Recovery from OCD when help isn’t accessible in Ontario.

After developing Obsessive Compulsive Disorder, this mental health service user finds herself increasingly house-bound and struggling to find help from doctors and therapists. Unable to access specialized care in Ontario, her family pays for her to travel to the US for private care and then pays for private therapy upon return. Service restrictions and lack of awareness amongst healthcare professionals create more challenges but she has overcome them and is now working, volunteering, and living her life again.

Four years ago I had become very obsessive-compulsive. I was horribly ashamed and embarrassed, but after 2 years of my symptoms worsening, I decided to see a GP, but not having a family doctor at the time, I went to see a doctor at a walk-in clinic who I had seen before and thought highly of. My intrusive thoughts and rituals took up about 2hrs/day and I had begun avoiding many of my usual activities based on my irrational fears. The doctor told me to get some blood work done and he’d refer me to a psychiatrist. Two-days later I had talked myself out of getting the blood work done, intrusive thoughts had terrified me from having my blood drawn.

Months went by and I had not heard back from that doctor – I never did receive a follow-up call with a referral to a psychiatrist. Eventually I did start going to talk therapy, but not with a Cognitive Behavioural Therapy (CBT) specialist as I had no idea that there were different types of talk therapy. Unfortunately, I was massively triggered following one of these sessions and my symptoms intensified, so I stopped going. The therapist had recommended that I return to my family doctor in order to get a prescription to reduce my anxiety. I decided instead to do more research into the meds that are commonly prescribed to people with OCD and I got even more freaked out when I saw that side-effects could actually increase anxiety. So I did nothing.

A year after my initial visit to the walk-in clinic, I had quit my job, dropped out of a Masters program, and was hiding out in my parents’ house coming up with excuses for my very odd behaviours. I decided I had no other choice but to see a doctor and try meds even if they could make me worse. The doctor I saw immediately put me on meds and told me to find a psychologist and to not bother finding a psychiatrist as I needed therapy – this was poor info as I later discovered. But I did find a very knowledgeable psychologist who after many interviews was able to initially help me through CBT and Exposure Response Prevention (ERP) therapy. However, two months after our initial meet, I had a major set back and became very reclusive, mostly confined to a bed in my parents house for 6 months, with the exception of 2 visits to my doctor to get higher doses of meds prescribed. At this point my rituals were taking up at least 6 hours/day. My family was scared by how quickly my quality of life deteriorated and I felt worse knowing that in addition to having to care for me, I was causing a lot of problems (arguments) among them.

After 6 months of this, I decided it was time to act on a piece of info that my psychologist had told me at our initial meeting – that although there were no facilities in Canada to treat people with severe OCD, there were 2 mental hospitals in the US that provide inpatient care for them, and that this treatment was covered by OHIP. To make a long story short, in my last visit to my doctor (i.e. the second time I left the house in 6 months), I had brought the correct OHIP form to his office and he agreed the treatment I was seeking would be the best option. However, he forgot about my form, and the piece of research he needed to do was never done (i.e. to show that this level of treatment is not available in Canada, which would have been easy enough to prove with calls to CAMH and Sunnybrook Hospital) as I would later find out. I was not able to call him as the clinic would not pass along messages to doctors from patients, and he did not have a direct line. I couldn’t just drop by his clinic, I was too debilitated for that.

After two months of waiting for my doctor to get back to me, my family decided to pay for my treatment so that I could get the help I needed. And I did – three months later, I was back in Toronto, able to go out on a regular basis, with my rituals taking up less than an hour/day. However, I was not able to get into OHIP funded recovery program, which is CRUCIAL post 24hr care, so I once again got saved by my family who paid for me to go back to my psychologist for 3 sessions/week for the first several months.

I eventually was able to get into a once/week 2 hour group OCD program at CAMH, but was told I had to either give up my private sessions or give up the group session. Since the group session would not have given me the support level I needed at the time, I had to give it up, which was depressing as it was my only contact with people in Toronto who had OCD and their support had helped considerably for the 2 group sessions I was able to attend prior to getting the ultimatum. On a side note, there was a 1.5 year wait list to get into a similar program at Sunnybrook. This is completely unacceptable, as untreated, mental illness tends to escalate, and it can escalate quite considerably over 1.5 years. It could literally be the difference between life and death for some.

It’s been 2 years since I entered the hospital in the US, and I’m able to work, volunteer, have a life, while also attending therapy once a week, self-funded. I’m still having a lot of problems finding a family doctor who knows about dealing with people who have OCD. I’ve seen 5 doctors in the past year – not one knew that there were: no hospitals in Canada that provided intensive treatment for people with OCD; that there are hospitals in the US, that are covered by OHIP that treat people with severe OCD. I wish that all doctors in Ontario knew that, because I know I’m not the only one in this province who has gone through or will go through hell because of OCD, not knowing that treatment is available. I don’t know if psychiatrists in Ontario know this, but I do know that the wait list to see a psychiatrist is also incredibly long. Psychologists are not covered by OHIP even though they might be a vital treatment provider and, in my case, have been and continue to be.

Purple crystals don’t help with sex addiction

U of T student seeks help for compulsively hooking up with people online. Goes to free counselling service at The House, targeted at youth. Feels awkward in a room decorated in purple and pink and frilly things and crystals. Struggles to explain the problem and get help. Hopes services will develop more rigorous screening processes to spot comorbid issues.

I should preface this by mentioning that it happened in 2004 and the clinic I went to is now run by a different organization. But I think the problem I ran into is likely one that a lot of guys encounter when they want to get help from mental health services: we feel like we shouldn’t be there. So hopefully this can help some other guys seeking help and maybe it can help services change so they spot larger problems that clients aren’t talking about.

I set up a counselling appointment at The House, which was a United Way funded agency at the time that offered health services for youth. I was spending all of my time online trying to find guys to hook up with or watching porn and it was interfering with my life pretty significantly. I was a student at U of T but had bad experiences with their psych services so I wanted to go off campus. But when I stepped into the counselling room at The House, I felt so awkward and anxious, I immediately regretted it.

The room was all purple and pink and there were lots of frilly fabrics and there was a purple crystal sitting on a table. For all I know, it could have just been that the counsellor used it as a paper-weight and got it on a trip home to Thunder Bay, but the moment I saw that room, all my defenses went up and I had already written-off anything the counsellor was going to say. It was hard enough to open up about what I was feeling and doing. That already felt emasculating. But now I had to do it in a bad parody of a hippie girl’s dorm room.

I was also dealing with a lot of internalized homophobia, so the only thing I wanted to do in that room was crush a beer can against my forehead, tell the counsellor there was nothing wrong, and then go and play some first-person shooter video games until I’d killed enough aliens to feel manly again. I realize this was all very unhealthy but I was very unhealthy. That’s why I went there.

So I was very defended through the conversation. It was embarrassing to explain the extent of the problem and I was embarrassed to be there. I remember not being very open with the counsellor but I did mention that guys would offer me money to hookup with them and the thing that really stuck out to me afterwards was that the counsellor said something like: “Well, why don’t you try that then?”

Throughout the conversation, the counsellor was trying to be very sex positive about everything I brought up, and I understand the importance of that, but I had a legitimate problem. I was trying to find a way out of the situations because I couldn’t control myself.

I never went back. The counsellor called to set up another appointment and I deleted the message. It was another three years before I tried therapy again. I was in a different city by then. Things had only gotten worse and the sex addiction issues turned out to only be a tiny part of other mental illnesses that overwhelmed everything. But I did finally get help and get over them.

I don’t know if things could have been different that day I went to see the counsellor. Maybe we could have avoided a lot of disasters and pain. Maybe not. My own lack of awareness and inability to articulate what I was dealing with certainly played a part in not fully describing the problem or the symptoms. My insecurities were a big barrier to getting help with issues caused by my insecurities.

But looking back, there were so many warning signs of the other mental illnesses I was dealing with. The counsellor seemed oblivious to those. I think it would have helped if there’d been a more rigorous screening process for other mental health issues. The other problems would have come up if the counsellor had done any standardized assessments on depression or anxiety disorders.

I think anybody that comes into a mental health service talking about one compulsive issue should get screened for others. There’s always others. And losing control of yourself is always going to cause anxiety and depression.

I think a clipboard with a mental illness symptom questionnaire on it–or an iPad if they’re slightly tech savvy–sitting on the table when a client walks in might be a hell of a lot more useful than a purple crystal.

And if you’re somebody that’s trying to get help, it is important to get effective, skilled help (not every therapist/counsellor is effective or skilled), but also be aware that your own insecurities can become one of the biggest barriers to getting the help you need. Talk about those insecurities and get help with them so they don’t chase you away from getting support.