Author: Glen Jennings

What do you think of when you think about OCD, or obsessive-compulsive disorder?   

Is it someone who has to obsessively organize their whole book collection by author? Or someone washing their hands, over and over and over for fear of catching an unknown disease? 

According to Austin Nugent, a Disability Program Administrator at HDI, even if you’re not completely wrong, you only have a small piece of the puzzle.  

“I think the most common misunderstanding is that mental health is one-size fits all, so if you have obsessive compulsive disorder, it’s going to look a certain way, like you see in the movies,” she said.  

For Austin, OCD doesn’t look like washing hands over and over again, or counting the number of times she closes the door or quadruple checking that the stove is off. It is intrusive thoughts caused by a sensation, image, or idea. These triggers are often perceived as insignificant by others, but for Nugent, her OCD attaches meaning to her intrusive thoughts leading to a great deal of distress. She gets stuck on things needing to be ‘just right’ like a conversation, the organization of a closet, the texture of food, or the formatting of a document.  

If things don’t meet the expectations of her OCD, she will seek reassurance, avoid particular situations, or perform mental rituals like ruminating for hours or days, or over explaining and correcting to alleviate her anxiety or discomfort. To most people, it may not even be noticeable that she is caught in an ‘OCD cycle.’ But for Nugent, it’s very real.  

“People often think I appear to be fine, so therefore I must be fine,” she said. “No. My brain is on a constant loop. My heart is racing, and I am super clammy and sweaty because I am on the verge of a full-fledged panic attack about something that happened two hours ago that most people would probably find very insignificant, like a typo in an email or a twitch in my eye.”  

A fear of what has happened is just one of the ways her anxiety manifests. It can also present as a fear of what-ifs.

“I also get uneasy about things that don’t happen, like someone saying something one way instead of another, convinced that I must be a ‘bad person,’” she said. “I know the twitch in my eye is probably because I’m tired, and someone not responding in a certain way is not indicative of my worth, but OCD will do all that it can to convince me otherwise.” 

But it’s not all a challenge, she noted.  

“Although OCD can cause me a lot of anxiety and be very time-consuming, I have learned to be proud of my journey, as I also find benefits and strengths in having OCD,” she said. “For example, it makes me incredibly detailed-orientated and very organized.” 

For Nugent, Mental Health Awareness Month is a reminder for others that for her, it isn’t confined to just a month. She is always aware of mental health, and the need to prioritize her mental health care.  

“Mental health awareness is a daily occurrence for me,” she said. “I need to pay very close attention and be very aware of my mental health needs constantly…if not, my OCD will rear its head and intensify, and then that ends up affecting every area of my life. Once I get in an OCD cycle, it can be very difficult for me to disrupt the cycle and move on with my day .” 

But Mental Health Awareness Month is also an opportunity. People who don’t have mental health conditions can get great benefits out of being mindful of their mental health and wellness.  

“Therapy is valuable for everybody,” she said. “It does not matter if you have a mental health condition or not, we all can benefit from having a toolkit of strategies when we’re in a rut.”  

She also encouraged people to learn more about mental health and challenge stereotypes. 

“There is so much misunderstanding around mental health,” she said, adding that just because it doesn’t look like it does in the movies doesn’t mean it isn’t real. “Don’t discredit anyone because they don’t fit the mold that you have in your mind of what OCD or anxiety or schizophrenia is supposed to be.” 

This article represents the opinions of the author and interviewee, not that of the University of Kentucky.  

Austin Nugent remembers the moment when someone first suggested she try therapy. 

“I was in Europe, and I called my mom from a four-star hotel on all-expense paid trip…and I called my mom from the hotel bathroom crying,” Nugent said. “She’s like, ‘why are you crying? Why are you so anxious? You’re on this once in a lifetime trip, and you’re still anxious.’ She was like, ‘When you get back, you’re going to therapy.’”

With help from her mom, Austin started seeing a therapist after she graduated college. However, she was still apprehensive to accept, and advocate for her mental health wants and needs. It wasn’t until she was talking to her brother, who has Down syndrome, when she realized that her mother might have been right. 

“I kind of had this a-ha moment…I would always talk to him about wanting to make sure he had pride in his disability, that concept of disability pride, owning his needs and feeling validated that he is human,” she said. “Somewhere along the way of having these conversations, I was like, ‘I feel a sense of hypocrisy because my needs are not being met.’”

Austin initially received a diagnosis of generalized anxiety disorder (GAD). At the time, that made sense to her. After all, in general, she was anxious. But it was not the right answer – not really. She would spend seven years in treatment for GAD before realizing that wasn’t the answer. Then, after an obsessive-compulsive disorder (OCD) specialist presented a case, Austin’s husband suggested that she revisit her diagnosis. Nugent contacted that specialist, who diagnosed her with ‘moderate to severe’ OCD. 

“I kind of had an identity crisis,” she said. “For the past seven years, I’d been the girl with generalized anxiety disorder. What do you mean I don’t have that? What do you mean that’s all been a lie?”

On top of that, the most common therapy for GAD, cognitive behavioral therapy (CBT), can be counterproductive to OCD treatment. That meant that not only did Nugent change her treatment plan to OCD therapy, she also had to spend time unlearning much of what she had learned in her previous treatment. 

“Everything I am feeling is still the same, but the way we approach it is so different,” she said. “There was a point where I really struggled with being angry at the mental healthcare system. It wasn’t anyone’s fault, but the fact that I had been misdiagnosed for so long…to know I’d spent seven years feeding my OCD and making it that much more intense meant it was that much harder to get a grasp when I finally received my diagnosis.”

Nugent says it can be difficult to find high-quality holistic mental healthcare: care that takes into account all of a person’s needs. There’s a shortage of mental health professionals, and by the time people seek help, they may have already hit a crisis point. 

And there are times when it’s difficult to tell when a condition is a symptom of something or just a general emotional response. People without mental health conditions can also experience periods of anxiety and depression. 

Nugent also stressed that people should not be afraid of medication. 

“My therapist was trying to open my eyes to the idea of medication,” she said. “I was so resistant. I was like ‘I don’t need meds,’ because of that stigma around medication. She explained that taking medication for a mental health condition is no different than if you have a broken foot and you put a cast on it and you use crutches until your bone is stable enough to walk on its own…that’s no different from mental health medication. It’s helping support your brain until you can develop those coping mechanisms and strategies to do it on your own.”

While it’s important to build coping strategies, it’s also important to have a support network. Sometimes that takes the form of an encouraging friend or partner, and sometimes it’s something as simple as having a pet to snuggle with. 

One of the most important aspects of having a support network is a therapist you can trust. Just like other relationships, not every therapist will be an ideal fit. Nugent says it’s important to trust your instincts. 

“I think we as humans, to a degree, know if something is helpful or if it’s maybe just filling time and space,” she said, adding that sometimes, “finding the right therapist, one that you feel comfortable with, yet is going to challenge you, can be difficult.” 

“I cannot tell you how many times I’m in a therapy session and I am so clammy, my heart is racing, because we’re actually unpacking and trying to work through what I need to work through,” she said. “That is uncomfortable. Behavior change and facing our anxiety is uncomfortable. If it felt good, we’d be more willing to do it.” 

But in the end, Nugent stressed that everyone’s journey looks different.

“There is no right path on a mental health journey,” she said. “It’s certainly not a linear path.” This means that there’s also room for people to cut themselves some slack if they have a rough day.

This article represents the opinions of the author and interviewee, not that of the University of Kentucky.