OCD loves to make you doubt yourself. At times, that can mean doubting whether you even have OCD. Maybe you look for every possible discrepancy between your experience and the portrayals you’ve seen on TV, in books, or even in a rigorously fact-checked (yet charming and accessible!) informational blog like this one. That’s because OCD thrives on doubt and isolation, and it can convince you that you are the only person in the entire world who feels the way that you do, and, therefore, that no existing solution can possibly help you.
And often, you don’t have to look hard to find the discrepancies that fuel this spiral. Representations of OCD in media can range from simply inaccurate to truly atrocious. While there is also accurate, informative content about OCD in the world, like information shared by experts and by those living with OCD, these descriptions still may not always perfectly reflect your specific experience. And OCD wants perfection—100 percent certainty. This can feel stressful and even scary if you’re seeking answers (and, like many people with OCD, reassurance).
Here are some reasons you may doubt your OCD or feel like it doesn’t line up with common portrayals—and a reminder that struggling to relate to more commonly discussed descriptions doesn’t mean that you don’t have OCD, or that you’re alone. It also doesn’t mean that treatment won’t work for you. Exposure and response prevention (ERP) therapy is an evidence-based approach that is consistently proven to be the most effective way of treating OCD symptoms—yes, even yours.
What if my OCD doesn’t fit into a specific subtype?
Subtypes are ways of categorizing a person’s OCD based on its theme, or focus. They’re recognizable patterns that can be helpful because OCD can take on many forms. Identifying the context in which your symptoms usually occur can help you better understand yourself and help your therapist direct your treatment to make it more effective.
Contamination OCD, which causes an intense fear of germs, illness, or becoming “contaminated” by certain substances, people, or environments, may be the most commonly portrayed form of OCD, but there are many themes you hear about less frequently. For example, existential OCD, which causes a fixation on big philosophical questions like “Why are we here?” and “What if nothing is real?”; and reading OCD, which occurs when your obsessions and/or compulsions center around what you’re reading, or the way you read. OCD can also shift themes, meaning its focus can change, which can also introduce uncertainty and make it seem more difficult to pin down.
Ultimately, OCD is defined by the specific way in which your brain latches onto a topic, not by the topic itself. It often seizes onto what’s most important to you, which may or may not be captured by a specific subtype. The fact that your OCD doesn’t fall neatly into one of the subtypes you most commonly see discussed doesn’t mean you’re not experiencing OCD. Subtypes are meant to be descriptive, not prescriptive, meaning they’re helpful if they help you. Regardless of your subtype, the treatment for OCD is the same—and will be tailored to your specific obsessions, compulsions, goals, and needs.
I don’t think my compulsions don’t take up a ton of time
You may have heard that one of the biggest issues with OCD is the way compulsions, which are repetitive physical or mental behaviors that you feel driven to perform in response to obsessive thoughts, can be incredibly time-consuming. And this is true for many people. But even if your compulsions don’t seem to be taking up a lot in terms of time, they’re still taking up way more of your mental energy than they should be. After all, every time you engage in a compulsion, you teach your brain that you need to do so to cope with the fears and feelings OCD creates. That means you’re likely to experience more OCD thoughts and distressing feelings, and you’ll feel an even greater need to perform the compulsion the next time. It’s a cycle that can be very hard to break out of—so much so, that sometimes it’s difficult to even notice when it’s happening.
Compulsions can often be deceiving. If you check whether you left your stove on multiple times per day, each individual instance of heading to the kitchen and examining the oven may take only a few seconds or minutes. But those minutes add up, as does the amount of time you spend considering whether or not to check.
It’s also important to note that not all compulsions are obvious, and not all compulsions manifest physically. Mental compulsions occur entirely in your mind, and they might entail constantly replaying past events, or engaging in repetitive thinking by doing something like counting, praying, or repeating a phrase. While these compulsions are invisible to observers, and you might even engage in them while doing other activities (like taking a walk with a friend, or sitting in a work meeting), they function the same way as any other compulsions: They are fueled by the desire to relieve fear, distress, anxiety, or disgust. Every time you do them, you reinforce the false idea that they’re necessary in order to prevent something bad from happening, prove you’re a good person, or keep yourself from causing harm.
My intrusive thoughts don’t cause me anxiety or distress
Intrusive thoughts are awful—and they can be awful in many varied ways. In addition to the anxiety and distress you might commonly see discussed, intrusive thoughts can also evoke feelings like disgust, guilt, shame, and confusion—or all of the above and more, all at the same time. One of the feelings evoked may even be a secondary guilt or anxiety about what it means if you’re not feeling “upset enough” about what you consider to be an objectively distressing image or thought. Your intrusive thoughts can also spur more existential questions, like, “What is the meaning of life?” and “Am I a bad person?” Pondering these quandaries may consume your focus even more than other intense emotions, or it could potentially distract you from the intensity of your feelings.
I don’t feel like OCD prevents me from living my life
If you’ve been dealing with OCD symptoms for a long time, they may feel so familiar to you that it’s hard to recognize just how much they interfere with your life and drive your decision-making. You might struggle to tell the difference between the choices and habits OCD pushes you toward, and those that actually align with your values and preferences.
For example, maybe you care a lot about showing up for your friends, and you also have contamination OCD, which leads to intrusive thoughts about food being poisoned or contaminated that have caused you to compulsively avoid eating anything you haven’t prepared yourself. You may be so used to living with OCD that refusing to eat food prepared by others doesn’t even feel like a compulsion, and when a friend announces they’re having a birthday dinner, you automatically decline the invitation. Even though some part of you may feel disappointment at not being able to celebrate with your friends, you may think of this decision as simply accommodating your preferences or boundaries—when really it’s accommodating, and perpetuating, your OCD.
Or maybe you have noticed some obsessive thinking and compulsive behavior, but you don’t think things are “bad enough” to qualify as OCD. You have an active social life, a satisfying work life, and a fulfilling home life, so what’s a cycle of obsessions and compulsions every now and then, right? You may even have convinced yourself that the perfectionism and “high standards” created by OCD are key to your success.
But the reality is that however much you have been able to succeed while managing OCD alone, you will have even more space to thrive without its interference. What’s more, as life goes on, inevitable stressors occur, and major changes happen, you may also find that your symptoms intensify or are triggered in new ways that you don’t have the skills or understanding to manage. Untreated OCD almost always gets worse over time, and there likely isn’t a human on earth who never encounters any major life changes or stressful moments that could trigger a symptom flare.
How ERP therapy can help
ERP therapy with a therapist specializing in OCD treatment helps you develop the skills to navigate the obsessions, fears, and thoughts OCD throws at you without derailing your life. Identifying what matters to you most, and what you want your life to look like, can give you a clearer picture of the ways OCD is affecting you by undermining your wellbeing and ability to act in accordance with your values.
An ERP therapist might recommend attending the aforementioned friend’s birthday party that your OCD tells you to avoid, even if you don’t end up eating anything at the restaurant. They might also suggest visiting the restaurant alone ahead of the party and trying a dish, or ordering something to eat at home. Steps like these slowly increase your ability to tolerate the discomfort OCD can cause without always resorting to compulsions, showing your brain that the fear response created by OCD is something you can handle. Any of this would happen gradually, and at your pace.
If you’re uncertain about whether you truly need to pursue OCD treatment because you feel like you’ve achieved goals well enough without it, it’s worth remembering that lessening the exhaustion, fear, and overwhelm brought on by OCD symptoms can only help you work towards the things you want, or maintain the things you think you have, more effectively. While you may think that the constant drive to try to counter OCD’s uncertainty has made you fastidious and thorough, learning to tolerate uncertainty through ERP instead of pouring your effort into countering it means you can now use that effort elsewhere.
No matter how your OCD presents, you deserve to stop measuring it against common representations and questioning whether it’s “real” enough to be treated. Grappling with OCD symptoms alone while also balancing all the other stressors of daily life takes an enormous amount of effort and perseverance. Treatment for OCD can help you redirect that impressive energy toward the things you truly care about.
