What OCD is — and what it isn’t — according to the experts

By CNN Newsource

Published October 11, 2023 9:28 AM

By Madeline Holcombe, CNN

(CNN) — When someone likes things just so or always seems to have their home in perfect condition, others may say “he is so OCD.”

But OCD — obsessive-compulsive disorder — isn’t a nifty personality trait of people who are organized. The condition is a disorder that can impact a person’s work, relationships and well-being, said Stephanie Woodrow, clinical director of the National Anxiety and OCD Treatment Center in Washington, DC.

This week is OCD Awareness Week, when activists, organizations and clinicians spread the word about the condition to dispel the stigma and share greater understanding, said Matthew Antonelli, interim executive director of the Boston-based International OCD Foundation.

This year, the theme of OCD Awareness Week is OCD Truths, and the focus of advocates, health professionals and patients involved is to cast light on the realities of living with the condition as well as the hope in treatment, he said.

“OCD does not have to control so much of your life. You can take steps towards regaining your life,” Antonelli said. “Effective treatment and medication have saved my life and it has become my life’s mission to help those who are suffering to find the help they need.”

Here’s what experts want you to know about OCD.

Obsessions and compulsions

In basic terms, OCD is a mental health disorder experienced by people of all ages and populations, Antonelli said. The chronic condition “occurs when a person gets caught in a cycle of obsessions and compulsions,” he added.

Those obsessions can be described as “unwanted intrusive thoughts, urges and images” and can cause intense feelings of stress, anxiety or disgust, Woodrow said.

Compulsions are the behaviors people will engage in mentally or physically to get relief from those distressing feelings, she added.

“These obsessions occur over and over again and feel outside of the person’s control,” Antonelli said in an email. “People with OCD usually recognize that using compulsions is only a temporary solution, but without any other way to cope, they rely on compulsions as a brief escape.”

Obsessions and compulsions can be managed with treatment, but a person with OCD is more susceptible to symptoms intensifying during times of stress, life transitions or hormonal changes, Woodrow said.

OCD is not a ‘personality quirk’

OCD is not just being a neat freak. And it is not an adjective to describe anyone with neurotic behavior, Woodrow said.

“The biggest misconception about OCD is that it’s a personality quirk or trait,” she said. “That’s really missing the fact that this is a very serious disorder that can really destroy people’s lives and impact their quality of living, not just for the individual, but for their loved ones as well.”

Yes, it may be stressful for some people to have things out of order, but that is different from the distress of a disorder, Woodrow said.

“You’re not having these intrusive thoughts that if something isn’t organized, the proper way, that something terrible is going to happen to your home,” she added. “You’re not engaging in these repetitive compulsive behaviors to try and prevent these horrible things from happening.”

People commonly say that “everyone is a little OCD,” but that is not true and minimizes the challenges people with the disorder can go through, Antonelli said.

And cleanliness and organization are far from the only manifestations of OCD — even though that is most often what we see in movies and television, Woodrow said.

The obsessions that drive the compulsions can vary widely, including sex, religion, contamination, romantic relationships and violence, Antonelli said.

Those intrusive thoughts can induce fear of harming someone you love or driving your own car over a bridge, Woodrow added.

“OCD is incredibly creative and there really are no limits,” she said.

But those thoughts do not make someone with OCD dangerous, and in reality they are often not at all at risk of doing the things their intrusive thoughts center around.

It’s just that people with OCD often worry about the things that matter most to them — such as safety or protecting those close to them, she said.

“A lot of times the themes revolve around things that people care about the most. And again, there is no danger or no risk of them actually becoming that person,” Woodrow said.

How to get help

Misconceptions about the condition can lead people with OCD to feel isolated and avoid treatment, which is especially unfortunate because of how treatable it is, Antonelli said.

With the help of mental health professionals and often a combination of therapies and medication, “OCD can be treated (to) greatly improve the quality of life of those who are suffering,” he said.

Usually, the best medication is an SRI (serotonin reuptake inhibitor), Antonelli added.

And exposure and response prevention therapy, which gradually exposes people to their obsessions in a safe environment, has been shown to be an effective form of treatment, Woodrow said. Acceptance and commitment therapy, which is based on cognitive behavioral therapy, may also be helpful, she said.

“Taken together, ERP and medication are considered the ‘first-line’ treatments for OCD,” Antonelli said. “About 70% of people will benefit from ERP and/or medication for their OCD.”

But these interventions may only be administered by a professional, and optimally your therapist will work with your medical provider or psychiatrist to develop a plan for you, he added.

How to support someone you love

Only a trained therapist can diagnose OCD, but it could be helpful to encourage your loved ones to talk to a provider if you notice obsessions and compulsions that “get in the way of important activities the person values, such as working, going to school, or spending time with friends,” Antonelli said in an email.

“The best thing one can do is support their loved ones’ treatment journeys and help them find effective care,” he added.

When your loved one has a diagnosis, it’s important to try not to engage in the compulsions with them — though it might be tempting to want to help them relieve their stress in the moment, Woodrow said.

The more you learn about the condition, the more you can “provide love and provide support without engaging in compulsion,” Woodrow added.

To get help for someone with an OCD diagnosis, you can access resources from the International OCD Foundation or join support groups to get information and support, Antonelli said.

“It is most important to know that you are not alone and it can get better,” he said.

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