Like most mental illnesses, Obsessive-Compulsive Disorder (OCD) has a tendency to be casually treated in conversation as a personality descriptor. How many times have we heard someone describe themselves as “OCD” simply for liking their desk tidy, or their bed made? How many times has someone been described as “bipolar” for having mood swings?
These tendencies bring up more important questions of mental health awareness. In light of Bell Let’s Talk day on January 30th, an interviewee, who prefers to remain anonymous, shares her insight and her own experience with OCD. The interviewee, 32, confesses to having suffered from serious symptoms since the age of 18, when her cleaning got “out of hand.” According to the Clarke Institute of Psychiatry, Toronto, the typical onset of OCD is indeed late adolescence, and complaints of contamination and dirt-related obsessions and compulsions are common among OCD patients. Other types of obsessive thoughts may concern self-harm or inflicting violence, contracting disease and illness, morality, or sex. Obsessive-compulsive behaviour can be ritualistic—one woman complained of having to wash her hands six times with soap, and six times without, according to the Clarke Institute of Psychiatry. They are purposeful and are aimed at mitigating feelings of anxiety so as to gain a brief relief from tension, although sufferers do not derive any pleasure from these behaviours.
Diagnosing OCD is by psychiatric interview, when a person is seen to “display or complain of either obsessions or compulsions or both, to a degree that affects his everyday functioning or causes him distress” (Diagnostic and Statistical Manual of Mental Disorders). Many OCD patients, including our interviewee, are acutely aware that their behaviour is extreme and deeply inconvenient to themselves and those around them. On discovering her condition and how it affects her, she claims that it all began when she stopped inviting her friends over, for fear that they would eat chips or food. “The hunt for crumbs, even invisible ones, would keep me up at night. I would sweep, swab, dust and wash my apartment every single day, no matter what. If I got late coming home from work, I would do it anyway, well into the night sometimes, waking up tired and angry for work the next day.” Secondary effects such as the one described by our interviewee (anger, irritability) are known to manifest if the disorder is taking up hours of the sufferer’s time each day, according to the Clarke Institute. As confirmed in our interview and by researchers at Clarke, they also have marked effects on family functioning, often by making unreasonable demands on loved ones. “My family suffered my mood swings and accusations that they don’t care about the amount of work I do to keep the house clean,” says the interviewee. “I asked them to stop blow drying their hair and various other unreasonable demands were made on them to keep the house in the state I left it in, when I knew that was never going to happen considering we were 4 women and a dog living in that house.”
The worst of her OCD-related suffering involved stress-induced hair fall and rashes on her head. This would happen if time was too short to give in to certain compulsions. “Also, crying from the frustration of being stuck in the cycle and clinical depression, which I was temporarily on medication for. The OCD was part of the reason for that depression.” the interviewee is not alone in this; a 1994 study claims that “67 per cent of OCD patients suffer from at least one episode of major depression over the course of their lifetime.”
When questioned on how she deals with it, she speaks candidly: “I deal with them by giving in a lot. I budget my time accordingly. Sometimes, I force myself to let it be but then I get a stomach upset from anxiety, even if I’ve forgotten what impulse exactly I decided to quash.” The interviewee confesses not to have committed to any kind of a treatment program. However, there are multiple treatments that have been found to be effective in combatting OCD, including psychological treatments like cognitive-behavioural therapy, with the strongest evidence supporting ERP (Exposure and Response Prevention therapy). This is done via gradual exposure to feared situations and consequences, in increasing intensity as anxious responses diminish. According to a study by Foa et al., 74-80 per cent of patients undergoing ERP experience reduced symptoms. Another mode of treatment found to be effective are anti-depressants, which are often used in combination with psychological treatments.
Although in many cases sufferers are already aware of their condition, our interviewee admits to having grown marginally in self-awareness over the years. “At night, I force myself not to get out of bed more than once or at most twice to go back and check the lights. I force myself not to sweep an already swept floor just because I’ve seen 2 hairs. I’m more realistic about the knowledge that it’s an illness, not a normal state of mind.” When asked what influenced this improvement, she cites her family as a driving force. “It made them unhappy the way I was and to see me like that. It took a toll on us all.”
When asked what she thinks of OCD being considered a quirk, she says: “That’s ridiculous. A quirk is flipping a penny into a pond when you pass one or eating only with brass utensils. Having an obsessive disorder is an illness and […] limits the level of happiness and contentment you get out of the moments that make up life because you waste several of those moments doing absolutely needless, pointless things just so that you feel okay—but it’s temporary. People who think it’s a cute quirk have obviously never met anyone with actual OCD.” Coming back to this thought, it’s important to make the distinction between somebody who merely has unusual or intrusive thoughts versus somebody whose daily functioning is hindered by their obsessions and compulsions.