People who have OCD live with obsessions, which are “repeated thoughts, urges, or mental images that cause anxiety” and/or compulsions, which are “repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought,” according to the National Institue of Mental Health.

There are many different manifestations of OCD and it’s a more nuanced, complex and distressing disorder than many realize.

“A lot of people think the only thing that is OCD is washing the hands and it’s more than that, you can be a checker, you can seeking reassurance, (you can have) avoidance,” said Francine McKay, certified peer support specialist at Northpointe Behavioral Health Systems, noting anxiety can be a big part of OCD.

Dave, a local man who has lived with OCD for 50 years, says his OCD manifests in the form of “double-checking,” meaning that he feels the need to repeatedly check to make sure that doors are locked, oven burners are off and things are in their place.

Dave says one way his OCD manifests is double-checking that books are neatly stacked and aligned to eliminate the risk of the books falling. (Journal photo by Cecilia Brown).

“I tend to double-check door locks, that I hung up the coffee cup OK, that I put it away OK in the cupboard, did I put the food away in the containers so they aren’t going to fall?” said Dave.

People with OCD typically spend at least an hour a day on these thoughts and behaviors and can’t control them, even when the person recognizes them as excessive — OCD has a physical, neurobiological basis and these thoughts and behaviors can become extremely difficult to stop or control.

“The obsessions become so real,” McKay said, noting that obsessive thoughts and compulsive behaviors can become more frequent and more intense in a vicious, self-reinforcing cycle, if not addressed.

Performing the compulsive behaviors may temporarily reduce anxiety, but interfere with important activities and “can cause significant distress in a person’s daily life,” according to the Massachusetts General Hospital’s OCD and Related Disorders Program.

For Dave, his thoughts and behaviors surrounding double-checking have an impact on his ability to feel comfortable using the stovetop burners on his oven.

Obsessions and compulsions can take many forms. For example, Dave a local man who has OCD, says he feels the need to check the dials for the burner stove repeatedly and make sure the white line is lined up with the “off” setting. (Journal photo by Cecilia Brown)

“In my case, one reason I won’t cook, is because I’m scared to death of not turning the burners off. And I mean, I can look at the settings where it says ‘off’ and ‘on’ and everything and maybe it’ll say off, pointing straight up, but for some reason, (I wonder) is the white line a little off to the center of the ‘OFF’ setting, where it says ‘O-F-F,’ he said, adding “then I keep looking at it, I keep checking it, I won’t touch it, but I’ll keep looking at it.”

He says even though things may look OK visually, he still has a feeling that things are not OK.

“It may look OK, but it doesn’t feel OK. That’s your OCD kicking in,” he said, offering an example of hanging a picture on the wall. “You could hang a picture on the wall and you could have a couple people hang the same picture on a wall and they can do it 10 times out of 10, fine, no problem,” he said. “It would take me eight out of 10 times, I wouldn’t feel right about it. It may look OK, but just the physical sensation, when I would let go (is unpleasant.)”

There’s a very real internal, physical reaction that he has when he tries to walk away from something without checking it, he says.

“It’s just something, that trigger, for some unknown reason, is this trigger saying ‘wait a minute, is it OK?’ … We all have the same feelings, hanging stuff up on the wall, touching the surface of the desk, the same physical sensations, it’s just that mine throw curveballs at me,” he said.

As many may imagine, this can be difficult to deal with — “it gets frustrating,” Dave says.

But there are ways to treat and manage OCD — Dave says he was fortunate to find a “wonderful therapist” and an effective medication. He says after after a lot of hard work, he feels like he’s felt an a major improvement, noting that it’s been gradual, but it “sure feels good.”

Dave noted the importance of finding a therapist that can put themselves into the shoes of someone with OCD and recognize that obsessive thoughts and compulsive behaviors are very real and have a significant impact on the person who has OCD.

McKay says cognitive-behavioral therapy can be helpful for OCD.

“You train your mind and you also face what you’re doing, say if I were to go to the door and check the door knob 10 to 20 times, what I would do is lock it, go back one time and thats it … you get very anxious about it but it seems to work,” McKay said, noting that “even if you did it five times, you’d be stopping at less than what you were doing and then you could work yourself down just to time.”

Support, reassurance and understanding can also be helpful for a person with OCD, McKay and Dave say.

“First, realize that the anxiousness that comes with (OCD). That is probably the biggest issue and being able to help them realize, after a while that there’s really nothing to be anxious about,” McKay said, “and reminding them to face it head on and to work to what your goal is and that’s to not be able turn it 10 to 20 times, trying to not to think that ‘it’s not a big thing’ because it is a big thing to the person.”

Dave encourages people who have OCD to seek support from friends and family, and emphasizes the importance of seeking professional guidance to find a strategy that works for them.