What if I’m so evil that I kill myself and destroy my family?

Harm related OCD sucks.

I always knew I was anxious. Even as a child, I would worry what people thought of me – whether my actions were “right” or not. My parents moved me to a new high school after the first year, for reasons I don’t really remember. They thought I was bullied because I came home from school in tears every day, but I have no memories of anyone being mean to me. At the time, my parents found a suicide note. I wasn’t planning anything, I wasn’t depressed, but thoughts of suicide wouldn’t leave my head, mixed with thoughts that I was bad, evil, didn’t deserve what I had, that demons would take me away. I was 11. I was too scared to tell anyone. I just tried to hide my badness behind good deeds.

20 years later, my anxiety and intrusive thoughts ebb and flow. Lots of OCD sufferers talk about spikes. My intrusive thoughts don’t feel like that to me. They feel more like jumping waves on the seashore. The waves never stop, but when the tide is out, they’re easy to jump. On those days, I can brush the thoughts off without a second glance. But I never catch the tide coming in. During the stressful times, the finishing PhD times, the breaking up with boyfriends times, or just during my period or on a random Tuesday, the smallest wave knocks me off my feet.

During those times, I start to notice the thoughts. My intrusive thoughts are sometimes a voice, a TV voice-over saying “she killed herself yesterday, she destroyed her family”, “you are a selfish, bad, evil person”, “you should hate yourself”, thoughts that I am already dead, or that I should just go and die. I feel the sensation of bringing a knife to my chest, or a rope around my neck. I see a silhouette of someone hanging from the stairs. I can be talking to someone and mid-sentence get flooded with the images. During those days, I know I am evil and selfish and I’m pretty sure everyone else knows too. As Charlie says in Top Gun, “I worry that everyone can see right through me”.

On a bad day, the thoughts are relentless. They trigger compulsions of internet ruminations over my symptoms (are my thoughts desires or phobias? What is good or evil?), of asking for reassurance that I’m a good person, of compulsively watching suicide prevention videos, of hiding in books or games for hours during the working day (and trying to hide that fact from my boss), of reasoning with the thoughts, or trying to. Of being unsure whether to believe the thoughts or not. Maybe they’re true? Maybe I should listen? I end those days feeling intense shame, which never leads to a good night’s sleep and starts the cycle all over again. I’m an associate professor at a top university and spend most of my time trying to hide the fact that some days, I can’t work.

A few years ago, I found the courage to tell my doctor I was struggling. I was incredibly lucky to be referred for free, professional help. I was diagnosed at first with Generalised Anxiety Disorder, because a lot of my anxiety centres around the words “what if”. But recently, a psychologist suggested that it might be OCD.

I remember that first Google search when my thoughts suddenly became symptoms. I find it hard to look in mirrors at night because demons will attack me (even though I know logically that it’s nonsense). I find it difficult to leave the house without checking in the right way that ovens, and hair straighteners, are off (I have to physically check and say the word “off” even if I know I haven’t used them). I have to prepare in case every person in the street attacks me. And those thoughts of self-harm and suicide that distress me so much; maybe those are intrusive thoughts too?

I haven’t taken medication for this and the therapy that’s working best for me is Acceptance and Commitment Therapy (ACT). Everyone is different and Exposure and Response Prevention (ERP) therapy didn’t work so well in my case. But ACT is helping me find ways of accepting the thoughts as warning signs that I’m tired, or hungry or stressed or lonely. The film Inside Out really helped me visualise them as just dodgy thought baubles (like the gum song!) – when Joy is in charge, she can brush them away.

I’m only just starting to accept that these thoughts will never go away – they are waves and the tide ebbs and flows. I’m hoping that therapy is going to act as swimming lessons.

At the same time, I’m so scared writing this down that you’ll tell me this isn’t OCD and that my thoughts are real.