“I am a little bit OCD” or “I love organizing; I am so OCD." You might have heard phrases similar to those before. The truth is that mental conditions often get reduced to some specific behaviors and are often used as a fun excuse for a “quirky” manner someone has. However, when an individual comes along that actually lives with the condition, suddenly it is not so fun any more. Obsessive-Compulsive Disorder (OCD) is often one of those conditions that are both excessively used as a self-diagnosis and, at the same time, completely misunderstood or mislabeled. What exactly is OCD, though, and how do individuals living with it experience the world? Let’s talk about it.

The science behind it

Obsessive-compulsive disorder is a psychiatric condition marked by the presence of obsessions (intrusive, unwelcome, and uncomfortable thoughts, urges, or images) as well as compulsions, which are repetitive behaviors or mental acts undertaken to alleviate the discomfort generated by the obsessions. OCD symptoms are chronic, time-consuming, and significantly impair daily functioning.

OCD’s core scientific components include obsessions, which are intrusive, recurring thoughts or images that cause significant anxiety or distress, and compulsions, which are behaviors (such as washing hands and checking) or mental acts (such as counting and repeating phrases) designed to neutralize or alleviate the distress associated with obsessions. The disorder has a significant functional impact; it becomes clinically significant when obsessions and compulsions take up a large amount of time, create distress, and impair social, occupational, or academic performance.

The cause of OCD is multifaceted, involving genetic predispositions, neological variables, temperament variances, and environmental influences such as childhood trauma and substantial life stresses, all of which can increase the likelihood of developing the disorder. OCD usually appears in childhood, adolescence, or early adulthood and has a chronic trajectory if untreated. Evidence-based approaches for treating OCD largely include cognitive-behavioral therapy with exposure and response (ERP) and selective serotonin reuptake inhibitors (SSRIs), which can successfully reduce symptom intensity.

Living with OCD

OCD has a wide-range impact on daily living. Misunderstandings, a desire for reassurance on a regular basis, and avoidance of social connections or closeness are all possible in relationships. Fatigue, interrupted sleep patterns, and an inability to engage in hobbies or relaxation all have a negative impact on self-care. The emotional consequences of OCD are deep; the desire to conceal symptoms and manage routines adds to feelings of weariness and shame. The disorder significantly hinders daily functioning, including concentration, decision-making, and task completion. Even little tasks, such as locking a door or writing an email, can feel burdensome, creating a sense of instability in life.

The truth is that every individual with this disorder can experience it in different ways. Like with all mental or physical conditions, the reality of everyday life can vary to a great extent from person to person. The important thing to note is that one case does not automatically invalidate another that looks slightly different. Compulsions are behaviors that people feel driven to execute in order to relieve the distress caused by their intrusive thoughts.

The compulsions someone might experience often depend on the surrounding environment, past experiences, trauma history, and many other things. They shape according to the person’s fears and thoughts while becoming obsessive and conveying the feeling that they are a necessity for controlling and ultimately overcoming the distressing situation. The tricky part in all of this is that a vicious cycle begins with no sign of escape. One upsetting and manipulative thought follows the next, while compulsions offer a brief relief without providing a long-term solution. In theory, this might not sound that intense and actually manageable. In reality, living with OCD can be for many a living hell, created by their own brain.

Obsessive-compulsive disorder can take up a lot of time out of a day. Whether that is due to the recurring obsessions or the compulsions that often follow. Again, this can look different for everyone. Some people might practice a lot of practical rituals (like organizing, cleaning, checking, washing hands, and repeating phrases), and others more mental rituals (like trying to cope with intrusive thoughts). Either way, these rituals usually put individuals in a state of mental paralysis, making them not able to move on with their day until the specific practice is done. Unfortunately, this does not mean that once it is done, it is out of the picture. They may provide temporary respite but ultimately reinforce the underlying worries. Distressing and intrusive thoughts will recur, and the cycle continues, with no exit in sight. It can take up hours out of the day and leave the person with mental exhaustion.

What is wrong with me?

This might be a question many people with OCD ask themselves constantly. Especially before getting a proper diagnosis. This is often due to the nature of intrusive thoughts OCD accompanies. These thoughts are frequently quite disturbing, extremely repulsive, and even represent something that is completely opposite of what the person experiencing them stands for. Intrusive thoughts frequently revolve on themes of contamination, causing injury, making mistakes, or other taboo topics, and they might occur suddenly, resulting in a persistent state of mental tension that is difficult to manage.

Someone who does not know yet that they have obsessive-compulsive disorder might think these thoughts are a representation of their personality, which understandably brings feelings of anxiety and distress, since it seems unexpected, like a betrayal of one's own self. Understanding the persistence of OCD despite rational knowledge indicates that the condition is driven by neurobiological factors rather than reasoning. This frequently results in a painful gap between what people know intellectually and how they feel emotionally, affecting the experience of living with OCD.

The reality is that these people are usually not bad or evil. The key here to understanding why this is not a part of a personality disorder is that people with OCD recognize that these thoughts are unwanted, irrational, and uncontrolled. They are driven by fear, anxiety, and the immense urge to neutralize a perceived threat. Individuals recognize the illogical character of the thought, yet they still manage to dominate, despite all the efforts to suffocate them. This is precisely one of the reasons why this disorder can be so tormenting and time-consuming. Here is where therapy comes in. Not only can psychotherapy help recognize the character of the behaviors and thoughts, but it can also help manage them and maybe even get rid of them.

OCD is therefore not a weird obsession for tidiness and organizing. It can feel like a living hell for some, and people living with it are desperate for a break. Similar to any other mental condition, the things that are visible on the outside are only the tip of the iceberg, and the profundity of it can go so much deeper. It is important to take individuals with mental disorders seriously and to try to understand their reality.

References

Keyes, Carly, et al. “The Battle of Living with Obsessive Compulsive Disorder: A Qualitative Study of Young People’s Experiences.” Child and Adolescent Mental Health, vol. 23, no. 3, 4 Apr. 2017, pp. 177–184.
Veale, David, and Alison Roberts. “Obsessive-Compulsive Disorder.” BMJ, vol. 348, no. Apr. 7, 6, 7 Apr. 2014, pp. 2183–2183.