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Living in the shadows of health

By Brian L. Odlaug, Samuel R. Chamberlain, and Jon E. Grant

Surprisingly, many of the common mental health conditions in the world also happen to be the least well known. While Obsessive Compulsive Disorder garners attention from international media, with celebrities talking openly about their experiences with the condition, Obsessive Compulsive Related Disorders are far less recognized and receive scant attention.

Obsessive Compulsive Related Disorders include body dysmorphic disorder, tic disorders (including Tourette’s Syndrome), hair pulling disorder, excoriation (skin picking) disorder, hoarding disorder, and hypochondriasis. The clinical course and severity of these disorders varies from person to person yet can often be recognized by common symptoms. One might ask, what makes these “disorders” in need of treatment rather than everyday habits? A “bad habit” becomes a diagnosable disorder when the behavior becomes hard to control, and has a negative impact on an individual’s ability to function: at home, at work, or in the community. These often impairing conditions affect millions of people around the world, but are usually hidden. What can we do to help those suffering in silence?

Promoting screening for Obsessive Compulsive and Related Disorders is of the utmost importance. Society, the media, and healthcare professionals also need to work together to increase awareness of these conditions and provide timely and adequate treatment. The majority of people with these conditions have never sought treatment, and may not even be aware that they have a medically recognized condition that is potentially treatable. Left untreated, Obsessive Compulsive and Related Disorders frequently follow a chronic course, meaning that symptoms often do not improve with time, without intervention. In fact, many people have suffered with the condition for 10, 20, even 30 or more years without clinical recognition. Few other classes of disorders — mental health or otherwise — carry the overall lack of recognition and treatment as these disorders.


Individuals living with these conditions also should be aware of valuable advocacy and support groups that exist worldwide, including the Trichotillomania Learning Center and Tourette’s Syndrome Association in the United States, and OCD Action in the United Kingdom, to name a few.

Bringing these disorders out from the shadows and into the mainstream of mental health and community consciousness can only serve to improve the quality of life for our family members, neighbors and friends.

Five things that you can do to help people who suffer from OCD:

  1. Clinicians should screen for Trichotillomania and Excoriation Disorder in all patients, but especially women. Most people will not acknowledge the behavior readily and may not even know that they have a diagnosable and treatable problem.
  2. Clinicians should be aware that although anxiety may worsen some of these behaviors, that OCD and the Related Disorders are not simply versions of anxiety and therefore must be treated differently.
  3. Due to the potential impairment of OCD, clinicians need to take it seriously and not view it simply as an oddity.
  4. Family members should be supportive of someone with OCD and not shame or embarrass the person into stopping the behavior.
  5. People with these conditions can help themselves and others as well. Print out articles or information on your condition and show them to family, friends, or even your doctor. They might not know a lot about these disorders either and you can help educate them.

Brian L. Odlaug is a Visiting Researcher at the University of Copenhagen, Department of Public Health. Brian has authored or co-authored over 120 peer-reviewed articles and book chapters, specializing in the areas of addiction, impulse control and obsessive compulsive disorder. Samuel R. Chamberlain is a practicing psychiatrist and Clinical Lecturer at the Department of Psychiatry, University of Cambridge. He has published more than 100 peer-reviewed articles including first-authored papers in Science, the American Journal of Psychiatry, the British Journal of Psychiatry, and others. Jon E. Grant is a Professor of Psychiatry and Behavioral Neuroscience at the University of Chicago where he directs the Addictive, Compulsive and Impulsive Disorders Research Program. They are co-authors of Clinical Guide to Obsessive Compulsive and Related Disorders.

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Image Credit: Person washing his hands. Photo by Lars Klintwall Malmqvist. Public domain via Wikimedia Commons.

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