A Letter to My Friends About My OCD

Dear friend,

I have obsessive compulsive disorder (OCD), along with social anxiety, generalized anxiety, body dysmorphic disorder (BDD), and an eating disorder. Previously I haven’t talked much, if any, about them with you but that is going to change. My OCD has been getting continually worse, and I can no longer brush it under the rug. I will be actively working towards my recovery, and if you are interested I am going to tell you what you can do to help me.

First off, you may not know what OCD is, or think that it is just being neat and organized, which is wrong. Obsessive compulsive disorder is a mental illness where the person has obsessions, which are unwanted intrusive thoughts that cause them a lot of anxiety. In order to lower the crippling anxiety, the person performs a compulsion, which is an action that temporarily relieves the anxiety. However, the intrusive thought comes back and a never ending cycle ensues. The obsessions and compulsions can be anything, for some people it involves germs and cleaning but for others it is something else like morals or a fear of harming others. The possibilities for an intrusive thought is endless, and the OCD attacks what the person values most. In this letter I won’t go into detail about my personal OCD, but if you are interested in knowing more I am happy to share my story with you.

The best treatment for OCD is called exposure response prevention therapy (ERP). It is where the person with OCD exposes themselves to their triggers (when I say trigger I mean something that causes them a lot of anxiety, their obsession) and refrains from doing their compulsion. So, if someone is afraid of germs an exposure they could do is to touch a door knob in a public bathroom and then not do their compulsive behavior of washing their hands. I have recently started to do ERP and will be increasing the intensity a lot. It will be terrifying for me, and so I am going to make a list of helpful things to do and not do as I am working towards having my life back. I know some of the stuff you may have been doing the opposite, but don’t feel bad because neither of us knew that it wasn’t helping. Also, I don’t expect you to be perfect, but just try to keep this stuff in mind to help me.

DO NOT ASK ABOUT MY GRADES OR TALK ABOUT GRADES AROUND ME. Grades are a huge part of my OCD, and many of my exposures will be spending less time on homework, checking my assignments less, intentionally getting a problem wrong on a quiz/test, etc. This is already causing me a huge amount of anxiety, so please don’t bring it up because it will be a huge trigger for me.
Regarding food, please don’t refer to food as good, bad, healthy, or unhealthy. I am working on adding in all of the foods that I haven’t been eating for years (long story that I am willing to tell if you’re interested), and labeling food as good/bad will trigger my OCD. Also, I understand if you are on a diet or are trying to lose weight, but please refrain from telling me about it because I am going to be eating foods that scare me and talking about diets would be hard for me.
Don’t reassure me, ever. I know this is counterintuitive because as a friend, you want to insure me that things will be okay. I frequently ask people for reassurance, but I found out that asking for reassurance is a compulsion of mine. I am working on asking less reassurance, but if I do ask for reassurance don’t give me any, it will hurt me in the long run. If I ask for reassurance, the best response is to say “it could, it could not” or something like that.
Some of my exposures will be very intense, and in order to have a bearable level of anxiety around the trigger I will have to do exposures that are way overboard. To give you an idea someone with contamination OCD would have to eat gummy bears off of a public toilet (true story). Most people don’t do that, and you are probably like “What! No way would I do that!” That reaction is understandable, but in order to get the anxiety to a level where I can live my life I will have to do very intense exposures. So, if I tell you about an exposure, please have a positive response. Even if in your head you are thinking about how you would never do it, please don’t tell me that. Instead you could say something like “wow, that takes a lot of courage to do” or “you have a lot of bravery in order to do that”. Your reaction to my exposures will have a lot of impact on me, so please try to be positive about it for my sake.
Some of my exposure may go against your beliefs . For example I have scrupulosity/moral OCD (fear of being a bad person/being a unredeemable sinner), so an exposure I will have to do is to curse. If I am talking about an exposure and it makes you uncomfortable, just tell me, I will understand. I don’t want to make you uncomfortable at all.
Please just know that if you are talking about a subject that is triggering me, I will say something like “that is really triggering me right now, can we talk about something else?” Don’t feel bad if I do that, some days are better than others so what is fine one day will trigger me the next.
Know that while I have OCD, I am not OCD. My OCD is a separate part of me, and I am not just defined by my OCD. Also, OCD is not an adjective.
Accept me for me. While I am going to be more open about what I’m going through, I am still me, you just know more about what is going on in my life.

Sincerely,

Ashley