The following statements describe perceptions that people may have with regard to obsessive-compulsive disorder (OCD), including the nature of the problem, its known causes and the available treatments.
Some of these statements are true, some are false and some are partially true. Enhance your understanding of OCD by going through them.
Myths and Realities about OCD
1. OCD is extremely rare.
FALSE
This was believed to be true until the 1980s.
2. OCD affects men and women equally often.
TRUE
This is one of the few psychological disorders that is equally prevalent among men and women.
3. OCD affects approximately two to three people out of 100 (2%-3%).
TRUE
Numerous studies in multiple countries suggest that this figure is reliable, both in adults and in adolescents.
4. OCD is categorized as an anxiety disorder.
TRUE
It is categorized with phobias, panic disorder, agoraphobia, generalized anxiety disorder, etc. Each of these disorders has its own distinguishing characteristics.
5. OCD is often associated with depression.
TRUE
For some individuals, OCD occurs following a depression. For others, depressive episodes seem to be a consequence of OCD: that is, fatigue, lack of motivation, etc., may lead to a depressed response.
6. OCD can begin at any age.
MOSTLY TRUE
Most people with OCD begin to have at least some symptoms before the age of 40.
7. People with obsessions (e.g., aggressive thoughts) but without compulsions (e.g., compulsive checking) are also considered to have OCD.
TRUE
Approximately 20% to 30% of people with OCD do not have any compulsions that are visible to others (e.g., cleaning, checking, hoarding, organizing); they mainly have invasive thoughts. There are now treatments available for both forms of OCD.
8. OCD is caused by stress.
PARTIALLY TRUE IN MANY CASES
Stress may trigger or deteriorate into OCD, but it is never the sole cause.
9. OCD is caused by a biochemical (serotonin) imbalance in the brain.
SEEMS TO BE TRUE FOR MANY
This idea is based, for the most part, on the fact that medications that are effective for OCD act on the serotonin system.
10. OCD is caused by genetic factors.
PROBABLY TRUE IN SOME CASES
In approximately 50% of OCD cases, another member of the family (e.g., a parent, sibling, grandparent, cousin, aunt or uncle) also suffers from the disorder. Genetic factors therefore seem to play a role in some cases.
11. The exact causes of OCD are unknown.
TRUE
Many hypotheses exist. There seem to be many contributing factors, but there is no single cause. However, it is not necessary to know the exact causes of OCD to treat it effectively.
12. People with OCD have the potential to lead a full life.
TRUE
This is the primary objective of therapy.
13. Some forms of OCD are worse than others.
FALSE
For people who are suffering, it is always the form that affects them that seems the worst.
14. I could lose control of myself because of OCD.
FALSE
People affected by OCD are usually more in control of themselves than the average person.
15. I could be dangerous because of OCD.
FALSE
People with OCD are no more dangerous than people without it.
16. I am truly different from others because I have OCD.
FALSE
OCD does in fact govern a part of one’s life for people who suffer from it. However, it does not define them: it’s a problem that affects an aspect of their life among many others.
17. OCD arises from unconscious conflicts.
FALSE
Numerous psychoanalytic papers have suggested this explanation. However, there is NO scientific proof supporting the idea that OCD is due to unconscious conflicts.
18. OCD is caused by a neuroanatomic deformation or anomaly in the brain.
POSSIBLY TRUE IN A SMALL MINORITY OF CASES
This kind of problem has been observed in a small number of people who have symptoms similar to OCD, but there is no proof that it is true for most people with the disorder.
19. OCD is caused by an infection in the brain.
POSSIBLY TRUE IN A SMALL MINORITY OF CASES
This kind of problem has been observed in a small number of people whose behaviour is similar to OCD, but there is no proof that it is true for most people with the disorder.
20. OCD is little known and understood by the majority of health professionals (doctors, psychologists, etc.).
UNFORTUNATELY TRUE
Many health professionals will recognize OCD when people have well-known symptoms, such as washing one’s hands or checking things compulsively, but few will recognize the lesser-known forms. Professionals who do not frequently encounter people with OCD often have difficulty understanding the disorder.
21. OCD is a sign of stupidity.
FALSE
Studies have shown that there is no link between OCD and intelligence.
22. I cannot have children because of OCD.
FALSE
There is no proof that the children of people with OCD will also suffer from the disorder.
23. OCD is a form of insanity.
FALSE
Most people with OCD are afraid of going insane, but this is just a fear, not a reality.
24. OCD adversely affects my whole personality.
FALSE
OCD may seem to be highly integrated into the affected person’s personality, but they have qualities that are independent of it. OCD is a disorder, not a person.
25. If I have OCD, I will suffer from it all my life.
FALSE
While they may remain vulnerable, the majority of people who benefit from behavioural therapy do not continue to have OCD for their whole life.
26. Mild forms of medication can cure OCD.
GENERALLY FALSE
There are many anecdotes regarding people who have benefited from one kind of treatment or another. It’s entirely possible. However, there is no proof confirming it. There is, however, evidence showing that, in general, pharmacological and behavioural therapy are effective in reducing OCD symptoms.
27. There are medications that can cure OCD.
PARTIALLY TRUE
Many people are helped by medication, but few are healed. The degree of improvement varies from a little to a lot. For some, OCD does not recur once the medication is stopped, but many report that symptoms do recur. Behavioural therapy significantly reduces the risk of symptoms recurring.
28. There is no effective treatment for OCD.
FALSE
Cognitive-behavioural therapy and pharmacological treatment have been shown to be effective, either alone or in combination.
29. Cognitive-behavioural therapy treats the symptoms but doesn’t deal with the real causes.
FALSE
Cognitive-behavioural therapy treats the symptoms and also the various factors (stress, personality, personal experience, etc.) that contribute to maintaining the disorder. The symptoms seem to be the main obstacle to people’s normal functioning in their professional, family and social lives. No other causes of their suffering have been identified.
30. Cognitive-behavioural therapy is the treatment of choice for OCD.
TRUE
Other forms of therapy can help people. However, cognitive-behavioural therapy is the only one whose efficacy has been shown numerous times.
31. Antidepressants that act on the serotonin system (a neurotransmitter in the brain) are known to be effective for OCD.
TRUE
Luvox, Zoloft, Prozac and Paxil (selective serotonin reuptake inhibitors, or SSRIs) have specific effects on the serotonin system. Anafranil and other SRI medications have a powerful effect on the serotonin system but also have an effect on other neurotransmitters. Other medications may be used in combination with SSRIs and SRIs to enhance or maximize their effects.
32. If I have already tried cognitive-behavioural therapy without success, I have less chance of being cured.
FALSE
Some people do not completely overcome OCD in one course of therapy. The success of the treatment depends on the therapist’s competence and the patient’s motivation to change and level of comfort with and confidence in the therapist. A “failed” first attempt is often due to the lack of one of these elements.
33. If I take medication to treat OCD, I’ll have to take it all my life.
FALSE FOR MANY PEOPLE
A significant number of people manage to reduce and eliminate medication, especially after benefiting from behavioural therapy. However, others prefer to keep the support offered by medication, sometimes at a very reduced dosage. For example, people who have already experienced several relapses or who have a history of recurring depression may decide to continue taking medication.
34. If OCD is based on genetic or physical causes, then psychotherapy won’t have any effect.
FALSE
Genetics are one factor among many that contribute to the disorder or make the person vulnerable to it, but psychological processes are what seem to maintain the problem. We work on those processes.
35. If medication doesn’t work for me, behavioural therapy won’t help me either.
FALSE
While medication and cognitive-behavioural therapy both cause similar changes in parts of the brain that seem to be overactivated, not responding to medication does not mean that behavioural therapy won’t work.
36. If a medication doesn’t work for me, other medications won’t work either.
FALSE
We cannot determine in advance what the best medication is for each person. It is generally recommended that several medications be tried before concluding that pharmacological treatment is ineffective. People who don’t respond to a second course of treatment with suitable medication prescribed by a family doctor should seek the expertise of a psychiatrist specializing in OCD.
37. All psychotherapy is the same.
FALSE
There are many forms of psychotherapy, and many of them can provide support. However, cognitive-behavioural therapy is the only one that emphasizes learning concrete techniques which are specially adapted to OCD and allow affected individuals to regain control over their thoughts and behaviour.
38. Cognitive-behavioural therapy is very demanding.
PARTIALLY TRUE
Cognitive-behavioural therapy requires a significant commitment and ongoing effort. The therapist’s role is to make the process the least difficult possible. The vast majority of people who fully commit to therapy will succeed.