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Try telling someone you have OCD, and there are some stock responses you’re likely to be on the receiving end of. Aren’t we all a bit OCD? I know what you mean. I just hate it when things aren’t straight. Can you tidy my house? The fact is, people love to squeal that they’re sooo OCD about this, that, and the other. They use the term to mean a funny or cute personality quirk that involves them quite liking things to be just so.
In reality, OCD is not a synonym for perfectionist, nor is it a scale for anal retentiveness upon which we all fall somewhere. Those who suffer from OCD experience obsessions that cause them distress, and respond to those obsessions by completing a compulsion. There are infinite numbers of obsessions someone could have or compulsions they may complete in response; the stereotype that says someone with OCD will have a tidy house where everything is lined up perfectly is untrue. Only some people will have a compulsion to tidy. Equally, OCD is not enjoyable or fun, so finding that having things lined up and colour-coordinated makes you happy doesn’t mean that you have OCD. It is only OCD if the absence of such order causes you debilitating stress and panic.
In my case, I was gripped by a fierce obsession that I was a bad person. Weird and strange obsessions flooded my brain whenever I was awake. From thinking I smelled, to worrying I had been rude, or killed someone with a thought—you name it, if it’s bad, I’ve probably thought it. Intrusive thoughts, random, uncomfortable thoughts that just pop into your head, are common in OCD, and I’ve had many of them. In fact, most people have intrusive thoughts. Have you ever stood on a platform and thought you might jump, or push someone else under a train? That’s an intrusive thought. Most people just think, oh, that was weird, and move on with their lives. People with OCD are highly anxious and likely to attach significance to things. When they have intrusive thoughts, they often become obsessions.
Throughout my life, the compulsions I’ve had in response to these obsessions have varied, I’ve performed strange movements with my body and repeated special phrases, among other things. But the thing that really stuck was making daily lists of hundreds of bad things I might have done. At my worst, I would lie in bed and try to stay as still as possible, since every movement I made seemed wrong. I ended up dropping out of university and finding myself in a locked psychiatric ward, before trundling through two psychiatric hospitals. It has taken me a long time and a lot of therapy to get my life on track.
Why did I become like this? What causes the brain to go so haywire? Professionals and those with the condition often take a medical approach towards answering this question. They talk of genes, faults in different parts of the brain, and chemical imbalances. Maybe that was the reason then, I was just wired this way. But the truth is, researchers have yet to pin down a specific gene, brain area, or chemical that links to OCD. It's more of a working hypothesis that this may well be the case. Where studies do show differences in the biological makeup of an OCD sufferer, the results are frequently conflicting, and it is hard to tell if the differences represent an innate problem, or are just the result of the way the brain is currently functioning.
Is it nurture then? "Did you have a traumatic birth?" I was once asked by a therapist. "Oh lord, do we have to do this?" I was thinking, attempting to shut the conversation down, before remembering: you know what, I did. My mother had sudden preeclampsia and I had to be delivered a month early. "You nearly killed your mum when you arrived," my father tells me regularly, with slightly concerning relish.
The truth is, we don't really know what causes OCD. Researchers aren't sure yet, and they may not know in our lifetimes. Indeed, discussing the causes of mental health conditions is often much like wading through a murky and marshy bog. This can be frustrating for a generation who've become accustomed to having reams of scientific information at our fingertips.
What we do know is that the condition is devastating. It is estimated that 1 to 2 percent of the population lives with OCD. Sufferers frequently wait years before seeking help. For many of these people, including me, the reason they don't confide in anyone because they don't realise they have it. There is much misinformation around what OCD actually is. They know they have strange thoughts. They know they are distressed by them. But they have no frame of reference for what they are going through. The thoughts they have seem bizarre, often frightening. They fear that if they told someone, they'd think they were mad.
Imagine you start to have awful, unwanted obsessions that you are going to kill someone you care about, despite that the idea is completely at odds with your values and morals. In response, you start compulsively repeating the words no, no, no in your head whenever the thought comes. You now find yourself spending much of the day internally screaming: No, No, No. You see yourself being sectioned off, separated from your family for their protection. Would you be able to tell?
Probably not.
But you might be more likely to, if you knew what having OCD really means.
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