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Obsessive Compulsive Disorder: Myth vs. Fact

Nowadays, Obsessive Compulsive Disorder (OCD) is almost an internet trend. There are a number of social media sites that glorify incorrect notions about what OCD is and are instead redefining it as the preference for neatness and pleasing visual aesthetics. A number of memes, quizzes, and image-based articles confirm how the internet is slowing changing our perception about what it means to have OCD.

Not only does this trivialize what it means to have OCD, but it perpetuates the continuing stigma about mental health and the conditions affecting it. To set things straight, NJ Family Psychiatry and Therapy of Paramus NJ, has addressed some of the common myths and facts associated with OCD.

First and foremost, we’d like to offer an actual definition of what OCD is. According to the National Institute of Mental Health, “Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, recurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over”. With this definition, let’s take a look at some of the myths surrounding OCD.

MYTH: If you like things neat, then you must have OCD.

FACT: OCD is not simply “preferring” things to be neat. Rather, people with OCD have a compulsive need to participate in certain behaviors and often would rather not have to engage in or repeat these behaviors. These certain behaviors can include cleaning, hand washing, ordering or arranging items, repeatedly checking things, compulsive counting, and others.

These compulsive behaviors are caused by uncontrollable thoughts, can be recognized as excessive, take up at least an hour a day, are not pleasurable but can cause brief anxiety relief, and can cause an individual to experience problems in their daily life from participating in these behaviors.

MYTH: If you are a perfectionist, then you must have OCD.

FACT: Being a perfectionist may simply be a personality trait, however if the need for perfection affects interpersonal relationships, it could indicate the presence of Obsessive Compulsive Personality Disorder (OCPD). OCPD is a personality disorder characterized by an excessive devotion to work, rigid and inflexible adherence to rules, hoarding, and a relentless control over one’s environment.

OCD and OCPD are different disorders even though they sound similar. For starters, while OCD is classified as an anxiety disorder, OCPD is classified as a personality disorder. Also, individuals with OCD are aware of the abnormality of their obsessions and compulsions, while those with OCPD generally see no problem with their behavior. Finally, because OCD is affected by anxiety, the symptoms can change over time depending on the nature of an individual’s anxiety, while OCPD behaviors typically stay the same since most individuals with OCPD are inflexible and reject change.

MYTH: All people with OCD have visible compulsions.

FACT: There is a subtype of OCD, called Pure obsessional OCD or Pure-O, that is characterized by compulsions that occur largely in the patient’s mind and are not visible to others. With Pure-O, individuals usually have unwanted thoughts that are violent, sexual, disgusting, or sacrilegious in nature. Individuals can also worry about the safety of those around them, experience fear of doing illegal activities, have an overwhelming concern about religious purity, or have existential fears.

In people with Pure-O, these thoughts cannot be simply dismissed, rather they cause a great deal of anxiety. Furthermore, individuals with Pure-O manifest the “obsessive” in obsessive compulsive disorder and cannot get the thought or thoughts to stop occurring. In fact, they more they try to repress or control their thought process, the more intrusive thoughts occur, making their anxiety worse. However, most people with Pure-O will not actually act on these thoughts, rather they just have a fear that they will.

MYTH: Compulsive behaviors indicate OCD.

FACT: Not all compulsive behaviors indicate OCD. Compulsive shopping, gambling, lying, or drinking are either their own psychological problems or are caused by different psychological problems. People with OCD realize that their obsessions and compulsions are not normal and try to combat this, while people with other certain types of compulsive behaviors do not often see a problem.

MYTH: OCD only affects adults.

FACT: At least 1 out of every 200 children have been diagnosed with OCD. To give a reference, this is the same number of kids with childhood diabetes. OCD can occur as early as 3 years of age, but most childhood cases are diagnosed between ages 8-12. During the late teen years and early adulthood is another common age range when OCD is first diagnosed.

In children the symptoms of OCD can vary. In most cases, Pediatric OCD symptoms will gradually develop over several weeks or months. However in some cases, such as with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) or Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS), OCD symptoms can occur seemingly almost overnight.

According to the International OCD Foundation, common obsessions and compulsions in children include:

  • Worrying about germs, getting sick, or dying
  • Extreme fears about bad things happening or doing something wrong
  • Feeling that things have to be “just right”
  • Disturbing and unwanted thoughts or images about hurting others
  • Disturbing and unwanted thoughts or images of a sexual nature
  • Excessive checking and re-checking that the door is locked
  • Excessive hand washing or cleaning
  • Repeating actions until they are “just right”
  • Ordering or arranging things
  • Mental compulsions (excessive praying, mental reviewing)
  • Frequent confession or apologizing Saying lucky words or numbers
  • Excessively seeking reassurance (asking: “are you sure I’m going to be okay?)

MYTH: OCD occurs in women more often than men.

FACT: According to the International OCD Foundation, “OCD equally affects men, women, and children of all races, ethnicities, and backgrounds”. However, there may be some differences in the way the genders experience OCD. A recent study found that males generally have an earlier age of onset, as well as have a higher prevalence of hoarding and sexual obsessions, while females tend to have more contamination obsessions and cleaning compulsions.

MYTH: Childhood trauma causes OCD.

FACT: Currently, there is no known cause of OCD. However, recent research has suggested that genetics, environment, and differences in the brain may be possible influences for developing OCD. Although it has been found that OCD does run in families, research suggests that genes are not entirely responsible for the development of OCD. While it is also believed that environmental factors play a role, it is not clear which environmental factors can increase or decrease the likelihood of OCD. When it comes to the OCD brain, research has found that their may be problems associated with communication between the front and deeper regions of the brain.

The only form of OCD that currently has a known cause is Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS). This type of OCD is directly caused by the body’s reaction to the streptococcus inflection and varies from other types of pediatric OCD. PANDAS varies from other types of pediatric OCD in that its symptoms have a sudden, extreme onset.

MYTH: OCD can be self-diagnosed.

FACT: Contrary to what all the internet quizzes will have you believe, OCD can only be diagnosed by a licensed therapist. During a consultation, your therapist will look to see if you have obsessions, participates in compulsive behaviors, and determine whether or not these obsessions and compulsions intervene with daily activities such as work, school, or having a healthy social life. If you are concerned that you may have OCD or OCPD, schedule a consultation with one of our licensed OCD therapists and NJ Family Psychiatry and Therapy in Paramus, NJ.

MYTH: OCD cannot be treated.

FACT: There are various treatment methods available for OCD. The type of treatment used will depend on various factors including the extent and type of symptoms, as well as the anxieties behind them. Family Psychiatry and Therapy of Paramus, NJ uses the following treatment approaches for OCD:

  • Cognitive Behavior Therapy (CBT): works to address negative thought patterns and change them into more positive thoughts and actions. With OCD, a specific form of CBT used is exposure and response prevention or ERP. ERP exposes individuals to the anxieties that trigger obsessions and then gradually trains them to prevent compulsive behavior through a process called habituation.
  • Dialectical Behavior Therapy (DBT): a combination of cognitive and behavioral therapies, DBT aims to alter negative thought patterns and behaviors into more positive thoughts and behaviors. Through creating a controlled and safe environment, DBT helps individuals practice managing their emotions and behaviors.
  • Biofeedback: uses computers and electronic sensors to measure, process, and provide “feedback” about an individual’s physiological state such as muscle tension, blood volume pulse, heart rate, skin conductance, hand temperature, respiration, and brainwave activity. This feedback offers information about how the body is dealing with stress and helps the individual become more aware of these factors so that they can learn control their anxieties.
  • Medication: Most people with OCD, about 7 out of 10, have benefitted from the use of medications. Medications for OCD generally include serotonin reuptake inhibitors (SRIs) such as: Luvox (fluvoxamine), Zoloft (sertraline), Celexa (citalopram), Lexapro (escitalopram), Prozac (fluoxetine), Paxil (paroxetine), Anafranil (clomipramine), and Effexor (venlafaxine).
  • For licensed OCD therapists, that offer Cognitive Behavior Therapy, Dialectical Behavior Therapy, Biofeedback, and medication, schedule a consultation with NJ Family Psychiatry and Therapy of Paramus, NJ.

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Helene A. Miller / And Other Providers
Family Psychiatry and Therapy brings compassion, understanding, and skilled care to patients throughout New Jersey. Our team of mental health professionals focuses on providing a positive and uplifting experience that aids our patients in facing life’s toughest challenges.