“Why Can’t I Have One of the Cool Mental Illnesses?” by Daniel Sidman

Oct 19th, 2022 | By | Category: Nonfiction, Prose

The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020 states that OCD, the anxiety disorder which I have, is the tenth most disabling disorder worldwide. This statistic got me thinking. First, I didn’t know that there was a ranking system. Since when was this a competition? Who is keeping stats for this, and how? Do people place bets on this? Is there an underground betting scene for mental illnesses that I don’t know about? Are there mental illness bookies, a Mental Illness March Madness? Are there a bunch of guys huddled around a dog-eared copy of the DSM-V in some bar saying things like, “Yeah, bipolar disorder looks good this year but my money is on major depressive disorder again. They’re always a perennial powerhouse. And you can’t count out schizoaffective disorder either.”

Since I’m a competitive person I also want to know why OCD isn’t number one? On the one hand, I’m happy to hear that we cracked the top ten, but we need to do better. We can’t let depression win every year. What can we do, what can I do to get our disorder’s stats up? How can I help the squad? Obsessions and compulsions already take up a large part of my day, but maybe I need to work harder. Maybe I need to be more compulsive. Maybe I need to wash my hands and check the locks on the doors and windows more than I already am. If I spend fifteen minutes checking the door and window locks every night I need to make that thirty minutes. If you want to be the best, you have to want it more than the other guy. If you’re going to have a disabling mental illness, you might as well be the best.

Truth be told, I don’t wish that OCD was more disabling than it already is. My main gripe with OCD is that it’s not cool. I could handle this far better if only OCD had better street cred. If you’re going to be saddled with a chronic mental illness, you might as well get one of the cool ones. It’s a simple fact that some mental maladies are sexier than others. OCD, unfortunately, occupies a bottom spot on the mental illness coolness hierarchy.

Part of the issue is that the roster for Team OCD (or as I like to call us, the Obsessive Owls) is weak in comparison to some of the other mental disorders. Look at some of the people on Team Depression: Michael Phelps, Buzz Aldrin, The Rock, Georgia O’Keefe, Sylvia Plath, James Baldwin. The list goes on. Bipolar disorder boasts Mariah Carey, Sinead O’Connor, Jean-Claude Van Damme, Amy Winehouse, Kanye West, Kurt Cobain, and Van Gogh. Team Schizophrenia is nothing to scoff at either, with names like Edvard Munch, Jack Kerouac, John Nash Jr., and Zelda Fitzgerald adorning its ranks.

Then take a look at OCD. Who do we have? Howie Mandel, Lena Dunham, Howard Stern, Detective Adrian Monk if we’re permitting ourselves the freedom to include fictional figures in this discussion. No offense to these people, but it’s not exactly a star-studded squad. Comparatively, we’re the Bad News Bears of the mental illness world. Mr. Monk is a beloved character and a talented detective, but he’s a far cry from cool. Nikola Tesla and Howard Hughes are probably the strongest players on the squad, but the two of them alone can’t carry us. Plus, Tesla had some questionable views about women and eugenics. Michelangelo would be a solid addition to the roster, but as Jane Kromm notes in “Psychological States and the Artist: The Problem of Michelangelo,” it’s unclear whether the famous Renaissance man had OCD or if he was just obsessive about his art, which is of course a different thing entirely.

OCD’s long-standing lack of coolness is also due to the symptomatology of the disorder. Many of the other mental illnesses have cooler symptoms.

Let’s start with depression. Being stretched out despondently on a divan smoking a cigarette is cool/sexy. The sad boy/girl is a well-established trope in art and life. Being sad is alluring, intriguing, sexy, mysterious. Doing drugs and drinking because you’re sad is cool. And if we’re being real here, suicide is also sexy. It shows real conviction, real sticktoitiveness. Many of the greats do it, or rather have done it. Sylvia Plath, Hemingway, Virginia Woolf, Anne Sexton, Anthony Bourdain, Van Gogh. Again, the list goes on.

Hallucinating (schizophrenia) is also cool. Who can dispute the coolness of seeing things that aren’t there? Hearing voices is also cool. Thinking that every man wearing a red tie is part of a secret Communist plot against you like John Nash? That’s undeniably cool.

Mercuriality is sexy, and so alternating between being prostrated by melancholy and fits of hypomania makes bipolar disorder a more becoming mental illness as well. Just look at Van Gogh: Crushing absinthe your whole life and then cutting your ear off and giving it to a prostitute after a heated argument with your artist friend is irrefutably cool.

In contrast, look at the symptoms of OCD. I freak out if all of the pens on my desk aren’t lined up perfectly. There’s nothing cool about checking if the stove is off fifteen times in a row, or washing your hands until they crack and bleed, or staying up late scouring the internet trying to determine if the mole on your left testicle is melanoma or not, or repeatedly visiting the doctor to have him/her appraise said mole on your left testicle despite being told on multiple visits that its benign. Apologies to Howard Hughes, but locking yourself inside a Las Vegas hotel room, growing out your fingernails and collecting your piss in mason jars does not exactly scream “cool” either.

Media portrayals of OCD reinforce the disorder’s uncoolness. In TV shows and movies, OCD is frequently a punchline. Just look at the aforementioned Mr. Monk. His OCD tendencies are the running joke of the entire series. Ditto movies like Bandits, with the neurotic bank robber Terry Collins (Billy Bob Thornton) providing the comic relief to his straight man criminal counterpart Joe Blake (Bruce Willis). In Matchstick Men, the tics, phobias, and obsessive cleanliness of Nicolas Cage’s conman character is played up in part for laughs as well, but it’s also portrayed as a character flaw, a neurotic weakness that ultimately enables Cage to be duped by his criminal partner.

Even cartoons give OCD and anxiety a bad rap. In Rugrats, Chuckie Finster is a neurotic foil and sidekick to the adventurous protagonist Tommy Pickles. In Winnie the Pooh, the anxiety-ridden Piglet plays second fiddle to the show’s scatter-brained and charismatic eponymous protagonist. In “Pathology in the Hundred Acre Wood: a neurodevelopmental perspective on A.A. Milne,” Shea et al. point out that although Pooh’s behaviors most likely make him a candidate for ADHD, his “perseveration on food and his repetitive counting behaviours raise the diagnostic possibility of Obsessive Compulsive Disorder (OCD).” Still, his hallmark hyperactivity and impulsivity probably makes him a stronger candidate for the former disorder.

Psychiatric evaluations of cartoon characters aside, the question remains: What can be done about this? How can OCD level up in the rankings? In the great ongoing race to be the undisputed champ of the mental illness world, how do we secure that top spot for OCD sufferers around the globe? How do we make OCD cool? For starters, we need a public image overhaul. Somehow, we need to get more flattering portrayals of people with the illness in TV shows and movies. Instead of the lovable but ultimately uncool Mr. Monk, we need a whiskey-swilling, OCD-afflicted private eye with a cigarette dangling from their bottom lip. A devil-may-care detective who doesn’t play by the rules, but will drive home thirty minutes from a crime scene to make sure that the stove is turned off. Or envision this: a Chuck-Norris-type action star kicking ass in a barroom somewhere, but his compulsion is to punch every baddie exactly seven times and he counts each punch aloud as it lands in the face of a nondescript goon.

In addition to this media makeover, we also need more real people with OCD to step forward and join the ranks, but this is a challenge since the prevailing ethos of the disorder is so unbecoming. Citing data from an Epidemiology Catchment Area survey by Karno et al., in “Epidemiology of obsessive compulsive disorder” Rasmussen and Eissen state that OCD “is 50–200 times more common than previously believed and twice as common as schizophrenia or panic disorder in the general population,” and also state that these findings have been corroborated in another study. In light of this, there are conceivably many celebs out there currently concealing their OCD. Think about it: If you’re an A-list celebrity or athlete, you’re far more likely to go public as a member of the Depressed Dinosaurs or crosstown rivals Bipolar Bears, or even the Schizophrenic Snakes. Your first choice is certainly not going to be coming out as a sufferer of la folie du doute and signing for the lowly Owls.

But there’s also a question of causality here, a sort of Catch-22 that inhibits OCD from improving its stature in the mental illness rankings: Will more favorable media portrayals of people/characters/animals with OCD serve to make the anxiety disorder a more attractive choice and encourage more people to go public about their OCD-induced plight, or do we first need more well-liked celebs to sign up for the squad in order to start to promote change in the way OCD is perceived and then portrayed? Something needs to shift. Someone needs to make the first move.

Maybe the problem is that OCD is often poorly understood, in part due to the fact that people with OCD present such a wide range of symptoms and behaviors. Contrary to popular perception, not everyone with OCD washes their hands, or hoards, or counts their steps, or checks the locks on windows and doors, or asks repeatedly for reassurance. Some compulsive behaviors are entirely mental and internal. There’s health-related OCD, and relationship OCD, and OCD where you worry that you might lose control and kill a member of your family, and OCD where you worry extensively about sinning and going to hell as a consequence. The list is endless. If we really want to become a title contender in the mental illness world, OCD needs not just a cooler image, but also a more well-defined one. All of this being said, I think the solution is clear: OCD needs a new PR person.

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Daniel Sidman is a writer/comic currently based out of Baltimore, Maryland. Due to a tattoo attempt gone awry involving a Jean-Paul Sartre quote, he has the word “you” italically inscribed in his right deltoid.

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