Welcome Halloween Fans to ‘How to Understand and Manage Bipolar Disorder: OCD’ Last night I penned this snippet;
Do you really want the truth? Can you handle the truth? Bipolar is the loneliness illness on this Earth! There is no Earth. There is nothing. No one can save you from this immense loneliness. Can I help you? I doubt it. Can you help me? Obviously not. I can try and be helpful, but right now I can’t help myself. I’m not going on with this right now.
I thought about deleting this comment as, for me, it was too raw. Deletion, however, would be cheating and the blog would not be a true reflection of the illness. As such I would be doing my readers a HUGE disservice. So, instead I thought let’s use this and examine the symptoms of OCD and anxiety in the next blog, and here we are, ‘Managing and Understanding Bipolar Disorder: OCD.’ This follows on nicely from my previous post examining the symptoms of bipolar disorder.
How to Understand and Manage Bipolar Disorder: A Connection to OCD
I would imagine there are those out there who would say, but OCD is a completely different diagnosis. I disagree, let me explain why. A man goes to the doctor’s surgery with breathing problems. The doctor listens to his chest and hears wheezing and diagnoses him on the spot with asthma, emphysema, pneumonia and COPD.
Does that sound correct or realistic? No, further examinations would be carried out to determine other symptoms and an underlying cause and then a diagnosis would be given. A single diagnosis. I like to think of Ockham’s Razor; the simplest solution is usually the right one. It is sloppy to assume the man has all of the above illnesses.
The same is true of mental health, however in mental health multiple diagnoses are common place. I suspect the reason for this is the overlapping symptoms of certain mental illnesses.
OCD and Bipolar Disorder
So, let’s consider another example. A lady goes to her psychiatrist stating that she has been experiencing hallucinations. She already had a diagnosis of bipolar. The doctor, however thinks well perhaps she has schizophrenia too. Why? well, because hallucinations are more common in schizophrenia, however they are not unheard of as a symptom of bipolar, just rare. This brings us to OCD.
OCD is a diagnosis in its own right; Obsessive Compulsive Disorder. The survivor has obsessive and disturbing thoughts and behavioral compulsions which form to alleviate anxiety. One of my obsessions as a child was that everything had to be straight or at right angles. My granddad liked everything at forty-five degrees (hereditary? probably) and so my poor mum and nan would have to watch as every ornament in my nan and granddad’s home was turned and turned back, turned and turned back, until one or the other got quite fed up and became loudly vocal on the matter.
The underlying anxiety in this instance, I suppose, is a need for cleanliness to a certain standard. Another obsession I had was the dangers of electric sockets, in terms of evolution the underlying anxiety could be a survival instinct. In practice I defrosted my big nan’s fridge over-night.
Anxiety and OCD
Anxiety and agitation are symptoms of both the North and South aspects of bipolar; manic and depressive. The obsessive thoughts range from why didn’t I act in a certain way in a situation that went wrong? and how can I prevent something from going wrong? Now, clearly these are not the actual conscious thought processes, these are the subconscious processes.
Anxiety and stress stimulate motivation, some level of anxiety keeps us safe; prevents us from crossing in front of a lorry, drives us in our working life and helps protect our children. I would go as far as to say some post-natal depression is caused by an underlying anxiety over the baby’s safety.
Managing Bipolar Disorder: Obsessions
Obsessions, in bipolar, can be fruitful. During the manic period survivors tend to take on projects with such vigor that obsession is apparent. The projects become all encompassing, but can lay unfinished when the South pole arises, the depression. I do try to motivate myself to plan and complete projects. This has taken a lot of effort, years of practice and some careful organisation.
Unfortunately, obsessions and compulsions have the power to take over lives, they can develop into phobias either through a directly frightening event or through association. My husband Declan suffered post-traumatic brain injury following a road accident. The song ‘Angels’ was playing in the car. Now he cannot listen to that song, and that is association.
So, anxiety triggers motivation and extreme anxiety morphs into obsessive thoughts and compulsive behaviors. In terms of bipolar anxiety is a symptom common to both poles, and obsessive compulsions develop from anxiety. As such I would argue that OCD is both a diagnosis in its own right and a symptom of bipolar directly connected to the symptom of anxiety. The obsessive thoughts can lead to dark places and worrying memories, hence an emotional outpouring as seen in blog four, or they can result in debilitating behaviors.
I took control of some of my symptoms as a child using a conditioning method. I didn’t know at that time that it was a conditioning method, I just knew it stopped a lot of nonsense. I think the turning point was when my dad had to explain to me that cleaning up the restaurant in which we having dinner was not the done-thing. At that time, I happened to have a rather long fancy for Christopher Lee, hence my vampire tales. To me, he will always be the greatest and most versatile actor, linguist and stuntman.
When I was thirteen I secretly took the day off school and caught the Victoria train. My dad worked on the underground and I had a pass. Once in London I hopped the underground to the west end and picked up ‘Dracula has Risen from the Grave’ from HMV and caught the train back. Bipolar survivors are characteristically unaware of dangers and can act recklessly. I kept it quiet though, mum would have had a fit. I told her recently, she was not impressed.
Anyway, I had my video (yes video, VHS) and my many horror books, but I also had this annoying tendency to straighten everything in the house. So, I said to myself go a day without being annoying, and it was annoying both to me and to everyone else and then you can watch your film. I managed the day and in time I extended this to a week. I am not perfectly cured, but I manage and that is the difference between harmful obsessions and the biannual spring clean. It is, as I know now, a behavioral method. It worked.
OCD, SSRIs and Benzos
I still get anxious, and as said in Blog 3 anti-depressants are very good at relieving sadness and the same is true of anxiety. I have a few friends who swear by benzos, but I find that these make me too tired to function. Once again, medically it is all about trial and error finding what works and what does not.
So, in conclusion OCD can be a symptom of bipolar triggered by anxiety. Behavior methods can alleviate the compulsions and, with practice and by incorporating the ‘stop’ method can also alleviate the obsessions. medication helps anxiety.
On a more personal note, I find that as this blog is progressing, I am sharing more personal details and experiences. This is, in many ways, a first for me. I do hope that some of my experiences assist someone else out there in the big web of the world. Until next time, happy Halloween. Thank you for reading ‘How to Understand and Manage Bipolar Disorder: OCD.’
Yours as ever
Valkyrie Kerry Kelly