Category Archives: Depression

Tuesday Q&A: Mike Michel

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Please welcome Twin Cities musician Mike Michel! Mike has had obsessive-compulsive disorder (OCD) since childhood, but another chronic condition, tinnitus, reared its ugly head a few years ago and turned his life upside down. Suddenly everything he loved—not to mention his livelihood—brought him pain and frustration. He didn’t give up, though, and he’ll tell you all about the journey himself. (The twist is that obsessive Googling eventually led Mike to the right help, but I know you won’t take that as justification, right?) Thanks for sharing your story, Mike!

When you were diagnosed with tinnitus in 2013 you took a hiatus from your career in music. After years of seeking treatment and finally getting some relief, you recently released your latest album, On The Mend. Can you tell us more about the album and how you were able to complete it?

On The Mend is a new recording and music campaign dedicated to raising awareness for invisible brain conditions. On The Mend is my first acoustic recording and draws upon afro-cuban grooves, positive messages of resiliency, and creating memorable melody. It was written during the midst of me being diagnosed with severe tinnitus (auditory cortex malfunction) and hyperacusis (extreme sound sensitivity). Both conditions were exacerbated by intense rumination from chronic OCD issues. Despite living with conditions where there are officially “no cures” I wanted the record to be upbeat and hopefully a healing tool for others.

After 20-plus years of being a professional musician, I made the decision to stop recording, writing, and performing music when these conditions were at their worst. I’m a music educator as well and I also cut my teaching duties by 70 percent. Since music and the arts is all I know, all I’ve ever trained for, and my highest life-skill set, I was traumatized and fell into a deep depression. My situation was unique as I was dealing with some genetic pre-disposition to these conditions (brain gating), a sphenoid compression (old head injury), and other variables. Musicians focus on developing their auditory cortex over many years, so it makes sense we’re more sensitive to sound over time as we are “always listening” for a pin to drop.

I reflected daily if this was a sign that I was supposed to move on from the arts. I looked into going back to school, volunteered at a mental health treatment center for seniors at a local hospital, and sought counseling and spiritual advice. Needless to say, nothing gave me more of a sense of purpose than my music, so I made the challenging decision to somehow get back into my craft in any way, shape, or form.

My OCD did come in handy, as I was a vigilant researcher of my conditions (insert smiley face). After a year of Googling, I came upon two people who had severe tinnitus and hyperacusis and they wrote books on how to heal yourself. That gave me hope and energized my will to carry on, so I pulled out an old classical guitar that belonged to my sister. Classical guitars have soft strings. Miraculously, strumming that instrument without ear plugs didn’t spike my tinnitus. At this point I sold a lot of my electric music gear, and the sight of an amplifier made me sick to my stomach. It pained me that I couldn’t plug in. After a few minutes strumming the old classical guitar, I realized my depression was due to the fact that I had no sense of purpose. I started to write some killer melodies on the guitar and lyrics, messages, and good stuff flowed pretty effortlessly. I started to get the higher life lessons involved with illness, why I received my conditions, and what I had to do to overcome this. I was lucky, as I wanted to live. Some people with severe cases of tinnitus and hyperacusis literally check out or go insane. Invisible conditions based in the brain are tough, right? We just don’t know a ton about the brain yet, so that adds another layer of stress on really not knowing the complete picture of what you have.

God bless LinkedIn. Really! My old friend Adam Wahlberg owns a Minnesota-based publishing company called Think Piece. Think Piece puts out books and music that deal with mental health, wellness, and resiliency. I saw one of his posts about his collaboration with Adam Levy and together they were releasing a record called Naubinway. I reconnected online with Adam to say hello and we decided to have lunch and talk about old times and mental health. I told him my story about leaving music due to my conditions but that I was finding a new sense of purpose writing these little tunes on this old guitar. After that lunch we decided that in due time it would be cool to collaborate on a music project together and release these tunes. I called the collection of songs “On The Mend.” I was broke, very vulnerable, and isolating myself since I couldn’t go see live music anymore but really wanted to somehow mold this music into a record. I didn’t know how I would physically record On The Mend as my fear of sound was increasing, but I knew intuitively I was supposed to.

I decided to start a GoFundMe, and it was really scary asking for money. Not a habit of mine. I reached to students, friends, and family and raised enough money to pay for a recording and hire great musicians and engineers to help me complete the process. I was completely overwhelmed by people’s generosity. I truly did not expect to raise much. With the help of this miraculous event and wonderful people I wanted to fulfill one of my objectives and work with producer/engineer Jason Orris at The Terrarium. Outside of being a great friend and talented musician, Jason has also dealt with tinnitus and won. He’s really got a grip on it and has gone on to make lots of music in the last two decades. His energy and compassion are what I needed to see this record through. I had good days and bad and I limited my time in the studio. Recording with ear plugs was maddening and challenging. I could barely hear a thing during the recording process. Sound travels through bone (skull) and some days I would drive home with immense facial pain. I needed to go through that process and build my confidence back up. I had to teach myself how to sing again as it had been seven years since I’d sung a tune in a recording studio. That was a trip, but I was a disciplined artist for the first time in my life and I truly thank these conditions for rerouting me and getting me back on my new path as a songwriter and an activist.

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Having OCD myself, many lyrics in On The Mend spoke to me. Some snippets: Rumination leads to destruction. You look for reasons, you look for safety. Liberation comes with patience. Your pain is invisible…real as an open wound. Are any of the songs specifically about OCD, or was the whole album a reflection on chronic invisible illness in general?

Both. I was trying to make the connection on songs like “Full Of Positives” that mind and body are connected. This is not a new revelation to most, but for me I realized that 20–30 years of being nervous person, having intermittent sleep, and always thinking the worst can lead to illness. I was a workaholic and not hardwired to deal with it. I always thought I was type A, but I was wrong. I’m in the process of learning how to live life in a new way. My therapist calls it my lower gear. I’m prone with OCD and, with that, I always get things finished in a complete manner in a short amount of time. I’m always against the clock and having one task unattended to used to keep me up at night. I’m still working on this concept of “letting go.” I’m learning new mindfulness skills with my therapist and it’s becoming a part of my life, which makes me feel so relieved! On paper mindfulness looks easy, but for my personality type it’s like climbing Mount Everest.

How long have you had OCD, and when did you realize that what you’d been going through was OCD? Can you share some of your symptoms and the techniques you’ve employed to combat them?

My first signs of OCD were around the age of 11. I keep getting vertigo in my big old Catholic church in Cincinnati where I grew up. I went to my pediatrician and he diagnosed me with vertigo, but we never got to the source or triggers. It was in the early ’80s and the awareness levels for mental health just weren’t that deep. Vertigo led to heart palpitations, panic attacks, and two seizures that I never told anyone about till this article. My intense rumination was wreaking havoc on my body. I thought about death and dying almost every day for 20 years. An 11-year-old kid shouldn’t be thinking of dying every day. I have my traditional moments of checking the stove burner three times, scratching my head all night, grinding my teeth all day, and being manic about to-do lists. To date, I’m happy to report that I’ve cut the severity of most of my symptoms by 50 percent. Since I haven’t been working as much in the last three years I applied for MinnesotaCare (a blessing beyond measure). My main priority in the last three years has been working on my physical, emotional, and spiritual self. To me there is no separation between them. Our brains are made of neurons, chemicals, and electromagnetic energy. Mindfulness, soothing supplements, non-ototoxic anti-anxiety medication, and amygdala training have been key to my current recovery. I look at this as a lifelong journey, and de-stressing my life is my top priority each day. It’s very challenging in a modern world to do this, but I do try each day to live moment by moment and not five years ahead anymore.

Neither OCD nor tinnitus is an illness others can see, but tinnitus is perhaps more socially acceptable. How did you tell family, friends, and coworkers about each diagnosis? Did you notice a difference in how people seemed to receive the news?

Here’s the miracle here. I was highly concerned that people in my life would be uncomfortable around me if I told them about my struggles. My GoFundMe was my coming-out party. I just laid it on the line, the darkness, the history, the tinnitus, hyperacusis, depression, and OCD. I realized it wasn’t about me; it was about making a record to help others. So I took my ego out of it finally and said fuck it, I might lose a lot of friends. The opposite happened and I can’t even explain how incredible that felt. I was totally supported in ways that I have never experienced. It was overwhelming to receive that amount of love. Another lesson for me was about the art of receiving, but with humility, grace, and acceptance. I grew immensely from the GoFundMe experience.

Say a fan approaches you and says, “My chronic illness has a profound effect on my life, but people tend to downplay it because they can’t see it. How can I help them understand what I’m going through?”

This is tough again as someone with illness has the right to vent. Any illness is confusing, stressful, and exhausting. But if you become your illness it will stay on board. I found myself wanting to educate everyone about tinnitus and hyperacusis for a while but I realized it has to be in small doses. First, out of respect to myself and not becoming my illness, and second, not cramming information down people’s throats. I believe in a healthy balance of education and empowerment. The reality is that until someone has gone through a major illness they really are not going to get where you are and may not care that much. We hear this quote a lot from people going through a health crisis: “I want my life back.” That sits so deep with me. To me that means I want to do normal stuff like work in the yard, go to a movie, get groceries, go see a friend, or have coffee with someone. When you have chronic illness all of the daily things you take for granted are gone and the smallest things are struggles. Hopefully not forever. So, I’ve discovered having a lighter delivery describing my conditions along with a calm demeanor works best. Touches of humor help, too. The preachy thing doesn’t work.

Finding people who are going through similar situations was a priority for me. Every illness has different levels. I have at least 100 people in my life that I’ve met with tinnitus. Since the launching of On The Mend, I have received dozens of emails from people all around the world asking about tinnitus management tools. That’s a tricky one, as thinking about tinnitus all the time is a not a healthy move, as it brings your awareness back to your internal sounds and intensifies them. To deal with this predicament, my OCD came in handy and I wrote an eight-page tinnitus/hyperacusis management manual for musicians. Now I can simply send a compassionate PDF via email and get back to my day. I would like to restate that I’m a work in progress and my tinnitus manual is simply a collection of positive data and resources that can point you to the fabulous practitioners who understand these conditions best. Most tinnitus cases are mild. Statistics show that 50 million Americans have some form of mild tinnitus. Three to five million have severe cases like mine. The difference between mild and severe tinnitus/hyperacusis is immense. The latter is debilitating.

So heading back to your original question, there have been many moments during my wellness journey where I’ve been approached by people with mild tinnitus and they say “I just tune out my tinnitus and forget about it, why can’t you?” Judgmental tones like this are the truest test of one’s ego and are a fabulous moment to educate people about compassion, awareness, and empathy. The “you’re weak” look gets old, too. My biggest recommendation is learning to let go of these judgments and formulate a standardized rebuttal that leads to a respectful educational moment for your agitator.

You noted in an interview with The Current that while having OCD meant you ruminated on the tinnitus, making it even more unbearable, it also pushed you to seek help. You said, “The good thing about OCDand there is a good thingis that you generally are a very thorough personality and you’re very proactive.” What steps did you take to balance tinnitus, OCD, and depression?

I’m still working on all the above. I’m a work in progress for sure, but from day one I knew I was not going to accept the general medical community’s belief that there was nothing I could do and just live with it. I spent hundreds of hours researching. Google forums can be destructive, and I had many dark setbacks researching. Tinnitus and hyperacusis generally have dismal articles written about them because they are brain conditions that are completely unknown to most neurologists. It’s a doom and gloom subject for sure. Nobody wants to talk about hearing intrusive noises in your head. OCD did assist my attitude of never giving up. I was lucky in the fact that even through these most challenging times, including severe depression, I had a small spark to carry on and make this a mystical health journey to fulfill higher life lessons and to evolve as a person. OCD helped me be a bad-ass researcher. I finally found the needle in the haystack and found a dozen practitioners who have helped me over the course of three and a half years.

If you could share just one piece of advice with others with OCD, what would it be?

You can talk to yourself all day, go to a million therapy appointments to vent and process, but action is needed to manage these conditions. Rewiring the brain is what is really going on. I’m hardly a brain expert, but seeing a therapist and hypnotist taught me about the power of the subconscious mind. Taking physical action, rerouting the energy, and raising your awareness levels take work. Finding your triggers takes time. It’s deep, the deepest part of your being. Rewiring a brain that’s been acting the same way, say like mine for 30 years, can’t be done in six months. My OCD would like to think so, but doing little exercises each day in a healthy way adds up. Thanks for letting me tell my story! Here’s to a healthy mind!

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Tuesday Q&A: Denis Asselin

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Denis on his pilgrimage

Welcome back to Tuesday Q&A! I admit the hiatus wasn’t exactly planned; life and the holidays conspired to throw me off schedule.

I couldn’t be happier to kick off the New Year with this post from Denis Asselin, an amazing advocate who’s been working tirelessly and with compassion to spread awareness about body dysmorphic disorder (BDD) since his son, Nathaniel, committed suicide after struggling with the disorder for years.

We all know how misunderstood OCD is, and it’s possible BDD is even more misunderstood. Denis is working hard to change that. His dedication is inspiring — and, honestly, he is so nice. Incredibly, genuinely nice. You can’t help but want to help him tell Nathaniel’s story and join his cause.

I’m always amazed to see what a parent is capable of after the tremendous pain of losing a child. After your son, Nathaniel, committed suicide you took action. Since 2012 you have participated in your initiative, “Walking With Nathaniel,” walking thousands of miles and raising thousands of dollars to spread awareness of the illness that led to Nathaniel’s death, BDD. Tell us why.

What does a parent do when s/he loses a child? Initially, cry a lot. What an incredibly sad event! Losing a child is the ultimate loss, and definitely not the natural order of things. The event and its repercussions were so significant. We were like ants at the base of Mt. Everest, required to climb to the very summit. I not only lost my personal and spiritual “equilibrium,” but initially I also lost a sense of purpose for living. As a father, I’m instinctually programmed to preserve and protect my children, and through no fault of my own, it felt as if I had failed in that critical mission. So what’s next when the void looms so large before you?

I distinctly remember seeing myself at a junction, the intersection of two possible paths to take for the rest of my life — one was to inevitably fold into myself, live in constant self-pity, be perpetually grumpy, and see myself as the ultimate victim. The energy required in the choice of that particular path would be dark, negative, and all-consuming. My social arena would close and include no one else; I would be a hermit and I would yell and blame everyone for everything, consider the universe totally unfair, and spread an aura of darkness wherever I found myself. The other road led to slow and progressive healing, to an eventual reordering of my life with what is (not what should have been). Bitterness would eventually melt away, and new possibilities would slowly reveal themselves and emerge. I would slowly see beauty and light pierce the huge darkness and recognize once again the gift of possible life and living before me, rather than a death in life. That vision/possibility included a forward movement — first in small steps and then in bigger ones. To me, walking forward reflected that outward expansion and healing.

After my wife, Judy, and my daughter, Carrie, and I returned from Spain where we had walked for three weeks on the Camino de Santiago after Nathaniel’s death, I felt as if I had more walk in me. Every time I took a step forward, I felt much better. At first I started to walk in circles (daily walks around the neighborhood) in wider and wider concentric circles. It was during those circular peregrinations that I hatched the plan to walk in a line rather than in a circle from our hometown (Cheyney, PA) to Boston, MA. I envisioned a new kind of “pilgrimage” à la El Camino, but here in the USA instead — a personal spiritual and physical journey of healing. I asked myself, “What would it look like to walk out my front door and go to Boston (the home of the International OCD Foundation), connecting along the way all the happy and sad chapters/places/events in Nathaniel’s life like dots on a trail map (where he was born, where he went to school, where he got his first job, where he died, where he was first hospitalized, where he stayed in clinics and treatment centers thereafter, where he had appointments with his doctors, psychiatrist, psychologists, and counselors)?” The imagined trajectory spanned 552 miles to Boston where he had spent an entire day in the Emergency Room at Mass General back in 2009 desperately seeking help because he couldn’t do “his life” anymore. I wanted my pilgrimage to end at the Boston harbor, at the water’s edge (just like Finisterre over the cliffs of the Atlantic in Spain at the end of the Camino). I would then face toward the east where the sun rises — again a symbol of an opening rather than a closure. That is how the Camino de Nathaniel was born and executed in 2012.

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Denis walking with Nathaniel

Tell us about Nathaniel. What kind of kid was he? What was he passionate about?

Nathaniel was an amazing human being. His spirit could fill the room, so could his physical presence — he was tall, handsome, fit, intelligent, highly responsible, sensitive, compassionate, loving, magnetic, funny, engaging, strong, athletic, generous, quick of mind, creative, energetic, positive, in brief a very old soul. I’m not saying this because he was my son. I recognized his incredible gifts and talents starting on the day he was born. He stared me in the eyes letting me know he was ready to journey forth. His close friends, Judy, Carrie, and extended family members would also describe him with the same litany of adjectives. Everyone loved Nathaniel. His force field was so strong. Everyone wanted to be his friend. Everyone wanted to be in his presence. Unfortunately, OCD/BDD slowly gnawed away at these incredible positive attributes during the long years of his illness. But even in the depth of his sickness, those deeply rooted qualities still radiated through in some recognizable measure. He was passionate about running, playing, and engaging in creative and imaginative games, staying fit, and doing his very best at all the time.

When was Nathaniel diagnosed with BDD, and how did you realize something might be wrong?

Unfortunately, the BDD diagnosis came much later during his 13-year illness, when he was 17. He was hospitalized at 11 for OCD behavior (but somehow the diagnosis seemed incomplete and not totally accurate). Then we began to see him spend more and more time in the bathroom grooming himself, worrying about flab on his tummy (there was actually none there) and imagined dark circles under his eyes, the placement of his hair, and the quality of his skin (any marks on his face would ruin his day and keep him in the bathroom for hours picking at it). He spent less and less time with his friends and worried more and more about his appearance and looks. He would look away and avoided eye contact. He shaved in the darkness in the bathroom, and returned repeatedly thereafter checking on imagined flaws on his face that he saw in the mirror. He literally got stuck in the mirror and the bathroom for hours on a daily basis. His social circle and connections began to get smaller. His social life slowly diminished. School became an issue. He would always overdo his assignments, not be able to live with anything less than perfection, and even be hard on himself for not knowing in advance what a teacher was going to teach him that day before s/he did. We had to withdraw him from formal schooling by his sophomore year in high school. The initial change in personality and in behavior came quickly at age 11 and then it was the unpredictable roller coaster ride up and down during the subsequent years as therapists, counselors, doctors, and we tried to understand what was going on with our dear boy/young man.

Why do you think so few understand what BDD is? How would you explain it to someone who has never heard of it before?

BDD is poorly understood because it hadn’t been recognized as a disorder until the mid 1980s. Katharine Phillips put the brain disorder on the map with her famous book The Broken Mirror. Everything she described in the text, Nathaniel had and had experienced. Although the disorder label was publicly available, very few therapists recognized its behavioral manifestations in their patients. If you were tall and handsome and beautiful like Nathaniel, would you feel comfortable announcing to others that you were obsessed all day with unrelenting worries about your looks? Folks would think you were vain. So, in general, sufferers tend to say nothing. They simply suffer in silence. Unlike the other OCD-related disorders, BDD self-awareness is rather poor. We now know that a BDD sufferer has perceptional processing problems, which accounts for the distortions described above. Nevertheless, what a sufferer sees, s/he totally and truly believes to be true. It is difficult for that person to achieve any level of objectivity. It affects up to 2% of the population. That’s a high percentage rate, yet mention BDD to anyone on the street, and you get a blank stare in return. Nobody seems to know it. Given the high suicide rate in the rank of BDD sufferers, we have a fatal illness on our hands, in my opinion. Medication dosage administered is usually twice as high in BDD cases than for the other OCD-related illnesses. Effective treatment protocol needs to be slowly and methodically administered if the sufferer is to experience any kind of relief. Of course, there are various levels of BDD illness. In hindsight, I think Nathaniel had the worst case of it. Although we sought the help and advice of the best professionals in the field, Nathaniel’s BDD progressed. There were some moments of hope for healing along the way, but the relapses were cruel and drove him even further down into the pit of despair. He could not imagine growing old with this impossible illness, and adopting a lifestyle that would require regular medication, counseling and, perhaps even occasional in-patient treatment as a tune-up. For Nathaniel, this was not a life to live for!

How is BDD related to OCD? Do they share any treatment methods, such as therapy or medication?

The obsessive behavior of BDD sufferers is similar to what we see in OCD. However, there are many differences. I do know that the SSRIs used in treatment for BDD are almost double in dosage for effective treatment than those used for regular OCD patients. Although there are day clinics and treatment programs specifically for BDD patients, those sufferers who need hospitalization or overnight surveillance are usually grouped with OCD-ers. Good BDD therapists would suggest that the treatment protocol be administered at a slower pace and that CBT treatment be more specifically tailored to this disorder. Of course, addressing the perceptional distortion remains key to healing. This would require visual retraining that works in tandem with the long-term behavioral restructuring required for control of unwanted thoughts.

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Nathaniel

Let’s pretend I’ve said the following to you: “The issue is that people today are just too caught up in material things and their looks. If they would just stop being so vain and focus on their inner beauty this wouldn’t be a problem.”  

A BDD sufferer is anything but vain. H/she is a silent sufferer of his/her illness. The inner turmoil is constant and very unrelenting. Sufferers usually don’t dare to mention what’s on their mind 24/7. Why would they? No one would believe them based on what the observer sees. Reassurance given by others is only a temporary patch of relief. It never lasts long and only fuels the retched beast. Unfortunately, those who are rich and have the financial means have recourse to plastic surgery as a temporary solution to their angst. Unfortunately, those procedures only give temporary relief, if any. Think Michael Jackson — so many surgeries that eventually his whole face totally appeared distorted by those interventions. But he had the money to pay, and no doubt the plastic surgeons involved didn’t dare to question the patient’s motive to assess whether or not BDD was the root of the malaise. I’m so appreciative of Reid Ewing, the actor on ABC’s Modern Family, who recently came out and publicly announced that he suffers from BDD and that all the plastic surgeries he underwent did not help one bit. What is more worrisome, however, is that those same surgeons never dug deeper to discern whether or not he had BDD, a brain disorder. Now that’s really unprofessional behavior.

It seems that people assume mostly women suffer from the disorder. Has anyone expressed surprise that your son had BDD? 

Good question. I think statistically the number is practically 50/50. Women and our cultural focus on women and fashion would suggest that BDD be more evident among females. However, muscle dsymorphia with men is gaining greater recognition these days — men who focus on their bodies, their physical build, their muscles, and their general appearance and body proportions. Our culture of aggressive advertisement that celebrates bodily perfection does not help the BDD cause, for sure. However, it was interesting for me to learn that there are even cases of BDD in remote villages in Africa where such cultural distractions and focus are absence or negligible. Check out Argentina where plastic surgery for woman is now a cultural phenomenon. How an Argentinian woman looks and the public and private discourse about her weight and size are quite disturbing phenomena, in my opinion. The culture is indeed playing a role in nurturing BDD.

What advice do you have for my younger readers who may be suffering in silence? How could a teenager approach his or her parents for support — and what if parents don’t understand and refuse to believe there’s a problem?

Don’t suffer in silence and in isolation! Find someone you can trust and describe what’s going on inside your head, even if it sounds a bit silly in the telling. Be sure you open up to someone who is non-judgmental and a really good listener. Let him/her know how painful your daily journey is. If possible, create a team dedicated and committed to your ultimate healing (parents, siblings, and even a good and close friend, etc.). Check out the new BDD website at IOCDF launched a year ago. There is something there for everyone — sufferer, parent, sibling, educator and professional. Invite your team to consult this rich resource too. Be sure your therapist/counselor/psychiatric/psychologist knows something about BDD and is well read and well trained in the treatment protocol. Strongly suggest that your family read the most recent literature about BDD, starting with Katharine Phillips’ book The Broken Mirror. Let them know that there are now specific treatment protocol manuals available, including one co-authored by Sabine Wilheim. But more importantly, try to understand that your brain is physically broken and that is why you are experiencing what you are experiencing. The bio-chemical process is physically responsible for the perceptional distortion. And don’t forget to add into the mix daily meditation, regular exercise, and good nutrition as ways to help support your efforts to heal. Let your personal mantra be, “I can do this. We can do this. I’m not alone. We are a team working together so I can heal. I deserve to be well and whole and complete in life!”

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Denis and his wife, Judy

How can people get involved in spreading awareness?

Getting the word out is not easy. If BDD affects 2% of the population, there is a good likelihood that someone in your life is impacted by this awful illness and is suffering immensely because of it on a daily basis. And worse still, no one knows! Check out our Walking With Nathaniel website. It is the personal story of one sufferer who did not deserve to suffer so cruelly. Let my awareness efforts inspire others to do something rather than feel victimized. Join the annual IOCDF 1,000,000 steps for OCD Awareness Walks in June. Can’t make it to Boston? Create your own awareness walk. No matter how small the team or the event, when you connect with other walkers physically or virtually, the community of supporters becomes larger and awareness grows incrementally, a step at a time. That is how all journeys begin and move forward. Moving forward beats staying still and stagnant. For me, it is definitely the ultimate balm for body, mind, spirit, and soul.

If you could offer just one piece of advice to someone with OCD or BDD, what would it be?

Please seek help! And remember, you are not alone! There are folks out there who want to help and can!

Tuesday Q&A: Clint Malarchuk

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ClintCoachingWelcome to Tuesday Q&A! This week we’re hearing from Clint Malarchuk, a man who is supposed to be tough, who isn’t supposed to admit to feeling weak — but he’s shattered misconceptions and is speaking out, particularly about his struggle with OCD, to help others.

Clint is tough, by the way. And he’s really, really nice. Really. I introduced myself to him and his wife, Joanie — who’s also incredibly nice — at the OCD Conference in Boston. They were the keynote speakers, so I recognized them from their photo in the conference program — and then everything started to come together and I realized I’d heard of him before.

Maybe you have, too. Clint was an NHL goalie who made headlines and shocked TV viewers in 1989 when his carotid artery was slashed by St. Louis Blues player Steve Tuttle’s blade during an attempt at a goal. (I’ll spare you the link to the video–finding it is up to you.)

Clint is lucky to be alive, and he’s not likely to be forgotten anytime soon. But his legacy will last far beyond this one bizarre, life-threatening incident: He’s become an advocate for mental health awareness. He’s a voice for other men who aren’t comfortable talking about mental illness, and his story of survival — off the ice — serves as an inspiration for us all. He shares it all in his new book, A Matter of Inches: How I Survived in the Crease and Beyond

You’re a well-known guy, and as you mentioned in your keynote, it’s largely because you had a horrific accident on live TV. One cause of OCD is a traumatic event. Do you think this accident contributed to the onset of your OCD symptoms? What effect did it have on your day-to-day life?

Yes, the trauma really set my OCD off. I certainly already had OCD, though. As a kid I struggled a lot with germs and worrisome thoughts, usually about my mother’s health and safety. I went through different phases of OCD, and even some times where my OCD wasn’t seemingly there. After the accident, my OCD became so magnified: Intrusive thoughts, checking, worrying, along with severe depression. It was difficult to leave the house. This all seemed to worsen within months after the accident.

I was born and raised in Minnesota, and I often say I grew up at the hockey rink. I’ve always thought goalie would be the most stressful position on the team, with the pressure of guarding the net against that tiny puck, hearing the crowd gasp and then groan in unison if it gets through — not to mention the fear of it flying at you with sometimes incredible speed. Did having anxiety affect your performance as a goalie? Did being a goalie cause anxiety?

Being a goalie in the NHL is said to be the most stressful positions in sports. All factors considered, I’d have to agree. With stress comes anxiety. Leading up to games my anxiety would increase immensely. As a result, so would my OCD symptoms. After games I would have a small window of reprieve. Looking back, how I managed to play at the highest level is beyond me. OCD did help me with game preparation. The anxiety was at times unbearable before games. Thank God, once the game started, I was able to perform and the anxiety would leave.

ClintNetAlthough you were diagnosed with OCD fairly early on you managed to slip through the cracks of the treatment system a bit, getting refills on medication for 12 years without ever seeing a psychiatrist. Knowing what you know now, what would you have done differently following your diagnosis?

Not having to really check in with the team doctor was a big downfall for me. I thought as long as I took my medication I would be fine. I could just tell the doctor I need a prescription refill and that was it. Over the years my body got immune to the meds and I definitely got worse. I think it was so gradual that I didn’t realize how bad I was getting. Knowing what I know now, I would have educated myself better and seen a psychiatrist regularly.

You reached a point when you attempted to self-medicate with alcohol, which led to an addiction. Here you were dealing with OCD, PTSD, depression, and addiction. Life had become so unbearable you attempted suicide in 2008. We all have our own ideas of what rock bottom means, but that must have been yours. How did you move on from that moment?

Looking back on my life, I would say I hit more than one rock bottom. At certain times my OCD was so unbearable that I just wanted to die. In 2008, my attempted suicide was a result of one of those states of mind. The only difference is that this time I acted on it, and I am very lucky I didn’t die. I ended up getting the real professional help I desperately needed, but I hope others get help before reaching this sort of rock bottom. Acceptance is a huge word here! I had to accept how sick I was. I had to accept things and go forward and get well. I also had to believe that I could get well, and be happy. I had to accept that it would take accountability on my part. I had to do the work that was required on my side.

You weren’t exactly thrilled about checking into treatment, but your wife, Joanie, gave you no choice. What can you tell my readers who may be hesitant about getting the help they need, even if it means residential treatment?

Checking into a treatment center was where all this began. I was so scared, the fear was paralyzing. I did not want to be admitted into a facility. I was forced into it. My wife and the NHL team I was coaching for insisted on it. Well, thank God they did — it changed me. I got on the right medication, I got educated, I learned tools, and I got healthy. I was so extreme that I don’t know that outpatient therapy would have done the trick. It was life saving and life changing.

ClintandJoanieIt goes without saying that having OCD is hard for us. But it can also take a toll on our loved ones. Joanie stood by you through some of the darkest moments of your life, and it couldn’t have been easy for her. Do you have any advice for my readers whose family members have OCD?

OCD is torturous for us sufferers, but it really hits the whole family as well. When I went into treatment, it was a dual diagnosis facility. Meaning I had to work on my OCD and my self-medicating with alcohol. My wife, Joanie, went to a five-day family program. This was a big turning point for her and us as a couple. Our marriage was in shambles. It was there where she learned about me and my disorder. She was educated and advised. The other families shared their experiences dealing with their loved ones. The biggest thing for Joanie was understanding that I was sick, that the OCD was not who I am, but what I had. There was hope and support for her. Education for family members is crucial, as is counseling.

You’ve noted that men often feel uncomfortable discussing mental illness, that they think they need to be indestructible. As an athlete in one of the rougher sports you especially felt the pressure to remain stoic, but you’ve since written a book and have given several candid interviews. What was the turning point that convinced you to start talking about your struggles with mental illness? 

I think being open in my interviews and getting feedback from fellow sufferers really helped me realize that I was not alone in my struggles. My candidness helped other people, and men started reaching out to me as well. Surviving a suicide attempt, waking up out of a coma with a bullet in my head, really made me reflect: Why was I spared?Why was I successful in that I played in the NHL? Why did I have all these demons through my life? Well, I put it all together and figured the success gives me a platform to speak publicly. Conquering my demons gives me something to speak about, and help those still in the dark places, still struggling. The book was the hardest thing I’ve ever done, but it’s been the most gratifying as well. The emails and conversations from people who read it makes it all worthwhile. Playing goalie in the NHL, you have to be tough, both mentally and physically. Men see that and know I did it while struggling with OCD and other problems. I guess I’ve made it easier for them to admit they’re struggling too.TheCrazyGame

You’re doing well now. How do you stay on top of your symptoms and prevent relapse?

Today, I have to be accountable and do my part to stay healthy. I stay on top of my medication and doctor visits. I try to work out regularly. I meditate to keep balanced. I go to meetings. I support others and be of service to others. I’m grateful every day. I try not to take anything for granted. My wife and family mean everything to me, so I have to be healthy for them. They’ve seen me at my worst and I want to be there for them in every way I can.

If you could give just one piece of advice to others with OCD, what would it be?

You don’t have to suffer. It was a long, hard road for me getting well — today there is a lot more help for us. Get help. I know I couldn’t have gotten better by myself. The OCD Conference in Boston really encouraged me. We’ve come a long way in research, medication, therapy, and support. Never feel shame in being ill with something that’s not your fault. Have hope…because it’s real.

Risk of Suicide Among Teens on Antidepressants Was Exaggerated

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Although I’ve been on the same antidepressant for the past eight years, and it’s worked wonders for me, I’ve been hesitant to oversell the idea to teenagers. In my book I note a few times that antidepressant use among teens is riskier than it is for adults because the medication may increase suicidal ideations. When it comes to suicide, after all, one can’t be too careful.

I just came across this article on NPR, and I have to admit I’m pretty shocked. At this point, we all know smoking cigarettes can have serious adverse health effects, such as lung cancer, so the warning labels are appropriate. But apparently there was never any real proof that teens taking antidepressants are more likely to consider or attempt suicide.download

According to “Warnings Against Antidepressants for Teens May Have Backfired,” by Rob Stein, “Starting in 2003, the FDA warned that popular antidepressants, such as Prozac, Zoloft and Paxil, might increase the risk that kids would think about killing themselves — or even actively attempt it.”

Since these warnings have been issued, antidepressant use among adolescents has dropped by 31 percent, and suicide attempts among adolescents has increased by nearly 22 percent.

The takeaway? Don’t write antidepressants off because of this warning from the FDA. The intention was always to prevent teens from committing suicide by keeping a closer eye on them while they took antidepressants, and it still holds true that you should stay in touch with your prescribing doctor and be upfront about how you’re feeling.

As always, if you are feeling suicidal, tell someone.