Living with OCD: What It’s Actually Like

Asserting that people with OCD just need to relax implies that it is purely a disorder rooted in stress. Although stressful situations can increase symptoms in individuals suffering from OCD, stress is not the sole cause of the disorder. In fact, OCD is a complex illness that has root causes at both the behavioral and biological levels.

In terms of behavior, many researchers believed that OCD arises from obsessions that stem from a neutral object becoming connected to a fearful stimulus. For example, a piece of chalk becomes associated with fear after having a panic attack while writing on the chalkboard. After this initial connection, compulsions develop to reduce the anxiety created in response to the stimulus connected to fear. These compulsions reinforce that reaction and create the vicious cycle of fear and habit that underlie OCD, a cycle which is subconscious and tied to abnormal brain activity, leaving individuals with no control over the obsessions and compulsions that dominate their life.

At the biological level, research suggests that OCD stems from abnormal activity in the caudate nucleus, a region of the brain’s basal ganglia. In order for a person to properly control their habits, this structure must fire in a specific manner. One study found that people with OCD possess hyperactivation in this region of the brain compared to those that do not, highlighting the contribution of underlying brain biology to the symptoms of this disorder.

Contrary to what you might think, when you suffer from OCD, obsessive thoughts can lead to compulsions that manifest in both physical and mental ways. Religious obsessions about always doing the morally right thing can lead to mentally compulsive thoughts of prayer to balance out these compulsions, and obsessive feelings of fear can lead to constantly reviewing the possible events of your day to ensure that they don’t lead to harm. You might know someone who suffers from OCD and not even realize it because their compulsions never manifest in a physical way; instead, these compulsions make their way through the person’s thought processes and go completely unnoticed to the outside world.

Although the common perception of someone with OCD is one dominated by cleanliness and organization, OCD is a complex disorder that spans far beyond these actions. Cleanliness and perfectionism are common obsessions, but numerous others including unwanted sexual thoughts, religious obsessions, and fear of losing control of your actions also exist. For example, someone with the obsession of unwanted sexual thoughts might compulsively avoid specific situations that trigger these thoughts. Ultimately, OCD is a connection between intrusive, obsessive thoughts and compulsive behaviors that attempt to control the anxiety that stems from these thoughts. The nature of the disorder spans far beyond simply being preoccupied with cleanliness and organization.

Possibly due to the aforementioned myth that OCD is all about cleanliness and keeping things organized—behaviors commonly associated with females—many people assume that OCD is a disorder that affects women more than men. However, the International OCD Foundation states that OCD affects people of all genders, races, and economic backgrounds equally. Perpetuating this myth does nothing but undermine the severity of OCD in men and could prevent many of them from seeking treatment due to the misguided belief that OCD is not likely to affect them. In addition, it stigmatizes the women who suffer from it by feeding into the myth that the disorder is limited to an obsession with cleanliness and organization.