What If I Let My Intrusive Thoughts Win?

Life with severe obsessive-compulsive disorder

For Anastasia Jill, her OCD symptoms have never fully gone away. Photo by Annie Spratt on Unsplash

My first thought in the morning is, “What if I accidentally killed my cat?” Once I’m sure she’s alive, I check her body for injuries and her food for parasites, convinced I’ve done something to cause her harm. Checking once isn’t enough. I have to do it multiple times in intervals of five. Five is a safe number. I will do this ten more times today, minimum. The checking provides a temporary relief, but I need to do what’s necessary to prevent a total meltdown.

It takes several hours before I’m ready to start my day. I worry constantly about everything: money, illness, homelessness, incarceration, ending up alone. Each time I try to make progress, the thoughts begin again: “What if I can’t get a job? What if I’m actually dying? What if I have a rodent problem and lose my home? What if I get sued?” The only fix comes in endless rumination, mentally reviewing the possibilities until I find a thought that makes me calm. Sometimes this involves Google searches: “Who can legally take my home? What are the signs of a stroke in animals? Can I go to jail for failure to pay student loans? Can I get sick from one day old bread?” I will read pages upon pages for peace of mind. Nothing is certain, and this means I never get the answers I’m looking for.

I know this research does more harm than good, but I can’t help it.

Sitting around will only fuel the rumination; after all, the first rule of recovery is to get up and do something—anything but think. It’s a Herculean effort, but I eventually get out of bed. Working from home is a blessing and a curse; I work on my own terms, but it gives my disorder more leeway. More often than not, I have to force myself to do what is needed.

Mindless television programs are on in the background at all times: 60 Days In, Hoarders, My 600-lb Life, My Strange Addiction. Other times, I play Lifetime movies, or shows from the Game Show Network. Anything to fill my head to block intrusive thoughts. If not television, then music. There will be no silence in my house. This also does little to help, though some compulsions are tamer than others.

I wash my hands after touching any surface, lest my body become “contaminated.” With what? Invisible germs, imaginary viruses, mold spores that aren’t there. I can’t leave a room without touching the doorframe five times. When I’m more wired up, I have to flick the light switch on and off five times two. If I don’t, bad things will happen. What bad things? I don’t know. Just really bad things. I’ve grown superstitious as well. Moving or discarding certain items will bring bad luck. I pick at my skin and pull my hair, sometimes I even hit myself in the face or head. I tell my brain to shut up. It doesn’t listen, and the cycle repeats.

“One.”

“Two.”

“Three.”

“Four.”

“Five.”

…and if it doesn’t feel just right, I start again.

Concepts like “it” and “bad” remain undefined, yet my fear of them drives the compulsions to continue. It doesn’t matter that the thoughts are nonsensical; they’re intrusive, never-ending, and urgent. I have to feed the monster. It’ll eat me alive if I don’t. Momentary reprieves are the smallest consolations.

All of this worrying gets me nowhere other than exactly where I started: anxious out of my mind, repeating the same tasks that don’t serve any real purpose. By afternoon, I’m exhausted. In the evenings, I have chest pain. In the night, it grows harder to breathe, let alone sleep. I can feel this taking years off my life. I never thought I’d see thirty, yet here I am. Still, I can’t imagine doing this for another ten years.

My resolve for recovery is getting lower. If this is how it’s going to be, why try so hard to fight for a marginal improvement? The only break I get is sleep. I need my rest so I can wake up again the next day. This brings more anxiety: what if tomorrow is the same, or worse? These kinds of thoughts follow me into my dreams.

This is an average day living with severe obsessive-compulsive disorder.

Obsessive-compulsive disorder, also known as OCD, is a mental health disorder marked by recurrent thoughts (obsessions) and repetitive actions (compulsions). It’s a distressing condition that preys on a person’s deepest fears, turning potential into uncertainty, and the unknown into catastrophe.

I’ve been living with OCD since I was eight years old, and the illness has only intensified in the last two decades. Medication has helped, but the biggest “what if” lurks: what if this stops working, or I can’t afford treatment, and I end up exactly where I was?

As burdensome as my current symptoms are, it was much worse before I entered treatment. Back then, OCD consumed my life in irrational ways. I can laugh now, but at the time, it felt like hell on earth.

For three years, I was convinced there were rodents living in my apartment. I would spend entire nights with my ear to the wall listening for the most minute noises. The sound was actually from rain and wind in the gutter, but my brain would say, “What if? Listen one more time, just one more time, then you can go to sleep.” The cycle would repeat until after five a.m. when I’d get up for school and work.

Somewhere around my twentieth birthday, I developed a shellfish allergy. In response to this, I would avoid food just to avoid contamination. When forced to eat, I would purge afterward because I didn’t ever trust the cook to keep food clean enough. My senior year of college, someone brought shellfish into a class I was in. I locked myself in the bathroom and refused to come out until class was over. Even after that day, I refused to sit in the spot where she had been.

Later that same year, upon flu season, I locked myself in a handicapped bathroom stall and wouldn’t come out until I’d washed my hands in four intervals of fifty-five to guarantee that I wouldn’t get sick. I didn’t care about being clean; I cared about dying—a fate sealed by the lack of clean hands.

As I grew older, my compulsions became more mental than physical. I fell into a pattern of rumination: repeatedly replaying and analyzing a thought or event in an effort to analyze it. This was due, in part, to the intensifying intrusive thoughts. I worried I was a bad person. I was terrified of hurting someone, or worse, making someone die. In fact, I was convinced I was violent, or a deviant. There was no factual basis for this, but OCD liked to say, “Yeah, but what if you are? What if you are and everyone knows? What if you’re that kind of person who doesn’t deserve to be happy?”

The conversation around OCD is heavily sanitized, dressed up as “quirky,” “neat,” or “overly anal” character flaws. The reality is far more draining. It has nothing to do with neatness or order; it’s about what happens if things aren’t “just so.” My hand-washing compulsion isn’t driven by cleanliness but a fear of contracting an illness I may or may not have come into contact with. Compulsions are performed in a vain attempt at repose.

OCD isn’t kind to its victims. Even the best of therapies can fail as this disorder is difficult to treat. The “brain lock” of anxiety you get stuck in is incredibly hard to overcome.

A common colloquialism these days is, “I let my intrusive thoughts win!” when the person is talking about something trivial like dyeing their hair or buying an unnecessary item. Everyone has intrusive thoughts from time to time, but the difference in OCD patients is the frequency fixation of the notion itself.

In a sense, I give into my intrusive thoughts each time I perform a compulsion. However, if I were truly to give in to the nature of these thoughts, I’d likely be institutionalized or in jail. My intrusive thoughts are sometimes violent or sexual in nature. This is a little-talked-about byproduct of OCD, either out of shame or stigma. People outside of the OCD world seldom understand that these thoughts are unwanted and involuntary.

For years, I resisted getting help not because of the stigma around psychiatric medication. Eventually, I knew if I didn’t seek treatment, I’d take my life. I’d already tried to kill myself too many times before to doubt the intent.

I made an appointment with a psychiatrist and was put on medication.

Most of the time, the meds I take help, though this doesn’t come without a new set of worries. Selective serotonin reuptake inhibitors (SSRIs) are the main type of treatment for OCD. It took years to find a medication that was actually helpful. Fluvoxamine is the only thing that’s worked for me, but I’m already approaching the maximum dose. After this, there are no more options. I’m worried about that day coming soon. I’m only thirty now; I likely have fifty-plus years left to go in life. The medication is also not a cure-all. The thoughts are less loud, but they’re still there every day. So many hours are wasted worrying, or checking, or trying to fix what (probably) isn’t there.

It occurs to me that I can’t spend the rest of my life living this way. It’s impractical to rot in bed when I have to work. This spurs thoughts of homelessness: what if I can’t work, and lose my job, can’t pay my bills and ultimately end up on the street?

I have to work harder to have a normal life.

And such a thing may never come.

During my late twenties, I hit a bit of a plateau. Things weren’t perfect, but I was doing better than I had in ages. All of the pain and anxiety resurfaced after the concurrent deaths of my mother and grandmother. My grief was superseded by a spike in my OCD symptoms, and I’ve been coping with the changes ever since. I don’t know what recovery looks like for me now. It seems to have only gotten worse with age. I’m hoping for a miracle, but this is the reality: I may be dealing with a severe version of this disorder for years to come.

There is still a real chance I will die young. Suicide rates in OCD patients are higher than the average population. I wish more than anything I didn’t have this disorder. It’s ruined my life, and I can see it taking more though I have nothing left to give.

Only one positive thing has come from my OCD experience, and that’s been the ability to help others.

I talk very openly about my OCD experience; the good, the bad, and the unforgivably ugly. It didn’t start out as an altruistic act. I have a hard time shutting up when times are tough, especially when this disorder is such a large part of my life. In talking about my symptoms, I’ve helped people close to me recognize it in themselves. Even among medical professionals, OCD is an understudied illness that isn’t well understood. It can take years to receive a proper diagnosis, and treatment itself involves hard work and enough mediation to take out a rhinoceros.

In an age of mental health awareness, OCD is still stigmatized in a different way than other illnesses. OCD is underestimated by the general public, leaving its destruction unrecognizable to most. It’s only after talking about my more severe spikes have loved ones recognized when their own thought patterns aren’t normal. Many are still reluctant to seek treatment. This is understandable to me. A doctor who isn’t familiar with the nature of OCD can do more harm than good.

I once saw a therapist who specialized in general mental health but knew very little about OCD. When I relayed the nature of my harm-related intrusive thoughts, they said they didn’t believe in intrusive thoughts, and that this was my own intuition. It fucked me up for months. I felt ashamed, embarrassed, terrified of ostracization. The worry never goes away; no fear of mine ever does.

It’s been ten years since that appointment. I know now that I’m not a predator, and I would never hurt a soul. I will not die of any diseases, and my cat is still purring by my side. But in the rare tranquil moments comes a whisper, a clot of doubt in my mind: “Well…what if?”

Anastasia Jill (they/them) is a queer writer living in Central Florida. They have been nominated for Best American Short Stories, The Pushcart Prize, and several other honors. Their work has been featured or is upcoming with Poets.org, Sundog Lit, Flash Fiction Online, Contemporary Verse 2, Broken Pencil, and more.