When my parents separated, my dad enrolled my sister and I in therapy. I was about 12.
I don’t remember much about each individual session. But I do remember going alone, at times, while other times I would go into sessions with my sister and Daddy.
We stopped going. I don’t know why.
When I was 15, I began taking Paxil. It was humiliating. I’ll never forget the day I woke up on the wrong side of the bed, and in the middle of my grouchiness, my sister asked, “Have you taken your meds today?”
When I was 17, I had a huge fight with my mom, and she begged me to go see her therapist. I refused.
I got pregnant at 18, married at 19, and had my oldest daughter when I was 19 1/2. Three years later, my son was born. And when my son was 4 months old, I left the kids’ dad.
My aunt took me in and offered to pay for a therapist. I saw her for about a year and a half. She put me back on Paxil, and was oddly very curious about the fact that I use fingernail clippers to clip the skin off of my fingers. I stopped seeing her after my divorce was final…after I moved from North Carolina back to Louisiana, where I still reside today.
Fast forward a few years…I finally found a job with cheap benefits and began seeing both a psychologist and a psychiatrist. I was diagnosed with Bipolar II disorder, manic depression with anxiety, and PTSD. I was prescribed Zoloft for depression, Xanax for situational anxiety, Clonidine and Trazadone for sleep, and lithium and Depakote for Bipolar Disorder. Six medications for three diagnoses. I gained weight at a rapid rate. I was tired all the time. I wasn’t sad. I wasn’t anything, really. A walking corpse.
Then I met my husband, who is a nurse. And I stopped taking all of those medications. I had convinced myself that all of my issues were situational. I stopped going to therapy, and I stopped seeing the psychiatrist.
A couple of years later, my PCP prescribed Wellbutrin and Trintellix, which I took until my insurance termed. Back to the drawing board. No meds. No money for therapy. No help.
I went about 6 years without insurance, which was a struggle. We needed the money I’d have spent on an insurance premium for other things. My stuff would have to wait. So I suffered in silence through my husband’s cancer diagnosis, coparenting problems, and financial issues. I tried to raise two teenagers, manage the house, handle appointments, and exist in support of others.
I didn’t do a very good job, but those few years were spent in survival mode. I wish I had given myself more grace for all the times I fell short.
I wish others had, too.
A little over a year ago, I was blessed with a job that offers amazing health insurance. Full transparency – I pay $30.74 per paycheck for a PPO plan. Copays are $35.00. And that copay applies to behavioral health visits.
On that same timeline, my daughter and I had a massive fight, and she moved out. She was upset with me about things I had done – and I don’t blame her. Conversely, I did not approve of her boyfriend or her choices therein. Things got really heated. My daughter told me I was the problem. She called me a narcissist. She said that peace was nowhere with me and she needed to get away from me for her mental health.
After she left (very dramatically, I’ll add), I began reflecting on what she said. I was overcome with shame. I began questioning every parenting decision I’d ever made.
I used to think that my kids were the ones who decided whether or not I am a good mother. I thought that I was a good mom because I stayed (my mom didn’t). I gave my kids everything they needed and most of what they wanted. I bent rules to make them happier. I didn’t put my hands on them. I was at almost every ballgame, every school program, every parent teacher conference. I worked 14 and 16 hour days to make sure I could provide for them. I listened to them. I valued their opinions. I gave them a say. I forgave easily. I was (overly) honest with them about my own shortcomings. I parented mostly in spite of how I was raised. I didn’t want them to fear me. I wanted them to respect me. And I thought they did.
If what my daughter said was true, then I must be a narcissist. Kids don’t walk away from their parents for no reason. If I had traumatized my child so badly that the only solution was to get as far away from me as possible, then I needed to make some serious changes before my son, who still lives at home, drew the same conclusion.
So I found a therapist. And for a year, I have seen her every week, notwithstanding a couple of cancellations due to illness and/or other obligations.
I’ll admit that I started going – at first – as sort of a quick fix to get my daughter back. Having been through several therapist and several medications, I assumed this go-round would be no different. That I’d be someone’s lab rat. That I’d tell a brand new person about my life, and they’d throw up their hands and go, “Sorry – I can’t help you.”
So I would say the first few months of my therapy sessions were tentative. I was guarded, to say the least.
After about three months, I still hadn’t heard from my daughter, and I had reconciled to the fact that she was never coming back. Three months of denial, only to finally try to accept the fact that I’d lost her forever. So on my 13th visit with my therapist, my focus changed from an attempt to get a quick fix to all of the acceptable ways to process grief….because the truth is that I grieved my child like she was dead. It was the only way my nervous system could cope with the assumption that she wasn’t going to come back.
I asked my therapist if I was a narcissist. I told her about all of my previous diagnoses and medications. I asked her to verify which of each of those things belonged to me.
And it hit me hard when she said, “We need to be very careful about how we label things. I am not going to diagnose you, because I will not allow you to use whatever I say as a crutch. I am here if you want to put the work in. But if you want me to pacify you with an excuse to offer up for why you are the way you are, I cannot help you.”
She might as well have punched me in the gut. I remember being upset. I remember not working much that day. And I remember staring into my mirror the next morning and not really liking the person looking back at me.
You’re nothing, I said to her. You are a waste of space. You’re a liar, a cheater, a manipulator, and worst of all, a terrible mother. You don’t deserve oxygen, let alone your kids. You’re not a victim because everybody leaves. Everyone else is a victim for having to deal with what you have put them through.
Like any other morning. The language has changed over the years, but there really isn’t a day that goes by when I don’t remind my own reflection that I’m no good. At 12, I was awkward and not worthy of a mother. At 23, I was fat and ugly and doomed to live in loneliness. At 29, I couldn’t keep a man happy no matter how much medication I took. And at 38, all of the evidence showed that I was not worthy of love because no one has ever stayed…not even my own kids, who I thought were biologically wired to love me.
So on visit 14, although hesitantly, I returned to therapy, and I said, “Forget about a diagnosis. Tell me how to become someone I can tolerate.”
And for the last nine months, I have been working on that.
I am not sure how long it would take someone to really get to know me. Some days I still feel like I don’t even know myself. But five or six weeks ago, and after nine months of genuine effort and hard work, my therapist said to me, “I don’t think you’re bipolar. I don’t think you’re a narcissist. I don’t think you have PTSD.” And while that relieved me, I wondered, “Well what the heck is wrong with me then?” But I didn’t ask that question out loud, because if nine months of treatment had taught me anything, it was that we cannot expect others to see us as humans and not labels if we don’t practice it ourselves.
Three weeks ago, my therapist told me that she believes I have something called Rumination OCD.
Huh?!? I don’t even know what that is.
I knew I was an overthinker. Anyone who has known me longer than about eleven minutes knows I’m an overthinker.
So I supposed – in that way – I fit the “rumination” bill. But OCD? I don’t wash my hands repeatedly. I don’t count things over and over. I don’t need objects arranged perfectly. I don’t perform any visible ritual because something terrible might happen if I don’t.
What I do is think…
…and think…
…and think…
…and then I think about what I just thought.
I analyze conversations. And then I analyze why I analyzed the conversation. And then I wonder whether my analysis was accurate. And then my brain scheduled a committee meeting to discuss the findings. I revisit decisions I’ve already made. I rehearse conversations that might never happen. I search for the exact moment a thing went wrong. I try to figure out what people mean. I question whether I’m doing the right thing, whether I’m a good person. I look at a situation from one perspective – then another – then another – convinced that somewhere inside all of that thinking is the one piece of information that will finally make my mind feel settled.
I spend hours a day trying to solve problems that don’t have a definitive answer.
And I always called it overthinking.
My therapist gave it another.
Rumination OCD is not considered a separate official subtype of OCD in the way we might discuss different psychiatric disorders. Rumination can function as a mental compulsion of OCD. OCD generally involves obsessions – unwanted, intrusive thoughts, images, doubts, or urges that cause distress – and compulsions, which are behaviors or mental acts performed in an attempt to reduce that distress or gain certainty.
And the way it was explained to me is that those compulsions aren’t always things another person can readily see. Sometimes the ritual happens entirely in someone’s mind.
Rumination isn’t just “thinking a lot.” Everyone replays an awkward conversation occasionally. Everyone worries. Everyone lies awake in the middle of the night, sometimes, wondering whether they’re doing the right thing.
Rumination becomes something different, though, when thinking starts functioning like a compulsion.
Something feels unresolved…so I think about it.
I feel anxious…so I analyze it.
I find an explanation, and for a moment, I feel better. Then my brain finds a hole in the explanation. But what if…? So I start again. I review. I analyze. Compare. Reconstruct. Seek reassurance. Google. Remember. Reinterpret.
And eventually I arrive at an answer that feels satisfying…for about 12 minutes. And then…yeah, but what about…?
And we’re back.
That’s the cycle.
The thinking feels productive because my brain insists that I’m solving something. But most times, I’m not solving anything. I am trying to achieve certainty.
My compulsions don’t necessarily look like compulsions. A mental compulsion can look like replaying a conversation repeatedly to determine what someone “really” meant…or reviewing my own behavior to determine whether I was wrong. Mentally checking my motives. Rehearsing future conversations. Imagining every possible outcome. Trying to remember something perfectly. Comparing one situation to another. Repeatedly asking myself if I’m a good person. Trying to determine if my feelings are “correct.” Seeking reassurance from other people. Researching something far beyond the point where I actually need more information. Trying to neutralize a frightening thought with a reassuring one. Going back through memories to look for evidence.
I don’t wash my hands. Instead, I try to think my way into certainty.
And the cruel part of all of it? Sometimes it actually works. Temporarily. And that’s what makes compulsions so compelling.
Let’s say I’m worried I handled a conversation badly.
I replay it.
Then I remember something the other person said.
Oh. Okay. That probably means they weren’t upset with me.
Relief.
My brain just learned something:
When we’re anxious, analyzing makes us feel better.
So the next time uncertainty appears, what does my brain want?
More analyzing.
Except eventually another thought appears:
Wait. What if they only said that because they were trying to be polite?
And off we go again. The relief didn’t resolve the obsession. It reinforced the ritual.
And the clincher is that rumination can disguise itself as self-awareness. And that’s been hard for me because I want to be self-aware. I want to examine my behavior. I want to learn from my mistakes. I want to take accountability. I want to understand why I do the things I do.
Those are good things.
But there is a point, my therapist says, where self-reflection stops producing insight, and starts producing anxiety. That’s why I apologize 75 times for the same mistake. Reflection leads to one of two things – understanding or action. But rumination demands another round of anxious thinking.
And rumination loves the past. But there are questions the past cannot answer. And in that case, it loves the future, too. If the past isn’t available, there’s always the “What if…?” game.
I appreciate that my therapist waited a year before officially diagnosing me. She needed more than three months of data. She heard how I processed conflict. How I talk about relationships. How I revisit decisions. How difficult uncertainty is for me. How easily reflection becomes an endless mental loop. And eventually, she saw a pattern I didn’t. I don’t subscribe to the idea that you can scroll through Facebook or TikTok – or even Google symptoms of a thing you’re experiencing – and automatically/unprofessionally diagnose yourself. The fact is that rumination can occur outside of OCD, too. A diagnosis – officially – depends on the larger pattern – what the thoughts are doing, what function the mental behaviors are serving, how much distress they cause, how much time they consume, and how much they interfere with someone’s life.
So…this post is not meant to diagnose anyone. It’s meant to tell people…this exists.
Because I didn’t know.
OCD is not an adjective. It’s exhausting. It consumes time. It interferes with relationships. It makes my mind feel like an interrogation room I can’t leave.
I am not writing this as an expert. I’m a newbie. And I’m learning as I go. But as someone who’s spent 39 years inside my own head. And strangely, having a name for the pattern has given me some distance from it. Now I catch myself in the middle of an internal investigation and not shame myself for it or panic over it.
I used to think that the solution to overthinking was finally finding the “right thought.” The perfect explanation. The missing piece. The answer that would finally settle everything.
And I’m beginning to understand why I haven’t found it. Because sometimes the problem isn’t that I didn’t think about something enough. The problem was believing that more thinking would make me less anxious.
Maybe healing isn’t finally answering every question my brain asks. Maybe it’s learning I don’t have to. I can leave some questions unanswered. Uncertainty is survivable. I can have a noisy brain…and still build a peaceful life.
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