The OCD Stories – Episode #513: Story: Amanda (OCD themes: Religion, Harm, and Contamination)

Date: November 23, 2025
Host: Stuart Ralph
Guest: Amanda

Episode Overview

In this episode, Stuart Ralph interviews Amanda as she shares her personal journey with Obsessive Compulsive Disorder (OCD), touching on themes of religion, harm, and contamination. Amanda openly discusses the progression of her symptoms from childhood through early adulthood, interactions with depression, the impact of the COVID-19 pandemic, the challenges of therapy, and the turning point provided by medication. She offers candid insights into family support, recovery roadblocks, and practical words of hope for others.

Key Discussion Points & Insights

Amanda’s Early Experiences with OCD & Depression

• Amanda’s silent battle: Opens with a formative quote:

  "Everyone is fighting a silent battle you know nothing about. And this is my silent battle."
  (Amanda, 01:57)

• OCD began in childhood:
  • Early signs included religious obsessions at Christian summer camp, where Amanda would repeatedly pray to "get it right" and guarantee heaven (03:00).
  • Hand-washing rituals that fixated on eliminating every germ imaginable, stemming from a misinterpretation of antibacterial promises on soap bottles (06:05).
  • Early perfectionism and stress over academic performance:

    "I was already so stressed and worried about performing perfectly in school."
    (Amanda, 04:32)

• Depression as a genetic background and ongoing challenge, surfacing with physical symptoms (IBS) and food control behaviors bordering on an eating disorder (09:30).

Navigating Adolescence: Compulsions and Masking

• Masked her struggles, especially depression, until a classmate’s death legitimized her feelings of sadness among peers (11:30).
• Increasing responsibilities (school, dance, work) led to visible withdrawal and intensified symptoms (14:00).
• COVID-19’s forced break provided some relief from depression but rapidly intensified contamination OCD:

  "Whenever my depression gets better, I feel like my OCD is like, okay, hey, I'm back."
  (Amanda, 16:54)

Harm OCD and Avoidance Compulsions

• First encounters with harm OCD: vivid, distressing dreams about violence or losing control when driving (18:26).
• Avoidance became the primary compulsion—ceasing to drive and evading situations perceived as potentially dangerous (31:00).

Therapy—Starting, Stopping, and Starting Again

• Initial therapy in high school was reluctantly accepted and lacked honest disclosure (22:00).
  • “I really think mental health help is best received when you actually want it.” (Amanda, 22:58)
• Renewed effort in college, especially after realizing compulsions were affecting others (e.g., boyfriend’s social behaviors) (25:23).
• Confronted reality through the Y-BOCS assessment for OCD:

  “I broke down crying because I was like, oh, my God, I'm not insane. Like, there is a word for these things that are going on in my head.”
  (Amanda, 27:30)

Trauma, Grief, and Compulsions

• A pivotal moment: Amanda experienced loss—her childhood dog and grandfather in a single day. In her grief, previously rigid compulsions temporarily dissolved:

  “I got into my bed just wearing, like, the clothes that I had been wearing all day, which is something I hadn't been able to do for probably two years...”
  (Amanda, 28:48)

Exposure and Response Prevention (ERP) & Inference-based CBT (ICBT)

• Exposure therapy started with intense difficulty and panic attacks:

  "The first time that I was doing the action I was supposed to do, I had a panic attack...I can't do this therapy."
  (Amanda, 29:29)

• Therapist’s support: “This is the worst it will be...the point is to keep exposing yourself, and your anxiety will eventually go down.” (Amanda, 30:03)
• ICBT helped Amanda catch new OCD themes quickly and challenge the validity of intrusive thoughts by recognizing abstract or hearsay foundations (32:45).

Medication and Breakthrough

• Severe depression prompted referral to a psychiatrist; Amanda began an antidepressant after genetic testing helped select the medication (36:40).
• Profound turning point:

  "I should have been on medicine just so much earlier...for the depression this is the one thing that has been so consistently helpful."
  (Amanda, 37:55)

• Milestone of recovery: Graduating from therapy, feeling "on the same playing field as everyone else" (39:15).

Notable Quotes & Memorable Moments

• On controlling others due to OCD:
  “My compulsions are starting to control other people, which is like, that’s not okay.”
  (Amanda, 25:23)

• On accepting help:
  “I didn’t necessarily want help yet, and I really think mental health help is best received when you actually want it.”
  (Amanda, 22:58)

• On exposure therapy:
  “I told her this, and she was like: This is the worst it will be...keep exposing yourself, and your anxiety will eventually go down.”
  (Amanda, 30:03)

• On recognizing intrusive thoughts:
  “Being able to see whatever my line of thinking was and then say...that's actually just a random fact that I read one time, and that hearsay is just some random story that I read on the Internet.”
  (Amanda, 33:30)

• On family and reassurance:
  “The way that they can help me is by not reassuring...my boyfriend’s also really good at this now...he’s like, I’m not even going to entertain that thought.”
  (Amanda, 35:00)

Important Timestamps

• 01:57 – Amanda begins her story, quoting a teacher on silent battles.
• 03:00 – Religious OCD during childhood camp; compulsive prayers.
• 06:05 – Early contamination OCD: Hand-washing rituals.
• 09:30 – Start of food control and its relationship with anxiety and IBS.
• 14:00 – Visible withdrawal and depression in high school.
• 16:54 – COVID-19 intensifies contamination OCD.
• 18:26 – Introduction of harm OCD: intrusive dreams and avoidant behaviors.
• 22:00 – Initial experience in therapy and barriers to open communication.
• 25:23 – Compulsions affecting relationships/social dynamics.
• 27:30 – Realization and relief through OCD diagnosis and assessment.
• 28:48 – Loss of loved ones prompts temporary suspension of compulsions.
• 29:29 – ERP therapy, panic attack, and therapist’s guidance.
• 32:45 – Helpful aspects of ICBT highlighted.
• 35:00 – Managing family accommodation and relationships.
• 36:40 – Turning point: seeking psychiatry and starting medication.
• 39:15 – Marking recovery: graduating from therapy.
• 38:15, 40:49, 42:03 – Amanda’s words of hope and advice to her younger self.
• 42:03 – “Continue”—the one word Amanda would put on a billboard.

Words of Hope & Final Advice (38:15, 40:49, 42:03)

• “Do it anyway. Do it happy, do it sad, do it scared, do it tired. Because life goes on, like, inevitably goes on.” (Amanda, 38:15)
• To her 16-year-old self: “Ask for help…being vulnerable is good and the people in your life who love you want to help you.” (Amanda, 39:55)
• On perseverance:

  “Continue. I have that tattooed. That’s the only thing you can do is just continue and it’s simple...that is truly just the only thing that is going to get you to keep moving forward.”
  (Amanda, 40:55)

Takeaways

• Symptom progression: Amanda’s experience exemplifies how OCD can evolve, intermingle with depression, and shift compulsions and themes in response to life stages and stressors.
• Therapeutic process: Successful treatment often combines the right timing, engagement, therapy modalities (ERP, ICBT), and—when needed—medication.
• Family/friend roles: Support, once redirected from reassurance to boundaries, becomes a vital asset.
• Recovery is non-linear: Setbacks, grief, new demands, and ongoing intrusive thoughts are part of the process.
• The power of vulnerability and perseverance: Amanda emphasizes open communication, asking for help, and simply continuing—“Do it anyway.”

This summary provides comprehensive coverage of Amanda’s episode for listeners and non-listeners alike, highlighting key insights, notable quotes, and the lived experience of navigating OCD and depression with hope and persistence.