Obsessive-compulsive disorder: OCD isn’t okay

By Shubhangi Shah

‘It’s OCD.’ Hearing such a statement by, or for, those who like things neat is not uncommon these days. For the uninitiated, OCD stands for obsessive-compulsive disorder, a mental health condition characterised by repetitive thoughts called obsessions, and the resulting behaviour called compulsion. It is a clinical diagnosis that significantly interferes with a patient’s day-to-day life.

Despite it being a major mental illness, ‘I’ve OCD’ is used pretty loosely these days. It seems it is one of those disorders people wouldn’t mind having. And why not? Who doesn’t want a shiny, clean floor and a well-organised cupboard? And if you could just clean on an autopilot mode without having to force it upon yourself, wouldn’t it be neat?

Probably as long as the idea of cleaning and organising does not trigger anxiety and becomes debilitating in nature. It would be neat if the mere act of showering does not take hours at a stretch, as you cannot do away with following a set ritual. It would be clean if washing hands multiple times a day does not show physically as damaged skin.

A to Z of OCD

The ‘O’ and ‘C’ in OCD stand for obsessive and compulsive, respectively. “Obsession is a repetitive, intrusive thought or image that comes to your mind recurrently,” says Dr Samir Parikh, director of mental health and behavioural sciences at Fortis Healthcare. The patients identify that it is not right. But, there is not much they can do about it. Such obsessions trigger anxiety, and to ease that, they end up doing certain activities (such as washing hands), which become compulsions. “An example: Cleanliness is an obsession for you. As a result, washing hands becomes a compulsion,” explains Dr Parikh. The ‘D’ in OCD stands for disorder, making it a clinical mental health illness.

Neat freak vs OCD

Many individuals like things clean and tidy. It promotes productivity and well-being. Also, not having to sieve through clutter saves you time. These are some of the reasons most people clean. However, this might not be the case with OCD patients. The obsession with cleanliness compels them to clean. In other words, dirt might annoy a neat freak but can trigger anxiety in an OCD patient.

“For OCD patients, it’s a compulsion to do a certain task, otherwise, they think great trouble would befall them,” says Dr Shuchin Bajaj, founder director, Ujala Cygnus Group of Hospitals. “And if they are unable to do so, it manifests both mentally as well as physically,” he adds. Mentally, the patient can suffer from anxiety. Physically, it can manifest in the form of tremors, ticks, etc.

Also, OCD doesn’t always conform to the ‘Mr or Ms Clean’ stereotype.

“Not everyone with OCD is obsessed with cleanliness,” says Dr Bajaj. It can manifest in other, sometimes harmful, ways too. There are OCD patients with harm obsessions, meaning they have obsessive thoughts of harming themselves or others. The compulsion: you might compulsively check if you have switched off the stove. The other forms of OCD include:

  • Symmetry obsessions with compulsions of ordering, arranging, and counting
  • Pure obsessional OCD, where the patient gets obsessive, intrusive thoughts or images with no visible physical compulsions
  • Hoarding.

Hence, every clean freak does not have OCD, and every OCD patient does not have an obsession with cleanliness.

Signs of OCD

Although OCD is a diverse diagnosis with a wide range of underlying symptoms, here are some common signs:

  • A constant fear of contamination or dirt
  • Wanting things symmetrical and/or organised
  • Doubt and having difficulty tolerating uncertainty
  • Aggressive or horrific thoughts of losing control and harming oneself or others.

Apart from these, if your obsessive thoughts and resulting compulsions start interfering with your day-to-day functions, such as in your personal, professional and social life, you know you are staring at an illness.

How OCD affects

If left untreated, OCD can become debilitating and significantly hamper the quality of life. Some harmful effects of OCD, as per Dr Shuchin Bajaj, include:

  • Difficulty in maintaining employment, making you prone to financial problems
  • Strained relationships
  • Physical evidence of compulsive behaviour. For example, damaged skin due to excessive hand-washing
  • Substance abuse disorder
  • Suicidal thoughts

Seek help

OCD is a serious mental health disorder. “It isn’t something that can be undone by itself,” says Dr Parikh. Hence, seek professional help. You must see a mental health expert “if your OCD is triggered frequently, hampers your quality of life, starts interfering with your professional and personal lives, and even causes physical harm”, he adds.

Treatment includes medication and therapy, experts say.

Coming to all the neat freaks, terming oneself as having OCD (without a diagnosis) invalidates the struggles of those living with this condition. The popular culture has not done them any favours either. Including cleaning and arranging bits (sitcoms FRIENDS and The Big Bang Theory come to mind) might bring comic relief, but it is neither comic nor relief for a person living and struggling with this condition. Hence, don’t throw the ‘I have OCD’ remark at the drop of a hat. Also, if struggling, do not shy away from seeking help.

“Liking things neat and organised is good,” says Dr Shuchin Bajaj. However, in OCD patients, it’s much more than that. “If it reaches a level where you cannot leave the house, you are cleaning and organising all the time, you cannot stand others as you think they are causing disorder in some way, then it’s time to see a doctor,” he adds. If not, cleaning is a habit just like any other you form over the years.