Unpacking Commonly Misused Mental Health Terms: OCD

At some point in your life, you’ve probably heard or even personally used the phrase “I’m so OCD!” to reference a tendency for excessive cleanliness or organization. While these comments can feel harmless in the moment, they minimize and invalidate the lived experience of those individuals diagnosed with Obsessive Compulsive Disorder (OCD), a disorder that is chronic and debilitating at its most severe. 

In fact, research suggests that individuals with OCD are at a higher risk for suicide attempts than the general population. In light of International OCD Awareness Week earlier this month, we want to provide some clarity to understand the condition, shape our attitudes, and make informed decisions with regards to our everyday language. 

What Is Obsessive-Compulsive Disorder? 

According to the National Alliance on Mental Illness, symptoms of obsessive-compulsive disorder include “repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions).” In other words, OCD involves a vicious cycle in which an individual performs a mental or physical act to reduce the anxiety caused by persistent disturbing thoughts. 

Because the compulsion provides only temporary relief, it reinforces the notion that the obsession can only be eliminated by completing the compulsion, which ultimately increases rather than relieves anxiety. Over time, this process can become so time-consuming that it begins to take priority over one’s work and social obligations. As a result, OCD can bring feelings of guilt, shame, and powerlessness. 

There Are Tons of Subtypes  

What many people colloquially label as “OCD” actually refers to the traits characterized by a separate diagnosis called Obsessive-Compulsive Personality Disorder (OCPD), such as perfectionism, orderliness, and rigidity. Contamination OCD is the most commonly known subtype of OCD, and it involves obsessions surrounding the fear of contamination and compulsions such as excessive hand washing or cleaning in an effort to prevent contamination. 

However, that is just one of many types of obsessions that people with OCD experience on a daily basis, several of which are a lot more subtle and invisible to the outside observer. For example, scrupulosity obsessions target one’s moral or religious beliefs and the resulting compulsions often include mental rituals of excessive prayer or ruminating on one’s past actions.  

Another subtype that often flies under the radar is relationship OCD, which can involve obsessions around cheating or finding the “perfect” partner and compulsions such as constant reassurance seeking. Regardless of the subtype, all individuals diagnosed with OCD can expect to see this same pattern of distressing thoughts followed by relentless efforts to avoid or decrease discomfort. 

It’s More Common Than You Think 

Many sources indicate that approximately 1-2% of the general population experiences obsessive-compulsive disorder, but it’s likely that this number is actually much higher.  

Unfortunately, OCD remains highly misunderstood and overlooked because it  often coincides with other mental health disorders that individuals seek treatment for including substance use disorders, eating disorders, and anxiety disorders . OCD can also be misdiagnosed due to biases and misconceptions from mental health providers or underreporting of symptoms from clients.

One factor that must be considered is that OCD does not discriminate amongst education or income levels, but more research is needed for racial and ethnic differences, as white individuals tend to be overrepresented in prevalence studies. The presence of bias and underreporting may also increase depending on the subtype of OCD, especially when individuals perform mental rather than physical compulsions (which are a lot harder to spot). Therefore, increasing provider knowledge of OCD and spreading awareness for laypersons is of the utmost importance to increase the likelihood of earlier intervention.  

There Is Hope 

Obsessive-compulsive disorder can wreak havoc on one’s day-to-day life and relationships, but the good news is that there’s hope and treatment available. Many evidenced-based treatments such as cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) have been proven to be effective to target irrational beliefs held by individuals with OCD. 

One of the most effective interventions for OCD, exposure and response prevention (ERP), helps the client to tolerate anxiety stemming from obsessions and related stimuli by using positive alternative behaviors to reduce compulsions. ERP also facilitates therapeutic rapport as the clinician empowers clients to confront their fears and make positive change in their lives. 

With the help of a clinician specializing in OCD, clients can heal and enjoy a fulfilling life in which they are the ones in control, not OCD.

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