This theme is awful

Yes, this is what makes ERP for this so hard. We’re told to “accept” thoughts as thoughts with any ocd theme, but with suicide, you read that any thought of suicide is dangerous and you need to seek help. And beyond that, I mean, let’s be honest, it’s just not a pleasant thought to have period, right? But what’s weird is I’m only particularly afraid of one way of hurting myself, even though there’s other, easier ways I could do it, but I don’t care to do those other things and they don’t scare me (driving a car, taking medication, holding a knife) and so on. So, yeah this theme is so hard.

I had that realization tonight I think. When I went through SOOCD, I could purposely lean into the thoughts and the anxiety. If I had an intrusive thought about who I’m attracted to, I could play along with it in my head. Whether it was during an exposure or just completely random. With this theme, I don’t think I’ve fully sat with the thoughts to the best of my ability. Like yeah, I’ll say the thoughts out loud, I’ll do a physical exposure even, but I won’t actually sit and “accept” them. And when the thoughts hit unexpectedly, I’ll try to “accept it” then afterwards say, “nah I just can’t do that” and reject it. In reality, I have to sit and go all in, like I did with SOOCD. Also too, what I’ve noticed is my current and precious anxieties get tied into this theme. I was going through loneliness and anxiety from that before this started. And now my mind will say “well you felt lonely so maybe you do want to kill yourself” and then I get the anxiety and harmful images that follows. But growing up I never once felt that way anytime I felt anxiety or depressed, and this theme now started from an intrusive thought. Everything I’ve described, plus the fact of what society tells us to do when any time this comes up in our head, makes this so difficult. But I think you’re right in the sense of, I need to lean all in, 100% to ERP with this, not half-ass it.

This resonates with me. ERP has also helped me embrace uncertainty and work on breaking the OCD cycle. It is hard and scary but definitely not analyzing the thoughts, and in my case not ruminating or seeking reassurance, helps in the longrun (these are basically the compulsions). Also sometimes the goal for me is reducing or delaying compulsions.

@Recoverer I literally have very similar obsessions like the example you gave. I think leaning into ERP will help you, you got this and have the tools! 💪🏼😊 Rooting for you!

@Recoverer I’ve had thoughts like that too. Feeling sad, angry, depressed, etc are all triggers for me. If I got upset about something I would start to panic that I’d become depressed and want to die. Then I’d repress all emotions which only led to even more distress. It was a constant fight with my own mind, because emotions are all neutral, not good or bad or safe or dangerous. But as a result I also restricted myself so much - I would avoid anything that could upset me (news, hanging out with people in fears of having upsetting convos, social media, etc.) and I restricted all the food I ate (no alcohol, caffeine, soda, “junk food”) because I believed the chemicals would make me depressed. I forced myself to exercise and wake up early in hopes it would help me avoid depression. But all of that wasn’t what I really wanted to do and it make me feel like I was on a constant hamster wheel of trying to avoid depression and “bad” feelings just so I could stay alive, when in reality none of that was helping me. I had to lean into erp to get my life back, and a lot of the exposures seem scary but doing them has improved my symptoms 90%. I still get thoughts, but I try to at least tell myself “that could happen but I don’t think it’ll happen right now” and move on. While intellectually I don’t like thinking that way, it tells my ocd that it doesn’t have anything to grab onto. Those thoughts become so much less threatening and I regain my power over my own mind- or at least become better friends with it. I also had to stop beating myself up for my thoughts. Self compassion has been a huge part in my recovery as well.

@MCT Your situation sounds exactly like mine. Do you think ERP would be the best option for me in this case ? I have my first session next week . So scared to even feel a little sad or off cus I fear I will be depressed and hurt myself

@Vero G Did you ever do any physical exposures as well? Like anything with objects? My fear is centered around only shooting myself, even though I don’t have access to a gun on my own and I don’t care to buy either. But I’m afraid of wanting to buy one and do it, or doing an exposure with one and doing it. I used to be afraid of knives but that’s gotten better. And I also don’t care about driving, taking meds, or anything like that. It’s just guns. And you’re right, it’s so hard to lean into anxiety with this because…I mean, suicide is the worst possible outcome someone with a mental health crisi can do, so to “accept” these thoughts…oof

@MCT I feel that, I would stop watching shows with guns in it because I’d get triggered, but I had to realize “if I’m gonna stop watching something, it’s gonna because it doesn’t interest me anymore, not because I need to avoid it since I’m afraid” because that’ll feed the fear. It sounds like you’re doing exactly what I need to be doing too, leaning into the anxiety and go all-in. So that’s interesting that I may have had the right notion before posting this. And I’m glad it’s helped you in your recovery and you’re able to distinguish the thoughts better. I hope I can reach the same place because I feel like this is my last ocd theme that I’ll battle because of how tough it is. And the fact I’m trying to work on other traumas/conflicts inside me along with the ocd.

@NrseKris Yes, with ocd, erp is the “gold standard” as they say. Think of it as not just ocd therapy, but facing a phobia.

@NrseKris Yes! I’m so glad you’re starting therapy. Without therapy I don’t know how I could’ve overcome my symptoms. And just dealing with the ocd itself was putting me in a dark place. I felt stuck between fearing depression so I did things to combat it, but at the same time what I was doing was only sending me into a depression. I decided to go all in with therapy and do everything my therapist has advised me to do and it really has helped a lot. I’m a therapist myself so I do trust erp already, but doing it myself I knew I had to commit to have any chance of finally getting better. Living with ocd, and suicidal ocd at that, is agonizing. I couldn’t have helped myself on my own.

@Recoverer I have done some ERP with scisors and knives. But there are sooo many posibilities, you dont actually have to use an object. You can watch videos, read things, write scripts, etc. depending on what triggers you. This is where the therapist can also help you a lot.

@MCT It is so great to hear from others who have suicidal OCD and in a VERY similar way. I also did a lot of these behaviors and am still working on them. Love to see that you have recovered so much! Also self compassion is sooo important, I've also been working on it a lot, it is something new to me. 🙌🏼

@Vero G I’m glad you’re working on your recovery as well!! Suicidal ocd is really scary, there were many points I didn’t feel I could trust myself and I thought I would die. I felt so helpless, ocd is a brutal condition. But doing erp and learning more about it, and connecting with people who also have ocd/socd has been a life saver.

@MCT May I ask if there was any medications you used that helped or didn’t help ?

@MCT I get scared that an intense emotion is gonna come over me that I “can’t handle” and I’ll like snap and hurt myself or do something crazy cus of the emotion or feeling..

@NrseKris Yes I’ve had this feeling many times!!! My therapist has helped me learn to sit with my emotions. I’ve had to learn to stop avoiding my feelings and realize everyone feels angry, sad, etc at times. It isn’t inherently dangerous. What does cause me more distress is trying to fight these emotions, which isn’t helpful either. I can’t say what’ll happen in the future, but up to this point every time I feared acting on my obsessions it didn’t happen! It’s a miracle 😉 I always try to keep the uncertainty though - like I know objectively right now I don’t want to hurt or kill myself, not sure how I’ll feel in the future though. Just like everyone else.

@NrseKris I’ve taken an antidepressant for 10 years which I don’t think helps my ocd because I believe ocd is mostly cognitive (the way you think about and perceive things, etc). But I was recently prescribed hydroxazine to use as needed for anxiety and while I’m afraid of taking it when I’m having symptoms, I’ve forced myself to do it and it has helped me calm down. I still need to do erp though.

@MCT Thank you for replying, I need to learn how to sit better with my emotions instead of fight or run but sometimes it feels so scary and even tho I don’t wana hurt myself I’m scared I’ll do it just to “escape the feeling” but same here up to this point it hasn’t happened, and I try to remind myself all feelings are transient and pass eventually. I have a 6 yr old son im a single mom and I fear so bad leaving him behind alone , I don’t wana leave him

@MCT I was prescribed lexapro but scared to start it, and clonazepam for acute anxiety but I haven’t taken either it scares me knowing there’s a bottle of pills I could swallow sometimes I wana flush them

@NrseKris That must be really scary, especially when you have a kid. But I think implementing self compassion and realizing we all feel these emotions and they all serve a purpose is important. I can completely understand your fear though, I’ve been there myself. I was already emotionally avoidant before my symptoms got bad, which I think contributed to my ocd in the first place. Learning to sit with sadness and anger and be ok with being uncomfortable has been huge in my recovery. I’m not perfect at it yet, and it still sucks to feel sad, angry, etc., but it goes along with that “what you resist, persists” notion. It’s so true!

@NrseKris I totally understand. It’s a good exposure though! For those of us with socd there will always be potential means around us. And even if there weren’t and we were truly suicidal, we would get our hands on them anyway. I was afraid of a lot of things, knives, pills, plastic bags, belts, scarves, exposed beams, balconies, etc. But I also look for any potential means bc my ocd is always scanning for danger. We can’t live in an empty box of safety, that would be no life at all!

@MCT Have you ever had plenty of moments where no matter what you do (especially after starting ERP) that the thoughts were true and you really were suicidal? That’s what I’m struggling with now. Like I’m accepting all of the thoughts as they come in, but it hasn’t clicked with me yet that “hey, this is ridiculous, this is just my mind being paranoid”. Like my anxiety is staying down and I ruminate less, but I have yet to realize that I don’t actually want to hurt myself. It still totally feels like I do, even though I can’t think of a legit reason to actually hurt myself.

@MCT Wow you really sound a lot like me. When all this started almost 10 yrs ago I was 19 , and I was terrified of everything-I’d rip up plastic bags and throw them away, hide knives, flush pills, throw away ropes and belts.. Over the years it came and went but the theme always stayed the same. I had done traditional therapy but never ERP cus I hadn’t gotten the ocd diagnosis until recently. The theme stays the same but kinda shifts, like right now I’m just afraid of my emotions and becoming depressed but I’m not hiding or throwing things away. Mostly just the thoughts and feelings itself that scares me

@Recoverer I guess I have the “advantage” of having actually been suicidal when I was younger. I also work with people who have true suicidal ideation and have tried to kill themselves. To me, the difference in my experience now and my experience as an adolescent was that I didn’t have any fear or anxiety around wanting to die, hurting myself, etc. It was more like a fantasy to me. But I also worry about being more “capable” or “likely” to kill myself because I self-harmed and had SI in the past. And although I know that socd and true SI are different, even in my own experience, it doesn’t help me when I’m experiencing obsessions. But deep down and logically I know they’re different. But ocd isn’t logical so it doesn’t make much of a difference.

@NrseKris I totally get that!! That’s why I’ve had to work a lot on emotional acceptance and sitting with emotions.

@MCT What I’ve also learned in erp is that we have to take the risk of not knowing. We have to stand up to the obsession and say, this could happen, but I’m not going to try to find out right now.

@MCT Thank you so much for replying, I’m having a hard time at work right now cus I think I feel down I’m not sure I just know I feel weird and I’m focusing on it and it’s making it worse and I’m trying not to panic I really fear it’s depression I’m scared of getting worse and wanting to die I’m really scared and don’t know what to do right now I just want to feel better

@MCT I don’t wana die but I’m scared that I won’t feel better and it will lead to that or that an emotion will be too overwhelming for me it’s hard being at work right now and feeling this I’m trying not to panic

@MCT I’m not sure maybe I’m ruminating but I get so scared that the feeling will intensify so much that I just do something bad to get rid of it I don’t want that to happen

@NrseKris Something I’ve learned in erp is that you don’t need to get rid of those feelings. While they’re agonizing, I know, they aren’t dangerous. Feeling panicked or anxious doesn’t make your fear more likely to come true. Trying to get rid of that fear results in compulsions, which we don’t want to engage in if we’re in recovery. Which means sometimes we just have to sit with that feeling and resist ruminating, trying to change our thoughts, other compulsions, etc. We don’t have to know the answers right now, we just have to feel the fear and push through it! I know it’s so hard to do but with practice it gets easier and your ocd won’t have anything to hold onto.

@MCT Like how would I know if this is something severe and I need to go get help asap ?? Like emergency ?

@MCT Thank you. I’m trying. I guess I just want to know if it’s bad to the point I should like go admit myself in a hospital or something ? Like sometimes I can’t tell if it’s a panic attack or I’m in a crisis it’s so scary

@MCT Like if it is depression, how do I accept it and let it be there without fearing it ?

@NrseKris The only problem with going to the emergency services is with ocd, you won’t get certainty on whether or not you’re in danger. In fact, what can happen too is strengthen your fear that you’re in danger, and make you even more anxious and upset. But if you actually feel like you’re in danger, always feel free to reach out. But with ocd unfortunately, it can be very tricky.

@Recoverer In the past when I was younger and I went to the ER for this they didn’t keep me because they didn’t think I was actually a harm to myself or someone else, but I still have the fear. It’s more of a fear of acting on impulse than actually wanting to or planning it

@NrseKris I totally agree with Recoverer. At the height of my symptoms I was researching inpatient facilities, thinking about going to buy clothes for when I’d admit myself, watched videos on tips for hospitalization, etc. I was really close to admitting myself, but I have family that supported me. Looking back, I don’t think hospitalization would’ve been a good idea for me and I’ve heard other people say that for ocd as well. Unless it’s specifically for ocd treatment. I think if you truly believe you’re in danger and have made a decision to try to kill yourself you should reach out. But as recoverer said, it is tricky with this theme. At the core of it you have to sit with the uncertainty of potentially dying by suicide. But if you do think you’re really at risk of dying, feel free to reach out for help. Only you can make that call.

@MCT Yea, I definitely don’t have a plan and I don’t want to die so it’s just that fear of acting on an impulse or an emotion. You see it in movies or hear stories like that happening so it’s just really scary. Also not being sure if I’m depressed or not scares me. I have my first session with NOCD therapist on Wednesday

@NrseKris I’m so glad to hear you’re getting into counseling! I think what you’re going through is what we’ve all dealt with when it comes to suicidal ocd. I hope you can find comfort in knowing you’re not alone and that recovery is possible!

@MCT Could you share some of the suicide OCD exposures?

@JessieB My therapist had me to a narrative exposure where when I get an intrusive thought, instead of trying to make it go away I think about what it would look/be like if that happened. Like “I feel sad, then I decide I’m going to k*ll myself so I go into my bathroom and take a knife… etc.” You can write these out or say them out loud. It was difficult but very effective and I still use this one. Also just saying back to my thoughts, “yeah that could happen,” “that would suck,” “I don’t feel that way right now but who knows about later,” etc. In session we’d talk about suicide as an exposure as well, but not try to figure out the why.

@MCT Now when I feel the need to google something I’m able to identify that it’s a compulsion so I also just don’t do it and work on accepting the anxiety and distress in the moment rather than trying to change it.

@MCT That’s my big compulsion is googling/research. And rumination. Thanks!!!!!

@JessieB Literally same. Before ERP I was stuck in a constant loop and it was horrible. But now I know what my compulsions are and what keeps my OCD going so I just try not to do those things because I don’t want my symptoms to get bad again!

@MCT 💯💯💯

It doesn’t even seem fair to have an obsession about this, it really is rotten.