“I’m so OCD!” – What OCD is and isn’t
The phrase “I’m so OCD,” has become very common to say, especially on social media. But when and why did obsessive-compulsive disorder (OCD) become so trendy? When used, it is typically describing someone who likes organization and cleanliness. This is clearly not an accurate depiction of what OCD is, or the experience of someone living with it. The overuse and generalization of OCD creates a misconception of what the disorder actually is and the impact it has on such individuals. That being said, this is not a post to guilt or shame anyone who has used the phrase before, or an attempt to enforce compliance of PC culture. Instead, the goal of this post is to educate on what OCD is, what it is not, and the difference between often confused pathologies and personalities.
What is OCD?
Before we can talk about what OCD is not, what it is must first be defined. OCD is defined as the presence of either obsessions, compulsion, or both. Obsessions are unwanted, or intrusive, thoughts, urges, or impulses that generate anxiety or distress. The individual must attempt to ignore or neutralize these images with another thought or action (i.e., compulsion). Compulsions are repetitive behaviors or mental acts performed to reduce anxiety or prevent something bad from happening. However, the compulsions and the bad event are not connected in a realistic way, or are clearly excessive.
The obsessions people are most familiar with are those that revolve around cleanliness, clinically referred to as contamination. Contamination obsessions are not simply the urge to keep things clean. These obsessions are rooted in fears like themselves or a loved one getting a terminal illness, or coming into contact with a harmful bacteria or virus. While contamination is the most common obsession, it only accounts for around 25% of those with OCD. Other types of obsessions are violent, symmetry, sexual orientation, pedophilia, and relationship. These obsessions do not reflect their personal wants or desires. For example, an individual with pedophilia OCD does not wish to be intimate with a child. Instead, they experience thoughts like, “what if I have a sexual thought about a kid?” or, “what if I have a sexual thought around a kid?” These thoughts cause the individual distress because it does not reflect their wants or desires. Every person experiences thoughts that “pop” into their head. Thoughts like, “what if I did X or Y?” For an individual with OCD, the thoughts produce immense anxiety. They may also worry that simply having the thought indicates they will act on it, which also produces anxiety.
What OCD is not
A disorder that is often confused with OCD is obsessive-compulsive personality disorder (OCPD). OCPD is defined as, “a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency…” An individual with OCPD may be preoccupied with lists, details, and rules, be perfectionistic to the point that it interferes with completing the task, is reluctant to delegate tasks to others, or shows general rigidity and stubbornness. While the name suggests otherwise, OCPD is quite different from OCD.
Those with OCPD are not guided by uncontrollable thoughts or irrational behaviors the same way someone with OCD is, as they do not experience obsessions or compulsions. OCPD reflects a personality style consisting of maladaptive traits and behaviors. They have a strong sense of following rules, orderliness, perfectionism, and doing things “the right way.” Often times, OCPD causes more distress to those around them opposed to the individual themselves.
Lastly, individuals with a Type A personality may be mislabeled as having OCD. Someone with a type A personality is competitive, very organized, very focused on work, has a lot of ambition, dislikes wasting time, feels irritated when delayed, highly focused on goals, and is more likely to experience stress when faced with challenges that affect success. Having a type A personality is not a pathology in the way OCD and OCPD are. It would be more similar to OCPD in the general sense, however there is no rigidity or inflexibility, and this personality style does not cause distress or dysfunction. They may be mislabeled as OCD due to their preferences for organization and orderliness, but these two criteria do not place the individual anywhere near the threshold for OCD. Again, there must be obsessions or compulsions, both of which are not present.
OCD can be extremely debilitating – interfering with the completion of daily activities and preventing individuals from fulfilling work, school, or social activities. They may be experiencing this for an incredibly long time before seeking treatment, as it takes on average 14-17 years before receiving treatment. Part of this is due to general mental health stigma, but a contributing factor may be not fully understanding the disorder and its symptoms. With treatment, like psychotherapy and medication, they can progress toward reducing symptoms and distress. By bettering everyone’s understanding of OCD, we can reduce stigma and hopefully increase the help they receive.
If you are interested in hearing personal stories of how OCD has affected people’s lives, check out these links: