I will start by explaining what OCD is, what CPTSD is, and how they influence each other for me. I want to emphasize that this is my experience and my experience only; not everyone with OCD has underlying trauma and not everyone with complex trauma will develop OCD. For me, Obsessive-Compulsive disorder genetically runs in the family, so I was likely to get it whether or not I experienced trauma. I feel that trauma has only exacerbated the OCD further.  

What is OCD? 

OCD is characterized as an anxiety disorder, one that involves obsessive, intrusive thoughts followed by compulsions. This can look vastly different for everyone. One person with OCD may have fears of contracting a deadly illness and wash their hands hundreds of times a day, while another person may question their sexuality repeatedly and have to touch the wall to reduce the thoughts. Others might convince themselves they are hitting someone with their car and have to check and re-check the spot they drove over to ensure they didn’t hurt anyone. Someone else might need to align everything in perfect symmetry to ‘prevent’ their family from dying. The key factors are obsessions and compulsions, anxiety, and the knowledge that these anxieties and compulsions are irrational to some extent. Often magical thinking is involved, such as thinking that touching the window in increments of two will keep one safe from a natural disaster.  

What is CPTSD? 

If you’re on this blog, you likely know what CPTSD is, so the short version—CPTSD is essentially PTSD with additional symptoms like emotional dysregulation, relationship challenges, excess shame and guilt, attachment struggles, and dissociation. CPTSD arises from not just one trauma but ongoing trauma (some examples include emotional abuse, physical abuse, sexual abuse, neglect, bullying, discrimination, and others), typically beginning in childhood, although not always. CPTSD survivors may have many comorbid conditions too. Speaking from my own experience at least, I had developed poor coping mechanisms for most of my life because of my complex trauma, such as eating disorders, self-harm, and other addictive behaviors. Many of us also struggle with depression, personality disorders, substance abuse, and chronic physical health issues.  

My Story with OCD and CPTSD 

I was diagnosed with OCD at nineteen years old, despite struggling for the majority of my life with it. I don’t remember a time I didn’t struggle with OCD and Generalized Anxiety disorder. I also have ADHD and Autism, conditions that I was born with but were not identified until later. I grew up feeling different for several reasons, including being a part of the LGBTQ+ community and grappling with those struggles. It has taken eight years of therapy (I am now twenty-eight years old) to have teased apart all of these factors. My OCD has centered around many themes, but the main themes I have dealt with since my teen years, and subsequently as an adult, have been around sex and harming others with my car. Two very different subjects, but both are very common for someone with OCD.  

While the intensity of my intrusive thoughts and compulsions was irrational and very characteristic of OCD, what I hadn’t made the connection to until this year was the way my traumas have influenced the content of my OCD.  

Let’s start with my fear that I was going to hurt someone while driving my car. I feared hitting a pedestrian, to the point that I would obsessively check the rearview mirror for people even in the middle of the highway, touching and tapping the window as an additional compulsion. As I said, this is not an uncommon thing for a person with OCD. That said, mine was not ‘random.’ I had been hit by a car as a pedestrian at the age of sixteen. I had already had OCD at that time, but my symptoms became more severe, likely from both the head trauma I endured and the emotional trauma of being hit.  

The next topic is much harder for me to discuss, but I have been able to come to terms with this through EMDR and IFS therapy this year. This combination of therapies has truly helped me. I have dealt with taboo thoughts, like many with OCD, around sex, sexuality, and harming others in a sexual way. For the vast majority with OCD, this is random and just a symptom of overactive basal ganglia. For me, that was part of it, but I also believe that my OCD latched onto this subject because of my history of childhood sexual trauma. It has been hard for me to tease apart what is my OCD and what is my reality, but I have had a very skilled therapist that has helped me do so. I have had to engage in OCD-specific treatment and CPTSD-specific treatment. For years I was only treating the OCD, that wasn’t enough. It didn’t alleviate the OCD as much as trauma treatment in conjunction has. It also didn’t address the CPTSD-specific issues I have, such as dissociation, emotional flashbacks, emotional dysregulation, etc.  

I share my story so that others can know that they are not alone. Perhaps you relate; perhaps you don’t. Either way, OCD in my opinion can most certainly be tied in with trauma, especially when you also have a genetic predisposition to the condition. I do emphasize that this is my experience and that everyone is different. I have worked with several professionals to get to this point, and I am grateful that today I can function in most respects. That said, that doesn’t mean it’s easy. I have to take medication daily for my OCD—and other conditions like ADHD, anxiety, and Bipolar disorder—and I go to therapy weekly and work on self-care every day. Discovering this past year that I have CPTSD, and treating it, has made a world of difference to my recovery from all mental health conditions.  

Guest Post Disclaimer: Any and all information shared in this guest blog post is intended for educational and informational purposes only. Nothing in this blog post, nor any content on CPTSDfoundation.org, is a supplement for or supersedes the relationship and direction of your medical or mental health providers. Thoughts, ideas, or opinions expressed by the writer of this guest blog do not necessarily reflect those of CPTSD Foundation. For more information, see our Privacy Policy and Full Disclaimer.

Kaden McNamara

I want to recognize the importance of noticing these trauma symptoms and share ideas to help us move forward. If you are struggling to feel safe and connected again, after all, we’ve been through, my hope is to encourage greater compassion for yourself. Maybe you don’t see yourself as a trauma survivor, or perhaps you do identify with other long-term trauma survivors. Know that either way, people survive and can even learn to thrive by repairing and healing the changes to the nervous system trauma causes that have left us feeling fearful, unsure, and alone. Understanding will also bring more awareness to mental health.

The Trauma Imparted by COVID

COVID has been a traumatic experience because our minds and bodies perceived threats to life and safety beyond our control. Over the past two years, the pandemic has done more than threaten our physical health — it has also threatened our social and therefore emotional health because we needed to keep apart from each other when we are wired for connection!

With COVID Winding Down. Why is this Hitting Me Now?

When the intensity of trauma starts to subside, that is when you might start feeling trauma symptoms most.

In the midst of experiencing any trauma, when you’re still going through it, you are likely to be living with a changed nervous system – a state of hypervigilance. The thinking parts of the brain may go offline, functioning on autopilot, for putting one foot in front of the other, trying to predict what threat is next, to survive.

At other times you may be living with hyperarousal, barely noticing life around you, feeling numb. It seems your nervous system has shut off its usual responsiveness to the world in order to avoid the impact of excessive anxiety or fear around you. Whether we’re children or adults experiencing trauma, we don’t necessarily realize the long-lasting impact it’s going to have on our nervous systems, because we’re solely focused on survival.

Dealing with COVID has demanded an extended period of vigilance from most of us. Almost every day for two years, there have been new concerns or changing requirements regarding masks, social distancing, warnings to watch for, symptoms, getting vaccines, being wary of new variants, undergoing testing, etc.

Whether you’ve been in a constant state of hyper- or hypo-arousal or one that fluctuates regarding how you cope or survive the trauma of the pandemic, this has impacted your nervous system.

After two years of dealing with the trauma of COVID, you might be:

1. Experiencing grief in any of its stages. We have lived for so long hoping the threat of danger will change, waiting for things to go back to “normal” and living in a state of hyper- or hypo-arousal. Now we’re exhausted! And we don’t have the same hope that in two weeks, even two months, or at the end of the year it will end. What if life never returns to normal? Accordingly, we may be going through the 5 stages of grief including denial, anger, bargaining, depression, and finally, acceptance. The pre-acceptance stages may only be starting now, or they may take some time to pass as you move through them.

2. Missing physical contact and feeling exceptionally lonely. With diminished in-person contact, and with people having shifted their boundaries around physical contact, you may not be getting the same amount of social interaction or connection you once had, including touch or hugs or just being in the same room as friends or loved ones, pre-pandemic and find yourself deeply missing that.
3. Overwhelmed and feeling outside of your window of tolerance. The nervous system changes with the impact of trauma. We’ve endured a long period of dysregulation – either in a hyper or hypo aroused state, or shifting between them. As we’ve lived in a chronic state of ongoing trauma, the window of tolerance begins to shrink — making it harder to think and feel at the same time.

4. Using a coping mechanism that is hurting you. To deal with feeling “not right”, “out of sorts”, “crazy”, etc., caused by being outside of your window of tolerance, you may be attempting to self-soothe or manage emotional dysregulation with alcohol, drugs, sex, self-harm, food use or food restriction.
5. Waiting for the other shoe to drop. People with a trauma history often find themselves expecting the next bad thing to happen: waiting for the other shoe to drop, and unable to feel safe in the present.

6. Having suicidal thoughts. Tragically, the pandemic has resulted in an increase in suicidal thoughts and suicide.

If you are experiencing any of these symptoms, you are not alone!

The world has endured the impact of global trauma, and that’s not even considering what may have been happening in your personal life or your trauma history.

All of this has left us with changes in our nervous systems, and the need to deal with them, with trauma-informed kindness and with compassion.

So, what can we do to heal from this long-lasting (and now chronic) trauma?

Here are some ideas that may help:

• Look for the helpers. There are good people out there!

• Feel all of your emotions with the power of AND.

• Widen your window of tolerance. Fortunately, we all have the power to do this!

• Accept the title of trauma survivor. No, you don’t have to wear a t-shirt, although I may wear mine with pride!

• Practice making decisions when everything feels risky.

• Start or continue to set healthy boundaries. Tune in — not out. What feels comfortable to you?

• Recognize things to appreciate. There is always something to be grateful for — we may just have to look a bit deeper today, to get past the worry and grief!

• Cultivate compassion for yourself and others. This is one of the most powerful tools to heal trauma.

• Prioritize self-care, no matter what this looks like for you!

• Find a trauma-informed therapist (even if you don’t think you have trauma).

We initially thought dealing with COVID would be a sprint. It has turned into a marathon (a few times over). We are understandably wary. But there is hope after trauma!

We now have a new capacity for empathy, at least on a small scale, for what it feels like for those with complex trauma to survive life with a nervous system constantly sounding the alarm of mortal threat. Hopefully, this new understanding will help us have more compassion, decrease the stigma against those with mental illness, and create more helpers among us. Ultimately, when we work on healing from trauma, we build resilience and can experience growth after trauma.

Guest Post Disclaimer: Any and all information shared in this guest blog post is intended for educational and informational purposes only. Nothing in this blog post, nor any content on CPTSDfoundation.org, is a supplement for or supersedes the relationship and direction of your medical or mental health providers. Thoughts, ideas, or opinions expressed by the writer of this guest blog do not necessarily reflect those of CPTSD Foundation. For more information, see our Privacy Policy and Full Disclaimer.

Original Post: https://brickelandassociates.com/6-signs-of-trauma-after-covid-finding-your-path-to-healing/ (Reposted with permission)

Robyn Brickel

Robyn is a Licensed Marriage and Family Therapist with 20+ years of experience providing psychotherapy, as well as the founder and clinical director of a private practice, Brickel and Associates, LLC in Old Town, Alexandria, Virginia. She and her team bring a strengths-based, trauma-informed, systems approach to the treatment of individuals (adolescents and adults), couples and families. She specializes in trauma (including attachment trauma) and the use of dissociative mechanisms; such as: self-harm, eating disorders and addictions. She also approaches treatment of perinatal mental health from a trauma-informed lens.

Robyn also guides clients and clinicians who wish to better understand the impact of trauma on mental health and relationships. She has a wide range of post graduate trauma and addictions education and is trained in numerous relational models of practice, including Emotionally Focused Couple Therapy (EFT), the Psychobiological Approach to Couple Therapy (PACT), and Imago therapy. She is a trained Sensorimotor Psychotherapist and is a Certified EMDRIA therapist and Approved Consultant. Utilizing all of these tools, along with mindfulness and ego state work to provide the best care to her clients. She prides herself in always learning and expanding her knowledge on a daily basis about the intricacies of treating complex trauma and trauma’s impact on perinatal distress.

She frequently shares insights, resources and links to mental health news on Facebook and Twitter as well as in her blog at BrickelandAssociates.com

To contact Robyn directly:

Robyn@RobynBrickel.com

www.BrickelandAssociates.com

brickelandassociates.com/

Habitual conduct or Compulsions, that stem from unstoppable urges brought on by Anxiety, is called Obsessive-Compulsive Disorder. Although a person may have similar practices that reflect this disorder, it does not mean they have it.  However, if you feel you or someone you know does, please continue on to be properly informed.

SYNOPSIS

A mental illness with a Chronic or profuse disposition of Anxiety is Obsessive-Compulsive Disorder. Individuals are in a dark pattern they cannot get out of. This disorder usually includes both obsessions symptoms and compulsions symptoms, but a person can experience one or the other. Although symptoms can eat up and disrupt a person’s regular life, the individual may not even be aware of the obstructive behavior.

OBSESSIVE/COMPULSIONS THEMES and EXAMPLES

Obsessions are unwanted intrusive thoughts that cause anxiety. Obsession themes are fear of germs, doubt and trouble dealing with it, needing things in a certain way and alignment, needing constant reassurance, combating thoughts about not having control and harming yourself or others, intruding thoughts on sexual or religious aspects. 

Obsession examples are fear of contamination of foreign surfaces, feeling tense when your possessions aren’t in ‘order’, hoarding, reciting phrases during tasks, eating for in the correct way, images of driving your car into a crowd of people, and unpleasant sexual images.

Compulsions are actions someone takes to get rid of obsessions and anxiety. Individuals are compelled to finish these tasks. Unfortunately, anxiety is never truly driven away from performing these rituals. Obsessive thoughts lead an individual to make a new order in their life to lessen anxiety. Compulsion themes are washing and cleaning, checking, counting, orderliness, following a strict routine, and demanding reassurance.  

Compulsion examples are raw hand skin-washing, getting up multiple times to make sure the door is locked or to make sure the stove is off, counting a particular way, soundlessly reciting phrases or prayers, or making sure your pantry foods are arranged the ‘correct’ way. The austerity of disorder is not the same for everyone. Symptoms often start small and then grow over time.

In the very first paragraph of this post, I brought up examples of people who have precise routines that they follow by heart. Most of what I brought up can help a person have an organized life but are not part of a disorder. They are not OCD. A person needs to keep on the lookout for regimens that disrupt their life. 

CAUSES

The root of OCD is not fully understood by scientists. OCD causes can be a small instalment or happen regularly after chapters in a person’s life. Speculations include relationship issues, relocating, experiencing issues at regular places a person visits, a person’s serotonin level drops, illness, abuse or history of abuse, excess brain activity, or death of loved ones. 

SYMPTOMS

Symptoms of OCD begin impeding regular life events. Being late for an outing with friends or getting to sleep much later than usual lately are ways OCD can negatively affect someone’s life. A person with the disorder may be aware of having it but are still shackled by the disorder.

TREATMENT

There is no cure but there is the treatment for OCD. The treatment is different for each individual. Psychotherapy and medication are the most common along with combining the two. One genre of Psychotherapy involves Cognitive Behavioral Therapy (CBT), which is very effective. Impulses brought on by OCD are combated by Exposure and response prevention (ERP), which is gradually exposing you to a feared object or obsession, like dirt, and learn to resist individuals’ collusion rituals. Individuals can achieve a better life and take charge of their disorder by applying ERP to their lives. OCD rituals can be reversed by some psychiatric medicines. Antidepressants are generally tried first. If an individual is 10 years old and up they can be prescribed Clomipramine (Anafril). If an individual is 7 years old and up they can be prescribed Fluoxetine (Prozac). Sertraline (Zoloft) is given to individuals 6 years old and up. Paroxetine (Paxil, Pexeva) is given to adults exclusively. These are just a few of the options doctors recommend. 

Make sure you go over all considerations with your healthcare provider. If a doctor gives multiple prescriptions they should begin with very low doses to see how symptoms are affected by it. The doctor will likely recommend the least amount needed to control the impulses. Treatment and medication could take weeks, if not months to take effect. Remember that medication of almost any kind has side effects, including what you may be prescribed. Keep track of your moods and any bodily changes you experience. Contact your doctor if you experience suicidal thoughts and behavior. This can increase in the early stages of taking medication. Note that suicidal patterns are meant to decrease in later stages of newly prescribed medication. Make sure you tell your healthcare provider all medications you take. Some prescription drugs can weaken the psychiatric medications you’re given.

ALTERNATIVE TREATMENT

OCD cannot always be treated by psychotherapy or medication. Fortunately, there are other options to look at. You could try Intense Outpatient and Residential Treatment programs. What this is a person who has trouble grappling goes to a program that focuses intently on ERP principled therapy for a few weeks. Another option is Deep Brain Stimulation (DBS). DBS is for patients who are at least 18yrs old who don’t respond well to regular treatment. The procedure includes Electrodes, which are embedded in a certain part of your brain, make electric impulses normalize a person’s OCD impulses. This is approved by the FDA. Lastly, there is Transcranial Magnetic Stimulation where if standard treatment isn’t working people between the ages of 22 and 68 use an FDA approved device called BrainsWAy Deep Transcranial Magnetic Stimulation. OCD indicators are amended by a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain. An individual’s scalp has an electromagnetic coil placed near the forehead. Your brain is utilized by this coil there relieving OCD issues. It should go without saying that you should consult your doctor before trying TMS and DBS.

CONCLUSION

Obsessive-Compulsive Disorder is a mental illness that can negatively affect someone’s life. If you felt that you or someone you care about identifies with anything you’ve just read, please contact a trusted professional who can correctly give you the treatment for this condition. A person is strong and brave for taking that step and it could be the first step in monumentally improving a mind and a life.

Guest Post Disclaimer: Any and all information shared in this guest blog post is intended for educational and informational purposes only. Nothing in this blog post, nor any content on CPTSDfoundation.org, is a supplement for or supersedes the relationship and direction of your medical or mental health providers. Thoughts, ideas, or opinions expressed by the writer of this guest blog do not necessarily reflect those of CPTSD Foundation. For more information, see our Privacy Policy and Full Disclaimer.

Alexis Mosby