Do You Have OCD, Or Do You Like Things "Just So?"

Are you obsessed with precision and order?  Do things need to be “just so?”  If things are out of place around you, does something feel out of place internally?  Do you double-check or triple-check or quadruple-check to make sure you turned off the stove before you leave the house for the day?  Do you have recurring thoughts that intrude on your day-to-day life?  Are there certain rituals that you repeat constantly in an effort to distract yourself from those thoughts, even if there’s no logic behind the habit?

If the above applies to you, you’re not alone.  In fact many people have these kinds of tendencies. By and large we’re all creatures of habit.  The question is, when do those habits rise to the level of pathology?   When do those tendencies become compulsions?  Where is the threshold that separates the eccentric from the diagnosable? 

Or, to put it bluntly, what separates the obsessive and the extremely orderly from those with OCD? 

WHAT IS OCD?

Most of us have heard the term obsessive-compulsive disorder before; we might have even seen it depicted in movies or television shows like As Good As It Gets or Monk.  But what is it, exactly?

OCD is a condition wherein a person develops thought patterns that become so intrusive and overwhelming that they begin to interfere with their life.  (That’s the obsessive part.)  Eventually the thought patterns become inescapable and oppressive to the point that they begin to compulsively perform rituals in an effort to distract themselves.  In other words, the compulsions are developed almost as a means to cope with the obsessions.

Unfortunately though the thoughts do not go away — at least not forever.  When they inevitably return the individual once again attempts to suppress the thoughts by engaging in these ritualistic behaviors, thus creating a dangerous cycle. 

TYPES OF OBSESSIONS

The range of obsessions and fears people with OCD have is very broad.  Generally though they fall into four major categories:

• Contamination Fears: These are among the most prevalent manifestations of OCD. Typically an individual suffering from contamination fears becomes obsessively fixated on what they perceive as dangers to their health: they worry that excessive exposure to x-rays is going to give them cancer, or that they will contract Lyme disease if they go for a walk in a grassy rural area.

• Accidental Catastrophe: This is when an individual becomes unreasonably worried that they might accidentally harm others. For example, they constantly worry that their apartment building will burn down because they accidentally left the stove on, or that they’ll leave the front door open and their dog will escape and run away.

• Symmetry/Order: People with this obsession are fixated on things being “just so,” and are constantly adjusting and rearranging objects so that they are perfectly aligned. They are perfectionists — but they’re so obsessed with the idea of perfection that they can’t leave good enough alone. Everything always has to be exactly right.

• Taboo/Unacceptable Thoughts: This includes intrusive thoughts about committing impulsive acts of violence and sexual obsessions. Though people with OCD are not typically dangerous, they consider the thoughts themselves to be toxic, and so perform ritualistic behaviors in an effort to stymie them.

TYPES OF COMPULSIONS

Typically there is a causal connection between the obsession itself and the ritual undertaken to combat it.  So a person with contamination fears might wash their hands constantly; a person afraid they might cause accidental harm might check and re-check to make sure the stove is off and the doors are locked; a person obsessed with order might be constantly adjusting and readjusting the arrangement of objects on their desk or in a room.  The compulsions that follow taboo obsessions are harder to categorize, because often they are performed covertly — a product of the shame often associated with these kinds of fixations.

WHAT’S THE DIFFERENCE BETWEEN BEING OBSESSIVE AND HAVING OCD?

The things that people with OCD obsess about are things that might concern many of us.  Who isn’t afraid of getting sick, or occasionally worries that they left the stove on or the front door open?  Who doesn’t like it when things are neat and orderly and clean? 

Joking aside, the problems that afflict someone with obsessional tendencies or traits are, to some extent, relatively common.  So if you felt like this article was addressing you at any point, you shouldn’t be worried.  Not necessarily. 

The question becomes, how do you know if you have OCD, or if you’re just being you?  The only real way to know is to consult with a psychotherapist.  But that being said, there are ways to look at your obsessions and judge if they rise to a diagnosable level. 

• Severity and intrusiveness: When obsessive thoughts and the rituals undertaken to suppress them begin to have an impact on your day-to-day life — when they cause so much distress that they start to affect your social life, or your ability to perform at work — then you might have OCD. Another sign you might have OCD: if you can no longer control your compulsions and perform them even when you don’t want to. If the above applies to you, it might be time to seek out professional help.

• Impact on Time: People with OCD become so fixated on their obsessions that tending to them begins to take up a significant amount of time and energy. So if you're beginning to feel emotionally and physically drained because you’re giving over too much of your life to your obsessions or your compulsions, you might have OCD.

• Awareness: The thing about people with OCD is that they are typically aware of the fact that their obsessions — and the rituals they undertake to distract themselves from those obsessions — are irrational. And yet they are still unable to control their compulsions or change their way of thinking. If you’re able to recognize that your behavior is excessive and your thought patterns are illogical and you still can’t control them, you might have OCD. 

• Flexibility: As we said above, there are many people out there who might have obsessions and compulsions that are similar to the ones experienced by those with OCD. But when those obsessions and compulsions become so severe that an individual can’t cope with a situation where they can't perform their rituals, they might have OCD.

WHEN TO SEEK HELP

If intrusive thoughts are beginning to impact your ability to function, it’s definitely time to seek help.  But anyone who suffers from intrusive thoughts that have a negative emotional impact on them might benefit from therapeutic intervention and or pharmacological intervention.  At Rappore, our therapists are equipped to deal with patients suffering from a wide range of afflictions, including OCD.  Founded by one of the architects of Columbia-Presbyterian’s mental health clinic, Rappore is making best-in-class psychotherapy and psychopharmacology available for as little as the cost of a co-pay.  To learn more about us and the conditions we treat, click the links above.  Or to get started, click here and take our Mental Health Fingerprint survey -- that way, we’ll have a better understanding of you, your problems, and your personality before we match you to one of your therapists.