While most people have heard of obsessive compulsive disorder (OCD), there are many misconceptions about what it truly means to have it. A Baylor College of Medicine expert discusses these common misconceptions and gives her advice on the best treatment options for OCD.
"OCD is characterized by having compulsions and obsessions that are caused by unwanted, intrusive thoughts. Individuals don't want these thoughts, and it causes anxiety and they engage in repetitive rituals, which don't bring them any joy or pleasure. It's something that they do because they feel like they have to in order to get rid of that thought," said Dr. Elizabeth McIngvale, assistant professor in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor.
She explained that one of the misconceptions about OCD is that there is just one, general type but in reality, there are many different categories of the disorder. Some of the main categories are:
- Contamination OCD: This often includes the fear of germs, the fear of blood-borne illnesses and the fear of household or environmental contaminants.
- Scrupulosity OCD: This is a form of OCD where individuals find themselves engaging in repetitive rituals around prayer, morals or beliefs. They get stuck in these types of behaviors and do them with a moral or religious base.
- Checking OCD: Individuals with this type of OCD may repetitively check their locks or their household appliances and engage in a lot of checking rituals to prevent something bad from happening.
- Symptomatic OCD: This can be very similar to hypochondriasis where individuals have intrusive thoughts that they have contracted an illness of some type and get sucked into engaging in compulsions around fears of having a disease.
- Perfectionism OCD: This form of OCD can involve rereading or rewriting documents for hours, checking to make sure that everything is done right even though the individual knows it is done correctly.
- Sexual intrusive thoughts: These are unwanted, intrusive thoughts around sexual behaviors that individuals often find grotesque, appalling or repulsive, and they engage in different rituals to get rid of the thought.
- Harming intrusive thoughts: Individuals fear that they might violently harm somebody or act out even though there is no history and/or intent to do so. A compulsion for individuals with this type of OCD is often to get rid of all the sharp objects in their house or remove all of the items that could be used as weapons.
Another big misconception about OCD is that it is a personality disorder, said McIngvale. There is a personality disorder called obsessive compulsive personality disorder (OCPD) but it is much different than OCD, she said.
"Obsessive compulsive personality disorder, in my opinion, is often what society thinks OCD is. People with OCPD might organize their closet perfectly, have all of their items color-coded and organized by type or category, or if you open their fridge all of their labels are lined up perfectly and everything has a place. However, individuals with OCPD often talk about the fact that there's not an unwanted, intrusive thought and there's no fear attached to these behaviors. They just organize things a certain way or do these kind of compulsive behaviors because it makes them feel better," McIngvale said. "However, with OCD, it is something that individuals don't enjoy – there's nothing they like about it, they are doing it because they feel like they have to in order to get rid of the intrusive thought or fear. It is debilitating and draining and not something that makes the individual feel better and more productive when they are done."
McIngvale also emphasized that it is incorrect to use OCD as an adjective. She gave the example of the improper use of the term as when someone says, "My co-worker is so OCD."
For individuals who think that they have OCD, McIngvale recommends finding a behavioral therapist who specializes in exposure with response prevention therapy, which is a specific form of cognitive behavioral therapy that is offered for OCD. It is the most researched, effective and well-known treatment for OCD. She added that the individual also meet with a psychiatrist who specializes in OCD for medication options for OCD.
"Unfortunately, OCD is one of the disorders that takes, on average, about 25 years for people to get a diagnosis and proper treatment, but I really want to make sure that everybody with OCD knows that there is hope and there is help available," McIngvale said.
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