Obsessive Compulsive Disorder is a complex condition. It’s a multifaceted disorder that may arise due to life events (interpersonal trauma, neglect, emotional abuse, etc.), brain structure abnormalities or even genetics.
Nicole Erkfitz, a therapist and executive director of AMFM Healthcare, told HuffPost that OCD is an “often misunderstood mental health condition, marked by persistent, distressing thoughts (obsessions) and repetitive behaviors (compulsions).”
While these thoughts and behaviours are known to interrupt the daily routine, job performance or relationships of an individual, it isn’t exactly the case for those who have high-functioning OCD. Those with this form of the condition may appear as driven and high-achieving; in other words, they may not even look like they’re dealing with OCD at all.
“Despite their preoccupation with obsessive thoughts, images or fears, these individuals are able to conceal their struggles from others,” said Nika Kalili, a therapist at Carrara Treatment Wellness & Spa.
Erkfitz said that the term high-functioning OCD is “an informal descriptor that some people use to convey the extent to which their condition affects their daily lives.” It’s not recognised as a separate clinical diagnosis, but rather a personal acknowledgement of their struggles with OCD.
Here are the signs of high-functioning OCD and how to best manage the condition:
High-functioning OCD can present with the same main criteria as OCD.
OCD’s hallmark characteristics are the same, no matter if you’re considered high-functioning or not. Those include experiencing obsessions or compulsions, which are distressing thoughts that occur often. A person will likely try to alleviate the thoughts by engaging in a compulsive behaviour. (The most common example here is being overly worried about germs, so a person will wash their hands much more often than normal.)
If these symptoms cause significant stress and are time consuming, there’s a concern that OCD may be present. These behaviours may also cause physical or emotional harm to the person experiencing them, and likely interfere with daily life.
High-functioning OCD can manifest as the need to excel.
An individual with high-functioning OCD experiences intrusive, recurrent and obsessive thoughts. Their thoughts may manifest as a fear of failure, and their resulting compulsions manifest in striving to excel, overworking and overcoming to be viewed as a dependable and competent person.
“These individuals face the same challenges as others with the disorder, yet they maintain their roles and responsibilities at work and home, despite their internal battles,” Erkfitz explained.
It’s common for individuals with high-functioning OCD to find themselves excelling in certain aspects of their life but continue to struggle internally with obsessive thoughts and compulsions.
Perfectionism and excessive worry are also issues.
People with high-functioning OCD may seem simply like they’re perfectionists or high-strung, but if those traits turn into obsessions or are part of intrusive thoughts, they can be a sign of something deeper.
Similarly, here are a few other ways high-functioning OCD can show up, according to both experts:
- Having an obsession to micromanage situations
- Excessive worrying that something bad may happen
- Intelligent and highly functional but suffers in silence
- Compulsions and obsessions that don’t impair functioning and aren’t severe
- Attempting to control future outcomes while obsessing over the past
- Perfectionism
- Stress
- Fear of embarrassment when mistakes are made
- Obsession over details and schedules
- Compulsively checking and rechecking work
- Over-analysing
- Taking on responsibilities to prevent mistakes
Those with high-functioning OCD often downplay their symptoms.
“Individuals perceived as high-functioning may outwardly appear as great employees, well put together parents, or exceptionally capable friends,” Erkfitz said. “Internally, however, they may be grappling with fears or failure, loss or abandonment.”
“Because their obsessions and compulsions are undetectable, unlike low-functioning OCD where the symptoms are debilitating, individuals with high-functioning OCD often dismiss or minimise the symptoms, or downplay it as part of their personality in which they believe they can manage by themselves,” Nika explained.
High-functioning OCD is treated similarly to other forms of OCD.
“Common approaches include pharmacological interventions such as Selective Serotonin Reuptake Inhibitors (SSRIs) and therapeutic strategies like exposure therapy, which gradually exposes individuals to their obsessive thoughts to reduce distress,” Erkfitz said.
Since OCD can also be intertwined with trauma, therapy often involves exploring the underlying needs that compulsions serve. For instance, some who have high-functioning OCD may struggle with a core belief of inadequacy. Case in point: building self-worth and esteem is crucial to their treatment process.
“Anytime OCD begins to hinder one’s ability to engage fully in life is a clear indicator that professional assistance may be beneficial,” Erkfitz said.
Whether you or someone you know is dealing with high-functioning OCD, it’s important to understand that the condition is more than just a series of quirky habits or a penchant for perfectionism. “It’s a serious health condition that deserves attention and care,” Erkfitz noted.
Professional support can make a substantial difference in managing the symptoms of OCD, enabling individuals to lead fuller, more satisfying lives.
“For anyone struggling with OCD or related symptoms, remember that reaching out for help is a sign of strength, not weakness,” Erkfitz said. “Your primary care doctor can be a gateway to specialised treatment, which can vastly improve your quality of life.”