WHAT IS OCD?

Fact versus Fiction

Jim Dhrymes MD

Private Practice

Unit Chief, Dual-Diagnosis Unit, VA Medical Center - Manhattan

Attending Physician, Bellevue CPEP

Clinical Asst. Professor of Psychiatry, NYU

If you are  arriving via Instagram, you already know what some of the fictional ideas about OCD are. They include:

  • Doing the same thing repetitively, over and over again: in and of itself, this is not OCD. 

  • Getting really into something, like being "obsessed" with it: also not OCD if not associated with key other symptoms.

  • Being a "germophobe" - this is also not in and of itself OCD.

The key components of Obsessive-Compulsive Disorder are obsessions, which are thoughts, and compulsions, which are actions. Both need to be present for the phenomenon to be considered OCD. Why is it important that we figure out whether something is "really OCD" or not? Because of what treatment approach to use.

Obsessions are indeed repetitive in nature, but they take on an intrusive quality, and are typically distressing. In response to the obsessive thought, a compulsion arises, which is typically to engage in a specific activity, such as hand-washing. It is key that both of these are present to a significant degree to the extent that they cause potentially serious problems in a person's life. For example, a person may have repetitive concerns about contamination and wash their hands every few minutes, including at home, to the extent that sores and significant irritation occurs on the hands. Another person may have repetitive concerns about the safety of their home, and return fifteen or twenty times to their home in the morning while trying to go to work, in order to ensure that they did not leave their stove on.

 

Milder forms do exist; I've listed these examples are to give a clearer idea of what OCD means. Just because a situation isn't exactly OCD, it may be another phenomenon for which treatment is available. If you are concerned about OCD or OCD-like symptoms, or are concerned about a loved one, consult with a doctor. Many treatments are available. This is often a difficult situation to bring up as often people feel ashamed or embarrassed, but rest assured that as mental health professionals we have significant experience in encountering these situations as well as providing treatment.