What is the difference between liking cleanliness and order and having OCD?
OCD takes up a lot of time and interferes with a person’s ability to function. The compulsion controls them and can prevent them going to work, answering emails, and, if they are a child, from going to school.
When people think of OCD, they may think of someone washing their hands a lot, or repeating things a certain number of times. What makes it a disorder is how debilitating it is to someone’s life. For people who have to write things over and over until it feels perfect, they might not be able to write at all because it so burdens them to write even one sentence, or they may have to do certain compulsions every time they walk somewhere. People may also have intrusive thoughts, which can interfere with quality of life.
What are intrusive thoughts, and how are they a symptom of OCD?
Intrusive thoughts are thoughts that intrude upon us that we don’t like, don’t want, and don’t agree with. Everyone has weird thoughts sometimes and they can be about anything. For example, if you’re standing on the subway platform, you may think how easy it could be to push someone or that you could be pushed yourself. Most people can then move on to a logical conclusion for the thought, such as, “I guess that entered my head because I’m contemplating how crazy the New York City subway system is.”
For individuals with OCD, the thoughts are stickier, and they give them more credit. They may grow concerned that the thought has entered their head, and question why it did and what it means about them, wondering if there is a part of them that wants to hurt someone, even though they are the least likely person to do so. They are so horrified about having had a thought about harming someone that they may do all sorts of compulsions to make sure they don’t hurt anybody, or avoid the subway all together, or confess these thoughts to others. They may repeat to themselves, “Don’t think about it, don’t think about it,” which, of course, makes them think about it more. This is a type of OCD less spoken about, one that can be very debilitating.
How can someone tell if they have OCD?
If a person’s obsessions and compulsions are taking a lot of time and interfering with life and functioning, they may have OCD. I often ask people, “Could you do it in another way?” If someone likes to check the stove before they go to bed to make sure it’s off, and I were to say, “Please don’t check tonight!,” could the person do it? Would they be OK? Somebody who is struggling with OCD often feels like they are unable to approach the situation any other way.
What causes OCD?
The understanding among experts is that it’s a mixture of genetic and environmental factors. It runs in families, and we have good research showing there is a genetic component. There is clearly an environmental component as well, since not everyone who is predisposed to OCD develops it. OCD grows over time: Every time you do a compulsion, you feel immediate relief, and that relief feels really good even though it’s only temporary. Hand washing brings relief to people who are afraid of germs, even if they don’t want to wash their hands all the time or their hands are raw and bleeding. But in that moment of relief, there is a reward to the system, training the person to do the compulsion again and again.