I recently read a post from Philosophy Bear about the negative impact that OCD has on wellbeing. I'd never seen this data before, but wasn’t massively surprised as I myself am a fellow OCD haver. OCD-er? OCD-man.
OCD is in a bit of a transition stage right now. When I was young, it was seen as the silly condition where you had to wash your hands over and over, or flick a light switch on and off. I think most people are enlightened enough now to know that that doesn't really capture the entire condition - but they still don't know what it is like. They know enough to know the caricature is wrong, but that's about it. So, I thought it'd be good to speak about what it's like on the front lines.
My brand of OCD
The OCD I have is not mild, but also not totally debilitating. It's probably best described as medium OCD. Ready Salted. I have seen versions of it that seem more crippling than my own. I once went on a date with a woman who cleaned her hands so much she’d bleed. I also have a close friend who can't meditate because he "thinks too much about how his eyelids are touching his eyes". There are other sufferers who worry they’re pedophiles, or that they’ll kill their own children. I'm fortunate enough to not experience it this severely.
My specific brand is called Real Event OCD. This means I obsess over and ruminate on real things that happened to me - almost all embarrassing or shameful memories. I think most of us have had this experience at some point. You lay awake at night, suddenly remember how clumsy your first kiss was, and you curl up in a ball. The cringe hurts and you want the mattress to swallow you whole - but from what I hear, you then move on and think about something else.
My mind does that, but then gets stuck. It plays it over and over and over. This is because it's in problem solving mode, and it's imagining there's something I can do to fix it. I stay awake for hours, ruminating, and sometimes even invent new memories where something worse happened. I then imagine consequences that are far more severe than they actually were. "I didn't say thank you to the cashier. What if they were depressed and I pushed them over the edge? Have I killed someone? I'm a monster!". Weirdly, I saw a perfect depiction of Real Event OCD in the TV show Barry (Spoiler alert for the link). Even though it doesn’t actually depict an OCD sufferer, this is just what it’s like! - down to the swearing under your breath, and slapping your forehead.
Me, after bumping into someone on the street.
Obsessions and Compulsions
As you can probably gather from the name, Obsessive Compulsive Disorder manifests in two parts, obsessions and compulsions. Obsessions we've already spoken about. These are the worries, concerns, or urges that you keep ruminating on. In my case, it's usually moral scrupulosity, but there are a wide range of obsessions. This is where you hear stories of people thinking if they don't open and close the door exactly 10 times something bad will happen. Compulsions are the behaviour that the obsession motivates. This is the actual opening and closing of the door. OCD is really just an eternal battle of arising obsessions, and fighting the urge to do the compulsion.
Obsessions and Compulsions are often poked fun at in popular culture, and I can see why - they are a bit odd. They’re also awful. OCD is a mental illness that warps your reality. Just instead of hearing voices, you’re thinking “If I don’t do X, something terrible will happen”. Sometimes you don’t even know the specifics of the bad thing, you just get scary vibes. You’re always on the Titanic, and acting on your compulsion is the one thing keeping the ship afloat.
The alternative is to not act on the compulsion - but it's very hard to do that! It's like your skin is covered in mosquito bites and you're not allowed to scratch. Unfortunately, just like scratching, when you do eventually act on a compulsion, it often only makes you wish you hadn't. You were duped into thinking it would provide lasting satisfaction, but it never does. The itch might subside for a moment, but just comes back with more intensity.
I remember I’d just passed my driving test. I was in a car park near our train station and driving toward the exit. A taxi was pulling out of a space, and I didn't stop in time, so kept driving. He beeped his horn at me, and probably said something I can't repeat here. I drove home, distraught.
As it happened, I needed to go back to the station later that day to go somewhere. After thinking about how this poor cab driver probably had a heart attack from the stress, and his children were orphaned, I approached his car. I knocked on the window, but he gestured that I go to the next driver as it was his turn to pick up a passenger. I persisted, and told him I need to speak to him. After he rolled down the window I explained that I was the driver that didn't let him out earlier, and I was really sorry for doing so. He looked at me blankly. I wonder if he even remembered it happened. He said something like "umm...okay?" and rolled his window back up.
You would hope that I walked away from that interaction feeling finally satisfied that I had made up for my error, but instead I just felt worse. Now I had not only almost killed him, I had made him endure a slightly awkward social interaction! I spent the rest of the day in despair - I had finally done it. I was worse than Hitler. That’s the scary thing about OCD, it’s insatiable. Just when you think you’ve done the thing that will solve the obsession, another thing is added to the list. It’s an inferno that you’re trying to put out with gasoline.
This is just one example, but this sort of thing happens all the time. If you’ve been friends with me for a while, you’ve probably received a long text at some point apologising for something that I did years ago. This is my compulsion - I feel like I need to constantly atone for my sins. No punishment is grave enough for saying something dumb while drunk 8 years ago! I must repent!
If I don’t, I feel very uneasy. I invent scenarios in my head where the person I feel I have wronged is devastated. I feel like my repenting is what they need to move on, all the while forgetting they almost certainly forgot anything happened to begin with. Weirdly, OCD produces a kind of self absorption. You imagine that acting on your compulsion is the one thing preventing disaster - when in reality, you really don’t have that much influence on the world.
I‘m medicated now, so I imagine my days of sending long text messages and bothering taxi drivers is over - but I’m one of the lucky ones. My OCD could be worse, and I was responsive to drugs.
My first day on Sertraline.
Sadly, there are plenty of people that don’t have that door open to them- so I’m with Philosophy Bear when he says that OCD is deserving of more research and treatment. It’s the fourth most common diagnosis in psychiatry, and can impact wellbeing as badly as Schizophrenia. Not the goofy hand washing disease people sometimes make it out to be.
Great piece dude! I'm also a fellow 'OCD-man', so this piece hit home. I'm much better now, after more than one year of ERP and ACT Therapy. They really are the gold standard, even for people who are resistent to drugs. It's mind-blowing how well-done ERP really improves your well-being and your life in general.
This is a good breakdown of the realities of OCD. It's not a funny quirk, but a serious, common, and debilitating condition. And it is **treatable**, often with a combination of medication and ERP (Exposure Response Prevention). I encourage anyone who suspects they have OCD or needs treatment to visit NOCD.com for free resources and support groups.