PLEASE NOTE: The following blog post contains discussion of topics that may be upsetting, including suicide. Please take care of yourself as you read this article. If you are in crisis, know that help is only a call or click away at 1-800-273-8255 or suicidepreventionlifeline.org.
Welcome back to another Faces Of OCD post! For more information about #FacesOfOCD and how to submit, click here.
Today we are going to hear from Jasmine Browning. Jasmine is an OCD advocate and pharmacy student. We asked her some questions about her experiences with OCD, diagnosis, treatment and stigma, and about how being a Black woman has impacted and informed her mental health journey. It’s time for the community to amplify melanated voices and hear from those in the Black community who suffer from OCD. Here is what Jasmine had to say:
Tell us a little bit about yourself.
Hi, my name is Jasmine. I am currently in my fourth year of pharmacy school. Studying and learning all there is to know about thousands of medications takes up the majority of my time — luckily, though, because I love to learn and my desire has always been to be a wealth of information in order to help others.
I’m passionate about loving the lord, serving others, especially those in marginalized communities, and laughing. I am so passionate about laughing; it is an absolute must. I have a pup named Olive who keeps me on my toes and constantly laughing. She is going through terrible twos and has become very stubborn and mouthy (probably my fault because she is as spoiled as can be).
I love spending time in the word of God and growing my relationship with Him. I also love yoga, meditation, and spending quality time with my friends and family, preferably at a local restaurant with a glass of wine.
Can you speak to your personal experiences of misdiagnoses? How long did it take for you to get a proper diagnosis?
My personal experience of being undiagnosed and then misdiagnosed is actually longer than I had even realized. The more I learn about OCD and truly reflect back on different moments in my life, the more I have come to understand that close to half my life was spent battling OCD. I can pinpoint times where I was clearly stuck in an OCD cycle and unaware. Specific instances that led to misdiagnosis occurred once in late middle school/early high school, when I did seek treatment and I was diagnosed with depression. Another was about three years ago when I was diagnosed with PTSD and situational anxiety.
"At the time, I was convinced I had schizophrenia."
However, the journey to my specific OCD diagnosis began a little over a year ago. At the time, I was convinced I had schizophrenia. There was a voice in my head that sounded like me but was not me, and I rationally understood that it wasn’t an external voice but I also had no clue who the voice was. OCD was so loud at this point in my life that I was terrified of my own thoughts, so my main compulsion was trying to sound out the voice. When I sought help, I told the physician about the voice in my head and how I knew I had schizophrenia. Her response was that she did not believe that to be true and went as far as to console me by saying that if I were to have schizophrenia, people function perfectly fine on appropriate treatment. I honestly have no idea what my diagnosis was when I left that appointment. All I know is she had prescribed me an antipsychotic. At the time, Google was my only resource because I had not learned about antipsychotics yet in school.
As soon as I looked up uses for the medication, I found schizophrenia. At this point I desperately wanted to feel better, despite my psychiatrist aunt and psychiatric specialized pharmacist mother telling me to not take the medication as it would only make me worse. The desperation to feel better drove me to pick up the medication from the pharmacy anyway.
I was able to get a second opinion about a week after that appointment and at that point I was diagnosed with generalized anxiety disorder with potential attention deficit disorder that they wanted to further assess after the anxiety got under control. I started going to therapy weekly and was on antidepressant medication. I remember feeling a little better, but then my obsessions became centered around perfectionism and things being just right. While all this was happening, I was in a great place in my life externally; I was living with my five best friends, I was in my last year of didactic coursework in pharmacy school (which basically means the stressful classes were behind me), had two amazing jobs, and was getting recognized for my leadership skills.
Living with my five best friends was the greatest battle for my OCD, yet it was my saving grace as Jasmine. On one hand, they were a compulsion as my constant reassurance providers. On the other hand, they threatened OCD by having the power to expose that I was simply a victim to OCD’s constant bullying to do everything just right and protect the perfect image that OCD made up for me. Looking back on it, I see how the five of them were just as much OCD’s victims as I, if not more. They were actively participating in an OCD cycle without having the slightest clue. OCD trapped us all in a traumatizing whirlwind of events, despite all of us having no desire to partake. One of those events was the night I attempted to commit suicide. With everything that happens in my life moving forward, I will always praise God for them for saving my life.
"OCD trapped us all in a traumatizing whirlwind of events, despite all of us having no desire to partake."
The next morning I went to an inpatient psychiatric hospital to get an assessment. I had no intention of staying or any idea that it would even be the recommendation. Yet there I was being assessed. The woman looked me in the eyes and said, “Are you ready to come stay with us?” I said absolutely not, as I spat out the million things that I didn’t get in order before coming for an assessment. Her response to my laundry list of reasons why I could not be committed was, “None of that matters if you are not alive to do those things.''
I ended up staying in the hospital for three days and two nights. The first night I slept 13 hours straight. When I saw the doctor I was met with a diagnosis of a major depressive disorder episode induced by sleep deprivation and stress. Basically, he told me I needed to get more sleep and that the help I needed was not there because I was too high functioning. Everyone in my life, and now even healthcare professionals that I desperately wanted to help me, were all saying, “I was just stressed, I was just too over-achieving, I just needed sleep.” No one wanted all these things to be true more than me, yet I was only getting worse. The worse I felt, the more OCD applied the “must” and “should” rules that continued to lead me down a horrible path of self destruction, or OCD demolishing my life. OCD told me I had no room for error or else I would lose everything I had worked for. Yet the factors I became unable to control were the people in my life that loved me and no longer knew how to help. OCD was not pleased when the reassurance-providing ceased and the people closest to me stopped participating in the cycle. OCD really isolated me at this point. I could only engage in the things and with the people I could control, those that would play into their roles in continuing the cycle.
And the cycle continued. Things really turned left in the blink of an eye. I lost my best friends, and my college was strongly advising me to take time off to seek treatment. And that’s exactly what happened. I packed up my belongings, went on medical leave, and went home. Nothing was just right anymore and my perfect image was shattered. I went on to have two more assessments, one that diagnosed me with OCD and one that diagnosed me with anxiety and depression. I started an intensive outpatient program at the same place that diagnosed me with anxiety and depression, because that diagnosis was familiar and deemed the acceptable mental illnesses to have. However, the treatment provided was still not helping, so I went back to the place that diagnosed me with OCD and got a full YBOCS (Yale Brown Obsessive Compulsive Scale) assessment.
"[I told] my therapists, 'I do not have OCD.'”
I still remember my actual first day of starting ERP in intensive outpatient therapy, telling my therapists “I do not have OCD.” Looking back at it I giggle at this moment because my obsessions quickly morphed into doubting my diagnosis. At the time of my assessment, my YBOCS score was severe — the recommendation was residential ERP. But my therapists trusted that I was extremely motivated and self-aware, so they were willing to let me go through ERP through an intensive outpatient program.
So, to answer your question, I probably had been living undiagnosed for close to 12 years and misdiagnosed for three years.
What additional obstacles have you faced as a Black woman with OCD?
I immediately think of a moment in my misdiagnosis journey involving the unbothered ease of a clinician prescribing an antipsychotic without proper assessment. This should be alarming, but realistically this is a common experience for African-American women. Many statistics show the disproportionate rates of the quality of healthcare that women of color receive compared to their counterparts.
In addition, my experience of going to predominantly white institutions for undergrad and then for pharmacy school put a heavy weight on my shoulders. The room for error is very slim for a black woman aspiring to be a pharmacist. There’s a need to work twice as hard to create space in an institution when only 70 years ago there were laws saying someone that looked like me was not qualified to learn next to my white counterpart.
Every day there is added pressure to be professional, refrain from showing anger, be polite, and assimilate through outfit and hair styling choices all to continuously prove that my place in the room is deserved. And I say deserved because of the belief that we are all created equally by God and no one is better than another person, yet more times than not the space does not feel deserved but rather a space I must continue to earn. That in itself can be daunting, especially in a time of injustice and upheaval directly impacting the Black community.
The pressure intensifies to put on a smile and hide the hurt, as does the fear that goes along with having black skin in the professional field where no one else looks like you. Their privilege allows them to continue to live carefree in spite of their benefit from inequity and systemic racism.
OCD amplifies feelings of having to prove my worthiness in everything I do. There’s a need to be perfect or for things to be just right, and to follow stringent rules to gain certainty in every single situation. Truthfully, most days I am exhausted from the internal battle with OCD. And to work so hard in my recovery each day and then to face the world … I feel like I need a break, from my mind and from the world, but that isn’t an option. The priceless value of my life, the deserved right to take up any space, the acceptance of my imperfections, my well deserved achievements, my loving relationships and continued contribution to my communities; all are truths that are attacked by my mind and then by the world.
"I need a break, from my mind and from the world, but that isn’t an option."
Being Black actually caused obstacles in my ERP treatment as well. As I have touched on, the root of my OCD is centered around “What if I am not worthy?” and the majority of my actions are driven by the what-ifs of what others could potentially think about my actions in all realms. For example, the discomfort caused by me sitting in a coffee shop without purchasing anything or the discomfort of going to a store and not purchasing anything. The intrusive thoughts often expand from “What if people think I am stealing,” to “What if people think I can't afford anything,” to “What if people think I am going to hurt someone” — basically all the what-ifs associated with everything that is opposite of my values. So I complete compulsions to compensate for the distress of the what-ifs.
In therapy the idea came up to have me sit in a coffee shop or go into a store without buying anything for an exposure, but we had to debrief the unpredictability of racism, which unfortunately was very mixed up in my obsessions. My therapists — who are not people of color — were great in acknowledging their inability to know what it was like to have OCD let alone be a Black woman with OCD.
While I am blessed to have found an OCD community, which has helped to alleviate the lack of understanding of OCD, I’ve still felt a level of isolation. I think the reason for this is twofold: OCD is not well understood and often misdiagnosed, and within the Black community people are not always encouraged to seek mental health services, let alone be open about suffering from a mental illness.
Stay tuned for Part 2 of Jasmine's story, coming soon!