Obsessive-Compulsive Disorder (OCD) is something so colloquialized, it almost seems unreal. I bet you've heard yourself say, "I'm so OCD about ________," without thinking twice. And as much as I want to blame TV and movies, it really was this kind of table talk that shaped the way I viewed the disorder before I recognized it in myself.
What comes to mind for you?
Maybe you visualize someone with an unexplained aversion, or perhaps a need for a specific kind of organization.
Technically, you'd be right. Fear of contamination and attraction to order and symmetry are legitimate and widely-experienced forms of OCD. But as with many things in our culture, the way the disorder is perceived can also be different from what it's really like.
Let's look at my case. I became aware of my depression and anxiety as early as age 12, but that didn't fully explain all of my thoughts, feelings, and behaviors, many of which I still experience in my adult life:
1. Unexplained Aggression & Unwanted Thoughts
At first I thought this one was kinda funny. I'd see people on the street and get a random urge to smack 'em in the face. Why?? No clue. They hadn't done anything to me. My mother and I would talk about this and laugh together because, as it turned out, she felt the same way! The hereditary aspect was intriguing, but really I started taking these thoughts more seriously when they began manifesting in different ways.
I experienced a similarly-aggressive impulse to give people the middle finger. I had vivid and horrific thoughts, even sometimes dreams, that I couldn't put out of my mind. And even though they rarely influenced my behavior, I felt a lot of shame for having the thoughts in the first place.
2. Task Verification & Repetition
I always felt the need to check and double check that I completed simple tasks, especially flushing the toilet or locking the door.
When I would use the restroom, I would tell myself intently to remember to flush. Don't forget. Don't forget. Don't forget. Don't forget. Even at times when I went back to check, I would get anxious about someone going in after me because I still wasn't sure whether or not I'd done it.
Each time I locked the door to my room, I'd twist the handle several times to see if it worked. Still, while changing my clothes or simply sitting down to work, I'd have to get up several times to go back to the door and check again. And again. And again.
> What's more, I couldn't control urges to mouth the words of other people as they spoke or repeat things they said in conversation.
3. Excoriation - (Didn't even know this was a real thing!)
Not only did people say it was gross to pick at scabs, they always warned me about potential scarring and adverse health effects. That didn't stop me. Any time I'd see a new scratch on my body, I couldn't stop myself from chipping away at it - even at night while I was sleeping.
When performing a task, I needed the comfort of having a number in mind:
I would count, sometimes aloud, the number of steps it took me to walk from one place to another.
If I was reading a book, I needed to count exactly how many pages were in each chapter and double check as I went on so I'd know I was making progress.
While sitting for long periods of time, I would focus by breaking it down by song (i.e. attending an hour-long lecture and singing 'Superbass' over and over in my head to pass the 3 and a half minutes).
5. Heightened Irrational Fears
I attributed this largely to my anxiety, but perhaps there was a little more to it. I had particularly strong fears related to everyday circumstances, especially things I thought could compromise my safety. I'd hold my breath in elevators, worrying they might break down or free fall. I had an escape plan whenever I was in a car driving over a bridge. What if it collapses? What if we drown? I'd duck or flinch when I walked past cars with passengers dangling their hands outside the window. What if they're holding a gun?
Some nights I could barely sleep because I constantly felt like I was in danger.
6. Obsessive Rumination Over Past Events
Certain things, I just couldn't let go. I'd make a mistake and be so consumed by shame or regret that I'd assume excessive blame for the consequences or go out of the way to overcompensate. I'd send myself down a psychological wormhole of whys and what-ifs, spending hours worrying about things that were outside my control. I could never make peace with things without asking others what they would have done in my situation and how they perceived me as a result of my choices. (Lynne S. Gots, PhD provides examples on this.)
But lots of people do those things. How do you know it's OCD?
You’re right. I’m sure we all experience strange thoughts or uncomfortable anxieties in one way or another. OCD is distinct because people who experience it may find it more difficult to traverse these things in a manner that does not interfere with their normal routine.
For people with OCD negative thoughts become obsessions. Behaviors emerge from compulsions. It's a step further than thinking or wanting to do something and simply being able to move on.
Mayo Clinic says: "You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior — the vicious cycle of OCD."
Believe it or not, writing this piece is the first time I've discussed my OCD with anyone other than my therapist. It's important to me because this kind of knowledge and shared experience can really be a game-changer for people who are still grappling with how to identify and describe their personal struggles.
Seriously? So what if it's really OCD?
"You may try to ignore or stop your obsessions, but that only increases your distress and anxiety."
As much as people say words don’t really matter, our system of language assigns meaning and value to the people, places, and things that make up our life experience. How does it make you feel when people forget your name? Or refer to you simply by what you’re wearing or how you look? Do you experience frustration when you forget what something is called? Or when you struggle to find the words to explain to someone how you feel?
Nomenclature is a basis for knowledge. It mitigates stigma and creates opportunities for research, identity formation, and community consciousness. Before I knew I had OCD, I just thought I was a weirdo having an isolated experience. I was disgusted by myself, and I struggled to find normalcy whilst managing thoughts I couldn’t control and fears I couldn’t rationalize. Now, I know there are millions of people like me: 1 in every 100 American adults. There are resources I can seek out to understand more about the causes, effects, and treatments, and I can talk to others about what I'm going through and how to care for myself.
Now imagine if I'd known earlier. If that 12 year-old me got what she really needed.
Challenge yourself to be intentional about your words. You may not even be aware that something you said is perpetuating a stereotype, influencing someone's perception, or limiting someone's beliefs in some way. There's someone reading this and only now learning this information for the first time.
If that's you, and if you feel like you may be having an experience similar to mine, don't do what I would do and rush off to WebMD yourself. OCD is complex. It varies in severity and in symptom, and is determined case-by-case using specific diagnostic techniques. Talk to a medical professional if you need advice or information.
I hope reading this makes you feel a little better about starting this conversation with others or supporting friends who may be trying to cope. Remember: you are never alone!