As I’ve frequently lamented, obsessive-compulsive disorder is an often misunderstood and misrepresented illness. Those with the disorder are often portrayed in the media as “neat freaks.”

It is true that many people with OCD deal with compulsions revolving around the need to have things arranged in some type of orderly fashion. Perhaps specific items (such as desktop articles) need to be lined up or spaced a certain distance from each other. Or maybe there has to be an even number of items visible to the sufferer (such as books on a bookshelf, for example). This type of OCD is often referred to as evening up. Evening up compulsions can also include mental compulsions such as counting, tapping, or touching things a certain number of times. These are all examples of how order, symmetry and evenness are often included in the compulsions of many people with OCD.

Then why on earth is disorganization so common in those with obsessive-compulsive disorder? One of the first things I said to my son Dan after he told me he had OCD was, “Why is your room so messy? Doesn’t OCD make you really neat?” Everything I knew about obsessive-compulsive disorder up to that point had come from the media, and most of what I’d learned was wrong. Many people with OCD have unbelievably messy living areas. I’m not talking about hoarders. That’s a whole ‘nother story. I’m talking about not being capable of keeping your space and belongings in any kind of order.

When Dan was suffering from severe OCD, I saw his college dormitory room, and that memory still makes me shudder. There were papers and artwork, sketchbooks, schoolwork, clothes, art supplies, books, towels, food, and toiletries, all completely covering the floor. When I questioned him about it, he said that once he lost control of the order, he just couldn’t get it back. It was too overwhelming. Perhaps his OCD took so much time and energy that he had none left for the activities of daily living, including keeping his room neat. For others with OCD the need to do everything “perfectly” leads to procrastination in cleaning. They wait until they feel they have enough time, motivation, and focus to clean perfectly. Chances are that time never comes, and like Dan, the chaos builds.

Another explanation some people with OCD give for not being able to keep their living space neat and clean is the fear of germs. While it might seem counterintuitive (if they’re afraid of germs, you’d think they’d clean up), it makes sense in a convoluted way. Perhaps a piece of food was dropped on the floor while cooking. Now the person with OCD feels that food on the floor is seriously contaminated and won’t touch it, so there it stays on the floor. Before you know it there are “germs” everywhere, and nothing can be cleaned or put back in its proper place.

It’s not hard to see that giving into OCD’s demands creates the world that those with the disorder are trying so desperately to avoid. They’re deathly afraid of germs, but are now surrounded by them. They crave order, yet are living in chaos. The list goes on.

Thankfully, nobody has to live this way if they are willing to get help. The vicious cycle of OCD can be beaten with exposure and response prevention (ERP) therapy, and the ability to keep a clean home will be just one of the many benefits of freedom from OCD.