Obsessive Compulsive Disorder is a complicated condition. It’s a complex disorder that may arise due to genetics, brain structure abnormalities, or life events like neglect, interpersonal trauma, or emotional abuse. Nicole Erkfitz, executive director of AMFM Healthcare and therapist, said that OCD is typically a misunderstood mental health condition marked by constant, distressing thoughts and repetitive behaviors.
These behaviors and thoughts are known to interrupt an individual’s job performance, daily routine, and relationships, but it’s not always the case for those with high-functioning OCD. People with this form of the condition may come off as high-achieving and driven. In other words, they may not even look like they have OCD. Despite their preoccupation with fears and obsessive thoughts, these people can hide their struggles from others.
According to Erkfitz, the term high-functioning OCD is an informal description that some use to show the extent to which their condition affects their daily lives. It’s not recognized as a different clinical diagnosis but a personal acknowledgment of their struggles with OCD. Here are some signs of high-functioning OCD and how to manage the condition.
High-functioning OCD may have the same criteria as OCD.
The hallmark characteristics of OCD are the same, no matter if you’re high-functioning or not. Those include experiencing compulsions or obsessions, which are distressing thoughts that happen often. A person will likely try to improve their thoughts by engaging in compulsive behaviors. The most common example is being overly concerned about germs, so someone will wash their hands much more than usual. If these symptoms cause major stress and are time-consuming, there’s a concern that OCD may be present. These behaviors might also cause emotional or physical harm to the person experiencing them and likely hinder their daily life.
High-functioning OCD can look like the need to excel.
Someone with high-functioning OCD experiences recurrent, intrusive and obsessive thoughts. Their thoughts can manifest as a fear of failure, and the resulting compulsions manifest in striving to succeed, overworking and overcoming to be seen as a competent and dependable person. Erkfitz explained that these people face the same challenges as others with OCD, but they maintain their responsibilities and roles at home and work despite their internal battles. It’s normal for people with high-functioning OCD to find themselves excelling in certain parts of their lives but continuing to struggle internally with obsessive compulsions and thoughts.
Excessive worry and perfectionism are also issues.
People with high-functioning OCD may seem like they’re high-strung or perfectionists, but if those traits are part of intrusive thoughts or turn into obsessions, they can be a sign of something more profound. High-functioning OCD can also show up as having an obsession with micromanaging situations, excessive worrying that something terrible will happen, being highly functional and intelligent but suffering in silence, and obsessions and compulsions that don’t impair functioning and aren’t severe.
It can also show up as attempting to control future outcomes while obsessing over the past, stress, perfectionism, fear of embarrassment when mistakes happen, over-analyzing, obsessing with schedules and details, and taking on responsibilities to prevent mistakes.
Those with high-functioning OCD usually downplay their symptoms.
People who are perceived as high-functioning may outwardly look like great employees, well-put-together parents, or competent friends. However, internally, they may be dealing with fears of failure, loss, and abandonment. Because their compulsions and obsessions are undetectable, unlike low-functioning OCD, where the symptoms are draining, people with high-functioning OCD typically minimize or dismiss the symptoms, downplaying it as part of their personality, which they think they can manage by themselves.
High-functioning OCD is treated like other forms of OCD.
Typical approaches include pharmacological interventions like Selective Serotonin Reuptake Inhibitors (SSRIs) and therapeutic tactics like exposure therapy, which gradually exposes people to their obsessive thoughts to decrease stress. Since OCD can also be linked with trauma, therapy typically involves exploring the hidden needs that compulsions serve. For example, some people with high-functioning OCD may struggle with a core belief of inadequacy, so building self-esteem and worth is essential to their treatment process.
According to Erkfitz, anytime OCD starts to hinder your ability to engage in life fully, it is a clear indicator that professional help may be beneficial. Whether you or someone you know is dealing with high-functioning OCD, it’s essential to understand that the condition is more than a series of quirky habits or an affinity for perfectionism. It’s a severe health condition that deserves care and attention. Professional support can make a huge difference in managing OCD symptoms, enabling people to lead fuller and more satisfying lives.
For anyone struggling with OCD or related symptoms, remember that getting help is a sign of strength, not weakness. Your primary care physician can be the start to getting specialized treatment, which can significantly improve your quality of life.
