Thursday, August 6, 2015

She has a great personality - Part I: Obsessive-compulsive personality disorder

When I was looking into ideas for a new series there were several directions I wanted to explore, but eventually I decided I wanted to write a few posts on personality disorders because I have two partial diagnoses myself and am closely acquainted with people who have other diagnoses in that field. Both of mine, obsessive-compulsive personality disorder and avoidant personality disorder, are ones I didn't get a "high score" for in the various forms of testing I had done with me, but I was a close enough match for both for them to end up in my list of diagnoses. I actually recognise myself a fair bit in both of them, which is why the first two posts of this series will focus on them, starting today with obsessive-compulsive personality disorder (OCPD).

When reading about obsessive-compulsive disorder (OCD) in the past, my web sources, mainly Wikipedia, were always adamant about it not being confused with OCPD because, they say, that's often done, and it's some sort of really bad thing to do (judging by the tone of the "do not confuse"-warnings) because they are completely different things. Well, I made sure I never confused them and steered clear of reading about OCPD because of how unrelated I was told it was to what I have. In the end, I now, since recently, have both diagnoses. Unrelated they may be, but I guess it's not impossible for you to have both. So I had to begin reading up on OCPD anyway, after being told for so long that I shouldn't bother with it. Also, what's with that extremely similar naming if people are so worried about the two diagnoses being confused with each other? Just saying, though. What you read in this post has nothing to do with OCD, even though I have that diagnosis, too, and wrote a post on it in the past.

My partial diagnosis of OCPD came together rather simply and quickly. I was in treatment for - among other things - depression, and one of the most common things people with depression have bothering them is that they have a lot of principles in their heads that go "I must..." I must perform well, I must satisfy this or that need of others, et cetera. When my therapist asked me to write down a few sentences like that that apply to myself, I filled an entire page. About fifty or so sentences of things I thought I must do in order to consider myself a valuable human being. And the list wasn't nearly complete.That's OCPD in a nutshell, everything has to be done to perfection according to a rigid set of rules, and if you don't live up to them, you suck. You put immense pressure on yourself to run every aspect of your life by these ideas written in stone and measure yourself by your success at fulfilling them every day. You obsess over them and you have the compulsion to follow them, hence the name of the disorder.

If I were to make a list of examples from my life this post wouldn't be done before next year. I'll just pick one I think is the weirdest and most useless to illustrate how invasive this disorder is in living one's life normally. I bet many of you have heard of that site Last.fm. You install a software on your computer and it "scrobbles" the music you are listening to with your media player of choice, and the scrobbles are then made into a set of lists including charts of what you listen to the most. I've been using it since late 2006. At one point a few years ago my taste in music drastically changed, and I wanted my charts to reflect my changed taste in music, but I did not want to delete anything because I didn't want to lose the data for historical value, and I also would consider it cheating. So I started to constantly listen to the music I'm into nowadays. Must have been around 2011. You know how hard it is to get a lot of new stuff past an entire top 500 of music that had been established for five years? So I constantly watch my charts, see what needs to go up, look what needs to go down and what can go past it, listen to things I like on repeat ad nauseam, all day every day. Just think of the maths in this. If you have an artist in, say, seventh place at a thousand plays, and you want to get it out of the top 50, you'll have to get forty-four artists above a thousand plays. It sucks the life out of you. But music is one of the most important things in my life and I identify myself by what music I like, so I feel it is necessary to do this to properly represent what kind of person I am.

Sound ridiculous? It is. And for years I have been trying to identify what it is inside me that causes me to spend so much time on that ritual. For the longest time I assumed it was a form of net addiction, until one day I read up on OCPD after the therapist at the clinic gave me that partial diagnosis, and then it dawned on me. A rigid set of rules linked directly to my self-worth. Obsession and compulsion are a constant given. And the difference between OCD and OCPD shows here. If it was the former, I'd feel strong symptoms of anxiety after non-fulfillment of the ritual, with the latter it is not about how I feel at that moment, it affects how well I think of myself as a person. Mind you, the above is just an example of many, I do not determine my intrinsic value by some charts no one will probably ever look at alone. It's this huge list of things I need to do perfectly, a list so long it is humanly impossible to get everything right. The perception of oneself suffers by the nature of the thing, because you simply cannot live up to every rule you burden yourself with.

I think the reason I only got a partial diagnosis and not a full diagnosis is that I can often "unhinge" my daily life from my suffocating rules. It's like when I play/record music. I want everything to be perfect, but I can quickly reach the point at which I say "ah, fuck it" and just do as well as I can and be happy with it. It's something that plays a major role in my life, but there's a healthy side of me that can just as well take over. No, not as in multiple personality, it's still me, it's just that mental illness can vary in severity depending on how you feel at any given moment. It's less true for personality disorders which in many cases tend to be always there, but it's not uncommon, either. Sometimes it dominates my thinking, sometimes it doesn't even cross my mind. Hence the partial diagnosis.

To close my first post on personality disorders, you'll already be getting the idea that almost all of them are united by the idea that you are your own harshest critic, that somehow you always fuck up. Maybe not narcissists, more on those friendly fellows later, but in most personality disorders you'll always catch a person if you ask them about the last time they did really great at something. Or generally something they're really great at. With OCPD it shouldn't surprise you that I think every single post in my blog sucks. You know, they don't live up to some outlandish idea of perfect writing. But we live in a time in which these disorders can be identified and treated, so I'm optimistic about the future. Mine and that of everyone else suffering from a personality disorder.

Alcoholism: A love story - Part IX: Self-harm and suicidal ideation

The previous post in the alcoholism-series was about the liberating feeling of sobriety. Since then I have broken my inofficial vow of abstinence on a small number of occasions. What happened was the same thing that always happens when I get drunk by myself in recent months: I get suicidal ideation and start cutting myself with a carpet knife. That's no fucking good. In December (last year), January and April it ended in me having an emergency admission (in the middle of the night, all three times) to the crappy local psychiatric hospital and staying there for a few days. I completely freak myself and everyone else out. So, hey, that sounds kind of serious, so what is happening here?

The obvious first. I am really unhappy with my life, and I suppress it very well. When you suppress something and get drunk, chances are what you suppress comes boiling up with a vengeance. I don't like to whine, but there are a lot of things wrong with how my life has been going in the past, well, thirty-three years or so. If it wasn't for my awesome dog and a few hobbies I can still get excited about - like writing this stuff - I'd pretty much be unhappy with every single thing that my life consists of. No, I'm not going to post a picture of my dog, stay focused. It's not just that I am unhappy, I also see no feasible way of changing it because the environment I live in is so suffocating. I'd have to get far away from this place, but where? Are other places better? And I need better friends, but how? There's no mailorder for those. And wherever I go I have these mental disorders in my head that I like to write about in this blog. And I need to do something productive, something I can be proud of, but what? I don't think of myself as particularly good at anything. I'd also like to be with someone again, but I promised not to whine.

Of course I can't talk about this to anyone when I'm sober, partly because "don't whine" is a strict rule of mine that was shoved down my throat by family my entire life, and partly because my social anxiety tells me no one wants to hear it anyway. Can't even hint. So I suppress. And try to look like nothing's bothering me. Then I get drunk, feel great while I'm mildly to moderately intoxicated, and then it explodes out of me. Basically I am The Inverted Hulk. I turn green and become a superhero of self-destruction. It literally builds up in the space of a minute, from a great mood to completely messed up. Start talking about suicide to friends and family, something which I hate, and start cutting up my arms. All the while living through a feeling of misery the word "depression" can't quite live up to.

But how did I arrive there? I used to not do that when I was drunk. Even though I've been unhappy with my life and bottling it up for as long as I can think back. Got whiny or annoying sometimes, but nothing to anywhere near that level of dysfunction. At one point I turned from a normal obnoxious drunk to The Inverted Hulk. And I think it has its roots in little over a year ago when someone close to me started making frequent, very dramatic and very convincing suicide threats to me. I was never one who could in any way live with the idea of the death of someone close to me, so it hit me hard. And it happened more and more, until it was all the time. What made the whole thing infinitely worse was that I was always given the feeling that it would be my fault, that I would be responsible for that person's death, which was a burden that exceeded what I could carry by a factor of a million. I'm not particularly good at carrying any of the burdens I have in life (as we all do), but that one was like putting a Himalayan mountain on the back of an ant and expecting it to keep going about its life normally as if nothing was there. Far lighter things have been known to flatten an ant (fuck off, PETA), so don't expect it to live very long with the weight of Mount Everest on its shoulders.

So I started breaking and falling apart. It wasn't that suicide threat thing that caused it, that was the general unhappiness with everything else with my life. But it brought me to the point of being unable to deal with everything. While I continued to bottle things up while sober, the drunk stage now got infinitely worse. My faith in life was shattered, and my tortured brain knew only one way to live it out. The way that person taught me so thoroughly.

For now that means drinking is absolutely out of the question. And there are a lot of areas in my life I need to work at very hard. I am soon going to be admitted to a day clinic to continue the therapy started at that clinic I've been to from mid-May to mid-July, and while I'm there I have a lot to build for myself, a life, something to have faith in and a future to look forward to. Something far away from what has been suffocating me all those years. Figuratively far away, not intending to move to Australia. Huge spiders. I have some big decisions and changes to make, and it won't be easy. But I need to have something. Anything resembling happiness. And you can bet your life on it that I will do everything in my power to try to accomplish that. I have no intention of ending my life as a fuck-up. Like nobody should.