Everyone thinks OCD is something that it isn't.

Some people like to think it’s a fancy term for germophobia or anal-retentiveness. T-shirt sellers seem to believe it’s a set of initials ripe for exploitation in the form of many, many obtuse comedic slogans. That one episode of Criminal Minds depicts it as deriving from a delusion so rigid that it just may compel you to obsessively start fires and kill people. (Yikes.)

Unfortunately for these folks, all of the above are far from the reality of the condition. I know, because I have it. And while representations of OCD can range from fairly accurate to just plain offensive, there is not a single one that encompasses every form. In fact, one of the most neglected truths about OCD out there is that it’s not always what you recognize. It’s sometimes not even remotely visible.

Take “invisible” compulsions. An invisible compulsion is a compulsion that other people can’t see. That means that to your mother, it may look like you’re irresponsibly staying up too late; or to your teacher, it may look like you’re slacking off on your assignments; or to your girlfriend, it may look like you are unwilling to say the words she wants to hear. All the while, to you, there was never really a choice in the first place.

To understand this, you have to know that OCD generally works in a two-part process. There’s an obsession (this can be a thought, a fear, a belief, or a feeling) that then triggers a compulsion (an action, routine, or ritual) – the exception being when someone experiences “Pure O” OCD, in which case there is only a repetitive thought or fixation with no compulsion.

What people generally fail to recognize, though, is that not all compulsions are hand-washing or stepping over cracks. In fact, not all are even physical or animate. It’s easy to imagine the interference of a compulsion like needing to stop and count every grain of spilled rice when a bowl has tipped over, or a need to check five times daily whether a door is locked. It’s harder to picture a block that happens inside the mind. Many individuals with OCD experience obsessive thought rituals, such as fixating on intrusive impulses or images, the compulsive need to follow a train of thought to its conclusion regardless of its relevance, or the acknowledgment of everything that flits across one’s mind.

For me, this might look like otherwise innocuous behavior. In conversations, for instance—the obsession says, How recently have you asked this person how they are—check now! What if something has changed—ask again! What if you run out of things to talk about and come across like you’re not trying—again! What if they want to say something but you haven’t given them an opening—again! In some ways, OCD could really be called the ‘What if’ disease – even if logic doesn’t imply that something is probable (if I just checked how someone was five minutes ago and they were fine, they’re probably still fine), the prodding What if? still plagues the brain and refuses to be ignored until something is done about it.

Or in another form, one could fixate around absolutism. My OCD is allergic to the idea of thoughtlessly saying something that could be proved untrue. This includes absolute ‘yes’es, absolute ‘no’s, and any statements of fact regarding the future (regardless of how certain I personally am about it). This also includes the use of Capital Letter Concepts (eg Love™, Happiness™, Good & Bad, and so on), among others. This might seem like no big deal until your relationships with people are impacted by an inability to commit to meaningful statements, or your need to phrase things as diplomatically as possible results in the impression of not thinking or feeling what you really do.

Other invisible compulsions might take place outside of the social or interpersonal sphere. A common feature of many OCD sufferers, for example, is the fixation on numbers, signs, or symbols. This can be fairly apparent when someone refuses to stay on the 13th floor because it’s unlucky; it’s less obvious when, for instance, a person might be unable to leave a situation or switch activities until the digits on a clock are arranged in a particular order. Anyone who has eaten out with me will have had to witness my ‘I am calculating things in my head’ vacant stare while I’m figuring out how to make my check a Winning Number without under-tipping. This is easy when you can get it to $10.10 or $7.77; it gets more complicated when you get higher up and have to start dipping into historical dates ($14.92? $17.76? When did the French Revolution happen again?)—especially when you’re bad at history.

There are rituals, even the ones you can see, which might seem like innocent quirks... until they add up. A lot of people might have certain orders in which they typically eat a dish or meal. But this can be taken to an extreme with an OCD person, who might feel compelled to pick out every crumb or garnish in a dish of pasta before eating it, even if it takes forty minutes, or might waste ten percent of every meal because they can’t eat the crusts, edges, or ends of any food they consume. Alternatively, many non-OCD folks have their own nighttime routines, which are harmless. Someone with OCD, though, may spend hours in front of the mirror scrutinizing their face or must put away every dish or flip every switch or stack every object before they can go to bed.

I could go on and on, but here are a few examples of the obsessions and compulsions that can happen without being perceived by others as ritual (and all of the following are from personal experience):

What if: I let a ‘bad’ or ‘judgmental’ thought pass by unchallenged, and as a result unconsciously am maintaining negative moral character?
Therefore: I must go over any negative or potentially stereotypical observation I ever have internally, assess its motivations, deconstruct whether or not it is harmful, and possibly deliberately make a silent commitment to improving.
Impact: This isn’t necessarily an inherently harmful practice, but it can become debilitating when it demands such concentrated introspection at every flit of an idea or intrusive thought or image in one’s head, genuine or otherwise.

What if: I misheard or misunderstood or imagined what someone was saying, which leads to a horrible slight or disaster?
Therefore: If I am not 120% certain that someone definitely did say [thing] (which can become impossible if it isn’t recorded somewhere), I cannot say or do anything that assumes [thing] is true.
Impact: Social cues, relationship signals, or even things that have been flat-out said before can all end up being ignored or not acted upon due to compulsive second-guessing.

What if: I begin something that I can’t finish in one go, never complete it, and end up having wasted that time and energy in a way that somehow ruins my entire future?
Therefore: I can’t start something if I don’t believe I can finish it in one try.
Impact: As someone with ADHD and therefore inability to judge times, this is a huge interference in completing assignments, readings, projects; anything really.

What if: I am making inefficient use of my time by going to sleep before accomplishing the maximum amount I could possibly accomplish?
Therefore: I cannot go to sleep until it is literally impossible for me to a) do anymore, or b) stay awake any longer.
Impact: As though it weren’t hard enough for me to sleep at reasonable times, thank you sleep disorders, I cannot even force myself to take drowsiness-causing medications or induce earlier rest times because the compulsion to stay awake wins out. The resulting sleep deprivation can just end up increasing stress and adding to the difficulty of the rest of each day.

What if: I miss an opportunity, message, conversation, or notification that will ultimately make the difference between a fulfilled life and one I regret?
Therefore: All messages, notifications, lists, and apps must be checked constantly throughout the day, every morning and every night; ill-advised invites are nevertheless answered with compulsive ‘yes’es or ‘maybe’s; vigilance is demanded at all times.
Impact: Ironically, this ends in compulsive impulsivity, missed obligations, divided attention, and delayed decisions.

Individually, just one of these compulsions might cause only a mild barrier to a productive life. But cumulatively, OCD is an incredibly debilitating disorder. From waking up (must check phone, must check planner, must check insert growing list here) to going to class (have to find a seat that is Just Right and lay out all of the Necessary items in the Most Efficient arrangement for productivity) to eating a meal (chicken nuggets first, fries second, no eating of ends, no over or under use of sauces) to writing a paper (is this sentence too complex, too simple, have I used this word too many times already?), having Obsessive-Compulsive Disorder is a full-time occupation. It’s not fun, but more than that, it takes time, it takes energy, and it takes a lot of stress simply to maintain a day-to-day existence.

So how can you be a good friend to your local OCD (Outstandingly Cool Dingo) with OCD?

For starters, you can stop claiming you’re “so OCD, haha” simply because you take color-coded notes or alphabetize your CD collection. OCD isn’t a character trait, it’s a full-fledged psychological condition; you can’t be “a little OCD” about “some” things. So feel free to erase that phrase from your vocabulary, and replace it with what you actually mean—and tell others to, too.

Secondly, please for the love of God just never, ever buy or wear any of these t-shirts. Seriously. Yes, even this one. I do not care how much you love the holidays.

Third, though, is to just honestly give us the benefit of the doubt. Sometimes “I can’t do this” really means “I can’t do this,” regardless of our physical capability or means. And just because our compulsions may be illogical doesn’t mean you can talk us out of them—I promise you, there is no one more frustrated by them than we are.