Kyle MacDonald: The telltale signs of OCD

Obsessive Compulsive Disorder is one of those conditions that's entered our everyday language to describe people who are fussy. But in reality, OCD is a very serious problem. Image / NZ Herald

"My friends and flatmates give me a hard time for being "OCD". I'm starting to get worried they might be right, I like things tidy, and get annoyed when things aren't clean. How can I tell if I am?"

I prefer order to chaos, always have. Years ago I had a flatmate (actually, truth be told more than one) who used to deliberately shuffle my CDs out of alphabetical order just to wind me up. Now of course iTunes has solved that particular issue for me, but I feel your pain.

In all seriousness, OCD, or Obsessive Compulsive Disorder, is one of those conditions that's entered our everyday language as a descriptor for people who are uptight or fussy about cleanliness and order, and particular about their surroundings. But in reality, OCD is a very serious and often very debilitating problem for those that suffer from it.

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All, and I mean all, psychiatric diagnoses exist on a continuum. For instance people can be negative and slightly pessimistic, but not depressed. Similarly, being very tidy or particular and "having" OCD are on the same continuum but not necessarily the same thing.

With all diagnoses, the main question is how much of a problem does it cause? Or, to put it in technical language, does the behaviour cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning"?

I'm not sure that annoying your flatmates counts.

When people suffer from OCD, they experience distressing, intrusive and obsessive thoughts, which can then only be alleviated by carrying out a particular compulsive behaviour.

This can often be repetitive, ritualised patterns, for example needing to turn the lights off in a certain sequence, or counting in a particular way. For others, it can involve needing to check that all appliances are turned off at the wall for fear of a fire.

In general the compulsions are about safety, contamination or orderliness. For some the obsessive thoughts can be as severe as believing someone they care about will die if they don't carry out the ritual.

But ultimately the emotional "engine" of OCD is overwhelming anxiety.

There are many theories about how and why OCD develops, but what is clear is that it is a misdirected, and over-learned way to manage anxiety. The anxiety fuels the obsessions, and the compulsions relieve the anxiety, setting up a loop of tension and relief that is highly reinforcing and hard to shift once it gets under way.

So forget what your friends and flatmates think, the only question is do your behaviours cause you distress? And do you feel unable to control your thoughts and actions as a consequence.

Otherwise, you're just tidy and conscientious. And I think that's a good thing.

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Where to get help:

• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906 (Palmerston North and Levin)
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• Depression helpline: 0800 111 757 (available 24/7)
• Samaritans: 0800 726 666 (available 24/7)
If it is an emergency and you feel like you or someone else is at risk, call 111.

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