"I'm so OCD!" is a popular punch line to many jokes. People use it to explain why they hang their T-shirts by color, order the same coffee every day or insist on guests removing their shoes before entering the house.
It's become so common that obsessive-compulsive disorder is now used more as a social lubricant to explain potentially awkward situations — "No, you can't have a bite of my ice cream. I'm totally OCD about germs." — than it is to describe an actual mental illness. Which, by the way, it is. And it is definitely no joke, says Kathryn Moore, PhD, licensed psychologist at Providence Saint John's Child and Family Development Center in Santa Monica, California.
Obsessive-compulsive disorder is characterized by two main symptoms: obsessions and compulsions (obviously). Obsessions are repetitive, intrusive thoughts that cause the person extreme anxiety. Generally, these thoughts fall into one of five categories: orderliness/cleanliness, violence, sex, magical thinking and religion. The compulsions are behaviors that the person must do to relieve the anxiety of the bad thought.
"It's a coping strategy to deal with stress," Moore explains.
But don't we all have some kind of quirky behaviors we use to deal with stress? I organize my closet whenever I'm stuck on a work assignment, and my best friend ameliorates her anxiety by making endless lists and schedules. How many closet reorgs or lists does it take before we cross the line from good habit to mental illness?
Want the short answer? "It's really about the level of impairment it's causing in their life," Moore explains. "If someone is spending more time doing their OCD behaviors than what they really want to be doing, it's a problem."
Want the less-short answer? Ask yourself these questions:
1. How much time are you spending doing or thinking about the thing? Moore says OCD sufferers will often spend hours a day engaged in their rituals, often to the exclusion of everything else.
2. How does the activity or thought feel? People who get genuine joy out of their activity, whether that's looking up illnesses on the Internet or making sure all of their dishes are symmetrical, are probably not OCD. Usually, people with OCD don't really want to do what they do, but they feel trapped by their thoughts and controlled by the behaviors — hence the name "compulsions" and not "just another fun Saturday night." At best they feel relieved... before the anxiety starts mounting again.
3. How much does it limit you physically? OCD sufferers often have a hard time just leaving the house, much less seeking treatment, Moore says. "They fear going to a store or doctor's office because of germs, or they can't leave because they're afraid of driving their car and hitting someone."
4. How much is it hurting those you care about? Are you choosing to spend time with your obsessive thoughts or doing your compulsions instead of being with other people? OCD sufferers often have problems with their work, relationships, love life and parenting because their illness trumps their loved ones, Moore says. Not sure if it's bothering your friends, co-workers and family? Ask them!
5. Do you feel stressed out and worried all of the time? OCD is an anxiety disorder, after all. It's normal to feel stressed sometimes, but if your worries are chronic, it can be a sign of a larger problem.
6. Do any of your family members have OCD? There is a strong genetic link for this mental illness, Moore says. So if you have a first-degree relative with OCD (such as a parent or sibling), then you're twice as likely to have it, too.
7. Are you prone to addictive behaviors? "People with OCD often have other compulsive behaviors, such as gambling, sex addiction or substance abuse," Moore says, "because that is how they deal with the world."
8. Are you a perfectionist? People who are neurotic, anxious or perfectionistic are more susceptible to having normal worries turn into full-blown OCD.
9. Is one of your parents an alcoholic? It may seem like a strange question, but some research has shown that children of alcoholics are far more likely to have OCD as adults. It likely stems from a need to control chaotic environments.
If any of these ring true for you, please consider seeking professional help. OCD is highly treatable using therapies such as exposure and response prevention therapy (ERP) and cognitive behavioral therapy (CBT) as well as medication. In the meantime, just knowing you have OCD can be immensely helpful. Names are powerful, and being able to simply say, "It's not me. It's my OCD," is a tried-and-true method of staving off an OCD attack in the moment.
"OCD sufferers can feel an immense amount of shame and distress over what they see as bad thoughts, which makes it terribly isolating," Moore says. "But if you struggle with this, know that you are not alone, and you do not have to be controlled by it."
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