Obsessive Compulsive Disorder (OCD) is widely recognized by the public, but it is also highly misunderstood. People believe they know what OCD means, but conventional understandings of OCD are far from the truth.
The problem with misinformation about any mental condition is that it keeps people from getting help to reduce their suffering. This misunderstanding of OCD frequently leads many who need treatment not to seek it, because they do not know that what they are experiencing is OCD. It is a disorder that can attack someone’s very values, identity, and sense of safety, and it’s most often talked about as a mere personality quirk or desire for organization. Far from what so many people believe, OCD can be completely debilitating.
As someone with OCD myself and a licensed therapist who treats other people with the condition, here are 5 things you should know about OCD:
OCD Is not what most people think
Unfortunately, in popular culture, OCD has become a sort of catch-all phrase associated with certain characteristics or personality traits. Many of these traits may suggest positive or helpful attributes. Characters on television and in the movies throughout the last few years can be seen portraying stereotypical “OCD behavior.” This portrayal often involves high levels of intelligence, social awkwardness, extreme neatness or cleanliness, or encyclopedic memory. They may demonstrate an extensive focus on details, perfectionism, and other quirky behaviors.
In reality, OCD is a debilitating but highly treatable condition that affects approximately 1 out of 40 people worldwide. OCD is characterized by a cycle of obsessions and compulsions. Obsessions are recurrent, unwanted, intrusive thoughts, images, feelings, or urges. These obsessions cause significant distress and anxiety in the individual experiencing them. Due to this discomfort, a person with OCD feels a strong urge to engage in compulsions, sometimes called rituals. Compulsions are any physical or mental action that an individual engages in an attempt to reduce anxiety, “undo” an obsession, or prevent a feared outcome.
That’s why, unlike its pop culture portrayal, OCD is not cute, funny, quirky, or beneficial, but painful, all-consuming, and terrorizing.
OCD is not a “one size fits all” diagnosis and manifests in many ways
Even if people have an understanding of the suffering OCD can cause, they have likely been exposed only to a couple of ways that OCD can present: people knocking on things several times, repeating certain phrases out loud multiple times, tapping or touching doorways, refusing to touch certain things, washing their hands repeatedly, making sure things are lined up symmetrically.
OCD involves so much more than this. What is often overlooked or ignored is the obsessions that frequently happen inside a person’s mind. These unwanted, intrusive, and distressing thoughts and doubts are the cause of the compulsions that others may witness. Some may experience taboo intrusive thoughts, which can be sexual or violent in nature. Others may obsess about whether they have done something terrible in the past, acted in a way that was inappropriate, said the “wrong” thing, lied, or cheated—the list is endless.
For example, OCD may tell the most faithful believer that God is disappointed in them and that they cannot be forgiven. OCD can whisper to a new mother who would do anything for her child that she could harm her baby, even though she does not want to do so. OCD will try to convince a partner that they have been unfaithful and need to leave. OCD will create doubt and confusion in the most valuable parts of a person’s life.
There are hundreds of different ways OCD can manifest, and the condition can attach itself to anything. It is as unique as each mind it invades. Many people will also report that their fears change from time to time, or that they experience several themes of OCD at once.
OCD isn’t always visible
One of the key mischaracterizations of OCD is that the condition is always visible and that someone with OCD will always show outward signs of the disorder. Actually, the two primary components of OCD, obsessions, and compulsions, can both go completely unseen by others.
The first—obsessions—involves thought processes, imagery, feelings, and urges that often cannot be seen by anyone. In my own experience treating people with OCD, one of the most somber things I hear is that they had no idea that their intrusive thoughts were part of a mental health problem. They had always heard that OCD was nothing more than performing specific actions like excessive hand-washing or lining things up a certain way. They never knew that having thoughts that troubled them, disgusted them, or caused them shame could be a sign of OCD.
The second—compulsions—refers to the actions taken in response to OCD fears, or obsessions. Though compulsions are thought to be physical, there are many times when compulsions are not seen by others, as they can also be entirely internal or obscured. They might occur in one’s mind, or in their interactions with others. Examples of unseen compulsions include rumination, mental reviewing, reassurance-seeking, distraction, avoidance, or any attempt to escape or find answers to an individual’s particular obsessions.
In many cases, people I worked with had not sought much-needed treatment for years because they believed their thoughts and behaviors were simply a part of who they are, and that there was nothing they could do about it. They suffered in silence for many, many years. In fact, research suggests it takes people with OCD 14-17 years on average to receive a formal diagnosis and evidence-based treatment. The lack of understanding and awareness is immensely important: OCD has been considered by the World Health Organization as one of the top 10 most disabling conditions, and untreated OCD leads people with the condition to be 10 times more likely than the general population to die by suicide.
OCD can have a severe impact on everyday life
The toll that OCD takes on daily living can vary from person to person, but often, the condition impacts many areas of functioning. People with OCD often report having relationship issues, trouble attending school or work, struggling with self-care, difficulty engaging in meaningful activities, and so on. Their physical health can even be impaired.
People who struggle with OCD are at greater risk of developing substance use disorders or other unhealthy coping mechanisms in an attempt to combat the intense feelings that OCD causes. It is also not uncommon for people with OCD to suffer from other mental health problems, like depression, as a result of their OCD symptoms. People with OCD may isolate themselves, and prefer to be alone. They may make excuses not to engage in activities that could cause them discomfort.
When OCD is misrepresented, it can lead many to be unaware of the true cause of several issues they’re facing. But, by understanding and getting proper treatment for the root cause, people can improve their overall quality of life, while their symptoms of depression, stress, and anxiety decrease—all because they are targeting the core issue: OCD.
OCD is very treatable and can be managed long-term
The good news is that today, far more than ever before, we know a lot about OCD. As we continue to educate others about what OCD is and what it isn’t, more and more people who desperately need treatment are able to get it. Exposure and Response Prevention (ERP) therapy is the most effective treatment for OCD, backed by decades of clinical research. For some, a combination of ERP and medication may be best.
ERP treatment involves teaching people to respond to their fears without responding to a thought, image, urge, or feeling by performing compulsions. In ERP, a therapist guides an individual through exposures that trigger their fear and anxiety and helps them learn to sit in the discomfort that this causes. Over time the person begins to recognize that they can handle distress and accept uncertainty about their fears, even though they may not like it. They learn that anxiety is just a feeling that will pass on its own.
ERP helped me—and it can help you too
OCD doesn’t need to take this toll on you forever. Once you find effective treatment, you can gain your freedom back. You’ll see that OCD doesn’t have to dictate what you need to do. You can live a happier, healthier, and more meaningful life.
Through ERP, you can learn to tolerate the feelings that intrusive thoughts may cause you, without participating in compulsions. ERP is most effective when the therapist conducting the treatment is an OCD specialist with training in ERP. As you begin your treatment journey with an OCD specialist, they’ll provide you with a personalized and structured plan for treatment that’s tailored to your unique needs and goals.
NOCD Therapy was created to make life-changing ERP treatment accessible. It offers convenient, effective, and affordable OCD treatment through live, face-to-face video ERP therapy sessions, as well as always-on support between sessions on the NOCD platform through peer communities, therapist messaging, therapy tools, online support groups, and more. All NOCD Therapists are licensed, specialize in treating OCD, receive ERP-specific training from world-renowned OCD experts and researchers, and deeply understand all themes of OCD.
If you or a loved one are struggling with OCD and think that you may benefit from ERP therapy, schedule a free 15-minute call to speak to someone on the NOCD Care Team. They can answer all of your questions about starting treatment, getting matched with a qualified and licensed OCD specialist, and more.