak on people, the havoc it can be, it's just not representative of how pervasive and how insidious this disorder can be in a human being to render it to be in the top 10 most disabling conditions on planet Earth. And I think when you hear it that way you can see how you know someone you know, in the way people perceive it at least like needing things clean or being afraid of one thing could not be a big deal. But that's not what OCD is and OCD is a really, really fucking big deal. Also embedded in the misunderstanding or lack of understanding of what OCD is is the misperception that if somebody is consumed by a fear, number one, the fact that it seems irrational, lends itself to people thinking that if someone is quote unquote falling into or feeding into an irrational fear that they're just being dramatic or they are just choosing not to utilize logic or reason or rationality. And there's something just effective about the way they're looking at it and they just need to be stronger. So that's completely incorrect because anybody with OCD would tell you that they're aware fully of the logic and reason and rationality or the lack thereof in their obsessions and by obsessions, I mean their intrusive thoughts and their beliefs and fears. But the thing about OCD is that irrationality and logic and reason do not permeate into the OCD brain. And so it's such a cluster of fuck because we as people with OCD can very clearly see the what is real and what is logical and our brains due to neural circuitry due to a different wiring due to very, very real disease pathology cannot reconcile that logic and reason with our fear response. And so our fear response lends itself to what if what if what if or to intrusive thoughts that are not able to be mitigated just by you know white knuckling it or by being strong or just ignoring it or just you know rationalizing through it. It just becomes a compulsion. So basically what I'm trying to say is feeding into the fears or the perceived what people perceive as feeding into the fears is not a choice. And that is that lets itself to then compulsions also not being a choice. So when people see repetitive behaviors, it can really quickly be misconstrued as people are choosing to engage in a certain action. And yes, I mean in theory, any anything we're doing, it's like we're doing and we're aware of it's not like you know some sort of alien like overtook our body. But one step short of an alien taking over our body, it feels like we cannot stop the behavior that we need to do the behavior. And again logic and reason and rationality do not permeate the OCD brain and we will you know, if you really want to understand the different hypotheses and the pathological evidence of why this is in OCD brains will come to me with on a neuroscience episode. I will tell you all about it. For the sake of this episode, it is not a choice. So nor some neither are engaging with obsessions of choice nor are engaging in compulsions, a choice or something that can be stopped just by sheer will. Another really important thing to address before we get into what OCD actually is is the fact that implicit and embedded in the misconception of OCD being something that people used to describe when they have excessive tendencies of things that they really like or that they really pride with themselves or they really appreciate. For example, being like, I'm so OCD about cleaning or I'm so OCD about organizing or about color coding or perfectionism or lining things up for whatever the hell people are saying that they're OCD about. Implicit in that statement is saying that I really like and need things to be a certain way because that's what I want. and what I like and what I value. And that is the complete and utter opposite of what OCD actually is. So there are terms for this. What people are referring to when they're talking about things that they like and things that they resonate with and things that they're so OCD about because they are very excessive and needing of something is called egocintonic. It is resonant with their values and their identity and they want to be doing it. They want things to be clean. They want things to be even or whatever the hell it is they're referring to. Sorry if I sound aggressive. It's just, it activates a lot within me as you can tell. What OCD actually is is egocintonic. Nobody with OCD, not one person on planet Earth OCD wants to be doing anything that they're doing. The compulsions they're doing are things that they do not want to be doing. They would rather be doing anything else. They want to be free. They feel trapped and prisoned by them, imprisoned. Their obsessions are not things that they want to be thinking about. Yes, in the world we live in, we talk about being obsessed with things that we love or things that we just can't get out of our heads that we really, really love. Taylor Swift, I'm so obsessed with Taylor Swift or I'm obsessed with ice cream or I'm so obsessed with this book I'm reading right now. It's used as a positive term about things we like or we enjoy. In the context of OCD and actually the technical definition of the word obsessed, but that's another conversation for another day, choosing my battles here, obsessed in the context of OCD. Our obsessions are intrusive, unwanted, irrational thoughts and beliefs and impulses that people do not want. And that is the key term because if we can get through and get across the difference between ego-syntonic things and things that people want and people appreciate, people value versus ego-distonic, the things that people want nothing to do with that are disgusted by or ashamed of or do not want to be thinking about and cannot get rid of it. That's ego-distonic and inherently there is a difference between what is misperceived as OCD versus what is OCD. And this distinction is extremely important not only because we need to get a better understanding of the fact that OCD is not a choice or something that we want to have or that we enjoy having or that we enjoy doing compulsions. Not only is that distinction important, but later we're gonna get into what obsessions can look like, what compulsions can be, the different themes, the different irrational thoughts and the intrusive thoughts that people have. Some of them are extremely taboo, terrifying, horrifying and just disgusting. And what I need you to know now before we get into the subject matter of those because we're going there, is that people with OCD do not want to be having any of that and do not resonate with it. It does not at all align with their values or who they are. It's like foreign horrific thoughts that are just sticking to our brain because we're so afraid of them being true. We are the last people who want those thoughts to be true or who want those thoughts to be in our brain at all or to be doing the compulsions to get rid of those thoughts. So there is a huge difference between egocentonic beliefs and experiences versus egocentonic in the case of OCD. And lastly, I feel like I could just talk about OCD as OCD is not forever, but I will cap it at this one. Before we get into what OCD is, most of the time when people talk about OCD or share it with people in their life or people around them and they do get across that it indeed is something that's distressing. People hear about what real OCD is and start saying, "Oh, I think I might actually have some OCD or I might be a little OCD," which we've already established that being OCD is not a thing that is not correct or accurate, it's frankly extremely disrespectful and just pure wrong. But aside from being OCD, some people hear about intrusive thoughts and compulsive behaviors and start thinking that they might have a little bit of OCD and I'm not here to discount anyone who is starting to identify with some of these symptoms and the common experience of having intrusive thoughts because every human has them or doing something habitually because every human does that sometimes and sometimes someone's hearing this and actually identifying it within themselves but embedded in the phrase, I might have a little OCD or I have a little OCD is it's just completely oxymoronic and contradictory to what constitutes the diagnosis of and the actual illness of obsessive compulsive disorder because at this point in time in psychology and psychiatry in the medical world as well as just conceptualizing OCD, in order to have actual obsessive compulsive disorder first and foremost, it is a binary. You either have it or you don't, you don't have a little bit. Yes, once you have it, there's scores and there's spectrum of how severe your OCD is based and that's based on how the intensity and how much of time it takes up from your day and it's not just taking up time but that time is stolen from you and you are equally and inversely disabled by the amount of time. So the more time that you are consumed by your obsessions and doing compulsions, the more disabled you are. And so for a bare minimum diagnosis, it requires your OCD to take at least one hour of your day. Now for those who don't have OCD, can you imagine at bare minimum one hour of your entire day being consumed by unwanted, intrusive, irrational thoughts and repetitive, painful, harmful compulsions to try to cope with those at minimum, one whole hour. That is already so far beyond distressing and what anyone would experience outside of, you know, having a little bit of OCD, like that's just not possible and is so unintentionally, but nonetheless, still unintentionally disrespectful and frankly, bastardizing of the actual experience of the disorder. So at minimum one hour, but people who have, you know, moderate to severe to extreme OCD and I'm using those words based on the Yale Broad Obsessive Compulsive Scale, the Y-Box Test of assessing OCD symptomatology. I mean, it can be like eight, 12, 16 hours of your day or even more if you're not getting sleep consumed by this disorder, consumed by pathological distress and I mean, like I talked about at the very beginning, this amount of debilitating pain drives people to end their life to escape it, not because they don't want to live because they don't think they can tolerate this amount of torture, especially when it's unidentified and untreated torture, you know, using that word to describe OCD and maybe not everyone resonates with it, but that is largely what it feels like for me and for so many people in the community I've talked to. So nobody is a little OCD is what I'm trying to say and nobody has a little bit of OCD. You either have it or you don't and if you have it, then it is a clinical medical diagnosis and embedded in that diagnosis is not just having obsessions and having compulsions but it being distrustful and disabling you in the amount of time that you are experiencing this and it's uncontrollable. Okay, so I am capping my rant on what OCD is not, though the robustness of that is really important because I am a firm believer in based on my experience of advocating and especially in research settings that in order to actually create the space for the open mind to fully take in the gravity and the robustness of what OCD actually is, we have to tear down those misconceptions and wipe them away to create that space. So that's what OCD is not but what is OCD? So we're gonna start with the very granular specific definition from the DSM, five, the diagnostic and statistical manual, the thing that is basically used to define and categorize psychiatric disorders in the current state of all mental health treatment. So the DSM defines obsessions as recurrent and persistent thoughts, urges, or impulses that are experienced at some time during the disturbance as intrusive and unwanted in that in most individuals causes market, anxiety, or distress. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thoughts, or action i.e. by performing a compulsion. Then compulsions are defined as repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation. However, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive. The obsessions or compulsions are time consuming. They take more than one hour per day, like I said, or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The obsessive compulsive symptoms are not attributable to the physiological effects of a substance or another medication. This is also important to note because we're going to talk about comorbidities and overlaps. The disturbance is not better explained by the symptoms of another mental disorder, and that can go with pretty much any other comorbidity that can look just like that, and things such as generalized anxiety disorder, preoccupation with appearance, like in BDD, body dysmorphic disorder, and tons of other repetitive behavior disorders or anxiety disorders. That's important to note and we'll get into that in a second. Let's go to just the beginnings of this definition. Even in the DSM, and it's very basic definition, which you can say so much more about, what's very clear is the terms persistent and recurrent thoughts, urges, or impulses. I first want to clarify because we're going to walk through this. That urges and impulses do not have embedded in them desires. Urges or impulses are feelings to do something, but people with OCD do not want it. They are recurrent, they are persistent, and they are intrusive and unwanted. That is first and foremost something we need to clear up just so we understand. We can have intrusive thoughts about, and this is very real for people with OCD, go jump in front of the train, go stab that person. You know what? Let's get this out of the way right now. Every human being has intrusive thoughts. Every single human being. If you breathe, you have intrusive thoughts. We have horrible thoughts. Sometimes intrusive thoughts can be random, sometimes they can be horrible about harming other people, harming ourselves, just the most disgusting out there thoughts because that's just our brains firing, making connections, and generating impulses that some, I mean like neural chemical impulses, not like impulses psychologically. That results in random ass things that pop in our brain. Everybody has them. The difference is for people with OCD because of their neural circuitry, they are unable to let go of those thoughts. So a typical non, a person without OCD has a thought and they're like, that's gross, that's weird. No. And they can let go of the thought and move on with their day. They might shudder at the thought, but they can let go of it. They do not attribute meaning to it. They do not live in fear of it because they recognize it as an intrusive thought, whether they have those terms to label it or not. But someone with OCD, again, because of the way that their brain is wired and the way their brain functions. They have an inability to be able to do the difference between an intrusive thought and a regular thought. And the amount of fear that is tagged with that intrusive thought or the amount of intense disgust or shame or whatever the intense negative emotion is, tags that in the brain to then take responsibility for even having a thought in the first place, even if it's completely random and has nothing to do with what we want and just popped out of nowhere. And so with the OCD brain, it's oftentimes called the sticky brain. We have these thoughts and they pop up and we can't let go of them and we are so shook by them that the only thing we can do is compulsions to try to neutralize or get rid of that thought, which is what compulsions had as a definition. They are repetitive behaviors. They can be something that is far more understood or portrayed in the media like handwashing, ordering or checking or mental acts that you're going to get into. They're the far more insidious and subversive part of compulsions such as praying, counting, repeating words silently. Even things like mental review and remination and pathological doubt seeking reassurance. There's so many behaviors with mental and physical that people do to try to get certainty about that thought or that urge or that feeling not being true or to try to get rid of it. The thing is though that there is no end to the cycle in the cycle of OCD. So you have the obsessions and you have the compulsions. And in theory, you have these obsessions that are so distressing and then you do compulsions to try to get rid of it. What the thing is, if it gets rid of it at all, it is only temporary because there is no resolve or end in OCD. OCD can be conceptualized as the doubting disorder where things are never 100%, which to be honest, life is not 100%. But we typically live with uncertainty or with uncertainty in many ways in life. It's always possible that you could enjoy a car, get hit or if you're riding in a plane that blanket crash or if you're taking a shower that the water could get too hot and burn you and you could die or your food could be poisoned or this other thing. And we're constantly putting ourselves in risk sway, even people with OCD. The thing is though, if someone gets fixated on that risk, there is no way for that person to find certainty but with OCD. It feels like we're trying to just get certainty in any way, shape, or form. But that's where that pathological action to try to ensure that certainty comes in. But of course, like we just said, there is no way to actually get the certainty. So even if we feel slightly better in the shorter term, like we checked the lock, even though we saw it and we know on a logical level that it is locked. But then our pathological doubt says, but what if it's not? What if I can't doubt my memory? What if I can't trust my memory? I am just getting overtaken by psychosis and I actually didn't see it. And again, this sounds so illogical and irrational, right? And this is a very basic example with locking locks. But that is a way to illustrate the core of what OCD is. There's no certainty other than your five senses and being able to rely on memory and even get other people to look at it, like seeking reassurance and validation. And then it might feel better in the short term, but do the nature of OCD. That certainty does not last. And then there is the, but what if, but what if or it is unlocked and I'm actually crazy and checking over and over and over again. And you can do that with memories. You can do that internally, like what if my memories and accurate reviewing the memory over and over and over again, asking people around you if something happened? I mean, this can extend to anything. So what I want to get across to you is the framework of what OCD is is obsessions are intrusive, irrational and extremely distressing. And it's not just anxiety. So we're getting into the anxiety versus OCD conversation a little later, but in some, OCD can be experienced in terms of the obsessions as anxiousness or anxiety and fear. It's valid. I'm not talking about generalizing anxiety disorder. I'm talking about like the experience of anxiety, but it can also, it's not just anxiety. It could also be disgust. That's a huge one. So just the feeling of disgust and needing to neutralize that feeling of disgust, whether it's rooted in rationality or not, which most of the time it's not rooted in rationality. So that's kind of the point. Also shame and guilt. And there are just so many different feelings that are just deeply uncomfortable. And so anxiety can be one of them, fear can be one of them, but it's definitely not all. And some people don't even have that as part of their OCD. So that is something to clear up for sure. So obsessions again are that experience of just horrific things that you don't want to think of. Like it could range from literally anything. That's where themes of OCD come in. So what you'll learn in the OCD community is that there are many different themes that can describe different sets of intrusive thoughts that one may have. Although it's not necessarily a different form of OCD. So subtypes are just a way to put into categories like the different obsessions that one needs to engage with in treatment. And it can be very validating and helpful to have names for them because it normalizes that this is a thing that many people experience. Like harm OCD, the intense fear of harming someone or in a very real way or sexual orientation OCD completely doubting one sexual orientation or taboo themed OCD just horrible things. And I'm really going there because we need to talk about the reality of an OCD. actually is, things like B.C.L.A.L.D. OCD being afraid of hurting animals or pedophilic OCD being afraid of hurting children. And what I'm telling you right now, these terms are horrible. There's also less taboo themes, sure, just right OCD. And that's important to talk about because it sounds like people wanting things a certain way and it's not again about wanting things. It's about somatically things feeling like they're just not right, not okay, and being locked in this horrific cycle of needing to quote unquote feel right, whatever that means. It's just our brain encoding that things were done a certain way, which has no logic or reason. You could do the same thing over and over and over again only one time it would feel right. And there's just an intolerance of being able to deal with that feeling, that lack of completion, until things are done just right. It's quite debilitating and it's not about wanting things a certain way. So to make that clear, there's things like just right OCD. There's somatic themed OCD of being hyper vigilant, hyper aware of your breathing and bodily processes and being fixated on if they're going correctly and being afraid of dying or there's health OCD. It's endless. And so I started off by just going deep into the end of taboo themed OCD because it's OCD is OCD's OCD. It is all OCD. But the public, the general public, people who are not educated about OCD could hear those themes and be extremely judgmental or disgusted thinking how bad are those people who have obsessions about things like pedophilia or biciality or harm or murder or anything and the point of that is to say that again, for the millionth time, intrusive thoughts are unwanted and the thing is OCD, if you think about intuitively, latches on to the things that we fear the most, that we hate the most, that we're the most afraid of because things like those horrible things I just mentioned elicit the most visceral reaction out of us and our brain is wired. The OCD brain is wired to notice that feeling of fear or discomfort or shame or guilt or petrifying whatever and latch on and try to figure out if that's actually a problem, if it's actually true or not. And that is the fucking point that the worst it is, like the more we don't want it, but our brain doesn't know how to let go and be like, "Oh, that's not true, don't think about that anymore." Just like people without OCD have those horrible thoughts once in a while, pops in their head, "What if I did something to my dog or what if I, or just having an intrusive visual image of people engaged in sexual intercourse or whatever and not wanting to think about that?" But people without OCD can get rid of it and be like, "Oh, that's gross, that's random, let me move on with my life and people with OCD cannot." And so then they do compulsions of any way shape or form to be able to figure it out, right? So you have this uncertainty, this confusion, this, it's not really confusion, but it starts feeling confusing when you think about something over and over and over again and you doubt something. So there's all this uncertainty in this doubt and maybe a byproduct of confusion and then there are compulsions to try to find certainty. And the way I describe it to people, and I don't know if other people have described it this way, but for me it's like certainty and trying to seek certainty and having with having OCD is like having a callender callender, is that how you pronounce it? Like the net, the meshy net thing that you used to strain stuff out and you're trying to catch water with a callender and obviously you're not going to catch shit with a callender or you might catch like dirt or you know things you don't want to catch, but you're not going to catch water, but you're trying and trying and trying and that is what OCD is like. That's what it's like to feel so uncertain and doubtful of literally everything that matters to you. Your security, your beliefs, your self concept, your integrity, your relationships, sexual orientation, your values, everything. And it is not the fault of someone with OCD, it is their brain freaking havoc and just not knowing how to tolerate that uncertainty. Probably the best way to illustrate this at this point is to just get into my full OCD story. Or at least the amount I can get into this episode because the amount that OCD has provided every freaking crevice of my life would take probably the rest of my life to explain, but to distill it down in the important parts and to take all of the pieces I've shared so far because I know it's been a dense episode of a lot of deconstruction and reconstruction to put that in perspective into what that looked like in my story would probably just make it make more sense. So I'll begin at birth because my clinicians have kind of unanimously decided and they believe and agree that I, for all intents and purposes was born with OCD. In the sense that my onset is as early as my earliest memories and it's not just having obsessions and doing compulsions, it's it being a significant part of my time and life that has gotten worse and been not a severe but is still qualified in the threshold of being pathological and disease state for my whole life and what that looked like in a little kid could be really confusing to people who think about the complexity of OCD and what I just talked about, but for me for as long as I could humanly remember I was always just so deeply afraid of everything and my brain would just take thoughts and latch onto them and you know looking back at how much of it was just so irrational and illogical but even if it wasn't irrational and illogical because very many a time the thoughts themselves are possible and they could be even rooted in things that have actually happened which you know hugely length itself to a comorbidity with post-traumatic stress disorder PTSD which we'll get into because a lot of my story is going to include talking about comorbidity and how that played a role in my OCD's overall progression and presentation but irrespective of if the thoughts were illogical or not the response and the compulsions were useless for the most part excessive and just spun so far into irrationality and magical thinking for lack of a better term but I didn't know any better and that's the natural thing to do when having OCD and needing to assert some level of safety or control even if it doesn't work like naturally in a person yeah with a fucked up brain at least the way I can see my own brain is fucked up and not in a judgmental way anymore but just you know it's just it does not function properly and it causes me a lot of distress but anyway if you don't resonate with that term then that's totally okay that's just for me how I feel but with with that brain with that messed up brain it's so natural and make so much sense that the only thing if I could do anything to try to lessen those deeply rooted fears and horrible thoughts then I would even if it doesn't work and if my brain is just coming up with all of these like ways to try to mitigate it even if they're completely out of the realm of logical reason like I'm to take in by the fear and that you know if you zoom out again like to just humanity and being a human being like when we are fearful we are we go into fight or flight or freeze or fawn or all the the F's that go into it like we act out of instinct and now think about someone who by the unlucky state of their brain is just always in fight flight or freeze mode and is just constantly activated like the whole world and everything about existence is a threat yeah you're gonna be doing a lot of stuff to try to mitigate it whether or not it works because there's a chance right that's the OCD brain before you know the chance and trying to mitigate the chance just robs you your whole life so it's kind of the point of treatment and recovery but he was to say getting back to the point I was born with OCD and from the youngest ages of being I had interest of thoughts of you know whatever came to my life so OCD kind of latches onto and morphs into whatever's important to you at any point which is why you know it's such a insidious disorder so what it looked like as a kid was being extremely afraid of my mom dying and not coming home from work and so when I was like four or five years old I or I guess earlier than that I was taught these 12 prayers to say for you know it was initially taught in a healthy way but like also to try to get me to do the prayers it was taught to me that like if you don't do it then the bad thing will happen and to do it to prevent the bad thing happening and so these 12 prayers I would just do over and over and over and for whatever reason my brain decided that 39 was the number of times I needed to do it because apparently three was a safe and good number. I hear a lot of things of me just as assigning judgment and value. I'm saying this from the perspective of being entreatment and being aware that it's a logical and irrational and completely bonkers. But that is again the point of OCD. Logically, I can know that the number three doesn't have an inherent value, but it feels like it does because that's what my brain decided to tell me or to latch onto. That feeling of safety is what I'm craving so deeply. So it's going to override logic or reason. And at the time as a kid, I didn't realize it was disabling me, so I had no reason not to do it. But anyway, three was this pure good number. And I don't know, maybe it was actually taught to me in a cultural way. There's a lot of cultural things that were taught to me that I'm unpacking now as my OCD latching onto it. But whatever reason, three was that number and then three times three is nine. So that felt like a pure number. And then 39 seemed like the perfect number because of three and the nine and the multiplicity of it all. It doesn't make sense, but it made sense in my OCD brain. And so I do this 12 prayers 39 times every single time I had a thought to try to will it to not come true. And then my brain would gain evidence in that threat that wasn't actually a threat beyond just the possibility that anyone might die. But I didn't know that again. And I'm sitting here as a kid like every time my mom does come home alive that I saved her or I prevented her from dying. So I'm just going to keep doing it. And anytime I had that intense fear come up, which I would just like sit in the bathroom in the dark because my mom used to work late and just do that over and over. Like that became a common thing that I did to cope with pretty much anything. And I had so many random rituals that I'm still in fact into this day of that I have and that I had. But my brain counts everything because it's very, very latched on to numbers. And so it counts the number of everything I do like breathing like after someone stops talking or like the number of steps I've taken like ever. I didn't realize it was not normal to count every single like a number of steps that you're taking or like flights that you're taking or the steps in each part of like a staircase or like anything like that. There was always counting an assessment of the number and needing to neutralize it to a safe number quote unquote or it had to keep repeating it or have to like compensate to make it happen or else like everything would go wrong and everything would go bad. It would be my fault. And I wouldn't feel like it was complete or I can move forward, which again is not logical. But it's this steeply visceral, somatic feeling that could not be overridden by sheer will. It just couldn't and especially like without understanding what was going on. So it was very much like repetitive checking. Oh my gosh. So much checking, checking of doors, checking of locks, especially once I was given a key to my house when I was seven years old. I remember the exact day that it happened. At least I think I do because I've learned neuroscience our memories are very wrong. But aside from that and my pathological doubt of that. I remember the day I was given a key and from then on I had this complete massive fear of ever losing that key of not locking the door in or of someone else getting a hold of the key, taking all of my family's possessions and money and us being homeless and us are life-themed ruined because I may have at some point lost the key. And so I used to hold that thing in my hand from the age of seven onwards like all day, like take it with me to the bathroom to have it with me like in the playground like it made indentures in my hand just trying to hold onto it and like always feel it. And I would always doubt it was there and then have to check it over and over. And it was just horrible and just kept me from doing so many things including going to the bathroom properly, my goodness. And that was, that was a less intense stuff honestly. But there was so much just vigilance. And I think what you can start to see is kind of whatever my fear was like yes, you can distill down obsessions or fears into common lists that many people have because human experience is very shared. And so that's why you know in a kind of cool way, like none of us are simple or unique enough to like have an entire list of obsessions that are completely separate from somebody else is because of the sheer nature of what it is like to be a human and what we would be afraid of naturally. But also like the unique combination of obsessions and like when they onset can you know defer based on people's life progression and the way that their values and life changes over time. And for me it kind of formed exactly to whatever was going on in my life. So anything with my parents and with domestic violence and a lot of the trauma I was going through my OCD latch on to to try to mitigate or protect or I was basically like my OCD said I was in it was my fault. Everything was my fault when I started going through horrific traumatic experiences of sexual abuse, violent abuse from not my immediate family, but from extended family just keeping it vague here, but I'm very open in general about that experience and other experiences. But just anything I went through my brain latch on to as my fault or I could have prevented or that I'm lying. That was a huge and not was is wasn't is a huge theme for my OCD pathologically doubting my memory and especially especially traumatic ones which gets very very hairy and then engaging in of course I just talked about a bunch of physical compulsions because it's very much easier to conceptualize I think for people but as much as I did and do experience physical compulsions mental compulsions are the sneaky fucking assholes that have kind of ruled my life till very recently in recovery and it's still something that I'm largely largely struggled with and I'm working through but have improved upon more than I ever thought possible. Mental compulsions, hmm they are not seen, they are not identified as compulsions by therapists and people around us because you can't see them, they feel like thinking they're so easy to hide and you know most people wouldn't have known I have OCD like mine didn't present in a way where it was like obvious in front of people watching I mean I guess if they watched me very intensely and I was alone a lot so I was able to do it but so much of my compulsions especially like the very pervasive ones were mental like counting and checking things mentally but then I think even more so like mental review and pathological doubts seeking reassurance rumination, oh my gosh rumination rumination is a compulsion I know it's also associated with other psychiatric illnesses but in the case of OCD it's an action and a thing to seek certainty and to try to solve a problem in your head that's unsolvable and like I said it can be about horrible horrible things such do not need to be figured out and are not true but I digress. I had a really hard time with my memory with being so afraid of not being able to interpret information I had a really hard time from a very young age being able to follow directions because I was so afraid of missing a step and I would ask questions and questions and questions it was kind of a joke with my teachers that like if they gave me one instruction like one step and like how to fold a paper I'd have like 10 questions and then like another 10 questions for the next one and it would just be this like they'd never met someone with that many questions and it was kind of like oh she's so like funny and she's so curious and like yes I am curious and I value your own way but that was not from curiosity that was from massive fear of not understanding and of checking over and over again thinking of every possibility scenario in which I might get it wrong and to a compulsion to make sure I wasn't and it just was widespread and it only got worse as I got older it started latching on to adult concerns and responsibilities and you know I was largely un-present and incapable of taking in information after a certain point and that did very much intersect with dealing with very excessive abuse when I was 12 and kind of just having an overall downhill spiral from there with my mental health with my diagnoses and again like all of this is covered in exceptional detail in past episodes which will be linked below my mental health journey episodes as well as my overall story so I won't get too much into it but regarding and related to the OCD overall it was just everything got worse including my OCD which makes sense and through late middle school early high school I just stopped being able to really internalize information at school and I mean it's kind of almost comical now like I don't really know most general education things and like I'm here I just sort of master's degree I'm getting my PhD and there's like basic biology and chemistry and physics and also like history and just things in general that people just know and my professors always say jokingly like oh like the stuff you learned in high school and I was like I didn't really learn anything in high school because I was completely incapable of taking in information because I was so busy being so fully consumed by my obsessions and my compulsions pretty much every freaking waking moment and you wouldn't have known Because it was in my head and I just like maybe spacey or like depressed, which I was, but also and even more so OCD which was so so bad and it got to a point where I tried college for two years and I talk about this far more of my other episodes but you know with with OCD's OCD specifically at the time I was So so sick and I you know, I'm living alone now. I have even more Ability to fully engage with my obsessions and compulsions Without you know anyone watching me or holding me to a standard which made things worse of course and I couldn't even go to class and Try to pay attention without being consumed by what if I didn't understand what if I didn't get it correct What if I didn't hear this and like trying to compulsively write down every single word from what my professors were saying and then of course You can't do that and in the process of like writing things down. You know, I'd actually even hearing what they're saying and I would then record classes as a Compulsion go listen to it over and over and over again I was so unpleasant that nothing could even permeate into my brain which was reinforcing that I can't learn And so I'd listen over and over and then like I just burnt out and I couldn't do it and I failed out of like almost all of my classes I didn't know I had OCD and That's kind of where I should stop and like add the level and layer of the misdiagnosis experience Because I did cover this in my past episodes but related specifically to OCD It's just even more heartbreaking than the other illnesses because I Started getting attention for my psychiatric conditions Around 13 years old largely due to attempts of suicide and also just being Hospitalized and people not knowing what to do with me for a whole lot of reasons, but OCD was like largely They was largely there as you're very very aware of by hearing my story and It was not found at all. It was not diagnosed. I was I say just not to dismiss these other disorders because I do have them some of them but it's it just didn't encapsulate the severity of my the complexity and severity of my condition and The treatments did not do justice is also what I needed. That's why I say just and there are also much more commonly diagnosed and in terms of its abilitation as much as they are debilitating It did not match up to OCD. So all that to say I was just diagnosed say that obviously kind of sarcastically with major depressive disorder generalizing anxiety disorder general suis-ideality panic disorder and then a little you know later on bulimia and social anxiety, but It did not capture What was going on with me and yes? I 100% did and do have pathological anxiety generalizing anxiety disorder across the board to me where I differentiate that from OCD and the parts that weren't Uncovered was the pervasiveness and the global nature of my anxious thoughts number one number two the extremes and the irrationality and the level of shame that came from the content of my anxious thoughts which very much were extrusive rampant recurring Could apply to literally any topic whatsoever which is Extremely pervasive and OCD talking about like some of the horrible things I talked about before with Anything ranging from harm to taboo thoughts of hurting Different people in different ways and just the most horrible things, you know fears of what if I murdered someone in the middle of the night and I Now that I know how to drive and I just blacked out or I was on something and I am gonna find out and you know seeing Police and thinking that what if they're here to arrest me for something I don't remember doing and trying to figure out where I was and if I ever Did wake up in the middle of the night and just like those types of things like There's a line there's anxiety and Then there's the absolute lack of certainty about anything and any Fearful thought that ever enters possible and compulsions more importantly compulsions and because of Largely what I talked about before the lack of understanding of what OCD is the lack of understanding of what compulsions are and even if people do kind of have an idea of compulsions Thank you that compulsions are simply just washing hands ordering things Checking locks checking stoves checking, you know like appliances. I mean, that's just such a tiny fraction of what's possible with OCD And then you get into mental compulsions and how that's just not even a thing that people in general and I when I say people I mean especially Mental health providers of any kind are aware of like that just wasn't found within me and like people are typically not Admitting to the extremes of their thoughts and they're not gonna be asked because people don't know about OCD so All that to say from the time I was 13 Well first off my symptoms started at zero and I Can ascribe most of the lack of Diagnosis and treatment overall for the numerous conditions I live with because I've got a brain y'all the numerous conditions and also physical which is included in my full story Tilt about around starting 13 that's because of just a lack of cultural awareness and stigma about anything related to mental health a lot of gaslighting about Symptoms and about experiences and a lot of parts of Living as a child of immigrants and not being allowed to experience anything other than gratitude for being able to be in this country And just in general like not having any concept whatsoever of mental psychiatric psychological health so Zero to 13 like let's call it that although there's so much pain and grief and horrible Experiences that are embedded into that experience. I don't mean to like Slide away from that especially for those who are in solidarity to understand that and have had that themselves That's just a different conversation for another day very very much about OCD Accessibility and treatment and awareness in general and that's largely why many of the events I'm doing this week are about being by-pock and growing up in Circumstances where you don't have access but again related to the it definitely amplifies a lot of my experience But is not necessarily the primary or only reason why I you know did not get help from zero to 13 But then once I started being seen by providers which you know It's a whole other conversation how that was handled at home and by my culture and how it was not taken seriously But even in front of providers even in front of full-blown psychiatrists therapists psychologists doctors It was not identified within me not only just for 13 years, but actually until I was 22 years old so I got to the point where my Entire life was crumbling. I was becoming less and less functional. I Told you I was in college just not functioning at all I ended up dropping out as many of you know with a 1.83 GPA after two years because I thought I was too stupid to function and the reality was I was extremely extremely sick and incapable and did not have treatment and I was not capable just because Not because I wasn't inherently capable because I had no functionality at the time. I couldn't do anything so I What other than compulsions joking not joking um, but I left school and my life just got smaller and smaller and I was massively fearful of running out of money and being broke and being homeless and so I Went years where I literally Would just sit in the dark of the apartment I lived in and I would not turn on the lights at night I would use the the flashlight on my phone and I would not turn on the lights because I was so afraid of spending so much money or wasting money in my mind that I could possibly be homeless and be my false because I Could have been saving money by by living that way. It got to the point where I Legitimately to go to the grocery store. I'd either not go because there's too much or it would be like an eight plus hour or deal of Going and reviewing every single thing in the store and comparing every single Like you know toilet paper for example like every single form of toilet paper doing the math To figure out per unit which one was the most physically responsible then even debating if I needed it at all versus I could just be disgusting and not have things like that or not have food or you know steal Honestly, that's a part of my life too like stealing nothing big, but like I was so scared of being broke that like you know stealing things to feel like I was safe and like I wouldn't run out of money and that was horrible and is usually In my past, but was part of how severe my OCD got and then After making decisions leaving and then going back in the store it out of the store over and over again returning things like I developed a reputation with the stores The vendors everywhere around me of how much I returned stuff how much I came back within the same day or multiple days later and honestly it's not even logical because imagine the amount of money and time obviously, but especially money I wasted on gas like returning stuff and going back and forth and back and forth, but I was just caught in cycles and I couldn't like sleep or I couldn't think of anything other than like what if I bought the wrong thing like I should go return this whatever like it was it was horrific it was absolutely horrific and I was isolated, I was miserable, I had and the worst part at least one of the worst parts is I still had no idea at all that was that it was OCD or that I was even suffering like I was suffering obviously but it was easy to just describe it to depression and anxiety I didn't even know at PTSD either that's another part of the story too but overall like I did not know that I had OCD and where it really came to a head at 22 at least in terms of identifying OCD or getting a diagnosis was that I'm living this way like you know I could go on and on about how much how how bad it was like those are just two of many many examples but I I was living this way overall and I was living with my partner now husband and it really came to a head because living with someone especially in one bedroom apartment makes you notice and realize the vast discrepancy and the way you function as opposed to someone else so I lived my own way doing things compulsively horrifically unhealthily and thought it was normal and then I start living with my now husband who of course without intending it and it's not at all his fault but like everything he did triggered me the way he lived the way he bought things the way he used things the fact that he dare ever used one full paper towel or that he would leave a light on when it was not necessary or even turn the lights on because you know there was it's so funny in talking about the difference between the rational logical part of one's brain versus like this versus the OCD part if that's how you want to conceptualize it at least for me I do like when I'm when I was with him like yeah I didn't insist we sit in the dark because I on some level knew that was weird although I did feel like for me I had to do it for myself and there was no excuse for that but I also like while I would sit with the lights on I would be just completely not present just boiling inside like about to explode with like just fear and needing to go turn the light off and I would sometimes even and just make up excuses and you know I'd badger him about literally everything he was doing because I was so triggered and like the amount of food he would eat or the way he would do literally anything and then finally it was a conversation of like what the fuck is going on and it kind of hit me like a ton of bricks like whoa I do things repetitively what if this is OCD and like it was really hard because immediately my brain dismissed like oh no like I don't have that although some of my OCD at the time did look pretty stereotypical to not the quirk or the adjective parts but like the repetitive handwashing or more importantly the checking of things like I think that's where the overlap existed of like oh I I really really struggle with that and I don't know how to stop and it really hit me that oh this might be what OCD is but I wish I could tell you from that realization then things got okay and I only went I say only in sarcastic terms 22 years without knowing I had OCD and then I finally got treatment but that's where the story gets even worse in my opinion because I now think I might have OCD I go seek out a psychologist to be able to see if this is true and you know, not to assign value judgments to people with different degrees, but I felt like if someone was gonna understand me, because of my previous, at that point, I had seen probably like 12 different therapists who we were working on depression and anxiety, and I felt like nobody understood me, and I was just right about everything, which in retrospect is hugely because of not addressing my whole picture and because I was so deeply fucked up that like I could not receive help even if I tried, but more importantly they did not see my whole case. had no idea that PTSD, which was extremely severe at that time, too. They obviously didn't know about the OCD and whatever. So I had a deep mistrust of therapists for that whole time, but I was like, okay, maybe I'll find someone with a PhD and they will know what they're doing and I could vet them that way. And then I found someone who was at the time I worked at Starbucks, actually, and I didn't have proper health insurance, but I did have employee benefits with them of certain therapy numbers of how much you could get. So anyway, I used that and I saw the psychologist and she diagnosed with the OCD from when I told her and then she started engaging in what she called treatment and what that was, was traditional cognitive behavioral therapy, CBT, I'm sure we've all heard of it, and faith-based therapy, which is a whole other story because of the fact that I had been a religious cult which we need to circle back to at some point with my OCD story. But nonetheless, basically she saw this as I was just really fearful and I just needed to stop doing compulsions. So like using traditional CBT to try to divert from the thought, like if I have a thought, just think about something else, I was tasked to put a rubber band on my wrist to just distract myself from the thought and not think about it. And while number one, that in and of itself is harmful because those are compulsive and are not actually what the treatments are for OCD is we're going to get to, it was already harmful in that way. Also though, there was no conceptualization of what actually my OCD entailed. It was only what I was reporting, so it was things like the concerns, the service level concerns of running out of money and the lights need to be a certain way and the certain things need to be bought in a certain manner and just these rules I had. But there was no further analysis of where else my obsessions were coming from or what my obsessions were or what compulsions I was doing. So it was entirely self reliant on my very poor insight of my case because I had no fucking clue of what was going on. And it was also just don't do it, like just don't do it, just be strong and don't do it, which is not the treatment for OCD, it's not empirically validated whatsoever. But that highlights right there the massive gap in treatment and understanding of the highest level clinicians. There's a statistic of up to 80% of clinicians misdiagnosed OCD and unfortunately OCD goes on average 14 to 17 years undiagnosed, misdiagnosed and improperly treated. So for me, it ended up being 25 years until when I got proper treatment and that's on the higher end of that really horrific average of just the amount of time people go treated incorrectly. And so to keep this short, I was going through this incorrect treatment and I was just trying to prove that it was working that I was doing better and basically I just got better hiding my compulsions and I still had no insight as to what my obsessions actually were or to be honest, but actual OCD is. So I ended with that therapy and then life kind of blew up and got even worse and I was diagnosed with metastatic thyroid cancer. I went through treatment and again, I'm not going to get into all the details of that because that is all in previous episodes, but the takeaways related to OCD are that I started going to trauma treatment because it was suggested to me that I might have severe PTSD by a medical doctor who was witnessing my behaviors related to just witnessing me for cancer, which was unrelated, but at least this person was perceptive enough to kind of assess me in any way, didn't see the OCD. But with that, I started going to a PTSD specialist who unfortunately was a horrible, horrible provider and I've actually been encouraged by other providers to file suit against her at the Texas psychological bar or whatever that is, but that's another conversation again for another day. But largely what happened with her in addition to a lot of unethical things that shouldn't have happened relationally was also by that it's mostly like we just talked about her and I learned all about her life and things I shouldn't have known and I avoided my own treatment by just talking to her. But that's because the dynamic ended up lending itself to that because as the way she conceptualized my case was I just had really bad PTSD and I didn't really have OCD, OCD was really a thing and I just needed to figure out what the cause of all my fears and thoughts were and then the compulsions would go away. And so it was just about finding the trauma or finding the root cause of all of my thoughts and then just like letting them go. And that is also, I mean what she was doing was psychodynamic therapy, psychoanalysis and that is also harmful and contraindicated and makes OCD worse. It does not treat OCD, it's not even, it's not helpful, but it's also harmful to OCD. But I didn't know that at the time I very because I am the patient. I did not have access to the advocacy and resources that now exist today. So I spent another year and a half going through incorrect treatment. I also started doing EMDR therapy for PTSD, which is helpful for PTSD, but unbeknownst to me. I was consumed by mental compulsions and things that did not allow me to actually engage at the EMDR properly. So I wasn't actually processing shit. So I kept going with unhelpful and horrible, horrible treatment. And finally, where there's a really came to a head and I finally was able to start on my path to evidence-based treatment and recovery, though not linear. But what happened was I was aware enough of some parts of my OCD like with school and what had happened in the past. And I just was trying to not do compulsions, the ones that I at least was aware of. And I was also trying to find out the core fear and reason behind it based on the past trauma. And with that framework, I went back to school, I would literally sit on my hands to not do compulsions. And I was able to get to a point where I could function, but what I now know is I was white-nuckling. And by function, I mean I could go do things, but I was still consumed by my obsessions. And I was still engaging with them and it just turned into mental compulsions. But the physical compulsions had less end. But again, I didn't know about mental compulsions, so I thought that I was getting better at things were working. And then, you know, I went through the pandemic and things were as they were for most people. But a key factor of all this was that I was home with my now husband, like all the time for two years. And then when he started finally leaving the house again, and I started leaving the house again, and I started having more time alone, I relapsed fully into my physical compulsions. And I, in that framework of understanding what I thought OCD was at the time, which are the physical compulsions, to me, I was like, oh shit, like this is bad. Like I don't know what to do. Like I am just at a complete loss and I don't know how to get out of this. And I am just, I am relapsing. And so in that framework, I thought my OCD was getting bad again, which in retrospect, it just had been bad the whole time, but it just was taking a new form. And because I was more alone, I was able to do more physical compulsions and not get caught. So like I just started doing them. And then at that time, I was 25, I had more brain capacity overall from just a lot of the physical illnesses and like things that I had been working through as a result of, as a byproduct of cancer treatment and a lot of diagnosis, I received again, very, very long complicated story, but that's all in other episodes, all that to say. I finally started learning about what real OCD is on the internet through the International OCD Foundation, the IOCDF through NoCD or Treat My OCD on social media. And I learned about exposure and response prevention, most importantly, I learned about evidence space, the gold standard treatment for OCD, which looked nothing like anything I had received before. And it was just absolutely mind-boggling that I had never heard of ERP this entire time. I also had no idea that OCD spanned to so many different themes. I had no, I mean, it was really like putting glasses on and like seeing myself for the first time of putting into perspective how my thoughts worked, all the things latched onto, all the things I just inherently felt like were, were shortcomings of me that made me a horrible person and realizing that those all could be OCD, like that just entirely transformed my life. And that's even before treatment. And then I go into treatment and I am learning all about the subtypes, the different compulsions, just kind of unearthing more and more and more about like how much this kind of profited every inch of my life and I didn't know who I was. I was fucking terrifying and then doing ERP was excruciating and was absolutely just one of the hardest things I've had to do in my whole life and I'm still in ERP and I'm still doing it. And that is I guess the next chapter of like what I'll share in terms of my story. So I start ERP treatment with my first ERP specialist vetted by the International OCD foundation because something else that I should point out is that the vast majority of clinicians for better or for worse on psychology today and on wherever they advertise their services tend to list everything as they're specialty like they treat everything and that oftentimes includes OCD because they think that they can treat OCD and they use CBT to treat it which the huge misconception is that CBT treats OCD like it treats most other conditions and it doesn't. Exposure response prevention ERP is a subset of C of cognitive behavioral therapies. It is not cognitive behavioral therapy. It is a subset and it's specifically formulated for and treats obsessive-pulsive disorder and it is the gold standard evidence based treatment for OCD but most clinicians don't know that at all and they think CBT treats everything and even if they do know that they think CBT is what they're supposed to do not ERP. So it's quite easy even if you for by some stroke of luck or miracle think or know that you have OCD when you actually do it's really easy to just go look for a therapist as they treat OCD and then go get treated incorrectly by said therapist just like I did and luckily the IOCDF has a directory of people who are actual OCD specialists and clinicians who know how to administer ERP and other adjunctive therapies and there's other companies like OCD that specifically only that entrained therapists to treat OCD properly. So I finally after 25 years started working with someone who was a specialist and I also got lucky in that my first OCD therapist happened to be trained on comorbid OCD and PTSD which I didn't know would be a problem or a thing but very quickly what happened for me was what was expected to be 12 to 24 sessions of ERP given the even though my OCD was very severe ERP or I was scoring extreme it was the highest part of the Y box but ERP for many many people is very efficacious and can reduce symptomatology and can make a difference pretty quickly even though it's extremely difficult and extremely counter intuitive because ERPs basically like experiencing the fullness of one's obsession and not doing a compulsion which sounds very simple but it's actually extremely difficult and it's supposed to habituate and show our system in our brain long story short that like we can tolerate the uncertainty we can tolerate the discomfort and the extreme horrific feelings of the obsession and we don't have to do the compulsion and we can write out the entire amount of distress and then we can break that loop slowly by continuing to not engage in compulsions as much and to create distance and to show ourselves we don't have to do the compulsions and again that sounds pretty simple but it's extremely extremely difficult and many many patients or people with OCD end up in residential treatment facilities to have to do this in a fully controlled environment because it's so so difficult and so intolerable for people rightly so but anyway it can work very effectively and very relatively to the amount of suffering like quickly for people and so that's kind of the expectation I was given going in and then very quickly they realized that I was not a case of typical OCD I had comorbid PTSD which many people live with comorbidities like it's kind of hard to not find someone who is OCD who doesn't also have generalized anxiety disorder or depression or major depressive disorder or many other things but the particular clusterfuck that comes with comorbid PTSD is that their treatments actually work inversely sometimes in that PTSD treatments can make OCD worse and OCD treatments can make PTSD worse and that's mostly in short in a very short way of explaining it because the function of PTSD treatment is to create safety and to process traumatic experiences that were not you know process properly by the brain and a lot of reassurance and in terms of OCD like a lot of reassurance and safety is provided which can be compulsive for people with OCD and then on the flip side with OCD treatment which was what I was running into with ERP so much of my OCD was intertwined with things that had actually happened extremely traumatic experiences and chronic traumatic abusive parts of my life and just things that were not processed correctly for like 25 years and rather than being able to tolerate the exposure enough even though it would be extremely just stressful and like be present to do the exposure I would start dissociating and I as my therapist said it looked like they kicked the chair out from underneath and I would just like go numb and I was getting out of my window of tolerance because of how traumatized I was and so it was prevent the way they described it was. It was like constantly working on pressing the gas and the brakes to like move at a very specific speed and it just was very difficult and so what made things even more complicated was that I was in the process of doing this treatment and getting my therapist getting to understand my very intricate case and then many months down the line while we were in the middle of treatment my first therapist had to leave the practice, they had to move out of the state and could no longer treat me and so they were very particular about me being referred to another clinician who was an expert at this comorbidity because of my case needing the understanding of the complexity of it all and so I had to wait several more months. It's already very difficult to come about a specialist who has availability given the limited number of them. Then you add on to that insurance and financial stuff and it just gets difficult but finally months later I was able to start seeing my second OCD therapist who started to get to know me back as well with all of the context from my first OCD therapist and was continuing to conceptualize my case and we were starting to get somewhere but several months down the line in that scenario she then had to unexpectedly leave the practice as well due to a dissonance between the provider and the practice and then in private practice that my therapist started was not taking insurance, I could not afford to see my therapist at the full rate and so I had to stop seeing my second therapist and that was excruciating because it really truly felt like I just was never going to get better which is not true because ERP what I should say is for my OCD that was not latched into my PTSD for my just more singular OCD symptoms because I was doing ERP and it was working and it was really giving me a lot of my life back and it's continued to do so and that's largely what I attribute so much of my recovery and change in life and improvement to. I was getting better but the amount of overwhelm I had from the parts that weren't getting better, the parts that were the biggest symptoms for me, the parts that were because they were so deeply rooted in trauma were of course just making a bigger impact on my life. My brain encoded that as like I'm just not going to get better and I can't get better and of course twisted into abandonment beliefs and things like that which were not logical but it's just how I felt and it was really really hard and I spent the next, well that I stopped working with that second therapist over a year ago and then I just started with my third OCD PTSD specialist I guess a month and a half ago from now and I'm really really lucky that I was able to find someone else who's a specialist and it's been going really really well since then and I'll definitely have more updates in future episodes but to make this more of just encapsulating my OCD story I'm still in OCD treatment and what I'm largely unpacking right now and starting to learn how to move through and handle are my mental compulsions and my deeply rooted obsessions about my memory, about trusting myself, about trusting other people and just being able to provide myself actual self compassion for my intrusive thoughts and for the things that have actually happened to me and it's a process and it's not linear. I still score severe on the Y-box which many people who score severely are in residential inpatient facilities and I was actually told by my past assessment psychologist to do the whole assessment of me and that whole recap is on past episodes that are linked in the show notes but long story short, she was under the impression that given the severity of my condition even though I present as functional because of the whatever, just the amount of bandwidth I have to present as functional even though internally I don't seem to be by her standard, and I could be that I would have to be in a residential facility but at this point I'm not and I'm getting by and I also do feel hopeful and I'm in the hands of someone who I feel like I can trust who's really really helping me and hopefully that won't be the case and if that is the case and that's okay too and that just is what it is and we'll have an update to this episode and I'll circle back to just some parts of my OCD story that will now make sense as to my themes and the way it impacted me and kind of overlaying the very severe and debilitating ways it can shape parts of people's lives. I think number one, it's pretty obvious that it shaped the trajectory of my life especially later in adolescence and adulthood, it would school with being an architectural student, with coming back with just the unique hurdles I've had to face and the delays and my progression in life and sure I am grateful for my path and I own the fact that I'm an architectural student and person and I just I've learned lessons of paving my own path and that's being making meaning out of my experience but also it didn't have to be that way and it definitely did not need to steal those possibilities and opportunities from me in the past and the amount of grief that exists from the amount of time and space and safety and loss that has come from living not just with OCD, not just with the severity and the horrificness that comes with this disorder in and of itself but all of the added time lost from misdiagnosis, lack of diagosis, lack of diagnosis, incorrect treatment, lack of access to treatment, like I am still very much living in the grief and the reconciliation of so much of the life that I lost because of how deeply misunderstood this disorder is and how hard it is to get actual treatment and the barriers not just from a lack of understanding but also the stigma and the taboo and the misunderstanding of the different presentations of it and also OCD meeting me as a very very vulnerable person from a very unsafe home with a very unstable, very abusive upbringing and I am circling back to it now is I and again most of this is detailed at length in my past episodes so I'm not going to go too much into it but I joined a religious cult when I was 14 and of course nobody joins a cult in their mind like there's a cult and I'm going to join it but what I did was I joined a religious cult and that was so much because of course that feeling safe to be is compared to my own home and a lot of factors but what really drove my participation in the cult and me buying into that prescribed framework of looking at the world and at religion and of my life was because I was a very vulnerable person my life was because I was undiagnosed of OCD I wanted nothing but certainty I was so deeply in pain about my existence and I needed answers about why I was suffering and why my life looked like what it looked like and what more importantly what I could do to get out of it and the cult and as you most cult provided a very certain framework of if you do this then that if you believe these things and do these things and perform these acts and give this money and blah blah blah like you will be free of your suffering and of course there's a larger conversation to have about like organized religion in general and like what you know detriments could happen but especially in these scenarios like what caused me to ignore my deeper non-ocD I guess red flags and knowing was this complete doubt of myself and my beliefs and feeling so dirty and horrible and unworthy and meeting of being saved and the cult latched onto that and my OCD just kept looking for the certainty that was being provided me there to me there and what's so difficult in processing and moving forward in my life is just seeing so clearly how having undiagnosed untreated OCD Let me two seven years in. a religious cult that abused me and I Can't change it and it's it's part of my past and it's something that will forever be a part of my advocacy Because I know I'm not the only one that things like this can happen to maybe it's not a cult, but it's something and that need for pathological certainty and all of the shame and guilt from the thoughts and impulses and actions I was doing and providing you with compulsions to do To benefit other people that I didn't know about and take nor my own inner Compass because I had no trust in myself It's a lot it's a lot to process and so I had to share about as part of my story because it just illustrates how Insidious and pervasive this disease can be and also I'm here now and I'm living and I am Flourishing by many standards and thriving in many ways and I have moved so far past those parts of my life equally and oppositely though recovery is So real and so powerful and my life looks absolutely nothing like it did in the Theros of OCD It looks nothing like it did just two years ago and I never in a million years could have predicted the way my life looks now and What's so important to Realize and hear about me talking about recovery is that I have not had the linear Simple-ish path of recovery where people do ERP and then they Gradually get better and then they have graduated treatments and they are just managing their OCD But at a far lesser level mine like I said has had complications and I'm still an intensive treatment three times a week and ERP has still saved my life so much and even within non-linear More difficult journey with comorbidities and hardships and lots of things that might not be common with other people's experience at least the exact circumstances There are still so much hope and Growth possible in Recovery at all and there's so much beauty and being able to exist even within the non-linear journey and That's why I think it's so important to advocate with everybody's story and everybody's trajectory through recovery especially though I am so passionate about sharing This part of my story because it doesn't necessarily fit what one would think of an IOC if advocate or someone who's putting themselves out there as a proponent for ERP and for OCD and not being fully recovered whatever that even means because you don't need to be for Treatment to have power and to hold hope and to continue to grow and evolve and you know be on the upwards spiral of Life which sometimes means continuing to face the same circumstances and repeating Behaviour sometimes but still coming with more perspective and more wisdom and more Hope and more data of what's possible and so What better way to end my OCD story than to just end in the non certainty the just Open endedness of where this journey will go my OCD story is not over and it won't be till I'm dead But especially my story of treatment and recovery is still very much in progress and I feel very grateful and honored to even be here to share that I am in recovery and that I have not you know Ended my life and the ways that I felt like I would because I didn't think I could live and continue to live in the amount of pain and suffering I was in and also because of just being in recovery to Access treatment to know what life looks like not completely in the grips of OCD, but still Have an understanding of how much of a disorder it is that needs to be managed and needs to just allow for so much acceptance and self-compassion about where we are in our journeys and it's just Ever evolving and it's it's really hard and vulnerable to just show up as My full self and be completely brutally honest about exactly where I am in recovery But that is what I think life-saving advocacy is because I Could only wish that someone else here is this and knows that they are not alone or someone who doesn't have OCD Can hear and see what it looks like for someone to live with OCD and it's not a it's not cured It's not you know completely in remission and yet and people can look like they're doing really well and still be really Really deeply struggling and if nothing else to just grow empathy for those people too and that's where I am It's an ever-evolving experience and I Just want to close this out by sharing some very last quick Mythbuss of common questions I get through my research and through people asking me questions and kind of making correlations or Having thoughts about what OCD may or may not be So rapid fire myth bus on top of all of the misconceptions that I debunked earlier in the episode number one People think that OCD is just a form of anxiety or as an anxiety disorder and at this moment in time in October of 2023 that is not true so OCD used to be Classified as an anxiety disorder in the DSM But then was reclassified in the DSM-5 as an obsessive and compulsive related disorder Which is different than an anxiety disorder and is distinct for a very specific reason because it was previously thought that OCD Which is driven by anxiety it was kind of like anxiety plus compulsions and it is just not true There's so much more complexity to that like I talked about before oftentimes obsessions can present as Deep pathological anxiety and can be that feeling but it can also be many other things that are not anxiety It can be discussed like extreme discussed or shame or guilt or many other Negative affect feelings that are not anxiety so it does a disservice to the disorder to call it a form of anxiety Also, it's not treated like anxiety exposure response prevention is specific for OCD and anxiety can oftentimes be treated with you know traditional cognitive behavioral therapy rooted in logic and recent Reason and rationality which does not work for OCD so by calling it an anxiety disorder or a form of anxiety It's inherently Saying and asserting something incorrect which is that it can be treated as anxiety which it cannot be so therefore There it's really important to make that distinction second of all people sometimes think that OCD is a form of PTSD Or as a form of trauma or as a way of coping with trauma and there's a lot of nuance in that nuance in that statement in that Of course compulsions can be seen as a coping mechanism for things that are just stressful which can include trauma However at this point in time it is not considered to be a form of PTSD It's also doing a disservice to the complexity of the disorder to say that it is a form of trauma because it is not treated as trauma It does not work to be treated as trauma and many a times if not most of the time OCD obsessions are not rooted in a reason for you know something that has happened Sometimes that is true but even so compulsively reacting to that behavior By default makes it not PTSD it makes it not trauma even if it is about a trauma But so often times intrusive thoughts are just that they're just intrusive thoughts that are not rooted in something that has actually happened or a traumatic event So it's just conflating two things that are not the case OCD is also largely Conceptualized not only as a neuropsychiatric disorder but a neurodevelopmental disorder It has a lot of overlap in terms of genome-wide association studies and correlative behaviors and correlative genetic predispositions to other neurodevelopmental disorders and Disorders on the neurodivergence spectrum including autism spectrum disorder and ADHD There's a lot more research to be done, but there is a lot of value in understanding the neurodevelopmental aspects of OCD Which of course there's still many psychiatric and affective Effect set the disorder has on our well-being and the way we interface of the world But it's also so much rooted in Neurobiological drivers of movement and inhibition and Phyllemic eating and just so many parts of Neurobiology, it's just a complex disorder so I I just had to drop them there as well Okay, so this episode is obviously So long and there's so so much more I could share honestly I My OCD is now already lushing onto full transparency about like how imperfectly I did this and all the things I didn't say it that I could have said that could have been in service of people and what if I did not represent it properly and to not encapsulate Every single thing I should have and it doesn't do the disorder justice and you know what? I'm just gonna have to sit with that and sit in uncertainty also though on a very practical note My computer keeps running out of storage and that's what I'm dealing with as I'm recording this episode So like I really actually have to end it now But this is not the end of this conversation by any means if you have been keeping up with the podcast and the research Caught the questions and concerns I have that are gonna be coming up with so many different people in the community who do research as well as people with lived experience. Like this conversation is open-ended. There's so much to say about OCD. And this is just the beginning, or it's not even the beginning, it's just one part of it. But this is just one place in honor of OCD Awareness Week where I can conceptualize OCD in the way that I understand it, at least from a lived experience perspective with a little bit of research sprinkled in there. And then just my OCD story in a nutshell that again is ever evolving, so there's gonna be more episodes talking about this. But thank you for holding space for me in this imperfect way. And I just hope that you learned something about this disorder and that you understand more about what it actually is. And why I am so fucking passionate about raising awareness and changing the way we perceive OCD in the way that I can, so that people don't have to suffer for as long as I did and other people do in this community. And I hope that you bring this advocacy with you in any way, shape or form that you can. If you see someone suffering, if you notice something within yourself to be able to ask this question, and to raise awareness about what this is without judgment and without this preconception that we're conditioned with. So I hope this was in service to you. And for everybody in the OCD community who's listening to this, I hope that you feel seen, heard and loved in some way, and you feel validated, you feel understood by this episode and with all of our unique experiences in the way that OCD presents, I hope you can find the commonality of hope and understanding and validation. And this episode is for you and for me and for all of us. And I will keep going with all of the advocacy and I know that you all will too. So happy OCD awareness week, everybody. And thank you so much for tuning into this episode and for just holding my story in its evolution. And as always, if you loved this episode, if you're loving the podcast, then if you can just take five seconds while you're right here and subscribe to the podcast where ever you're listening, that way you'll be the first to receive episodes and that really, really supports me. Also, if you can leave a five star rating and review on the podcast, it really, really supports me more than you know, to be able to grow the show and for people to feel safe engaging with this community and this space. And it really helps me continue to do the work that I'm doing. I am a one woman show running this and your support really, really helps me continue to keep this sustainable. Also, if you can share this episode with anyone who you think in your life would benefit from listening to my account of OCD, as well as just other episodes that might resonate with people and their interests in the human condition, every time you share an episode on social media, via text, via email, it will really, really helps me to continue to be able to do this. I sound like a broken record, but truly, I just want you to know how grateful I am for your support and for how much you are supporting me in growing this show and growing this space. And lastly, if you want to support me in a financial and tangible way to continue to pay for the overhead of this podcast and to just support me in a way if you felt supported by the show, then feel free to donate and support my coffee or my coffee. I still don't know how to pronounce that. That's also linked in the show notes and above all, just thank you for being here and for continuing to co-create with me and sharing your ideas and your support and your thoughts with me. This is why I show up here every week and I continue to do this and you all mean the world to me. So thank you so much for being here and I will see you so soon on the next episode of Chat With Emma.