Most of us believe that talking more about mental health is a good thing. It spreads awareness, helps people reach out for support and better support others, and leads to amazing efforts to tackle mental health challenges. All of this is true, but it’s only one side of the story. Inaccurate conversations about mental health, which are especially common online and on social media, lead to widespread stereotypes and stigma around many mental health conditions. One of the conditions most affected by this today is obsessive-compulsive disorder, or OCD.
The solution isn’t to talk less about mental health. It’s to talk even more about it: specifically, about the truth of mental health conditions, and about the misconceptions that create a narrow image of what these challenges are really like. This article aims to do exactly that.
What Really Is OCD?
Obsessive-compulsive disorder (OCD) is a mental health condition in which people experience uncontrollable, recurring thoughts, images, or urges called obsessions, and/or feel driven to perform repetitive behaviors called compulsions. Obsessions often bring intense and uncomfortable feelings, such as anxiety, fear, uncertainty, disgust, or a sense that something isn’t “just right.” Obsessions can be set off by a trigger (either internal or external) or appear seemingly out of nowhere.
Many common obsessions revolve around fear and anxiety, including a fear of germs; a fear of forgetting, losing, or misplacing something; a fear of losing control over one’s behavior; and worries about harm coming to yourself or others. Other common obsessions include unwanted aggressive thoughts toward others or oneself, unwanted or “forbidden” thoughts (for example, thoughts about acting against a religious principle or one’s morals), and a need to have things in perfect order, which is one of the most widely known. It’s important to know that these thoughts are unwanted and distressing to the person having them. They go against what that person actually wants and values, and having them doesn’t mean someone will act on them.
Compulsions go hand-in-hand with obsessions, as a person feels the urge to do them to stop obsessive thoughts. Compulsions don’t bring pleasure but rather provide temporary relief from the negative emotions obsessions bring. Matching many of the common obsessions, some of the most common compulsions are excessive cleaning or handwashing, repeatedly checking things (such as that the door is locked or the oven is off), praying or repeating words silently, ordering or arranging things in a particular, precise way, and compulsive counting.
OCD symptoms may start at any time, but they typically begin between late childhood and young adulthood. Symptoms may start slowly, go away for a while, or worsen over time, and they often get worse during stressful periods. Obsessions and compulsions can also change over time.
OCD can look different in children. While many adults with OCD recognize that their obsessions and compulsions don’t make sense, children may not realize these thoughts and behaviors are out of the ordinary and can truly believe they need to perform compulsions to keep something terrible from happening.
OCD can have a serious impact on many parts of life, including school, career development, relationships, and quality of life. Because compulsions can take up a large amount of time, people with OCD may find it hard to leave the house, have social interactions, or manage daily activities. OCD can also affect a person’s ability to complete schoolwork or keep up with a job, which can affect educational and career outcomes over time.
What Are the Risk Factors of OCD?
Although the exact causes of OCD aren’t fully understood, research has identified several factors that may increase the chances of developing it. These include:
- Genetics: People with a first-degree relative (such as a parent or sibling) who has OCD are at higher risk of developing it. However, no single gene or set of genes has been identified as the cause of OCD, and studies exploring the connection between genetics and OCD are ongoing.
- Brain structure and function: Studies have found that people with OCD often have differences in certain areas of the brain that affect the ability to control behavior and emotional responses. Researchers have also found that several brain areas, brain networks, and biological processes are connected to specific OCD symptoms.
- Temperament: Some research has found that people who are more socially reserved, show symptoms of anxiety or depression, or generally experience more negative emotions, especially as children, may be more likely to develop OCD.
- Childhood trauma: Some studies have found a link between childhood trauma and OCD symptoms. However, more research is needed to better understand this connection.
Having one or more of these risk factors doesn’t mean someone will develop OCD, and having OCD is never anyone’s fault.
Common Myths About OCD
OCD is only about wanting to be overly clean or organized
OCD is most commonly known for two specific symptoms: a fear of germs and a need to have things in perfect order. While this has led to OCD being talked about more, it has also narrowed how people understand the disorder. Many more symptoms are associated with OCD than just those two, and not all people with OCD have them. It’s also important to note that people with OCD who have germ or order-related obsessions don’t necessarily want to be excessively clean or organized. They feel they have to be, because it seems like the only way to get rid of their obsessive thoughts.
OCD is a minor personality quirk
OCD isn’t a simple quirk or preference, and it shouldn’t be seen that way because it’s not something to be minimized. OCD is a real mental health condition that has a serious impact on the health and well-being of those who have it. While OCD can affect how someone thinks and behaves, the condition itself is a disorder influenced by factors such as genetics and brain biology. It’s not simply part of your personality.
OCD is the same as having intrusive thoughts
Nearly everyone experiences intrusive thoughts: involuntary thoughts, images, or ideas that are often upsetting or distressing. Because obsessions can sound similar, some people believe OCD isn’t that serious. However, OCD obsessions have key differences that make them much more difficult to manage. While ordinary intrusive thoughts usually pass quickly, obsessions get stuck and repeat in cycles rather than fading away. They can trigger overwhelming anxiety or fear and make you feel compelled to take physical or mental action to get rid of these feelings.
Everyone has a little bit of OCD
People often claim that they, or everyone, have “a little bit of OCD” simply because they like to keep things clean, organized, or perfect. Although this may seem harmless, comments like this can be hurtful to people with OCD and contribute to mental health stigma overall, because they downplay the true impact of the disorder and dismiss the people actually going through its real difficulties.
People with OCD could overcome it if they had enough willpower
Some people believe that OCD, along with other mental health conditions such as depression and anxiety disorders, can be overcome by willpower alone because it’s “all in your head.” The reality is that OCD and other mental health conditions aren’t personality flaws or personal weaknesses. They’re real disorders, influenced by many factors outside our direct control. It can help to think of them the way we think of physical health conditions: their symptoms can’t simply be made to disappear in the moment through “willpower,” but they can be managed and treated over time. Overcoming a mental health condition doesn’t become easier just because it’s mental.
Avoiding triggers is the solution to OCD
Because obsessions often come up because of internal or external triggers, some people believe the solution to OCD is to avoid these triggers altogether. However, as mentioned earlier, obsessions don’t only appear because of triggers. They can also come up seemingly out of nowhere. Avoiding triggers also doesn’t lessen the severity of symptoms, and it can actually make OCD symptoms stronger. This kind of avoidance can also lead to isolation, which can make symptoms worse.
Treatment for OCD
OCD is treatable. If you think you might have OCD, the most important step is talking with a trusted adult and a doctor or mental health professional, since only a professional can diagnose OCD and recommend the right treatment.
- Exposure and Response Prevention (ERP): ERP is a specific type of cognitive behavioral therapy and one of the most effective treatments for OCD. With the guidance of a trained therapist, people are gradually exposed to situations that trigger their obsessions while practicing not performing their usual compulsions. While this may cause anxiety at first, compulsions and distress often decrease for most people as they continue treatment.
- Cognitive Behavioral Therapy (CBT): CBT can help people with OCD recognize unhelpful or untrue ways of thinking, build self-awareness, and learn how to respond to challenging situations. It works best when tailored to the specific characteristics of a condition, including OCD.
- Medication: For some people, OCD can be better managed with medication prescribed by a healthcare professional. The most commonly prescribed medications for OCD are SSRIs (selective serotonin reuptake inhibitors), which can help reduce the frequency and intensity of obsessions and compulsions, as well as the anxiety and depression that often accompany OCD. Decisions about starting, changing, or stopping medication should always be made with a healthcare provider.
Everyday Supports
These strategies can support your well-being alongside professional treatment, but they aren’t a replacement for it.
- Support systems: While you may hesitate at first, reaching out to friends, parents, or other trusted adults can be incredibly helpful. You can also seek support from teachers, school counselors, or support groups. Try to talk to people you trust to listen without judgment and offer empathetic support.
- Educating yourself and loved ones: Understanding OCD better can help you recognize and manage symptoms. Educating your loved ones about OCD can foster empathy and support, and can help them learn how to support you without accidentally reinforcing compulsions, such as by repeatedly offering reassurance.
- Establishing a routine: A daily routine can provide structure and reduce the anxiety and uncertainty that often intensify OCD symptoms. Making sure your routine includes time for relaxation and activities you enjoy can further help reduce stress.
- Healthy lifestyle: Eating a balanced diet, getting regular exercise, and getting enough sleep can support your overall well-being and make stress easier to manage.
- Mindfulness and relaxation techniques: Practices like meditation and deep breathing can help calm your mind and body during stressful moments.
Where to Find Support
If you or someone you know is struggling, talk to a trusted adult, school counselor, or doctor. The International OCD Foundation offers resources for finding OCD specialists and support groups. If you’re in crisis, call or text 988 to reach the 988 Suicide & Crisis Lifeline.
Sources
- National Institute of Mental Health, Obsessive-Compulsive Disorder: When Unwanted Thoughts or Repetitive Behaviors Take Over
- International OCD Foundation, About OCD
- International OCD Foundation, Breaking Down OCD Myths: Dispelling Misconceptions and Stigma
- MedlinePlus, Obsessive-Compulsive Disorder
- OCD-UK, The Impact of OCD
- NOCD, Do I Have OCD or Just Intrusive Thoughts?
