Let me tell you, simply because you like to Marie Kondo your apartment or are a bit of a perfectionist does not make you OCD.
OCD often shows up in pop culture, but it’s widely misunderstood. Here are some facts about how OCD works.
Savvy Psychologist is hosted by Dr. Monica Johnson. A transcript is available at Simplecast.
Have a mental health question? Email us at psychologist@quickanddirtytips.com or leave a voicemail at 929-256-2191.
Find Savvy Psychologist on Facebook or subscribe to the newsletter for more psychology tips.
Savvy Psychologist is a part of Quick and Dirty Tips.
Links:
https://quickanddirtytips.com/savvy-psychologist
https://www.facebook.com/savvypsychologist
https://www.kindmindpsych.com/
You all really had a response to my episode on bipolar disorder and many of you responded with requests for more mental health diagnoses that come up in pop culture and are frequently misunderstood. When you ask, I try to deliver, so today I’m going to talk about obsessive compulsive disorder.
Welcome back to Savvy Psychologist. I'm your host, Dr. Monica Johnson. Every week on this show, I'll help you face life's challenges with evidence-based approaches, a sympathetic ear, and zero judgment.
I received several responses related to OCD and I understand why. It’s very common for people to walk around and say “I’m so OCD.” Let me tell you, simply because you like to Marie Kondo your apartment or are a bit of a perfectionist does not make you OCD. Many of you disclosed to me that you have a diagnosis of OCD and found that when people do this it minimizes your experience. I hope the information I provide today will help us to understand the disorder better and to not use the disorder to describe our idiosyncrasies.
Similar to bipolar disorder, OCD afflicts a relatively small number of people. According to the DSM-5-TR, about 1.2% of the United States will experience OCD in a given year. Women are
affected at a slightly higher rate than men in adulthood, while men are
more commonly affected in childhood. Most people will experience symptoms by age 19, and while onset after the age of 35 is uncommon, OCD can occur later in life.
As the name suggests, OCD is characterized by both obsessions and compulsions. Obsessions are recurrent and persistent thoughts, beliefs, and ideas that dominate the afflicted persons headspace. They are perceived as being intrusive and unwanted. Compulsions, on the other hand, are either behaviors or mental acts that they feel compelled to do in response to the obsessions or for rigidly held rules that they feel must be applied.
Those who have a clinical diagnosis of OCD present with obsessions which I’ve just described and they engage in attempts to ignore or suppress the obsessions. Most of the time these obsessions cause anxiety and dread for the individual. So, the compulsions are present to reduce the anxiety and neutralize or prevent the obsession. Most individuals are aware that the experience is irrational and they want to resist these actions, but it often feels unwinnable for them.
The specifics of the obsessions and compulsions vary among individuals. However, there are some common symptoms which I will review. The one we most often reference in pop culture is related to cleaning. Those with OCD may have contamination obsessions and engage in cleaning compulsions. However, this isn’t just a person who is fastidious. I have had patients who wash their hands so much they bleed. In fact, for it to be clinically significant, the OCD elements have to take up significant time in your day—for example more than an hour each day—and/or cause significant impairment to other domains of your life. Now I know we’ve all been washing our hands more since COVID, but I doubt many of you are washing your hands 180 times or more a day, which is what it would take if you were doing a 20 second hand wash for at least an hour of your day.
Another common one is symmetry—obsessions and compulsions related to counting, ordering, and repeating. An example of this may be someone who needs to turn a light switch on and off a certain number of times.
A third common type is related to taboos or forbidden thoughts. These can be obsessions of a sexual, aggressive, or religious nature and any associated compulsions. For instance, I’ve worked with folks with OCD who were terrified they were pedophiles because they saw a baby and thought they were cute. They believed that thinking a baby was cute or wanting to touch their squishy feet meant they were attracted to children. They were tormented by this on a daily basis until they received appropriate treatment.
The last one I’ll discuss is harm. Many folks with OCD may have obsessions related to harm of themselves or others and will have related checking compulsions. For instance, a person may be convinced their mother is going to die if they don’t call them 42 times a day.
If OCD is left untreated, the course is usually chronic. A person will often have waxing and waning symptoms, but without treatment, remission rates in
adults are low (20% for those reevaluated 40 years later). There is also a concerning rate of suicidal ideation and suicide attempts among those with OCD. There is a mean rate of 14.2% for suicide attempts, lifetime suicidal ideation mean rate of 44.1%, and current suicide ideation mean rate of 25.9%. Factors that contribute to the risk of suicidality are severity of OCD, the symptoms dimension of unacceptable thoughts, comorbid disorders like depression and anxiety, and a history of suicidality.
If you’ve been a person who walks around saying that “you’re so OCD,” I hope this leaves you better informed and with an understanding that you are not and that OCD is a serious mental health disorder. But if you’re listening to this and believe you may actually be suffering with OCD, I implore you to seek treatment as it is not something you can tackle on your own. There are evidence based treatments like Exposure and Response Therapy or ExRP for short that are effective. I wish you well on your journey.
What’s a mental health disorder that you wish you understood better? Let me know on Instagram @kindmindpsych. You can also reach out to me via my email at psychologist@quickanddirtytips.com, or leave a voicemail at (929) 256-2191.