It Is Not What You Thought — Stigma around Obsessive Compulsive Disorder (OCD)
I was working as an assistant teacher in English in my hometown Qingdao, in China’s eastern Shandong province, during the summer before starting Medical school in the UK as an international student. After I had settled in, one of the first students that was introduced to me was a high school boy. His teacher mentioned that he is very talented and hardworking, but suffers from mental health problems. I knew this was something that I should bear in mind, but since nothing related to his condition had appeared obvious to me during our interactions, I soon threw this to the back of my mind.
What happened later was not foreseen. The experience gave me a realisation of how much mental disorders can interfere with people’s lives, and this is where my interest in mental health began.
As a medical student with some theoretical knowledge on mental health, I had never felt the effect of mental illness on people until encountering this student. And this quite unique experience on the stigma with OCD is what I would like to share in this blog.
In one of our lessons, we practiced IELTS English speaking questions, which is an exam that international students need to sit in order to study in the UK. In a question on multitasking, the student mentioned something, something which went unnoticeable at the time. He mentioned in his answer that he was less able to focus now as he had Obsessive Compulsive Disorder (OCD).
OCD is when people have obsessive thoughts or compulsive feelings. Usually people think of this as when people have to wash hands three times or having to organise things in a strict way, but that is not completely true. There are also other symptoms of OCD that are not commonly know by the public. Those may include being constantly aware and focused on body sensations such as breathing and blinking, worrying about being hurt, or having unpleasant thoughts or mental images suddenly dominatinng their minds.
Moreover, OCD is not only about those obsessive behaviours, but also the mental sufferings that come with those actions.
For example, a person without OCD may want to be super organised to achieve personal satisfaction and make themselves feel good, but a person with OCD doesn’t get any satisfaction or enjoyment out of the process. They may feel powerless to stop the thought of “have I locked my door?” from constantly emerging, and waste hours everyday just trying to check once and once again whether they have locked their door, in order to neutralise or make their obsessions go away. This process is torturing and distracting, and greatly interferes with people’s everyday life.
In all of my previous knowledge with OCD, it was mentioned under joking contexts, whether online or in real life conversations, to describe people as being perfectionists. It was such a buzzword and had always seemed to be a ‘commendatory’ term. I had never realised that this is an actual medical disorder which can cause much distress to the people affected by it.
With those presumptions in mind, I was a bit surprised to see that he was able to add a bit of ‘humour’ to his answer. ‘Great language proficiency and niche vocab’, I thought. The previous information that I was told about his mental health conditions was, well out of my mind, and my reactions were of course far from the perfect response I would have if I knew that this was not a joke.
The flash of realisation only caught me after I finished work. It struck me all of a sudden when I was walking home. Mixed feelings rushed in. Guilt. Remorse. Sympathy. They were light, but persistent.
This was unforgettable, especially considering that I am a medic who should have more prior knowledge on mental health. I had lost the chance to react to his answer, and never found an appropriate opportunity to apologise.
A few weeks later, he was absent from one of our scheduled lessons. He sent me a long text explaining what had happened.
“I’m very sorry, and I don’t know how to explain this to you.”
His mental condition had worsened, and he had restarted taking medications for his disorder, which showed some obvious side effects. He had found himself extremely sleepy, and it was hard to gain consciousness until very late in the mornings. I remember him was trying to assure me it wasn’t a case of going to sleep late. He mentioned how he did doubt about his willpower, but his consciousness level had changed completely compared to when he was not taking the medication. That was absolutely fine and understandable. But the question I had immediately, was that why is he trying so hard to explain and apologise for something that should be so comprehensive and seemed to be common sense?
It then was apparent from his descriptions, that the people around him, but perhaps himself too, were not well equipped with sufficient information about mental health.
The fact that some drugs for mental disorders have side effects is not something that is generally known and understood, at least in the environment that surrounds him. He was afraid of being blamed and thought of as finding excuses, or putting off responsibility, so he had tried to confess that there were other personal elements in this as well. But there was not. It is a mental health condition, not a personal resilience issue.
The experience with this student was a powerful one, and is one that is stuck in my mind until this day. It made me realise that the education on mental health at least in my city was far from enough, and there is still a big stigma yet to be resolved, on a regional, and likely, national level. Due to the hugely distorted images on mental illness created by media and film, and lack of exposure to more realistic and scientific resources, the negative associations with mental illness have nearly become a ‘fact’. Even when I simply look at words of some psychiatry related illness in mandarin, unpleasant scenes would still emerge in my mind.
We have already known that the most effective way to reduce stigma is through social contact, like interaction and experience with people suffering from mental illness. Non-direct social contact through social media is also a very effective way to educate on a large scale. Hopefully with those methods in mind when advocating, more and more people will appreciate and understand the topic of mental health.