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When Does OCD Become a Disorder?

Despite what the Kardashians say, this is what the disorder really involves.

If you have been Keeping Up With the Kardahsians, you may have seen Khloe Kardashian refer to herself as having “OCD” and "Khloe-C-D." I have seen and heard plenty of feedback from the reality stars' statements. A lot of people have felt offended by her claims to be suffering from the disorder and did not appreciate her comparing her desire to have an organized kitchen to the torturous hells of having OCD.

To be clear, I have no idea whether or not Khloe meets the criteria for clinical OCD. I am in no way diagnosing her. However, I realize there is much confusion in the public as to whether or not an individual has clinical OCD, or whether they are just people who prefer and operate better in neat and organized environments.

So, can you have traits of this disorder, but not the actual disorder? First, you can have some traits of all sorts of psychological conditions, yet not be diagnosed with them. For instance, I may have moments of feeling sad, guilty, and lethargic. This does not mean that I qualify for a diagnosis of Major Depressive Disorder. For the symptoms you are experiencing to be clinically significant enough for you to be diagnosed with the condition, you need to be experiencing a certain number of symptoms for a certain length of time. In the case of OCD, just because you have certain routines or preferences does not necessarily mean you meet the criteria for the diagnosis. Every successful medical student I’ve ever met has had traits of OCD. They can’t stop thinking about their test the next morning and they end up studying a lot. But is that enough for a diagnosis?

This is an excellent question. The way an individual would officially figure out if they meet the criteria for the disorder is to make an appointment for a diagnostic interview with a trained and licensed mental health professional, preferably one who specializes in OCD and related disorders.

Heather Mckean / Unsplash
Source: Heather Mckean / Unsplash

That being said, I will discuss what I believe to be the most essential ingredient in order to decipher between clinical OCD and having OCD tendencies such as being clean, neat, and organized: The symptoms you are experiencing need to interfere or prevent your social and occupational functioning. Basically, to be suffering from OCD you have to have impairment in your ability to work or your ability to interact with people in the world.

Here are some examples of difficulty functioning at your occupation due to OCD:

I had a client some years back who was unable to arrive to work on time because he was doing so many checking compulsions in his house. He would check every single electrical appliance he owned and then he checked them eight-to-ten more times to make sure they were unplugged and turned off before he felt he could leave his driveway. He sometimes even turned back to his house when he was already halfway to the office because of obsessive doubt that perhaps the iron was still left on.

I had another client who was fired from her customer service job because she would freeze up and not be able to speak on the phone if she needed to do a mental ritual. She could hardly concentrate on what the customer was saying because she was busy making lists and remembering all the places she had been last week—a rigorous mental ritual she used to “protect” herself against losing her memories. This client was fired, but I had a different client quit her job at a woman’s clothing store. Her quitting was a major compulsion, so she did not have to face seeing other women in the dressing rooms. Seeing the women changing evoked her obsessive doubt that she could possibly be gay. (This ia a common type of OCD known as Homosexual OCD or HOCD.)

OCD is interruptive even for my clients who work from home. I often work with moms or dads who have great difficulty functioning as a parent because of their OCD. For example, I have several clients that do not want to be alone at home with their children for fear that they will “suddenly snap” and kill the kids (Harm OCD), or that they will suddenly molest them (Pedophile OCD). I am not saying that these clients are unable to parent; it is just extremely difficult to juggle working while experiencing obsessive thoughts. It fully interferes with their ability to enjoy their children and be in the present moment with them.

There are so many examples, but clearly clinical OCD makes trying to earn a living a potential nightmare and causes significant impairment in social functioning. I had a different client who could not focus on dates. This client was single and was hoping to meet a nice person to settle down with. But he was completely bombing it in the romance department. He would drift off into the world of mental rituals whenever an obsession struck. He was physically there, but mentally somewhere else—not sexy at all. It was no surprise that he was always ghosted by his dates and hardly ever had a second date.

Another example of OCD causing impairment in social functioning was from my own experience. When my contamination OCD was very severe, I would go to parties or social gatherings dressed in multiple layers. One time, I showed up to my friend’s beach party wearing long-sleeved pants and shirt. Everyone else was in swimsuit. I lied (a common compulsion I used) and said that I had to go back to work in 15 minutes. While everyone else was relaxing on lounge chairs, I was busy standing on the side careful not to step in the sand for fear that I could possibly step on a sharp object and draw blood. It was pretty clear that I was not functioning well socially; I could not experience laughing, eating, and catching up with good friends.

It is not uncommon at all for people suffering from OCD to have friends, family, and co-workers become annoyed and frustrated with the sufferer. It is not uncommon for friends and family to avoid or stop including the individual in planned events. Conversely, people who do not meet the clinical criteria for OCD are usually seen by friends and family as “quirky," "cute," or "funny." Often friends and family will laugh and explain, “Oh, that’s just how Aunt Mae is.” Or, "She’s always liked order.” However, no one is avoiding Aunt Mae or leaving her out. This is because her borderline OCD is not crossing the threshold enough to impair her ability to maintain her relationships with her family.

Furthermore, a person with sub-clinical OCD will not have impairments in their ability to function at work. Sure, their desk may be super clean and organized, or they may have strict schedules for their children, but they can handle and complete their job requirements in a timely fashion without difficulties. This sub-clinical person can also maintain romantic relationships, and show up to a beach party in their bathing suit.

If you are reading this post and decide that your OCD is becoming unmanageable and interfering with your functioning in your daily life, please seek treatment immediately. It would be important to locate a professional who is trained in Exposure and Response Prevention Therapy.