Do you ever find yourself setting your alarm, checking to see if you set it, and then checking over and over again because you’re not sure it’s set? Do you wash your hands repeatedly because you think they’re still not clean enough? If this sounds familiar, you may have Obsessive-Compulsive Disorder (OCD), and the truth is you’re definitely not alone.
What is OCD?
The International OCD Foundation estimates that one out of 100 American adults – around 2 to 3 million — lives with OCD. Most are diagnosed before age 19, but not everyone receives an official diagnosis. Risk factors for OCD include:
- Genetics: Studies of twins demonstrate that having a first-degree relative with OCD increases your risk, especially if that relative showed signs in childhood or adolescence
- Brain structure and function: differences in certain brain structures are still being researched
- Environment: there is a potential association with childhood trauma, as well as certain types of childhood streptococcal infection
According to the Mayo Clinic, Obsessive-Compulsive Disorder (OCD)“features a pattern of unwanted thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress.” In fact, for some sufferers of OCD, life can at times become unmanageable due to the time and energy that such intrusive thoughts and behaviors use up.
Certain “themes” are usually central to the obsessions of each OCD sufferer. For one individual, it may be contamination with germs. For another, it may be managing devices like refrigerators and stoves.
Let’s Talk Obsessions and Compulsions
You may be familiar with these types of thoughts and actions, whether as a minor annoyance or something more distressing, obsessive thoughts are pervasive and won’t easily go away. The National Institute of Mental Health (NIMH) defines obsessions as “repeated thoughts, urges, or mental images that cause anxiety,” including “fear of germs or contamination; unwanted forbidden or taboo thoughts involving sex, religion, or harm; aggressive thoughts towards others or self; and having things symmetrical or in a perfect order.”
The NIMH describes compulsions as “repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought.” Common compulsions include:
- Excessive cleaning or handwashing
- Arranging things in a particularly precise way
- Repeatedly checking things
- Compulsive counting
The Story of Howie Mandel
Howie Mandel is a famous game-show host and comedian, and he’s very public about living with OCD. In an interview with the website Everyday Health, he shared:
“A thought that enters my head — good, bad, or indifferent — isn’t any different from anybody else’s. The problem is, it’s like a sticking record, and that thought continuously goes through and through like a loop. And I have a compulsion to act on it. The simplest example I can give you is: I don’t think I locked the door, so I go back and I check the door like everyone else. And then I still don’t think I locked the door, so I go back and check the door again. And I still think I didn’t lock the door. And I can go back, like, 30 times. Intellectually, I know that I’ve checked the door 29 times before, but I can’t stop myself from going back and checking it again and again and again.”
Mandel has been interviewed numerous times, and he’s open about the challenges faced by his family:
“When you have this, you become obsessed with this. I spend a lot of time worried or agitated or intolerant, so I’m tough to be with. I have a tough time being with myself, so I can only imagine what it’s like to live in a house with me. But they are understanding and patient.”
OCD is not OCPD
Obsessive-compulsive personality disorder (OCPD) is not OCD, so don’t allow anyone to label you without being diagnosed by a skilled clinician. OCPD is described in this way by the Merck Manual:
“To maintain a sense of control, patients focus on rules, minute details, procedures, schedules, and lists. As a result, the main point of a project or activity is lost. These patients repeatedly check for mistakes and pay extraordinary attention to detail. They do not make good use of their time, often leaving the most important tasks until the end. Their preoccupation with the details and making sure everything is perfect can endlessly delay completion. They are unaware of how their behavior affects their co-workers. When focused on one task, these patients may neglect all other aspects of their life.”
As you can see, there are stark difference between OCD and OCPD, and it’s wise to be aware and informed in order to discuss your symptoms, diagnosis, and treatment with your provider.
Treatment of OCD
OCD can be treated with many approaches, including but not limited to:
- Cognitive Behavior Therapy (CBT)
- Exposure and Response Prevention (ERP): a form of CBT in which the patient is exposed to certain “triggers” and learns appropriate responses
- Deep Brain Stimulation (DBS)
- Transcranial Magnetic Stimulation (TMS)
- Outpatient, inpatient, day program, and other therapies
Living With OCD
The first thing to realize is that you’re not alone if you have OCD. If one out of every 100 American adults lives with the condition, it’s more common than you think. If you have the symptoms and it’s impacting your life, there’s treatment and hope.
Howie Mandel advises:
“Be open about it. If you have even an inkling you might have it, go speak to your doctor. Let’s remove the stigma. There isn’t anybody out there who doesn’t have a mental health issue, whether it’s depression, anxiety, or how to cope with relationships. Having OCD is not an embarrassment anymore – for me. Just know that there is help and your life could be better if you go out and seek the help.”