OCD Is Misunderstood—Here’s What It Is and What It Isn’t

Let’s start with a gripe of mine: most people think they know what OCD is, but they don’t, and it can be annoying when you’re the one with OCD. It’s not their fault though. OCD has been boiled down in pop culture to a caricature of itself—a punchline about being “so neat,” a “germaphobe,” etc. The reality is much more complicated, and for people living with OCD, it can be overwhelming, isolating, scary, and honestly, exhausting.

We need to talk about it because the misunderstanding of OCD in the general population can leave people who are really struggling feeling dismissed—or even worse, invisible. It can cause barriers to seeking treatment, too. So, let’s break it down: what OCD isn’t, what it actually is, and why understanding the difference matters.

What OCD isn’t

We’ve all got that friend who’s a little particular about their stuff, right? Maybe their desk is spotless, their shoes are lined up perfectly in their closet, and they never let a dish sit in the sink. And when someone comments on how tidy they are, they laugh and say, “Oh, I’m just so OCD.” 

But here’s the thing: they’re probably not. 

Being neat or liking things organized doesn’t automatically mean you have obsessive-compulsive disorder. Sure, someone with OCD might care about cleanliness, but the difference is this: for someone with OCD who struggles with intrusive thoughts about contamination or needing to feel “just right” about things, the thought of a dirty kitchen or a misplaced item isn’t just annoying. It’s intrusive, overwhelming, and feels impossible to ignore.

OCD isn’t just a quirk or preference; it’s a disorder that can take over your life. And while pop culture often paints it as a fixation on germs or tidiness, it can look like so many other things. Which brings us to… 

What OCD actually is

Here’s where things get real. OCD is a mental health condition that comes with two main features: obsessions and compulsions. Obsessions are intrusive, unwanted thoughts, images, or urges that show up out of nowhere and refuse to leave. They can be about pretty much anything—harm, relationships, religion, health, taboo subjects, you name it. Compulsions are the actions (or mental rituals) people feel compelled to do in response to those obsessions. The goal? To get some relief from the distress coming from the obsessions.

Here’s one example: you ride your bike to campus on a Monday and park it at the bike rack in front of the academic building where you go to class, lock it, and check to be sure that your bike lock actually locked. Fairly common, right? But then you check it again. And then you walk to the second floor of your building where your class is and start to feel unsure if it’s really locked so you walk back down to the bike rack and check it again, just in case. And after you’ve done all this checking, you still don’t feel certain. Halfway through class, the thought hits you again and again: What if it’s unlocked? My bike will get stolen. Should I check again, even though I’ll miss some of the lecture? Then on Wednesday when you come back to campus for class again, you do it all over again.

This isn’t just being forgetful or cautious—it’s an example of OCD symptoms beginning to affect a person’s life.

And it doesn’t always look like this. OCD can show up in ways that don’t get talked about enough. Maybe it’s intrusive thoughts about relationships (sometimes called “relationship OCD”) where you’re constantly doubting if you love your partner or if they love you. Maybe it’s disturbing thoughts that make you feel ashamed or terrified to share with anyone else. Or maybe it’s counting, organizing, or touching rituals that you do over and over, even when you know they don’t make sense.

The common thread? These thoughts and behaviors aren’t voluntary, and they’re not about logic—they’re about uncertainty and trying to feel safe at all costs.

Why people with OCD might not get diagnosed 

One of the hardest parts of living with OCD is how isolating it can feel. A lot of people keep their struggles private for years, even decades. Why? Because sharing those thoughts feels terrifying. There’s a lot of shame tied to OCD—fears about being judged, misunderstood, or even rejected. People worry that others will think they’re ridiculous at best or dangerous at worst because of the thoughts they’re having.

Another reason is that people just don’t know they have OCD. Maybe they have been going to therapy or their doctor’s office on and off for years but not a single doctor or mental health provider ever diagnosed them with OCD. Many healthcare providers and even therapists aren’t aware of the ins and outs of OCD and its many presentations.

Unfortunately, not getting the diagnosis can keep people stuck. Without treating OCD, it’s unlikely to go away. Folks with OCD need new ways of understanding their thoughts and new tools to help them manage their symptoms.

How OCD Can Be Treated 

The good news? OCD is very treatable. And while it might feel impossible to some people to quiet those intrusive thoughts or stop the compulsions, there really is relief—with the right help.

Therapy is the cornerstone of treatment, especially approaches stemming from cognitive-behavioral approaches such as Exposure and Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT). ERP helps you face your fears in a safe, controlled way while learning to resist the urge to perform compulsions. Over time, this retrains your brain to handle the anxiety without relying on rituals.

For some, medication can also be an important part of the puzzle, addressing the underlying brain chemistry that fuels OCD. 

The key is finding a therapist who really gets OCD and creating a treatment plan that works for you. Whether it’s you or someone you love who’s struggling, reaching out for help is a brave step, and it can make all the difference.

Want to chat about this? Reach out to me if you have questions or concerns about your own or a loved one’s mental health.

Ready to get treatment? Schedule an appointment.