1. Kai
    February 26, 2019 @ 8:28 am

    Hello, Mark.
    I’d like to lead off by saying that your videos about OCD have been a critical component in what has helped me overcome a large majority of my issues with practicing poor mental health.
    I have struggled with OCD (noticeably to myself) since I entered my early teens. I struggled with multiple themes, engaging in checking, reassurance seeking, ruminating, etc.
    At this point in my life, with the help of your videos and therapy, I have cut out a majority of my overt internal and external compulsions.
    Here’s my question – With the help of ERP, i currently rarely experience anxiety in the extremes that i used to, and when I do, I push into it’s discomfort.
    But what I am currently left with is medium to major-grade depression. Before and through the peak period of experiencing symptoms of OCD, this med-grade depression was present. What I’m wondering is – could it be
    a well-disguised extension of OCD? I haven’t noticed you touch on the subject of depression very often in your videos, and I’m curious about your perspective.
    Why I believe it may be an extension of OCD – My personal experience of depression is a consistent cycle of me engaging in inactivity, due to not wanting to experience feelings I don’t like.
    For example – I have chronic low energy, despite undergoing routine checks with bloodwork and finding nothing, maintaining a healthy diet, regular sleeping patterns, regular exercise, etc.
    Feeling so exhausted a large part of the time leads me to disengage with my responsibilities and spend days, sometimes weeks, watching television and procrastinating (a compulsion, I believe).
    I tend to consistently try really hard to be self-disciplined, run out of energy, engage in inactivity, which triggers depression, which in turn makes me do much less of what I want to do.
    After a few weeks of inactivity (a type of relapse in engaging in compulsions?), I’ll be so fed up with myself for being unproductive, I’ll come back to being very disciplined for a couple of weeks.
    And then I’ll get tired, and the cycle repeats itself.
    Though I don’t practice overt and typical OCD compulsions at this point, this pattern affects my life a lot and I want to be on a course of consistent recovery.
    Do you have any tips for staying on track with your recovery process?
    What do you recommend I do with having a diagnosis of both OCD and Major depressive disorder?
    My feelings of low-motivation/poor self-control are contributing heavily to my depression and quality of life, and yet I still find it hard to consistently practise healthy, pro-active behaviour.
    Am I feeding the thought that I am too tired to engage in activities by engaging in inactivity? Or am I genuinely tired? Does It make a difference?
    Do you have any specific tips for those struggling with depression who have struggled/are struggling with OCD?
    Apologies for this being so long and thanks so much,


  2. Mark
    March 1, 2019 @ 7:41 pm

    Hi Kai, it’s great you’re noticing these things. One way of viewing mental illness is that it’s just the practice of trying to avoid and control experiences we don’t like, across all diagnostic labels. This is actually the reason, when I talk about compulsions, I say they’re reactions to “feelings you don’t like”. Our brains can throw up whatever experience will get us to react with compulsions. The brain doesn’t care what labels have been stuck on it. And that’s also why I encourage people to not get too hooked on mental illness labels. I only have one brain. So I wouldn’t approach “OCD” and “depression” separately. I have experiences and I need to learn skills to handle those experiences and do the things I care about in life instead of putting those experiences in charge of my actions.

    When we’re struggling, we get stuck on this unhelpful pattern IF X THEN Y. For example: IF X (I’m anxious about the party tonight) THEN Y (I shouldn’t go) or IF X (my relationship could get contaminated by an intrusive thought I had today) THEN Y (I should reschedule my date for next week) or IF X (I’m exhausted) THEN Y (I should just watch TV). Recovery and building better mental is all about breaking these patterns. So something that helped me a lot was learning how to feel bad while doing things I cared about. That feeling of exhaustion or tiredness can be there and I don’t have to control it. I can make space for it and figure out how to move towards my values while it’s there.

    Something else that helped me was to recognize that I’d gotten hooked on feeling terrible and I used that to pressure myself to get productive. But that’s a poor fuel, and you can see why: we just have to get angrier and more stressed and procrastinate even more before we get productive. This stuff all gets wrapped up in judgments–judging how we feel, judging what we’re doing, judging our brains, judging our health, etc. But we can simply notice, in each moment, that we have a choice, with whatever thoughts and feelings we’re experiencing. We can choose to do something in that moment that we care about. That’s all. And take a step.


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