As someone who was diagnosed with OCD when I was six years old, I’m happy to see the progress we’ve made in breaking the stigma around the disorder. That being said, I’ve also been discouraged by some of the discourse online that oversimplifies the condition.
Nearly every day, I come across a new video, post, or a comment from someone who is self-diagnosed with OCD, typically without actually seeking a professional opinion. Now, I completely understand and empathize with the fact that many individuals do not have the proper mental health resources or access to therapy to get a clinical diagnosis. However, assuming you have a very real, very debilitating disorder without professional confirmation can be extremely harmful and invalidating to both yourself and patients with said disorder.
Why? Because this further spreads misinformation about OCD, which is already rampant on the internet.
Having Intrusive Thoughts Doesn’t Mean You Have OCD. Here’s What Experts Want You to Know.
For example, I recently came across a video of someone claiming to have OCD simply because they experience intrusive thoughts. Now, I totally understand how they made the jump from intrusive thoughts to an OCD diagnosis, as that’s what many people associate with the disorder today. I mean, hey, it’s better than the handwashing stereotype we’ve had over the past few decades, right?
But just because you experience intrusive thoughts—like every other human on this planet, mind you—does not mean you have OCD. In fact, only 1% of children have OCD, while about 2.5% of adults have or will develop OCD in their lifetime.
OCD vs. Intrusive Thoughts
Those with OCD are often crippled by ego-dystonic intrusive thoughts, such as a fear of sexually harming someone, cheating on their partner, hurting a child, or falling out of love with their spouse. Yes, I know these are extreme examples, but they are commonly experienced by those with the disorder. And the reason I’m calling these out to begin with is that OCD has become a quirky label tossed around by many individuals who don’t actually understand the depths and implications of the disorder.
Let me make this clear: Intrusive thoughts are not the same as impulsive thoughts, desires, or urges. Rather, they’re unwanted, involuntary ideas or images that plague OCD sufferers and are typically the opposite of what they’d actually want and value. OCD patients are so hypervigilant that they will flag any and all intrusive thoughts that come across their desk and perform compulsions (like rationalizing or seeking reassurance) to lessen their anxiety and dispel the idea that they’re an awful, dangerous person.
However, according to Joanna Hardis, LISW-S, OCD specialist, cognitive behavioral therapist, and 2x author, what defines OCD is not the experience of an intrusive thought itself, but rather the individual’s reaction to it.
For example, Hardis adds, in response to an intrusive thought, someone with OCD might start thinking/asking themselves: “What does this thought mean?” “What does it say about me and my character?” “What kind of person has these thoughts?” “Am I a dangerous person?” “What if I harm someone?” “Good people shouldn’t have thoughts like this.”
We all have strange, icky thoughts that don’t sit well with us. Just because you have intrusive thoughts like the ones above—and even experience the fear behind them—doesn’t mean you have OCD. It means you’re human. While most people can move on from intrusive thoughts after a while, those with OCD usually get “stuck” and begin to define themselves through these thoughts. They cannot easily separate from them, and so they start to believe they’re a horrid person, filled with guilt and shame.
Obsessive Thoughts Plus Compulsions
Intrusive thoughts—which many people with OCD label “obsessions,” since they’re often on a repetitive loop—trigger such deep, persistent fear and doubt that the individual will then feel compelled to perform compulsions. This perceived sense of urgency and responsibility is a driving force behind the OCD.
“They engage in compulsions, either overt or in their heads, to relieve the distress caused [by] the content of the obsession,” Hardis explains. “Compulsions are a regulatory mechanism, and they work in the short term.”
While some compulsions might be physical, such as the stereotypical cleaning, hand-washing, checking, and organizing, other compulsions can be mental, such as ruminating, seeking reassurance, or attempting to rationalize or understand the intentions behind your own thoughts. These, coupled with obsessions, can become so disruptive and downright debilitating that they interfere with daily life, like work, school, social obligations, and even basic self-care. Typically, that’s what sets clinical OCD apart from obsessive-compulsive behaviors/tendencies.
“People with OCD often struggle to the point of not being able to live what feels like a productive life until they get a handle on things,” says Jerilyn Adams, founder and therapist at Totality Counseling LLC. “Simply having an intrusive thought or liking things a certain way does not make OCD. Also, if you sometimes do compulsions such as checking, cleaning, or researching, the time you spend doing this matters. If you can check once and move on, you’re not experiencing the same thing as someone who does the same thing and also has OCD.”
“You have to meet criteria, and that’s done by a licensed clinician, not TikTok or AI,” Hardis adds. “OCD exists on a spectrum, so you can [have] traits but not meet full diagnostic criteria.”
That being said, these symptoms can still interfere with your life and deserve treatment, even if they’re not considered clinical OCD.
The ‘Doubting Disorder’
A less commonly discussed facet of OCD is its doubting mechanism, which can present in less obvious ways than those noted above.
“At its core, OCD is a disorder of doubt—not just any doubt, but a relentless, intrusive, and distressing form of uncertainty that feels impossible to ignore,” Joshua Fletcher, MSc, PGCert, psychotherapist, writes in his Psychology Today article on the topic. “It convinces you that if you don’t do something—whether it’s mentally checking, ruminating, or seeking reassurance—you’ll be stuck with the anxiety forever, or worse, your worst fear might come true. What makes OCD so difficult to live with is that it tricks you into trying to achieve certainty through the feeling of doubt—which, of course, is a paradox. The more you try to feel sure about something, the more uncertain you become.”
While many of the intrusive thoughts experienced by OCD are ego-dystonic in nature, OCD can also latch onto actual, rational doubt. OCD absolutely despises uncertainty, so any area of our life that’s not 100% set in stone (e.g., our romantic relationships or health) can feel unsteady and unsafe. One common presentation of this is relationship-OCD, a subtype that’s taken TikTok by storm.
People tend to assume they have ROCD simply because they experience overthinking and doubts in their relationships. For many OCD sufferers—myself included—ROCD is a real struggle, as the disorder tends to attack what/who we value most.
Simply experiencing obsessive thoughts or excessive doubt within a relationship does not mean you have OCD. Relationship overthinking can occur without it being clinically diagnosed, and those with OCD can still have valid doubts in their relationships, too.
The difference, as stated earlier, is the individual’s response to those doubts. OCD will often view real relationship worries (both minor and major) as pressing issues that require immediate solutions, rather than ones that can be addressed productively with your partner at a more reasonable time. Sitting with and tolerating the uncertainty for even just a few minutes can feel excruciating to those with OCD, while those without the disorder might be able to delay reassuring conversations or put the doubts on the back burner to prioritize other tasks.
The mere overthinking in and of itself is not automatically OCD; and just because you have OCD doesn’t mean the doubts aren’t real, either. Either way, the goal is to better manage your responses to these doubts and accept the uncertainty as part of life and love.
The Harm of Self-Diagnosing OCD
Labeling natural, human thoughts, feelings, behaviors, and patterns as OCD can be incredibly harmful to the OCD community, as patients already feel misunderstood and isolated. Watching people oversimplify the disorder might perpetuate more confusion, alienation, and shame.
“It could cause people who have been diagnosed with OCD to compare severity or cause confusion about why someone may be able to get over their ‘symptoms’ much more easily than they can,” says Adams. “And to anyone who may have misdiagnosed themselves, they may take on an identity of having a mental health illness that isn’t true for them. It can be hard to come to terms with not having something you’ve told yourself is true and cause further confusion for mental health treatment if you choose to go that route.”
When in doubt, if you feel you might have OCD, it’s always best to consult a professional for a proper evaluation. Whether or not you have clinical OCD, you still deserve the support and treatment that best suits your needs.
The post This Is the Biggest Misconception About Having OCD, According to Therapists appeared first on VICE.
