When someone hears the phrase OCD (which stands for “Obsessive Compulsive Disorder”), they are most likely inclined to picture someone who relentlessly washes their hands and organizes everything around them. While cleanliness can be one manifestation of OCD, it is not the only one. In fact, the inclination that many people feel to associate OCD with only this one stereotype of the disorder is actually incredibly stigmatizing to those of us who deal with a different subtype.

I was diagnosed with OCD last month. Here are common symptoms, as listed in a handout given to me by my therapist:

-unwanted or upsetting doubts

-thoughts about harm, contamination, sex, religious themes, or health

-rituals like excessive washing, checking, praying, repeating routine activities

-special thoughts designed to counteract negative thoughts

Looking back, I can pinpoint specific periods in my life when I was plagued by intrusive thoughts I could not seem to escape. What’s difficult about having OCD is that it’s incredibly difficult for folks who don’t deal with it to understand. I have had obsessive fears about being pregnant (even before I was sexually active), extreme hypochondriac tendencies, fear that I will somehow harm people I love (some people’s fears are centered around worries they will physically harm others, but mine are usually concerns that I will cause someone extreme emotional distress), as well as obsessive thoughts about my sexuality and the viability of my relationships. One of my main compulsions is to seek reassurance from others, but without experiencing OCD, it is easy for people to feel like I’m being needy or crazy. Especially considering that compulsions do not make the thoughts go away for good, it just means I will eventually cycle back into the same gnawing fear and need for reassurance. And repeat.

In this way, my mental illness has taken on a toll on my personal relationships. I’m not meaning to disparage any of my friends, because it’s actually unhealthy to support someone with OCD’s need for constant reassurance. The best way to manage OCD is through ritual prevention.

My OCD is mostly obsessional, so a lot of my “solutions” involve making mental checklists to reassure myself. The biggest pitfalls for me lie in anything that I can’t unequivocally prove: that I will be happy in my relationship forever or that I am without a doubt attracted primarily to men. Now, I feel the need to clarify here that I don’t think it would be a bad thing if I was more interested in women than men. What constitutes my situation as OCD is the fact that I fear I will never be fully certain of who I want to be with, and thus will be unhappy forever. The same type of fears play into around my relationship doubts. It is extremely exhausting and guilt-inducing because my boyfriend is an incredible gem and I love him dearly, but sometimes I get irrational worries about our relationship that I can’t seem to shake. What makes it worse is if I bring them up to people who don’t have or understand OCD, they interpret this as meaning my relationship is not going well. That’s not the case, but it causes me to spiral further.

However, my worries aren’t always things I can’t prove. For example, I also have feared getting pregnant for almost as long as I can remember. I was taking pregnancy tests long before I started having sex. I have bought pregnancy tests and tampons at the same time. I have taken multiple pregnancy tests in the same day. So regardless of what the facts are telling me (“Elizabeth, you’re definitely not pregnant”), I just can’t believe it’s true. Or, I believe it’s true but feel like if I don’t keep thinking about it then what I fear most will happen. This latter worry is a big one for me in all aspects of my OCD.

So, back to treatment. OCD is not curable, but it can be more manageable with therapy. The main way to control your OCD is to try NOT to control it. Counterintuitive, I know. But here’s the thing: when you try to rationalize with your obsessive thoughts or push them away, they’ll just resurface even stronger. They’re like a little kid who just won’t quit pestering you. The best thing you can do is let them do their thing for awhile until they get bored. Basically, someone who has OCD has to learn to sit with their intrusive thoughts without doing any of their normal compulsions. Over time the thoughts will have less power.

I’m sure this article makes me sound like a crazy person and I was really hesitant to write it. However, I did because I know how hard it is to not have people understand what’s going on in your head. I also know that people may not perceive me as someone who struggles so much with mental illness because I manage to keep it pretty well contained until I’m in the privacy of my own apartment and only have my dog as my witness. (Pray for him y’all. He’s seen some big-time breakdowns.) It took me a long time to finally go to therapy because I felt like maybe there was nothing actually wrong with me, but maybe I’m just a big baby who likes to be unhappy. Getting my diagnosis was a huge relief and extremely validating, but it’s still a daily struggle with accepting myself and finding hope. OCD is real and it’s tough and it’s multi-faceted. You might have an obsessively clean apartment because you fear germs, or you might have a messy one because you spend all your time in your head convincing yourself you’ll never be happy or certain of anything. (It’s grand!)

I’ve said everything I was planning on saying and I’m not really certain how to end it. I guess I’ll just say these three things:

1. If someone tells you they have been diagnosed with something, particularly an illness that manifests itself in doubt, don’t try to question the validity of the diagnosis.
2. Mental illness should not be stigmatized, and everyone should feel as free to say they are struggling with their head as they would to say they have a back ache.
3. Everyone can benefit from therapy, regardless of if you have a mental illness or not. We all go through shit, and we need all the help we can get.