Content warning: this article discusses mental health and distressing intrusive thoughts.
Obsessive-compulsive disorder (OCD) is a deeply misunderstood mental disorder, and that needs to change.
To begin to understand OCD, one must first debunk the misconceptions that social media and casual conversation have created surrounding the disorder. Colloquialisms like “I’m so OCD” in regard to organizing one’s bookshelf might make the disorder seem like a “quirky” or “fun” personality trait, but in reality, they minimize the deep distress and chronic mental anguish that burden individuals with OCD every day.
There is nothing quirky or fun about OCD. Individuals who suffer with the disorder often deal with daily torment that can create lasting psychological or physical impacts, including a sense of misalignment from reality, distrust of self, physical harm to one’s body or difficulty in experiencing pleasure.
Having spent a lot of time researching the condition, I believe it is incredibly important to clear up misconceptions about OCD and eliminate the stigma that surrounds the ugly truth of this disorder.
As the name implies, obsessive-compulsive disorder is formed around a cycle dominated by obsessions and compulsions. In the context of this discussion, an obsession is an unwanted thought, mental image or distressing feeling. A compulsion is a physical or mental behaviour completed for the intended purpose of alleviating the fear around an obsession.
When a person with OCD is triggered by an obsession, they feel distress and usually attribute some sort of significance to the unwanted thought or feeling. In response to their obsession, they complete a compulsion to rid themselves of it and thus eliminate the anxiety the thought evokes, or to feel a sort of mental cleansing.
While the compulsion often delivers temporary relief, the obsession always returns — and the individual’s repeated compulsions in response to the obsession forms a mental cycle in which they begin to feel that repeatedly completing that compulsion is the only way to enjoy peace. In other words, they reinforce compulsive behaviours that ultimately do nothing to eliminate their stress.
Without intervention, this creates an infinite loop in which an individual with OCD becomes greatly distressed by each obsession, with more and more of their life spent completing mentally toxic compulsions.
Let’s be clear: just about every person experiences obsessions. Having unwanted or intrusive thoughts isn’t abnormal. The difference between the “OCD brain” and the “non-OCD brain” is that the latter is able to discard an obsession as nothing worth stressing over, while the former attributes significant value to the thought and erroneously fears there must be some truth to it.
Let’s use a common example of an intrusive thought, sometimes referred to as the call of the void: a sudden thought about performing a dangerous behaviour for no apparent reason. Maybe you’ve been driving your car and had a sudden intrusive thought: what would happen if I veered off the road and drove into oncoming traffic?
Again, remember that obsessions — in this case, an intrusive thought — are normal, and are not limited to people with OCD. This kind of thought can happen to anyone.
For a person without OCD, this thought is likely fleeting. They might think it’s strange, but they ultimately brush it off or even laugh at its absurdity. To a person without OCD, this is nothing more than a meaningless thought, and it doesn’t hold much attention. The cycle ends there because there isn’t a cycle at all.
But for a person with OCD, this intrusive thought might carry a lot more weight. Because of thought-action fusion — the idea that thinking about an action equates to actually carrying out that action — the individual might become deeply afraid that they have a genuine desire to drive their car off the road, or a fear that they might lose control and drive off the road impulsively.
The OCD brain quickly moves down a slippery slope of “what if?” statements, which might mean questioning their own morality, fearing for the safety of other passengers in the car or worrying that they might endanger individuals in the other lane. Suddenly, a meaningless intrusive thought becomes a much deeper ordeal, opening the door for compulsions.
Compulsions can take a variety of forms. They might be something physical, like tapping the steering wheel a set number of times. They might be emotional, like seeking reassurance from others in the car that no one feels physically threatened. They might be mental, like mentally replaying that moment in the car over and over to hyper-analyze whether there was actually any possibility that they might have done something dangerous.
The form of the compulsion might vary, but the final result is the same: the person with OCD temporarily alleviates their distress, but it ultimately returns stronger and reinforced by a belief that obsessions can only be cleared by further compulsions.
It’s highly important to mention that just because a person with OCD places more value on an intrusive thought, that doesn’t mean that the intrusive thought is more likely to come true. In fact, people with OCD that revolves around physically harmful obsessions (like the example we’ve just explored) are usually incredibly gentle individuals who are horrified by violence and are perhaps the least likely to randomly veer into oncoming traffic.
This touches on a crucial element of OCD: obsessions will often form around the themes that are most important to a person. Think of OCD as a mental parasite that homes in on whatever its victim cares the most about. Let’s look at a few common examples.
A person who highly values their relationships may experience relationship-themed OCD, where they may fear that their relationships are falling apart or that they are responsible for hurting the other person. A potential compulsion might be repeatedly seeking reassurance from their partner that they haven’t done anything to upset them.
Someone with deep morals or values might be haunted by morality-themed OCD in which they question whether they are a “bad person.” They might worry that they have accidentally done something awful without realizing it, like obsessively worrying whether that bump during the drive was a speed bump or a hit-and-run. A potential compulsion might be replaying moments or possibilities over and over in their mind or revisiting the site of a feared wrongdoing until they are satisfied that they haven’t done anything nefarious.
Religious OCD might take the form of fixating on whether they’ve committed a sin or will be bound to eternal torment in the afterlife. A potential compulsion might be repeated or constant prayer, or repeated attempts at completing a specific prayer until it feels “just right” or “genuine enough.”
People who are concerned about staying healthy might face contamination OCD, fearing germs or illness. Compulsions might include constant and repeated hand-washing, disinfecting items for hours at a time or an unwillingness to leave the house for fear of picking up a contaminant.
If you don’t have OCD, maybe you’ve looked over these examples and thought “so what? That doesn’t seem like something to stress over.” But to a person with OCD, these thoughts can become chronic and debilitating, especially if they spend hours a day completing compulsions.
If you’re an individual without OCD, the first step to understanding OCD is to comprehend that the “OCD brain” simply works differently from your own. “Get over it” is never a helpful or realistic response to an obsession — this will only isolate the individual with OCD and potentially worsen their fears.
The examples I’ve listed here are only a few types of things that a person with OCD might have obsessions over. A person dealing with OCD might have completely different obsessive themes than the ones I’ve mentioned, or they may experience multiple themes. In some cases, multiple themes might combine — like a person with moral and contamination OCD worrying that their actions might be responsible for another person becoming ill.
Essentially, when the cycle of obsessions and compulsions is in full effect, OCD is much worse than a fleeting worry here or there. It becomes a living hell — a person beginning to feel as though they are trapped in a prison cell confined within their own mind.
Unfortunately, the misunderstandings and stigma around OCD force a lot of individuals to feel as though they need to suffer in silence. People with OCD are often experts at hiding their compulsions and keeping their obsessions to themselves.
If you know someone with OCD, keep in mind that the version of them that they allow you to see might not be indicative of what they’re really going through — even if they seem completely fine.
So, the next time that you feel like joking about “being so OCD,” take a moment to reflect on the real anguish that individuals with OCD face on a daily basis. Understand that OCD is not a silly quirk or cute personality trait; it is an ugly, oppressive disorder that traps kind, loving people in cycles of guilt, fear and sadness. Making the effort to understand the truth about OCD is the first step to eliminating the vast social misunderstandings around it.
If you’d like to learn more about OCD, visit the International OCD Foundation website. If you are an individual suffering from obsessive-compulsive disorder, the best response is to find a dedicated OCD therapist — help does exist.
If you or someone you know is in crisis, call or text 9-8-8 for the Suicide Crisis helpline, available 24/7 across Canada.