Above average cleanliness not indicator of OCD

Q. I am really neat and keep my house spotless. My husband says I have OCD. He has told all of our friends and now every time I clean my rugs, people say it’s OCD. Even our children have started calling me “OCD Mom.” It is my understanding that having a normal, clean house is not a mental health problem. Can you explain OCD to my family?

A. You are correct in your assessment that having a clean house usually has little to do with an Obsessive Compulsive Disorder (OCD). Even though many people refer to those who are neat and orderly as OCD, it is a misunderstanding of the term and the condition.

People who have been diagnosed with OCD are often quite messy. Because they may take excessive time with ritualistic cleaning, are usually fearful of germs and have anxiety when discarding even meaningless things, their living spaces are often cluttered and messy.

OCD is actually an anxiety disorder in which people have unwanted and repeated thought (obsessions) or ritualistic behaviors (compulsions). They believe that to relieve the anxiety of their unwanted thoughts they must perform rituals to assure their safety or to rid themselves of fear. If people with OCD do not perform their compulsive rituals, they experience heightened anxiety that is difficult for them to control.

Some of the most common obsessions are fear of contaminates such as body fluids, chemicals and germs. Others obsessions are fear of harming loved ones, a fear of offending God or violating moral standards, and doubting one’s own religious beliefs. It is normal to experience some of these fears occasionally, but someone with OCD will be unable to stop the thoughts. I had a patient in my New York practice who had been a respected high school principal. As her OCD worsened, she became convinced that she was not praying enough. Eventually, her prayer ritual extended to almost 8 hours daily, and she lost her job.

Some of the most common compulsions are excessive washing, checking, counting or repeating ritualistic phrases. These compulsions may be relatively simple such as uttering a protective word or they may be elaborate routines. One of my New York patients had a ritualistic ceremony over the way her door was locked and her alarm clock was set. If she did not check her locks and alarm clock at least 11 times, she believed that she would be murdered by an intruder during the night. Such severe OCD can interfere in one’s life so that the individual is unable to work or socialize.

Without an evaluation it is difficult to tell if your cleaning routine is in a normal range of behavior. If you are habitually late or having difficulties with activities of daily living because of your cleaning and orderliness, then you could possibly have OCD.

Additionally, if something is moved from its place and you experience extreme distress this could be another indicator that there is a problem.

If you suspect that you have OCD or simply want to present information to your family, you can find some excellent online resources about the condition and treatment options. I would suggest that you begin with the website for the International OCD Foundation (www.ocfoundation.org).

— Nancy Ryburn holds a doctorate degree in psychology from Yeshiva University in New York City. She teaches psychology at Southeast Arkansas College and maintains a private practice.