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Monday, April 18, 2011

You are so OCD!

Dr. Jeff Szymanski

Dr. Jeff Szymanski received his PhD in Clinical Psychology from Northern Illinois University in 1997, and has a long track record of teaching and training. He is the author of the upcoming book “The Perfectionist’s Handbook,” and is the Executive Director of the International OCD Foundation.

“You are so OCD!” is a fairly common phrase these days. When I hear someone use it — though I cringe a little inside — I rarely have the feeling that this is a deliberate attempt to make light of obsessive compulsive disorder (OCD). Quite the opposite: I typically get the impression that someone is trying to relate to someone struggling with OCD.

I think some of the confusion has to do with the terms themselves. Obsessive refers to a personality trait describing someone who thinks and worries a lot. Compulsive is also a personality trait, indicating someone who is hyper-organized, detail-oriented, and a perfectionist. In other words, what I think people really intend to say is, “You are being obsessive” or “You are being compulsive.”

Why be so picky about the “D”? When we add “D” — or disorder — to the end of a personality trait or mood state (e.g., depression) it is meant to indicate something very important: intensity. Let’s consider another commonly used phrase: “I’m so depressed.” When people say this, what they mean is that they are feeling a little down, sad, without energy to do anything, etc.

Have you ever met someone with Major Depressive Disorder? It is of an entirely different magnitude. Individuals with a “disorder” are, by definition, in enormous psychological and emotional pain; their day-to-day responsibilities are drastically affected (for example, they may be unable to care for a child or get to work); and the unwanted thoughts and feelings they experience are present for most of their waking day. Additionally, those with disorders experience this over a significant amount of time.

What is your advice to a friend who is feeling down? “Go for a walk.” “Look on the bright side.” “Tomorrow is another day.” “Snap out of it!” “Don’t be so hard on yourself.” Does this advice sound familiar? If you are truly just having a bad day — or bad couple of days — whether you take this advice or not, your mood improves. We all have ups and downs. In this case you are sad, but you don’t have Major Depressive Disorder.

Let’s return to OCD. I have a neat office. I would describe myself — and others would agree — that I am somewhat compulsive. If someone moves something on my nicely arranged desk, I move it back. This is a personality trait. I prefer it that way. I like my things nicely arranged and organized. While I might be annoyed with the person who moved my things around, I am not suddenly experiencing acute and intense anxiety.

When I park my car in the morning and walk away, sometimes the thought occurs to me, “Did I lock the doors?” Though I might feel a little anxious and I might even go back and check the car, I am not suddenly overcome by fears, doubts and catastrophic images. This, however, is the experience of someone with OCD. My doubts and anxiety were minimal to begin with. The thoughts and worries about my car actually go away without me doing anything. Talk with someone who has a diagnosis of OCD. No matter what they do, they are plagued for hours every day, day after day, with unrelenting, crushing anxiety.

I’m not a fan of monitoring and correcting people’s language. As I said at the outset, I don’t think that saying someone is “being OCD” about something is inherently or intentionally mean, inconsiderate or disrespectful. However, stop for a moment and think about what the implications are of mixing a personality trait with a disorder — anxiety and sadness come and go. No big deal. Just get over it. This is your experience of these emotions, so why wouldn’t that be the case for someone else? When you label someone’s experience as disordered, when you really mean the personality trait, what you are ultimately telling people with OCD to do is just get over it.

Posted by: WebMD Blogs at 11:16 am