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OCD in Place of Anorexia

by Kristina Randle, Ph.D., LCSW

Just when I thought I’ve won the seemingly endless battle against my OCD by triumphing over my eating disorder (anorexia, to be specific), common symptoms (checking the switches countless times, washing my hands forever, hoarding) and gotten a hold over my rampaging thoughts, I had a severe panic attack a few days ago.

I’ve been frequenting a beauty spa for microderm abrasion for a few months ever since I had a severe acne outbreak due to my anorexia. And here’s the root of my panic attack. Two weeks ago, my esthetician changed the treatment without informing me of what the new treatment detailed. It was only after I had (what I now know is) Intense Pulsed Light (IPL) did I return home and researched on it.
OCD sufferers always have to keep ourselves well-informed to clear any lingering doubts in our mind, ie. checking the switches to fulfill the remaining 99% of doubt, with 1% fulfilled when we first switched it off. However, I had a panic attack precisely because I didn’t even have that 1% to rely on. What I found out about IPL is this: there are hundreds of people who’ve suffered from fat loss, indentations, wrinkles, fine lines, orange textured and saggy skin ranging from a few weeks to months after their IPL.

I went ballistic, trying to find the cause of their fat loss. I knew I couldn’t cope feeling like this for a few months if I tried to eliminate my worry by following CBT. I cried for three days straight, after which I felt so empty and light-headed, I didn’t want to think anymore. From what little information I’ve gathered, there are two groups of IPL victims: ones with severe burns directly after IPL because the setting was too high and the ones who didn’t have any visible side effects until weeks to months after their IPL.

Of course, there are countless people who’ve gained much from IPL and didn’t suffer from any negative side effects, but being plagued with OCD, my mind seems unconvinced I’m going to be all right. I spent quite a sum consulting a professional doctor the other day and his reassurance that “IPL can’t cause lipoatrophy (fat loss) because it doesn’t penetrate deep enough,” and “The IPL machines used at beauty spas aren’t lasers. Only certified doctors can utilise them, and only lasers can cause fat loss,” only served to further my agony because from what I’ve read from the victims’ accounts, the doctors always deny their injuries and claims they’ve never had a victim in their years of IPL practice.

Just what am I supposed to do? Worry incessantly for six whole months before I’m fully convinced my fat cells aren’t damaged? I would have gone for a scan to check the state of my fat cells, but the doctor says that’s impossible, says you can’t miss lipoatrophy because your face will look sunken and hollow. I’m aware of what my mind’s going through due to the load of information I crammed into my brain when I first realised I had OCD: this is an obsessive thought and I’m compulsed to seek the answers to all my questions before I’m convinced.

My cheeks have been feeling numb these past few days, so I’d like to ask if it’s possible my brain’s sending signals to make them feel numb because this problem has been weighing itself on my mind 24/7. Like those people who lose their voices momentarily due to an extreme shock. Is it possible? I feel my face is getting thinner since I’ve been checking my face obsessively, every day. Has my view become distorted due to my persistent train of thought?

My mom thinks I’m ridiculous because I’m not relieved even after I’ve the doctor’s reassurance and there’s nobody else I can turn to. I’d really appreciate a reply, some comfort or advice; anything. I can’t stand feeling like this for the next six months (it’ll take a total of six months for myself to become fully convinced I’m not suffering from lipoatrophy). Please, and thank you.

Among OCD sufferers, specifically among those with health-related anxieties, often no amount of reassurance is ever enough. In fact, the act of seeking reassurance can make OCD worse. It temporarily decreases anxiety but it reinforces the seeking reassurance behavior. OCD sufferers should resist the urge to seek reassurance and endure their anxiety. If an individual usually seeks reassurance when they feel anxious then not doing so will increase their anxiety, possibly to very intense levels but those levels cannot be sustained. Anxiety always decreases. In that way, anxiety is akin to the law of gravity: what goes up must come down. Individuals with OCD are unwilling to endure their anxiety. They do everything in their power to escape it. This is a mistake. Anxiety avoided in the short run, only intensifies it in the long run.

You may be overreacting to the IPL treatment. Your level of concern in any situation should match the most likely outcome. The professional advice you sought supports the idea that your level of concern should be minimal. You minimize the doctor’s advice but focus intensively on the outcome that frightens you the most. You must get in the habit of basing your reactions on the reality of a situation, on the truth. This is essential to overcoming OCD. What one feels to be true may be very different from what actually is true. I understand that changing thought patterns is not an easy task. It is a skill that you can learn with practice and professional help.

Congratulations on working through anorexia but OCD can be equally as problematic. Both anorexia and OCD are control disorders. Sufferers are attempting to gain control of their lives but no one with either disorder effectively achieves this outcome. If you haven’t done so already, please seek counseling for your OCD. Very effective treatments exist for OCD, one of the best being exposure and response prevention therapy. The find help tab at the top of this page can help you locate a therapist in your community. I wish you well. Please take care.

Dr. Kristina Randle

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