By Nichita Costea
CN: Obsessive Compulsive Disorder; Depression
About the author
I grew up on a farm in south-eastern Romania and planned to become a medic for most of my life. I applied to Cambridge on a very powerful impulse to escape a trajectory I realised would not suit me, and I am currently in my second year, studying Natural Sciences at Christ’s. My main areas of interest are evolutionary biology, neurobiology and philosophy of science. In my free time, I take photos, read, and sometimes write poetry. I have lived with OCD as well as episodes of depression for the last four years and have been in therapy for the last three.
A brief explainer about OCD
As is the case with most mental health issues, what little information manages to permeate the public perspective on OCD is only related to the outward appearance of this condition. While many people may claim they have ‘OCD tendencies’, they refer strictly to a behaviour which is similar to the visible compulsions that sufferers feel forced to do in order to decrease their anxiety. The most well-known compulsions relate to hand washing, orderliness or the avoidance of unlucky numbers, but these repetitive actions in and of themselves do not define this disease. The O in OCD is most often forgotten about and represents the obsessions that trigger extremely high levels of anxiety in sufferers. Obsessional thoughts are responses to external or internal stimuli (such as other thoughts), which focus on disastrous consequences to one’s identity, family, or impact on the world (usually involving their central values), that can only be avoided through compulsions. For example, a mother may compulsively wash her hands to be completely sure that her children do not die from a disease, or a driver may constantly check newspapers or call the police station to make sure that they have not hit anyone with their car without noticing. Sufferers often realise that their obsessions are unrealistic, but the level of fear triggered by these thoughts is indistinguishable from real danger. So, the only visible part of OCD, the compulsions, are the apparently rational responses of a brain subjected to incredibly high levels of anxiety, and not a result of an ‘orderly’ personality. In addition, compulsions can be entirely mental, especially when related to questions of identity and morality, with the stigma surrounding these topics making this subtype of OCD appear artificially rare. Effective treatment is very difficult and usually involves a combination of traditional cognitive behavioural therapy and exposure and response prevention, the latter of which strives to neutralise obsessions by stopping compulsions. Medication can be effective in alleviating anxiety and enabling therapeutic progress but cannot ‘cure’ OCD by itself.
Humans like thinking in 4-year intervals. At 20, I’ve only had 5 of these, the last of which is ending at a point in history where nothing seems certain. This period turned my life to ash multiple times over, taught me pain, and finally built me up into what I am today. I’m writing this to congratulate myself, forgive myself, and, if I can muster the courage to share it, inspire others to keep going.
Lately, I’ve been feeling like a member of the Scooby-Doo team. The only difference is that every time I catch and unmask any of the monsters that haunt me, the culprit seems to be the same: uncertainty. Even while trying to avoid generalisations, this aspect of life seems to pop up out of every crevice – whenever my neuronal circuits fire, it is there. I see it externally, in the news and the endless attempts to predict whether the world is falling apart or not, or in my degree under the problem of induction and the endless ways in which scientists try to place life into little boxes. Internally, it is an even more permanent fixture: both my constant anxiety and my random bouts of depression are responses to uncertainty – trying to compulsively control and feeling compulsively controlled are the two sides of the same coin. However, even before truly realising the extent to which this single (I find it very hard to place it in a category) element had been driving my reality, I had noticed that some people aren’t affected by it. This single thing, this difference between how I perceive the world and how others do so has puzzled me since early childhood. Of course, I don’t want to create a false dichotomy – this is all on a scale, as all of us have to deal with uncertainty, but I find that under this aspect I had received the short end of the stick. Call it the neuroticism of big 5, being the person that ‘worries too much’ or ask your future therapist (if you’re reading this there’s a high chance that you’ll need one at some point) for a better explanation. Nature or nurture, genes or past traumas, fact is that some of us are just not that good at dealing with nonlinearity, which represents most interactions in life. I now feel as though I have reached a point where I have a broad idea of how to handle this, and while giving people sterile advice might sometimes work, I feel that stories can help in a much more effective way. That being said, here is mine:
I haven’t always hated myself, but I always thought something was off. I used to be the kid who was always crying. From the day I went to primary school to the middle of high school, my tear ducts were frankly abused. Why? I have some clues, but even after 3 years of therapy it’s pretty vague and ultimately beside the point of my analysis. For most of this time I moved between the city I was going to school in and my parents’ farm during weekends, ending up as an outsider to the kids in both places. The friends I had were as isolated as me, and our interactions only shielded us from the real world instead of teaching us how to live in it. This is not to say that my experience is by any means special, but my reason for focusing on this is to point out that the things which I perceived as important at the time (social groups, games, sports, my father’s approval) eluded me.
Unsurprisingly, I tended to compensate for this lack of external progress by building a very complex internal world – as many bookish people do. This did not help, nor did the fact that an aunt fed my magical thinking-oriented brain metric tons of conspiracy theories (reptilians, crystals, Planet X, the whole thing), which I devoured – 9-year-olds don’t have a sensitive bullshit detector. Adding to that the fact that I was good at school and had always been praised by teachers meant that it became possible to insulate myself from reality and from the crucial learning experiences that others were going through. This led to the sedimentation of a core belief – that rationality was all I needed to get through life successfully, and that my being ‘special’ meant that I should avoid the methods that others use – the ones that actually work.
Until recently, my only encounter with broadly linear personal development had occurred around the time I turned 16. It was a roughly 10-month interval during which I became less sedentary and started to grow socially. This was my only experience of what everyone was calling ‘the most beautiful years of your life’. I was making mistakes, but I opened up and it felt like I was getting better at things. All of this culminated in a relationship that brought out both the good things that my rich internal world could produce, as well as its terribly mangled and fragile structure. However, the maniacal bliss that it inspired in me indirectly resulted in a functional collapse of my brain. This happened on the night before the national biology Olympiad – a fear that I was a bad person, a newfound sense of responsibility and a gesture with the moral weight of a feather (making eye contact with someone who wasn’t my girlfriend) to confirm that suspicion.
I dread explaining my life’s story without a clear purpose, and this is the first point at which I can clearly touch on it. In this instance, I was uncertain whether or not I was a bad person (where this belief came from, I’m still not quite sure). Without me knowing, a solution to this problem was proposed by my brain: you are a good person if you act like the model of a good person that you made up. This model, besides being binary, also said that the innocent gesture I had made was not compatible with my definition of a good person – tough luck. By the time I got on a train to return home, my brain had developed this model: it came up with many more tests of this ‘goodness’ hypothesis. The format was: Am I the kind of person that would do…? Afterwards it would present me with images of these things, which acted both as tests and proofs (one of my magical beliefs at the time was that if I think about something, it is going to happen). The blank was filled exclusively by the opposite of the things that I valued, OCD attacks only what you care about the most. While the first test was innocent, as this misfiring circuit looked for weak spots it got closer and closer and the sheer terror got higher and higher. Details are beside the point, but for a picture of my mind at the time, imagine taking your worst nightmares, being convinced that they will happen and that you will be responsible for them, and then try to live.
I spent a year under intense anxiety, completely confused, somehow functional yet always under extreme pressure and ready to snap. I could no longer feel emotions, and it was as if I was watching my life through a television screen. I was barely living, trying to do anything to stop the thoughts (listening to Merzbow – google him – made me feel slightly relaxed). Initially I didn’t think I needed therapy, and instead I tried to explain all of this through what I perceived at the time as rational means: reading philosophy and eventually coming across every teenage pseudo-intellectual’s second favourite author: Camus (hence the absurd). Naturally, all the progress that I had made went away, and I had to end the relationship as the permanent torment made me very toxic, and I hated myself even more for it. I eventually started therapy, almost a year later, and very slowly began to unravel what had been happening. I learned that I had OCD, and then spent the next 6 months depressed and frustrated about what this disease had taken away from me, while also being reluctant to follow the treatment. More nuanced attacks of uncertainty began: Do I really have this? How can the therapist not see that I am a horrible person?
During all this mess something quite ridiculous happened: I got into Cambridge. The decision to apply could not have been more spur of the moment. Two weeks before the deadline I was convinced I would do medicine in Romania, but some idea of the ‘increased efficiency’ of being a scientist convinced me to apply. As it turns out, the years of having to drag myself through biology Olympiads – the fact that a complete breakdown occurred during one is no coincidence – had some use. During those two weeks and the month leading up to the interview I truly did everything in my power to get in, but ultimately the offer was up to chance. This ‘win’ got me out of my depression, but it only did so at a considerable cost: it was another proof that striving to be hyper-rational, control every variable and eliminate uncertainty is the only way to succeed. Besides this, going to a place where I assumed more people would be ‘like me’ reinforced the idea that my ‘try to understand and predict as much as possible’ self would ultimately be normalised. All I did from January to October 2019 was wait for this magical world to engulf me. I avoided following my treatment, as I felt like I don’t really need to do anything about it and the excitement I had for the end of the year reduced my anxiety.
While Cambridge might be a prestigious university and a nice place to live in, it is still part of the real world, and it took me quite a while to realise that. In the first four months that I spent there, I was constantly playing catch-up. I had no work ethic, very little background knowledge and had just come out of two years and a half of extremely poor mental health, yet still tried to take on difficult courses and adapt to the new normal. I was so absorbed by improving my efficiency and my ‘productivity’ that my therapist was at some point afraid that I might have a psychotic breakdown. Luckily, that never came, but instead Covid shook the world, and in the process popped the bubble I had put myself into.
By taking away the single thing that was propping me up at the time, having to go back home threw me in a state of limbo. I had waited to leave the place for a year, yet here I was, not 6 months after I had left, devoid of hope but full of work to do, with exams looming over the next few months. OCD came back (it had never left), en force. However, now it had a trick up its sleeve: it not only affected my waking hours, but the images started to seep into my sleep, and I would wake up absolutely disgusted, as far away from a ‘revision’ mindset as I could be. After exams were over, I had a few months of leisure, which turned out to be less bad, as I developed some hobbies and started to tentatively do some of my therapy work. A word on this – one of the most effective treatments for OCD is exposure and response prevention, which involves imagining your worst fears in a controlled way while trying not to use unhealthy compulsions to reduce your level of anxiety. It amounts to self-induced torture, yet it is basically the only approach that works, and I avoided it as much as I could during my first two years of therapy. In the back of my mind, I always harboured the thought that I’ll somehow get through without doing it, maybe motivated by a belief that I could think myself out of it, in my own ‘special’ way. While I had started to do the work, I did not fully embrace it. I was not yet convinced that OCD was something I had and was still afraid that it might reflect how horrible I was as a person. In a hideous way, my next experience would solve this issue.
Someone made an innocent joke – another feather – about my value as a person. I wouldn’t blame the person for anything, it was a simple joke. But I did not take that for what it was, and instead saw it as confirmation that something really was wrong with me. This peaked my anxiety and, as many times before, amplified the symptoms of OCD. Thoughts came more often, were meaner, and I would wake up from horrible nightmares every other day. My friends dismissed me, told me we all go through difficult times, so I gave up trying to reach out. Asking my family for support – a can of worms I don’t dare get into – was not an option. I had never felt so alone and reading my notes from those days reflects a complete lack of hope for external help. One day, at the beginning of October, OCD got to a point that it had never been at before – the details are too harrowing, but it reached the limits of what this disease could do to me, short of developing into something else entirely. Waking up that morning, I remember thinking that I had to make a decision: either kill myself or start to fight this. Looking out the window of my room in Christ’s, I concluded that since I had made it all the way there, even if I was as horrible a person as I believed, ending it all would be a waste, very much against my utilitarian tendencies. Maybe it was the CBT convincing me that I was a human being after all, worthy as any of a chance at life, or maybe I was just afraid of death, I’m not sure. Point is, after this there remained no other choice, so I had to fight to take back my brain, and that’s all that I’ve been doing since.
Rage was the only thing that can describe the following two months. I would relentlessly attack the obsessive thoughts that came reflexively to my mind, put myself through ERP no matter how I felt and did everything with a sense of vengeance. I became skeptical of external help and advice, completely dropped asking for support, and insulated myself from loneliness by completely denying that I needed other people. This was unfortunately necessary, as facing the abyss by yourself is no mean feat, but that approach could never last. This was how I removed the first layer of the onion, but, as everyone knows, the deeper you go into these layers, the more tears you will shed. I had shaken myself free from the complete control of OCD, but the seeds that had made it grow were still germinating deep within my identity.
While doing therapy work consistently brought the dysfunctional circuitry to the forefront of my life, I only realised that uncertainty was the key after another piece of this puzzle metaphorically hit me over the head. The immensely complex coping mechanism of hyper-rationality, well-fed on dopamine and instant rewards is not something I had been completely unaware of, but I was definitely blind to how central a role it had played in shielding me from the negative emotions that created it in the first place. In a similar way to how my starting to question and fight OCD required a horribly painful event (but at an immensely smaller scale), to dislocate the coping mechanism that had previously made my life liveable I needed it to fail in a dramatic fashion, and at a cost that would convince my brain that this structure needs to be dismantled. A possible encounter with someone that randomly and tentatively popped into my life and which was set at an uncertain point in the future, initially perceived as positive but decidedly not central, contained every element that could make my unhealthy circuits fire at full power.
I unsurprisingly have very strong impulses to clarify mixed signals, at the same time as being powerfully and unhealthily attracted to them, so this combination of uncertainty and the lack of anything else to look forward to in the near future of lockdown amplified the attention I gave this and secured the existence of a serious emotional cost to failure. At the same time, reassurance seeking meant to reduce my anxious response to uncertainty resulted in behaviours that compromised the entire situation, proving the ineffectiveness of this approach. With core beliefs, changes don’t happen out of the blue. No matter how much you rationalise it or how often others tell you that what you are thinking is wrong, the brain only listens to the cost it has to pay for its own errors. It’s unfortunate that unhealthy coping has sabotaged me once again but I cannot express how thankful I am that by doing this, it finally toppled itself. Of course, I am now left naked, and without the comfortable support of ‘rationality’ to protect me from my self-hatred, feelings of deficiency and regret, they have been pummelling me on a daily basis. Luckily, unpleasant states are something that humans have been dealing with for a long time, so it was not hard to find inspiration that could help me rebuild myself.
Tarafs are small, multicultural folk ensembles, common in my native Romania, that sing about typically folk topics: love, loss, money, nothing fancy. Their songs are pure experience, there is no greater meaning to them other than the feelings they evoke and a philosophy of putting one foot in front of the other. The sound is a blend of languages, and while only some of the songs are in Romanian, I sing along to all of them. This music does not give advice, does not provide a framework to understand reality, but it blends into one’s emotions and makes them look normal and acceptable. At the same time, this was the first thing I did not try to fit into the naïvely rational perception of myself that I had built up over the years – no considering whether or not this fits my aesthetic sense or taste, nor whether I want to be the kind of person that listens to this stuff. Acceptance had always been difficult for me and this rang true to that ideal. I’ve now stopped asking what this or that reflects – I just catch myself in these futile loops and ask what action I can do in this very moment. Usually, it’s as simple as throwing something in the bin, washing a cup, or going for a walk.
Lately, I’ve been waging my own little war on meaning, trying to root it out from every crevice of my brain and replacing it with something that loves uncertainty. The years of instant reactions to my obsessive thoughts, a technology addiction and the lack of any modicum of discipline have left my decision-making abilities severely compromised. Uncertainty still hurts me more than most: I project, build grand ideals and put my faith in silver bullets. The possibility of catching Covid gives me anxiety attacks about every other week, the fear of spreading it to vulnerable people a perfect match to questions regarding my morality. Adding to all of this, my degree is hard, and while I don’t like finding excuses for myself, I can’t say that everything goes as well as it could when 30 to 50% of my mental capacity is consumed by my condition. In spite of all they took away from me, I am thankful to OCD and its cronies for providing me with the greatest challenge of my life. What lies ahead is something similar to the eastern European country roads I grew up with – cracked, full of potholes, yet navigable and able to bring you to beautiful places. You can’t build a house on quicksand, but I like to think that I am finally on solid footing. I may not have yet pierced the core of my suffering, but I’m pretty sure I am on the right track.
Fighting against uncertainty is a losing battle. No matter how well you think you can predict the future, unknown unknowns will prove you wrong. Even if you can ‘break even’ and be right sometimes, the resources you invest in that endeavour will run out. I spent years asking whether I was a good person or not, trying to control each and every variable that might give me an answer, and felt like I lost my mind because of it. But right answers don’t exist outside of mathematics, the real world doesn’t care about human logic, and inducting from experience is a fair-weather friend. If you want to live, you need to accept that some questions simply don’t have answers.
I don’t know whether or not I’m a good person. I don’t know what is true. I don’t know how to do the work I have to do. I don’t know if anyone cares or if the world will end tomorrow. All I know is that when I take my next step into the dark, my eyes will be closed.