Am I experiencing 'Pure-O' OCD? I feel lost...

Is it bad to self-diagnose? I have seen so many psychologists since I was a child, and while I have been diagnosed and have taken medication for panic disorder and depression, the idea that I have have been struggling with OCD has never crossed my mind.

I'd like some advice from people who have direct experience with 'Pure-O' OCD...Someone to tell me whether they can relate to my experiences. It's interesting, because I don't believe in pathologizing people's experiences, but I find that it can be validating to connect with people who have gone through similar things, and to see myself reflected in others. Sometimes putting a name to a feelingcan help find new coping strategies, and that's what I'm looking for here.

Anyhow, I've dealt with anxiety my whole life. Panic attacks that sometimes come from seemingly nowhere - or nowhere logical - severe social anxiety, constant self-doubt, irrational fears of friends and family dying or being injured, and blaming myself. I had my anxiety mostly under control after some major life changes occurred, especially after I learned the value of seeking out and accepting support, and learning how not to feel ashamed or guilty for leaning on my loved ones. A few months ago, after moving into a less-than-perfect roommate situation with a couple, where I felt like a visitor in my own home, my anxiety resurfaced. It has escalated to the point where last weekend, I felt almost unable to move, sweating, coming in and out of panic attacks. I had that familiar elephant-sitting-on-my-chest feeling, completely unrelenting.

The anxiety seems to be stemming from constant feelings of guilt and responsibility - irrational beliefs that my minor mistakes at work will ruin people's lives, that I will be responsible for the downfall of the organization I work at, that I'm hurting my partner, that she couldn't possibly love me. I often have a very hard time sleeping because I am constantly visualizing the harm that I could potentially be causing others. I am constantly confessing my anxieties to my co-workers, girlfriend, friends, and family, and they all reassure me, but it gives me little respite. And even when I am reassured, it only takes a few hours before I find something else to obsess about and blame myself for. The other night, I was spending the night at my girlfriend’s house when I was suddenly overcome with the unfounded feeling that I had left my oven on at my apartment, and that I was going to kill everyone in my building. It was one in the morning, and I went all the way home to make sure that it was off. Even though I know logically that my fears are unfounded, I cannot stop thinking about them.

My anxiety has become a constant nagging. I scour the internet for hours, fact-checking, literally searching for things I've been wrong about, and subsequently torment myself about it. I've never thought about my obsessive thinking in terms of OCD, especially because I don't show the tell-tale signs. I don't have very observable 'neutralizing' activities. When I was younger, maybe... I have struggled with self-harm and anorexia when I was much younger (14-18), and in hindsight, I can understand those things as ways to ‘neutralize’ anxious obsessions, or to feel a sense of control when I feel out-of-control. More recently, my obsessions have been very internal. Playing word games in my head, watching TV for hours, playing the same game on my phone over and over again... I sometimes even find myself even wishing to find a new anxiety to obsess about in order to neutralize the current anxiety.

Does this sound like 'Pure-O' OCD to those of you who experience it? Is it possible to experience OCD in waves? Because sometimes the feelings of guilt and self-blame subside for a few months, only to resurface when I least expect it. If so, what kinds of coping strategies would you suggest?

Hi, j.ezra. Believe me when I say that I know EXACTLY what you are going through. Pure O OCD can be very hard to diagnose because, as you mentioned, there are no outward or observable compulsions--only mental neutralizing activities. Because of this, the OCD diagnosis is often overlooked and a diagnosis such as Generalized Anxiety Disorder is often applied (which you may very well have--this is why it is important to get evaluated and tell your therapist exactly what you shared here).

I was diagnosed with Pure O OCD back in February of this year, and it has been a long time coming. I first experienced Pure O OCD back when I was nine years old, during the summer of 2000. My mom was working nights at the time, and when I forgot to say goodbye to her one night before she left, I spent the entire night worrying. "Oh my gosh, I forgot to say 'goodbye' to her like I do every night. What if she dies in a car accident and I won't have the chance to tell her how much I love her?" The worry actually made me physically ill, and for the rest of the summer, I had a fear of dying. I always made sure that I said something kind to my friends and family before I went to bed at night because I feared that something would happen to them if I did not.

Over the years (mostly during the summers when I was out of school and my mind was not otherwise occupied), I had other obsessions. When I was thirteen, I had a fear of killing myself. I did not WANT to kill myself or die by any means, but everytime that I was around a razor or a knife, I had the fear that I would slit my wrists, die, and go to hell--and there was nothing that I could do about it or anything that anyone could do to help me. A couple of years later, I became afraid that I was a lesbian--despite the fact that I clearly liked guys and had never been attracted to women. But there was that niggling of "Well, what if I really DON'T like guys." It was the doubt that was tearing me up insisde, even though it was completely irrational to feel this way because I was straight. I've also feared self-harm and harm to others in many other ways. "What if I just drank that bottle of nail polish remover or huffed that can of computer duster?" "What if I forget to check the pilot light on the gas stove and everyone in my apartment building dies?" "What if I don't pick up my trash at a restaurant and the employee who is in charge of this area gets fired?" Over the years, I've also been afraid that I was (or could "potentially" be) a pedophile, an animal abuser, or a psychopath/murderer. It was the latter fear of "possibly" being a murderer that caused me to check into a psychiatric hospital back in February, where I received my diagnosis and was put on an SSRI (Prozac) for the obsessions and was recommended to get cognitive behavior therapy.

The good news is that if you DO have Pure O OCD, most patients (I believe 90-100% from what I read in a previous article) can fully recover with therapy, medication, or some combination of the two. I know how scary it is to have this disorder. It feels almost like having a secret life that isolates you from everyone else. You are constantly ruminating and trying to come to a definite answer (whether it is concluding that you really do love your spouse or that you do not have the potential of being a psycho killer), and it takes over your life. I ruined this semester of school and ended up losing my job because I let the obsessions take over and had to be hospitalized a month ago, so I know what it feels like to be totally lost and debilitated by OCD. My family didn't understand what I was going through during my hospitalization. "Just remember the times that you were happy and try not to think so much about how you feel."

If it were that easy not to "obsess", it wouldn't be called Pure OBSESSIONAL OCD