I hate getting my period. I hate it for all the obvious reasons — it's painful, inconvenient, uncomfortable, expensive and not really something that any of us look forward to. But a much less obvious reason that I hate getting my period is that I have Obsessive Compulsive Disorder (OCD).
Although I had lived with its symptoms my whole life, I was formally diagnosed with OCD around 5 years ago. Before this, I had been diagnosed with anxiety and later, depression. Both of these were probably also true at the time but OCD is often misdiagnosed, in as many as 50% of cases.
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OCD can present itself in many forms: symmetry and ordering, ruminations/intrusive thoughts and checking are just some of them. I tend to cycle through most of these forms, but the one I come up against the most is contamination OCD.
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Often (and in retrospect), when these thoughts and images occur, I have no evidence that any kind of cross-contamination has actually taken place. But in the moment, it feels undeniably real.
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What I know about Contamination Obsessive Compulsive Disorder, as someone who lives with it, is that it is the occurrence of obsessions (often in the form of looping and persistent thoughts) and the presence/completing of compulsion as a result of the feeling brought about by these obsessions. Dr Rocco Crino, a senior clinical psychologist with many years of experience in OCD and related conditions, explains further. “Contamination concerns may be associated with a threatening outcome (illness to self or others), or may be associated with disgust, or contamination from an unwanted intrusive thought," he tells Refinery29 Australia. "A common feature in contamination OCD is, at times, imaginary cross-contamination and the spreading of contaminants from the original source to other items, resulting in elaborate decontamination rituals and/or avoidance.”
The way I experience obsessions is through looping thoughts and images. Thoughts like “I have been contaminated by bodily fluids (blood, spit, semen etc)” as images of these fluids flash in my mind. Often (and in retrospect), when these thoughts and images occur, I have no evidence that any kind of cross-contamination has actually taken place. But in the moment, it feels undeniably real.
Even as I sit writing this article on the train from Canberra to Sydney, my brain is obsessing over a man with a reddish-brown stain on his pants standing beside me waiting to get into his seat. How he brushed past my arm moments before…was there now blood on my sleeve, seeping into the fabric, onto my skin and into my being? Was I now carrying an unknown disease that could hurt me? Could my having that disease hurt my family? I slow down my panicked breathing and remind myself that I must simply acknowledge the thoughts, let them pass and continue with writing.
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These obsessions are closely followed by compulsions.
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The solution seems ‘achievable’ — just do the compulsion and feel better. But the more I try to move towards the finish line, the further away the finish line gets.
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Compulsions were/are (for me), as Dr Crino says, an elaborate decontamination ritual that I would perform to quieten the looping thought/obsession. It is extremely difficult to communicate the overwhelming urgency of these compulsions. At the time, in my mind, they are the only thing I can hear and see, as OCD works to convince me that my wellbeing and that of the people I love are in dire straits unless I act immediately and thoroughly.
The solution seems ‘achievable’ — just do the compulsion and feel better. But the more I try to move towards the finish line, the further away the finish line gets. Not to mention the fact that, the more I complete these compulsions, the more I am subconsciously telling myself that the obsession is ‘true’, and the more I am reinforcing the idea that my OCD is ‘correct’.
You know that feeling you get when you finish rinsing the shampoo from your hair and your brain quietly narrates, “Shampoo is done. Now condition."? Well, I don’t experience that sense of completion. It is as though my OCD blocks my brain from giving me that message and this is where the repetition of the compulsion takes centre stage. Wash, repeat, wash, repeat, wash, repeat. This is all while the looming feeling of hurting everyone starts to take over my body. Wash, repeat — until my brain gets the memo and OCD permits me to move on.
At times, when my OCD was very prevalent, I could cheat the system and create my own completion point by saying a random word really loudly. That way, when my OCD would try to convince me later that I didn’t clean myself, I could combat it with, “Yes I did, because I remember yelling 'chicken' at the top of my lungs”. This only worked sometimes and when it did, it saved me from hours of cleaning.
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That's where menstruating comes into play. As you now know, I have an intense fear of the presence of bodily fluids. And, well, I was born with a cervix and bleeding is something it likes to do every month. (You might be thinking: You could take the pill and skip your periods. That’s sweet of you to think that. But, I also have ever-present health anxiety and the side effects of the pill are an efficient trigger for it.)
When I have my period and I see my own blood (in my underwear, down my leg, on the toilet seat) my OCD immediately concludes, “That is not my blood. It is someone else’s and I have now contracted an infinite number of blood-borne diseases that will kill me”. And if I manage to tame my OCD into believing that it's my blood by convincing myself — “Let’s look at the facts… I am menstruating. I am in my bathroom. It can really only be MY blood." Then my OCD changes its tactic and instead insists that “I have a disease and unless I decontaminate my entire body, I will spread that disease to my family and they will die.”
Needless to say, menstruating is a very stressful time for me.
I would like to point out that having OCD doesn’t make me unique. I am one of 3% of Australians who live with the disorder in one (or many) of its forms. That’s over 500,000 people. And while my diagnosis came as a relief because I finally had the terminology to communicate what I was experiencing, it was daunting (and at the time heartbreaking) to hear that OCD is considered a lifelong disorder. Dr Crino substantiates this, saying, “Total cure is rare. The goal of treatment is to have the individual control the OCD, rather than the OCD control the individual.”
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The treatments on offer currently include Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention Therapy. CBT involves learning new ways to approach thinking patterns with the help of a treating psychologist and offers tools to challenge unhelpful patterns and behaviours. Exposure and Response Prevention Therapy, managed by a treating psychologist, involves exposure to OCD-based triggers/fears, with the goal of refraining from actioning the compulsions that come up as a result. An example of this from my experience would be: My OCD has me believe that hugging my family will result in cross-contamination and their death, so in order to get better, I must hug them. Exposure and Response Prevention Therapy is excruciatingly confronting because it involves doing the things that scare you most to teach yourself that it isn’t what you believe it to be.
With these tools, the support of my psychologist, my partner and my family, I am now in a place where I can live alongside my OCD. It is still there, chatting in the background, but it is no longer my driving force. One of the greatest things I have done for myself (and I acknowledge that this is not possible for everyone) is to be loud and shameless about my diagnosis.
That is not to say I don’t feel embarrassed by its presence sometimes. But, because of where I am at in my relationship with my OCD, it's important that I speak out from a position of lived experience — because OCD is often suffered in silence, isolation and shame. OCD is incredibly lonely and misunderstood and if I can do my part and add my voice to the conversation around OCD, I absolutely, proudly, will.
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