The Dangers Of Drinking Too Much Water When You Have An Eating Disorder

So in last week’s blog, I talked about a recent lesson I had learnt about the importance of familiar surroundings when you struggle with OCD, and funnily enough I have learnt something else in the past week too.
I am learning a lot of things lately. It is like being back in pre-school only Daniel Jones hasn’t stolen my green crayon (if you are reading this Daniel then yes I know it was you and I still want it back), and the topics of these recent lessons have been far more focused on mental health and less on how messy one can get whilst finger painting/what noise a cow makes (hint: it is moo).

In life, we are constantly being told to drink more water. If you have ever sat in a doctors’ waiting room you will have no doubt seen several posters about how drinking a lot of water is very important, how kidneys love the stuff, how dangerous it is to get dehydrated, and from all of these posters and health warnings you may assume that the more water you drink the healthier you are, which…well… isn’t exactly true, especially if you are someone who is struggling with an eating disorder.

Drinking too much fluid is by no means something common to all people with eating disorders however, and in my years of experience getting to know fellow sufferers, there seem to be three camps of people and how their disorders manage fluids.
In one camp we have the people with eating disorders who struggle to drink enough water and end up extremely dehydrated, then there is a second camp of people who could drink a whole swimming pool if they had a big enough straw, and then finally in the third camp there are the people with eating disorders who do not have a problem with maintaining safe fluid levels and would therefore like to leave the camp I have just put them in and go back home to a habitat that is slightly less tent like.

As it happens, I am in the second aforementioned camp (ours has a lovely log fire and on Saturdays we roast marshmallows), and I struggle with drinking too much water even if I am not at all thirsty.
It is odd because I have always known that drinking too much liquid isn’t good for you, but when it comes down to it, me gulping down glass after glass of water is like some uncontrollable compulsion, a kind of outer body experience.
Many a time I have been pouring myself another litre and in my head have been thinking “NO. STOP! THIS IS DANGEROUS NOW” but my body won’t listen and carries on filling up my glass anyway. It doesn’t matter how ill I feel, drinking the water feels like an urgent and necessary task as if I need to dowse a fireball that is burning somewhere in my stomach, no matter how much water it takes.

Even in the camp of people with eating disorders who struggle with drinking too much water, it is likely that everyone will do so for a variety of reasons and it is rare for two sufferers with the same disordered behaviours to have the same reasons for carrying them out.
When it comes to me though, my compulsion to drink a lot of fluid is partly because of posters I used to see at my local gym telling me that if I didn’t drink enough my body would hold onto water (leading me to fear that the number on the scales would go higher), but mainly it is because no matter how many doctors or dieticians talk to me about the science of the intestine, I am convinced that if I do not drink ridiculous amounts, any food I eat will get stuck in me forever.

Technically I know all about stomach acids and the body’s ability to break down solid foods via various muscle contractions and other clever things that go on behind one’s belly button, but in my head, eating anything solid conjures up an image of that solid thing getting stuck in a tube. Say for example I eat an apple, it doesn’t matter how much I chew it, when it is in my stomach I still picture it as a big red cartoon like shiny apple with the stalk attached, a lump that will stay there unless I am able to create enough waves to erode and wash it away.

For this reason, to try and keep my drinking under some form of control, I have been on a fluid chart for years where I write down everything I drink to try and keep an eye on things so that it doesn’t get out of hand. If I don’t write my fluids down my brain tends to trick me and convince me that I haven’t had a mouthful of water in days (even if I am surrounded by empty bottles of Evian and have been peeing every five seconds), so it is safer for me to keep a record of it so that when the compulsion to drink a lot comes, I can remind myself that I have already drunk more than enough and need to distract myself elsewhere. Last week however, this fluid chart thing went a little bit off plan with the disappearance of my parents on holiday.

I have had several people message me asking what on earth happened after the mass break down described last week, whether my parents ended up cancelling the holiday or whether we gave it a go despite plan A being a rather sizeable fail.

Well, after people had realised that I couldn’t stay at my parents’ friends’ house for the duration of the holiday, the immediate conclusion was that the holiday would be cancelled, but eventually we managed to come up with an alternative plan wherein mum and dad would go off to Malaysia as planned and I would stay at home with my sister and my most legendary friend of all time alternating sleeping over to try and help me stay safe.

It was going rather well for the first few days (or at least better than the disaster that had been plan A), but as time went on I started to get more and more anxious about my parents being away and consequently the urge to drink increased in order to wash all of that anxiety and stress away. I know it sounds pathetic but without my mum there to verify how much I was drinking and suddenly in total control of my fluid intake myself, things started to get out of hand. People who stayed over would be able to support me in the day time but when up late at night I couldn’t help but manically gulp glass after glass of water over the sink. All the people who write those “yay kidneys like water, stay hydrated” posters would probably be thinking that is great but as with most things in life, moderation is key and you can have too much of a “good thing”.
Drinking too much water can cause problems for anyone who has been hitting it hard on the old H20 because your kidneys cannot process it and consequently the water stays in you where it can dilute the salt/sodium level in your blood and cause a condition called hyponatremia, which doesn’t sound particularly exciting but in general language this is known as water intoxication, and I am pretty sure that phrases containing the word “toxic” are never good phrases to hear describe someones physical health.

In healthy adults eating and maintaining a healthy diet, a few extra glasses of water will not cause this kind of thing, but the risks when it comes to people with eating disorders is often greater purely because they may not have been consuming enough salt/sodium in the first place, and essentially there is a risk of drowning your cells on the inside. This then leads to things like heart problems, fainting, water on the brain, seizures, psychotic episodes, death, and basically a lot of things that mean you “aren’t very well” which is exactly what happened to me a few days after my parents flew off to Malaysia and is exactly why my poor sleepy friend had to call an ambulance at 2am on a Saturday morning having been woken by me banging around, generally delirious and spouting nonsense (and a little bit of water. I was like a living water feature. Delightful).

The reason I stayed in hospital for so long however is a slightly more complicated story which I will have to get around to next week, just so that we are all up to date and clear as to why I was so rude as miss a blog post two Mondays ago (Oh the shame. And I was raised in a house with such good manners!), but as an initial explanation, the problem was that I was hospitalised for drinking too much water, and it is now after some severe tellings off from several health professionals that I feel the need to write this post about it so that people realise just how dangerous drinking too much water can be when you have an eating disorder, in case it is something other people struggle with themselves and seriously need to seek support for. If you are one of those people who struggles with drinking too much water I know you are probably doing what I used to do upon hearing these kind of things, the whole “surely it can’t be that bad” and “it would never happen to me” but trust me when I say that water intoxication is extremely dangerous and potentially fatal so if you struggle with it, even if your head tells you “you will be fine”, it is vital you get regular blood tests to check your sodium balance.

Luckily after a few days of being on a water restriction in hospital (good lord was I thirsty), my sodium levels returned to a more acceptable level…it is just that other things started to go wrong after that but again, patience dear friends! All in good time!

Now what I don’t want is for someone who already struggles with drinking enough to read this blog and suddenly panic and start restricting their fluids more than they already were because that is NOT what I am saying you should do and that is dangerous for a different bunch of reasons all on their own. I am just saying it is dangerous to go ridiculously overboard when it comes to fluid consumption even if your eating disorder tries to force you in that direction, and that instead of not drinking anything, just do it all in moderation. Water isn’t dangerous, everyone loves a good paddle or dip in the swimming pool, you just have to keep it at a safe level and be careful not to drown.

Take care everyone x

Kidney

P.s I am sorry if this blog is a little bit all over the place. Physically I am still not in the best place right now and my ability to write is somewhat affected but please bear with me! I am sure recovery will hurry up soon!

Why Familiar Surroundings Are Important When You Suffer With OCD

The original title of the blog I was planning to write today was “Tips on staying away from home when you have mental health problems”. You see, my parents were jetting off to Malaysia and seeing as I am not well enough to manage by myself at the moment, the plan was for me to go and stay with their friends in this lovely little house out in the countryside.
We have been planning it for months, I had visited the house and felt OK about it seeing how nice my bedroom, personal office AND personal bathroom were going to be. There was even a cat called Pingu. A cat. Named after my favourite childhood penguin. Ideal right?

Well I thought so, but was still worried about managing my mental health with new carers who do not know me as well as my parents, so I came up with a list of coping strategies and ways to manage it. Consequently I decided to write a blog sharing my oh so helpful tips incase anyone else out there was in a similar situation, but then…well…I went to the house where I was due to stay for two weeks, lasted approximately four hours and then was driven home in hysterics at midnight with my parents due to fly the next day despite having still not packed so much as a flip flop, because we have been spending weeks packing for me to go away (if you want to imagine how many things and bags it was, think of the average stuffed car that people often drive off to uni in, double it and chuck a penguin on top for good measure. Oh and a Christmas elf. One must never travel without one’s cuddly Christmas elf. Oh there we go! I did give a travel tip! YAY ME.)

Clearly then, I am in no place to be giving tips about staying away from home right now BUT over the course of this traumatic experience, I have been reminded of a valuable lesson about mental health problems, so I thought I would share that with you today instead.

Having been mentally ill and having been in therapy for over a decade, I would say I understand my conditions and myself rather well, which is why I felt that I could make a plan about an approaching situation in advance without running into any unforeseen issues.
Trying to do my same rituals in a different place however, really reminded me of something a lot of people might not realise: that being that sometimes with OCD, it is not just about carrying out a specific behaviour like a shower routine, it is about carrying out a very specific shower routine in a very specific shower.

I always knew that because of OCD and anorexia, I have a LOT of routines, rituals and specific ways of doing things. I eat out of certain bowls with a certain spoon, I drink tea out of a certain mug at certain times of the day and I wash my hands, shower and get dressed in very specific ways. As rigid as these and a number of different actions in my day are, logically you could assume that I could carry them out in a different place so long as I had the correct equipment. There was a shower where I was going to stay so of course I could do my shower routine, there was a sink so of course I could wash my hands and I was taking all of my cutlery/crockery so obviously I would be able to eat all in my usual ways.

Even I can admit that years ago, though still having OCD, I was able to do these fixed ritual things in other places with other sinks and showers. I have been on holiday since my diagnoses, have stayed in a hospital and went to university (kind of…), always carrying out the same actions just in different locations. Therefore I tried to do that this time going to a strange house but, with things how they are at the moment, as hard as I tried and as good as my intentions were at the time I attempted it, it isn’t possible (at least to a manageable realistic degree that doesn’t involve hysterics 24/7 for a fortnight which is less “a good challenge” and more cruel torture. I am all for accepting challenges and trying things out of my comfort zone but sometimes you need to eat a few mini muffins before you are up to demolishing an entire five tier wedding cake by yourself).

I was truly shocked as I sort of hadn’t realised how bad things have got again.
The descent has been a gradual process, little slips that in the end add up to a sky diver height of a fall. It is like what they say about if you put a frog in boiling hot water it will hop out but if you put it in warm water and gradually turn the heat up it will boil to death before it realises (that is what they say isn’t it? Who are these people? Please dear readers, do not go putting frogs in boiling water. If you really want to see some green bubbling in a pan just whack in a bag of frozen peas, far more humane AND one of your five a day).

When we pulled up at the house I fully intended on staying for the next two weeks (obviously I did, I had my penguin and my cuddly Christmas elf, I was committed to this trip). Even though I was anxious, by using multiple packets of anti bacterial wipes and with support from my parents, I got through the unpacking and after two hours my room, bathroom and office all looked really nice, filled with familiar things, a comfortable home from home.

It was when I tried to shower that things went so horribly wrong. First there was the issue that the shower was a stand in shower cubicle with a door. At my house our shower head is hanging above the bath, so when I am getting all lathered I can stand out of the flow of water to reach the required bubbliness (I know that this is not the most environmentally friendly way to live my life and that I could just turn the shower off but just know that I am unable to do that at the moment and to be honest when you are focusing on just keeping yourself alive your carbon footprint is not a top priority. At least I am not flying across the globe in an aeroplane to Malaysia like SOME people…).
With this stand in shower however, I was unable to reach the desired bubbliness needed to get through all of my thought routines because before I had time to count to the required numbers the suds had all been washed away.
Then there was a problem that I had to put my soaps in a basket so my lemon shower gel for feet was too close to my banana shower gel for body and far too close to a wall that I couldn’t touch, and the way you turned on the shower made my usual vitally important life saving way impossible.

I took so long to shower that all the hot water ran out and after a while of forcing myself to stand under the cold ice like hail pelting me in the face, I got out though I still didn’t feel clean. I was in a bit of a state but I didn’t want to give up so I persevered and tried to get on regardless but it was one thing after another. I couldn’t wash my hands in the sink because the tap distance to the back of the sink meant holding my arm at 135 degrees rather than 90, I couldn’t step off the towel I had laid on the floor because my bare feet couldn’t touch the tiles and I couldn’t put on the socks that I had brought into the bathroom with me without direct access to trousers and slippers. “You should have taken slippers in and trousers too” I hear you cry but I had thought of that already and couldn’t because there was nowhere safe in the bathroom to put those things at an acceptable distance away from each other. I found myself standing stranded on this towel shivering and blue with cold, so I naturally did what any other person would do in that situation. I cried uncontrollably and screamed in terror for my mother.

Luckily my parents were still there because the unpacking had taken such a long time that they had ended up staying for dinner whilst I showered.
Seafood rice was cooked and eaten and a homemade rhubarb crumble was just being served when the screaming happened and mum came running. She tried to help by offering solutions, one being the ideal “I can go and get the trousers and not let them touch anything”, but I didn’t want to do that. Yes it would have been safe, but I wanted to solve the problem by myself somehow with support.
Mum could have easily gotten my trousers and I could have left the bathroom but what the hell would I do the next day when she was on a beach somewhere in Malaysia? Around this point my “in a bit of a state” descended into full on “out of control don’t know what I am doing dangerous risky chaotic hysterics and panic” and from there things are a bit of a blur. All I know is that I cried for several hours (I tried to talk too but was at that hiccuping crying point so “I don’t know how to manage I want to disappear” came out more like “Hic gasp gulp hic scream”), and my parents and friends frantically tried to decide what to do.
When I was able to talk and sob at the same time I made it clear that I felt it was a challenge too many and that rather than tackling the “parents away and totally different location for all rituals for two weeks” I wanted to attempt the “parents aka usual carers away, in a familiar place” challenge. Losing both was like losing both of my homes, a tortoise rudely ripped from his semi detached terrace house and his shell in the same day leaving a cold naked slug unable to survive in its place.

There were then more hours of discussion before we realised that this really was not a feasible option and then after two hours of packing all of my things back into the bags we had unpacked them from (we didn’t have to pack my elf. He went and got himself back in the car the second he heard the first bout of screaming. He knows me well), we were back in the car driving home in the dark, leaving the abandoned now cold homemade crumble on the dining table. It is a big shame. My parents love rhubarb crumble.

So it was that I ended up back home after my much shorter than planned and somewhat failed “stay away from home with mental health problems”. On the plus side I did manage to get to the house and unpack…I just left two weeks too early.

Clearly then, I think I have proved my point and raised awareness to all the people who might not understand OCD, that when it comes to OCD and other mental health problems with ritualistic behaviours, it isn’t just the rituals that are important to a sufferer but the specific location and circumstances under which those rituals are carried out.

Take care everyone x

Bubbly

Why We Need To Keep Talking About Mental Health

Tomorrow is a very special day for this blog that you are oh so kindly reading in this moment (cheers for that), for tomorrow will mark the one year anniversary of Born Without Marbles being “a thing” on the internet as opposed to an idea in my head that I was too scared to carry out.
That means that I have been harping on about mental health, whether you have liked it or not, for an entire year, and I wouldn’t be surprised if there were people out there wondering why on earth I am still waffling on about illnesses that the majority of the population are well aware of by now.
Ok the general public may have misconceived ideas and perceptions as to what an illness may really be like, but everyone has a rough idea these days as to what things like OCD and Anorexia actually are, so why am I still talking about these things and why do I plan on continuing to talk about these things for the foreseeable future? Newton isn’t still harping on about the time that apple fell on his head (partly because Gravity is old news that doesn’t own the headlines these days and partly because he died in 1726 which somewhat limits his abilities to “harp on”), so why do I keep talking about what it is like to be mentally ill when the existence of mental illnesses is no longer breaking news. Well friends, whether you have been here from the beginning or whether this is your first experience of Born Without Marbles (Welcome. Please excuse the penguins I have left lying around in each post. They are kind of important), today I am going to answer that question and tell you why, even after a year of weekly waffling, I still feel that we all need to keep talking about mental health.

Of course there are all the obvious things like the fact that the more we talk about mental illness, the more research there will be and in turn the more likely we are to find a cure. To explain why I personally have such a passion for the subject however, I need to take you back to 2003, and, more specifically, eleven year old Katie (to set the scene I looked exactly the same as I do now only shorter).
As the name of this blog suggests, I can see that I have shown signs of mental illness from the moment I was born, but it was in 2003 that things really began to become a problem, that I became afraid and ashamed for the first time of the thoughts going on in my head. It was the first time that I didn’t feel normal, and feared that I was different from everyone else.

Every day at school I would watch other pupils in awe. I would see them eating school dinners, opening doors and shaking hands with each other as if it was the easiest thing in the world, and I would wonder how on earth they did it all. For some reason when I tried to open a door, I would find myself frozen in fear, unable to touch the handle as if someone was holding my arms behind my back. When I was in the queue for school dinners, my head was screaming at me to run away because I wasn’t allowed to eat, and no matter how hard I tried to concentrate in lessons about ox bow lakes, all I could see in my mind were images of terrible things happening to all the people I loved, and hear threats that the only way to stop those things happening was to repeat some kind of ritual. This would have been rubbish enough, but the worst bit was that I had no idea what this meant or why this was happening. I thought long and hard, trying to come up with an explanation but the whole thing made very little sense to me. What was so scary about the germs on a door handle when I had evidence all around me showing that nothing bad was happening to people “contaminated” with them? Why couldn’t I go to lunch, even on pasta days? Logically I knew that I loved pasta (pasta is flipping awesome), so why did the idea of eating a steaming bowlful topped with as much cheese as I could get away with before a disapproving dinner lady grasped my cheddar filled palm, scare me so much?
These things went on for months, and I said nothing to anyone because I was too afraid. Maybe mental health wasn’t as widely discussed in 2003 or maybe I was just unaware of what mental illnesses were, but I had never heard of anyone experiencing these things so I kept silent and hoped they would go away. Spoiler alert: they didn’t. Of all the awkward situations I found myself in however, there is one in particular that sticks in my mind and one that continues to motivate me and my dedication to this blog today.

“It” happened at the end of a music lesson. Now, in my school, music was taught in a separate building to all others, ditto art, drama, and DT who all had their own individual buildings (something tells me the staff members of the more creative subjects did not get on well…this explanation of the separate buildings certainly correlates with the time I saw the head of drama pelting the art teacher’s studio with water balloons anyway…)

On the day in which our story occurred, our class had been taken to a room on the top floor of the music building where there were a lot of computers and keyboards set up for us to spend a few hours learning how to play the theme tune from Titanic (a vital part to any eleven year old’s education). Then, the lesson ended and we were dismissed, a fact that meant we were going to have to leave the room and therefore, someone was going to have to open the door. Usually I was very good at avoiding such a responsibility, and at the end of every lesson I would fumble around with my bag until someone else had done the job so that I could scoot on after them without touching anything. This technique worked perfectly for every lesson, but today, for some reason, the teacher wanted us to lead out in single file from the nearest computer to the door. I think maybe someone had been messing about with a keyboard, playing Celine Dion’s soundtrack with a little too much gusto, so in the exit of the classroom, the teacher wanted to establish some serious authority. I felt sick. I was at the computer nearest the door. I was to be the first to leave, I was to lead my fellow students to freedom. I was to open the door. When I saw that it was a push door then, I was thrilled. Happily I nudged the door with my foot and led my classmates out, but the relief was short lived as I realised we were headed for another door, a pull one with a handle…AND AN EXIT CODE KEYPAD.
I thought about pausing in the corridor to let someone overtake but the corridor was too narrow, it was single file, there was no escape, and as I walked down the stair case to the door I genuinely felt like I was walking to the gallows. This was it. I was going to have to touch a door handle, and it was going to be the end of the world. When I reached the door I stopped. The time had come to raise my hand, but I couldn’t move. Instead, I just found myself stuck, panic building as the queue of students eager to go home started forming behind me. Luckily everyone was talking about the day too much to notice my embarrassing situation at first, but after a few minutes of standing in a line waiting, understandably, people started wondering what the hell was going on, and from the back of the line I heard a voice ask perfectly reasonably “is there something wrong with the door?” From then it went silent and all I could hear was the response in my head of “no actually, there is nothing wrong with the door, there is something wrong with me and I have no idea what it is”.

Eventually, after what felt like 34 years, the person behind me became impatient, reached around and opened the door, and from there I ran sobbing to the medical centre with shame, fear and embarrassment. I didn’t want to see anyone ever again, I had to hide, so I decided to take refuge in the sanitarium. When the nurse asked me what was wrong, I lied and told her that I had a tummy ache. I spent the rest of the day curled up on the sofa with a hot wheat bag watching episodes of the Simpsons, feeling more alone than I knew it was possible to feel. There were hundreds of other pupils in the school, but for some reason I was different, I couldn’t open doors or eat meals like they appeared to, and there was nobody, least of all me, who understood why.

It is for that Katie sitting on that sofa with that smelly hot wheat bag that I started this blog, and it is for all the smelly hot wheat bag holding people out there pretending to be fine, pretending to have tummy aches to cover up the fact they are terrified of their own minds and too scared to speak out for fear that other people won’t believe them, that I write this blog. Had I heard about mental health problems sooner, maybe I would have asked for support sooner, but what I would have found more helpful than any of the symptoms listed in the millions of health care packs, would have been the knowledge that there was at least someone out there who struggled with the same things, who let me know I wasn’t crazy, that I wasn’t alone. It is for that reason that, no matter how much awareness there is about the existence of mental illnesses, I will keep talking about my experiences with mental health problems in public spaces. This isn’t a blog to just give information, in my eyes, this blog is a friend, both to me, to the readers and to anyone out there who comments to say that they can relate to my problems and thus remind me once again that none of us are alone.

So happy birthday Born Without Marbles, and thank you from the bottom of my heart for all the support anyone reading this has ever provided. Here’s to another year, another 52 weeks of my ramblings, another 365 days of friendship.

Take care everyone x

MarblesBirthday

An Explanation Of Invisible OCD Rituals

When most people imagine someone with OCD carrying out a ritual, they probably picture them visually carrying the ritual out in the “real world”. Maybe some will picture a person repeatedly tapping a light switch, arranging books or washing their hands, but it is unlikely that the person pictured will simply be standing there with no obvious signs of ritualistic activity.
However, many people with OCD actually have rituals that can be carried out invisibly, and this is a side to OCD that I feel needs more discussion/awareness raised, partly to help others understand the condition better, but partly to help sufferers who do not realise that what they are experiencing is actually a form of OCD that can be treated.

Now I have started to write this blog post I have realised just how hard trying to explain a mental ritual is to people who may not have had them themselves (damn it past Katie why did you have this as an idea for a blog).
If trying to give a rough idea in terms of my OCD though, my personal thought rituals generally involve things like compulsively picturing certain events or people, thinking the same words a certain number of times, having to remember something in exact detail or ritualistic blinking (which I suppose isn’t really a thought ritual as if you know what I am doing you can physically see it, but in most circumstances people don’t notice and thus I count it as one of the lesser known invisible sides to the illness. Even when people do notice I am fairly good at covering it up anyway. You would not believe the number of times people have asked if I am ok because I am flapping my eyelids like the wings of a hummingbird and I have had to pretend I had an eyelash. I used to feel very bad saying this as I don’t like lying, but recently the guilt has gone as I realised that it isn’t actually a lie. It is indeed a true fact that I have eyelashes…just not in the specific eye location implied by my blinking…God this is a long set of brackets…sorry about that…I will close them now…actually wait…no it is ok that was all I had to say about blinking…today at least).

Some of these thought rituals mentioned above are fairly straightforward, as in the “repeating a certain thought over and over”. Okay it can take a long time but it is easy to understand and explain to professionals as a symptom. This is not however the case with all thought rituals, and in order to give some impression of just how complex they can become, I thought I would explain a specifically long and complicated one of mine (if you are able to follow this next bit and gain any sense from it then congratulations, you are a genius, please apply to Mensa immediately).

So, probably the most complex of my rituals is one that I carry out every night before I go to sleep in order to “keep my friends and family safe” (though I am of course aware that rationally there is no way that my thoughts prior to the land of nod are capable of such safeguarding. Nevertheless I still carry them out every evening without fail…GAH!)

The start of the ritual involves picturing a long mantlepiece (it is made of high quality mahogany in case you are interested), and it is lined with photo frames, each one containing the face of a loved one that I wish to protect. Over the years the photos of the people in these frames have changed as people have come and gone from my life, but it is rare that a picture is removed and more common for an extra one to randomly appear when someone becomes particularly special to me (bear in mind this is a very long mantlepiece that can hold an infinite number of frames. It is a nightmare to dust.)
Once all the pictures are imagined in their neat little line, the next step is to imagine a paintbrush with green paint on the end drawing a tick over the face of each person to confirm them as safe, much like an attendance sheet register thing that you have in school. What must not happen is that I picture a red cross being painted over each face. It sounds easy enough, after all they are my thoughts so surely I can think what I want (ha!), but it is very much like that trick when people ask you to imagine a scenario and not to imagine a white elephant, a statement after which you can think of little other than a trunked creature looming in the forefront of your mind. Once the green tick is imagined on the person’s face I then have to move on to the next picture and so on until all of the faces are adorned with a flourish of bright jade acrylic. However, if during this process one of the pictures goes wrong (aka they get a red cross), then I have to start the entire thing again from photo one. Even if I finally manage a line of perfect ticks though, the ritual is not over, as then I have to imagine staring at all these approved photographs for 100 counts without imagining a gust of wind blowing any of the pictures over which is incredibly stressful as if such a wind occurs I have to whip out the paint brush and start all over again. That little explanation from the painting of the green ticks is step ONE of this thought ritual.
There are ten steps overall. TEN.

Rest assured, I will not elaborate on the next nine steps as I fear I would be here all day. No matter what step I get to however, if there are any mistakes I am sent back to step one and hopefully this explains somewhat the difficulty, complexity and time consuming nature of rituals that may not be visible like those in which I wash my hands multiple times. I realise it probably sounds a bit weird to say that I get stressed and upset over imaginary breezes blowing imaginary photo frames off an imaginary mantlepiece, but if those breezes come and if those pictures fall then I fear I will put everyone I have ever loved in danger due to my negligence, an understandably scary thought for anyone.

You are probably wondering how on earth I concocted such ridiculously long mental routines, yet if you were to ask me how they appeared I honestly couldn’t tell you. They didn’t exactly appear overnight, rather they developed over time in a gradual process I cannot remember the beginning of. That said, if I had to pin the origin of my mental rituals it would probably be my first hospital admission to a psychiatric unit over ten years ago. With most people, OCD tends to evolve and morph over time as the person’s life and situation changes and it is often a dramatic change in environment or situation (like suddenly being inpatient in hospital), that can cause rituals to flick on stealth mode and turn invisible. Before my first hospital admission, all of my rituals were visible and involved things like showering for hours on end or repeatedly washing my hands. In hospital however, none of these rituals were possible as I was physically locked out of my bathroom and had to ask for permission each time I needed to use it, at which point I would be supervised and stopped from engaging in any behaviours. Now, on the surface, you would think this cured the problem. True, I was no longer showering for hours every day, but that wasn’t because I didn’t have OCD anymore, it was because I was physically incapable of getting to the shower despite best efforts (turns out I am rubbish at picking locks/kicking down doors of psychiatric unit shower rooms. I would make a poor criminal.)
By being physically locked away from the equipment needed to do my usual rituals then, my rituals changed and adapted. The OCD was too strong to just disappear at the first hurdle in the road and instead my compulsive behaviours became located in areas nobody could lock me out of, areas nobody could bar my access too, those areas being found in my own head (just left of imagination next to the frontal lobe to be specific).

The reason this invisible kind of thought ritual OCD is less talked about than its more apparent variants is probably because of how difficult it is to explain (let alone understand…seriously if you are following this get on that Mensa thing). Nevertheless, difficult or not I think it is a really important topic to raise awareness of as like I said near the start, some people may be suffering from OCD in this way and not really aware of it. I have been in treatment for years so when aspects of my OCD became internal I knew immediately what it was, yet I am sure there will be people out there struggling who never knew that this was a thing. Perhaps there are people out there silently suffering, in distress as they find themselves having to paint ticks and avoid imaginary gales without having any idea of why or how to stop it. Had I no knowledge of OCD and were I experiencing such things there is a good chance I wouldn’t tell anyone because even I can admit that thought rituals sound a bit “crazy” and are not something you would want to bring up voluntarily or admit to, especially if you didn’t know anyone else felt the same. Maybe people with thought rituals don’t even realise it is OCD because they think OCD is washing, and it is for those people (as well as any other lovely people reading this of course) that I have written this post.

If you are struggling with compulsively carrying out intricate thought patterns that cause distress if not performed correctly, you certainly are not alone and it doesn’t mean you are crazy. Obviously I cannot diagnose anyone online, but if you relate to this post there is a good chance that what you are struggling with is an invisible form of OCD. That probably sounds scary if you haven’t ever considered yourself as a person with mental illness in need of therapy, but hopefully it will provide some comfort knowing that your struggles are part of an illness that can be treated. It is not something to be suffered in silence even if your routines are performed in such a manner and I would urge anyone out there relating to this to go to the GP and ask for help. If they have any awareness of mental health issues they will NOT think you are “weird”, they will understand that this is a common issue for OCD sufferers and hopefully by speaking out you will be able to get the help you need. Also if there are any GPs out there or students training in medicine, maybe this post could help you identify these symptoms and help someone in the future. Either way I really think invisible thought OCD rituals need more discussion. The more we are aware of OCD, the more we can understand and most importantly of all, defeat it.

Take care everyone x

mantlepiece