Jason was referred to me from his General Practitioner. He had moved back with his parents after his wife gave birth to their now 5 month daughter. Jason had never been diagnosed with any mental health disorder but following the birth of his daughter started experiencing intrusive thoughts about smothering his daughter with a swaddle blanket. This thought had become so distressing that he felt he was a danger of hurting his daughter and moved out of his home. This is the reality of OCD.
Last Monday I sat down after working with six clients with OCD to relax into the nothingness that is Facebook. The third article in my newsfeed was the quiz, “How OCD are you?” This puzzle sat in stark contrast to the client that sat across from me with her hands bleeding and cracked from washing or the client who had been unable to drive in three years because they were fearful of hitting someone or the client who had been unable to cuddle her child for six months for fear of hurting them.
Mental illness is the poor cousin to its physical counterpart. If unacceptable to write a quiz “How diabetic are you?” Why is it somehow acceptable if it’s a mental illness? Obsessiveness is a personality trait but it is not OCD. The message is clear, a throw away comment “you are so OCD” while meant in jest does invalidate the millions of people with OCD. Individual change equates with collective change. Legislation is built on individuals coming together with a share goal.
Eccentricity and cleanliness have become synonymous with OCD. Telling a friend they are “a little OCD” is a subtle way of telling them they need to relax a little. What are the implications of this association and does it matter?
OCD seems to have become a euphemism for sterility. While we can understand the association due to movies like “As good as it gets”, the “I’m so OCD” statement is more than just that. Obsessive Compulsive Disorder (OCD) is an mental disorder that involves unwanted and disturbing thoughts, images and impulses that intrude into a person’s mind causing a great deal of anxiety. This in turn promotes a series of repetitive behaviours or mental acts (compulsions) to “feel better”. For example a person leaves the house but experiences the intrusion they have left hair straighter on. A surge of anxiety is experienced and the person walks upstairs and stares at the unplugged cord until they “feel right”. This process may need to be repeated several times until a sense of completeness is reached.
The most common obsessive fears include a fear of getting AIDS, hurting a person they love either sexually or through psychical actions, fear of running someone over and the need to have things ordered and “just so”. For example, Mary thought she had been contaminated by asbestos from walking past an Old Queenslander. Compulsions on the other hand are repetitive behaviors or actions that a person uses with the intention of reducing or neutralizing the anxiety associated with their obsessions. People with OCD realize this is only a temporary solution but without a better way to cope they rely on the compulsion as a temporary escape. The need to engage in compulsions is so strong because the anxiety is so high. Essentially image your worst fear, then the anxiety associated with it and that is what people with OCD experience on a daily basis. Compulsions can also include avoiding situations that trigger obsessions. Examples of compulsions include repetitive checking, showering, cleaning, ordering, re-reading, tapping and counting. Examples include staring at the ground to check that cracks are not syringes, showering from 3-5 hours daily and having to re-read a sentence hundreds of times due to being fearful they will not understand.
The World Health Organization ranks obsessive-compulsive disorder (OCD) as one of the 10 most debilitating conditions due to lost income and decreased quality of life. So why is this condition being touted as a quirk and megastores like Target selling red garments over the festive season bearing the slogan “OCD: Obsessive Christmas Disorder”? Perhaps the answer lies in the physical versus mental dichotomy. This year lets honour and respect those with OCD so that next Christmas Target will not think it suitable to sell OCD jumpers.