I'm a little OCD

“It’s like their foot is on the brake telling them to stop, but the brake isn’t attached to the part of the wheel that can actually stop them.”

This post was from my series about obsessive-compulsive disorder. I have moved all my OCD and mental health content to a separate newsletter called Psychology Onions.

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There is a significant lack of scientific understanding about obsessive-compulsive disorder. Because of this, sufferers are often misdiagnosed for many years and end up receiving insufficient or incorrect treatment. According to researchers at the University of Michigan, “The average time it takes to receive treatment after meeting diagnostic criteria for OCD is 11 years.” However, new research¹ is starting to help us better understand this disorder:

In their paper, the U-M researchers focused on the cingulo-opercular network—a collection of brain areas linked by highways of nerve connections deep in the center of the brain. The area normally acts as a monitor for errors or the potential need to stop an action, and gets the decision-making areas at the front of the brain involved when it senses something is “off.”

​​A consistent pattern emerged from the combined data: Compared with healthy volunteers, people with OCD had far more activity in the specific brain areas involved in recognizing that they were making an error, but less activity in the areas that could help them stop.

“It’s like their foot is on the brake telling them to stop, but the brake isn’t attached to the part of the wheel that can actually stop them.”

While OCD was once classified as an anxiety disorder—and patients are often anxious about their behavior — it’s now seen as a separate mental illness. The anxiety that many OCD patients experience is now thought to be a secondary effect of their condition, brought on by recognizing that they are unable to control repetitive behaviors.

People love to say “I’m a little OCD.” For most, OCD is seen as a cute little personality quirk rather than a debilitating disorder—which is fine. I’m not one of those “my mental illness isn’t a joke” types. People are allowed to be wrong—that's central to the human condition. We don’t know like 99.99% of… anything. So when I’m having a beer with a friend of mine and he nods that he also “has some OCD” I don’t hold it against him—he doesn’t know what OCD really is, just like I don’t really know what rickets is. I think rickets has something to do with weak bones and sunlight? Maybe?

Everyone has bouts of perfectionism and superstition, or liking things organized and having some fear around germs. But that doesn’t make you OCD. Lining up paper perfectly on your desk, color coding your wardrobe, or going back to check you closed the garage door doesn’t make you “a little OCD.” Saying you’re “a little OCD” is like a recently-elected city council member in Des Moines saying he’s “kind of the President of the United States.” 

The distortion of OCD from mental illness to personality trait isn’t unique to the condition. Anxiety, depression, ADHD, paranoia—we all have a bit of this in our lives. That doesn’t mean we all have a mental illness. For example, no matter how many TikTok videos we see sponsored by Cerebral/Ahead/Done—everyone can’t have ADHD. I’ve been scalping cats for years! Who knew that was ADHD all along!!!

When you haven’t told anyone you have ADHD for 8 minutes.

So who can we blame for this miscategorization of OCD as a personality trait rather than a mental illness? The media? Is it the media? The powerful elite? Beff Jezos? Hollywood? Hollywood definitely isn’t helping. Hollywood loves showing OCD as a strait-laced condition with some home organization, counting, and cleaning rituals. Having trouble convincing someone in the movie industry to pick up your screenplay? Just give your main character a few counting rituals and excessive hand washing pizzazz and watch Hollywood execs literally blow a hole through their pants with excitement.

Let’s take the popular detective comedy-drama, Monk. OCD is less like solving crimes with the quirky Adrian Monk and more like sitting on the toilet, pushing toilet paper up your ass for an hour, making yourself bleed and ensuring you’re late for a family reunion.

OCD is disturbing. It’s fucking disgusting. Humiliating. Shameful. I’m at the family reunion, but I’m not, really. I’m talking to my cousin but my incessant thoughts are digging into my brain like finishing nails. I don’t think this is exactly the kind of T.V. content the USA Network was thinking about when they gave Adrian Monk his little “OCD gimmick.”

My OCD introduced itself when I was fairly young. I just didn’t have a name for it yet. During my middle school years, an “impure” or fleeting sexual thought meant I was contaminated. If a thought crossed my mind, whatever I was touching or looking at was “dirty.” I would Lysol my bed sheets and spray the ceiling with bleach and wash and rewash chairs and door handles and books and light switches. I would ritualize my showers—and I would have to start the process over if a sinful thought crossed my mind.

When I got older, I became acutely paranoid. What if I killed somebody on my drive home? I would circle the block, retrace my journey, go back to where I started. I would make sure there wasn’t a dead body in the street, a totaled car I ran off the road. Then I would circle back again to make sure I didn’t miss anything. Then again. And again. And again. Because I killed somebody. I just know it.
I killed somebody.

I killed somebody.

I killed somebody.

I killed somebody.

I killed somebody.

I killed somebody. I know it.

But anyway. You get it. I’m just a little OCD. 

Missed last week’s post? 📚 Read it here.

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Again, this post was from my series about obsessive-compulsive disorder. I have moved all my OCD and mental health content to a separate newsletter called Psychology Onions.

1. Stuck in a Loop of ‘Wrongness’: Brain Study Shows Roots of OCD; link here