Washing my hands until they crack and bleed stops me from getting sick. Turning my shampoo bottle slightly to the left keeps my sister alive. Organizing my spice rack ensures no car accidents happen on my street today.
Breathe.
Breathe.
Breathe.
Three times, not four. Perfect.
I have obsessive-compulsive disorder (OCD), and I can’t remember a time when I didn’t. Over the years, I’ve learned to make sure I’m Abby first, and my OCD is second. If you take nothing else away from my story, take that. OCD—or however your anxiety manifests itself—is intertwined with who you are, but it is not the whole you (despite how it may sometimes feel).
What is OCD?
Defining OCD itself is vital, as it’s often misinterpreted as a personality trait (“I can’t stand leaving dirty laundry around—I’m so OCD”) instead of a deeply experienced mental illness. OCD is a cycle of intrusive, repetitive, and nonsensical thought patterns (obsessions) that lead to actions or rituals (compulsions) meant to appease the obsession, regardless of the detriment to one’s daily life.
“I suffer from OCD, depression, and anxiety,” says Victoria H., a third-year student at the University of Windsor in Ontario, Canada. “Sometimes instead of studying or listening to lectures, I will have OCD/anxiety triggers and will not be able to concentrate.”
OCD is actually quite common—and more importantly, it’s treatable.
- 1 in 40 adults in the US experience some form of OCD.
- There are a variety of treatment options, specifically cognitive behavioral therapy (CBT), with research showing improvement in 85% of individuals.
What it feels like to have OCD
My OCD tosses around my thoughts in a bluster of confusion. It morphs and changes so regularly that differentiating a rational thought from a compulsive one can feel nearly impossible. For example, when I was 10, I repeatedly asked my mom whether Abigail was my real name because I didn’t believe my internal dialogue was reliable. Imagine not trusting your own thoughts.
Basically, OCD keeps you stuck in a perpetual “loop of wrongness.” You have to determine whether your brain is tricking you before your compulsions kick in and reality is thrown aside. There’s an awareness of how illogical these compulsions are, but there doesn’t seem to be a way to stop them. It feels like an uncontrollable invader has burrowed into your brain and set up camp, minus the s’mores.
“Although the behavior may seem pointless or even harmful (to the outside perspective), the [individual] can remain stuck and unable to stop the actions, which are often taxing and difficult to manage,” says Andrea Cornell, a licensed marriage and family therapist at Cornell & Associates in New York City who specializes in holistic therapeutic approaches to anxiety.
The act of deciding whether your brain is tricking you ends up feeling selfish. You think to yourself, if I sit here and analyze this compulsion instead of completing a simple act (in my case, turning the shampoo bottle), my sister might die! Wouldn’t you turn the shampoo bottle just to be safe?
For a long time, I did succumb to my compulsions. I doused myself in hand sanitizer and tried not to leave my house. When nothing bad happened—because it generally doesn’t—it felt like it was due to completing these compulsive actions. This perpetuated a harmful cycle of rationalization, morphing my unhealthy compulsions into something that felt right.
Reading, writing, arithmetic, and anxiety: How OCD can manifest in college
OCD development has been linked to genetic and biological risk factors (e.g., natural serotonin levels, family history), but contextual factors are also involved in the surfacing of symptoms. Stress plays a large role in most mental health struggles, including OCD.
OCD and anxiety disorders generally surface around 19 to 20 years of age, when the immense academic pressure to perform is prominent for many. At this age, you’re also likely to experience:
- New financial responsibility
- Relocation for school or work
- Societal expectations to be successful
- New social dynamics
- Natural reduction in parental support
“Any stress, including a transition period, can exacerbate OCD symptoms,” says Dr. Avital Falk, a clinical psychologist and assistant professor of psychology in clinical psychiatry at Weill Cornell Medicine in New York City. “Young adulthood is a life stage that is full of transitions, and it can therefore be a particularly challenging time.”
Some students with OCD may experience a zone-like state, hyper-focusing on their unhealthy interpretations of perfection. For me, the possibility of leaving out an important piece of information when writing a paper felt exactly like my fear of missing germs when washing my hands.
“The specifics of OCD symptoms vary from person to person and tend to play on the areas that bother a person the most,” says Dr. Falk. “For example, if a person is very concerned about academics, that individual may have more rituals or compulsions in the academic realm. A student may check essays over and over for errors, or erase and rewrite emails again and again.”
Calm, cool, and obsessive: Treatment options and lifestyle changes for coping with OCD
All is not lost, my fellow anxious friends. OCD has an intertwined relationship with anxiety disorders, and many approaches to managing anxiety also help OCD.
“The benefits of lifestyle changes and natural relaxation techniques are highly correlated in reducing anxiety,” Cornell says. “Managing anxiety is most effective when we use physical and mental techniques. Our bodies affect our feelings, and making ourselves a priority is the first step.”
Here’s what’s helped give me back some control in my life.
Lifestyle changes
- Nature-based activities: My mind is most at peace when I’m hiking, but it took me years to understand how the simplicity of nature can simplify your thoughts as well.
- Mindfulness: Remaining in the present moment is vital, and if you can ground yourself with deliberate, active breathing and awareness techniques, a way out emerges.
- Yoga: Yoga brings me to the present moment, teaches me how to feel my physical anxiety manifestations, and gives my brain a break as I’m mostly trying not to fall over.
These lifestyle tools are especially helpful for those who don’t have health insurance. For the following treatments, check for on-campus services that may be low or no cost for students, or look for mental health services in your community that accept payment using a sliding scale based on what you can afford.
Cognitive behavioral therapy (CBT)
CBT teaches you how to recognize and rework negative, irrational, and harmful thought processes. This is vital with OCD, as the gap between recognizing obsessive thoughts and stopping their consequent actions is really hard to manage.
Exposure and response prevention therapy (ERP)
ERP exposes an individual to an obsession or fear and then blocks the compulsive action, demonstrating that a compulsion is unnecessary. With practice, this helps to break the link between the two. For example, my childhood therapist had me touch a trash can (anxiety-inducing event) and then not wash my hands (compulsion). It felt like absolute anarchy, but it allowed me to see the blatant disconnect I was living in.
Medication
Antidepressants and other psychiatric medications are commonly prescribed to help treat OCD. Typically, medications work best in combination with therapy and should be prescribed by a psychiatrist.
