Transferred to our Brisbane newsroom from Sydney, she introduced herself as the managing editor of our Escape travel section. She was also newly returned from a work trip to Fiji or Italy or some other exotic locale – I don’t remember where.

What I do remember is thinking how sophisticated she seemed. Worldly. Well travelled. Whip smart. All of which is to say there was nothing – absolutely nothing – in her demeanour to suggest that she was imagining an armoury of knives stabbing my face.

While I was thinking about how cool her necklace was, she was thinking about how she could possibly keep her face impassive given the bloody horror she saw unfolding on mine.

Armstrong, 51, has Obsessive Compulsive Disorder, or OCD as it is more commonly referred to. Diagnosed just a year ago this month, she has been accompanied by its dark shadow since she was a little girl.

In that time and throughout decades of both misdiagnosis, and missed diagnosis, she somehow learned how to live with it. Manage it. Mask it. Mute it.

But it is only now, some 40 years after it began its assault on her mind and spirit, that she is ready to talk about it.

Earlier this year, Armstrong approached me at work one day, and said, in her quiet and steady manner, that she had a story for me. Sure, I answered, what’s it about? “It’s about me, actually, but it’s also about hundreds of thousands of other people like me,” she said.

It is for those people that Armstrong has decided to share her story. Because while this highly complex disorder presents itself in many different manifestations, Armstrong says that for many sufferers there is one abiding commonality. Shame.

“There are so many people with OCD who don’t seek professional help because of those feelings of shame, and I’m hoping that by speaking about my own experience, someone might recognise themselves and ask for that help,” Armstrong says.

She’s also hoping that by sharing her experience, people might learn not just what this long misunderstood and frequently misdiagnosed disorder that an estimated 500,000 Australians have is, but what it is not.

OCD is not just washing your hands again and again. Or lining up things in a row. Or flicking a light switch on and off 27 times. It’s not just performing an elaborate ritual of specific movements in a specific order.

To be clear, it can certainly be all of those things, but it is also so much more.

There are many different categories – also sometimes referred to as themes or subtypes – of OCD, but each is characterised by a cycle of obsessions (including intrusive thoughts, images and urges) and subsequent compulsions. These are mental or physical actions or rituals performed to cope with, or relieve the anxiety, of the obsessions.

Doctor of clinical psychology, Jessica Byrne, who works specifically in treating OCD and runs an outpatients course at Brisbane’s Belmont Private Hospital, says while there are “many types of OCD, the three most common are contamination, harm, and just right”.

In the broadest of explanations, contamination is an obsession around dirt or germs; harm is an obsession around harming oneself or others, and just right is an obsession for things or experiences to be perfect, “just right”, or “just so”. Each has its own array of compulsions that may follow.

Other subtypes of OCD may include religious, moral, responsibility, relationship, sexual, pedophilia and existential – and a person may also have more than one of any of the above in varying degrees.

It is still not known exactly what causes OCD, but the current thinking is that it is a combination of genetic, biological and environmental factors, including childhood stress, or trauma.

Statistics show that 80 per cent of individuals with OCD first experience symptoms in childhood or adolescence.

What is known is that it is a particularly distressing disorder – the World Health Organisation ranks OCD as one of the top 10 most disabling illnesses of any kind – and one where the stigma associated with it has prevented many sufferers from public disclosure, seeking help, or both.

Until recently. Like Attention Deficit Hyperactivity Disorder (ADHD) before it, OCD is, in the crudest of terms, having a moment.

There are growing numbers of social media accounts and podcasts, and help groups centred around OCD and high-profile figures with the disorder are speaking up, including David Beckham, Cameron Diaz and Jessica Alba.

In June this year, British actress Tuppence Middleton (Downton Abbey) published a best-selling book, Scorpions: a Memoir, about her experience. Middleton calls her brutal OCD “the scorpions in my head”.

Armstrong also has a name for her OCD. She calls it “my personal stalker”. And it began stalking her when she was just 11 years old.

That’s where she starts her story, that first time it entered her home, her bedroom and her head, leaving her terrified and gasping for air under the covers.

“My mother and I had moved from where we had been living in Papua New Guinea to Tweed Heads (NSW) to live with my Nana,” Armstrong recalls.

“One day I was catching the bus to school and I remember looking out the window and seeing my Nana running for a different bus. She was on her way to do some volunteer work and I just remember thinking that she wasn’t going to make it, and that it was all my fault.

“I just had this overwhelming sense of responsibility for her that spiralled into a sense of doom throughout the day.

“I was in this panic, just this sense of suspended fear and then over the next few weeks, when I went to bed every night, I would be consumed by intrusive thoughts of being buried alive. It wasn’t just a disturbing thought though. It was visceral.

“I would be lying on my bed but it felt like the ground, and the dirt would start falling on top of me. The dirt would start falling and falling, until I couldn’t breathe properly. I would just lie there trembling until I fell asleep.”

The next day, she would get up, get dressed and go to school, not saying a word to anyone about the terrors of the night before.

Armstrong says that while her childhood was, in many ways, a happy one – it was also quite disrupted. After her parents parted ways when she was two years old, Armstrong and her mother spent some years in Tamworth, Adelaide, Papua New Guinea, Tweed Heads and Brisbane.

By the time she finished her senior education, Armstrong had been to 10 different schools, including boarding school. By the time she was 18, she had moved by herself to Sydney and into her own apartment.

And all the time, her personal stalker was shadowing her steps.

“When I moved to Sydney, I really wanted to be in a big city and live a big life,” Armstrong remembers.

“I got a job as an editor’s assistant at a magazine, and life was pretty good, and pretty exciting. I was living in Bondi with a girlfriend, and we were partying a lot and it was so much fun. Carefree.”

Until it wasn’t. One night, in 1993, out of the blue, she fell into what she now describes as “a very deep, dark hole”.

“I was over at a friend’s house and I just started spiralling, I had a panic attack. I remember my friend saying, ‘You okay, Kel?’ and all I knew was I had to get out
of there. I went home and tried to make sense of the storm raging in my head.
I was in a very, very bad way. But for no obvious reason.”

Concerned, her friend booked an appointment with a psychologist, who diagnosed the-then 20-year-old with depression.

“She put me on Prozac and said, ‘This will show you how to be happy again’.”

And for a time it worked. Until it didn’t.

Her personal stalker showed up again when Armstrong turned 21, and this time it wasn’t mucking about.

“I started having thoughts that I was being cut by razor blades,” she says, “and it was frightening and confusing, especially for a young girl.”

Armstrong couldn’t bring herself to tell her psychologist or anybody. Instead, she did what many of us do when unable or not ready to face something truly confronting – she ran from it.

With her mother and stepfather now living in Colorado in the United States, Armstrong visited them, then began travelling, first to New York and then joining the millions of other young Aussies living in London.

“Those years in London were really happy ones for me,” she says.

“I was working in retail, I was going out a lot and I ended up falling in love. It was a really happy, healthy relationship for three years until I was 27.

“I still had the tendency to think negatively, but I was mostly really, really happy, and the dark thoughts that had been impossible to dismiss were kept at bay.”

When the relationship ended, however, all the light in Armstrong’s world went out.

“Oh,” she says, a world of pain contained in that one small word, “it was horrible. I returned to Sydney, and then the razor blades started stalking me again, and never let go until I was about 40. For the next decade or so it was very intense.

“I couldn’t have razor blades in my bathroom and I’d hide them in hotel
rooms. I couldn’t have knives on display or in the sink. Every time I’d pick up a knife to use it, I would unwillingly visualise hurting myself. That would be my immediate thought.’’

If those thoughts were not frightening enough, over the next decade, Armstrong would also have to deal with the fear of swallowing her own tongue. Or chewing it.

There were also feelings of being sucked into a vast, empty black hole. Thoughts and urges to end her life. To drive her car dangerously – her personal stalker urging her on every step of the way.

“During these cycles of OCD I’d perform mostly mental compulsions to relieve myself from the relentless anxiety the thoughts triggered,” she says.

Thoughts that were the complete opposite of her true self caused enormous doubt and confusion.

“I’d ruminate on these thoughts and what they meant for hours. I’d Google for answers I’d never find, replace the thought with something else, argue with the thoughts over and over. I honestly thought I was psychotic or going crazy,’’ she says.

And all the while, she somehow kept going. Kept getting dressed in those stylish clothes I so admired that first day I met her. Kept moving up the career ladder. Became a journalist. Then an editor. Then managing editor of Escape. Travelled the world. Made lifelong friends. Enjoyed loving relationships. Kept trying to put one foot in front of the other while her own scorpions skittered around her head.

She kept trying to get better, she kept seeking psychological help, including talk therapy. Sometimes this would work for a period of time, and sometimes it wouldn’t.

She was diagnosed and treated for Generalised Anxiety Disorder (GAD), and medicated accordingly. Make no mistake, Armstrong says she certainly has that condition, and sometimes slipped into depression. Little wonder, given the internal battles raging inside her head, but OCD was never mentioned by any of the health professionals who treated her.

Indeed when she herself raised the possibility with one psychologist, she was told no, she did not have it because there were no obvious compulsions.

She knows now though. She knows exactly what she has. Armstrong has moderate, clinical OCD, and her subtype is harm. She also has sensorimotor, which is basically when someone is highly focused on a particular part of their body – in Armstrong’s case, her tongue.

Harm OCD, as mentioned earlier, centres on the fear of hurting yourself, or others, in the form of unwanted or intrusive thoughts or images. This leads to physical or mental actions to try to relieve the anxiety associated with the obsession.

In some cases, a person might hear about a crime in the media, and wonder if they committed it. In others they might hide all sharp objects in their house – in all cases it is, as Armstrong says, “a nightmarish way to live your life”.

Her own nightmare loosened its grip on her (although she continues to monitor, and take care of her mental health) on July 31 last year, the day after her 51st birthday.

Her GP wrote to Anxiety House in Brisbane where she was placed on the waiting list to see a psychologist who specialises in adolescent and adult OCD. The GP also referred Armstrong to a psychiatrist at Brisbane’s Belmont Private Hospital.

And it was that psychiatrist who, after several assessments, told Armstrong what her personal stalker’s name was.

They recommended Exposure and Response Prevention (ERP) therapy and Armstrong began fortnightly treatment at Anxiety House Brisbane.

“From the moment I sat down with my psychologist at Anxiety House, and told her all about my mental health history, she said, ‘You have OCD, and you’ve had various cycles of OCD throughout your life. You’ve had it as a child, you’ve had post-natal OCD, you have perimenopausal OCD, and I want you to know that I can help you. I want you to know there is a specific type of therapy which will help you’, and I think I just burst into tears. It was this enormous wave of relief … saying you are not alone, and you are not crazy.”

It was the reassurance that Armstrong needed. Because Armstrong is also a mother – and a really great one.

I know this from hearing her talk about her beloved little girl, the photos she shares of the two of them, and the joy in her voice when she speaks of her eight-year-old daughter. But becoming a mother also saw Armstrong experience some of the harshest blows that OCD can land.

“When I was 43, I got pregnant (although no longer with her daughter’s father, their relationship is amicable and her former partner regularly sees his daughter), and I’d had three miscarriages previously so I was already quite anxious,” she says.

“My obstetrician in New York said she’d like me to see a psychiatrist. I went on a very low dose of an antidepressant which was the equivalent of Prozac.

“But after I had this beautiful little baby, my OCD spiralled (OCD cycles very commonly spike during periods of marked hormonal changes such as adolescence, pregnancy, post-natal, perimenopause and menopause), and it was just horrible.

“I would find myself going out and I’d walk into the subway and I’d have these dreadful visions of someone hurting my baby. But I would force myself to go because I wanted us to get outside and enjoy the day.

“But then this little person that I love more than life itself, you know that I wanted with all my heart, to be having these visuals of something terrible happening to her, was … well, it was terrifying. I would look around and the image in my head seemed so real, like it was actually happening. Your body’s physical response is to go into flight or fight mode.

“I now know that, in OCD sufferers, the rational part of the brain is overtaken by the instinctual brain due to processing errors. I’d go into this panic.

“I’d start shaking and trembling, and I was so scared to tell my psychiatrist.”

Occasionally – and for Armstrong this has been by far the most distressing part of the disorder – she wondered if she herself would harm her baby. Something she has never and would never do.

Because here’s probably the cruellest thing about OCD. It lies. It lies and lies and lies. And the biggest lie it tells its sufferers is that they will harm the thing or the person they love the most.

People with OCD are the least likely to act on their intrusive thoughts. There’s a name for this aspect of OCD. Ego dystonic.

“Ego dystonic means that it is actually the complete opposite of who you are, your morals and your values. It tells you that you will do the one thing that you would actually never do,” she says.

“But of course, the fact that you’re even thinking it makes you believe that you are …” there is a long pause, “the worst person in the world. And it’s near impossible to stop thinking about it. Like the pink elephant metaphor.”

Armstrong is, in fact, a great person. Kind. Friendly. Strong – and getting stronger every day.

When her psychiatrist told her there was a specific type of therapy that would help her, it was ERP.

Byrne says there is “very strong evidence” that it improves OCD.

“People with OCD avoid their fears through the use of repetitive behaviours, known as compulsions,” she says.

“However, in the long term, these compulsions reinforce OCD.

“What ERP is about is slowly and systematically getting people used to their fears – which is the exposure part, without using compulsions – which is the response prevention part.”

Byrne says ERP is tailored to each individual, based on their core fear.

“For example, for a person with harm OCD, ERP might look like spending time with loved ones while experiencing intrusive thoughts without using reassurance or checking behaviours.

“When they are at a family dinner, for example, they might repetitively ask ‘Have I done something wrong?’ ERP teaches them, through experience, that thoughts are not facts.”

For Armstrong, ERP therapy, which she has done for the past eight months with a psychologist at Anxiety House Brisbane, has “changed my life”.

“When I started ERP, we sat together and came up with a hierarchy of exposures,” Armstrong says.

“My list included walking around the knife section of a department store which would be a three out of 10 on a scale of how much anxiety that would give me.

“Another one of my exposures was to watch Dexter (a television series centred around a serial killer that Armstrong had avoided), and also to use knives at home, to cut up vegetables without doing the compulsions.

“To know that the thoughts could come and go and that nothing is going to happen, and by not giving attention to those thoughts, that everything really is fine.”

Armstrong says she also had to read articles about celebrity suicides and studies on suicide statistics.

“At first this gave me a lot of anxiety,” she says, “but then I got to the point where I could read them with interest only.

“I can watch and read these things and feel educated instead of terrified that I am going to become one of those statistics.’’

The best way to describe what ERP has given her is respite. And hope.

At her last appointment with her psychologist, Armstrong was told she could reduce her fortnightly appointments. She was told that she had reached a point where she could, as she says, “just live her life”.

And while she says she will continue to prioritise and check her mental health, her personal stalker no longer lurks at every corner. And when it does show up, she has the tools to manage it.

“OCD is like being in a constant battle between the devil and the angel on your shoulders. It’s like you’re in quicksand, and you are trying to breathe and claw your way out. The harder you fight to get out, the more you get sucked in.

“The gift I have now is the understanding that the more you do the trying, the more you do the rumination, and the compulsion and the analysis – the more you desperately try to cancel those thoughts – the more power you give them.

“You get this temporary relief, but because you’ve paid such attention to it, the next time, it just comes back stronger. Because you’ve treated it like it’s real – and it’s not.”

Armstrong smiles her big, glorious smile. She reiterates her hope that someone will read her story and be helped by it. She looks at me and thanks me for listening.

I look at her and think that my first impression of her was exactly right. She is worldly, well travelled and whip smart.

But there’s something else too.

Kelli Armstrong is also one of the most courageous people I’ve ever met.

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Beyond Blue 1300 224 636

Visit sane.org.au, treatmyocd.com or ocdclinicbrisbane.com.au