“That’s So OCD”: Understanding What Obsessive Compulsive Disorder (OCD) Really Is
You’ve probably heard someone at some point in their life casually say something like “I’m so OCD” or “that’s my OCD” when pointing out their preference for things to be organized or their desire to keep things tidy. If you’re reading this, you may already know the truth- OCD is not a cute personality quirk, it is a real, sometimes debilitating condition that is often misdiagnosed and misunderstood. Today, I’m going to try to break it down a bit more.
What OCD Actually Is:
By definition, OCD involves two categories of symptoms:
Obsessions: intrusive, unwanted thoughts, images, or urges that are upsetting and cause distress.
Compulsions: Outward behaviors or mental acts that are done to decrease the distress related to the obsessions or to prevent something bad from happening.
OCD is not about someone doing things a certain way because it makes them feel good. It is engaging in behaviors or mental acts because it is the only thing that will reduce the significant distress caused by obsessions and provide temporary relief.
However, unlike the satisfaction one may get from organizing their closet by colors, the relief or “satisfaction” those with OCD get from engaging in compulsions doesn’t last. This results in a never-ending cycle of having to repeat compulsive behaviors to regain the sense of relief.
OCD Preys on Uncertainty
OCD loves to latch onto the “what ifs.”
What if something bad happens and it is my fault?
What if I think I am making choices because I think they make me happy, but I should be doing something different that could make me feel happier?
What if I miss something important and there are severe consequences because of it?
Because there is nothing certain in life (except death and taxes, depending on who you ask), OCD tricks people into an ongoing search for reassurance.
OCD Targets What We Care About Most
OCD tends to latch onto what means the most to someone- this can include things like values, relationships, and morality.
That is part of what makes OCD so distressing – the thoughts and obsessions go against what a person believes. Sometimes this results thoughts that are very disturbing, even taboo (more on that to come in another post).
It can also make it more difficult for people to open up about their symptoms. They fear that they will be judged or misunderstood.
OCD Can be “Invisible”
Even if someone understands how severe OCD is, there still are many misconceptions. I would argue that the most recognized themes of OCD are those that involve outward compulsions- things like excessive handwashing, checking things, or cleaning. As mentioned earlier, compulsions do not have to be outward behaviors, they can be mental acts too.
This can look like:
Repeatedly scanning your body and ruminating about physical sensations to ensure you’re not contaminated or you don’t have a serious illness
Self-reassurance and mental checking that you did not do anything to offend someone or cause harm
Compulsive prayers or repeating numbers or phrases in your mind to prevent something bad from happening
Why Is OCD Misdiagnosed?
Unfortunately, It can take many years for someone with OCD to receive the correct diagnosis, even after they seek help. There are several factors that can contribute to this.
Shame: OCD can result in very stigmatizing thoughts. Most people are not comfortable sharing these thoughts with others. In fact, many are afraid of anyone ever finding out some of their thoughts.
Stereotypes: People may not recognize their symptoms or know how to describe them if they do not look like the “OCD” they have seen portrayed.
Mental Compulsions: These are often missed or go unrecognized as compulsions.
Symptom Overlap: Symptoms can overlap with other conditions, leading to misdiagnosis. Common misdiagnoses include other anxiety disorders, depression, ADHD, and even psychotic disorders. OCD can also occur alongside other psychiatric conditions.
Why Diagnosis Matters:
OCD is very treatable, but it requires specific types of treatment—which is why an accurate diagnosis is so important.
The gold standard therapy for OCD is Exposure Response Prevention (ERP), which increases ability to tolerate the distress related to obsessions while reducing reliance on compulsions to decrease that distress.
Medication can also be helpful when used in conjunction with therapy. However, medications and dosing for OCD differ from those used for depression or generalized anxiety, making an accurate diagnosis essential.
If this information resonates with you, you are not alone and help is available. As always, if you are concerned that you may have OCD or another mental health condition, it is best to seek evaluation through a qualified mental health provider rather than self-diagnose. I plan to write more about OCD in the future, but for now, if you want more information about OCD or finding treatment, the following resources can be helpful:
Resources:
International OCD Foundation (IOCDF) https://iocdf.org/
BeyondOCD.org https://beyondocd.org/
NOCD https://www.treatmyocd.com/learn/blog