“I need to wash my hands every time someone touches them.”
“I can’t stop doing homework. Even when it’s perfect.”
“I have to check all the locks and stoves before I leave. Repeatedly.”
“My thoughts consume me.”
These are the things that people with obsessive-compulsive disorder (OCD) may face every day.
Obsessive-compulsive disorder is distinguished by irrational thoughts or fears that further lead to tedious and repetitive behaviors. According to an Anxiety and Depression Association of America 2014 study, 2.2 million Americans are diagnosed with OCD — including some students on Cal Poly’s campus.
192 of the 856 students at the Cal Poly Disability Resource Center have self-reported psychological impairments. The majority of these psychological impairments are anxiety cases, which include OCD.
Graphic by Celina Oseguera
The history
First acknowledged in the 1600s, and once labeled simply “religious melancholy,” OCD evolved as a concept based on Sigmund Freud’s ideas of mental structure, mental energies and defense mechanisms, according to Stanford Medicine.
As time went on, advances in medicine have allowed scientists and psychologists to understand the biology of the disorder.
OCD at Cal Poly
Eric Goodman, a licensed psychologist and lecturer at Cal Poly in the psychology graduate program, specializes in treating OCD. Goodman has helped more than 100 Cal Poly students diagnosed with OCD.
Those diagnosed with OCD overreact to scary and unpleasant thoughts in their heads, and in an attempt to get rid of these thoughts, create ritualistic behaviors, Goodman said.
“The compulsions make the obsessions stronger and last longer,” Goodman said. “People feel stuck in a cycle.”
Those suffering from OCD often know their thoughts are completely irrational, but are incapable of stopping them. The compulsions they experience can range from aggressive compulsions to contamination obsessions to religious obsessions to repeating rituals, like rewriting over and over again. It varies from person to person, depending specifically on their case.
Animal science sophomore Katie Mazer was diagnosed with OCD in fourth grade.
At that age, Mazer would have to hear her parents say goodnight to her every night before bed. It was more than habit. It was more serious than that.
“If my parents didn’t say that they loved me back, every night before I went to sleep, if it wasn’t the last thing I heard, I thought they were going to die,” Mazer said.
Video by Erica Evans
Mazer sought out professional help early on and now knows how to minimize her compulsions in her everyday life.
Cause
Vanessa Dominguez, Training & Transitional Services Coordinator at Cal Poly Disability Resource Center, has 13 years of experience working with a variety of mental disorders, including OCD.
While there is no clear cause for the disorder, according to Dominguez, it is sometimes a result of nature versus nurture — environmental surroundings versus genetic composition.
“Though a person could be predisposed to the condition, it is the epigenetics, or the environment, that can really shape a diagnosis. It can all be intertwined, which is why it is difficult to pinpoint the exact cause of the disorder,” Dominguez said. “Everyone has a variety of different backgrounds and genetic makeups, which may correlate to increased risk for OCD, but which do not define a singular cause for OCD.”
Treatments
Psychologists have developed a variety of different treatments that can help relieve obsessive-compulsive tendencies.
Treatments for OCD include cognitive behavior therapy and pharmacotherapy, according to Disability Resource Center graduate intern Jesse Westfall.
Cognitive behavior therapy can consist of cognitive therapy or exposure therapy; perhaps even both, Westfall said.
Cognitive therapy is when a counselor or therapist tries to talk through the obsessions and compulsions with the patient.
Exposure therapy is another type of therapy that falls under cognitive behavior therapy. In exposure therapy, the patient is not allowed to act upon their compulsions. For example, a patient who washes their hands repeatedly throughout the day would not be allowed to wash their hands in this sort of therapy.
Pharmacotherapy is when the patient is prescribed medication that fits their individual needs.
OCD misconceptions
One common misconception of OCD compulsions is they are the same as perfectionistic tendencies.
People with OCD cannot control the actions that cause them distress. The actions are unwanted behaviors that cause them to act a certain way. It becomes a disorder when the compulsions start to interfere with their social, school and work life, according to Westfall.
Tucking bed sheets a certain way, being overly hygienic or excessively organized are perfectionistic tendencies, not obsessive-compulsive.
Distinguishing the difference between OCD and perfectionistic tendencies is important in understanding the disorder, as well as respecting those who have it, Dominguez said
“You hear the stereotypical term ‘Oh she’s so OCD,’ or ‘That was such an OCD moment,’ and when you step back and realize, that’s actually a disorder, that’s a diagnosis. Someone actually identifies as that way,” Dominguez said. “I know when I step back and think about that, I need to not say that because I’m having a perfectionistic tendency, but I’m not OCD. It’s very different.”
Those who think they may have OCD tendencies can take a screening for OCD provided on the Anxiety and Depression Association of America website, print out the results and show them to a health care professional. This screening is not a diagnosis, only a list of questions to assist the health care professional.
The Cal Poly Health and Wellness Center has counseling services that can help and further lead patients to ongoing care in the community, as well as the Disability Resource Center and PULSE. Academic centers, including within department tutors, offer resources for those with mental impairments as well.