Understanding OCD: Beyond the Stereotypes
- Sindhura Saini
- Jul 1
- 3 min read
A St. Louis Psychiatrist Explains the Realities of Obsessive-Compulsive Disorder
When most people hear “OCD,” they picture someone who’s overly tidy, obsessed with cleaning, or constantly organizing. But as a psychiatrist practicing in St. Louis, I can tell you that Obsessive-Compulsive Disorder is much more than a preference for neatness — and the media rarely gets it right.
Many individuals in the St. Louis area silently struggle with OCD symptoms that don’t match what they’ve seen on TV. That mismatch often delays diagnosis and treatment. In this post, I’ll explain the subtypes of OCD, how media portrayals fall short, and how people in our local St. Louis community can access help and support.
What Is OCD?
OCD is a chronic mental health condition characterized by:
Obsessions: Unwanted, intrusive thoughts, images, or urges that cause anxiety or distress.
Compulsions: Repetitive behaviors or mental actions performed to neutralize that anxiety.
This cycle can be extremely disruptive — whether you live in Webster Groves, Richmond Heights, the Central West End, or elsewhere in the greater St. Louis area.
Common Subtypes of OCD (Beyond Cleaning)
Here are some of the more common — but often hidden — subtypes I see in my St. Louis psychiatric practice:
1. Contamination OCD
Fear of germs, illness, or environmental toxins; may lead to excessive cleaning, hand-washing, or avoiding public spaces like the MetroLink or local grocery stores.
2. Harm OCD
Unwanted thoughts about accidentally or intentionally harming others, such as pushing someone at the Gateway Arch or hurting a loved one. These thoughts are distressing and ego-dystonic — the opposite of what the person wants.
3. Scrupulosity (Religious or Moral OCD)
In a city with vibrant religious communities — from Ladue churches to South City mosques — this subtype can lead to obsessive fears about sinning or offending a higher power, along with compulsive praying or confessing.
4. “Just Right” OCD
The need for symmetry or order. Individuals may spend hours arranging things until they feel “just right,” sometimes avoiding activities like shopping at St. Louis Galleria or dining out because of the anxiety it causes.
5. Relationship OCD (ROCD)
Obsessive doubts about one’s romantic relationship, including frequent reassurance-seeking or comparison to others. In St. Louis, where family and community ties are strong, this can be especially distressing.
6. Existential OCD
Repetitive worries about philosophical questions — like the meaning of life or reality. These intrusive thoughts can make it difficult to focus on work or school, whether you’re at Washington University, SLU, or elsewhere.
Why the Media Gets OCD Wrong
Popular shows and movies often reduce OCD to a personality quirk. Characters like Sheldon Cooper or Monica Geller are depicted as simply controlling or particular — ignoring the debilitating anxiety, shame, and distress that real people with OCD experience.
These portrayals:
Trivialize the condition, making it harder for people to seek help.
Create stigma, especially for those with taboo obsessions.
Delay diagnosis, particularly in communities like St. Louis where awareness may still be catching up to national conversations.
Real People in St. Louis, Real Struggles
At my psychiatric practice in Richmond Heights, I often work with individuals who have spent years feeling confused or ashamed of their thoughts, unsure whether what they’re experiencing “counts” as OCD. The answer is: if it’s interfering with your life, it matters. And help is available.
What Treatment Looks Like in St. Louis
The gold-standard treatment for OCD includes:
Exposure and Response Prevention (ERP) therapy
Medication (often SSRIs or other antidepressants)
If you're in the St. Louis area and looking for support, I offer both therapy referrals and medication management — in person at my Richmond Heights office or via telepsychiatry for patients across Missouri.
Take the Next Step
You don’t have to navigate OCD alone. Whether you're a student at SLU, a parent in Kirkwood, or a young professional in Clayton, know that real, evidence-based help is within reach — right here in St. Louis.
➡️ Ready to explore whether you might be experiencing OCD? Schedule a consultation here
Comments