What It Looks Like: Obsessive Compulsive Disorder

“I’m so OCD.” “My OCD is kicking in.” “I’m OCD about _____.” You’ve probably heard obsessive compulsive disorder (or OCD) used casually in conversation in one of these ways. Too often, OCD is used to describe feeling particular about something or what Freud may have considered anal retentiveness.

Not only is this use offensive and inappropriate, it also paints an inaccurate picture of what living with this condition is like. Obsessive compulsive disorder is often chronic and can greatly impact daily functioning. It’s not a behavior description or a joke and now we’re going to review what OCD really looks like.

As the name suggests, the disorder centers around obsessions, compulsions, or both. What does this mean?

Disclaimer: This post—like all my content—is NOT intended for the purpose of diagnosis or treatment. It is for informational purposes only. The only place you can truly receive diagnosis and treatment is with a YOUR professional, qualified treatment provider following the proper assessment(s). Proceed with caution and use this post and all posts for information purposes ONLY.

Obsessions and Compulsions Defined

Obsessions are intrusive thoughts that are often repetitive and produce anxiety. Being intrusive indicates they aren’t able to be ignored or pushed away. Some other type of thought or action is needed to manage them.

Compulsions are the thoughts or actions that calm obsessions. These are usually bound by rigid rules and feel like something that has to be completed in order to manage the distress brought on by the obsessions. Compulsions can also be preventative; they occur to keep obsessive thoughts away and avoid anxiety.

How They Work

Most people are familiar with orderliness and cleanliness as part of the experience of OCD. You should know this isn’t the only way OCD manifests and, further, may not be something many people with OCD experience at all. There are many ways that OCD presents itself. It’s often very creative and rooted in personal fears and beliefs.

Obsessions, to start, can vary widely but tend to center around something going wrong. It can be as specific as, “I’ve hurt my children and didn’t know it,” or vague as, “something terrible is going to happen.” The thought plays over and over, increasing distress about the possibility of the fearsome event until something is done about it.

Compulsions come into play to relieve the anxiety. If the obsessive thought is the above, “I’ve hurt my children and didn’t know it,” you may check on your kids every time the thought arises. This is a checking compulsion where you consistently have to check on the focal point of the obsession to ensure nothing is amiss.

As mentioned earlier, compulsions can sometimes happen before the obsessions to prevent anxiety. With the example of, “something terrible is going to happen,” you may count to 10 before opening your front door or have to keep pumping gas until the cost is rounded to the nearest 50 cents. If these actions don’t occur, you’ll worry for the rest of the day about the impending terrible event or may develop another compulsion to manage the earlier failed attempt.

What makes OCD a disorder and not just isolated thought and behavior patterns is how it impacts life. Your functioning from day to day is interrupted by obsessions and compulsions. Maybe you’re getting in trouble at your job because you’re making frequent calls to your significant other to ensure they’re safe because your obsessive thoughts have you focused on all the ways they could be killed. Perhaps you’re not getting enough sleep because the obsessive thoughts about unknowingly harming your children have you up several times in the evening to check on them taking up an extra two hours of time after you’ve tried to lay down to sleep.

There are so many ways OCD can invade life and complicate daily functioning it’s tough to touch on all of them but I do want to share some examples to help improve understanding of how it can look in real life.

Further Examples

Starting with the most commonly depicted concept of Obsessive Compulsive Disorder, let’s look at a cleanliness example.

You fear germs and being contaminated. You don’t wash your hands until raw or shower four times a day. However, when your obsessive thoughts are triggered by a person being sick at work or you finding a bug bite on your leg, they play on repeat. They keep going, getting in the way of sleep and focus because any moment of quiet brings them slamming into your brain. You check in with loved ones about it and get their opinions, ask your co-workers’ opinions, look up symptoms on the internet which takes up chunks of time from other activities and may prompt worry about you from others. In the end, you have to see a doctor to stop the worry leading to an excess of doctor bills weighing on you financially.

Cleanliness is not the only way OCD manifests and another common example of it has to do with orderliness or having things arranged in a particular way.

No, you don’t keep your bookshelf arranged in alphabetical order and your living space isn’t labeled and categorized. Yet, you do have a photo on your wall of you and your parents that you adjust first thing in the morning before doing anything else (even using the bathroom) and every evening as the last thing before going to bed because if you don’t ensure it is perfectly even, your parents will fall terribly ill. You also have a particular place for three items in your car and if they aren’t by the time you’re on the road, you will get into a car accident. You also count your steps, which must be even before reaching your destination. All of these compulsions slow you down and interrupt your day and focus.

Orderliness is not as straightforward as it seems just as OCD is not often fully straightforward. One way we see this is when obsessions are the main focus of the disorder with little to no compulsions. This is often so with those who have socially disturbing thoughts such as intrusive thoughts about violence to others despite no desire to hurt others and no history of it. These thoughts can be about strangers, family, friends, co-workers…and you regularly engage yourself in a mental battle about your own character and desires. You may have behaviors that don’t seem like compulsions because they are normalized like praying to confess and be absolved. In this situation, it may be often and time-consuming.

This is only the tip of the iceberg for what OCD might look like and, as always, the only way to properly diagnose and treat the mental illnesses I talk about on this blog is to seek appropriate professional help. I cannot provide that here and only write for informational purposes. My hope in delivering this information is to change the perspective on what Obsessive Compulsive Disorder really looks like and how it is not a description of being picky or particular about something.

If there’s one thing I’d like everyone to take away from this, it’s to stop using OCD as a casual descriptor. It’s a serious mental health disorder that majorly impacts function, even more than I’ve been able to describe here. Overall, it is hurtful to those who live with and battle OCD to use the diagnosis flippantly to describe your interest in a clean work desk or special way you like your coffee. Be aware and be mindful.

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Source Cited

American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). Arlington, VA, US: American Psychiatric Publishing, Inc.