Monday, April 28, 2014

OCD is not a throwaway line

Being 'a bit OCD' seems to be turning up more and more in everyday conversation. It's a jolly way of saying you like things a bit neater or more in straight lines than the average person.

Except that's not what OCD is at all. A recent tweet by Stephen Fry along similar lines is discussed in this powerful piece by David Adam, where he examines what's wrong with talking about OCD as a minor behavioural quirk:

This matters for two reasons. First: the more that OCD is cemented in the public consciousness as a trivial and superficial tic, the more that misleading impression damages vulnerable people. It takes real courage to confront mental distress and seek help. Yet when people with OCD do so, they often find bafflement and hostility, even from within the medical profession. If OCD is simply someone who washes their hands then why is this patient telling me of unwanted thoughts to hurt their children? If OCD is someone who lines up their DVDs in alphabetical order, then is this teacher who wonders if she knocked someone down in her car last night and compulsively calls hospitals to make sure she didn't, safe to carry on working? Those aren't hypothetical examples. Parents with OCD are separated from their families. Workers are suspended from their jobs, but not because they pose any threat. One of the defining features of obsessive thoughts is that they are unwanted; we don't act on them. They get treated in that way because their symptoms either weren't recognised as OCD or because the reality of OCD was blurred by the popular misconception.
Second: people with OCD get their information from the same sources. We believe OCD is something else. If OCD is angst about symmetrical cakes then what is wrong with me? Why can't I shake these crazy ideas about catching HIV from my cat? Why do I think about having sex with next door's rabbit? Those too are genuine OCD examples. And here's the killer line: they are the kind of weird thoughts that everybody has from time to time. OCD is when they get stuck.
OCD is listed by the World Health Organisation as one of the 10 most debilitating illnesses in the world. Despite this, it's still mainly hidden, and misunderstood, Adam describes it as:
a disorder of thought: harrowing, distressing, torturing, impossible-to-shake thought. That's the O in OCD – obsession – and it's what causes most of the D from the same abbreviation. (It stands for disorder but means distress.) Ironically, the compulsions, the C in OCD, the most visible and least understood feature of the condition, are almost always what we do to make ourselves feel better. Compulsions are a response to an obsessive irrational thought.
We still don't know why our mental wiring goes disastrously wrong like this, and chemical and therapeutic treatments are still quite trial-and-error. Adam points out that there is a gap of over 10 years between people first experiencing the symptoms, and going for help (more of his story here). A lot of this is the stigma attached to mental health problems, particularly such extreme and irrational thoughts - who would want to own up to them? But this is a mainstream mental health problem, affecting roughly 1 in 100 people (probably more, as it's under-reported). 
So if you're just 'a bit OCD', be thankful, be very very thankful. 


  1. Great post - same applies to aspergers and autism, terms which are misused in the same way.

  2. And "depressed". We are all guilty, it's too easy.

  3. 'Depressed' is more understandable, it applies to other things than mood (from weather to customer spending). But yes, feeling depressed isn't the same as having depression, and if we think they're the same thing, then we end up wondering why people can't just cheer up.