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More than hand-washing and cleaning: A better understanding of OCD

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When Sheldon from “The Big Bang Theory” tirelessly knocks on Penny's door three times, the audience is supposed to laugh. When Monica Geller from “Friends” cleans obsessively and panics over disorganization, it's reduced to a punchline. When people proclaim they're “so OCD” about whatever, they inappropriately and inaccurately use a mental health disorder and its symptoms to describe cleanliness.

"It does a disservice to the patients, to their communities, [and] their families because this information is misrepresented," Angela Fang, assistant professor in the psychology department, said.

Misuse of obsessive-compulsive disorder (OCD) in our social lingo and media perpetuates harmful stigmas and fails to address the emotional distress and labor behind this disorder.

All too often, compulsions such as hand-washing and cleaning are glossed over and oversimplified as the hallmarks of OCD. However, this does not recognize the purpose behind these rituals nor address the fact that not everyone with OCD has contamination obsessions.

"Obsessions are any intrusive, unwanted, repetitive thoughts, and they can be about a range of things," Fang said. "Compulsions, on the other hand, are more kind of actions. They're more behaviors that are performed specifically to reduce anxiety or neutralize anxiety caused by the obsessions."

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It's important to note that for people with OCD, these thoughts — while extremely distressing — are just thoughts and do not reflect a patient's capability or plan to act on them. Both obsessions and compulsions look different for each person with OCD. While stereotypes typically draw on contamination obsessions (fears around contamination and contracting diseases or illnesses), other common themes include harm, sexual, and perfectionism obsessions. Similarly, where hand-washing and cleaning are the most commonly portrayed compulsions, others also include checking, repeating, and mental compulsions.

"OCD actually has so many symptom dimensions beyond contamination concerns," Fang said. 

Since OCD is such a heterogeneous disorder, the impacts of the coronavirus pandemic vary widely amongst those with OCD. Some of Fang's patients felt validated as more people started to experience and understand the fear of contamination in their own lives, for instance.

"A lot of our patients felt really validated in one camp, and in another camp, they felt much worse because there was the real threat of COVID out there, and that can sometimes prey on their obsessions that ‘Wow, there really is this threat, and the risk of getting this is really high,’” Fang said.

Since those with contamination OCD are already prone to believing the risk of contracting an illness or disease is higher than it actually is, the increased risk of COVID-19 can drastically build upon already existing anxieties.

With disruptive and distressing circumstances such as the coronavirus pandemic, those struggling with OCD may need to practice more self-care to balance their physical health with their mental health. Resources such as the International OCD Foundation exist to support anyone struggling with OCD, whether by helping in the search for a therapist or providing information about the disorder itself.

For those looking to support a loved one with OCD, Fang warns folks not to engage in someone's compulsions with them, as that only helps to accommodate the disorder.

"The rituals really just help in the short term, and in the long term, all the patient has learned is that they have to do the rituals in order to feel better,” Fang said. “It reinforces the idea that you have to do something about these thoughts, when really there's nothing to do …  because the thoughts are just thoughts.”

Instead, supporting a loved one with OCD means helping them not engage in their compulsions excessively and learning more about OCD and its complexities.

OCD isn’t a punchline or a quirky way to describe your behaviors; it's a serious disorder that affects 2.3% of American adults in their lifetime. With mental illness rates among college campuses on the rise, an extension of kindness and empathy can help spread awareness of OCD and break the stigmas held against those struggling.

 

Further resources for those with OCD:

Mental Health at Hall Health

International OCD Foundation

The TLC Foundation

Overcoming OCD: The College Student's Guide

Reach writer Tatum Lindquist at wellness@dailyuw.com. Twitter: @TatumLindquist

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