By Laura Chackes, PsyD
Mental health awareness has come a long way. We talk about anxiety and depression more openly than ever before. We put “it’s okay to not be okay” on coffee mugs and Instagram stories. And that progress has made a big difference in how many young people are seeking treatment.
But here’s the problem. Awareness isn’t one-size-fits-all. When we only make room for the mental health conditions that feel familiar or easy to explain, we leave a lot of people behind. Quietly struggling. Certain that what’s happening to them is too weird, too embarrassing, or too shameful to say out loud.
I think about this a lot when it comes to conditions like OCD and BFRBs.
OCD is not a personality quirk. It’s not being “so OCD” about keeping your desk tidy. Obsessive-Compulsive Disorder is a painful, often debilitating condition in which intrusive thoughts (unwanted, distressing, and relentless) drive compulsive behaviors that offer only temporary relief. The thoughts can be about harm, contamination, religion, relationships, identity. They feel shameful by design. They target what people care about most.
Because OCD so often involves thoughts that feel unspeakable, people suffer in silence for years, sometimes decades, before they ever tell anyone what’s going on. The average time between onset and treatment is 14 to 17 years. That’s not because OCD is hard to treat. It’s because the shame keeps people from asking for help.
BFRBs (Body-Focused Repetitive Behaviors) carry that same weight of secrecy. Hair pulling, skin picking, nail biting, cheek chewing. These are real, neurologically-rooted conditions that affect an estimated 1 in 20 people. And yet most people who live with them have never heard the term BFRB. They just know they can’t stop, they’ve tried to stop, and they feel deep shame about what they do to their own bodies.
They wear long sleeves in summer. They cancel plans. They sit through conversations while quietly, desperately trying not to fidget, and then hating themselves when they do. Many have never told a single person.
That’s what stigma actually does. It doesn’t just make people feel bad. It makes them feel alone. It delays treatment. It compounds suffering that is already hard enough.
And real awareness, not just the comfortable kind, is the antidote.
When someone hears a name for what they’re experiencing for the first time, something shifts. When they realize there’s a word for it, that others live with it too, that it’s not a character flaw or a sign that something is fundamentally broken in them. That moment can be life-changing. I’ve seen it happen. It’s one of the reasons this work matters so much to me.
Talking about OCD and BFRBs openly, accurately, without the jokes or minimizing, tells people with those conditions that they don’t have to hide. It makes it easier for them to reach out. It helps the people in their lives understand what they’re actually dealing with. It chips away, slowly but surely, at the wall of shame that keeps so many people isolated.
Mental health awareness month is a good reminder. But the goal isn’t just to post. It’s to actually expand the conversation. To make more room, to say the harder, less familiar things, to reach the people who have been waiting a long time to feel seen.
If you’ve been quietly living with something you’ve never told anyone about, I want you to know that there’s probably a name for it. There’s probably a community of people who understand. And there is absolutely help available.
You don’t have to keep carrying it alone.