When you’re just the way you are… and when you might benefit from treatment

By Patrick Carey
6 minute READ
Featured media

We hear from lots of people who aren’t sure whether or not they really need OCD treatment. They ask questions like: Isn’t this just how I am? Does it really matter if I do that? Would my life really be better if that were different? So what does it mean to have a mental disorder/condition/illness? And where’s the boundary between “We just are the way we are” and “It may be time to talk to someone about that?”

You’ll probably be unsurprised to hear there isn’t really an easy answer to these questions. We can go through the specific symptoms for each condition. But even with those symptoms there’s a missing piece: in most cases, symptoms become a diagnosable mental health condition when you feel like it’s a big problem in your life. There are certainly exceptions, like when a mental disorder causes someone to do something drastic and they find themselves in treatment without any choice, or when someone’s family steps in and forces them to get treatment. But because most mental health conditions can’t be easily detected by other people, there’s a greater burden on most patients to recognize that their life is being negatively impacted and find help.

We’re not always great at deciding for ourselves whether or not something is negatively impacting our lives, and even when we do make this decision it can be difficult to find treatment. It might take someone we trust letting us know that we seem to be suffering unnecessarily for us to finally seek change. Or sometimes we end up in one of those “breakdown moments” when it becomes impossible to ignore the problem any longer.

Think You’re Living with OCD?

Take this quiz

Instead of rambling on further, here are a few scenarios:

It’s important to me that things are really neat and tidy

A man organizing things

A lot of people like to keep things clean, and in most cases it’s not a bad thing. Here’s the thing: it’s not really the behavior (cleaning or tidying up) that’s the problem. It’s the motivation behind that behavior.

Are you doing it because you like having things clean or because there’s a need to have them clean (for example, if you’re having family visit soon and you don’t want the recycling bin to spill over on them)?

Again, things start to look more like “disorders” or “conditions” when there’s a lot of distress involved. If you’ve already tidied up and you still feel like things are not right, it begins to seem like a compulsion. And if it feels like there’s something much larger at stake (to use a common example, if it feels like something bad will happen to someone you love if things are not just right), it’s likely that the behavior is associated with– or will soon be associated with– significant distress.

I just hate using public restrooms or anything like that

Cleaning dirty sink

Public restrooms can indeed be sort of nasty. So can the many subtypes of public restrooms: tiny airplane bathrooms, dark porta-potties, those weird bathrooms on the back of buses that everyone hates you for actually using.

Most people decide to use them anyways… because they sort of need to. Other people find ways to avoid public bathrooms altogether. It’s kind of abnormal to do so, but whether or not it’s a “problem” again requires further investigation.

When you’re afraid, the feared result seems like a certainty, not a small possibility. If you really refuse to do something that most people do, in most circumstances, there’s a decent chance it’s a problem that might benefit from treatment.

People who decide they cannot use public restrooms under any circumstances are likely motivated by an irrational fear of something bad happening to them if they were to use one. But, once again, ultimately you have to decide whether or not there even is a problem.

I’m always apologizing and worrying that I messed up

A woman apologizing

Does it always feel like you’ve messed up in social situations? Do you find yourself lying in bed regretting something hours after everyone else seemed to forget about it?

This level of fear that you’ve done something wrong can really start to come between you and the things you want in life. For instance, you might shut down in social situations instead of talking with people, out of fear that you might mess up and hurt someone’s feelings. In doing so, you miss countless opportunities to meet people and enjoy their company.

A number of conditions can underlie this level of guilt and worry about other people. The point, at least for now, isn’t what condition you might have. Instead, ask yourself: why am I so afraid of bothering or hurting someone that I’m talking with? What assumptions am I making when I assess these situations?

If you can think through all of this, you’re already well on your way to developing a healthier relationship with the risk of “messing up” socially. If you’re not sure where to go next, or you can’t approach this sort of reasoning because there’s too much fear or anxiety involved, you might benefit from speaking with a therapist soon.

This is a very small sample of all the different things you can worry about (hooray!), but hopefully they give you a sense of the way you can start to figure out whether your type of worrying is “normal” or “pathological” (and, yes, these are loaded terms that should be looked at more carefully).

A few themes we can notice from these scenarios:

  1. If you feel like your worry is a problem, it’s a problem
  2. If your worrying bothers you, it’s a problem
  3. If your worry keeps you from doing things you want to do, it’s a problem
  4. If people close to you tell you that your worry is a problem, it might be a problem
  5. If you seem to worry a lot more about certain things than most people, it might be a problem
  6. Worrying about some things, or even most things, is not a problem in itself
  7. Knowing what is motivating you to worry (and behave in a worried way, like avoiding bathrooms or apologizing a ton) is important, but it sometimes it takes a professional to figure out your motivation with you

As always, these thoughts don’t apply to everyone, and you should consult a doctor or therapist about your particular case.

For now, whether you’re feeling calm or anxious, we hope some parts of your day are great!

Until next time,

The nOCD Team

Whether you’re feeling stuck with OCD, concerned about someone you care about, or just curious what a global community of people working together on their mental health looks like, feel free to check out the nOCD website for more: www.treatmyocd.com

Patrick Carey
WRITTEN BYPatrick Carey

Read next