[Tw: self-harm, suicide] OCD: How bad could it be?

Tw: self-harm, suicide

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Today I want to talk about a question I was once asked by a friend. For context, this friend is someone I consider myself a big sister to & they’re very earnest & genuine.

We’d somehow got to talking about my health issues & as part of the convo, the question that came up regarding illness severity was: could you die from your illness?

[I have lots to say (InshAllah another time) about the focus on mortality as a measure of illness severity but putting that aside for now, I just want to focus on the answer to this question.]

I said yes, I could die from my illness. My friend was taken aback by this & struggled when I explained that OCD can cause suicidal thoughts. In this case, I do think suicide is still conceived of by some folks as a voluntary action to end a situation rather than a symptom of an illness. But even that aside, I don’t think many folks realize just how severe OCD can be.

Many other folks have written about the damage done from flippant uses of terms like “I’m so OCD” to describe perfectionism etc. in terms of leading to stigma about it not being a real disorder or not causing severe anxiety etc. I haven’t seen too much yet about the extent of the harm that OCD can cause.

OCD often brings with it a comorbid diagnosis of depression. So perhaps the suicidal thoughts are getting attributed to depression rather than OCD. But I think discussions about OCD even in a clinical setting sometimes miss the causality. Changes to one’s life due to OCD can bring on a situational depression as well. That’s not to say people with OCD can’t have depression unconnected to their OCD. I have that too. But OCD by itself can result in depression IMO by restrictions it can impose on one’s life.

In addition to suicidal thoughts, OCD can result in severe issues outside of depressive symptoms. An emblematic example is when I was treated in a partial hospital program for OCD. My first day, I was asked to do a test where they measured how fast I would walk down a hallway to assess whether I would be able to leave the building in an emergency such as a fire.

You might be thinking what that test has to do with OCD. The answer is many types of OCD can cause debilitating anxiety that make certain tasks very difficult to complete in a timely manner. An example would be checking or counting type behaviours which slow down how fast someone actually walks. In my case, my contamination OCD makes it difficult to leave my apartment if there is a fire alarm without first grabbing gloves etc so I can feel safe touching surfaces I’d consider dirty etc.

All that to say that in addition to suicidal thoughts as a result of anxiety & depression caused by OCD, it can also result in inadvertent self-harm by not being able to do things necessary to take care of oneself in an emergency.

I’ll write another post later about less severe inadvertent self-harm resulting from OCD.

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