Zahra Mohsin, Year 2 Medicine
“I’m so OCD.”
Phrases like this are often casually thrown around when obsessive-compulsive disorder (OCD) is discussed. However, the reality of OCD is far more profound and complex than the stereotype suggests.
What is OCD?
OCD is a mental health condition in which individuals experience obsessive thoughts and compulsive behaviours (NHS, 2023a). The disorder has two main components: intrusive thoughts, images, or impulses (obsessions), and compulsive behaviours performed to relieve the anxiety these obsessions cause (TED-Ed, 2015).
Common misconceptions about OCD lead many people to label themselves as “having OCD” simply because they enjoy cleaning or prefer things to be organised (YoungMinds, 2024). While these behaviours can be symptoms of OCD, the condition itself is far more complex. Individuals with OCD find it extremely difficult—if not impossible—to dismiss their intrusive thoughts, no matter how hard they try (BBC, n.d.).
What Causes OCD?
The exact cause of OCD remains unknown, but several theories attempt to explain its origin. Some suggest that OCD may develop through personal experiences, such as growing up with parents who exhibit similar behaviours or coping with ongoing stress and anxiety. In some cases, pregnancy or childbirth may trigger perinatal OCD (Mind, 2023).
Other theories point to biological factors, including the possibility of a link to abnormally low levels of serotonin. However, it remains unclear whether low serotonin is a cause or an effect of the condition (Mind, 2023).
OCD can affect anyone—men, women, or children—at any age. Symptoms may appear as early as six years old, but they more commonly begin around puberty or in early adulthood. Approximately one in fifty people will experience OCD at some point in their lives (Royal College of Psychiatrists, 2019). Despite its prevalence, OCD is often misunderstood and misrepresented.
Myth 1: OCD is about being obsessively clean and tidy
The reality of OCD is far more complex than simply liking things neat or organised. People with OCD often experience deeply distressing, repetitive, and intrusive thoughts, alongside a persistent sense of danger or doubt (Benenden Health, n.d.).
Common obsession-compulsion patterns include:
- Contamination fears, leading to excessive cleaning or washing
- Fear of causing harm, prompting constant checking (e.g., repeatedly ensuring doors are locked)
- A need for symmetry, leading to compulsive ordering or counting (Stein et al., 2019)
Some individuals also experience disturbing intrusive thoughts of an aggressive or sexual nature (Stein et al., 2019). While some with OCD may indeed be excessively tidy, these traits alone do not define the condition. OCD is characterised by uncontrollable and irrational thoughts and behaviours that the individual cannot easily dismiss (Benenden Health, n.d.).
Myth 2: Those with OCD wash their hands constantly
Excessive handwashing is often portrayed as the hallmark of OCD, but this is an oversimplification. Compulsions—repetitive actions performed to reduce anxiety—are a key feature of the disorder (TED-Ed, 2015). Handwashing is a common compulsion, especially in individuals with contamination fears.
Such individuals may also:
- Avoid touching others
- Refrain from shaking hands
- Obsessively brush their teeth (Psych2Go, 2021)
However, OCD manifests in many forms, and not all individuals engage in compulsive handwashing (Benenden Health, n.d.).
Myth 3: Repetitive behaviours always mean OCD
While actions like double-checking or frequent handwashing can be occasional habits, OCD is a severe condition that significantly disrupts daily life (TED-Ed, 2015). People with OCD have little control over their thoughts or behaviours, which can consume hours each day and interfere with work, school, and relationships.
The difference lies in distress and disruption. OCD behaviours are not just quirks or preferences—they are intense compulsions tied to anxiety and often cause personal suffering. These behaviours may also strain relationships, as loved ones struggle to understand the disorder or feel overwhelmed by the person’s need for reassurance (NeuroLaunch, 2024).
Myth 4: People with OCD don’t realise their behaviours are irrational
Most individuals with OCD are fully aware that their behaviours are irrational and lack logical basis. Still, they often feel compelled to act “just in case” (NHS, 2023b). These urges reflect the overwhelming fear and discomfort that obsessions can create, making it incredibly difficult to resist compulsions—even when one knows they don’t make sense.
How OCD Can Be Treated
Fortunately, effective treatments for OCD are available. One of the most common is cognitive behavioural therapy (CBT), where patients work with a therapist to confront their fears and intrusive thoughts without resorting to compulsions (NHS, 2023c). Over time, this helps desensitise individuals to their anxieties.
Medication is also an option, particularly in more severe cases. Selective serotonin reuptake inhibitors (SSRIs)—a class of antidepressants—are often used to increase serotonin levels in the brain and reduce OCD symptoms (NHS, 2023c).
Conclusion
Despite being heavily stereotyped, OCD is a multifaceted condition that can manifest in many different ways and affect people differently. It is vital to continue raising awareness, dispelling myths, and encouraging accurate understanding of what OCD really is. By doing so, we can help more individuals seek treatment—ultimately improving their mental health and overall quality of life.
References
• BBC. n.d. Obsessive behaviour: the facts. bbc.co.uk. [Online]. [Accessed 9 April 2025]. Available from:
https://www.bbc.co.uk/science/humanbody/mind/articles/disorders/ocd.shtml • Benenden Health n.d. OCD: Myths vs reality. Benenden Health. [Online]. [Accessed 9 April 2025]. Available from: https://www.benenden.co.uk/be-healthy/mind/ocd myths/
• Mind. 2023. Causes of OCD. Mind.org.uk. [Online]. [Accessed 9 April 2025]. Available from: https://www.mind.org.uk/information-support/types-of-mental health-problems/obsessive-compulsive-disorder-ocd/causes-of-ocd/
• NeuroLaunch. 2024. Understanding OCD: Debunking Myths and Addressing Safety Concerns. NeuroLaunch.com. [Online]. [Accessed 9 April 2025]. Available from: https://neurolaunch.com/is-someone-with-ocd-dangerous/
• NHS. 2023a. Overview – Obsessive Compulsive Disorder (OCD). nhs.uk. [Online]. [Accessed 9 April 2025]. Available from: https://www.nhs.uk/mental
health/conditions/obsessive-compulsive-disorder-ocd/overview/
• NHS. 2023b. Symptoms – Obsessive Compulsive Disorder (OCD). nhs.uk. [Online]. [Accessed 9 April 2025]. Available from: https://www.nhs.uk/mental
health/conditions/obsessive-compulsive-disorder-ocd/symptoms/
• NHS. 2023c. Treatment – Obsessive compulsive disorder (OCD). NHS. [Online]. [Accessed 9 April 2025]. Available from: https://www.nhs.uk/mental health/conditions/obsessive-compulsive-disorder-ocd/treatment/.
• Psych2Go. 2021. 4 Types of OCD & How They Manifest. [Online]. [Accessed 9 April 2025]. Available from: https://www.youtube.com/watch?v=u_qfAtvX8Os • Royal College of Psychiatrists. 2019. Obsessive-compulsive disorder (OCD). Royal College of Psychiatrists. [Online]. [Accessed 9 April 2025]. Available from: https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and-mental-health problems/obsessive-compulsive-disorder
• Stein, D.J., Costa, D.L.C., Lochner, C., Miguel, E.C., Reddy, Y.C.J., Shavitt, R.G., van den Heuvel, O.A. and Simpson, H.B. 2019. Obsessive–compulsive disorder. Nature Reviews Disease Primers. [Online]. 5(1), p.52. [Accessed 9 April 2025]. Available from: https://doi.org/10.1038/s41572-019-0102-3
• TED-Ed. 2015. Debunking the myths of OCD – Natascha M. Santos. [Online]. [Accessed 9 April 2025].
• YoungMinds. 2024. Words Matter: Debunking Stereotypes About OCD | Blog. YoungMinds. [Online]. [Accessed 9 April 2025]. Available from:
https://www.youngminds.org.uk/young-person/blog/words-matter-debunking stereotypes-about-ocd/
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