Why You Are Not ‘So OCD’: OCD Myths
I have lost count of the number of times I have heard people say ‘I’m so OCD’ when they just want something to be tidy, clean, arranged in a particular order or done a certain way. Or, how many times I’ve seen phrases like ‘Obsessive Cat Disorder’ on mugs or prints. Or, how often I’ve been frustrated by people declaring they wished they had a ‘bit of OCD’ so their house would be tidier.
And every time, I think to myself ‘you have no idea what OCD is like.’
So, here are ten myths about OCD:
We are all ‘a little bit OCD’ - OCD stands for Obsessive Compulsive Disorder, a condition affecting 1-2% of the population (which is definitely not everyone). A disorder is something which deviates from the norm and disrupts normal physical or mental functions. According to the Diagnostic and Statistical Manual of Mental Disorders (the manual psychiatrists use to diagnose mental health conditions), OCD causes “clinically significant distress or impairment in social, occupational, or other important areas of functioning”, and obsessions/compulsions are “time-consuming (e.g. take more than 1 hour per day)”. This is not something everyone experiences. Furthermore, studies have shown differences in the brain scans between people who have OCD and people who don’t. So no, we are not all ‘a little bit OCD.’
OCD is an obsession with being clean and tidy - OCD is repetitive, unwanted intrusive thoughts which cause distress and anxiety. Obsessions can be about pretty much anything, but common themes include:
- Harm OCD (intrusive thoughts around harming someone or themselves)
- Relationship OCD (persistent doubts around relationships)
- Contamination OCD (intrusive thoughts around germs and getting sick)
- Scrupulosity (intrusive thoughts/images/worries about religion or morality)
- Sexual intrusive thoughts (of an unwanted nature, often leading to feelings of self-disgust and guilt)
- Fear of something bad happening to themselves or loved ones (e.g. fires, burglaries, car crashes etc)
Someone who likes things clean and tidy does not necessarily have OCD, and many people who have OCD are not clean and tidy.People who have OCD wash their hands a lot - Although this is a stereotype associated with OCD, only around 26.5% of people with OCD have compulsions around washing or cleaning. This means that even less will experience hand-washing as a compulsion. This did affect me as a teenager and my hands were very sore a lot. But since the age of 16, I haven’t experienced this as much and other OCD themes have taken over. OCD is not all about hand-washing!
It is obvious when someone has OCD because compulsions are visible - Compulsions are repetitive acts linked to the person’s obsessions or intrusive thoughts. They are carried out to try to reduce anxiety, make the intrusive thought go away, or to neutralise the thought. They take up a great deal of time and thought space. Some compulsions, of course, are visible - for example, hoarding, cleaning, checking physical things (such as doors being locked), tapping, re-ordering etc. However, there are many which aren’t - for example, thinking neutralising thoughts to counteract unpleasant ones, checking emotions or bodily sensations repeatedly, praying, counting or repeating words in head etc. You can’t always see someone acting on a compulsion.
People with OCD are dangerous - There is huge stigma for many OCD sufferers and even more so for those with Harm OCD. They may have thoughts about harming someone, worry they are a pedophile (pedophile OCD is a known subset of OCD and is NOT Pedophilia), or have intrusive thoughts/images of causing harm. This causes the person immense distress, guilt, anxiety, shame and self-hatred. People with these forms of OCD are no more likely to act on these thoughts or cause harm than someone without these thoughts or OCD. OCD, even in these forms, does not make somebody dangerous.
OCD intrusive thoughts represent the individual’s thoughts or feelings - This is the myth which causes OCD sufferers a great deal of shame, guilt and distress, particularly when facing Harm OCD. OCD thoughts are EGO-DYSTONIC meaning that they go against the person’s values and morals. They do not align with their identity and the individual feels the thought is unacceptable and does not wish to be thinking it. This is why they feel so much distress.
People with OCD just need to know their actions are irrational - People with OCD already know (most of the time) that their compulsive acts aren’t logical and aren’t actually going to prevent anything from happening. That doesn’t make it any easier. Acting on the compulsion feels easier than enduring the anxiety or distress from the intrusive thought. The problem is that it is only temporary, and can become all-consuming.
OCD sticks to one theme - OCD themes change over time. Someone who has contamination OCD at the age of 14 (like myself…) may not by the age of 20. Instead, their OCD may have shifted themes to unwanted sexual intrusive thoughts. Or, by the age of 25, fears their parents are going to die and obsessions around checking their safety. OCD can cause doubt and anxiety about pretty much anything.
OCD isn’t treatable and a person will have OCD forever - The bottom line is that OCD IS treatable. To what extent varies based on the individual and their experiences. Some people believe they will live with OCD forever. Others report experiencing it for a period in their life, accessing therapy and medication and not having it anymore. Either way, treatment can help an individual manage their OCD better. National guidelines recommend Cognitive Behavioural Therapy, Exposure and Response Prevention Therapy and SSRI antidepressant medication since research shows these are highly effective in treating OCD, especially in combination.
OCD isn’t that bad and can be helpful - OCD is ranked among the world’s top 10 most disabling conditions by the World Health Organisation. 41% of OCD sufferers have psychotic-like experiences, 10% have attempted suicide and half experience suicidal thoughts. 50% of all OCD cases are classed as ‘severe’ with less than 25% classified as mild. It disrupts, or can ruin, individual’s education, careers, relationships and quality of life, and can lead to self-harm, substance abuse and divorce. Just because a person with contamination OCD may have a slightly cleaner home than some people does not mean OCD is helpful in any way.
References
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(pdf: https://www.bmj.com/bmj/section-pdf/755603?path=/bmj/348/7953/Clinical_Review.full.pdf)