When Howie Mandel revealed he has OCD, he thought it was the end of the world.
It happened many years ago in a New York radio studio. The world-famous comedian had finished his segment and wanted to leave—without touching the door handle. (His OCD symptoms include intense contamination fears.) When the host and others made fun of him (“just open the door!”) Mandel told them about his diagnosis. He didn’t want to, but there were only a few people in the room, so he felt OK about it.
Someone got the door for him. Then he stepped outside, and realized that his microphone had been “hot”—that everything he’d said had gone out over the airwaves, to millions of listeners. He’d accidentally told the world his secret.
“I’ve never had such a dark, desperate, scary moment,” he says. “I thought, my kids in school are going to be ridiculed, no one is going to hire someone who is mentally ill, so my career is over, my family life as I know it is over. So I thought, ‘I’m going to go down the elevator and just run into traffic.'”
It was a terrible moment. “I never felt so lonely in my life,” Mandel recalls. But years later, he knows this moment left him determined to help others escape shame, stigma and misunderstanding—and get the right treatment for OCD.
Today, Mandel still lives with OCD—it’s considered a chronic condition. But it doesn’t stop him from having a full life.
That’s why he has teamed up with NOCD—along with fellow comic legend Maria Bamford—to raise awareness about what OCD is, what popular culture gets wrong about it, and how you can manage it with specialized treatment.
What OCD is (and what it isn’t)
Many people imagine they know what OCD is. It’s shorthand for liking things neat. Or a punchline about being a little intense about the spoons for a minute. People joke: “I’m having an OCD moment.” Or “I’m so OCD about cleaning my house.”
Mandel and Bamford know what’s funny. Comic talent made their careers. Being funny made Mandel a household name (“funny bought me a house!” he says). They’re experts about OCD, and they know that it’s no joke. And it’s not a personality quirk or a mood, either.
Even today, with his illness under control, OCD has had a big impact on Mandel’s life. It’s the reason he shaved his head in the first place (feels cleaner) and why he’s often lived apart from his family whenever someone in the household is sick.
“People throw the term OCD around like it’s no big deal,” Mandel explains, “but it’s a severe and very common mental health condition that needs specialty treatment.”
Living a great life with OCD
At NOCD, we know how overwhelming OCD symptoms can be. We’re everyday people who have conquered OCD, therapists who specialize in treating it professionally, and loved ones of people who have achieved recovery. We want you to know that, along with Mandel and Bamford, there are so many thousands of others who have reclaimed their lives from this misunderstood, debilitating condition.
“Even to this day, I don’t think a day goes by when I don’t have a moment of suffering or discomfort,” Mandel says. “I suffered with OCD my whole life. Then in my 40s, my wife gave me an ultimatum. I had to get help.”
Mandel found the help he needed. And he wants you to know that with the right treatment, you can, too.
The need for specialized OCD treatment
The first step toward a better life with OCD is understanding what it really is. That means overcoming stereotypes, misinformation and shame, and instead looking at what top experts and real people with OCD have to say about the condition.
OCD starts with distressing intrusive thoughts, images, worries, or fears—called obsessions—leading to an overwhelming urge to respond with compulsions, which are any behaviors done to calm that distress. For example, you might wash your hands repeatedly due to an intrusive fear of catching a deadly disease, or avoid people you love after experiencing a sudden intrusive image of hurting someone with a knife. But these compulsions never work for long. Intrusive thoughts and fears always return, and the vicious cycle of obsessions and compulsions only gets worse over time. OCD can fill you with doubt about your own identity, make you afraid of the things you love most, and upend your relationships, careers, and health.
As Bamford says, OCD isn’t about neatly arranging your kitchen utensils: “It’s being so afraid of stabbing your loved ones, that you throw them all away.” And the results can be devastating: studies show that 11% of people with OCD attempt suicide.
Mandel and Bamford want to help people with OCD escape stereotypes and misconceptions, and find the right kind of treatment.
“We’re hoping that this campaign serves as a wake-up call for society,” says Stephen Smith, co-founder and CEO of NOCD. “Even in a world that’s becoming much more accepting of mental health concerns, most people with OCD aren’t able to talk about their OCD symptoms openly. With these partnerships, we can reach those who need help the most, bring evidence-based treatment directly to them online, and end global suffering caused by OCD.”
As long as shame and misunderstanding persist, many will suffer needlessly. Almost all people with OCD—95%—have not been diagnosed. Yet a diagnosis, followed by the right kind of therapy, could reduce symptoms in 8 out of 10 people who experience this debilitating condition.
However, it’s important to find the right kind of therapy, Mandel stresses. That’s because the wrong kind can actually make OCD worse.
In psychoanalysis, for example, you are encouraged to think about your problems and get insights into your own thoughts and feelings. It encourages you to question your beliefs about yourself, seek underlying reasons and answers. In other words, it encourages you to think about your own thoughts, and can give you reassurance about your view of the world.
This sort of therapy can be a tremendous help for many mental health issues, but it’s simply not suited for OCD. Running from uncertainty and ruminating about your own thoughts, for example, can actually serve as compulsions that fuel your OCD. In fact, writes Miami psychologist Ilisa Kaufman, “many sufferers look forward to going to psychoanalysis because they are getting the reassurance and answers their OCD is craving.” That’s one reason why experts consider psychoanalysis and other forms of talk therapy ineffective against OCD.
Even more behavioral forms of treatment can be ineffective or harmful when they’re used to treat OCD. Take general forms of Cognitive Behavioral Therapy (CBT), for example—it’s a broad category of several more specific forms of therapy, and they’re not all interchangeable.
In some CBT approaches, for example, you might be encouraged to “gather evidence” that a particular thought or feeling isn’t based in reality. It’s a great antidote to catastrophizing—or exaggerating certain problems. So, for example, you might be convinced that your life will be ruined if you’re late for work, and you may need to look at the facts (other people come in late sometimes, no one has been fired, and your performance reviews are good).
For many people’s struggles, this approach makes a big difference. But “gathering evidence” can morph into seeking reassurance—meaning that you begin to feel as if you need evidence that you won’t be fired, or else you won’t feel okay. But how much evidence is enough? If you’re struggling with OCD, the answer is simple: it’s never enough. And soon, you’re asking your coworker for the sixth time that day to remind you that your job is safe. So a therapist who is not OCD-savvy can end up encouraging behavior that, in the long-term, makes OCD symptoms worse.
Another CBT technique is “thought stopping,” which has to do with heading off a harmful, unreasonable fear by snapping a rubber band on your wrist, yelling “stop!” or doing some other unpleasant action. In theory, this may condition you to avoid your thoughts. In reality, though, a person with OCD can easily turn “thought stopping” into a repeated compulsive behavior.
“This treatment essentially amounts to helping people with OCD do rituals, which is the opposite of what we know works as a treatment for OCD,” according to psychologists Dean McKay, PhD, Jonathan Abramowitz, PhD, and Eric Storch, PhD.
This is why Mandel urges anyone with OCD to make sure your therapist is well-informed. “General therapy isn’t just ineffective for OCD,” he says. “It can actually be harmful.”
So what actually does work for OCD?
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Exposure and response prevention (ERP) therapy
ERP is the gold standard in OCD treatment, with decades of expert research backing it up. And you don’t need to go to a therapist’s office to turn your life around. In fact, ERP delivered through teletherapy can be even more effective than in-person sessions.
In short, this kind of therapy teaches you the opposite of “thought stopping.” In ERP, you learn to live with and accept troubling intrusive thoughts and the uncomfortable feelings they bring about. Over time, you teach yourself that the thoughts aren’t dangerous or meaningful, and that you don’t have to respond to them at all: you can live life on your own terms, rather than being ruled by OCD’s rules and fears.
Remember: You’re not alone with your OCD
It was a complete stranger who saved Mandel on that dark day when his OCD secret came out. As he stood on the sidewalk, thinking about jumping in front of a speeding car, someone walked up and said, “Are you Howie Mandel?”
“I didn’t make eye contact,” Mandel recalls. “I said, yeah.” The man said he’d just heard him on the radio.
“I thought, ‘Oh, my God. This confirms it. And I’m about to take a step [into traffic],” Mandel recalls. “But then he said two words: ‘Me too.'”
The man went on: “I have OCD and that was so cool to hear you talk about it.”
That was when Mandel realized, “I wasn’t alone. Somebody was there with me. And that saved me.”
Once he got back home, Mandel was greeted with piles of mail from people thanking him for speaking out. That’s why he’s on a mission now to spread the word that OCD isn’t rare, isn’t unbeatable, and isn’t something to hide. If you have OCD, or think you might, you can access specialized help—help that really works.
“That’s the impetus for me joining with NOCD,” he says. “Somebody to talk to, somebody understanding—that is the life jacket that everybody in this world needs.”