Misunderstanding OCD

We’ve all heard people describe themselves as being OCD. Such as, “I’m so OCD, I have to alphabetize my spice cabinet” or “I’m so OCD, I have to write in blue ink.” Things like this are often said, in a self-deprecating, negative tone of voice but everyone has a good chuckle about it. We all know what the person is saying, that they are super organized or really particular about something and the term OCD just seems to cover it all. No harm done, right? Wrong.

OCD, Obsessive Compulsive Disorder, is a significant mental health diagnosis that is defined in the DSM-V as recurrent, intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that take up more than one hour of a person’s day and/or cause significant distress or impairment in their daily living. Treatment can include evidence-based therapeutic modalities and, for some, medication, as well. This is very different from being extremely organized or particular about certain things.

This cavalier attitude towards OCD helps perpetuate the stigma of both this particular diagnosis and all mental health issues. This makes it less likely that someone will feel comfortable reaching out for help and can increase the shame people may feel when given a mental health diagnosis.

Let’s look at some common misunderstandings about OCD:

• “Relax, you’re overreacting.” OCD is not about being “high-strung” or “too emotional.” Part of the OCD diagnosis is having unwanted persistent thoughts (obsessions) which can be made worse in stressful situations. These unwanted thoughts can involve topics such as contamination, perfectionism, harm coming to oneself or a loved one, loss of control over one’s actions, unwanted violent or sexual thoughts and/or religious obsessions. The repetitive behaviors (compulsions) are done as a coping mechanism to handle the anxiety brought on by the obsessions. These behaviors can include frequent and excessive hand washing, cleaning, checking (that the door is locked or the oven turned off, for example), counting, praying and/or repeatedly reviewing things in one’s mind.
• We all do these things at some point or another. Yes, this is true. Just as many of us might go through a period of depression or anxiety, some of us may exhibit a trait or two that could be defined as part of the OCD criteria. These brief periods of experiencing these traits or conditions, however, do not mean that we meet the full criteria for a DSM-V diagnosis. When one meets the full criteria for a diagnosis, it often means the criteria are causing an impairment in an individual’s daily living; that the individual would describe it as interfering in their ability to live their life as before.
• Being a “neat freak” means you have OCD. There are many people who equate OCD with frequent handwashing or someone who bleaches every surface of their home. Remember, though, as described above, individuals experiencing OCD can be triggered by many different things. In addition to handwashing and cleanliness (contamination), these triggers can include perfectionism, fear of harm coming to oneself or a loved one, loss of control over one’s actions, unwanted violent or sexual thoughts and/or religious obsessions, just to name a few. The compulsions of individuals experiencing OCD are a way for them to ease the anxiety they are feeling. Compulsions can include things like repeatedly checking to make sure the oven is turned off or the front door is locked; repeating the same action over and over until the individual feels it was done “correctly;” and counting items to certain numbers or doing things a certain number of times.
• People with OCD are “weird” or “crazy.” Individuals experiencing a diagnosis of OCD are dealing with a significant mental health diagnosis. So significant that Obsessive Compulsive Disorder has its own chapter in the DSM-V: Obsessive-Compulsive and Related Disorders. While significant, OCD is also treatable and individuals with this diagnosis have a high probability of being able to lead full and productive lives. Exposure and Response Prevention (ERP) is an evidence-based therapeutic modality for working with OCD. This modality falls under the umbrella of Cognitive Behavioral Therapy (CBT). Medication, for some, is also helpful. Therapy options reach even farther when considering family therapy and support groups.

Receiving a mental health diagnosis is along the same lines as receiving a diagnosis from your doctor. For example, you may need to take medication on a regular basis, return for regular check-ups and make some lifestyle adjustments. A mental health diagnosis may require the same exact steps. With better understanding, hopefully we can leave individuals feeling better informed and with a greater understanding of not only OCD but with mental health in general.

“I’m soooo OCD” + Other Common Myths About Obsessive Compulsive Disorder. Retrieved from iocdf.org/brochures-and-fact-sheets/