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What is OCD Anyway?

I refuse to be the word police, however

I refuse to be the word police.

In the media and pop culture OCD gets referenced a lot: closets are color-coded, pencils must be in a straight line , tangled phone cords are triggering someone’s “OCD.” Try searching #OCD on Twitter, and see what many people think OCD means. However, I have worked with truly tortured individuals. People who, when they see their own struggles compared to a tangled phone cord or misaligned pencils, feel that much more “crazy” and isolated, and who want to just give in and give up.

I don’t want people to stop using the term OCD. I do, however, want individuals to understand what they mean when they say it. Here is a checklist for you to consider:

1) Do you spend hours a day feeling intense anxiety?

2) Do you find yourself experiencing intense, unwanted thoughts or images repeatedly throughout your day?

3) Do you find yourself spending a good part of your day doing behaviors to quell your anxiety?

4) Do you avoid doing things you would otherwise do if you didn’t feel this anxiety?

If you aren’t answering yes to these questions, let me offer an alternative to the phrase “I’m so OCD” or “That’s so OCD.” You might actually be “obsessive”: you worry, you think a lot, you spend time in “what if” scenarios, or you like the aesthetics of symmetry. Or, maybe you are actually “compulsive”: you are anal, organized, detail-oriented, like to line things up, and create order in chaos. You may even have both of these traits — like me. I do not have OCD, but, like many people, I do have obsessive and compulsive traits. For example, because I am a “everything has its place” person, when friends come to my house they like to move around my possessions to see how long it takes before I move them back. The difference is, I know my behaviors are an indulgences and eccentricities. The difference is, I like it!

I’ve never met someone with OCD who liked it.

As OCD Awareness Week kicks off, I am reminded of when I was running therapy groups at the OCD Institute at Mclean Hospital and asking patients to talk about their symptoms. Even in a facility dedicated to individuals with OCD, they would stare at each other in astonishment as they explained their behaviors to each other: “You do WHAT? Don’t you know that is crazy?” I get that it is hard to understand what someone with OCD actually goes through — even people with OCD have a hard time being empathetic with each other!

However, what other disorder or medical condition can you think of where it takes 14 to 17 years from onset of OCD symptoms to get effective treatment? Why the lag? In large part because people with OCD know that the compulsive behaviors they engage in don’t make any sense. But — and this is the part that sets OCD, with a capital D for Disorder, apart from just obsessive and compulsive behaviors — for people with OCD, the obsessions and compulsions aren’t about preferring pencils to be aligned on a desk or having a penchant for color-coded closets. They are a survival mechanism; the behaviors give people temporary relief from the seemingly unending anxiety and torture in their minds.

I want you to take a moment and think of a time in your life when you experienced very strong, unpleasant, unwanted feelings. After a particularly painful break up? Loss of a loved one? The stress of suddenly being unemployed? All good reasons for having these intense feelings. Now imagine that you had feelings to that degree, but you had no identifiable reason for it. Your brain — not your “self” — is giving you misinformation. You’ve heard the phrase, “Time heals all wounds.” Imagine that it didn’t — that the anxiety got worse and worse over time (this is in fact the case for individuals with an untreated anxiety disorder).

So what is the solution?

As we approach OCD Awareness week, I am reminded how stigma about mental illness keeps many people from stepping forward and seeking help. And misinformation about mental health issues, such as the idea that OCD is just a quirk that you can “get over,” only serves to compound that stigma.

For those of you who have ever used the term OCD a bit loosely — I forgive you. And I don’t want to keep you from lamenting or boasting your own “obsessive” or compulsive” traits. But if I can convince some of you during OCD Awareness Week to also learn a little more about OCD, then I will truly consider our awareness-building efforts a success.