In A Nutshell
We all know those people who need to have things just so. Their tendencies might be the target of jokes, but those with real obsessive-compulsive disorders can find that their need to have things just right or their need to repeat things over and over again can ruin their lives. When habits become time-consuming, cause a person mental or emotional distress because they can’t stop their thoughts, and when their compulsions—which they do in order to try to alleviate that distress—only make it worse, they’re not just being anal-retentive, and it’s no longer a cause for jokes.
The Whole Bushel
We all know those people. They’re the ones that have to have their books neatly alphabetized by author, they’re the ones that have their closet organized by color and they may also be the ones that have certain silverware for certain foods. We call them anal-retentive, we call them OCD . . . and even though it’s probably the condition that’s easiest to joke about, for those who have obsessive-compulsive disorder, it’s not a laughing matter at all.
So what’s the difference? Where’s the line that someone crosses when they go from just being picky to being diagnosed with a mental disorder?
In order to be diagnosed as obsessive-compulsive, there are some criteria that have to be met aside from just liking things a certain way and insisting that things be done in a certain manner or order.
Those with OCD can have obsessions, compulsions, or both. The difference there? Obsessions are things that a person sees in their mind over and over again. It can be a mental image that keeps infringing on daily life, or it could be a repetitive thought that keeps intruding on your daily routine, showing up in your mind no matter what you’re doing. We all have things that repeatedly distract us from our daily businesses, but those with true obsessions know what they are and try to make them go away with no success. If the obsession is with a certain activity, getting the chance to perform it—or thinking about performing it later—doesn’t relieve the stress, pressure, or obsession.
Compulsions are defined as behaviors that a person has to perform over and over again, such as checking to make sure the front door is locked, organizing items in groups of arbitrary size, or needing to keep things in a specific order. Most often and most importantly, these rituals become not just a part of daily life, but the person feels that they must repeat them every day in order to keep something horrible from happening.
On the surface, some of those can seem like a person’s just being a little anal. To those watching, it might not seem important that you check the front door five times to make sure it’s locked, and it might be easy to tell them to just stop being anal. But there’s more to it than that.
In order to be diagnosed as suffering from obsessive-compulsive disorders, the routines that a person goes through must take a significant amount of time—so much time that it interferes with their ability to accomplish their daily chores, it hurts their ability to interact in social settings, and it can often interfere with their ability to do their jobs. The person must also know that they don’t like their obsessions, thoughts, and habits. Those who are just anal can take pleasure in organizing and re-organizing, in keeping things neat and tidy and in their proper place. For those who have OCD, however, there’s a sense of extreme distress that accompanies a disruption in their routine.
There’s also often a sense in the person’s thoughts that they know it’s not absolutely, 100 percent necessary that they go through their routines, but they have absolutely, 100 percent no choice but to do so. Someone who’s anal might be annoyed that they can’t have their favorite soup spoon, but it doesn’t mean they’re not going to eat their soup—they might just grumble about it a bit. Someone who has OCD and needs to tap their bowl five times before they eat a spoonful won’t just be annoyed if they can’t do it, they’ll be downright distressed and agitated.
OCD can also exist alongside other disorders, but it’s also important to note that obsessions or compulsions related to, for example, food consumption don’t make someone who’s been diagnosed with an eating disorder also obsessive-compulsive.
Show Me The Proof
Centers for Disease Control: Diagnosing OCD
National Center for Biotechnology Information: Obsessive-Compulsive Disorder: Core Interventions in the Treatment of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder