OCD: The Things We Didn’t Have Words For

Looking back now, I’m fairly sure my nan would probably have been diagnosed with OCD. But when I was little, she was just Nan.

She had her ways, as lots of older relatives do. She hated insects or animals coming into the house because they brought germs in with them. She was always cleaning. Drawers were packed with things she thought might one day be useful — elastic bands, old envelopes, carefully folded plastic bags — organised into neat little piles. Looking back, it sat somewhere between collecting and hoarding, but in a very controlled, meticulous way.

Everything followed a routine.

Meals were always at exactly the same time each day. Food went onto the plate in the same order. The house ran according to patterns and rituals that most of us didn’t even notice after a while. I lived with her and my parents until I was six, and after that, I stayed there regularly, so none of it felt unusual to me. It was simply how Nan did things.

But if something disrupted the routine — if plans changed unexpectedly, if something was out of place, if things didn’t happen “correctly” — she became visibly anxious. As a child, I didn’t think much of it. As an adult, I often wonder what was really going on for her.

We didn’t talk about mental health then, certainly not in the way we do now. OCD wasn’t something people understood beyond stereotypes about cleanliness or being “particular”. I sometimes wonder how different her life might have been if she’d had language for what she was experiencing — and support without shame attached to it.

Because OCD is so often misunderstood.

According to OCD-UK, OCD involves a cycle of intrusive thoughts, fears or doubts (obsessions) and behaviours or mental rituals (compulsions) aimed at reducing anxiety or preventing something bad happening. It’s not simply about liking things tidy or organised.

And while contamination fears and excessive cleaning can be part of OCD, the condition is much broader and more complex than people often realise.

OCD Is Not a Personality Trait

One of the biggest misconceptions about OCD is that it’s somehow quirky or harmless. In reality, OCD can be exhausting.

Many people experience relentless intrusive thoughts that feel frightening, upsetting or deeply at odds with who they are. Others become trapped in cycles of checking, reassurance-seeking, mental reviewing, counting, or routines designed to prevent anxiety spiralling.

OCD Action explains that compulsions are often attempts to gain certainty or relief — even when the person logically knows their fears may not make sense.

That’s an important point. People with OCD are usually very aware that their fears sound irrational. That awareness doesn’t stop the anxiety feeling real.

One person described it as: “Having an alarm system in your brain that never switches off.”

Another said: “I knew the thought wasn’t true, but I still couldn’t let it go.”

That tension — knowing something logically while feeling something completely different emotionally — can be incredibly distressing.

The OCD We Don’t Always See

What strikes me now when I think about my nan is how much effort must have gone into holding everything together. Because OCD isn’t always dramatic or obvious.

Sometimes it looks like:

• needing routines to feel safe

• keeping things “just so”

• over-preparing for every possibility

• storing things “in case”

• avoiding uncertainty

• struggling when plans suddenly change

• perfectionism driven by anxiety rather than ambition

  
  

And often, people become very skilled at masking it. From the outside, they may seem organised, dependable, even highly capable. Internally, they may be spending enormous mental energy managing fear and discomfort.

Supporting Someone With OCD

Most people don’t expect perfection from others. They just want understanding.

That means:

• listening without judgement

• avoiding jokes like “I’m so OCD”

• recognising OCD is not simply cleanliness or neatness

• understanding that reassurance can sometimes accidentally feed the anxiety cycle

• encouraging support without shaming someone

  
  

Often the most helpful response isn’t trying to “fix” the fear immediately.

It’s simply:

• “That sounds really hard.”

• “You don’t have to explain everything perfectly.”

• “How can I support you?”

  
  

OCD in the Workplace

Workplaces matter here too. Many people with OCD become experts at appearing calm and competent while battling huge amounts of anxiety internally. Deadlines, uncertainty, fear of mistakes, changing priorities, responsibility and perfectionism can all become major pressure points.

And because OCD is still misunderstood, many employees fear being judged if they disclose it.

Simple adjustments can make a significant difference:

• clear communication and expectations

• reducing unnecessary ambiguity

• written follow-ups after meetings

• flexibility around appointments or therapy

• psychologically safe management conversations

• avoiding public criticism or embarrassment

  
  

Most importantly, managers should avoid assumptions. Not everybody with OCD needs the same support. For some, structure helps enormously. For others, rigid environments can worsen anxiety. The key is listening rather than stereotyping.

Understanding What Earlier Generations Carried

When I think about my nan now, I think less about the routines themselves and more about the anxiety underneath them. I wonder how exhausting it must have been to constantly try to keep things feeling “safe” or “right”. And I think about how many people from older generations simply carried these struggles quietly because there was no vocabulary, no awareness, and very little compassion around mental health.

There are still misconceptions about OCD today, but organisations like OCD-UK’s Understanding OCD guide and OCD Action are helping change that through education, support and advocacy.

Sometimes understanding arrives years later. Sometimes compassion does too.