The Misunderstood Diagnosis: What OCD Really Means
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Moving Past the Myths
Obsessive-Compulsive Disorder (OCD) is one of the most misunderstood mental health conditions. While many people casually use phrases like “I’m so OCD” to describe being neat or particular, the reality of living with OCD is far more complex and challenging. In this post, we’ll explore what OCD really is, debunk some of the common myths, and look at how those affected can find relief and effective treatment.
What Is OCD?
At its core, OCD is a mental health disorder that affects how a person experiences thoughts and behaviors. People with OCD experience recurring, intrusive thoughts (obsessions) that cause significant anxiety. To alleviate that anxiety, they engage in repetitive behaviors (compulsions), which can provide temporary relief but ultimately fuel the cycle of distress.
Breaking It Down: Obsessions vs. Compulsions
To really understand OCD, it’s important to differentiate between the two key components: obsessions and compulsions.
Obsessions: These are unwanted, intrusive thoughts, images, or urges that cause significant anxiety. These thoughts often focus on distressing topics, such as contamination, harm, or morality. For example, someone might be haunted by the idea that they didn’t lock the door properly, despite checking it multiple times.
Compulsions: In an attempt to relieve the distress caused by the obsessions, individuals may engage in repetitive behaviors or mental acts. These can range from overt actions like washing hands repeatedly to mental rituals, such as silently counting. While these behaviors may provide temporary relief, they do not address the root cause and can consume significant time and energy.
Debunking OCD Myths: What It’s Not
Before diving deeper into what OCD entails, let’s take a moment to dispel some of the most common misconceptions:
Myth 1: OCD is just about being neat or organized.
While some people with OCD may have cleanliness or organization-related compulsions, the disorder is not about being tidy. Many obsessions have nothing to do with cleanliness and can instead focus on fears of harm, morality, or even relationships.
Myth 2: People with OCD can just “snap out of it.”
OCD is not a habit or quirk that can be easily turned off. It’s a chronic disorder that requires treatment, often involving therapy and sometimes medication, to manage effectively.
Myth 3: Only adults suffer from OCD.
OCD can develop at any age. In fact, it often begins in childhood or teenage years, although many don’t receive a diagnosis until later in life.
Myth 4: People with OCD are “crazy” or dangerous.
OCD is a mental health condition, not a sign of instability or danger. The anxiety and distress that come with OCD are internal struggles, not threats to others.
Signs and Symptoms: Recognizing OCD
So, how do you know if you or someone you love might be dealing with OCD? Here are some common signs and symptoms:
Excessive washing or cleaning
Repeated handwashing, cleaning, or sanitizing due to fears of contamination is a classic compulsion for some people with OCD.
Checking behaviors
This could include repeatedly checking doors, appliances, or even one’s own body to make sure nothing is wrong or out of place
Counting or mental rituals
Some individuals perform mental rituals like counting, repeating words, or praying in a specific way to prevent harm or alleviate anxiety.
Fear of causing harm
People with OCD often worry excessively about hurting others, even if there’s no real risk. These fears can revolve around everyday activities, like driving a car or cooking a meal.
Intrusive, taboo thoughts
Some obsessions can involve disturbing or taboo topics like violent, sexual, or blasphemous thoughts. These thoughts can cause significant guilt and distress, even though the person doesn’t act on them.
How OCD Affects Daily Life
Living with OCD can be exhausting. Because the obsessive-compulsive cycle is driven by anxiety and distress, individuals can feel trapped in an endless loop of unwanted thoughts and rituals. This often takes a toll on relationships, work, and overall quality of life.
Some people might spend hours each day performing compulsions, leaving little time for normal daily activities. Others might avoid certain places or situations altogether to reduce their anxiety, which can further limit their day-to-day functioning.
What Causes OCD? Understanding the Science
While there’s no single cause of OCD, researchers believe that a combination of genetic, neurological, and environmental factors contribute to its development. Some key areas of study include:
Genetics: Family studies have shown that OCD tends to run in families, suggesting a genetic component. However, having a family member with OCD doesn’t mean someone will definitely develop it.
Brain structure and function: Neuroimaging studies have identified differences in certain areas of the brain involved in regulating behavior and emotions in people with OCD. These differences may contribute to the obsessive-compulsive cycle.
Environmental factors: Stressful life events, trauma, or childhood infections may trigger or worsen OCD symptoms in some individuals.
Treatment Options: Breaking Free from the OCD Cycle
The good news is that effective treatments are available for OCD. While it’s a chronic condition, many people experience significant relief and improved quality of life with the right interventions. The most common approaches include:
Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP)
Cognitive Behavioral Therapy (CBT), particularly a technique called Exposure and Response Prevention (ERP), is the gold standard for OCD treatment. ERP involves gradually exposing the person to the source of their anxiety (the obsession) without allowing them to engage in the compulsive behavior. Over time, this reduces the power of the obsession to cause distress.
For example, someone with a fear of contamination might be asked to touch a surface they consider dirty without washing their hands afterward. With repeated exposure, the anxiety decreases, and the person learns that they can tolerate the discomfort without resorting to compulsions.
I prefer to introduce clients to this approach in office to help support them through the anxieties associated with exposures. We can also work on breaking down cognitive distortions associated with exposures. This makes it much easier to engage in ERP outside of the office.
Medications
Selective Serotonin Reuptake Inhibitors (SSRIs) are often prescribed to help manage OCD symptoms. These medications can reduce the intensity of obsessions and compulsions by affecting serotonin levels in the brain. There are several nuances to using SSRIs for OCD. I generally recommend higher those than those used to treat depression and anxiety. I also tell clients that it takes longer to see a true treatment response. For comparison, we generally wait 6-8 weeks at a treatment level dose to determine if SSRIs work for depression and anxiety. When treating OCD, we generally need to wait 12-16 weeks at a treatment level dose to determine efficacy.
These are points in that many get frustrated with the lack of relief they are getting on their regimen and stop or switch medications before reaching an adequate treatment dose or treatment duration. Providing the proper coaching and psychoeducation surrounding medication can help manage expectations for clients and lead to a much more robust response to treatment.
Tips for Managing OCD Day-to-Day
In addition to clinical treatment, there are several strategies that can help individuals manage OCD symptoms in their daily lives:
Mindfulness and relaxation techniques
Practices like meditation and deep breathing can help reduce overall anxiety and make it easier to manage obsessive thoughts.
Build a support system
Having friends, family, or a support group who understand the challenges of OCD can make a huge difference. They can provide encouragement and remind you that you’re not alone in your journey.
Limit avoidance behaviors
Try to resist the urge to avoid situations that trigger anxiety. Avoidance often strengthens the power of obsessions, while confronting them can help reduce their grip over time.
Final Thoughts: There’s Hope for OCD
Living with OCD can be overwhelming, but it’s important to remember that you’re not defined by your disorder. With the right treatment and support, many people with OCD can lead fulfilling, productive lives. If you or someone you know is struggling with OCD, reaching out for help is the first step toward breaking free from the cycle of obsessions and compulsions.
Remember, OCD is not about personality quirks or being overly tidy—it’s a real and treatable condition. By understanding what OCD really is and getting the right support, relief is possible. Treatment and management of OCD is something we specialize in at Intempo Psychiatry and we’d be more than happy to work with you!
Until next time!
Dr. McCall
