If you’re here, I’m glad it didn’t take you a day, week, month, or year longer, like it does for most people. The majority of individuals who have Obsessive-Compulsive Disorder (OCD) take an average of 10-17 years to get properly diagnosed and the right treatment. The fact that you’re here means that you now no longer have to be stuck in the black hole that is having no idea what’s going on inside your brain and feeling like you’re going “crazy”. Unfortunately, people stay stuck in that hole for far too long.
Which is really depressing and frustrating to think about, considering how effective treatment is for this condition. In fact, research shows that Exposure and response Prevention (ERP) is more effective for OCD and anxiety than any other treatment for any other disorder. That’s absolutely *wild* to me given how long people have to wait for the right diagnosis and treatment!
Feeling alone and different
Instead of getting the right diagnosis, many people wander around in the darkness feeling like they’re the only one with these types of thoughts. Lots of people I work with report feeling like there’s something “wrong” with them. They live a life where they may seem very much like they’re functioning on the outside. However, on the inside, they’re struggling with feeling like they’re losing control and – quite frankly – losing their mind.
That’s what so many people who have OCD feel like before they realize they actually have a disorder that is not their fault, but rather, something inherently different about how their brains interpret threat and tolerate doubt. That feeling of realizing that this isn’t your fault, and that this isn’t something wrong with your brain, must be incredibly powerful and relieving for people. I can imagine it is also scary. So if you’re there, welcome. But know that a big part of this is behind you because you’ve identified what this could possibly be – OCD.
So what’s next? What exactly is OCD, especially since so many people out there believe it only has to do with fears of contamination, avoidance of germs, and needing things to be perfect and orderly?
First things first, those presentations can definitely happen, and they can be quite debilitating. Any form of OCD can be debilitating. Having worked nearly 10 years at a residential OCD and anxiety recovery unit, I have seen some of the most complex and debilitating cases of OCD and anxiety in the world. I’ve seen this disorder threaten peoples’ lives, destroy families, steal potential and freedom, and so much more. But we often confuse OCD for what it’s not, which is a preference for things to be neat, orderly, tidy, or just so.
If you prefer it, it’s not OCD. OCD is anything but a preference.
Obsessions and Compulsions
OCD involves obsessions and compulsions. Technically, according to the DSM, you can have obsessions *or* compulsions, though in all of my time working with this population, I’ve never worked with someone who did not have a ritual or anxiety reduction strategy of some kind – even if it was a subtle mental compulsion or avoidance. Obsessions can be intrusive, unwelcome experiences such as intrusive thoughts, ideas, images, impulses, urges, feelings, or commands. Rituals are things that someone does in order to reduce the anxiety that they feel as a result of an obsession. Anything can be a ritual, and rituals can be observable or non-observable (i.e., mental). In order to have OCD, emphasis on “disorder” here, you would also need to meet criteria of having 1) distress, 2) impairment, and 3) technically, these experiences taking up more than an hour a day.
Let’s break that down a little bit.
1. Distress: In order to have OCD (again, emphasis on disorder), you would have to experience some distress from this. In the event of children or those who have less insight or not as much motivation, I may also ask about the distress that it causes within the family and for loved ones. This is actually true of many mental health conditions. If there was no distress or impairment, one could say that they have tendencies that are associated with this condition, but they would not have the disorder, and therefore would not have “OCD”.
Distress could be from obsessions, the compulsions, or both. I say distress also means that someone has gotten to the point where they no longer want to continue they way they’ve been living. These uncomfortable feelings may also be present in the form of high anxiety or sadness.
2. Impairment: In addition to distress, one would also need to have some level of impairment in their life. Impairment is any way in which the obsessions, compulsions, or both have negatively influenced you. Things you need to do include ADLs or activities of daily living. Activities of daily living may be things you don’t necessarily want to do or enjoy doing but have to do.
Impairment may also come in the form of impeding you from engaging in enjoyable activities, like sports, hanging out with friends, maintaining romantic relationships, and whatever else you would like to do if OCD and anxiety weren’t part of the equation. If obsessions and compulsions are getting in the way of you living your best life, and this is distressing to you, then you very well may have OCD.
3. An hour+ a day: I’m going to show my bad therapist card here and be completely honest in saying that I rarely ever actually assess for this. The truth is that obsessions and compulsions are hard to quantify – especially if we’re evaluating things like mental/non-observable compulsions (e.g. rumination, self-assurance, praying) and avoidance. In fact, by avoiding, one might actually gain time in their day (i.e., by not showering, by not going to work).
Because this is hard to quantify, I’m not going to die on a hill if someone says they meet all other criteria but can’t necessarily say if these experiences take up an hour or more a day. If they meet all of the other criteria, and this isn’t better explained by another mental health condition, then I will likely give them a diagnosis of OCD.
OCD is the doubt disorder
And if I know anything about OCD, it’s that it will make you doubt. It can make you doubt anything and everything. It can especially make you doubt your symptoms and diagnosis. It’s possible that you’ll read all of the above, think “check, check, YEP, that’s me”. Then, in a few minutes or hours, think that you didn’t read it correctly or that something *you* are the exception to what I wrote.
Again, that’s another example of doubt and the doubt disorder (OCD) in action.
With that said, you can’t get a diagnosis via a blog, but! If you feel like this resonates, I’m so glad to have given that to you. Again, there’s hopefulness in the fact that OCD and anxiety are some of the most treatable conditions in the world. Even though they can be extremely debilitating when left untreated, they do not have to be that way forever.
If you want to learn more about OCD and anxiety, check out my OCD/Anxiety Cycle workshop CLICK HERE. By purchasing, you’ll get an immediate download, plus two worksheets.
The good news is that you no longer have to be wandering around in that dark. That’s the worst place to be. Now it’s just time to learn more about it and *do* something about it – and that’s where I come in. You can find some more help on my Instagram (@jenna.overbaugh) and on my podcast. It’s called All The Hard Things, available wherever you find your podcasts.
I’m rooting for you guys and I’m here for you every step of the way. Hang in there. You’ve got this.
Remember: this blog post is for informational purposes only. It is not to be construed as mental health or medical advice. The information and education provided here is not intended to supplement or replace professional advice. Always check with your own physician or medical or mental health professional before trying or implementing any information read here.