It’s on the news, portrayed in TV and movies, the subject of countless reality TV shows and even discussed in our Jewish publications (including this one). It is those 3 letters that have gotten into our vernacular at a young age: OCD. You’ve probably heard of it before—OCD or obsessive compulsive disorder, a mental illness that’s marked by obsessive thoughts and compulsive behaviors. But how much do you really know about OCD?

From conversations with people in our frum community, some who have suffered with OCD and others who have not, I would suggest that OCD is one of the most misunderstood health conditions out there. In fact, many people have ideas about it that simply aren’t true. That’s why, in honor of International OCD Awareness Week (October 13-19), let’s examine some of the most important things that those who suffer with OCD wish you knew:

1. Not everyone who is clean and neat has OCD. One well-documented subtype of OCD is an obsession with cleanliness—such as constantly washing your hands or excessively cleaning household items. But a cleanliness complex can also be a personality trait, said Jeff Szymanski, PhD, executive director of the International OCD Foundation and one of the world’s leading authorities on OCD. “And that’s part of the confusion. If it’s a personality trait, you have control — you can choose to do it or not. If you have obsessive compulsive disorder, you’re doing it out of unrelenting debilitating anxiety.” But at the same time…

2. Not everyone with OCD obsesses over cleanliness. Being overly focused on contamination or germs may be a common obsessional theme of OCD, and those suffering may compulsively clean—but contamination OCD is not the only OCD subtype (and not everyone with OCD has it). Some other common OCD subtypes include responsibility OCD (where the person obsesses over being responsible for things that could occur in his environment), fear-of-harm OCD (obsessive concern about potentially harming or having harmed another person), relationship OCD (obsessive concern that the person in the relationship is not the “right one” or that the sufferer isn’t “good enough” in the relationship or that the relationship will not endure), sensorimotor OCD (obsessions over normal body functions like breathing), scrupulosity (often called religious OCD) and purely-obsessional OCD (“Pure-O”). While these are all different subtypes of OCD, someone who has one subtype doesn’t necessarily (and usually doesn’t) have the others.

3. You don’t realize that when you say “I’m so OCD” or use #SoOCD you are belittling the disorder and its treatment. When you clean your room or are meticulous about the way your clothing looks on you, you are not reacting to “some OCD.” OCD is being afraid of things that you know will never happen, but still wanting to feel in control of it all in some way. It’s based in thoughts that create fear and a racing heart. It is responsible for emotions like guilt, doubt and questions that you can never truly get the answers to, which tend to make those suffering from it engage in certain behaviors that they think will get rid of the anxiety and doubt, but ultimately don’t. When you make personally dismissive comments about OCD, it’s invalidating and humiliating to those who actually feel that pain and anguish. But at the same time…

4. You have intrusive thoughts just like us. The difference is, we obsess about them. Intrusive thoughts are common in all people. Ever driven down the street and had the thought, “What if I drove down the other side of the road?” or standing on a cliff and thinking “What if I jumped?” Those are intrusive thoughts. They can be scary or unsettling but everyone gets them. The difference is when you think them you’re able to shake it off as nothing serious because it’s irrational or silly. But when someone with OCD thinks about them she or he can’t stop thinking about them. The difference in their intrusive thoughts is that when someone has OCD—it causes disorder in his or her life.

5. OCD did not come from my being “too frum.” Being careful to have proper kavana during Shema, or taking extra care about the details in a mitzvah like cleaning for Pesach, tefillin, kashrus or taharas hamispacha, and strong aversions and fears to improper or even heretical thoughts that pop into one’s mind are all examples of instances that could be identified as piety or scrupulosity. But Rav Yisroel Salanter (Ohr Yisroel, Letter 25) already noted that there is a difference between zehirus and scrupulosity. Scrupulosity is a type of OCD, which is a psychological disorder. In scrupulosity, a person’s religious convictions are merely one aspect of his or her being that OCD uses to cultivate doubt and create anxiety. It is not connected to Torah observance or religious life at all. If OCD didn’t attack a person’s religious beliefs, it would surely take on a different form, whether that be a contamination fear or a checking compulsion or another arena for OCD to unleash anxiety. Scrupulosity takes strong religious ideals and blows them out of proportion, making them distorted and corrupt. The main difference is the motivation and the emotion behind the practice. In fact, understanding one’s religious practices and hashkafa well is helpful in combatting scrupulosity.

6. Reassurance is not helpful for a person suffering with OCD. People will appreciate that you “just wanted to assure [them] that it is ok.” At times, they will even ask you (perhaps a bit too often) if the spill on the ground is blood, if the stove might have been left on or if you locked the doors before we went to sleep. They may ask the rabbi or the mikvah attendant questions multiple times hoping to get a definitive answer that will stick. The truth is, that while reassurance might feel good for a short time, it proves unhelpful as the doubt and anxiety return quickly. People with OCD, through treatment, learn to handle their own doubts and the anxiety that could come with it.

7. OCD is treatable. Many people don’t seek OCD treatment because they’re embarrassed, and that may be why people think it can’t be treated. “OCD is definitely treatable,” Szymanski said. The first line of OCD treatment is exposure and response prevention, a face-your-fears therapy. Some people work better with a combination of behavioral therapy and medications. Most often, with proper commitment and compliance to treatment, the prognosis for symptom management is great.

8. “I am a person. I happen to have OCD.” Often our community has a problem with labels. More than once, I have been asked to explain “What’s wrong with… Is she OCD?” The answer to the question is “no.” A person is a person. Often the person is a bright, energetic, beautiful, friendly, dependable baalat middot v’chesed. She (like everyone else in the world) is not OCD. OCD is a diagnosis of a treatable challenge that some people face—it is not a definition of that person. When we boil a person down to the label of that person’s challenge we ignore the person and the maalos that she or he brings to the world. When we do that, we get to wear a label too—shallow and dismissive, shameful and wrong. That condition is a bit more difficult to treat but we certainly can. For, as good Jews, we are certainly better than that.

Rabbi Jonathan Schwartz, PsyD, is the rav of Congregation Adath Israel of the Jewish Educational Center (JEC) in Elizabeth/Hillside, New Jersey, and the clinical director of the Center for Anxiety Relief in Union, New Jersey, where he specializes in the treatment of anxiety disorders and OCD. He has lectured extensively, especially in the areas of the intersection of Judaism, psychology and mental health. He can be reached at [email protected].