What can the Target Christmas sweater teach us about OCD?

U-M psychiatrist explains what obsessive-compulsive disorder is REALLY about

target OCD sweater

This week, Target made news for debuting a holiday-themed sweater that labeled OCD as “Obsessive Christmas Disorder” – a play on the condition’s real full name, obsessive compulsive disorder.

Critics are accusing the store as “trivializing mental illness” and are saying that this message “perpetuates myths and misunderstandings.”

We sat down with OCD expert and Assistant Professor of Psychiatry Kate Fitzgerald, M.D., to set the record straight.

How do you identify true OCD?

Fitzgerald_576Dr. Fitzgerald: Typically, we diagnose true OCD (Obsessive-Compulsive Disorder) in someone who has unusual, intrusive and repetitive worry or fears. These fears or worries may interfere with his or her functioning in some way (school attendance or performance, relationships with family members or peers, involvement in activities). Generally, a person with true OCD reports thoughts or fears that come to mind over and over again, even though they might realize the worries do not make sense. Some examples of obsessive thoughts are fear of contamination, accidental violence, or needing to feel “just right.”

How do you distinguish between compulsive behaviors like shopping and OCD?

Dr. Fitzgerald: Compulsive shopping starts out pleasurable; as with any addiction, compulsive shoppers may end up feeling regretful or guilty, but the pleasure of buying keeps them going back  to buy more. This is very different from the compulsions of OCD. In OCD, intrusive thoughts cause severe anxiety that trigger compulsive behavior to correct or prevent a feared outcome. Compulsive behaviors are committed to reduce the sensation of anxiety. For example, washing your hands over and over again is not pleasurable. It is done to reduce anxiety that your hands might be contaminated and could cause you to become very sick.

When someone casually says, “I’m so OCD,” it might mean that being extremely organized gives them pleasure or satisfaction. With true OCD, if a person does not act on a compulsive urge, they may fear that something very bad will happen as a result.

What percent of the population has true OCD?

Dr. Fitzgerald:  According to the National Institute of Mental Health, over 2 million adults in the U.S. suffer from obsessive-compulsive disorder, or 1-3 percent of the population. Eighteen percent of teens and adults have subclinical symptoms of OCD. Subclinical symptoms mean present but minimal stress, and usually mean that a person does not need treatment.

Eighty percent of the population has some degree of ‘OCD-like’ thoughts and behaviors. They do not impair functioning and if a person checks once, they are satisfied. These behaviors are not as sticky or extreme as true OCD. An example of this is a person feeling the desire to double-check that they have left the house with their passport while heading to the airport. Once you double check, you are all set and do not need to check again.

Can a person have ‘Obsessive Christmas Disorder’ or be overly obsessed with a holiday or event?

Dr. Fitzgerald: No, a person cannot have obsessive Christmas disorder or have OCD about a specific holiday or fun event. The key to remember is that there is no fear or distress involved in this situation. Sometimes, a child may become hyperfocused on Christmas or other exciting events, but usually this is pleasurable for the child and perceived as “cute” by parents and other adults. In rare cases, a child may have a hyper-focused, pleasurable interest that dominates their time and gets in the way of having other, normal interests. This level of hyperfocus is considered a “stereotypic interest,” characteristic of autism spectrum disorders, but does not usually involve the topic of Christmas.

Help us help people with the real OCD:

Do you know someone with obsessive-compulsive disorder? We’re currently recruiting participants for a study on cognitive behavioral therapy, or CBT, for obsessive-compulsive disorder. The goal of this study is to see what brain changes are important for CBT to reduce OCD symptoms in adolescents and adults. In the future, we will use this information to try and improve how we deliver CBT so that it can more fully help people of various ages.

Learn more about the study here

PsychlogosqThe U-M Department of Psychiatry is part of the University of Michigan Health System, one of the nation’s leading health care facilities, and is home to the nation’s first comprehensive Depression Center and the Molecular and Behavioral Neurosciences Institute. It provides patients with state-of-the-art treatment and care of psychiatric disorders, much of it based on the innovative research done by U-M faculty. U-M was one of the very first universities to provide modern diagnosis and research on mental disorders.