Obsessive-Compulsive Disorder is a serious mental illness that is often misunderstood, trivialised, and stigmatised to the detriment of people who genuinely suffer from the disorder. Here’s a list of 15 things people with OCD want you to know about our illness, to break down some stereotypes and help diminish the stigma surrounding this distressing disorder.
We’ve all seen those who love getting into the Christmas spirit joke about their ‘Obsessive-Christmas Disorder’, or people who are neat and organised laugh self deprecatingly about being “sooo OCD!”. But Jeff Szymanski, executive director of the International OCD Foundation, explains how the severity of ‘compulsive’ and ‘disorder’ become lost when ‘OCD’ is used as a common descriptor:
“‘Obsessive’ is a personality trait. It doesn’t get in the way of your functioning, it’s something you prefer. What people are meaning to say is, ‘I am obsessive rather than OCD’. You’re now mixing a distressing psychological disorder with a personality preference, and when you mix them, you lose the severity of the disorder.”
Depictions of Obsessive-Compulsive Disorder in popular media often portray the patient as being quirky or unconventional as opposed to suffering from a debilitating mental illness – seen in characters like Adrian Monk, the defective detective who solves crimes with the help of “his sympathetic but funny “problem””, or Glee’s Emma Pillsbury, who dons a pair of plastic gloves to sanitiser her (colour co-ordinated) grapes at lunch. OCD is often played for laughs in this way, which only spreads misinformation and reiterates hurtful, overly simplistic stereotypes about individuals with OCD.
Obsessive-Compulsive Disorder is an anxiety disorder that affects roughly 2% of the population. OCD is often accompanied by other psychiatric disorders, with the comorbidity rate being as high as 90%. Those suffering from OCD are ten times more likely to commit suicide than the general population, and suicidal ideation (thinking about or planning suicide) is prevalent among people with OCD.
OCD is characterised by unwanted negative thoughts or ‘obsessions’, which can only be (temporarily) relieved by performing an irrational ritual, or ‘compulsion’. An unwanted thought could be the fear of contaminating food served to others, which would naturally cause most healthy people to wash their hands. For people with OCD however, the anxiety that we might serve someone else poisoned food isn’t eased by a thorough hand wash. A patient is compelled to repeatedly wash their hands, not out of any realistic concerns about germs, but as a way to deal with our heightened sense of responsibility for the safety of ourselves and others.
Problematic shows like ‘Obsessive Compulsive Cleaners’ depict those with OCD as having a positive quirk that makes us housekeeping superstars, but the reality of OCD is much different. Because obsessions revolve around anxieties, the compulsion to clean is often irrational, and a person with OCD might focus on obsessively cleaning one area of a house that causes them anxiety, while leaving the rest in a state of disarray (in fact, hoarding is actually a common symptom of Obsessive-Compulsive Disorder).
Symptoms of OCD range from more benign obsessions such as a fear of germs or forgetting to lock the car, to fears of acting on unwanted impulses, intrusive violent images, religious and moral fixations, or thoughts about pedophila and incest.
Everyone suffers from the odd intrusive thoughts, but people with OCD struggle to dismiss them and tend to assign meaning to and dwell on these thoughts, which in turn leads to more compulsive rituals. Julie Zack explains:
You may see a person crossing the street from your vehicle, and think that you could physically run them over. You would usually dismiss this as an odd thought because, of course, you would never actually do that. Someone with OCD might think the same thing, and the thought will replay over and over again causing debilitating stress. The OCD individual may even check their front fenders a few times after driving, or return to the crosswalk to make sure that they did not actually run someone over. They will know by memory that nothing happened, but the fear and anxiety of even considering causing harm to another human being is so intense that checking to make sure it didn’t happen seems to be the only option.
Estimates from the International OCD Foundation suggest that it can take between 14 and 17 years to get an appropriate diagnosis.
Many assert there is a neurological basis to OCD that involves an imbalance of chemicals such as serotonin, meaning that antidepressant medications might ease symptoms for some people, while others posit behavioural, genetic, and autoimmune causes. Cognitive behavioural therapy techniques may be useful in treating people with OCD, but the misinformation around the illness combined with extensive wait times between onset and diagnoses means that Obsessive-Compulsive Disorder is often left untreated for long periods of time, and usually turns chronic (with remission rates as low as 20%).
Not only is living with constant anxiety and bouts of depression incredibly draining, but performing physical compulsions all day long is exhausting for people with OCD. Likewise, compulsions can be incredibly time consuming; for example, the fear of an unlocked front door may make a person return home multiple times to check, resulting in them missing their school bus or being late to work.
OCD side effects include difficulty maintaining relationships and employment, substance use disorder, and physical evidence of compulsions such as damaged skin or patches of missing hair from OCD spectrum disorders such as trichotillomania (hair-pulling disorder).
One of the defining characteristics of OCD for most people is the knowledge that our obsessions and compulsions are indeed irrational (distinguishing OCD as an anxiety disorder as opposed to a psychotic illness). As Brianna Wiest explains, “The big reason why people with obsessive thoughts or compulsive behaviors can’t get past them is because … they are associating a cause-and-effect that, while improbable, isn’t impossible. It’s not out of the question for a headache to be cancer, or a bad review to mean being let go from a job”. People with OCD are often extremely logical, but their rationale is founded in anxiety and hyper vigilance rather than a probable reality.
Physical rituals for people with Obsessive-Compulsive Disorder are only part of the issue – most of us suffer from a range of mental rituals including counting, mentally repeating specific phrases, and compulsive visualisation and substitution of distressing images with neutralising alternatives. Many people with OCD are highly intelligent and high functioning, while also fearing the inevitable discrimination that accompanies their illness, meaning we might outwardly appear to be in control while concealing paralysing mental symptoms.
The list of famous OCD sufferers is extensive and includes greats such as Albert Einstein, Nikola Tesla, Howard Hughes, Leonardo DiCaprio, David Beckham, Lena Dunham, Rachel Bloom, Megan Fox, and Amanda Seyfried, among others.
Slowly but surely, we’re working to reduce the stigma surrounding Obsessive-Compulsive Disorder. Organisations like the International OCD Foundation and StigmaWatch aim to challenge ignorant and stigmatising ideas about OCD, while shows like Crazy Ex-Girlfriend and Pure work to dismantle stereotypes about mental illness in the media. You too can help by reading and writing about OCD, actively challenging misconceptions about OCD, and by striving to end the trivialisation of serious mental illnesses.
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