The Face of Anxiety and OCD

For my dog Gus, anxiety is a squirrel.

For whatever reason, your anxiety and OCD often pick a target.  What follows from exposure to whatever scares you are feelings of fear, dread, and often intrusive thoughts related to that topic.  Whether it's a fear of germs, a fear of harming yourself, or a fear of stepping on cracks... the anxiety takes hold.

What you have to remember though is that the face of anxiety is different for each individual person.

If you don't know someone well (and sometimes even if you do), you often have no idea what sets off his or her OCD and anxiety.  Few of us go around shouting our greatest fears from the rooftops, and our fears don't always follow logical rules.  

For example, someone with harm OCD, who fears they want to hurt others, might not be set off by the stereotypical exposure to dirt, but could be set off by seeing knives.  At a restaurant where most of us are completely carefree and oblivious to the silverware, this person might be close to a panic attack, or feel the need to do certain compulsions to avoid disaster.

The other thing is that a lot of us are pretty good at hiding our inner turmoil.  We try to maintain an image of cool, calm and collected.  When intrusive thoughts are too dark, too scary, or too embarrassing, we want them kept to ourselves and do our best to hide them from the public eye.

So what can you do to be supportive?  Two things stand out to me.

First, don't assume.  When your friend says they have OCD and anxiety, realize that it could mean many different things.  You won't just know what sets them off unless they share.  

Second, if your friend does share, try to refrain from judgement.  Think about your own idiosyncratic fears.  OCD or not, we all have them.  One of my non-OCD fears is that Diet Coke is poison. (Yes, some scientific studies have shown bad effects, but most of my concern with the artificial sweeteners is just based on feeling.)

Just as every person is unique, every manifestation of mental illness is unique.  There is no one face of anxiety and OCD, just like there is no one face of Bipolar Disorder or Schizophrenia.  Those with the same diagnosis share many common threads, but we are ultimately all our own blanket of crazy.  Keep an open mind and remember that you don't have to completely understand to empathize.