October is OCD Awareness Month

Behind the jokes about being 'so OCD' are real people managing a condition that can be exhausting, isolating, and debilitating. OCD is one of the most misunderstood mental health conditions I encounter in my work, and October's awareness month feels like the right moment to talk about Obsessive-Compulsive Disorder (OCD).

Helpful Terms to Know

OCD: Obsessive-Compulsive Disorder Intrusive thoughts: unwanted, random thoughts or mental images that suddenly pop into your head out of nowhere. They are often shocking, scary, or completely inappropriate, and they usually contradict who you actually are and what you believe in. Obsessions: intrusive thoughts, images, or urges Compulsions: repetitive behaviors or mental acts done to reduce anxiety

Common Types of OCD

- Contamination and Washing The Obsession: Fear of germs, dirt, bodily fluids, household chemicals, or diseases. The Compulsion: Excessive hand washing, showering, cleaning household items, or avoiding places perceived as "contaminated."

- Checking and Doubt The Obsession: Fear that something terrible will happen because of a mistake (e.g., leaving the stove on, a door unlocked, or making an error in an email). The Compulsion: Repeatedly checking locks, switches, appliances, or documents. Individuals may also re-read texts or retrace driving routes to ensure no drastic errors occurred.

- Symmetry and Ordering The Obsession: Intense distress if things are not lined up, symmetrical, or arranged in a specific "just right" way. The Compulsion: Rearranging objects until they feel balanced, organizing items by color or size, or repeating physical actions until they feel "correct."

- Intrusive Thoughts (Pure O / Harm, Sexual, or Religious) The Obsession: Unwanted, highly distressing thoughts, mental images, or urges that go against a person's core morals. Common themes include harming loved ones (Harm OCD), inappropriate sexual thoughts, or blasphemous thoughts against one's religion (Scrupulosity). The Compulsion: These are often mental compulsions (hence the informal term "Pure O," though physical compulsions can occur too). Examples include mental reviewing, praying repeatedly to neutralize thoughts, seeking reassurance, or avoiding triggers.

- Hoarding and Excessive Saving The Obsession: Fear of throwing away items because they might be "needed later", or distress associated with throwing away possessions of seemingly little value. The Compulsion: Accumulating and saving excessive amounts of items, resulting in cluttered living spaces that impair daily functioning.

Facts and Myths about OCD

Like many mental health conditions, OCD is surrounded by misconceptions that can make it harder for people to recognize it in themselves or seek help. Below, I want to address some of the most common ones I hear, both in my office and in everyday conversation.

Myth: "OCD is just about being neat, organized, and washing hands" Fact: Contamination and cleaning-related subtypes affects approximately 25% to 46% of people diagnosed with OCD.

Myth: "Everyone is a little OCD" Fact: This is not accurate. OCD is a real medical concern and can be extremely exhausting and debilitating. There is no such thing as "a little" OCD; there is a strict criteria of symptoms and impairments that determine if someone will be clinically diagnosed.

Myth: "OCD is always obvious and easy to spot" Fact: OCD is often hidden and not spoken about. Many people with OCD feel an immense sense of guilt and shame due to the nature of their experiences, and do not share it with others. OCD often takes years to be diagnosed.

Myth: "If someone is having intrusive thoughts, that person is subconsciously wanting to act on them and is dangerous" Fact: Intrusive thoughts are what we call ego-dystonic. This means the thoughts completely contradict a person's actual character, morals, and desires. A person with OCD actually finds these thoughts horrifying and goes to great lengths to make sure they never act on them. These thoughts appear randomly and can be extemely distressing for the person experiencing them.

Phrases to Avoid Saying to Someone with OCD

• "Just don't think about it"
• "Everyone is a little OCD"
• "You're awful, why would you think those things?"
• "That doesn't even make sense"

Phrases to Try Instead

• "I love you, and I am right here with you."
• "I know this is may be exhausting for you, and I can see you trying your best."
• "You don't have to figure this out right this second."
• "I love you, but I'm not going to answer that because I know it will only keep the OCD loop going."

How to Contact a Therapist for Support with OCD

If any of this resonates with you, or with someone you care about, reaching out to a therapist is a meaningful first step. Use our script! “Hello, my name is (your name) and I would like to become a new patient and set up an intake session. I would like to be paired with a clinician who has experience working with OCD.” The staff on the other line will take it from there and lead you to next steps of becoming a new patient.

You may have OCD, but you are not your OCD. You do not have to carry this information and exhaustion alone. You can reach out and receive support.