Last week, within 24 hours, I heard two blithe references to people “being OCD” on TV – one on The Mindy Project when someone said they organize their closet by color and Mindy said they were OCD, and one on Rachael Ray’s afternoon show when a chef said he’s “very OCD” in the kitchen. (Quit judging my TV habits, please.)
This is more than a touch annoying to someone who battles the demon of OCD daily, and my friends with OCD agree that this is one of the more obvious demonstrations of how poorly mental health problems are understood, especially OCD. I’ve recently learned that the World Health Organization lists OCD as one of the 10 most debilitating diseases known to man. Ponder that for a second.
Just to clarify, OCD means Obsessive-Compulsive Disorder. It causes one’s brain to fixate on horrific and terrifying things (these vary but they usually involve death, harming others, sexual aberrations, etc.). The person doesn’t want to have these thoughts and feels overwhelmed with anxiety because of them, leading to compulsions which are an attempt to get rid of said thought(s) – the (warped) reasoning being that, since the compulsion leads to a momentary lessening of anxiety, continuing the behavior will remove the anxiety completely. It doesn’t, but someone with OCD keeps trying their compulsions anyway. Many movies and TV shows have attempted to portray OCD, but they always do so in a very generic way, as with the show Monk or the movie As Good as it Gets, wherein Jack Nicholson plays a reclusive writer who does things like separate his M&M’s by color and turn the lock on his door a certain number of “magic” times.
The problem with these depictions is that it’s impossible to show the inside of a person’s brain, so all people see is the weird behaviors, and thus these sorts of Hollywood characters become lovably quirky rather than the inwardly tormented, often suicidal people that they really are. It’s virtually impossible to explain what it’s like unless someone actually has it. The best TV depiction of OCD is all of the shows about hoarders, as hoarding is a variety of OCD. The person thinks that if they get rid of something, a disaster will happen that could’ve been prevented if only they’d kept that empty yogurt container. Strange, yes, but that’s why those people fill their homes with “junk.” It shouldn’t be any more entertaining to watch than the show Intervention. The hoarding shows should be educational and sad, not entertaining, as they tend to be…”Let’s watch someone be crazy and chuckle at their silliness!”
But here’s the thing that actually makes it a true brain disorder: The person with OCD is every bit as aware as you are that his/her obsession(s) are absurd. My friend Riley who just died of OCD (sure, it will be chalked up to an overdose, but I’m telling you, Riley’s overdose was only an attempt to make his brain shut the hell up for a few hours. Countless people have died of OCD, but not one of them has that listed on the certificate of death…another indication of how little people understand). The person with OCD can offer far more “reasons” than you possibly could of why s/he should quit thinking about these things. And that’s the fucking madness of it, my friends…we want to stop, but our brains won’t let us. Literally.
As I’ve thought about how to write about this issue, here’s the analogy that came to my mind: If you know about ALS (Lou Gehrig’s Disease), it seems like just about as cruel a fate as life could offer. Like Stephen Hawking, those with ALS have brains that remain perfectly functioning while their bodies make it impossible for them to do anything, including communicate. Those who are forced to watch it happen must feel almost as tormented as the person to whom it is happening.
A severe mental illness is essentially the other side of the same coin: One’s brain is the torture chamber while the body remains perfectly normal. By no means am I trying to belittle something as awful as ALS or to say that any one life-sucking affliction is worse than another. Rather, I’m trying to get your attention just a bit by describing the inner torment of a mentally ill person. I once said to a counselor that I’d agree to have my legs removed in order to get rid of OCD…in a heartbeat. She sort of looked at me doubtfully, and I reiterated it: “I wouldn’t even hesitate for a second.” Others with OCD have echoed my sentiments throughout the years.
Let me tell you about the treatment for OCD so you might understand why so few people are willing to follow through with it. If medication is ineffective, the only other hope for someone with OCD is to undergo Exposure and Response Prevention (ERP) treatment. I tried this for awhile, but my obsessions are so intangible and my compulsions virtually unnoticeable and unstoppable because they are about 95% internal, the doctor agreed that I was hard to treat. But in the same conversation he told me that the easiest version of OCD to treat is germophobia.
Now, if you’re someone who carries around hand sanitizer and uses it a lot, you are NOT a germophobe. A true germophobe might take a shower that lasts 3 hours and come out bleeding or raw from scrubbing themselves so hard. If they mess up their shower rituals, they will start all over to make sure they do it “right.” A germophobe isn’t someone you see on a plane wearing a mask. A germophobe isn’t on the plane at all because they are locked in their house vacuuming a room 18 times in a row to make sure they’ve done it “right” and gotten all the dirt up. If someone has OCD, they are in a mental prison than never goes away – ever. I have literally had the same maddening thoughts in my head (see my book) for 12 years, and I cannot think of a moment when those very thoughts are not at the forefront of my brain.
So, the ERP treatment for this true germophobe, according to the doctor I saw is one of two options: 1. Don’t bathe or wash your hands for a week. 2. Put your hands in the toilet and don’t wash them while sitting with the doctor for your entire session. Even a completely normal brain would struggle with either assignment, I suppose, but in the context of OCD, you are asking someone to do something that scares them so much that their lives are completely dedicated to preventing the disaster that might happen by being exposed to a germ. If you’re scared of heights, this would be equivalent to being forced to stand on the plexiglass platform jutting out into thin air at the Sears Tower for an hour. Or if you’re scared of snakes, this would be equivalent to letting snakes crawl all over you for the 45 minutes of an ERP session.
Why do I feel compelled (funny pun, huh!) to write all of this? It’s not so you’ll feel sorry for me or anyone else with OCD…It’s so you’ll be a bit more thoughtful about minimizing the torment of mental illness. If you like your closet a certain way, don’t say you’re “OCD.” If you having an emotionally up and down week, don’t say you’re bipolar. Shoot, you might not even want to say “I’m depressed” when you have a bad day anymore. These things aren’t jokes. They take people’s lives away in a literal sense but even those of us who haven’t harmed ourselves are living in a prison that you can’t see. Even when we act like we’re doing okay, we’re actually hiding from the embarrassment of telling you how hard things actually are (see my post about why “how are you?” is the world’s toughest question).
Over the past few years, I’ve had two casual conversations with business men who have said OCD is a great quality in employees because “those sorts of people” do the best work. My friends, this is akin to telling someone you think cancer is a great quality because you prefer bald heads to hairy ones.
Even psychiatrists and therapists will tell you that OCD is one of the least understood mental illnesses. Depression, bi-polar disorder, anxiety, and ADD are FAR better understood and more easily treated than OCD. There are some anti-depressants that happen to help with OCD, but there is no such thing as a drug specifically for OCD, as there are for the other mental illnesses I just listed. If you have OCD, doctors basically start throwing darts semi-blindly and hoping one of them gets close to the problem. Often, medications don’t work, and for obvious reasons, people resist the idea of ERP. Then comes the decision of how long one is willing to live with the inner torture.
So this post has been a tad heavy, no? At least the comic at the top is funny, right? But I don’t write this to weigh you down, but as always, with the hope of educating a few folks as to the often-hidden suffering of those with a mental illness. Eventually, I have no doubt that the masses will recognize mental illnesses for what they are – faulty wiring in the brain – no more and no less. But sadly, we still live in a world where, according to one recent survey, nearly 50% of evangelical Christians still believe that prayer is all that’s needed to heal a mental illness. Would they say that about cancer? Obviously not. In the 1980’s, many people thought AIDS was God’s judgment on gay people. Thankfully, with enough education, most people don’t see it that way anymore. I hope that mental illnesses will be next in line to get fair treatment in the minds of the mentally healthy, but the only way that will happen is for people to get educated.
So, as always, I’d like to suggest that you either reach out to someone you know who’s battling a mental illness to let them know they are not alone. Or if you know someone who might need a bit of education on these matters, share this post with them.
Thanks for putting up with some not-so-light reading! You’ve survived. I’m done.
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