Understanding OCD Beyond the Stereotypes
Lindsay Knake
| 4 min read
Lindsay Knake is a brand journalist for Blue Cross Blue Shield of Michigan.
If you think of obsessive-compulsive disorder (OCD), you may think of a person who needs everything to be tidy or who washes their hands until they are raw.
OCD, however, is much broader than these stereotypes. Let’s take a look at what OCD is, how it affects people and treatments.
What is OCD?
This mental health disorder is characterized by having recurring, uncontrollable intrusive thoughts that feel real and cause distress, and then following a compulsive behavior or thought to temporarily relieve the distress or prevent the intrusive thought from happening. A person must deal with these thoughts and compulsions for at least an hour a day.
Up to 2% of Americans have OCD, which is more common in girls and women and typically develops in adolescence or early adulthood. Children and young adults may not realize their thought patterns are out of the ordinary, according to the National Institute of Mental Health.
It can take up to a decade for someone to get a diagnosis after OCD develops, according to Harvard Health.
Intrusive thoughts and compulsions
Intrusive thoughts can take many different forms. These thoughts create self-doubt and are often ego-dystonic, meaning they do not align with an individual’s values or actions.
Here are common obsessions:
- Fear of accidents or being a victim of violence
- Fear of committing acts of violence on others
- Fear of contamination
- Having taboo thoughts about sex or religion
- Excessively worry about morality
Common compulsions include:
- Constant self-reassurance
- Avoiding
- Mental problem solving to prepare for possible emergencies
- Repeating a prayer or counting
- Repeated washing or bathing
- Repeated checking of locks or stoves
Misconceptions about OCD
OCD is not merely perfectionism or a preference for neatness and order. A person with OCD can feel if they make a mistake or have a messy home, then something bad will happen to them or a loved one.
Most people have uncomfortable intrusive thoughts such as “what if I drive off the road?” but can let them go. People with OCD, however, believe the intrusive thoughts are real and that a part of them actually wants to drive off the road, which causes distress.
Many people with OCD may not have visible compulsions like handwashing or repeatedly checking to see if the door is locked, but rather compulsions that are entirely internal. Called thought compulsions, they typically fall into one of three categories: problem solving, reassurance and avoidance.
OCD can be confused with anxiety, but it is a different disorder. People with anxiety may find relief from their emotions with problem solving, reassurance or avoidance, but the more a person with OCD uses compulsions to resolve their distress, the more it feeds future intrusive thoughts. OCD can contribute to overall feelings of anxiety and depression because of the ongoing distress.
The severity of OCD varies from person to person. While some people have fairly benign intrusive thoughts, others have obsessions and compulsions that become disabling and prevent them from going to school or work, according to the Mayo Clinic.
Treatments for OCD
OCD is a treatable mental health disorder for most. A common therapeutic treatment is exposure and response prevention (ERP), in which a person with OCD works with a trained therapist to allow themselves to understand the thoughts are not real, sit with the distressing feelings and avoid the compulsion. Over time, a person may be able to acknowledge the thought, feel minor discomfort and move on. About 60%of people with OCD find their symptoms improve with ERP, according to research.
Acceptance and commitment therapy (ACT) is another treatment involving accepting all thoughts and emotions rather than trying to change them, identifying values and working toward living those values.
Common medications to treat OCD include antidepressants such as selective serotonin reuptake inhibitors (SSRIs), according to the American Psychiatric Association (APA).
OCD is not curable, and a person may deal with a recurrence of OCD during times of stress. However, with treatment the intrusive thoughts can diminish into quiet background noise. Anyone with symptoms of OCD that interfere with their daily life should talk to their primary care physician.
Image: Getty Images
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