Mental disability and mental health are not mutually exclusive

Image: A head with a face and brain visible, mapped into different sections labeled in German. The 1894 print represents phrenological mapping of the brain. From Wikipedia.

Right now, I have a mental disability that affects my day to day functioning, my minute to minute existence. I have to make considerations for myself, these parts of me that aren’t going away. I spend, on average, probably an accumulated hour a day righting myself from OCD attacks. It takes a little chunk of time to calm my pulse, to tweeze a hair from my chin, to quit procrastinating. This is an hour I could spend doing other things, as much time in a week as I spend at one of my jobs. Little by little, it’s not too bad, but it adds up and adds some extra challenge to life. My mental disabilities are active, and they are disabling.

Because I have OCD, I often have to counter little attacks of anxiety when I check my email, refresh my dashboard, or look at comments on my Bitch posts. Because I have OCD, I have to ward off dozens of intrusive thoughts throughout my day – horrible images that I’m not going to recount that try to disable my functioning, that I am only able to combat after years and years of practice. Because I have OCD, I have to check and recheck certain things – I just took 15 minutes to walk down to my car and make sure the doors were locked and the emergency brake was on. Because I have mild ADD, I have to constantly clear out my tabs in Firefox so I can get back to work. Because I have trichotillomania, I am constantly feeling my skin for hairs I want to pluck, constantly wondering where my tweezers are.

Despite all these symptoms, this is also the healthiest I’ve been mentally in quite some time. I feel good about myself and my life and my mind. I am confident. I think I am worthy of the positive attention I get, enough so that I feel ready to examine the negative attention I get and try to alter my behavior in consideration of this. I like the way I look and the way my body works. When I wake up in the morning, I feel good, and happy to be alive. ETA: These are all indications of my privilege, too.

I am writing more than I think I’ve ever written in my life. The words do not always come easily, but they are always there. Writing is what I want to make my bread and butter. I’ve always felt it to be a realistic goal, but for the first time, it doesn’t feel distant – it feels palpable, and I know it will happen. I am confident in myself. I like myself. I feel like I can, even if it’s not today.

At the outset of my most recent major OCD experience, I got very ambitious. My thinking was that I didn’t have time to be put out of my life by disability, so the disability had to be eliminated. From one perspective, I think this ambitious, goal-oriented approach help me empower myself when I felt cowed by my thoughts. (eta: again, thanks privilege!) But as happens so often with empowerment, I used the master's tools to get to it. This desire was also indicative of my internalized ableism. I thought that disability and happiness were completely incompatible, and so the only option for my disability was destruction.

My OCD is not curable, but its presence does not negate my happiness. Though, I will not always be this – happy. I haven’t always been. Sometimes it’s because of disability, sometimes it is not. But disability right now is not erasing or silencing my health. It’s there alongside my health, challenging it, making it stronger, preparing my health to survive and work through and with my disabilities.

Further reading:
Stop and think: invisible access for invisible disabilities
Disability and birth control: parts one, two, and three
OCD, Language, & My Place on the Disability Spectrum: One and Two
‘Normal’ and the Dominant Narrative
I can’t count on anybody to understand. (Blogging Against Disablism Day 2010)
Trichotillomania: cures, shame, localization, management

The Pain is real even though you can’t see it

Disability and birth control: part three

This is the final part of a series for Blogging Against Disableism Day. Part one and part two ran previously. See more of BADD 2010.

After I tossed my birth control in the trash, things were pretty okay. My mind was in line, condoms and withdrawal (a tip from another friend) served me just fine, and when it didn't, Plan B didn't knock me too far out of line (at that point).

But after intercourse one night, I had some nasty gas. Or cramps. Something that made me double up next to my partner on the twin bed in his dorm room for an hour. It passed, I went to sleep, and didn't think about it much the next morning. The next day, at work, I doubled up again, on a couch this time. I could not walk it off. A student who had an appointment with me came in, and I had to beg off. I waited a few hours and then called my roommate to take me to the hospital.

After several boring hours at the hospital, pain going in and out, the verdict was returned: ruptured ovarian cysts.

"Could this be caused by birth control?" I asked a nurse. "Certainly, honey!" she replied. I was relieved - I threw that stuff away.

-

I recovered well and went to a male gynecologist whom I was comfortable with, even when he described the discomforting image of my ladybusiness filled with blood from the ruptured ovary. Months passed. In the late summer, I went back in for a check-up. Things were fine until Dr. Man called me into his office. "So, what are you doing about birth control?"

"Well, we've been using condoms and pulling out, but I'd really like to talk about maybe getting a diaphragm or an IUD?"

"Oh no. I only prescribe non-hormonal methods to people in stable relationships."

"Well, I've been with my boyfriend almost two years now, and we're pretty..."

"No, I'm talking like... mortgage, kids together. You're not ready for that yet. I think hormonal methods are much more appropriate for you." He smiled.

"Well, you know, I think that the pill might have caused the ruptures? - "

"Oh, no, that's not possible. This will actually prevent them!"

"But didn't like it that much the first time around, it didn't make me feel good, you know, mentally?"

"Sometimes you have to try several different kinds. It takes a while to get the right fit."

"But I'm not good at taking pills - "

He smiled, and pulled up a NuvaRing, and talked me into it.

Never mind that I said I was uncomfortable. Never mind I said I was looking for a non-hormonal method of birth control. Never mind the strife and pain and suffering that trying hormonal methods, of searching for the "right" (read: hormonal) fit. Never mind that I researched and requested specific other methods. Never mind that I already had a reliable and effective method of birth control.

I was judged too young, too immature, too unstable. I am a woman and a person with disabilities, and for that reason, my input on my own body was dismissed, and another method that had already proved harmful was pushed upon me.

Now, I should say this: I'm sure that HBC can help people with ovarian cysts. But they don't help me - every time I've taken and gone off HBC, I have had ruptured cysts within a few months. I had never had them before I started HBC, and I don't have them when I'm not on it. In some women, HBC and ovarian cysts are unrelated, or helpful. For my body, it's a causation.

Ruptured ovarian cysts are one physical, temporarily disabling ramification of hormonal birth control for my body. But the major tremors were, as I've belabored, mental.

In the month I was on the NuvaRing, I was anxious. I was angry. I was out of my head. I couldn't concentrate, on anything. My sex drive plummeted and I couldn't climax. I deal with OCD on a daily basis, but this was different, meaner. The obsessions and compulsions were full of rage. The trichotillomania was almost violent.

The tipping point finally came when I screamed at a close friend and broke my phone in a rage...brought on by a lost puzzle piece.

(I think this is funny, in retrospect.)

I took out the ring the next day.

--

Things were good, for a year or so. I wasn't on any kind of hormonal birth control, and I didn't get pregnant. I was busy. I wrote two honors theses, graduated with honors, got a temporary job with health insurance, found the perfect apartment with my partner. One afternoon, though, our usual methods malfunctioned, and I had to take Plan B. It most likely wasn't necessary, but my anxiety surrounding pregnancy was only relieved by being extra-careful.

A month later, I went into an anxiety tailspin - deep enough that I am still dealing with its ramifications. I had health insurance, so I got therapy and went to a female gynecologist who encouraged me to look into non-hormonal methods. Getting service from her was too expensive, but another friend recommended a local abortion clinic, who fitted me for a diaphragm for only $25.

I had to try two different sizes. Figuring out how to fit it was frustrating enough to inspire a tearful phone call to my mother. The tubes of spermicide are expensive. It's a pain to remember to take it out the next day.

But getting a diaphragm was the best decision I've made regarding my fertility.

For the purposes of curious readers contemplating different methods of birth control, I'll describe my system with my partner. After foreplay and before intercourse, I insert my diaphragm (it's easier when I'm aroused). We go for a while without a condom. I am comfortable with because withdrawal is 97% effective when used consistently and correctly, because we have both been tested and neither of us have STIs, because we have been monogamous and stable for four years and I trust him, because it feels pretty awesome, and because I have a diaphragm in in case of early ejaculation. When my partner feels that it is necessary and after I have climaxed, he puts on a condom, and finishes.

This is satisfying, exciting, and I feel comfortable and confident in my methodology. Mistakes are rarely made, and there is always a safety net in the case of an accident. We are able to plan our family and our life without worrying about unexpected conception. I have little to no anxiety, even when my (often irregular) period is slightly late.

This is the right method of birth control for me. It was hard won, but you know what? It's an accomplishment in self-care, and I'm proud of it.

--

In concluding this series, I want to reiterate that hormonal birth control can be wonderful and liberating and healthy for many women. This is not a diatribe against hormonal birth control in and of itself. If this works for you, I am so glad.

So, what are the lessons I want to communicate to readers facing choices about their method of birth control?

As with any other decision we make regarding our body, our choices are judged and policed. This is not okay. You should not have to use birth control. You should not feel that you have to use any particular method of birth control. While doctors and partners and friends and mothers are worth listening to, it is your body and your health, and you can do what you want with it. Your body and your reproductive system are yours, and you and no one else knows what is best for you.

Doctors are not the only source of information on the topic, and they cannot dictate what you should do. They are prone to bad advice. Doctors do not know everything and are subject to biases that can block you from finding the method that's right for you. Diaphragms are a valid choice. So is withdrawal. So are condoms. So is the sponge.* So are hormonal methods. There are other methods than hormonal birth control, and hormonal birth control is not right for everybody.

Only you have the right to make decisions about your reproductive health, but that doesn't mean that you don't need help. The words of other women are powerful. Your mother, your friends, your mentors, may very well have information and stories to share. Ask women you trust about their experiences, and talk to them about your options and feelings.

*Thanks to Liss for reminding me of this method!

Disability and birth control: part two

Image: Two round pink plastic cases of birth control on white fabric. One is open to reveal the birth control pills inside.

This is part two of a two three-part series for Blogging Against Disableism Day. Part one is here. Unlike part one, this is a narrative. See more of BADD 2010.

When I was 19, hormonal birth control was just what you did if you were “good” about your sexuality. The (notoriously incompetent) nurse practitioners at health services of the women’s college I attended asked every patient if they were pregnant at every appointment, if they needed birth control – even if they were lesbians, even if their male lover was trans, even if they weren’t sexually active, even when they'd already said no. But even if students mentioned problems with hormonal birth control, or that they used condoms regularly, or that they didn’t have penis-in-vagina sex, birth control was still offered, even thrust upon us. It was a mandatory question, with a disapproving look or tut if it was rejected.

I was excited about the pill. The pill is (according to cultural narratives) what a responsible lady like myself does when she enters into a sexual relationship with the potential of pregnancy. I didn’t want to get pregnant – so badly that even with the pill, we still used condoms and the withdrawal method. I didn’t have a lot of shame about losing my virginity – which is a construct, but it was the construct I used at the time – but there were certain rules I needed to follow.

And it was great, for two months. My sex life was (and is) just wonderful, a revelation, a joy. The pill, too, seemed perfect. It was $5 a month. There were no mood swings or weight gain. And it relieved to a certain extent my paranoia about pregnancy.

The problems began when I went home for the summer, new relationship still intact but suddenly long-distance, friends suddenly 2000 miles away. I continued taking the pill over the summer. I wasn’t having sex but hey, once you’re on the pill, you stay on it, right?

I remember, very clearly, the morning I went crazy. It was quite a simple moment.

One day, I woke up and thought, “what if I have AIDS?”

And suddenly, I could not eat, period. I could not sleep, period. I could not think or read or write. I could not work. I could not look forward to my trip to see my boyfriend. I could not.

This remains the most terrifying time of my life – when my brain mutinied, when I literally could not think of anything else.

The fear ostensibly came from internalized slut-shaming. A year and a half prior, I’d given a few sketchballs some ill-advised blowjobs. None of these experiences were good or healthy, and some of them were not particularly consensual (you’ll be hearing more about this in a few weeks). But all of them were low-risk, and my fear of being infected was disproportionate and unrealistic (though an HIV test is a good idea for any sexually active person). When I got into a completely awesome, empowering, mutually satisfying sexual relationship, the previous year’s misadventures seemed more and more horrifying, in retrospect. I felt bad for myself and about myself. And when I took the pill that I thought made my totally awesome sexual relationship possible, it warped and twisted that shame into a monster that coated my every action and thought.

Even in the midst of this debilitating, disabling obsession, I still took the pill when my phone alarm went off at 6 pm. I’d never been good at taking pills, but I was rigorous about the pill. After all, I didn’t want to get pregnant, and the pill was the only really safe way to keep from getting pregnant, right?

--

I told my mom about it, and it got a little better. I got an HIV test (negative), and it got a little better. I went to see my boyfriend in Virginia, and it got a little better. By the time I came back from Virginia, I felt…okay. Not bad.

I kept taking the pill. I didn’t want to get pregnant.

Two weeks later, at some trivial trigger, my mind, suddenly, was off to the races again, and it just all came back.

It wasn’t health related, or an infection, this time. This time, it was my partner’s ex, and my conviction that he would leave me for her.

One of my partner’s exes began leaving some flirtatious messages on social networking sites. When I saw that, I was garden-variety-jealous and threatened. It didn’t seem like a big deal at first. This is what women do in relationships, right? Cheating with an ex is something we’re supposed to be afraid of, right? But instead of waning as I worked through my internalized sexism, these fears did not leave my mind.

In a paradox: I didn’t actually trust him less – my partner is and was great, and has never done anything to pique my jealousy - but the patriarchy assured me that this competition with a woman unknown to me was normal. My conditioning kicked in and helped the hormones in my body nurse an unfounded anxiety, conditioning me to see my inability to sleep and my waning appetite as okay, as normal, as just part of being in a relationship.

I was in love for the first time, and I was made insecure by the message that society sends heterosexual women: “your man, he is going to leave you. He is going to cheat on you, and another woman will steal him away.” My partner is wonderful and trustworthy and extremely monogamous, and I knew that, and I trusted in him.

But I could not, could not, could not, stop obsessing over it. It was compulsive, too: I checked his social networking page and his ex’s pages several dozen times a day, fearful of the next update or a sudden relationship change that would leave me single and heartbroken.

I wasn’t having sex, but I kept taking the pill. I don’t know why. I just thought that's what you did, didn't realize it had anything to do with my suddenly disability.

I lost 15, then 20, then 25, pounds very quickly. I lived for my partner’s expression of love every night, my one reassurance that everything was okay and I would not lose him suddenly. “Love you”, over IM or phone, would coax me to sleep, slowly – and I would wake up too few hours later and race to check his MySpace. On the rare occasion that he didn’t sign off with an expression of love, I went into hysterics. (He had no idea about my Problems, we’d only been dating a few months at that point).

When I went back to school and regained my support system, things got better. I was still anxious – still on the pill, using several other forms of birth control – but my friends could talk me down from anxiety spirals in ways my mom could not, and self-medication was plentiful. And I saw my boyfriend regularly, which assured me to some extent that I would not suddenly lose him.

In an airport on my way home for Thanksgiving, I finally made the connection between the constant anxiety, nervousness, worry, and the pill. An offhand comment to a friend about it turned to a click moment with her help – maybe this worry wasn’t normal, maybe it wasn’t a natural by product.

I threw away my pills, and things almost immediately got better. I had fun. I gained weight back. I wasn’t free of anxiety, or obsession, or compulsion, but it was no longer interfering.

But it was not the last time reproductive choice, sexism (internal and external) and hormones would gang up on my mind.

Sorry for the lateness of this post - this is difficult to write about. Later this week: Part Three!

Disability and birth control: part one

Picture: Several cartons of Plan B contraceptive stacked one of top of the other against a beige background.

This post is part one in a series. Please check out parts two and three.

This year, Blogging Against Disablism Day falls in the context of a great deal of celebration around the 50th anniversary of FDA approval of the hormonal birth control pill. Since most of my disability experiences have come with the birth control pill, I thought I’d take the BADD opportunity to talk about the intersection and write out my birth control narrative – what works for me, what doesn’t, and what ableism has to do with it.

Birth control is and was often (though by no means always) constructed as an unambiguous win for women. It’s strongly, strongly associated with the birth of the second wave of the feminist movement (though I’ve noted that the second wave is often omitted, effectively erasing the work of the first wave). And hormonal birth control has been wonderful and liberating for women in the final balance. The fiftieth anniversary of hormonal birth control should be celebrated. Hormonal birth control is wonderful.

But it is not unambiguously positive for women. It is not all of our liberation.

Birth control as a topic is simply not centrally relevant or empowering to every woman. Not all women are at risk of pregnancy. Widespread (rather than individual) centralization of birth control in feminism alienates and marginalizes their already problematized bodies: trans women, intersex women, older women, lesbian women, women with disabilities that affect their reproductive system, asexual women, women who want to get pregnant. Not to mention the loaded history of otherwise non-privileged bodies with birth control in light of the eugenics movement.

In the course of discussion of birth control, though, options which are not hormonal birth control or condoms are often erased or devalued. IUDs are unobtainable. Withdrawal is silly and irresponsible. Diaphragms are old-fashioned, ineffective, and irrelevant.

But these are the options those who need non-hormonal birth control. The voices of folks who need and use alternative methods of birth control are ignored or erased in favor of more popular methods. The downsides of these methods are not discussed or dismissed as minimal, marginal.

Women with disabilities are often (though not always) sexual, and some of us are at risk of pregnancy. When we go to the doctor, our questions may be brushed away because of disbelief in our sexuality. Our concerns about certain methods may be ignored because we are women, and not competent to make decisions about our own bodies. Our desires may be blocked due to our finances. Our fertility and desire for children may be discouraged or ignored based on the assumption that we don’t want to pass on to children the qualities and conditions that make society uncomfortable with us.

I’m writing about my experience with birth control for a few reasons.

The first reason: to provide a narrative of my disability and how I’ve experienced it: its causes, its fluctuations, its triggers. Folks with disabilities are socialized to be ashamed of our bodies and our disabilities. It’s important for those of us who can and want to contribute our voices to the conversation surrounding disability in an effort to counter harmful stereotypes and tropes.

Another reason: to provide a practical example of how ableism and reproductive rights intersect, and how feminist and mainstream constructions harm marginalized folks by normalizing some experiencing and othering others.

The last reason: to provide an alternative birth control narrative – a different story of how I’ve prevented getting pregnant thus far. I’m not the only one who’s had hormonal birth control pushed upon me, but I have found a system that’s wonderful for me. I want to share my methods and my journey towards them in the hope that someone whose birth control needs are challenged will find some useful tool in my story.

Check back tomorrow for said narrative. Also check out:

Pregnancy, my greatest fear

OCD, language, and my place on the disability spectrum: parts one and two

See more of BADD 2010.

ETA 5/5/10: I forgot to mention somewhere that trans men are often excluded from discussions of birth control, though many trans men use it. In a post that critiques the discussion of birth control in feminist communities, this erases the experiences of some folks, which is not cool. Apologies.

Trichotillomania: cures, shame, localization, management

From lily-day's deviantArt

Trigger warning.

Via Shakesville comes a story about trichotillomania and a possible cure:

A new study published this week in the Archives of General Psychiatry may hold promise for those who compulsively pull their hair. Researchers say participants who took an antioxidant called N-acetylcysteine, sold over the counter at vitamin stores, had significant improvement over patients who took placebos.

I like this article because it also non-judgementally addresses the shame of trichotillomania, or compulsive hair-pulling:

Trichotillomania is such a stigmatizing disorder that people will go to great lengths to hide it -- to explain bald spots to acquaintances, some patients will lie and say they had cancer, Woods said.

"I have talked to patients who have pulled for 25 years, and their husbands don't even know it, they hide it so well," he said.

I've had trich for about seven years now. It's manageable, now; I don't touch the eyebrows I once tore out almost entirely. (Actually, I really like the thick Brooke Shields look of my eyebrows now).

One issue I had with the article was its localization of hair-pulling to the eyebrows, head, eyelashes, and pubic hair. Trich is far from limited to those areas - in fact, I usually avoid those areas when I do pluck these days. I tend to go for the hair on my feet (particularly my toes) and my fingers, the dark coarse hairs around my nipples, and stray coarse hair on my chin and neck.

I go for hairs that stick out, that don't bend, that poke. Maybe it's because they're easy to find, visually and texturally. Maybe it has something to do with the way they subconsciously clash with my view of feminine women as possessed of only soft, and downy body hair. At some point, it was ingrained in me that only men have coarse or dark hair on their chest and chin, and perhaps I'm punishing myself for that.

As Liss at Shakesville mentioned in the comments of the article above, trich can be a good stress reliever when controlled. Usually, I only pluck to get rid of the coarse hairs that my fingers find over and over again on my chin, and occasionally when stressed I'll go after others. As long as I'm not digging (and thus creating sores) I don't worry too much about it.

But when it does get to the point where I'm obsessively looking for more, more "weird hairs", I know it's moved from stress relief to self-abuse. So I hide the tweezers. I know where they are, but stopping the automatic response of getting them out to pluck helps me to consider the compulsiveness of my actions and dampens the need.

Those of you that have trich: how do you manage it? Is yours typically localized?

OCD, language, and my place on the disability spectrum, part two

Today I'm responding to this post on Feministe and discussing my own experience with disability. Part one is a narrative of my experience with OCD and anxiety. Part two is a discussion of my place between privilege and oppression and ableism terminology.

At the Feministe post above, amandaw came to the conclusion that "temporarily non-disabled" was the best way to express the privilege that comes with functioning as our society deems acceptable. I like the less ominous term "currently non-disabled" from the comments better, but in both I love the emphasis on the temporal. It helps to focus on the idea that everyone experience this oppression, or they will.

It also frames my experiences, recent and long-ago, in a helpful way. Though I am successful, and confident, and happy today, I was not at one point in large part because of ableism (and sexism, and lookism, but that's another story for another time). I did not receive adequate care for my issues with anxiety, OCD, and trichotillomania until I specifically went to a psychiatrist at 20 and said "I am having problems, and I think it might be OCD." When I went to a psychiatrist at 13, without any idea of what was going on (I was not yet skilled at Google), I was mis-diagnosed and my anxiety was ignored, in accordance with a host of other issues with that specific doctor.

I am not physically disabled, nor am I usually significantly mentally disabled.

However, I am always on the OCD spectrum, manifesting symptoms of trichotillomania (the urge to pluck one's hair out) and both obsessiveness and compulsion.

I usually commit myself to hand-wringing about my privilege, so by identifying as oppressed and not privileged in this situation is uncomfortable to me. But though this disability is invisible, and though it is not always significantly disabling, it is always there. Recognizing it, and holding a claim on being on the disability spectrum is a powerful way for me to recognize the parts of me that are unproductive, and help me to mediate and navigate my disability as a feminist.

The temporal inclusion of the terms used to describe non-disabled persons helps me claim my healthy functioning today. I'm not 100% OCD-free, and never will be. But it's currently not disabling.

I am lucky. I do not need to rely on pharmaceutical drugs to manage my disability. I'm able to manage it by fighting it mentally and taking care of my body.

However, I am not neurotypical. I think neurotypical is a useful term, but it does not describe how I function. My OCD is not disabling because I know how to fight, not because I'm rid of it. OCD is not neurotypical, and I have OCD.

It’s weird to exist between privilege and oppression, especially as a woman of mostly clear-cut and powerful privilege. To me, it’s similar to my position on the fat spectrum. I’m a size 12/14 (though that fluctuates) and 5’11, which means that I’m in between fat and slim. At times, I’ve been persecuted for my weight, at other times, praised.

I am white. I am middle-upper class. I am heterosexual. I am cis. These things aren’t going to change much. But I am vulnerable to other oppressions – gender, age, disability, and size – and my feminism fluctuates with them.

OCD, language, and my place on the disability spectrum, part one

Today I'm responding to this post on Feministe and discussing my own experience with disability. Part one is a narrative of my experience with OCD and anxiety. Part two will be a discussion of my place between privilege and oppression and ableism terminology.

Possible trigger warning.
Though I remember being fascinated with plucking the white hairs out of my dad's beard in my young childhood, I was a happy and confident child who did not manifest symptoms of anxiety. I was an odd girl, by eight a feminist who was both attracted to makeup and ashamed of that attraction, but I had friends and did reasonably well in school, underperforming only minimally.

Something changed when we hit puberty. My slight discomfort with outward gendering because extreme discomfort. Sex was not a topic of discussion beyond the basic facts of life in my household, and so I was ashamed of finding boys attractive and wanting them to find me attractive. Though I wanted romance desperately, I did not feel comfortable existing and being seen solely as feminine or sexy. Though my own conventionally lovely and very smart feminist mother contradicted this, I was under the impression at puberty that you chose to be smart or beautiful, and I liked being smart.

The judgment was swift and immediate. In public school in seventh grade I was very suddenly on the outside with few to no friends. My former friends weren't cruel, but they spoke a language of boys and clothes and makeup that I did not and would not understand or participate in. I began to hate myself, and books were not the support I'd hoped they'd be. My grades plummeted along with my social life, but I did not become feminine or smart to resolve this.

I switched to a private school for eighth grade, and it only got worse. At the second school, I was a specific target rather than just friendless - because I was weird, because I didn't contribute, because I was a girl who didn't act like one and there weren't enough targets around. It wasn't exactly gender dysphoria, but the binary of smart or cute confounded me. I chose none of the above where I should and could have chosen both.

(I also thought I was fat. Who doesn't, when they are fourteen.)

Ages twelve through sixteeen were traumatic, and I don't remember these years very well. But looking back, I am certain that this was the beginning of my issues with obsessive-compulsive disorder and anxiety.

When I was faced with a wave of people who didn't care at public school, I began to count - the tiles, the number of lockers to mine, the number of Tommy Hilfiger logos I saw. The private school was more dramatically traumatic, but I would focus on angles, shadows, pages. I would check my messy crate over and over to make sure I had some small thing. I would check, check, check to make sure people weren't laughing at me (which they often were).

A shrink I saw told me I had ADD and gave me drugs. I couldn't concentrate, couldn't relate, couldn't regain my confidence because I had (and have) generalized anxiety disorder and OCD - there were so many confounding awful irregularities and hatred in my view of the world. But no one ever thought I had OCD - I was extremely messy, and cleanliness is the persistent stereotype of OCD. ADD was a good enough diagnosis for my therapist (who did not treat me competently in this and most other situations).

At sixteen, I began plucking out my eyebrows one day in class. I thought they were too bushy, and I was bored, and it was...soothing. When I went to the bathroom, half my eyebrow was gone.

After the next class, half of my other eyebrow was gone. I didn't even realize I'd done it.

Though I began this new manifestation of trichotillomania - probably the one I experience most consistently since that time - my hormones began to calm, and so did I. Slowly, I began to make friends, take care of myself, and stop giving a shit what other people thought. Slowly, my grades and anxiety improved.

Going to an all-women's college was a revelation (which will be discussed in greater detail in another post). As suddenly as I was on the outside in seventh grade, I was on the inside again. Everywhere I looked, there were women on the fat spectrum, on the crazy spectrum, or otherwise weird - and they were not humiliated, but instead welcomed. I had been watching the popular kids and trying to figure out their secret since age 12, and I applied that knowledge to my social interactions in college. I was confident, cool, popular. I began wearing makeup and drinking and making out with boys (contradicting the women's college stereotype) - all the things I missed out on in high school.

What's more, I had true academic success for the first time. I'd always been very smart, but never gotten great grades - I graduated high school with a cumulative GPA under 3.0, but I made a 4.0 my first two semesters in college.

I was still plucking, but it was not as bad.

I began dating my first boyfriend (and current partner) in 2006, my sophomore year, and accordingly began taking hormonal birth control. And when I returned home for the summer, things fell apart.

About three weeks after arriving home, halfway across the country from J and my friends, I woke up one morning and convinced myself I had HIV, literally out of nowhere. I wasn't think about AIDS, or watching something on TV. I didn't have unprotected sex. My sexual history was not risky. I just sat up in bed, looked out the window, and was suddenly consumed with terror at my possible status. I could not eat or sleep for weeks, until I talked to my mom about what was going on and got tested (it was negative).

I was fine for a couple weeks, until I convinced myself - with a little more provocation, but not a lot - that J was cheating on me with his ex, who didn't even live anywhere nearby. There was no basis for this in his actions at all. J has always been unfailingly reliable and trustworthy. I had not been cheated on before. But again, I could not eat, or sleep. It was like something had invaded and corrupted my mind and happiness. I didn't know if I was ever going to come out the other side.

And instead of plucking my eyebrows, I moved to begin plucking my leg hairs.

In both cases, I was severely obsessed to the point where it was disabling. This was partially because I was cut off from my social support, and it got better when I returned to school. But I didn't recover peace until a friend convinced me to throw away my hormonal birth control.

A year later, after many different crises related to me convincing myself I was pregnant despite consistent use of condoms (pregnancy is one of my OCD obsessions), I decided to try the NuvaRing. Immediately, the obsessions came back. My sex drive also plummeted, and I got a helping serving of uncontrollable anger (true story: while on the NuvaRing, I threw and broke my phone in a fit of fury over a lost puzzle piece.)

Again, I went off of it, and all the symptoms lessened significantly without disappearing completely.

In December, we had our first and only condom malfunction in three years, and I took Plan B. Soon after, I returned to Kansas for the first time in two years. It was a great trip, and the plan B worked, but in January the obsessions came back in a major, disabling way for the first time since that awful summer in 2006. OCD violated my mind again and again, and I couldn't have a coherent train of thought in any context.

Thanks to therapy, recognition of the issue, and care for my body, it's calmed down since then. I've learned to distinguish and label OCD thoughts, to wait to act on compulsions, to calm myself. I've learned to treat myself better, to get sun, to exercise, to eat well. I've learned to share my struggles with my partner. But January through March of this year were terrifying.

Barring unprotected rape, I probably will never go on hormonal BC again, no matter how many doctors push it at me. I'm using a diaphragm now in case of condom failure (more on this later).

And usually, my mental functioning is fine - a little trich, but not too bad, a little obsessive, but not too bad, a little compulsion, but not too bad. I might pluck out some pubes before I stop myself, or invading my partner's privacy to check and make sure he's not texting other girls, or drive back home from work to double-check and make sure the coffee pot's not still on. But I know what these harmful and counterproductive actions are - obsessive-compulsive disorder. And slowly, I'm lessening my dependence on them and cha

It's not disabling, but it's not neurotypical...

Part two, on terminology and identification, is here.