Until recently, OCD was commonly recognized as a rare mental illness, and medical professionals defined it as such (Summerfeldt 2004). OCD is short for obsessive-compulsive disorder, a condition in which people experience recurring, intrusive, and uncontrolled thoughts (NIH). However, recent studies instead suggest that OCD results from the inability to cope with uncertainty, as seen from the surge of cases from the COVID-19 pandemic (Van et al. 2022). Going forward, psychiatrists should take more care in diagnosing OCD as a “mental illness” because that label may reify the sense of disease and lead to stigma.  

OCD symptoms increased over COVID-19 due to an increase in uncertainty (Van et al. 2022). COVID-19 has revealed that for some people, OCD is more of a coping mechanism and situational response than a mental illness (Costa et al. 2021). For instance, a 52-year-old woman, who was recently divorced, started to experience OCD symptoms in 2020 as a result of excessive fears of contamination (Costa et al. 2021). She experienced distress in and outside of her home, and felt uncomfortable with things feeling dirty. The woman engaged in compulsive hand washing and cleaning of surfaces in her house, resulting in an OCD diagnosis. (Costa et al. 2021).  

OCD as a “Mental Disorder”. 

When people struggle with OCD, their unwanted obsessive thoughts lead to repetitive, or compulsive, behaviors (Summerfeldt 2004). Common compulsions include excessively cleaning one’s hands, ordering or rearranging things until they are perfectly aligned, counting, or repeating words silently or under one’s breath (Summerfeldt 2004). 

In the Medical Model that has often been used to diagnose mental illness, OCD is always viewed as a “‘thing’ that an individual has” and is unable to escape (Cartwright 2024). For instance, The Diagnostic and Statistical Manual of Mental Disorders had long thought of OCD as a rare mental illness, and specified OCD as an “anxiety disorder” (Substance Abuse 2016). The National Institute of Health also has suggested that OCD is a mental illness, similar to anxiety and depression (NIH 2007). 

Sociologist and Philosopher Pierre- Henri Castel argues that “psychiatry’s approach to OCD” is “presently at an inflection point” because these definitions are “conceptually flawed.” (Wakefield 2014). As a result of this flawed labeling, psychiatrists today are beginning to perceive OCD as a dynamic disorder that is constantly evolving rather than an actual “mental illness” (Loughman and Haslam 2018). Sociologists Baptiste Brossard and Amy Chandler emphasize that “psychiatrist power has changed,” specifically for conditions such as OCD (Brossard and Chandler 2022:2). Psychiatrist work is reconsidering how they explain mental health as they are learning to “express caution” when it comes to labeling (Brossard and Chandler 2022:2). OCD is now being understood as something that changes depending on the context and the individual’s experience (Cartwright 2024).

Psychiatrist work is reconsidering how they explain mental health as they are learning to “express caution” when it comes to labeling (Brossard and Chandler 2022:2).

OCD is a Response to Uncertainty.

As seen with COVID-19, people with OCD have an intolerance with uncertainty, and as identified by a number of psychiatrists, people with OCD attempt to ease their distress by turning to compulsions (Tolin et al. 2003). Compulsions, also known as “checking” behaviors, are a response to distress because they can provide individuals with reassurance (Costa et al. 2021). Tolin describes that people with checking compulsions find uncertainty highly distressing and “engage in compulsive rituals to restore certainty” (Tolin et al. 2003). Compulsions work hand in hand with a prominent feature of OCD, pathological doubt. Individuals with pathological doubt are constantly “disbelieving their senses” and thus “needing continuous reaffirmation,” says sociologist Judith Rappaport (Rappaport 1991). 

Reducing Stigma. 

Psychiatrists indicate that there is significant stigma around OCD compulsions, which affects the well-being of people with OCD (Ociskova et al. 2013). Since many OCD compulsions include muttering or repeated movements, individuals that perform compulsions are quickly judged. Ociskova and colleagues (2013) depict that “when society notices that a certain person ‘behaves strangely’ or ‘act madly’, the labeling process begins and may lead to a permanent stigmatization”. Moreover, when individuals are labeled to have OCD as a “mental illness,” it can lead to social isolation (Ociskova et al. 2013).  The negative perceptions of people with OCD can also heighten OCD behaviors as it can lead to more uncertainty with oneself. The stigma surrounding OCD was found to discourage people with OCD from getting help from a professional (Ociskova et al. 2013).  

For some, OCD may be more of a reaction to uncertainty in ones life rather than a debilitating mental illness. By treating OCD as a response to uncertain conditions rather than a mental illness, hopefully those engaging in compulsive behaviors will feel less stigma, and have a greater openness to seek help. With less stigma, people will seek the help they need and feel more comfortable in public with their compulsions. 

References

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Anon. n.d.-b. “What Is Obsessive-Compulsive Disorder?” American Psychiatric Association. Retrieved March 11, 2024 (https://www.psychiatry.org/patients-families/obsessive-compulsive-disorder/what-is-obsessive-compulsive-disorder).

Brossard, Baptiste, and Amy Chandler. 2022. Explaining Mental Illness: Sociological Perspectives. Bristol, England: Bristol University Press.

Costa, Ana, Sabrina Jesus, Luís Simões, Mónica Almeida, and João Alcafache. 2021. “A Case of Obsessive-Compulsive Disorder Triggered by the Pandemic.” Psych 3(4):890–96. doi: 10.3390/psych3040055.

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