A Religious Variation of Obsessive-Compulsive Disorder

In the summer of 2020, amidst the beginning of the COVID-19 pandemic, I experienced the onset of a lesser-known variant of obsessive-compulsive disorder (OCD), which is triggered by religious topics. This type of OCD is known as “scrupulosity.” I experienced recurring thoughts about Hell, offending God, and committing a wrongful act, whether intentional or unintentional. These thoughts come with feelings of vigilance—and scrutinizing thoughts and words—looking for discrepancies. Every action is questioned as right or wrong, and it can become a burden on everyday living if this disorder moves to the extreme side of the spectrum.

Scrupulosity has varying levels of intensity. It can be fleeting or come at full force. It can take months to calm down, and sometimes the disorder comes and goes throughout the year. I was able to make a full recovery with the help of mental health professionals who knew how to diagnose and manage scrupulosity.

Scrupulosity is known among those in the Catholic tradition, which is the religion in which I grew up, but it can also affect others who belong to other denominations or faiths or who have no religious affiliation. Some Catholics, however, recognize scrupulosity not as an illness but as a practice that can have benefits. This view can be harmful for individuals who are affected by this condition, because scrupulosity is a mental health problem that requires treatment. Because this condition is not well known, the biggest challenge with scrupulosity is recognizing that there indeed is a mental health issue that needs attention and care.

What triggered my scrupulosity disorder was a change of heart; I wanted to better myself to become a more morally sound person. I looked within myself and recognized that I had done some things that were truly wrong and that I needed to improve. What started out as a kindhearted goal quickly turned into a nightmare.

I began searching online for answers to my unending questions about religion. Is this action right or is it wrong? Will I go to Hell for lying? Because my questions—or compulsions at this point—were unending and received no answers, I began experiencing symptoms of anxiety, which were rooted in OCD. At this point, I didn’t know that I had OCD, but I knew that something was wrong.

I began feeding my compulsions and was unable to stop myself from doing so. Everyday living started to feel excruciatingly painful. As soon as I woke up, I would experience intense anxiety. Am I living the right way? Will I go to Hell if I die at this very moment? Afterward, I would examine every action that I had done and every thought that had passed through my mind during the day, trying to find a problem that, in hindsight, was never there. Is stepping on grass a sin because I might be killing the grass? Is thinking about another topic during class a sin because I’m not paying attention to the teacher? Is not eating every single crumb on my plate a sin because I would be wasting food? Questions like these were on my mind nonstop, and I would spend my days wondering whether I’d done something morally wrong, pacing back and forth in my room for hours. It may be obvious to most people that there is nothing wrong with the actions I questioned, but I thought I was in imminent danger of violating the tenets of my belief. I couldn’t sleep. I couldn’t talk to anyone. I couldn’t focus on school or homework, and my grades plummeted. I felt like I was trapped in a box, with no means of escape. I needed help.

The hardest part of this madness was asking for help. In fact, I did not get the help I needed until my parents accepted that I had a mental health problem. Because my grades were dropping, my parents became angry with me. I had never received a C in class before. I tried to tell them that there was something wrong with me, but they could not understand my specific illness. Mental illness, especially a fairly rare disorder such as scrupulosity, is often not fully recognized as a real health issue. My parents are Asian immigrants and come from a traditional background. They could not see that something beyond my ability to handle was affecting my daily living, and they were not able to take my mental illness seriously.

If the general public were better educated on mental disorders, then perhaps more people would realize that mental illness is a real ailment. But, alas, it is often difficult to remove the stigma of mental illness—with some believing that people with a mental illness are faking their condition.

After more discussion and increased stress caused by my compulsions and intrusive thoughts, my parents and I finally agreed that I had a problem for which professional help was needed. However, because scrupulosity is not well known, we had difficulty finding a suitable mental health provider. We talked to several professionals, including physicians and therapists, who were not sure how to treat my illness. Even though they were familiar with OCD, they did not seem to know scrupulosity as an OCD variant.

It took many days of searching before we found a Catholic therapist and a psychiatrist who had experience working with people affected by scrupulosity; they knew how to manage this disorder. Among the strategies they recommended, the best ones worked by nullifying intrusive thoughts and stopping them before they spiraled out of control. I used a phrase that would counteract the intrusive thought. For example, one helpful phrase was, “If you think this thought will lead to stress, then stop it right away.” So whenever I had a stressful thought, I would interject with this phrase. At first, I found this and other phrases difficult to use because of the strength of the thoughts they were meant to counteract. However, with discipline and by strictly applying and listening to these phrases, I could stop the compulsions quickly. However, because my compulsions were very strong, I had to memorize many phrases to use in different situations.

Because my parents had a very traditional background and were not well versed in recognizing and accepting mental illness, asking for help from them was one of the most troubling experiences that I had to go through. I imagine that this is the case also for others. However, from my experience, asking for help is the best first step toward remedying this serious mental health condition and starting to heal from it.

Mental illness, especially scrupulosity, needs more attention because many people like me are struggling to go about their daily lives while being affected by this or similar disorders. As my experience shows, not enough mental health professionals are available who can treat patients experiencing scrupulosity. Mental health professionals should be more familiar with this OCD subtype, and I hope that both the general public and the health care community will get to know its name.