My Life with OCD and Social Anxiety Disorder

By Anonymous

I have been suffering from obsessive compulsive disorder (OCD) and social anxiety disorder since childhood. Today, I understand my diagnoses and how they affect my ability to work, especially in a country where mental illness isn’t usually understood.

However, I wasn’t correctly and properly diagnosed with these illnesses until I was in college. This was partly because I spent my childhood and adolescent years mistaking the symptoms for being a normal part of life that other people also went through. I erroneously thought that my classmates in school were also dealing with these symptoms. But, in actuality, that wasn't the case.

My symptoms included extreme anxiety pertaining to an imagined HIV infection. This led me to perform highly disconcerting and time-consuming mental compulsions to ensure my safety and convince myself that I wasn’t infected. Even though there was strong evidence that I was physically well, oftentimes I found myself overwhelmed with fear.

When I was a child (around nine), I was appalled by the mere sight of blood. When I was 13, the school I was attending incorporated an "Ethics and Morality" class into our curriculum in which they taught us about the dangers of HIV/AIDS. That was the moment my fear of the disease began to control my life. I also started to equate seeing blood with automatically getting infected with HIV; it didn't matter if it was in a movie or in real life.

While completing an elementary school science project that involved making a miniature wooden house, I accidentally pricked my finger with a nail. I then had mental compulsions that I carried out for a prolonged period of time to ensure myself that the nail was fresh (new) and hence couldn't have been contaminated with the virus. This resulted in severe anxiety that I found unbearable.

As I reached my early 20s, the fears moved into other aspects of my life, where I became wary of sharp objects like razors and needles. A simple task like shaving my facial hair with a razor blade became a trigger for my OCD. To curtail this from happening, I meticulously tried to avoid situations that could aggravate my anxiety. As a result I went without shaving for several weeks in order to ensure that I didn’t get infected via sharp objects. The mental and physical compulsions that I carried out endlessly to guarantee my safety proved to be extremely painful and exacerbated my anxiety.

I also avoided going to any cafeterias or restaurants to drink or eat, lest they would serve me a drink with an unwashed cup or food with an unwashed utensil that might have been used by a previous customer who might have HIV.

I’ve had other symptoms unrelated to HIV/AIDS. Throughout my academic life I have also struggled with the fear of having the knowledge I have in my mind transferred to another person's mind. In order to check that it didn't happen I used to repeatedly memorize and recite what I studied to prepare for exams which included every word.

Moreover, I used to spend a protracted period of time checking if the faucets were turned off and the electric appliances were unplugged before leaving the house. Trying to leave the house became a dreadful experience. I would go back and recheck everything lest I forgot to switch off something.

In addition,  it has always been very difficult for me to socialize with other people. I find it unbearable to converse with people. I have been unable to work due to the constraints caused by my OCD and, especially, social anxiety disorder. Since work is mandatory in order to lead an independent, productive and functional life, I have made it my mission to find one where the setting provides empathy and compassion for my OCD and social anxiety disorder.

In Ethiopia, it is safe to say that public awareness about OCD, social anxiety disorder, and other mental health conditions does not exist. The major reason societal awareness about mental illness is nonexistent in this country is because the majority of the populace equate mental health disorders with “demonic possession” and other faith-related phenomena. Whenever I find it difficult to function in a social setting, it is perceived as a character flaw and aloofness by others. This usually prompts people to treat me derisively and, in some cases, act hostilely towards me.

I consider myself lucky because I have an extremely understanding mother. Hence, the only solace and support I get is from my mother and, occasionally, from my therapist. But there is nothing genuine being done about mental health here in Addis Ababa (Ethiopia), let alone the provision of accommodations for a conducive work environment for people with OCD and/or social anxiety disorder.

The only way to accommodate people like me who suffer from OCD and/or social anxiety disorder is by educating employers about these illnesses and training them to not only be willingly tolerant of but also compassionate and empathetic towards people who suffer from these conditions.

Oftentimes most people feel obligated to feign ephemeral concern and tolerance towards those of us who suffer from mental health conditions out of pity, thereby prompting them to treat us contemptuously rather than out of genuine concern and empathy. They don't see us as having the capability to earn a living by ourselves if we are provided with accommodative opportunities. Hence, instead of paving the way for us to be independent, people (including employers) deliberately deprive us of getting the opportunity to hold job positions that we are more than qualified for, solely due to the fact that we have some difficulties arising from our illnesses that they mistake for weaknesses. During the job interviews I have had, the would-be employers were momentarily tolerant of me for a couple of minutes which immediately devolved into their impatience and disparaging criticisms of what they perceived as my "social ineptitude" and how "I lack the social skills required for the job and how fidgety I am during the interview and if I suffer from substance use disorder". I have always been a lifelong teetotaler and have never had a predilection to abuse substances. Hence, I have become accustomed to such speculative, offensive and derogatory remarks made by interviewers. If these people get mandatory training and education about what mental illness is and that the condition is real and not a "malediction", then they will hopefully and gradually learn to show genuine tolerance towards and be supportive of us. I am neither a policymaker nor possess the influence to bring such much-needed changes in the work milieu in this country that could be inclusive of people with mental health conditions, but I staunchly believe that these changes should be made in order to make the hiring process more considerate and welcoming. That would be a good start, followed hopefully by making the actual workplace accommodative to us through the implementation of the aforementioned mandatory training and education to the staff(employees) as well, who can become learned and, therefore, respectful colleagues to us. But judging by the status quo in this country, it is going to take a very, very long time for these changes to come to fruition when and if ever they are implemented.

It is only when these practices are enforced in the workplace and become the norm that people with such mental health conditions can fully benefit from and enjoy a productive life.

Moreover, effective treatments for people like me who suffer from these disorders should be made easily and widely accessible in Ethiopia.

Invaluable and appropriate resources needed for the delivery of such treatments are unfortunately not widely available to sufferers, including me, which can be exemplified by the glaring dearth of mental health professionals, most notably, psychiatrists, in the country.

My initial visit to see a psychiatrist happened serendipitously. When I was in college, I went to see a medical doctor for a persistent headache and earache I was having and was subsequently prescribed medication which didn't help. So, the physician recommended that I see a psychiatrist he was acquainted with. I have been under the psychiatrist's care ever since. However, I only have sessions with him, at most, twice a year. I have also been on anti-anxiety medication for a long time and still am. As also prescribed by my therapist, I apply exposure and response prevention (ERP) method to confront and deal with some of the intrusive thoughts (obsessions) and consequently refrain from carrying out the compulsions. But I have learned through experience that ERP is not always a foolproof method. There are some obsession-triggering situations that you just can't intentionally expose yourself to and then expect to fight against and refuse the overwhelming urge to perform compulsions. Since the occurrence of obsessions is cyclical in my case, as evidenced by a new intrusive thought almost always supplanting an older one following the neutralization of the latter, instead of dealing with each obsession separately when it happens as per ERP, my therapist, my mother and I are trying to train myself to be able to develop the capacity to somehow stop performing the compulsions altogether, as it is these compulsions that exacerbate the ensuing anxiety. I am trying to gradually habituate myself to indiscriminately refraining from performing any type of compulsion, irrespective of severity. It is an ostensibly impossible task to achieve given the chronic nature of OCD but I am seeing some progress in my quest to fully control my OCD.

Genuine community-level mobilization and calls to action could bring about public awareness to this neglected realm of medicine, i.e. psychiatry, in this country, thereby benefiting people like me who need access to modern forms of appropriate treatment and care that the field can offer.