Obsessive-Compulsive Disorder (OCD) may be one of the most misunderstood mental health conditions. It’s estimated that 1 in 100 people in the US lives with OCD, so it’s more common than you think, however, the way it’s often portrayed in the media may not be entirely accurate (think Monica Geller in Friends or Adrian Monk in Monk). In this article, we explain exactly what OCD is and take a look at common stereotypes in an effort to set the record straight.
What is Obsessive-Compulsive Disorder?
OCD can impact anyone, regardless of age or gender. It can emerge any time from preschool to adulthood, but most commonly appears between the ages of 12 and 20. OCD is a disorder in which people have recurring, unwanted thoughts, ideas, or sensations (obsessions) that compels them to do something repetitively (compulsions). The repetitious behaviors, such as hand washing, checking things, or cleaning, can significantly interfere with a person’s daily life. The key here is that the behaviors / compulsions are a direct result of the recurring, unwanted thoughts and anxiety. They do not occur without each other. Or to put it another way, many people without OCD have stressful thoughts or repetitive behaviors. However, these thoughts and behaviors are usually not linked, and do not typically disrupt your life.
A diagnosis of OCD requires the presence of obsessions and/or compulsions that are time-consuming (more than one hour a day), cause significant distress, and impair work or social function. Contrary to popular belief, OCD is not just about hand-washing and being neat. While there are similarities across cases, individual manifestations of the disorder tend to mirror anxieties based on an individual’s life experiences.
Surprisingly, people with OCD usually recognize that their thoughts and obsessive impulses are not reasonable. However, the distress caused by these intrusive thoughts can’t be dismissed by logic or rationale.
Typical Obsessive Thoughts May Include (But Are Not Limited To):
Extreme concern with order, symmetry, or precision
Recurring, intrusive thoughts of certain sounds, images, words, or numbers
Fear of misplacing or discarding something important, or forgetting to do something important
Fear or recurring thoughts of existential crises or death
Fear of blurting out obscenities or insults, or of hitting something (loss of control)
The compulsions that are linked to or follow repetitive behaviors or activities that a person performs in response to an obsession. In the person’s mind, these behaviors prevent or reduce the distress related to the obsession, and that’s why they do them.
Typical Compulsions May Include (But Are Not Limited To):
Excessive hand washing, showering, or brushing teeth
Repeatedly checking locks, switches, or making sure appliances are turned off
Constantly seeking approval or reassurance
Repeated cleaning of household objects
Ordering or arranging things in a particular way
Counting and recounting currency
Repeated counting to a certain number
OCD-related conditions include hoarding disorder (HD), body dysmorphic disorder (BDD), as well as hair-pulling and skin-picking disorders.
Causes Of OCD
The exact cause of Obsessive-Compulsive Disorder is unknown, but scientists believe that several areas of the brain may not respond normally to serotonin, a chemical nerve cells use to communicate with one another. In other words, neural miscommunication could be the root cause.
Genetics, something we discussed in our previous article, plays a part - if you, your parent, or a sibling, have OCD, there's a 20-45% chance another family member also has it. Like other anxiety disorders, childhood trauma and environmental factors may cause onset OCD symptoms.
Myths About OCD
So what are the misconceptions about OCD? And where did they come from? As is often the case, OCD myths can stem from pop culture and entertainment. For example, if you saw Leonardo DiCaprio in 2004’s The Aviator, you know the true story of the reclusive billionaire industrialist, filmmaker, and pilot Howard Hughes, whose desire for extreme control over cleanliness and order in his home seemed truly unfathomable. Or if you watched USA Network’s Monk, you saw a brilliant former city detective frequently battling with his OCD tendencies.
The problem with these portrayals is that they may not be accurate, and the disorder and its obsessions and compulsions are often treated as a gimmick to a serious condition. Viewers are encouraged to laugh when in reality, it can cause fear and shame to those who live with it.
Three Common Myths About OCD, & Why They Don’t Reflect Reality
Myth 1: OCD is only about cleanliness and being tidy. A fixation on keeping things clean is just one of the common compulsions of OCD, but not the only one. And not everyone with OCD has this particular compulsion. Triggers related to cleanliness and symptoms related to washing make up only a small part of the range of OCD triggers and symptoms. People can also have obsessions related to a wide variety of things, including losing control, hurting others and themselves, or losing things.
Myth 2: OCD isn’t treatable and will never go away. Many people don’t seek treatment because they’re embarrassed; they believe they are alone in their experience and that their symptoms are unique to only them. This can be one reason why it goes untreated. But research proves it can be treated through therapy and prescription medication. It will likely never go away completely but symptoms can be managed so that they stop impacting daily life. In fact, it’s considered one of the most “highly manageable” mental health disorders.
Myth 3: We’re all “a little bit OCD'' sometimes. Untrue and in fact, it is an inappropriate expression to use by those who do not have OCD and are unfamiliar with how devastating untreated symptoms can be.
Stigma is a systemic problem faced across a variety of mental health disorders, which is why it is so important to realize that words and actions can trivialize those living with it. People with OCD cannot simply “turn it off.” Research has shown their brains are wired differently - results show higher levels of extreme worry and fear that can entirely overwhelm you.
Treatment For OCD
There are no tests for OCD, however, trained mental health specialists can diagnose it by asking a series of questions that try to get at the three signs of OCD: having obsessive thoughts, exhibiting compulsive behaviors, and whether they get in the way of normal activities.
With proper treatment by qualified mental health specialists, people with OCD can lead full and productive lives. Many respond positively to a type of therapy called Exposure and Response Prevention (ERP) therapy, designed specifically to treat OCD. Cognitive-behavioral therapy (CBT) is another effective therapy. These therapies are often prescribed in combination with medication. Finally, many individuals report that support groups provide a safe, understanding place for those with OCD to feel less alone.
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