Obsessive-compulsive disorder, or OCD, is a mental illness that is experienced by as many as 1 in 100 Americans each year, with roughly 50 percent of these cases classified as severe.
To put this into perspective, each day, more than 300,000 pedestrians enter the heart of Times Square. This means that, of those pedestrians, roughly 3,000 of them have OCD and 1,500 have a more severe form of the disorder. In a typical sports stadium—let’s say Heinz Field, the home of the Pittsburgh Steelers, with 68,400 seats—684 people are probably diagnosed with OCD. In your college lecture hall, chances are at least one person is struggling with the illness.
Even though OCD is more prevalent than celiac disease, few people understand how to separate the facts from fiction when it comes to the illness. Many people with OCD are misunderstood and struggle with a stigma that can negatively impact life at home, work and in their relationships.
Here are four common myths about OCD and the facts that prove them wrong.
1. MYTH: People with OCD love keeping things neat and organized.
Raise your hand if you’ve ever heard someone playfully say, “I’m so OCD,” while organizing a desk or cleaning a room. In many ways, this is the equivalent of saying, “I’m such a cancer patient,” because you feel like staying in bed all day or, “I’m so anorexic,” because you choose to avoid dessert after dinner.
OCD is a serious mental illness marked by high levels of anxiety and emotional distress. People with OCD might have cleanliness rituals, but they don’t enjoy them. They keep things clean and organized because otherwise they will experience crushing anxiety.
Then again, it’s also important to remember that not everyone with OCD has compulsions related to cleanliness.
2. MYTH: OCD is just about cleaning, hand-washing and being a “germaphobe.”
OCD is a heterogeneous disorder. In other words, it manifests differently in different people. In fact, only a portion of individuals with OCD are afraid of germs or have compulsions related to keeping themselves (and their world) clean.
Common fears, or obsessions, in people with OCD include:
- Fear of germs or contamination
- Fear of committing a sin
- Fear of harming themselves or others
- Fear of a loved one dying
- Fear of certain numbers, colors, words, etc.
- Fear of becoming a sexual predator
People with OCD perform rituals to mitigate the anxiety associated with their obsessions. These are known as compulsions.
Common compulsions in people with OCD include:
- Repeating certain movements
- Cleaning excessively
- Ordering or arranging things in the “right” way
- Tapping or touching objects
These symptoms vary from individual to individual and can even change over the course of a person’s lifetime.
3. MYTH: When a person has OCD, it’s obvious.
Although it may be hard to believe, you’ve likely encountered many individuals with OCD and haven’t realized it. People with OCD are often able to hide or suppress their symptoms in public, especially if they’re receiving proper treatment.
There is also a contingent of patients with OCD who demonstrate no visible compulsions, even when they’re alone. Pure obsessional OCD, also known as Pure-O, is a subtype of OCD that involves compulsions that are largely performed inside the patient’s head. People with Pure-O often don’t even recognize that they have OCD, since their symptoms don’t resemble the more traditional depictions of the disorder.
4. MYTH: People with OCD are weak-willed and just need to relax.
For a healthy individual, the symptoms associated with OCD might seem absurd or even comical. (No one likes it when their life-threatening illness is seen as a joke.) The solution seems obvious:
- “Just stop washing your hands.”
- “Calm down! Nothing bad will happen.”
- “The stove is off. You don’t need to check it again.”
- “Why can’t you throw away all this useless junk?”
- “Can’t you just be realistic?”
OCD isn’t a personality quirk—it’s a disease. If curing a chronic illness was as simple as just “calming down,” no one in the world would be sick. People with OCD have brain regions that are literally malfunctioning, making it difficult—if not outright impossible—to fight their disorder without treatment. Certain antidepressants can be used to recalibrate the brain and soothe some of the symptoms, and exposure and response prevention (ERP) can help patients train their brains to respond less severely to their anxieties. Despite all of this, OCD is still a chronic condition that can follow a person for his or her entire life.
The next time you hear someone bring up one of these common OCD myths, tell the person the facts instead. Don’t let this misinformation continue to harm the very real people struggling with this condition.
What does OCD look like?
A father of a newborn came in to see me reporting that he hadn’t slept in four days and was fearful he would have a nervous breakdown. Upon inquiry, he hesitantly admitted that he was having recurrent thoughts of killing his newborn son, a common fear of people with Pure-O OCD. People with this form of OCD aren’t any more likely to become a murderer than someone else, but nonetheless, they live with the crushing anxiety that they will one day snap. He responded well to an antidepressant that contained serotonin and dopamine.
An elderly gentleman visited me for treatment. In each session, he was disheveled and exhausted, but wouldn't explain why. Finally, he admitted that he had been sleeping in his backyard on a wicker couch because he was afraid of “messing up his house.” He responded to a serotonin antidepressant and a small dose of a dopamine antipsychotic.
Of course, these individuals make up a minuscule portion of people suffering from this disorder. The obsessions and compulsions associated with OCD are variable and countless. Not everyone responds well to medication and not everyone tolerates therapy. Right now, researchers are trying to determine whether or not brain surgery can help patients conquer this frightening disorder.
OCD—and mental illness in general—is still highly stigmatized and misunderstood. The best thing we can do as citizens is stay informed and avoid relying on the (often inaccurate) media depictions of people with these conditions.
Contributed by Courtney Lopresti, M.S., Neuroscience.