Think you know obsessive-compulsive disorder? Think again. OCD is one of the most misunderstood mental health conditions. Many assume it’s all about being tidy or organized, but the reality is far more complex.
OCD can manifest in ways most people don’t expect, and its impact on daily life can be significant. Here, we separate the OCD facts from the myths—some of these may surprise you.
OCD Fact #1: It’s Not Just About Cleanliness
Pop culture often portrays OCD as excessive hand-washing, but contamination fears are only one form of the disorder. Some people experience fears of harming loved ones, intrusive religious obsessions (scrupulosity), or an intense need for things to feel “just right.”
“OCD is the most complicated thing,” says Alegra Kastens, LMFT, founder of The Center for OCD, Anxiety, and Eating Disorders in New York. “If we look at a massive pizza of OCD, contamination makes up a small slice, and people don’t understand the rest of the pie.”
OCD Fact #2: Yes, People Know Their Fears Are Irrational
Unlike some anxiety disorders, people with OCD are usually aware their fears don’t make logical sense. However, that awareness doesn’t stop the distress. The disorder creates a paradox: The more a person tries to dismiss a thought, the more powerful it becomes. This is why reassurance-seeking and compulsions become so hard to resist.
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OCD Fact #3: It Can Be Devastatingly Time-Consuming
Compulsions can steal hours out of a person’s day. Many people with OCD get trapped in loops of checking, repeating, or mental reviewing, which interferes with work, relationships, and daily life. Some people even struggle to leave their homes because they must go through elaborate rituals before stepping outside.
OCD Fact #4: ‘Being a Little OCD’ Is Not a Thing
Saying “I’m so OCD” when you like things neat is misleading. True OCD is a diagnosable disorder that can cause significant distress. People with OCD don’t enjoy their compulsions—they perform them to reduce anxiety, even when they know it’s illogical. Only 1.2% of U.S. adults actually have obsessive-compulsive disorder, according to the National Institute of Mental Health.
OCD Fact #5: Your Guilt Could Be a Symptom
It’s hard to know where OCD starts and personality ends. “After two decades with OCD, I’ve only recently realized that some of my most annoying behaviors might be linked to the conditions,” says Amy Keller Laird, founder of Mental.
Take real-event OCD, when a person becomes very fixated on a past event—even if it was no big deal, they’ve been forgiven, or everyone else has moved on. “They feel shame that’s very unhealthy,” says Kastens. “It’s not just the event you’re fixating on. There’s some kind of doubt or some kind of story that you’re buying into about that event.”
OCD Fact #6: The Condition Often Includes Intrusive Thoughts
Many people experience fleeting intrusive thoughts, but those with OCD fixate on them, fearing they mean something terrible about who they are. These thoughts can be violent, taboo, or completely irrational. The fear isn’t of acting on them—it’s the distress that comes from having the thought at all.
OCD Fact #7: It Can Make You Doubt Your Own Memories
People with OCD may repeatedly check things because they don’t trust their own memory. Someone with “just right” OCD may feel that an email to their boss must be written perfectly, rereading it for an hour before hitting send, says Elizabeth McIngvale, Ph.D., LCSW, director of the McLean OCD Institute in Houston, who treats OCD patients and has OCD herself.
OCD Fact #8: There’s a Symptom Called ‘Mental Compulsions’
Not all compulsions are physical. Some people with OCD engage in internal rituals, such as mentally repeating prayers or phrases, to neutralize their anxiety. This is why OCD is sometimes called “the doubting disease”—the mind refuses to accept uncertainty.
OCD Fact #9: It’s Not Just About Fear—It’s About Certainty
OCD is often driven by the need for absolute certainty. Since life is inherently uncertain, the disorder fuels an endless loop of checking and reassurance-seeking. For many, this need for certainty is stronger than the fear itself.
OCD Fact #10: Exposure Therapy Is the Gold Standard for Treatment
One of the most effective treatments for OCD is Exposure and Response Prevention (ERP), which helps people face their fears without engaging in compulsions. Many people have found ERP to be life-changing, though it can be difficult at first.
OCD Fact #11: It Can Masquerade as Perfectionism
Some people with OCD need things to feel perfect before they can move on. This is different from ordinary perfectionism because the anxiety is overwhelming and irrational, and begins to hold them back in other areas of their lives.
OCD Fact #12: Some People Struggle with Harm OCD
Harm OCD involves intrusive thoughts about hurting oneself or others—despite having no desire to act on them. This can be terrifying and lead to avoidance of certain objects or situations. “You add a layer of shame and stigma that people with very taboo obsessions have,” says Kastens.
OCD Fact #13: It Can Be Completely Invisible
Purely obsessional OCD (Pure O) involves intrusive thoughts without visible compulsions. People with Pure O still experience mental rituals and avoidance behaviors, making it just as distressing. This is one reason OCD is so misunderstood, says Kastens, who herself has OCD. Contamination obsessions and compulsions (touching, washing) are physical. Mental compulsions can’t be seen, so they’re less known.
OCD Fact #14: Symptoms Can Change Over Time
What someone obsesses over in their teens might not be what they fixate on in their 30s. OCD symptoms often evolve with different life stages.
OCD Fact #15: It Makes Relationships Difficult
OCD can color every aspect of adult life, including relationships, says McIngvale. You might get stuck in a cycle of doubt: What if he doesn’t really like me that much? What if she’s lying to me?
This type of obsessional thinking is sometimes called relationship OCD, and it can lead to ambivalence, clinginess, or distress for both partners. Additionally, certain OCD subtypes, such as contamination OCD or intrusive sexual thoughts, can make intimacy difficult, as compulsions and fears may interfere with physical closeness.
OCD Fact #16: The Media Gets OCD Wrong—A Lot
Shows and movies often misrepresent OCD as a quirky personality trait instead of a debilitating disorder. This misguided portrayal fuels stigma and misunderstanding.
OCD Fact #17: OCD and Depression Often Go Hand-in-Hand
A study in the Frontiers of Psychiatry found that living with OCD can be exhausting, leading many to develop depression. The constant battle with intrusive thoughts can drain emotional energy.
OCD Fact #18: People with OCD Can Be High-Functioning
Some people with OCD can work, socialize, and mask their symptoms. But that doesn’t mean they aren’t suffering internally.
OCD Fact #19: It’s Not a Choice
No one chooses to have OCD, and it’s not something that can be turned off with willpower alone. Telling someone to “just stop,” or giving them so-called tough love, doesn’t help.
OCD Fact #20: Talk Therapy Could Make It Worse
While ERP is the gold standard, general talk therapy could backfire. “[It] can ultimately serve as one big compulsion if the therapist lacks training in evidence-based treatment for OCD,” says Kastens.
“The client comes in and brings up an obsession, and the therapist becomes a co-compulsor,” she says. “And you spin and spin and spin, ruminating out loud with the therapist offering repeated reassurance. You’re not getting out of the obsessive-compulsive cycle, you’re maintaining it.”
OCD Fact #21: You Are Not Your OCD
One of the most important things for people with OCD to remember: OCD does not define you. With the right support, you can take control of your life.
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