OCD Isn’t What You Think It Is: Exploring a Stereotype
As a therapist with lived experience of obsessive-compulsive disorder (OCD), I understand firsthand how profoundly misunderstood this condition can be.
I never thought of myself as an “anxious” person, but after the birth of my first child in 2008, that changed. I began experiencing intense, overwhelming anxiety centered on my baby’s safety, accompanied by near-constant intrusive thoughts that played like a movie I couldn’t turn off. In an effort to manage the distress, I developed what I now know were “safety behaviors”—compulsions that, while seemingly irrational, offered fleeting moments of control in a world that suddenly felt terrifyingly unpredictable.
My mind was rarely quiet. I was constantly scanning for danger, imagining worst-case scenarios, checking, and mentally rehearsing plans to keep my baby safe from every possible threat. The thoughts were relentless. I felt trapped in my own head and, at times, convinced that I was “losing my mind”.
Even though I lived in one of the largest metropolitan areas in the United States, finding specialized treatment and support was far more difficult than I ever imagined. I saw provider after provider, each time leaving with the same mix of frustration and hopelessness- I was often slapped with a “postpartum depression” diagnosis and offered medication, but it never felt right because I didn’t feel depressed. Years passed before I stumbled across a psychiatrist listed in my insurance directory and scheduled an appointment—more out of exhaustion than optimism.
When I finally met him, I was prepared for another disappointing encounter. He was an elderly man with a calm, measured demeanor, and I braced myself for the usual blank stares or misplaced reassurance. But when I described my symptoms—the vivid intrusive thoughts, the mental “movies” on repeat, the rituals I performed to feel momentarily safe—he simply…listened. He didn’t flinch or rush to explain them away. Instead, in one of the most validating moments of my life, he told me that intrusive thoughts were common—especially after childbirth—and that effective, evidence-based treatments existed to help.
That conversation changed everything. For the first time, I understood that what I was experiencing wasn’t a personal weakness or a sign of being “crazy.” It was OCD. That moment of understanding became a turning point that not only transformed how I saw myself, but also how I approach my work today—as a therapist committed to helping others find the same clarity, compassion, and relief that once allowed me to move forward with confidence and, eventually, peace.
Key Takeaways
OCD develops through a mix of genetic, biological, and environmental factors.
OCD is not about being clean or neat, it’s a complex anxiety disorder involving intrusive thoughts and compulsive behaviors.
Around 50% of individuals with OCD are initially misdiagnosed, delaying access to proper treatment.
ERP therapy is the gold standard for managing OCD symptoms.
Awareness and education reduce stigma and support early intervention.
Feeling stuck in a cycle of intrusive thoughts?
Schedule a session with a therapist at Balanced Wellness to start your OCD recovery journey.
How Does OCD Develop? Where Does It Come From?
OCD doesn’t have a single cause—it develops through a combination of genetic, biological, and environmental factors. Research shows that OCD often runs in families, suggesting a hereditary component. However, genes alone aren’t the full story.
Brain-imaging studies reveal that people with OCD often have differences in brain circuits that regulate decision-making, emotion, and impulse control. These differences make it harder to disengage from intrusive thoughts or resist the urge to perform compulsions.
Environmental triggers (like major life transitions, illness, or trauma) can also play a role. For some, OCD begins in childhood; for others, it appears later in life. Stress doesn’t cause OCD, but it can intensify symptoms.
Learning also reinforces OCD behaviors. When performing a compulsion brings temporary relief, the brain “learns” that ritualizing works, creating a powerful cycle that strengthens anxiety over time. Importantly, OCD is not caused by personality flaws, weakness, or a need for control. It’s a complex interplay of biology, experience, and coping mechanisms.
How OCD Is Misdiagnosed
Because OCD shares symptoms with other anxiety disorders, it’s frequently mistaken for generalized anxiety disorder (GAD) or depression. Both involve excessive worry, but OCD includes repetitive, unwanted thoughts and behaviors aimed at neutralizing those thoughts.
Studies show that up to 50% of people with OCD are initially misdiagnosed, delaying access to proper care. This is concerning because the most effective treatment, exposure and response prevention (ERP), is different from therapies typically used for generalized anxiety or depression. ERP teaches individuals to face fears and resist compulsions, gradually reducing the intensity of anxiety over time.
Misdiagnosis is even more likely when compulsions are invisible. Mental rituals (such as replaying events, seeking reassurance, or silently counting) can go unnoticed without specialized assessment. Accurate diagnosis requires clinicians trained in OCD-specific presentations.
OCD vs. Anxiety Disorders
OCD and anxiety disorders share features of fear and worry, but their mechanics differ. Anxiety disorders involve realistic concerns about everyday life, such as finances or relationships. OCD, however, centers on irrational or exaggerated fears that feel uncontrollable, even when the person recognizes they’re unreasonable.
For example, someone with anxiety might worry about missing a deadline. Someone with OCD might obsess that they accidentally offended someone and mentally replay the conversation for hours to be “sure.” The difference lies in the intrusive, repetitive nature of the thought and the ritualized effort to neutralize it.
OCD is also highly individualized. Symptoms vary greatly from person to person and may shift over time. Recognizing this diversity is crucial to providing evidence-based and effective care.
Common Obsessions and Compulsions
Obsessions (Intrusive Thoughts):
Fear of contamination or germs
Fear of harming others or making a mistake
Fear of losing control or disappointing others
Unwanted or taboo thoughts
Needing things to feel “just right” or symmetrical
Compulsions (Repetitive Behaviors or Mental Acts):
Excessive cleaning or handwashing
Repeated checking of doors, locks, or appliances
Seeking reassurance from others or informational sources
Mentally reviewing or “undoing” thoughts
Avoiding situations that trigger anxiety
Most people with OCD know their fears are irrational, but that insight doesn’t make them easier to stop. OCD isn’t about choice or control; it’s about survival in the face of overwhelming anxiety.
Why Awareness and Education Matter
When OCD is reduced to a personality “quirk”, it diminishes the very real suffering that people experience. Awareness and education are essential for dismantling stigma and encouraging early intervention.
OCD is highly treatable. Cognitive-behavioral therapy (CBT) with exposure and response prevention (ERP) remains the gold standard, helping 60–80% of individuals significantly reduce symptoms. With proper treatment, many people find freedom from the exhausting cycle of obsessions and compulsions.
By replacing stereotypes with understanding, we make it easier for individuals to seek help, and to see OCD not as a flaw, but as a treatable condition rooted in the brain’s complex wiring.
A Compassionate Note from a Therapist
If you see yourself in these words, please know you’re not alone, and there’s nothing “wrong” with you for having these thoughts. OCD can make you feel trapped inside your own mind, but help is available. As both a therapist and someone with lived experience, I understand how isolating it can feel to face fears that others might not understand.
At Balanced Wellness, through specialized therapy approaches like ERP, you can learn to quiet intrusive thoughts and reclaim the parts of life OCD has taken from you. Healing starts with understanding, and seeking help is a sign of courage, not weakness.
If you’re ready to begin that journey, I’d be honored to help.
Learn more about OCD therapy at Balanced Wellness or reach out to schedule a free consultation.
FAQs
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OCD is not about being neat or organized — it’s a complex anxiety disorder involving intrusive thoughts and repetitive behaviors (compulsions) performed to relieve distress. These thoughts are unwanted and often irrational, yet they feel impossible to ignore. The “cleanliness” stereotype minimizes the reality of what people with OCD experience. Learn more about how therapy can help manage anxiety-based conditions on our Therapy Services page.
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OCD develops through a combination of genetic, biological, and environmental factors. Research shows differences in brain circuits that control emotion and impulse regulation, as well as learned behavioral patterns that reinforce anxiety. Major life changes—such as trauma, illness, or childbirth—can trigger or intensify symptoms. You can read more about these experiences in our related post on Postpartum OCD, which explores how intrusive thoughts can emerge after birth and how effective treatment is available.
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Because OCD shares features with other anxiety disorders and depression, it’s often mistaken for generalized anxiety disorder (GAD) or mood-related concerns. Many individuals also experience “invisible” compulsions — like mental reviewing, reassurance seeking, or silent counting — that are easily overlooked. Up to 50% of people with OCD are initially misdiagnosed, which delays proper care. Accurate assessment by a therapist trained in OCD-specific symptoms makes all the difference. If you’re unsure, visit our New Clients page to learn what an initial consultation looks like.
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OCD is highly treatable. The most effective approach is Exposure and Response Prevention (ERP) therapy, a specialized form of cognitive-behavioral therapy (CBT) that helps individuals face intrusive thoughts and resist compulsions in a structured, supportive way. Many people experience significant relief through ERP therapy alone or in combination with medication. To learn how Balanced Wellness supports clients using evidence-based treatment, visit our Services page.
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Education helps reduce stigma and fosters understanding that OCD is not a personality flaw — it’s a neurobiological condition that responds to treatment. When people understand OCD symptoms, they’re more likely to seek professional help early and access ERP therapy before symptoms worsen. Sharing accurate information helps shift the conversation from “quirky habits” to meaningful recovery. For more insight into compassionate care for anxiety and OCD, explore our About page.
