by Vanessa Bruce Little
By this point, you likely know how I intend to start this post. You’ve heard it before, but the words we use matter. OCD – or Obsessive-Compulsive Disorder – is one of those terms we often hear casually thrown around to explain someone’s preference for order or cleanliness. Off-the-cuff remarks like, “Oh, I can never leave my dishes in the sink; I’m too OCD” or “I had to remake the bed – it’s just my OCD” serve to further confuse the issue by minimizing the impact of actual OCD and pathologizing completely normal behaviour. OCD is not about keeping things tidy or perfectly in order. OCD is a serious mental illness in which someone experiences obsessions that cause intense feelings of anxiety and consequently, performs rituals or behaviours (called compulsions) to help reduce that anxiety. Although sometimes these obsessions and compulsions are related to cleanliness or order –often, they are not.
So what exactly is an obsession? Obsessions are persistent, intrusive and unwanted thoughts or urges that the person feels unable to control. Someone with OCD usually knows that that their obsessions may not make sense but is not able to control them, which can cause considerable anxiety.
And what about a compulsion? Compulsions are repeated behaviours that the person performs in order to decrease the anxiety caused by the obsession. These activities vary from person to person. Some common compulsions include: counting, touching, washing, and checking. Although compulsions might make the person feel better temporarily, they can actually make their anxiety worse over time. But even if the person knows that the compulsions don’t really help, it’s very difficult to resist performing them.
In order to be considered OCD, these obsessions and compulsions need to significantly interfere with the person’s ability to live their life normally – at school, at home, at work, and in their relationships.
So why does someone develop OCD? It’s complicated and the truth is that we often don’t know – but both genetics and the environment likely play a role. In rare cases, OCD can be caused by a bacterial infection.
The good news is that OCD is treatable. Most often, a combination of medication and psychotherapy (Cognitive Behavior Therapy with Exposure and Response Prevention) will be recommended. If you’re worried that you or your teenager may have OCD, talk to your family doctor. And remember – language matters, so the next time you’re complaining about your need for a clean house, skip the OCD label and remember that liking things to be clean is totally normal.
Other helpful resources:
Vanessa Bruce Little is the Knowledge Translation Lead at TeenMentalHealth.org (IWK Health Centre/Dalhousie University), a role for which she relies heavily on her background in Clinical Psychology, clinical training, and experience working with youth and families with behavioural, emotional, and social issues. In addition to developing the content of many of Teen Mental Health’s resources, Vanessa also coordinates large-scale projects and supervises students from a variety of disciplines. She strongly believes that you have to communicate in a way people will “hear” and that the quality of the content is irrelevant if your audience can’t understand it.