Understanding OCD
Over the past few years with the increasing popularization of mental health therapy, many therapy terms have entered common language. This has had a positive effect in many ways with the increasing normalization of self-care and healthy boundaries. However, there has also been increasing confusion, such as in the dilution of the meaning of serious mental health conditions, over self-diagnosis of these conditions, and resulting confusion in what these conditions actually are and the extent to which people suffer from them (consider the many articles that start with “I cured my depression by…”, which make major depressive disorder sound a lot less serious and easier to recover from than it actually is).
One such condition is Obsessive Compulsive Disorder, or OCD. Maybe you’re someone who has some anxiety and is wondering if you have OCD. To that end, let’s clear up the confusion and look at what OCD actually is.
OCD consists of two main things. The first is Obsessions and the second is Compulsions.
Obsessions are thoughts, ideas, images, doubts and other conceptions exist in your mind that do not make sense and which cause you fear or anxiety. They do not make sense because another person considering the same thought who does not have OCD would dismiss the thought as unlikely. This could be a thought like “I wonder if I hit someone with my car on my way home” despite having been attentive to the drive home, it having been daytime, and not having seen anyone on the road. Or perhaps, “Maybe I caught Ebola by touching that doorknob” despite there being no cases of Ebola in the region.
The fear or anxiety caused by the Obsession is so intense that it drives a Compulsion, which is a thought or behavior that is intended to reduce or resolve the anxiety. So for the fearful thought of having hit someone with your car, the compulsion may be to drive back over the same route to check for any bodies on the side of the road. For the fearful thought of having caught Ebola by touching a doorknob, the compulsion may be to thoroughly wash your hands.
Obviously all of us tend to experience senseless or unlikely fearful thoughts from time to time and then to engage in behaviors that are intended to resolve the fears. For example, maybe you’re the kind of person who goes around the house to check that all of the doors and windows are closed and locked and that the oven is off before leaving the house even though you’re confident everything is ok. Maybe a person doing this in front of a friend would laugh and say “I’m so OCD!” with some awareness that the “obsession” is somewhat senseless and the “compulsion” is largely unnecessary. So what makes an obsession and compulsion rise to the level of OCD?
Simply put, obsessions and compulsions, even ones that are somewhat senseless, are not considered to be OCD until they begin to significantly interfere with a person’s life. Doing a three- or four-minute circuit of your house before leaving for work each morning is usually not considered to be OCD since a slight delay in leaving is unlikely to affect anything important in your life – you’re not likely to run late to work to the point of losing your job, or running late to see friends to the point of losing the friendship. However, if the fear did not resolve easily with one circuit and the ritual built up to the point where it was taking an hour to leave the house, and that was placing your job or friendships or other important things in your life at risk, then that’s when the problem would likely rise to the level of OCD.
This is similar to how feelings of persistent sadness do not mean a person has major depressive disorder unless the sadness begins to result in problems like difficulty getting out of bed and a loss of interest in things that previously brought pleasure, resulting in job loss, difficulty completing education, social isolation or a tangible negative effect on other important life areas.
It’s good that we are having more conversations about problems like anxiety and depression in society, and how this is enabling us to have more open conversations with our friends and loved ones to get support. It’s also important to recognize that Major Depressive Disorder, Generalized Anxiety Disorder, OCD and other mental health diagnoses are serious conditions that have a significant and measurable impact on people’s lives and which are complex and difficult to recover from. So it’s important to also recognize that even though we might use the same language in society, there is a vast difference between how people may casually refer to OCD in society and what the experience is actually like for someone living with diagnosable OCD.
The good news is that OCD is very treatable and recovery is possible with support. Learn more about our OCD program here.
