Living with obsessive-compulsive disorder (OCD) is challenging. This mental disorder, defined as a combination of anxiety-inducing thoughts and behaviors, is not only time-consuming, but it can also create significant distress on the individual facing it and take a toll on family, friends, and colleagues.
If you know someone with OCD, you may have found yourself wondering why they can’t just stop the behavior or thoughts. While it’s a natural question when you see a loved one struggling with an OCD obsession or compulsion, it’s not really helping someone with OCD.
In fact, a lot of the questions and comments you might find yourself thinking are best kept to yourself. Not only can they sound unsympathetic, but they could also make the OCD thoughts and behaviors worse.
Here are five things you should not say to someone with OCD – as well as what to say to someone with OCD.
#1 It’s all in your head.
Technically, OCD is all in someone’s head. To be more specific, the brain structures associated with OCD are the anterior cingulate cortex and medial prefrontal cortex. Hyperactivity in the cortico-striatal-thalamo-cortical (CSTC) pathway, a brain circuit that controls movement execution, habit formation, and reward, is involved in OCD.
However, saying this dismisses OCD as a real mental health disorder. Someone with clinical OCD is suffering from a very real and disabling disorder. They work every day to face their obsessions and compulsions, and it is not helpful to hear this type of comment.
This comment could also make the person with OCD feel even worse. OCD is often called the “doubting disease” because it is rooted in doubt. People with OCD might obsess over things like: Did I send that email? Are my hands clean enough? Did I turn the light off? Is the garage door really closed? By saying that OCD is all in their head, you are sending the message that OCD is not a legitimate disorder and that they are making it up. Or if they just demonstrated enough willpower, they could get over it. As a result, the person may doubt whether they have a disability and avoid seeking treatment.
Instead, be an ally and recognize that your friend or family member has a serious mental disability. Not only can you then learn to be aware of when they are struggling, but also how to help them. You also can encourage them to get treatment. Let’s take a look at the rest of our list of “what should you not say to someone with OCD.”
#2 Just stop.
If you have ever observed a friend or family member struggle with a particular OCD compulsion, it is tempting to say, “Just stop!” For example, if they are repeatedly tapping a phone or checking to make sure something “is good” or “just right,” you may feel frustrated and say (or yell), “Stop it!”
Someone with OCD cannot simply stop the behavior. It is called a compulsion for a reason. They are compelled to do the behavior. It is not a bad habit that can be broken.
Rather than telling someone to “just stop it,” instead ask if they are struggling. A simple, “Do you need help?” is a kinder and gentler way to show support.
#3 You’re lucky to have OCD.
A common stereotype about people with OCD is that they are organized and neat. Someone who tends to be messy may joke about OCD being a positive characteristic.
It is important to remember that OCD is not a character trait. It is a mental disorder. Also, not everyone with OCD is organized and neat. OCD manifests across a broad spectrum of obsessions and compulsions. One person’s neat and orderly may be another’s color-coordinated pile of clothes on the floor or another’s excessive collection of an inanimate object. It also could manifest with obsessive thoughts that are not outwardly visible in a behavior.
Clinical OCD consumes at least one hour per day with thoughts and behaviors, but many people with OCD lose hours and hours of their lives every day. Would you want to spend four hours a day making sure your hangers are perfectly aligned or that your shoes are arranged just right?
If you admire a trait about someone like their organizational skills, then speak to that. Keep the OCD out of it. No one feels lucky to suffer from OCD.
#4 I’m a little OCD too.
Unless you have been clinically diagnosed with OCD, don’t use this phrase. Preferring things to be orderly or having a Type A personality does not mean you have OCD. There is a process and criteria for how OCD is diagnosed.
Saying you are a “little OCD” is insensitive. OCD is not an adjective or a way of life. It is a debilitating mental disorder.
#5 Is your OCD gone?
Let’s examine this disorder a little further by asking, can OCD go away? OCD is not the flu. It does not just go away. It is a lifelong illness that needs to be managed. It is common for someone with OCD to overcome a particular compulsive behavior only for a different compulsive behavior to show up in its place. It’s like constantly playing whack-a-mole with obsessions and compulsions.
It is possible for OCD symptoms to decrease – or even for a person to go into remission – but it often takes a combination of therapy and medication. A significant number of OCD patients are treatment-resistant, meaning that medication does not bring sufficient relief. Those patients may benefit from Deep Transcranial Magnetic Stimulation (Deep TMS™).
However, OCD needs to be managed for life. Patients may need their medications adjusted, try new medications, or do maintenance Deep TMS sessions.
If you know someone whose symptoms have decreased or are in remission, it’s important to know how to support someone with OCD. Ask how they are doing from time to time. If their symptoms are returning or getting worse, encourage them to talk to their healthcare provider.
No one wants to feel alone on their mental health journey. By knowing what not to say – and better ways to express your concerns and questions – you can be part of their support system on their journey.