The Color of OCD

Obsessive Compulsive Disorder (OCD) is a chronic and often debilitating mental health condition marked by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) that are done to relieve the distress those thoughts bring. For many living with OCD, these cycles can take over hours of the day and deeply interfere with relationships, work, and basic daily functioning.

And yet, despite how disruptive and painful OCD can be, it’s a condition that’s frequently missed or misunderstood, even by well-meaning providers. It can take years, sometimes close to a decade, for someone to receive an accurate OCD diagnosis, and even longer to access effective, specialized treatment.

Why? There are several reasons. OCD doesn’t always present in the ways people expect. Most are familiar with the more visible symptoms, like hand washing or a need for symmetry. But OCD can also show up in quiet, internal ways, like intrusive fears about harm, sexuality, relationships, or morality. Because of this, symptoms are often mislabeled as general anxiety, depression, or even personality issues.

And for people of color, the road to an accurate diagnosis is often even more complicated.

OCD within Racial and Ethnic Groups

Although OCD occurs at similar rates across racial and ethnic groups, people of color are underrepresented in research, underdiagnosed in clinical settings, and less likely to receive appropriate treatment. This isn’t just about access to care, it’s also about recognition. When someone’s distress doesn’t fit into a narrow cultural understanding of what OCD “looks like,” it’s more likely to be overlooked. Cultural norms can influence how OCD shows up, how someone talks about their symptoms, how providers interpret that distress, and whether the person even feels safe naming it. For example, a recent literature review in Iran found that religious beliefs and family dynamics heavily shaped the content and expression of OCD symptoms for Iranians. Recent studies conducted in the US have also found that Black individuals are more likely than White individuals to report contamination fears, excessive cleaning behaviors, and hoarding tendencies, while Latiné individuals more frequently experience symptoms related to religious scrupulosity and contamination.

That’s why it’s essential for clinicians to consider the sociocultural lens their patients are operating within. Without that awareness, critical nuances get missed, and people remain undiagnosed, untreated, and in the OCD cycle.

This delay in recognition can lead to years of silent suffering, and for many, the belief that they’re simply “broken,” “too sensitive,” or “bad.”

Living with OCD

People living with mental health conditions already face a great deal of stigma and isolation. But for people of color, these challenges are often made even heavier by the realities of racial discrimination and marginalization. In fact, research shows that ongoing experiences of racism can be a major source of stress, actually increasing obsessive-compulsive symptoms over time.

Living with OCD can feel incredibly isolating and misunderstood. And for people of color, who have historically been left out of OCD research and treatment, this sense of isolation can be even more intense. Trauma adds another layer of complexity to this as well. Intrusive thoughts and compulsive behaviors can become more intense after trauma, as individuals turn to rituals in an attempt to manage overwhelming anxiety or fear. Studies have found that trauma disrupts one’s ability to regulate emotions, which can make OCD symptoms worse and create a cycle of distress that’s hard to break. For example, between 88% and 95.6% of Black individuals with OCD also struggle with at least one other mental health condition, such as depression, generalized anxiety, or PTSD. This proves just how important it is to provide both holistic and culturally responsive care.

Recognizing OCD

Recognizing and properly treating OCD in people of color is a vital step toward breaking down the systemic barriers that exist in mental health care. When therapists take the time to understand how cultural, racial, and historical factors shape someone’s experience with OCD, they help create a more inclusive, compassionate, and just mental health field. Culturally attuned care doesn’t just ease suffering; it honors the dignity of people whose suffering has been overlooked. In this way, advancing equity in OCD diagnosis and treatment isn’t just a clinical responsibility; it’s a meaningful act of social justice.

Schedule an Appointment at the Soultality Center for Psychotherapy in Boston, MA

You don’t have to navigate the challenges of OCD alone. At Soultality, we honor and welcome the unique ways that culture, identity, and lived experience shape your journey with OCD and mental health. 

The clinicians here at Soultality are committed to providing compassionate, culturally informed care. Whether you’re seeking understanding, healing, or simply a place to be heard, we’re here to walk alongside you. If you’re ready to take the next step or just want to learn more about how we can help, visit us at Soultality. You deserve care that honors all of who you are. Schedule your next appointment with one of our clinicians here. 

Written by our clinician, Chioma Opara