15 Facts About OCD That May Surprise You

Here’s the truth about what it’s like to have obsessive-compulsive disorder.

We’ve all encountered people with quirks, whether it’s someone who color-coordinates their clothes closet or a germaphobe who seems to have a never-ending supply of hand sanitizer at the ready. However, it’s essential to recognize that these peculiarities do not necessarily indicate obsessive-compulsive disorder (OCD), which is a distinct type of anxiety disorder that carries substantial implications for those affected by it.

Alison Dotson, the president of OCD Twin Cities, an affiliate of the International OCD Foundation, and the author of “Being Me With OCD: How I Learned to Obsess Less and Live My Life,” understands the challenges of living with OCD firsthand. At 36 years old, she has grappled with the condition for most of her life and has dedicated herself to raising awareness about OCD. Dotson emphasizes that people often mean well but remain largely uninformed about the true nature of OCD. She firmly believes it’s time for everyone to understand the gravity of this disorder.

So, here’s what you need to know about OCD, straight from the people who live with it.

1. OCD Is a Serious Mental Disorder

The American Psychiatric Association defines OCD as a condition characterized by “recurring, unwanted thoughts, ideas, or sensations (obsessions) that make individuals feel driven to do something repetitively (compulsions).” These repetitive behaviors can significantly disrupt daily life and social interactions. Obsessions are persistent thoughts or urges that individuals attempt, often unsuccessfully, to ignore or suppress. Compulsions, on the other hand, are repetitive behaviors or mental acts that individuals with OCD feel compelled to perform. Failing to execute these compulsions can lead to overwhelming anxiety and fear.

In simpler terms, OCD can be viewed as a disorder marked by exaggerated reactions to everyday thoughts. For example, a person with OCD might repeatedly check if they locked their front door, making them late for appointments or even causing them to avoid leaving the house due to excessive doubt.

2. OCD Affects More People Than You Think

The National Institute of Mental Health (NIMH) estimates that 1.2% of adults in the United States have OCD. It’s more prevalent than you might imagine. Diane Davey, a registered nurse and program director at the Obsessive-Compulsive Disorder Institute at McLean Hospital, emphasizes that OCD is not an exotic illness; it’s quite common. Furthermore, it’s an equal-opportunity condition that can affect anyone, regardless of age, gender, or background. The chances are high that you know someone with OCD, but they might be hiding it due to shame and embarrassment.

3. OCD Is Not a Joke

Contrary to what some may believe, OCD is not a personality trait or a cute quirk. It’s a serious disorder that causes significant distress to those who live with it. Popular culture sometimes portrays OCD in a humorous light, as seen in movies like “As Good As It Gets,” where Jack Nicholson’s character has OCD-related rituals. However, this depiction fails to capture the true suffering that OCD can bring into a person’s life.

“I think that’s really one of the biggest myths about OCD: it really isn’t funny,” says Davey. “It’s a disorder, and it’s very distressing for people who have it.”

4. OCD Is a Form of Anxiety, Not Psychosis

While people with OCD may experience compulsive thoughts, they remain grounded in reality, unlike individuals with conditions like schizophrenia. Ethan Smith, a writer, director, and producer from Los Angeles who struggled with OCD for years, had thoughts of self-harm that led to multiple psychiatric hospitalizations. Despite the intensity of his obsessions, Smith always maintained an awareness that the thoughts were irrational.

“The healthy part of your brain knows that the OCD part of your brain—whatever it’s telling you, whatever the thought is—is completely irrational,” explains Smith.

5. OCD Encompasses Diverse Obsessions

Obsessions in OCD can vary widely. Some individuals obsess over cleanliness and hygiene, leading them to wash their hands compulsively. Others grapple with fears of losing control, causing harm to others, or contracting illnesses. Some obsessions revolve around perfectionism, where everything must be exact or symmetrical. Superstitious thoughts, unwanted sexual thoughts, or religious concerns are also common. For example, Ethan Smith’s obsessions began with fears of choking, which eventually led to restrictive eating habits. As an adult, he developed fears of self-harm, resulting in the disposal of prepared food and extreme debilitation.

6. It’s Not Just Hand-Washing

While frequent hand-washing is a classic compulsion associated with OCD, it’s just one facet of the disorder. Compulsions manifest in various ways, including counting, tapping, checking, or repeating tasks. These rituals are performed to alleviate the anxiety associated with obsessive thoughts. Importantly, compulsions can sometimes serve as avoidance strategies. Alison Dotson, who dealt with religious and sexual obsessions, resorted to praying excessively and avoiding situations where she feared inappropriate physical contact.

7. OCD Affects People of All Ages

OCD is typically diagnosed by age 19, with boys often experiencing an earlier onset than girls. However, the condition can surface in adults as well. In some cases, women develop OCD during pregnancy or shortly after giving birth, adding another layer of complexity to the condition’s timeline. It’s important to note that young children may exhibit ritualistic behaviors, but these don’t necessarily indicate OCD, as they can be typical developmental phases.

8. Life Events Can Trigger OCD Flare-Ups

While the exact causes of OCD remain unclear, certain life events can exacerbate symptoms. A study published in Psychiatry Research identified three traumatic events associated with increased OCD symptoms, particularly in women: the hospitalization of a family member, major personal physical illness, and the loss of a personally valuable object. However, even less severe life events can lead to OCD flare-ups. For example, Ethan Smith’s fear of an E. coli outbreak made him feel terrified despite not being near any affected tomatoes.

9. Many People With OCD Hide Their Condition

Individuals with OCD are often adept at concealing their symptoms, and it may take many years for them to seek appropriate treatment. The shame and embarrassment associated with their compulsive behaviors and thoughts lead them to hide their struggles from family, friends, and coworkers. It’s important to recognize that any behavior that seems excessive, such as frequent hand-washing or obsessive cleanliness, may be a sign of OCD, especially if it causes distress in the person involved.

10. OCD Can Be Genetic

While the precise causes of OCD are still being studied, genetics likely play a role. It’s not uncommon to find multiple family members with OCD, highlighting the genetic component of the disorder. Families with a history of OCD often have several individuals affected, spanning generations. Researchers are also investigating the impact of environmental factors and stress on the development of OCD.

11. OCD Can Co-Exist With Other Disorders

OCD frequently occurs alongside other mental health conditions, including anxiety, depression, and body dysmorphic disorder. Major depression, in particular, is prevalent among individuals with OCD. It’s important to recognize that these co-existing disorders can complicate diagnosis and treatment, requiring a comprehensive approach to address all aspects of a person’s mental health.

12. Reassuring People With OCD Isn’t Helpful

Counterintuitively, providing reassurance to someone with OCD about their fears can worsen their condition. Reassurance-seeking behavior is a common compulsion in OCD. Telling someone with OCD that their fears won’t come true can inadvertently reinforce their compulsive behavior. Instead, it’s more helpful to acknowledge their concerns while encouraging them to confront their obsessions and compulsions. Offering support and understanding, rather than reassurance, can be a more effective way to assist someone with OCD.

13. A Fulfilling Life Is Possible With OCD

With appropriate treatment, individuals with OCD can lead fulfilling lives. Cognitive-behavioral therapy, specifically a form called “exposure and response prevention” (ERP), is considered the gold standard for treating OCD. ERP involves gradually confronting the thoughts or situations that trigger obsessions and resisting the urge to perform compulsions until the anxiety subsides. While it requires considerable willpower and determination, ERP has been instrumental in helping many individuals with OCD regain control of their lives.

14. Listen and Avoid Judgment

If someone confides in you about their OCD, it’s crucial to listen and refrain from passing judgment. OCD is a genuine mental health condition, and attempting to dismiss or trivialize it can exacerbate feelings of shame and isolation. Instead, offer your support, understanding, and encouragement for them to seek professional help and treatment.

15. Remission Is Achievable

There is hope for individuals with OCD. Healthcare providers may recommend various treatments, including cognitive-behavioral therapy, antidepressant medications, or a combination of therapies. Exposure and response prevention (ERP) therapy, in particular, has proven highly effective. It involves confronting obsessions and gradually reducing compulsive behaviors. Achieving remission and regaining control over one’s life is a realistic goal for many individuals with OCD.

In summary, OCD is a complex and often misunderstood disorder that impacts the lives of millions of people. It’s essential to recognize the severity of OCD, understand its diverse manifestations, and offer empathy and support to those who grapple with this challenging condition. By fostering awareness and promoting appropriate treatment, we can help individuals with OCD regain control of their lives and reduce the stigma associated with mental health disorders.