OCD misconceptions

Obsessive compulsive disorder (OCD) is a common psychiatric condition that affects about 1-2% of people worldwide. While people might throw out the phrase, “I’m being OCD,” when organizing or perfecting something, the diagnosis is more complicated than striving for cleanliness or perfection. It is characterized by obsessions, which are unwanted, recurrent thoughts, images or impulses that one finds very upsetting. This distress motivates a behavioral response in the form of different compulsions, such as ritualistic or repetitive behaviors or avoidance of things that trigger distress. Baylor College of Medicine psychologist Dr. Eric Storch debunks several common OCD misconceptions.

Myth: OCD mainly pertains to being extremely clean and organized.
Fact: When talking about OCD, people often think primarily about contamination fears. While that is one subtype of OCD, there are so many other domains as well, which include unwanted, intrusive thoughts about topics such as harm, religion or relationships, or obsessions about something bad happening, as well as symmetry/ordering-type rituals.

Myth: All perfectionists have OCD.
Fact: Perfectionism certainly can become problematic in nature and result in difficulty in day-to-day functioning but also can be quite adaptive at times. The key is when perfectionism goes from being something helpful to a characteristic that is impairing and distressing if things cannot be done a certain way.

Myth: Compulsions are only physical.
Fact: Compulsions can be physical in nature, but oftentimes they are not. Counting, prayer or certain thinking patterns are common examples of compulsions that people cannot see but are still there and problematic. Another compulsive behavior involves avoidance. People staying away from things that bring about the potential of the feared outcome happening is a common presentation within OCD.

Myth: OCD looks the same for all patients.
Fact: OCD is an incredibly heterogenous condition. OCD for one person looks drastically different in someone else. Symptoms can be extremely different in terms of how they present, or what motivates them, such as fear of something bad happening or feelings of incompleteness. Also, many people with OCD have other concerns like anxiety or depression that can further complicate presentation.

Myth: OCD is solely a result of genetics.
Fact: Not at all! OCD is a multi-determined condition. Genetics can play a role. If one identical twin has it, the other twin has a 40 to 50% chance of having OCD. But other factors come into play that are environmental in nature such as parenting, life experiences and traumatic events. These factors come together to contribute to one having an increased risk of OCD.

Myth: OCD is not treatable.
Fact: This is completely inaccurate. The OCD Program at Baylor Medicine focuses on treating OCD for all types of presenting problems with an array of treatments. This includes effective behavioral therapies, including cognitive behavioral therapy (CBT), as well as various medications, typically antidepressants. While these approaches are extremely effective, other options are available even when those interventions do not work, including different types of noninvasive brain stimulation and invasive brain stimulation, known as deep brain stimulation (DBS). DBS for OCD targets regions of the brain believed to be implicated in OCD and is extremely effective for those that did not respond well to multiple rounds of therapies or medications. There are many types of treatments that help people improve quality of life and symptom presentation. But what needs to improve is access to treatment and consistency in the type of mental health treatment people receive.

The OCD field has come so far, and we know that there are certain treatments that work well for OCD like CBT or medications, but other approaches do not work as well. Getting the right type of treatment is crucial. If you have a heart problem and a doctor prescribes medication that improves kidney function, your heart will not improve because you received the wrong treatment. This notion also applies to mental health treatment. We need to make sure that people with OCD get personalized, effective care.

By Homa Warren