“I’m so OCD.” You’ve probably heard this phrase before. It’s what a friend says when they need a synonym for being punctual or when they want everything on their desk — from pens to laptop and books — to be positioned in a specific way. Or maybe you’ve heard it when someone needs a word to describe the intensity of their cleaning habits.
Contrary to popular belief, obsessive-compulsive disorder (OCD) is not an illness of cleanliness or rigidity. Many people with OCD have dysfunctional beliefs, which may include an inflated sense of responsibility, perfectionism, intolerance of uncertainty, or the need to control thoughts. OCD is characterized by the DSM-5 as the presence of obsessions and/or compulsions. Obsessions are recurrent, intrusive, time-consuming, and persistent thoughts, urges, or images. Often, the person will attempt to ignore or suppress these thoughts by focusing on another thought or action. Compulsions are repetitive behaviors or mental actions that a person feels driven to perform in response to an obsession. These compulsions are done with the goal of reducing or preventing anxiety, or preventing something harmful from happening. It differs from being cautious in that compulsions are excessive and do not realistically prevent the obsession (American Psychiatric Association, 2013). According to the National Institute of Mental Health, OCD is present in approximately 1.2% of the population with 50.6% of those inflicted having severe OCD. In the United States alone, 2.2 million are affected (Myrick and Pavelko, 2015).
Most people experience impulsive and distressing thoughts that can be considered symptomatic of OCD (Moulding, et al.). It can be constantly worrying that you forgot to lock your door, believing that your professor is going to give you a surprise quiz, or feeling that your car will break down while you’re driving. This behavior is normal and usually only causes a brief or low level of distress. A person with OCD focuses on their obsessions and compulsions to the point where their daily functioning becomes impaired.
Alison Dotson, author of the memoir Being Me With OCD, has an experience with OCD that exemplifies the misconception of the disorder. Although she began displaying symptoms as a child, she was diagnosed shortly before her 27th birthday. “I suffered in silence for years and years because all I knew about OCD was that people wash their hands too much and always check to make sure the stove is off,” she said in an interview with The Atlantic. When Dotson would mention her diagnosis to her loved ones, they would approach her with a tone of confusion:
“‘Are you sure? I’ve been to your apartment. I mean, it wasn’t messy or anything, but it didn’t seem like you clean compulsively.’ I explained to him that an obsession with germs is only one symptom of OCD and that I mostly just have obsessive thoughts without trying to get rid of them with a corresponding compulsive behavior. (I have since realized that avoiding situations that trigger or make me face the source of my obsessions is a compulsion.) I tried to express to him how my irrational fears can completely take over until I feel like I have no control over my own thoughts or happiness (Dotson, 2014).”
When Dotson’s friend Joe asked for an example of an obsession, she paused:
“No one, not even my psychiatrist, knew the specifics of my deepest fears. Dr. Grant knew in general what I had been struggling with, but he knew how painful it would be for me to detail any of my obsessions with him. He knew enough to comfort me and let me know I wasn’t alone. I chose a ‘safe’ example to share with Joe. ‘When I was little, I had a fear of being burned alive. And it wasn’t just that I was afraid it might happen; I was sure it was going to happen. I would cry in bed at night and ask God why I had to be in a fire. I worried about it constantly.’ I think he sympathized with me, but because what he knew about OCD didn’t match up with what he knew about me, he didn’t seem convinced (Dotson, 2014).”
It speaks volumes that Dotson considered her fear of being burnt alive as a “safe” obsession to reveal to her friends. The image of OCD being a “cleaning disorder” does not accurately portray or represent the severity of its symptoms. Even medical professionals expressed their skepticism towards her diagnosis. After coming down with a painful stomach ache, Dotson went to see a gastroenterologist. While asking her for the names of medications she had been taking, Dotson had mentioned that she was diagnosed with OCD. The doctor then proceeded to reflect the stereotype that is often perpetuated towards OCD:
“Don’t we all?” he said with a note of disgust in his voice. “Psychiatry – that’s like the designer profession to have. Someone comes to you and says, ‘I wash my hands a lot,’ and you diagnose them with OCD. It’s so easy (Dotson, 2014).”
Misuse of the word is common and has skewed our paradigm of the illness itself. People often equate OCD with positive characteristics such as cleanliness and orderliness and while OCD is occasionally related to cleanliness, it does not encompass or describe the illness fully. People with OCD can have obsessions and compulsions that center around religion, sexuality, checking, and the body. While those with illnesses such as depression, schizophrenia, and bipolar disorder are often considered dangerous, those with OCDs often serve as a form of comic relief. Instead of focusing on the amount of anxiety they feel as a result of their illness, their repetitive behaviors are often considered humorous (Pavelko & Myrick, 2015). This complicated and debilitating illness is misrepresented and seen as a quirk rather than the serious illness that it is. Obsessive-compulsive disorder is a chronic mental illness and, like all mental illnesses, affects the lives of those who have it. Limiting our knowledge of this disorder prevents people who may have the disorder from seeking help and minimizes the pain felt by those who have it.
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Dotson, A. (2014). Being me with OCD: how I learned to obsess less and live my life. Minneapolis, MN: Free Spirit Publishing.
Moulding, R., Coles, M. E., Abramowitz, J. S., Alcolado, G. M., Alonso, P., Belloch, A., & Wong, W. (2014). Part 2. They scare because we care: The relationship between obsessive intrusive thoughts and appraisals and control strategies across 15 cities. Journal Of Obsessive-Compulsive And Related Disorders, 3280-291.
Rachelle L. Pavelko, Jessica Gall Myrick, That’s so OCD: The effects of disease trivialization via social media on user perceptions and impression formation, Computers in Human Behavior, Volume 49, August 2015, Pages 251-258, ISSN 0747-5632,
Tipu, F. (2015, February 22). OCD Is Not a Quirk. Retrieved February 07, 2017, from https://www.theatlantic.com/health/archive/2015/02/ocd-is-a-disorder-not-a-quirk/385562/
