'What if I've killed someone and forgotten about it?' What it's like living with Harm OCD.

I’ve known I have OCD for a very long time.

At the age of 11, I was diagnosed with a classic case of contamination OCD – the 'germophobia' stereotype that pop culture knows and loves. I’d wash my hands up to a hundred times a day, have obsessive rituals around my bedtime routine and refuse to use public toilets.

When I ‘recovered’ from this in my later teenage years, I thought I was sorted. Society had me believe that the lack of visible compulsions excluded me from that diagnosis anymore. It took me almost another decade to realise that my OCD had just changed form. That I wasn’t a bad person. That intrusive thoughts were a part of my life, and that the echo chamber of my mind wasn’t a great place to be with them.

Listen: Penny Moodie speaks to Mia Freedman about her experience with relationship OCD. Post continues below.

This second chapter of my journey started a few years ago, triggered by an episode of Unforgotten, a UK crime series. In the show, a lady with dementia had forgotten she had buried a body in the backyard of her home. A thought crept up on me after watching: What if I had killed someone and forgotten about it?

This thought turned into an obsession, the obsession led to compulsions, and those compulsions led me to some very dark places. But they also taught me a lot. A lot about being human, and a lot more about OCD, mental health and how we, as a society, manage mental illness. 

It’s been a journey. I’m still on it.

I want to mention that I'm not a mental health professional. A professional worrier and overthinker, yes, but, unfortunately, I’m not professionally trained in the ways of the brain, so what I say is by no means to be taken as advice or a replacement for treatment.

But for those not in the know about OCD, here are nine things I want you to understand:

1. Please, please don’t describe your affinity for cleanliness as 'so OCD'.

I repeat: please. I’ve overheard it on the train, from co-workers and even from a well-meaning acquaintance. It’s never nice to hear your debilitating mental illness used as a joke or written off as a cute quirk. As I’ll come to explain, the majority of OCD sufferers don’t even suffer from cleaning compulsions – and those who do don’t just like the corners of their bed straightened. Instead, they’ll engage in hours upon hours of rigid rituals that suck the joy out of every day. OCD isn’t cute! Perpetuating the idea that OCD is strictly contamination focused is also super unhelpful when it comes to understanding OCD and consequently, encouraging sufferers to get help.

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2. There are many, many different obsessions out there.

Unfortunately, OCD is the kind of disease that can centre around almost any obsession. There are religious, violent, existential, sexual and sensorimotor obsessions to name a few. Me? I walk around all day wondering if I’ve managed to commit a crime unawares. It SOUNDS illogical. It IS illogical. But it doesn’t matter. Uncertainty is the enemy and I can’t rule it out 100%. 

Sometimes I’ll walk 200 metres past a leaf on the ground and turn back to remove it because I had a thought that an elderly person might slip and fall on it – and it’d be all my fault for not picking it up. Sometimes, I’ll hit a stick on the road while driving, know it’s a stick, drive five minutes and loop back around, worried it might actually not have been a stick at all, but a person. OCD doesn’t discriminate. It comes after what you hold dear and it comes hard. 

3. In contrast to what pop culture would have you believe, OCD can be an invisible illness.

OCD compulsions aren’t always physical, they can be mental, too. This can include checking, reassurance seeking, mental review and plenty more. As with many mental illnesses, this can make it incredibly difficult to get by in your day to day, especially when outsiders see you apparently ‘thriving’. Can you check your emails whilst mentally reviewing your drive to work, concerned you’ve run someone over? Sure can. It’s very easy to function normally on the outside whilst inside, your mind is a tiny prison you can’t escape.

4. But OCD can also result in physical symptoms... 

On top of all the thoughts whizzing about in your mind, OCD can also lead to muscle tension, exhaustion, fatigue, nausea, stomach upset, headaches, digestive issues and more. 

5. Sufferers often feel they can’t speak about it. 

Due to OCD playing on our value system and often revolving around taboo topics, sufferers often feel they can’t speak about it. Intrusive thoughts aren’t unique to OCD. Everyone gets intrusive thoughts. The difference is, those of us with OCD attach a whole lot of meaning to them. 

Imagine for a second that a thought like this popped into your mind: What would happen if I took my foot off the brake and ran over these pedestrians crossing the road? It’s a possibility, it’s natural to have these things pop into your head, and most people would dismiss it as nonsense and be on to their next thought within milliseconds. However, if you have Harm OCD, like me, this thought will set off an entire stream of associated thoughts, laden with judgement. What kind of person would think something like that? If I think it, could I do it? And what else could I do? It’s essentially a really s**tty game of 'what if' that never ends. 

Naturally, people who are distressed by, say, a thought about harming a loved one aren’t keen to share with people, afraid those around them will think they are deranged or dangerous. It’s a lonely place to be. Stats vary but on average it takes people with OCD nine years to be diagnosed. That’s an awfully long time.

6. OCD treatment is HARD.

We’re trying. No one would ever choose to go through this experience so please be patient with us. Many effective treatments require you to confront your OCD head-on. One such treatment, exposure therapy, requires sufferers to overcome fear by confronting it. For someone with contamination fears, this could mean not washing their hands after touching a doorknob or handle. For me, it means writing first-person stories about committing a crime and reading them over and over until the fear dissipates. Both scenarios are about as confronting as it gets because the fear is given life-or-death value. If progress is slow, be patient with us. We didn’t choose this and we’re trying. 

7. It takes a village.

Therapy alone often isn’t enough. A supportive team of friends and family goes a long way. The more I’ve spoken out about my OCD and the distress it brings to me every day, the more support has turned up. Friends have sat by and listened patiently as I’ve shared some pretty wild thoughts. And clearly, they’re listening. Recently I text a friend asking her to confirm I definitely did *not* commit a crime on our recent night out. Her response to my reassurance-seeking –  "I'm not answering that but we had a fun night" – was 100 per cent the correct response and I appreciate her listening and learning about how to deal with these questions along with me.

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8. We might do some s**tty things.

Let me take you back to the worst day of my life, circa 2007. I was sick in the middle of the school holidays and seeking to cheer me up a little, my younger sister went to fix me a snack, whilst I lay plonked in front of the TV watching repeats of That’s So Raven on the Disney channel. 

Imitating my mum’s ‘sick from school’ treat for us, she'd collected various bits and pieces from the pantry to create a snack plate. With a gappy smile, she presented me her offering. Before even laying eyes upon the perfect platter, I questioned her: had she washed her hands? How many times. She hadn't – and I uttered the coldest and most regrettable sentence of my life. 

“I can't eat it. Take it away”. 

To this very day, I am haunted by her tear-filled blue eyes.

9. The work is never done. But we’re trying.

Mental illnesses ebb and flow, and OCD is no different. Keeping obsessions and compulsions at bay is a constant job. As such, the work is never done. 

You can’t “give” yourself a new expression of OCD (a common fear amongst us sufferers) but the way it expresses may alter and change with time. When I was younger, my obsessions and compulsions were based on contamination. I’d have elaborate washing rituals which left me with cracked heels and hands and stringent rules around “inside” and “outside” clothes. Whilst I have very few concerns around contamination now (I even let dogs sleep in my bed! Yay!), my OCD is far from cured. I’m always working hard to ensure I sleep enough, eat properly, exercise, take my medication and don’t follow rogue thoughts. It’s hard and I’m always working.

There is so much more to this complex disorder than anyone would ever be able to tackle in one article, but hopefully, this sheds a little light on what is an insidious and truly crippling disorder. One that movies and TV shows constantly fail to depict accurately. 

If you take away nothing else, please remember this – next time you need a way to describe your love of Tupperware and organisation, make it anything but "so OCD".

If you or someone you know is struggling with mental health, please reach out to SANE Australia on 1800 187 263.

Feature image: Supplied.

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