UNDERSTANDING OCD: Why It’s Not Just About Liking Things a Certain Way

After more than a decade in the mental health field, one phrase I continue to hear, often casually and without ill intent is: “I think I may be a little OCD.” While this statement is commonly used to describe being organized or detail-oriented, it opens the door to an important clinical conversation. There is a meaningful difference between routines that support daily functioning and obsessive-compulsive disorder (OCD) rituals that are driven by anxiety and distress. As clinicians supporting individuals throughout their care experiences, it is essential that we approach this topic with respect and dignity, working to clarify these differences, reduce stigma, and increase understanding.

Routines are a normal and often helpful part of daily life. They provide structure, predictability, and efficiency, all in which can feel grounding in an ever-changing world. Examples include having a consistent morning or bedtime routine, keeping a workspace organized to reduce distractions, double-checking work for accuracy, or planning ahead. These behaviors are flexible. If a routine is interrupted or altered, it may cause frustration or inconvenience, but it typically does not result in significant emotional distress.

In contrast, OCD rituals or compulsions are rigid and anxiety driven. They are not preferences or productivity tools, but behaviors performed in response to intrusive and unwanted thoughts (obsessions). These compulsions are carried out to reduce overwhelming anxiety or to prevent feared outcomes from occurring. Key characteristics of OCD rituals may include an intense sense of urgency or pressure to perform the behavior, significant distress if the ritual is delayed or prevented, fear-based thinking, brief relief after completing the ritual, and a sense of being controlled by the behavior rather than choosing it. This “significant distress” can present in many ways. Physically, it may include racing thoughts, increased heart rate, nausea, or chest tightness. Emotionally, individuals may experience panic, fear, guilt, or a sense of impending danger. For some, intrusive thoughts intensify the longer a compulsion is resisted. Others may feel mentally exhausted, irritable, or unable to concentrate until the ritual is completed. This distress is not simply annoyance or frustration, it can feel overwhelming or unbearable in the moment. While performing the ritual often provides temporary relief, the anxiety typically returns, reinforcing the cycle. OCD rituals are driven by the need to relieve distress, not by choice, preference, or usefulness.

OCD is a mental health condition that can significantly interfere with work, relationships, and overall quality of life. At the same time, valuing order, organization, and routine is completely valid. Many people function best with structure, and intentionally building routines that support daily functioning can be a meaningful strength! For adults living with OCD, however, rituals are not habits they enjoy or traits they identify with—they are symptoms they often wish they did not have. Understanding the distinction between choice-driven routines and anxiety-driven compulsions helps reduce stigma and encourages more informed, compassionate conversations about mental health.

It is also important to briefly distinguish OCD from Obsessive-Compulsive Personality Disorder (OCPD), a separate diagnosis that is often misunderstood and not talked about nearly enough. OCPD is characterized by a rigid need for control, perfectionism, and adherence to rules or standards that feel “right” or necessary to the individual. Unlike OCD, individuals with OCPD are typically not distressed by their patterns of thinking or behavior and may not view them as problematic at all. These traits are often perceived as having “high standards,” even when they contribute to burnout, conflict, emotional distance, or strain in relationships. Clarifying the differences between OCD and OCPD is essential for accurate diagnosis, compassionate understanding, and connecting individuals with appropriate support.

Ultimately, you know yourself better than anyone else. If certain thoughts, behaviors, or routines feel distressing, overwhelming, or difficult to manage, talk about it and seek support. Advocating for yourself, asking questions, sharing your experiences, and exploring what helps can be gentle yet powerful steps toward greater understanding and improved mental health. Your lived experience matters most.

Kindly and with care,

Julie