OCD's dirty secret: It's not always about staying clean, by Sarah Tippit, LMFT

“I am going to host regular OCD meetings at my house, not because I have it, but because surely somebody will start cleaning!”

Every time I see such a meme on social media that pokes fun at OCD, I cringe, because the disorder is no laughing matter.

And I wonder why, when there appears to be a push for society to be more open and accepting of mental illness, many continue to trivialize, mock, and willfully misrepresent an extremely painful, and at times disabling condition affecting 1 in 40 adults and 1 in 200 children (about as many as have diabetes), according to the International OCD Foundation. (1)

OCD is a chronic disorder numerous studies indicate has neurobiological origins. (2) It is characterized by repetitive, intrusive, unwanted, and highly disturbing thoughts from which a person feels there is no relief. These are followed by mental or physical compulsions meant to neutralize the thoughts. This cycle – uncontrollable intrusive thoughts followed by repetitive compulsions -- occurs frequently throughout a sufferer’s day, sometimes from the moment he wakes up until he falls asleep at night. At times the bad thoughts may even invade a sufferer’s dreams. When the disorder flares it can become very life limiting, affecting work, school, relationships, social functioning. Luckily nowadays there is treatment available which can, in most cases, help sufferers manage their symptoms.

Yet memes such as: “I have OCD: Obsessive Christmas Disorder!” or “Hand sanitizer is the gateway drug for OCD!” do not help. They perpetuate a misleading stereotype that OCD is an annoying personality quirk and that the disorder tends to center on a need for cleanliness. In fact, symptoms involving compulsive arranging, or fear of germs, may only represent the tip of the ice burg in terms of the scope of a typical sufferer’s symptoms. 

Fear of contamination represents only about a quarter of the types of intrusive thoughts with which lifetime OCD sufferers typically struggle according to a 2010 national survey of more than 2,000 U.S. adults. (2) It is my opinion that unhelpful OCD memes serve to alienate the combined 73-plus percent of people with OCD, who, according to the survey, struggle with moral concerns or unwanted, intrusive thoughts of a sexual or religious nature. I can’t tell you how many people who seek OCD treatment with me say they are reluctant to share their concerns for fear they will be mislabeled as “deviant” because their OCD doesn’t fit into the “stereotypical” box.

Moreover, the content of the thoughts in OCD often shifts. The survey notes that 81 percent of people with OCD report that their thoughts have multiple themes. In the beginning of their disorder people might report thoughts of contamination and then later suffer with other types of intrusive thoughts. These could range from erroneous “magical thinking” to fears they are contracting or spreading a dreaded disease, to thoughts that they might harm themselves, their children, their coworkers, or those they love the most. And it’s important also to note that people tortured by these types of obsessive thoughts are typically the least likely to act on the content of their fears, according to numerous top experts in the field. (4) People with OCD usually go to great lengths to escape their bad thoughts and avoid any contact with those they erroneously believe might be harmed. Yet they suffer in silence and continue to hesitate to seek treatment, for fear their therapist will misunderstand their symptoms, place them involuntarily in the hospital, or report them to police. And the stigma is very real. Even people in the mental health field, who do not understand OCD, have been known to misjudge or mischaracterize, and consequently wrongly treat sufferers, which is why it is so important to continue to educate the public on its characteristics.

Studies reveal there are likely genetic and neurobiological bases for the disorder. Often people with OCD present with other mental illnesses such as anxiety, PTSD, depression. Yet despite its chronic nature and the complexity that occurs when OCD mixes with other mental illnesses, OCD can, in most cases, be effectively managed. If you think you may have OCD it’s very important that you seek out a therapist who has experience with and dedication to treating it frequently.

And the next time you see somebody making a flippant comment about OCD, remember that these jokes make it that much more difficult for sufferers, who fear they will be misdiagnosed or ostracized, to come out of the closet and seek out the compassion and treatment they so desperately need.

If you believe you or a loved one may have OCD, feel free to call me with questions or to set up an appointment for a confidential evaluation. I work out of offices in both downtown San Diego and Escondido and am here to help. (619) 272-6858 ext. 707

1. https://iocdf.org/about-ocd/who-gets-ocd/ Retrieved from URL.
2. http://hope4ocd.com/neurobiology.php Retrieved from URL.
3. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Ruscio AM, Stein DJ, Chiu WT, Kessler RC Mol Psychiatry. 2010 Jan; 15(1):53-63.
4. https://www.ocdonline.com/ Retrieved from URL.