Written by: Caitlin Saliba
Edited by: Holly Paik
Obsessive Compulsive Disorder, or OCD, is arguably one of the most trivialized mental health conditions. With OCD often being used lightly and comedically as a synonym for someone who strongly prefers cleanliness, the actual meaning and reality of the disorder has become somewhat blurred. This leads to those dealing with the disorder to face comments such as “it can’t be that bad,” “we’re all a little OCD sometimes,” and countless other things that diminish the challenges they may be facing as a result of this disorder, as well as any work they’re putting in to improve their symptoms. Therefore, it’s imperative to fully and accurately understand the full spectrum of mental health disorders, as that understanding is the key to reducing stigma, trivialization and prejudice against individuals suffering from said disorders.Understanding the different aspects of OCD, as with any disorder, will help to curb these vast misunderstandings from occurring about the condition.
Before one is able to understand the different pieces of a disorder, it’s important to completely comprehend the “bigger picture,” including things like what OCD actually is, as well as when and how it starts. Obsessive Compulsive Disorder, as stated by the Mayo Clinic (2023), is characterized by a pattern of unwanted thoughts and fears, as well as repetitive behaviors to help soothe these thoughts and fears. The cognitive patterns experienced by individuals with this disorder are labeled as obsessions, with the repetitive behaviors to address the obsessions being referred to as compulsions. These two elements go hand-in-hand, and together can create high amounts of anxiety, stress, and even impairment for individuals with OCD. Typically, the onset of OCD occurs before the age of 25, oftentimes during childhood or adolescence. In a 1996 study, it was found that the mean age of onset is 21 years old for men and 22 years old for women. This same study also found that major symptoms had begun before the age of 15 in roughly one-third of participants, before the age of 25 in roughly two-thirds of participants, and before the age of 35 (but after 25) in less than 15% of participants (Stanford Medicine, 2023).
OCD is thought to have a number of potential causes, with each case having a slightly different “story” as to how it developed. There are a combination of environmental, genetic, and learned behaviors that help contribute to the onset of a disorder such as OCD, with a particular proponent being early childhood adversity. In 2020, there was a study examining individuals ranging from 18 - 65 years of age, which broke them into two groups: spontaneous onset OCD, and OCD that occurred as a result of traumatic experience(s) that occurred within a month prior to onset. It was found that out of the traumatic experience (TE) group, 61% had experienced general life trauma, and 57% of those individuals had experienced a traumatic event within a month prior to onset, highlighting the role that life experiences play in the development of OCD (Murayama et. al, 2020).
Outside of traumatic life events, there are a wide array of different factors that can contribute to developing OCD. Genetics play a large role in the vulnerability one has to Obsessive Compulsive Disorder, and when combined with traumatic life events, can significantly increase one’s risk for the disorder. While there hasn’t been a discovery of an “OCD gene,” twin and family studies have found (albeit slightly inconsistently) that OCD is familial (Pauls, 2010). Other psychological theories of Obsessive Compulsive Disorder suggest that this familial relation could be due in part to “Learning Theory.” Learning Theory holds that OCD symptoms could potentially be the result of someone developing negative thoughts and behavior patterns by observing it; this could be a child learning from a parent, sibling, or other close family member (OCD UK, 2023). Similar to learned avoidance, the person learning obsessive-compulsive behaviors may learn from their “role model” that certain situations or things might call for a ritual, or in other words, learn which compulsions “go with” certain obsessions, which could lead them to develop the same pattern of behavior.
With an understanding of how OCD can come about, it’s now important to also understand the two significant parts of the disorder-- the obsessions and the compulsions. While these two things go hand-in-hand, they’re two different things that combine to create the behavior commonly exhibited from individuals with OCD. Obsessions are unwanted but persistent thoughts, which could include images in the person’s head, impulses, and fears. The person that is dealing with OCD becomes swarmed by these thoughts on a day-to-day basis, which in turn leads to highly impaired functioning. These obsessions can last hours or even days at a time, and as a result the individual can become extremely physically and mentally fatigued (OCD UK). In an effort to try and ward off these unwanted thoughts or feelings, or to soothe them, individuals with OCD also participate in rituals, or compulsions.
Compulsions are the process of how individuals with OCD cope and deal with the besiegement of unwanted thoughts that occur with OCD. While compulsions can look different for everyone, they are all purposeful and repetitive actions that one is compelled to perform following an encounter with an obsession. The purpose is to soothe anxiety or fear, and to provide (typically temporary) relief for the individual. Examples of compulsions include checking (locks, oven, gas/water taps, etc,); cleaning, washing (hands, surfaces, floors, etc.); repeating acts (such as flipping a light switch a specific amount of times); hoarding, and more. There are two types of compulsions - overt and covert. Overt compulsions are able to be observed by others, and may include things like checking or hoarding. On the other hand, covert compulsions are rituals that others are unable to observe, such as repeating a specific phrase in one’s head (OCD UK). While compulsions of all types are not typically in the best interest of the individual performing these rituals, it’s important to still understand that they’re behaving in this way in order to alleviate stress or anxiety from obsessive thoughts.
As clearly illustrated through the information provided, obsessive compulsive disorder tends to be widely misrepresented online and in person by those perpetuating the idea that clean individuals are “OCD.” By allowing this type of rhetoric to continue and not spread awareness on the reality of the disorder, we allow trivialization, stigma, and prejudices surrounding OCD to perpetuate. Accurate understanding and knowledge on different types of disorders is the cornerstone to destigmatizing the world of mental health. Stigma and trivialization of disorders can make those who have them feel alone, judged, or even embarrassed that they’re behaving in a way that they cannot control or help. By promoting psychological education and understanding, we are able to take a step forward into a society that is accepting, non-judgmental, and understanding of individuals with all different types of conditions or disorders.
References:
About OCD. (n.d.). Obsessive-Compulsive and Related Disorders. https://med.stanford.edu/ocd/about.html
Murayama, K., Nakao, T., Ohno, A., Tsuruta, S., Tomiyama, H., Hasuzawa, S., Mizobe, T., Kato, K., & Kanba, S. (2020). Impacts of stressful life events and traumatic experiences on onset of Obsessive-Compulsive Disorder. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.561266
Obsessive-compulsive disorder (OCD) - Symptoms and causes - Mayo Clinic. (2023, November 21). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432
Pauls, D. L. (2010). The genetics of obsessive-compulsive disorder: a review. Dialogues in Clinical Neuroscience, 12(2), 149–163. https://doi.org/10.31887/dcns.2010.12.2/dpauls
What are obsessions? | OCD-UK. (n.d.). https://www.ocduk.org/ocd/obsessions/
What are compulsions? | OCD-UK. (n.d.). https://www.ocduk.org/ocd/compulsions/
What causes OCD | OCD-UK. (n.d.). https://www.ocduk.org/ocd/what-causes-ocd/
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