Have you ever skipped lines on the pavement as a child while you were holding your parent’s hand? Have you ever stepped on a line out of a mistake and your brain sort of short-circuited for a second and demanded you go back and skip it again properly? Yeah, that wasn’t pretty fun of your brain to do that. You couldn’t quite put a finger on it, but the notion made you uncomfortable. Maybe it was one of your first encounters with anxiety, maybe it just tickled some part of your amygdala.
Now imagine your brain doing that with almost anything in your life, be it skipping lines on pavements, washing hands after everything you touch or counting to ten or else your whole family will die in a tragic accident. That’s your brain on OCD. But OCD is so much more.
OCD, or obsessive-compulsive disorder, is, according to the American Psychiatric Association, placed within the class of psychiatric disorders known as anxiety disorders. According to the book The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder, about one in forty people has OCD. This disorder is characterized by obsessions and/or compulsions that are time-consuming; they interfere with normal routines and daily functioning, causing distress to both the one who suffers and their loved ones.
Obsessive-compulsive disorder can have many different causes. Various factors play a role in its formation. There are biological and psychological causes that have different influences on each person, Alex Reich, a psychologist, tells me. A biological factor is the possible genetic predisposition, which has been proven to play a role in some of those affected.
“Psychological factors can have a decisive influence. In particular,” Alex continues, “unsettling and traumatizing experiences in childhood often lead to obsessive-compulsive disorder later in life. But too strict upbringing with little freedom or special attention to cleanliness is a potential trigger for it as well. Also, as with most mental illnesses, one’s character and personality matter.”
Marco’s OCD story started way back in High School, “when I didn’t really know what it meant and that what was going on inside my head was the disorder that was quite popular and embraced by most of the teenagers under the name of obsessive-compulsive disorder.”
“I don’t think there is necessarily a trigger in my case, it usually happens when I’m not busy and not thinking about anything important in particular,” Marco tells me.
Ana was never actually diagnosed with OCD. But from what she had observed from her behaviors and patterns, there are some similarities. “I think at first I took it as a good thing that would force me to be productive in Uni – as in studying 3 to 4 weeks and not taking care of myself during exams session.” Of course, almost all students do this, but Ana was obsessed with doing the most with little to no self-care.
“I would forget to eat, and I would sleep very few hours. I was essentially exhausted to the point of fainting when I would go in for the exam. There were also some small signs that resemble the OCD description as in I wanted everything to go as planned. Now it seems stupid to wear just white T-Shirts when I study but for some reason, it was comfortable for me at that point.”
There are habits that Ana formed to not get stuck in those bad thoughts. “If I don’t have time for myself during a period of a few days I get anxious and I feel so drained to the point that I can’t talk anymore. Sometimes if I have people around for more than a few days and everything is loud, I just want to scream and run away.”
Ana’s most common trigger is not having time to herself to regain her balance and analyze the state she’s in. “Making new friends was an easy thing. Now it doesn’t seem so easy. And my biggest trigger now is something unpredictable happening, although I used to be a very spontaneous person.”
HOW IT IS PERCEIVED
“I believe there are many misconceptions when it comes to OCD, mostly because it is seen by many to be a disorder of little concern. From a medical point of view, it is believed that OCD doesn’t really affect a person’s ability to function in society properly. Many assimilate OCD primarily with repeated hand washing, but that’s just a small fraction of what OCD really means.” In Alex’s opinion, obsessions often create stress and anxiety, which in extreme cases develop into an anxiety disorder or other types of psychological disorders.
Social media does little to nothing to relieve the stigma around it, or if it does, it creates a false perception of what OCD is really like. From trends on TikTok in which people explain OCD as being really organized or having color-coordinated closets, people are shown that OCD is everything except what it is. Sure, being organized can be a compulsion based on wanting control and most likely a sensory overload issue, but OCD is much, much more than that.
“Although each individual deals with the stigma of having OCD in a different matter, I believe that today many speak about it openly and even use it as an excuse for their poor behavior. We often hear statements such as I am like that because of my OCD or My OCD kicked in, leaving little room for exercising responsibility and desire to grow.” Alex believes that the internet and the media generated a culture of acceptance and ultimately of hopelessness when dealing with OCD instead of motivating and encouraging the ability to change and seek professional help.
This and the fact that the media sees the compulsion in OCD as the actual disorder, people have been self-diagnosing with OCD when there isn’t the case while people who suffer from it but aren’t particularly clean or organized have flown under the radar, not believing they meet the criteria since their symptoms are different.
So, let’s see what OCD really is about.
You’ve probably sat on a train platform before and a sudden thought struck you, maybe it was what if you were to just throw yourself in front of the oncoming train? or what if you threw someone else?
Have you ever held a baby in your arms and the sudden urge to just throw him across the room materialized out of nowhere? Most people just laugh it off, tell themselves those are just silly little thoughts and then go on with their day, neither hurting themselves, others, or the baby.
Those are called intrusive thoughts and urges.
Authors, Winston and Seif, in the book Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive, Or Disturbing Thoughts, established steps to be taken for coping with the intrusive thoughts: recognizing the thoughts; acknowledging the intrusive thoughts, accepting them and allow them to flow instead of fighting them back or repressing them; float and feel or concentrate on what is as opposed to what if; let time pass, be patient, don’t urge on it and finally, proceed as continuing to do whatever you were doing prior to the intrusive thoughts.
For people who suffer from OCD, this could be easier said than done. Once a thought materializes, so do the obsession and the anxiety. To alienate that anxiety and that doom feeling, people with OCD start doing compulsions to feel better and to make sure those thoughts won’t come true.
Compulsions can be anything, from mental compulsions such as ruminating (a different, much more distressing form of problem-solving) to physical compulsions, such as counting, washing hands, ordering, checking, ignoring, and avoiding.
Intrusive thoughts aren’t the problem in OCD. Research shows that we all have intrusive thoughts and obsessive urges – not just people who have OCD. Anxiety comes from the meaning/responsibility/attention we assign and give to these thoughts. So, we reinforce intrusive thoughts and anxiety by ritualizing. This makes compulsions the problem – not the thoughts.
“The obvious difference between intrusive thoughts and OCD is that intrusive thoughts happen mainly around thoughts and ideas and are usually kept secret from the rest of us. OCD on the contrary is more behavioral and more easily recognized,” Alex explains. OCD primarily creates fear and anxiety in an individual and does not extend to one’s social circle, but the intrusive thoughts consist of mainly negative or perverse thoughts and ideas regarding others.
OCD affects Marco by sending morbidly dark thoughts and scenarios and spontaneous/manipulative “tasks” to his mind that force him into doing random things unless he wants to bear the implied consequences. “I also check the door lock before sleep, the faucets and the stove multiple times before leaving the house.”
For Marco, personally, anxiety acts more on a physical level rather than a psychological one. “I usually knock on wood when I get intrusive thoughts, and although it might sound silly, it does make me feel better. It’s either that or I tell myself repeatedly to stop until the occurred thought goes away.”
When Ana thinks about intrusive thoughts, she remembers some thoughts related to death or something bad happening to the people she cares about. “The most recent one I have is when I open a door and for a split second, I think I’ll find someone from my family dead in that room. Most of them are related to suicide. I also had dreams that both of my parents would commit suicide. I can usually shake the idea easily but it’s still there almost every time I open a door at home.”
OCD starts with the mind. From there it makes its way into our habits and routines. OCD has many different subtypes, from the most known ones such as ROCD (relationship OCD) or COCD (contamination OCD) to the taboo ones (POCD, Pure O, SOCD).
“Anxiety is an overwhelming feeling that takes over your body, while OCD takes over your mind.”– Marco
People avoid other people, organize their spaces, and clean their things not because they want it to be a certain way. Often these are the only things they have control over since they can’t control their obsessive thoughts and their reaction to them.
Ana thinks about anxiety more as fear and stress making you feel uncomfortable even in moments and environments that are not out of the ordinary. OCD, she says, comes after the anxiety in an unhealthy way to prevent it. As in developing certain behaviors and thinking that you can prevent fear or keep it under control.
THE GOOD NEWS
The thoughts are not the problem. Neither is having OCD (I mean, boy, does it suck). But the problem is the importance we give these silty thoughts/urges. The problem is the rituals, the compulsions. By continuing to do this thing so that this other thing won’t happen, we enforce the anxiety, and we give the thought meaning.
There are treatments that can help manage OCD, most notably Cognitive Behavioral Therapy (CBT), but also medication. Alex Reich tells me that although there are people who were able to unlearn and reduce the intensity of their compulsions through discipline or relaxation practices (yoga etc.), it is proven that psychotherapy and medication can help stop the compulsions or reduce them to a manageable level.
Cognitive therapy is about recognizing and questioning one’s own thought patterns. The goal is to identify the thoughts underlying the compulsive behavior and then change them. So, then questions such as: What’s the use of checking ten times to see if the door is locked? are being dealt with. “The focus is to cognitively understand how these compulsive actions actually protect from something.”
For Ana, things that help are time by herself when she can go out with her bike and enjoy the sun. Reading outside, watching a movie, being active around the house and cleaning are also ways in which she can keep stress-free. “Staying on my phone too much definitely doesn’t help in the long run even if it feels a bit comfortable just to sit in bed and watch stupid videos.”
While OCD and intrusive thoughts don’t sound like a fun ride in the park, studies have shown that treatment such as medication, therapy and connecting with nature and others, does help.
And as someone who struggles with OCD, I can promise that it gets better.