We all have our own unique habits, superstitious beliefs, or harmless little rituals that we carry out or adhere to on a fairly regular basis. Examples of this are wearing lucky socks or avoiding walking under a ladder, a black cat, and so on.
However, for people suffering from obsessive-compulsive disorder, or OCD, these unique habits take on a different form, known as compulsions. For someone with OCD, obsessions and compulsions cause crippling distress and easily begin to interfere in regular everyday activities.
In popular media, OCD is portrayed as a personality quirk that people have when they’re really picky, extremely phobic, or downright fixated with cleanliness. The problem is, these portrayals aren’t exactly what OCD is about, leading to a lot of misunderstandings and misconceptions.
Obsessive-Compulsive Disorder can manifest in a variety of ways, varying greatly from person to person. There’s definitely much more to it than what is commonly portrayed in movies and TV, oftentimes a lot more difficult to deal with, and quite debilitating in many cases.
In this article, we aim to shed light on many of these myths and mixed-up facts, hopefully giving you, the reader, a better idea of what obsessive-compulsive disorder is really all about.
As its name suggests, obsessive-compulsive disorder has two distinct aspects.
Obsessions are the pervasive, unwanted thoughts, images, or urges, and oftentimes of a disturbing, violent nature involving friends or loved ones. These dark thoughts have become so intrusive that these have already started interfering with work, school, or social life.
And then you have the compulsions— the ritualistic behaviors, mental acts, or patterns sufferers engage in– often repeatedly– to suppress or alleviate the anxiety, fear, overwhelm and stress the obsessions are causing.
However temporary and relatively short-lived, any relief is indeed a welcome respite, and so OCD sufferers often fall back into these compulsions should the obsessions return. Which, unfortunately, the longer one does compulsions, the more likely obsessions are to return.
The fact that these invasive, disturbing thoughts can return any time, and not much can be done by the rituals to seriously alleviate the trouble and anxiety they bring all feeds a vicious cycle: obsessions become even stronger, compulsions become even more time-consuming, wearing out anyone suffering from OCD.
One huge misconception is that sufferers with obsessive-compulsive disorder just have a bunch of annoying habits that can be controlled or stopped anytime.
Understand that OCD is a mental illness— which means there’s something fundamentally wrong in the way the brain is wired or supposed to function. In fact, therein lies the problem: those unfortunate enough to have OCD simply have no ability to just “switch it off.” This is why they are unable to control their intrusive thoughts (obsessions).
For normal people, yes, we might have the occasional disturbing, intrusive thought, but ultimately, we can shrug it off and move on with our day.
Now imagine for a moment what happens if you can’t shrug off these thoughts, and can’t move on with your day.
Sufferers of OCD are simply unable to do the same. Those with OCD have little or no control over their obsessive thoughts or compulsive behaviors, and this causes a great deal of anxiety and distress.
For those with OCD, this is not a willpower issue– it’s more of a physiological inability to correctly process these thoughts because of the way the brain is wired.
OCD is commonly portrayed in the media as someone who is obsessed with being clean and overly sanitary, such as one who is washing their hands or someone who can’t touch doorknobs or handrails. The problem is, many people who fall into these patterns of fixation think they might have obsessive-compulsive disorder.
These actions, among many others, may be examples of obsessive or compulsive tendencies that a lot of us may exhibit from time to time, but actually having OCD is actually quite rare, with experts estimating about 1.5 to 2.5% of the population afflicted with the disorder.
So no, being OCD is not the same as being obsessed with cleanliness.These people more likely just prefer a clean house. And when this is further taken to the extreme, the clinical term for those absolutely fixated on order is called obsessive-compulsive personality disorder, which is completely distinct from OCD.
In the same manner, being overly picky or overly perfectionistic might not necessarily mean you have OCD as well.
So as discussed, just because you’re fixated on being clean, overly detailed and orderly, or a perfectionist doesn’t necessarily mean you have obsessive-compulsive disorder.
There’s an entire set of diagnostic criteria that separates people genuinely suffering from OCD from those who may just be a bit more meticulous or hygiene-fixated than everyone else. Consulting with a doctor, mental health provider, or psychiatrist is really the recommended course of action to get a formal OCD diagnosis.
There are a number of free OCD tests available online, some of them prepared by professionals whose only goal is to help as many sufferers of obsessive-compulsive disorder as they are able to support.
So if you suspect that you or a loved one might have OCD, go ahead and consult with your doctor. A properly trained clinician can administer the proper tests and give you an official diagnosis, letting you know if you actually have (or don’t have) obsessive-compulsive disorder.
The reality is, despite all the advances in research and medical technology, we still don’t have a concrete conclusion on what causes OCD.
Some studies suggest that OCD may have hereditary or genetic components, and can be passed down along generational lines. Another clue we’ve gained is that OCD is somehow associated with decreased serotonin levels.
Serotonin is a neurotransmitter that (among other things) facilitates communication between brain structures, and helps regulate vital processes like sleep, impulse control, aggression, mood, body temperature, and others.
What we’re still trying to find out is whether the lower levels of serotonin is a result of having OCD or the cause of the disorder.
What we’re still trying to find out is whether the lower levels of serotonin is a result of having OCD or the cause of the disorder.
OCD is considered a neurobiological disorder, and so if it’s one thing that we do know so far, is that those who suffer from OCD have brains actually configured to behave in a certain way.
There are three specific regions of the brain involved:
In a normal person, once you get a “something is wrong” thought (e.g. like when you thought you left the door to your apartment unlocked), your orbitofrontal cortex fires up. Your cingulate gyrus then picks up the signal, making you feel uneasy until you fix the mistake (like walking back to your apartment to check your door).
Once you’ve corrected the situation, your caudate nucleus triggers a gear shift function, acknowledging you’ve taken action– letting you then forget about the whole thing and getting on with the rest of your day.
Now with OCD patients, brain scans show these three areas are abnormally hyperactive. The “something is wrong” feeling is magnified immensely, leading to a disturbing sense of urgency and anxiety. The cingulate gyrus is constantly switched on, causing even more distress. Finally, the caudate nucleus is also stuck, so even when corrective action is done, the feeling of anxiousness and stress doesn’t go away.
This explains why those suffering from OCD have the compulsions and the anxiety that they have.
Another common misconception for many people is that OCD is easy to recognize in someone else. Meaning to say people sort of expect someone with obsessive-compulsive disorder exhibit those compulsive rituals or behaviors in the open.
Rituals, like flipping the light switch a certain number of times or aligning their phones to match the corner of a table, might be thought of as amusing by others, and even played up for entertainment purposes in TV and movies, but for a person with OCD, these actions bring about a considerable amount of distress and shame.
You can say that the majority of those suffering from OCD are fighting this battle in their own mind. Keep in mind that it is the uncontrollable obsessions that are at the root of it all, and much of the sufferer’s energy is spent in keeping these thoughts away, resorting to the compulsive mental rituals to deal with the anxiety.
For this reason, those with OCD often bear this burden quietly, suffering in silence and dealing with it all their fear deep down inside, unseen by the rest of us.
Yes, they are. People with obsessive-compulsive disorder are actually hyper-aware of the things they do as a result of their condition, and even understand the relationship between their obsessions and compulsions quite well.
Whatever compulsions they may have, they try to hide the fact that they do these rituals from the public. They know it doesn’t make sense, and that most people just don’t get it. As a result, shame, embarrassment, guilt, fear, and anxiety. So as you can imagine, they’re clearly not having an easy time experiencing life.
Of course, sufferers do the best they can to keep everything under control, especially if they’re going through therapy and know how to manage their anxieties.
Still, the best way for normal people to approach this situation– as with any mental disorder– is with a lot more sensitivity and support. You want to let sufferers know that you represent a safe space where they don’t have to be on guard and they can talk to you about anything.
OCD can also manifest in many different ways, and can also vary in severity from case to case. Most people with obsessive-compulsive disorder are likely to fall into one of the following categories:
A lot of the dark, disturbing, unwanted thoughts sufferers of OCD obsess about generate a lot of guilt and fear. No doubt about it, these could be the worst thoughts you have ever had. On repeat.
And as we’ve mentioned earlier, it’s not as if they can switch off these thoughts– their brains are stuck in a short circuit, or in a non-resolving loop that even amplifies the emotion and the anxiety that comes with the obsessions.
Typically, sufferers of OCD feel guilt at how they are unable to fully manage their own thoughts and these feelings of guilt chips away at their sense of self-worth over time.
Persistent OCD can easily lead someone into depression. Studies show that roughly 3 out of 4 people with OCD ends up with depression as well because of how taxing and demoralizing it is to deal with an obsessive-compulsive disorder on a daily basis.
The constant guilt about disturbing thoughts counter to who they are, and actively trying to keep them at bay just takes so much energy, sapping away your will and resolve, which is why so many people with OCD also end up having depression.
Left to feed on the sufferer’s anxiety, struggling with OCD is a Sisyphean feat, which means that it a task that seems impossible to complete. It’s so hard to feel good about yourself when you’re too occupied either feeling guilty or too drained from the never-ending cycle of obsessions and compulsions.
Now that you have a better idea of what obsessive-compulsive disorder is all about, you can see that the way OCD is depicted in many popular movies and TV shows.
Thanks to character stereotypes in shows like Monk, Friends, Glee,or The Big Bang Theory, a lot of people have misconceptions about OCD, thinking that being overly habitual, perfectionist or anal retentive is what OCD is all about.
Let’s take for example the hit TV show Monk, which ran from 2002-2009, starring Tony Shalhoub (who is a fine actor and did the best to provide an adequately sensitive performance despite the flawed material he had to work with): the premise here is that Shalhoub’s titular character is a detective with severe OCD.
Now, in the show, Monk is depicted as having phobias of all kinds (which really isn’t what OCD is about), being overly fussy about trivial things and fixated with cleanliness (which we also now know is not what OCD is all about). He is marketed as wacky, shown to be anal retentive, a pain to work with, and quite hard to please (which, again, is not what OCD is all about).
Psychology Today pointed out how the show hadn’t quite captured the essence of OCD. Which was a shame, because Tony Shalhoub’s performances were otherwise very “convincing and compassionate”.
Sadly, the title character, storylines, and plot devices were riddled with inconsistencies and often fell flat in terms of realism. And for many who legitimately suffer from OCD, the show was a grave injustice, as it often made fun of the disease without properly depicting the realities of OCD.
Despite having similar names and symptoms, OCD and OCPD are distinct forms of mental illness that have unique and specific characteristics. The main difference is that OCD is designated an anxiety disorder while OCPD is considered a personality disorder.
They might have similar names and symptoms, but OCD (obsessive-compulsive disorder) and OCPD (obsessive-compulsive personality disorder) are two distinct, different forms of mental illness, each one having its own unique and very specific criteria for diagnosis.
To put it simply, OCD is more closely considered an anxiety disorder, while OCPD is categorized as a personality disorder.
A person with OCPD has a strict adherence to order and structure, valuing control at the expense of flexibility, and by extension, openness to trying new things or different experiences. There’s an evident preoccupation with details, lists, or rules to the extent that the orderliness is more important that the actual activity, oftentimes at the expense of everything else.
OCPD has something to do with a strict upbringing, or something that might have profoundly shaken one’s sense of security.
Those with OCPD do what they can to make their own world feel “right” or to otherwise retain some sense of control. Hence, common manifestations may include not having their food touch, having their room or work area meticulously arranged in a certain way, or having perfectly pressed clothing at all times.
In fact, using Tony Shalhoub’s character on Monkas an example, you can say Adrian Monk might likely have OCPD rather than obsessive-compulsive disorder. So when some people say “OCD” they might actually be referring to OCPD instead.
These days, there are a lot of jokes being made about OCD, and while there really is no problem in humor or making light of an otherwise stressful situation, the problem is that much of the entertainment being created has some very inaccurate depictions, as well as stereotypes, of OCD.
If you’re going to make a joke about OCD, you should at least make an effort to gain a better understanding of what sufferers have to go through every day.
So saying “I am so OCD” just because your food can’t touch one another or because you’re nitpicking at the littlest details is pretty unfair, and even hurtful to people who actually suffer from persistent dark thoughts and uncontrollable ritualistic urges.
Those with OCD already have enough of a bad time as it is. They suffer in silence, take great pains to conceal their issues, and already feel a great deal of crippling anxiety, fear, and helplessness. Mockery only makes those genuinely suffering from OCD feel even worse, and even more unlikely to come out and ask for help.
As with many other mental disorders, there are a variety of management plans and treatments that can be implemented to help a sufferer better deal with OCD.
But let’s get something out of the way: there is no cure for OCD. Once you have obsessive-compulsive disorder, it is for life.
Now the obsessions might still be there, but acknowledging and accepting them without having to feel guilty, afraid, or anxious goes a long way towards breaking the cycle and minimizing its effects on you.
It may sound easier said than done, and it does require a lot of effort. But with a mix of proper therapy, medication, love and support, those with OCD can still live relatively happy, normal, and productive lives.
One of the more commonly employed techniques for managing obsessive-compulsive disorder is cognitive behavioral therapyor CBT. Essentially, CBT aims to teach sufferers of OCD how their thoughts, feelings, and behaviors all feed off each other and helps develop better coping skills to break the cycle of negative thinking and behavior.
A lot of the work involved is geared towards empowering the sufferer to be more aware that being able to break this cycle of distorted thinking and distorted behavior is indeed possible and well within reach, now giving them an improved sense of control over the situation.
Acknowledging situations that are stressful and recognizing the need to think more rationally when confronted by stressful episodes are also part of CBT. A hierarchy of obsessional triggers is developed as a tool and a guide, helping the patient be more aware as well as more prepared to deal with these situations.
The goal is to build the patient’s confidence, now having the means to successfully break the cycle, further strengthening resolve with each little victory.
It is important to note that this involves quite a lot of work, and the patient has to be sufficiently motivated enough to work cooperatively with the therapist.
Understandably, CBT might prove to be more challenging for those with advanced cases of OCD, as they have more severe presentations of anxiety. Medication is sometimes used in tandem to help tone down the levels of anxiety, allowing the patient to then engage in therapy.
Yes, there are a good number of books out there on the topic of obsessive-compulsive behavior. A few of them we’ve read so far include: “Brain Lock: Free Yourself from Obsessive-Compulsive Behavior”from Dr. Jeffrey Schwartz. Dr. Schwartz also wrote “You Are Not Your Brain: The 4-Step Solution for Changing Bad Habits, Ending Unhealthy Thinking, and Taking Control of Your Life”, another useful resource in learning more about OCD.
Norman Doidge’s “The Brain That Changes Itself”is another good read with a lot of useful information. Other recommended books would include“Everyday Mindfulness for OCD: Tips, Tricks, and Skills for Living Joyfully”by Jon Hershfield and Shala Nicely, “Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, or Disturbing Thoughts”by Sally M. Winston and Martin N. Seif, and finally, “What to Do When Your Brain Gets Stuck: A Kid’s Guide to Overcoming OCD (What-to-Do Guides for Kids)”by Dawn Huebner and Bonnie Matthews.
While we have made some significant progress in understanding obsessive-compulsive disorder and how sufferers can better manage their obsessions and compulsions, a lot of myths, misconceptions, and misunderstandings about OCD persists to this day.
Today, we know that sufferers from OCD have brains that work differently, leaving them unable to “let go” and moving on with their normal lives. It’s these persistent intrusive thoughts, the guilt and fear they bring, and the compulsions that follow that all feed into an uncontrollable downward spiral of anxiety and distress.
Breaking that cycle is the goal of available therapies such as CBT, empowering sufferers of OCD to eventually take better control of their situation, and also building their confidence and self-esteem in the process.
OCD is a serious condition, and those who feel they suffer from it can seek professional help. It is important to get a formal diagnosis from an OCD specialist, doctor, or psychiatrist.
Aside from access to regular supervised therapy and medication (in more advanced cases), there are a lot more resources now available online through websites dedicated to improving mental health, and online communities where much-needed support can be found.
Most importantly, a lot more love, sensitivity, and understanding can go a long way. For the benefit of those suffering from OCD, we can all do so much better by creating a more welcoming, secure, and nurturing environment so they can get all the help and support they so badly need.
If you or someone you love is still trying to recognize if they have OCD, take this free online OCD test.