In some cases, people’s obsessions and compulsions might be quite obvious and they will present with a classic case of OCD. Sufferers who fear contamination (obsession) and wash their hands until they bleed (compulsion) are a good example.
But it is not always that easy to figure out if you or someone you care about has the disorder. Some symptoms of OCD might not seem as if they are symptoms of anything at all. For example, at least a year before we knew my son Dan had OCD, he stopped choosing what clothes to put on in the morning. “Just pick out anything for me; I don’t care what,” he’d say.
While I might have thought this behavior was a little odd for a teenager, it never once crossed my mind that Dan was consciously avoiding making decisions. I now know that this is not an uncommon symptom of OCD. If Dan didn’t have to decide what to wear, or what movie to go to with friends, or give his opinion on anything, then he would not be responsible for anything bad that might happen as a result of his decision.
As is typical for those suffering from OCD, Dan intellectually knew his thinking made no sense, but nonetheless felt compelled to do whatever his OCD told him to do. There was always that doubt, that uncertainty, which is another mainstay of OCD: “What if I wear my blue shirt and then someone I love dies?”
Reassurance-seeking, such as asking “Are you sure everything is okay?” is a common compulsion in OCD. As a matter of fact, when Dan entered his residential treatment program, cell phone use was discouraged because so many clients would continually call home for reassurance. I told Dan’s social worker that he never asked for reassurance, and that was true. But what he did do was routinely apologize for things most people would never apologize for. He’d say things such as “I’m sorry I spent so much money at the supermarket,” (when he actually hadn’t) and I’d answer, “You didn’t spend that much; you have to eat.” Now it is easy for me to see that Dan’s apologies were a form of reassurance-seeking and my responses to him were classic enabling.
Of course, a lot of people avoid making decisions, and I’m sure just as many are always saying they’re sorry. I am in no way suggesting they all have OCD. What I am saying is that OCD can manifest itself in countless ways; no two OCD sufferers will have exactly the same combination of obsessions and compulsions. Couple that with the knowledge that there are still lots of therapists out there who are not that familiar with OCD symptoms and proper treatment, and you could have the makings of a difficult diagnosis.
If you have, or think you might have, obsessive-compulsive disorder, I can’t stress enough the importance of finding a competent health care provider who has had experience, and success, in treating sufferers with exposure and response prevention (ERP) therapy, the first-line psychological treatment for OCD. Only then will you be able to fight this potentially devastating disorder head-on.