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The Mental Illness that We Joke About


The National Alliance on Mental Illness (NAMI) defines obsessive-compulsive disorder (OCD) as being “characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions).” Obsessions are intrusive and irrational thoughts or impulses that are unwanted and upsetting but still occur repeatedly. OCD is an anxiety-related disorder.

It is a serious mental illness. It is not having your own system for arranging cans, putting away dishes, cleaning, sorting supplies, or keeping up with work tasks. It is not your pattern of mowing the lawn vertically, horizontally, or diagonally. It is not how often you clean out your cabinets and closets. Unless you have personal experience, it is not likely that you really understand how serious OCD can be or the crushing effect it can have on someone’s life. It is not funny at all.

Obsessive thoughts may take the form of thoughts about harming someone, unpleasant images, fear of saying something inappropriate in public, or doubts about having done something that is important, such as locking a door. Any of us could have such thoughts from time to time, but it is the frequency of the thought, the ability to be rational about it, and the fact that it doesn’t interfere with or overwhelm the rest of our lives that differentiates these occasional intrusions from the debilitating disorder that is OCD.

Compulsions are repetitive acts that temporarily relieve the stress brought on by an obsession. People with these disorders know that these rituals don’t make sense but feel they must perform them to relieve the anxiety and, in some cases, to prevent something bad from happening. The urge to act on these compulsions in order to relieve anxiety is often so overwhelming that the person is forced to act, even while knowing their behavior is irrational and possibly while trying to hide it from others. Compulsions can take the form of physical actions, mental rituals, or having to repeat an action a specified number of times. “Checking” can be physical or mental and manifests in many ways.

OCD has a major disruptive effect on a person’s life and relationships. Like any mental illness, it also has ripple effects on those in their family or work circles. Although it cannot be cured, there is treatment to lessen the effects of OCD so that a person can function more normally in society. OCD may be a brain chemistry imbalance which interferes with the body’s ability to use serotonin, a chemical which brain cells use to communicate with each other. About 25% of those with OCD have an immediate family member who is also affected.

This illness cannot be cured, but like most other mental illnesses it can be treated effectively. Diagnosis is made by a professional analysis of symptoms and behaviors and also by medical testing to rule out other causes. Treatment includes psychotherapy and medication. It is not a disorder that anyone should live with but it is one for which the person should seek treatment. You may be the person who provides the encouragement for taking that step. You may be able to look up treatment resources and even provide transportation and support. Although you may not fully understand the illness, you will be helping to relieve someone’s intense suffering.

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