It’s common to hear someone casually refer to themselves as “so OCD” as they show off their perfectly labeled filing cabinet. While many people enjoy a color-coded Post-It note system, even the strongest type-A personality is not necessarily enough for a diagnosis of obsessive-compulsive disorder, or OCD.
The mental health disorder OCD entails having intrusive obsessions, compulsions, or both. Obsessions, according to the National Institute of Mental Health, are anxiety-inducing thoughts or urges, such as the fear of contamination, violence, or aggression, or a need for symmetry or perfect order. Compulsions are the repetitive behaviors—like washing hands excessively or following precise routines—the patient feels the need to do, often as a way to quiet the obsessions.
“People tend to think if you’re doing these things, that you do the ability or the volition to stop,” says psychiatrist Gail Saltz, MD. “And really, when you have OCD, you do not.”
What separates OCD from a mere desire for cleanliness or structure? A person with OCD cannot control and does not get pleasure from performing compulsions. These thoughts and rituals actually disrupt the person’s daily life and relationships.
On average, OCD appears around age 19, but the reason is not always clear. Research has found evidence of genetic, environmental, and psychological factors.
For mild to moderate cases of OCD, psychotherapy can treat the unwanted thoughts and behaviors. A common method is a type of cognitive behavioral therapy called exposure response therapy, which exposes the patient to the anxiety they obsess over (such as germs or objects arranged in the “wrong” order), without letting them perform the compulsion.
Medication can also help treat OCD, especially certain classes of antidepressants such as SRIs and SSRIs. (Learn more about the different types of antidepressants here.) These meds, combined with psychotherapy, can reduce or even eliminate the OCD symptoms. For some patients, however, symptoms may still present themselves, and part of treatment involves learning to manage symptoms on a day-to-day basis.
“Without treatment for OCD,” says Dr. Saltz, “people can ruin their lives. They cannot stop this behavior on their own. It’s really crucial—and the earlier, the better—to seek treatment.”