Mike’s thoughts were driving him “crazy.”

One thought would lead him into another and another. His anxiety would shoot to the roof and he couldn’t stand it. He felt these thoughts would never stop tormenting him. He appeared distracted and aloof to those around him. He was too busy thinking. His brain was constantly on rewind and reviewing his thoughts and actions. Did I say this? Did she say that? What if I said this? What if this happened?

What if? What if… were constant questions in his mind. Sometimes he felt as if his brain were going to explode because it was racing a thousand miles per hour. He was sure about one thing: he needed 100 percent assurance regarding his thoughts and doubts. He spent countless hours looking for evidence to erase his doubts. It was never enough. He could never arrive at a feeling of peace.

Mike often became upset with people who didn’t understand the pain that OCD causes. When someone said “I am so OCD,” he would get irritated. He felt that people who really had OCD wouldn’t joke about it. Having OCD is not a joking matter, he lamented — but only to himself. Many people suffering from mental obsessions are embarrassed by them and may wait for years before disclosing their troubling thoughts to close friends and family. Mike was among them.

He often wondered why his OCD suffering was not the contamination or checking type. He thought those would be easier to control and manage than the obsessions he experienced. The kind of OCD Mike had didn’t fit the kind of OCD the media often describes. He wondered how he could be helped if it were all in his head. He felt hopeless.

Characteristics of People with OCD

Research indicates that OCD sufferers often exhibit high creativity and imagination and above-average intelligence. For those experiencing primarily mental obsessions, it is difficult to dismiss a random weird thought as non-sufferers do.

Individuals with mental obsessions will try to pick apart their thoughts in order to figure them out and resist them. They will also try to figure out their thoughts don’t match their self-image. They can spend hours scrutinizing the answers. It doesn’t matter how long they search through their mind for reassurance or how long it takes them to find the answer on the Internet. The answers will not satisfy the uncertainty they experience.

Treatment for OCD

Is there any hope of real help for them? Of course. However, OCD treatment is difficult, and that is one of the main reasons some stay away from treatment. Making obsessions better by performing compulsions is a temporary relief. Unfortunately, compulsions only reinforce OCD symptoms.

If you think you or someone you love has OCD, education is key. Reviewing the guidelines set by the IOCD Foundation, the ADAA, and mental health providers experienced in treating OCD, are good places to start. Sometimes individuals are not ready for or cannot afford treatment, so self-help books can be a first step. Checking what experts in the field recommend is helpful.

According to the IOCD Foundation, it can take between 14 to 17 years from the time OCD begins for people to find the right treatment. When ready, it’s important that individuals are well-informed about their options. Will the treatment be psychotherapy and medication combined? Will it be medication or psychotherapy alone? Those who wish to overcome their struggles also need to learn what kind of questions to ask potential providers.

Studies show that the most effective type of therapy for OCD is Cognitive-Behavioral Therapy, which includes Exposure and Response Prevention. These two elements are essential in treating OCD. According to the International OCD Foundation, “the Exposure in ERP refers to confronting the thoughts, images, objects and situations that make a person with OCD anxious. The Response Prevention in ERP refers to making a choice not to do a compulsive behavior after coming into contact with the things that make a person with OCD anxious.”

Usually, this strategy does not make sense to those suffering from OCD. What they want most is to decrease their anxiety, so when their therapist tells them they have to do exposures, it sounds counterintuitive. Sometimes, they have already done the exposures themselves and have found that their anxiety only increases to the point they “feel like they are dying.” The psychotherapist will coach them through this process each week. The main goal is to habituate. Through weekly homework assignments, the client learns to “teach” the “false alarm” in the brain to get used to the situation. The client will learn to prevent the response (compulsion) until anxiety is decreased.

It has been said that “in order to get out of the woods, you have to go through the woods.” People with OCD will need to experience the dark and scary woods as they are getting out. They will learn that the goal for treatment is not about finding evidence to their “irrational thoughts.” They already know this. They will learn skills for a lifetime that they can employ on their own.

When OCD tries to creep in, they will learn to recognize it and use the skills to keep it at bay. And lastly, they will learn that living with uncertainty is okay — because the truth is, uncertainties surround us all. Once people with OCD learn to accept this truth, they know they don’t have to be slaves to their OCD ever again.

What OCD Feels Like: Being Absolutely Uncertain