Whenever I talk about my mental health journey, I tend to break it into two acts, like halves of a theatrical show. There’s Act 1: Obsessive-Compulsive Disorder (OCD). This begins in early childhood, climaxes at finally getting diagnosed at 19, and resolves around my early 20’s after Exposure and Response Prevention (ERP) treatment. Then, there’s Act 2: Borderline Personality Disorder (BPD) which picks up speed just as Act 1 is finishing and slows down about two years later, which brings us to today.
For me, BPD manifested as intense and rapid mood swings, chronic suicidal ideation, relationship difficulties, and extreme sensitivity to invalidation. I define BPD most simply as extreme emotions and extremely poor coping skills for dealing with those emotions. What was weird though was, from my point of view, I didn’t have these symptoms, or at least not to a severe extent, until after I had dealt with my OCD.
Looking back, I can of course recognize signs of BPD from earlier like in my teens and before my OCD was treated. There were times I got intensely angry or felt invisible and invalidated. I’m sure I was already heading in the direction of BPD. Yet, it wasn’t until the OCD quieted down that the BPD then flourished. It was as if before ERP treatment and recovery from OCD, I was too busy with OCD and all the ritualizing to have time or energy for anything else. I was very anxious, but besides that emotionally numb.
Knowing how to feel emotions is a skill that takes in depth practice. It’s something most people learn starting in childhood, and they get increasingly skilled as they grow up with more complex emotions and experiences. When I was in the trenches of OCD though for so many years, I believe it somehow stunted my emotional development. I never felt much of anything besides scared, so I never learned how to deal with feeling anything besides scared. And I wasn’t even that good at feeling scared.
But once I started working on my OCD with exposure therapy, suddenly there was space for emotions. And I had no idea how to deal with them. They were big and juicy and intense emotions pent up from so much time unfelt. And rather than feeling them productively, I pushed them away or acted in other unskillful ways which spun them out of control. Hence the BPD.
Since then, I’ve undergone and graduated from an intense Dialectical Behavioral Therapy (DBT) program. DBT was originally designed for BPD but is now used for a wide variety of people and symptoms. DBT is all about skills, and in particular learning skills for handling emotions in constructive rather than destructive ways. There’s a whole module on emotion regulation and another one just on distress tolerance.
These DBT skills have made an enormous difference in my life. In fact, they probably saved my life, and I’m extremely grateful to have undergone both ERP and DBT treatment.
I don’t write about these two “acts” of my mental health journey to scare anyone working on treating their OCD that once it’s gone they will suddenly develop a severe personality disorder. I write about it because the other day I was talking to an OCD support group. Much to my surprise, after sharing these descriptions of feeling emotionally stunted by untreated OCD, many people could relate. I thought it was such a small detail of my story; yet, it really resonated with others.
It makes me wonder what some of the other effects are of having untreated OCD for so long. This is another reason why early intervention and treatment are so important. Not only is treatment more likely to be successful, but perhaps waiting longer affects emotional development and other areas of mental health. That’s not to say you can’t reach recovery if you don’t treat your OCD right away. I (and others who went even longer before starting treatment) show that is not true. It’s merely to say the earlier the better.
How do you view OCD and your emotional development. Do you feel that OCD stunted your ability to know how to feel and process emotions? Is this something you had considered before?