Mention of obsessive-compulsive disorder (OCD) often conjures up images of meticulous organization and particularity—perfectionism. Some people may think of fear of germs or constant cleaning and hand washing.
Many people with the condition exist that way, but that’s not the reality for everyone with the condition, according to mental health experts, who say this narrow view can directly harm patients.
“There are a lot of people who have the condition for real,” said Laura Mlynarski, a clinical psychologist at the DMV. “But that’s only a small portion of the OCD symptoms we see.” “And one of the dangers of really focusing on something like that is that you ignore the huge scope of the presentation, and there are so many taboo topics within OCD that cause tremendous distress, amplified by shame.”
What are the lesser-known symptoms of OCD?
According to the Centers for Disease Control and Prevention (CDC), OCD affects approximately 8 million adults and 1 in 100 children in the United States. It is defined as a pattern of fears and intrusive thoughts (compulsions) that lead to repetitive behaviors and rituals, or compulsions, to alleviate the fears. This creates a vicious cycle that can be extremely distressing to the person experiencing it.
According to the Anxiety and Depression Association of America, it takes an average of 14 to 17 years after symptoms appear to receive a proper OCD diagnosis.
OCD can manifest itself in a variety of ways. Many people’s obsessions may be related to germs, cleaning, or the need for precise objects. Here are some of the best known and most common ways OCD manifests:
But for many other people, intrusive thoughts can take the form of fears of harming oneself or others, doubts about one’s memory of past events, or fears of breaking religious rules or morals. Intrusive thoughts may also manifest as fears, especially those related to romantic relationships, health issues, or unwanted thoughts about socially unacceptable topics.
Compulsions may include, but are not limited to, constant checking, avoiding things associated with the fear, counting or tapping in specific patterns, and other rituals.
There are also a number of health conditions thought to be related to obsessive-compulsive disorder, including but not limited to anxiety, depression, Tourette syndrome, post-traumatic stress disorder, attention deficit hyperactivity disorder, hoarding and body-focused repetitive behaviors such as trichotillomania and scratching.
Stereotypes and Stigma
Many popular media depictions of the disorder focus on contamination OCD and symmetry OCD, which are associated with cleanliness and order, respectively. Contamination and symmetry are among the most common subtypes, but the way they are depicted often ignores the patient’s experience.
“The joke is, ‘Oh, that’s really OCD.’ (…) It becomes trivialized in a way and becomes the butt of the joke,” said Charles Manseuto, director of the Behavioral Treatment Center of Greater Washington. He also serves on the Scientific Advisory Board of the International OCD Foundation and is a founding member of the Mid-Atlantic Chapter.
Because most media portrayals only focus on OCD, which involves fear of contamination and symmetry, the majority of the general public is not exposed to what all other types of OCD can look like.
“OCD is a big basket. It’s not just one thing. And when they have a view or a stereotype about it (…) often the description is like a hodgepodge of miscellaneous things that people think of as OCD,” Manseuto said. “I think it would be great if people understood that there are many different variations of obsessive-compulsive disorder, and that there are many other problems that I think are related.”
Due to widespread stereotypes, some patients may not recognize their symptoms as potentially obsessive-compulsive disorder and thus may not seek the right treatment.
“When we present OCD as something that only manifests itself in a few ways, people don’t actually think that diagnosis applies to them,” says Meghan Meros, a therapist based in Maryland.
Meros himself has experienced OCD. She told News4 she initially doubted she had the disease because her symptoms did not match what she had been told.
“I, like many people, knew there were certain stereotypes out there and I thought, ‘Well, does what I’m experiencing match?’” she said.
Meros eventually found a therapist with OCD training.
“I was really glad I actually reached out to an OCD therapist to help me understand what was going on,” she said.
Find the right supplier
The main treatments for obsessive-compulsive disorder are exposure and response prevention therapy and medication, which involve confronting the person with situations that trigger obsessions.
Treatment for this disorder can be very effective. However, mental health care is not always available. According to the National Alliance on Mental Illness, approximately 10% of American adults with mental illness do not have insurance coverage, and more than 120 million people live in designated mental health professional shortage areas.
But once someone finds a provider, it’s important for the provider to be educated about OCD, Mlynarski said. This is because providers without such training may misdiagnose patients who do not present with the most common subtypes.
She said some patients have been hospitalized or given antipsychotic medication because psychiatrists mistook the characteristic intrusive thoughts of obsessive-compulsive disorder for a psychotic disorder.
“There are very important aspects of atypical antipsychotics and pharmacological treatment of obsessive-compulsive disorder, but the treatment process looks very different when OCD is misdiagnosed as an active psychotic disorder,” Dr. Mlynarski said. “It makes the symptoms worse. It makes it much more difficult for the patient.”
Receiving treatment can be scary, but for patients who receive the right treatment, it can be life-changing, Meros said.
“When people deal with OCD, they may have fears about what treatment is actually like because they feel like they need to be compulsive. They feel like treatment is essential to being safe, so they may see treatment as a way to take away from feeling safe,” Meros said. “So if we can hear more stories of people who have actually found hope and healing through therapy, I think more people will be able to find the courage to actually start.”
Where to Get Help from DMV
If you or someone you know is struggling with OCD symptoms, here are some places to start:
- The International OCD Foundation Database where users can find suppliers Search in your area using filters such as gender, race/ethnicity, specialty, and more.
- In today’s psychology “Find a therapist.” A feature that allows users to filter providers by location, status, insurance, etc. Many registered service providers offer sliding scale payment plans.
- The Anxiety and Depression Association therapist database A person who treats a variety of mental health conditions, including OCD.
- Suicide and Crisis Lifeline Find mental health and substance abuse resources Near you.
- Substance Abuse and Mental Health Services Administration helpline You can call 800-662-HELP (800-662-4357). We can provide treatment recommendations and information in English and Spanish.
- also to the Substance Abuse and Mental Health Services Administration. Treatment facility database By location. You can also send a text message to 435748.
- DC Department of Behavioral Health Access the helpline You can call 888-7WE-HELP (888-793-4357). We have behavioral health specialists on staff who can help connect callers with treatment.
- Virginia’s Community Services Commission can help provide treatment for mental health problems. you can find directory here.
- NOCD It’s an app that connects patients with providers specifically trained in OCD and accepts most major insurances. There are also forums where patients can connect with others in the OCD community.
- TLC Foundation for Body-Focused Repetitive Behaviors Provider Directory and support group.
- OCD story A website where users can read about people’s experiences with OCD and share their own.
If you or someone you know is in crisis, call or text 988 to contact the Suicide and Crisis Lifeline or chat live. 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources For further assistance.
