choicesI’ve been an advocate for OCD awareness for almost ten years now and while I feel that some progress has been made in the public’s understanding of the disorder, we still have a long way to go. One of the more difficult concepts to get across, I believe, is just how debilitating obsessive-compulsive disorder can be. Maybe because many people, on some level, can relate to some of the more common obsessions and compulsions, they also believe they “know how those with OCD feel.” Perhaps these people are afraid of germs or everything has to be “just so.” But in reality, unless they actually have obsessive-compulsive disorder, they have no idea of the torment those with OCD experience.

One aspect of OCD that I believe falls into this category is indecision. For whatever reason, I seem to be coming across more and more people with OCD (and those with depression as well) who are affected by this issue. But not affected like those of us without OCD. While those of us without the disorder might agonize over important decisions and possibly even lose a night’s sleep, those with OCD might be paralyzed with fear over any decision – large or small.

For example:

Reviewing breakfast options over and over again in your mind, trying to determine the best combination of food to eat. The perfect meal always seems to be just out of reach, so a decision is not made, and the meal is skipped.

Thinking of, praying about, and analyzing the pros and cons of attending a particular event for days on end. Not being able to come to a decision means missing the event, and then the worrying (for days) begins over the repercussions of not showing up.

Deciding what shirt to wear to work and fearing that whatever you choose might lead to someone you love getting hurt (you know it makes no sense, but still, you never know…). You’re late for work so you grab a shirt and for hours after repeat the phrase, “Nobody will get hurt.” You’re not able to concentrate on anything else for the rest of the day.

In the above examples, avoidance is evident, as is the need for certainty. Perfectionism often plays a role in indecisiveness as well.

It’s not hard to see how lives can almost be destroyed by this level of indecisiveness. I hope these examples have illustrated how indecision in those with OCD differs from “regular” indecision. And while these situations can indeed be debilitating, there is a solution. As I’ve said over and over again, OCD, no matter how severe, is treatable. Addressing cognitive distortions and embracing exposure and response prevention (ERP) therapy are both life-changing decisions that should be easy to make.