As a kid, John had always enjoyed roller coasters. He loved the wind through his hair and the feeling of his heart pounding out of his chest as the coaster took him on fantastic, blissful adventures. As he got older, though, John started to notice that he didn’t enjoy these rides anymore. At first, he started having worries about the safety of the ride. He would read stories of coasters coming off their rails, seriously injuring many of their occupants. This would scare John, but he loved the adrenaline too much to stop riding them. He instead began to check for loose bolts before getting on. After conducting a quick search, he would be satisfied and board the roller coaster. Eventually, though, this routine wasn’t good enough for him. “What if there are loose bolts on the track that I can’t see?” he would think. He decided to walk once around the track to see if he could see any loose bolts. Satisfied again, he entered the line for the ride.
This continued for a while, until one day he realized that the coaster had been running during his check. It might have shaken one of the bolts loose after he had checked it. He’d better check again. He would leave the line to investigate the track again. But wait, the roller coaster had been running during that check, so he’d better try once more. Satisfied that three checks is a pretty good guarantee, he enters the ride. After a while of this, he becomes wary about three checks being good enough. He now checks the ride five times before entering, but by that time the line has grown so long that before he can get on the ride, he has to go check the bolts again. A year goes by, and John doesn’t even like roller coasters anymore. In fact, he can’t even enter his once-favorite theme park without feeling an overwhelming fear of being hit by a wayward coaster.
John is just one of the many people that suffer from a mental disorder called Obsessive-Compulsive disorder, or OCD. Although a hypothetical situation, our friend John reflects a lot of what some people with OCD experience, and that number is not a few. About 1 in every 40 adults has or will have OCD at some point in their lives. In fact, the number of teens that have OCD is about the same as the number of autistic teens. (International OCD Foundation, 2024) But what exactly is OCD and how does it work?
You may have heard the phrase, “I’m so OCD” or “Sorry, my OCD is just going crazy” when someone requires something to be neat or tidy. Maybe you’ve been caught saying that yourself. If so, don’t feel singled out. Over the course of my time with OCD, I’ve heard lots of people say similar things. It’s not uncommon, and most of the time, it’s not meant to be unkind either. Comments like these usually just come from a misunderstanding of what OCD is and how it works. Sometimes, though, these comments can create stigma surrounding OCD and those that have it. (Understanding the stigma surrounding OCD: Latest research and ways to break the cycle, 2023) We’ll explore this idea in depth in a minute, but first we need some background knowledge of how OCD works in a human brain. As a note, the functions of the brain when it comes to OCD are still an exploratory subject. Exact knowledge of what it looks like is not known, but from the studies that have been conducted one major theory has emerged.
To model this, think of the human brain as a city. You know that for a city to function, it has to have a lot of different parts working in unison. You’ve got the mayor, the city council, the law enforcement, etc. All these departments work together according to the rules and values of the city to make the city work the way it is intended. Let’s use an arbitrary town named Smithville as an example.
In Smithville, people value kindness and fairness for all; they abhor violence. This value that they have will drive the city council to create rules to keep the citizens safe. There will be more rules surrounding this value than the others because of the emphasis the people have put on it. Now, when any of the departments have to make decisions on what to do in a certain situation, they can look back on these rules the people have created to guide them.
You do this all the time. You have your own values and opinions that have developed over time that guide your decisions. Maybe you prefer dark chocolate over milk chocolate. If presented with a choice, you’d likely choose dark chocolate. You ran the decision through your values and opinions. Some values—like what chocolate you prefer—are pretty trivial, but others are core to who we are. They are created through incredibly personal experiences and are deemed as the most important values we have. It is in these core values we begin to understand OCD.
Back to Smithville. One peaceful summer day, about a quarter after 3:00, a scream is heard. Shots are fired. Someone calls 9-1-1. The tranquility of the town has been abruptly disturbed by an act of violence. This scene illustrates the next step in understanding OCD. There is a part of your brain called the orbitofrontal complex—OFC for short—that sits just above your eyes. (Know your brain: Obsessive-compulsive disorder [OCD]) Figure 1 illustrates this.
According to research, the orbitofrontal cortex in those with OCD seems to be more active than those without OCD. Whether or not this is the cause or just an effect of OCD is not clear, though evidence leads us to believe that the OFC is part of the cause. (Menzies et al., 2008) The OFC is in charge of perceiving threats. It becomes excited in dangerous situations. (Know your brain: Obsessive-compulsive disorder (OCD)) In our city analogy, it is the one calling 9-1-1. This part of the brain uses past experiences and the rules we have set to judge whether or not something is dangerous. In OCD, the OFC may be a little over-reactive, considering something that is not threatening as dangerous. (Neuroscientifically Challenged, 2021) This is the beginning of the “obsessive” part of “obsessive-compulsive disorder”.
Back in Smithville, the police have received the call from the OFC concerning the violent act. The OFC sees it as a threat to what the city stands for. It is now up to the police chief to decide what to do. He can either send men to resolve the case, or he can retain them. And how many men does he send? When does he send them? How does he send them? By boat? By car? By plane? A perfect balance of these is what will constitute a perfect response. (Menzies et al., 2008) This decision is the job of the basal ganglia (Figure 1). It is in charge of allowing or restricting motion based on the information it receives. (Know your brain: Obsessive-compulsive disorder (OCD)) Figure 2 attempts to illustrate what may happening inside the basal ganglia when it receives this information.
The basal ganglia has two methods in which to deal with the information it receives: the direct pathway, and the indirect pathway. The direct pathway results in action, similar to the police chief sending officers to the scene of the crime. The indirect pathway inhibits action. A combination of these two results in whether or not action is taken, what action is taken, and how much is taken. (Saxena et al.) Along with being a major factor in the movement of the body, it also is “especially important to: facilitation of goal-directed actions, development of habitual responses, and switching to a new behavior when it’s deemed necessary” (Know your brain: Obsessive-compulsive disorder [OCD]).
In our example, the police chief of Smithville decides to send officers to the scene of the crime. They move quickly and apprehend the criminal. Crisis averted. The city id safe again. The OFC is put at ease. These officers could be thought of as the thalamus.
The thalamus is the one actually doing the work to stimulate movement. It receives its directions from the basal ganglia and executes them, whether it is to move or to not. In turn, it sends feedback to the OFC which calms it, telling it that the crisis is averted and all is well. (Saxena et al.) The cycle has been stopped, and the basal ganglia has decided to shift its attention elsewhere. You’ve experienced this before. After a mildly scary experience is over, you are usually able to shift your attention to something else, like your upcoming exam in math class. The problem for those with OCD is that this system doesn’t quite work correctly.
Let’s use John to demonstrate this. John has an obsessive thought that the bolts on the ride are not tight enough and the cart could come off the rails, thus resulting in his death. This stems from a value of his life. He is scared that getting on this roller coaster will be the last decision he makes. Is this irrational? Yes, but to him, it’s real. 9-1-1 has been called and now it is up to the chief of police to decide what to do. As a result, John decides to check the bolts before he gets on. The basal ganglia has used direct and indirect pathways (mostly direct) to tell the thalamus to act. After taking action and checking the bolts, John finds relief and the basal ganglia moves on to another thought, but it also stores in its memory what worked to resolve that fear. Now every time John finds himself worrying about the bolts on the roller coaster, he has to do that same action. This is called a compulsion. It is the action that someone with OCD takes to “fix” a fear or calm an emotion. Compulsions can be internal, such as praying or counting, or external, such as washing hands. (Neuroscientifically Challenged, 2021) (Breaking the stigma: Myths and facts about OCD, 2023)
The problem is that in the brains of people with OCD, the direct pathway is over-excited, causing it to overtake the indirect pathway. (Know your brain: Obsessive-compulsive disorder [OCD]) This makes thoughts stay with the person much longer than desired. This is the second part to the “obsessive” nature of OCD—the inability to move on to new thoughts. After time, the person decides to do the compulsion even more or make it even more extravagant to try to fix the problem. That may work for a while, but once the thought cannot be discarded again, they have to up the dosage of the compulsion. This works until the thought returns even stronger, which results in a need for an even stronger compulsion. In the end they become like John, who even the thought of entering an amusement park sends shivers down his spine. Thus is the destructive cycle of OCD.
This is just a simple overview, and not everyone with OCD is afraid of roller coasters. Each person has their own values and beliefs, and thus they have their own obsessions and compulsions. In my case, my OCD is centered around the value of being liked. I want people to enjoy being around me. This drives me to worry about everything I say and do around others. To “fix” this, I become silent. I don’t let people know my deep feelings because I worry they will think I’m weird. In reality, how is anyone going to like me if I don’t ever open up to anyone? When I do end up talking to someone, I afterwards run through the interaction in my head, making sure I didn’t say anything wrong that would make them think I’m weird. For a long time, I wasn’t sure what was going on with me. I had heard of the word OCD one, maybe, two times, but to me it didn’t really mean anything. It wasn’t until I received counseling and was diagnosed with it that I really came to understand what it was.
Now that we have come to a basic understanding of OCD, we can delve deeper into some of the stigma. In general, most people don’t understand what OCD is and how destructive it can be. In 2024, Dr. Kinsey Simone, a professor at the University of Tennessee, did a study where she asked pre-service teachers in multiple educational levels a number of questions regarding OCD. Her results are astounding. (Figure 3) According to her findings, around half of the teachers she polled thought everyone has a little bit of OCD and 83% think that OCD is not a serious illness. (Simone, 2024) It’s plain to see that these teachers do not understand OCD. To them, it may only be a “personal quirk or a minor inconvenience, rather than a serious mental issue” (Understanding the stigma surrounding OCD: Latest research and ways to break the cycle, 2023).
I agree with this finding. I can’t tell you how many times I’ve had to explain to people what OCD is and how it works. And the feedback I get the most after that conversation is along the lines of, “I didn’t know that. I always figured it was about needing things to be neat and clean.” This kind of stigma is by far the most common I’ve encountered. How much more could we connect with our friends with OCD if we better understand what they actually are thinking and feeling? How much more would they feel loved if we gave them the patience and understanding they are craving?
While most people are very courteous when I open up to them about my OCD, there has been a number of people that have been less than kind. To them, the thoughts and feelings that I have are inconvenient or dangerous. They see me as a problem and someone to keep an eye on. This kind of stigma has been the center of research for many years, and it starts with what our obsessions are about.
There are actually two subcategories of OCD: autogenous and reactive OCD. In his article, “Testing the Autogenous-Reactive Model of Obsessions,” researcher Han-Joo Lee explains that autogenous obsessions are thoughts or images “sexual, aggressive, blasphemous, or repulsive [in nature]”(Lee et al., 2005) Examples of these could be having images of jumping in front of a car fill your mind or thoughts of strangling your best friend. These obsessions are usually accompanied by a large amount of distress and center around our value of being upstanding, moral citizens. Reactive obsessions, on the other hand, are obsessions surrounding perceived threats—like John obsessing over a roller coaster disaster. Lee continues that “perceived threat[s] tend … to be not the obsession itself, but rather its possible negative consequence(s)”(Lee et al., 2005). This is where you’ll find those who obsess over germs or symmetry. The compulsions that follow are often used to try to prevent a possible negative consequence, such as getting sick. Those with OCD can have obsessions in either or both of these categories.
Studies of OCD stigma have shown that the types of obsessions someone with OCD has can affect how that person is perceived in public. A study by Gabriella T. Ponzini explores this idea in depth. She and her team gave vignettes of a man named John (coincidence, I swear), highlighting various aspects of both reactive and autogenous obsessions, randomly out to 30 different people. Each of the participants read the vignette and gave feedback on what their thoughts were on John. To ensure the reliability of their study, they used three different mental health stigma scales to recreate the study with just under 700 participants. They also added General Anxiety Disorder and Schizophrenia vignettes as control groups. The results of one of the scales are provided in Figure 4. (Ponzini et al., 2024).
The higher the number on the left, the greater the stigma of the type of obsession. Sexual and harm/aggression obsessions received the greatest amount of stigma, with feedback reports saying that John is a threat to society, that he should have his children taken away from him, or that he is insane. Contamination and symmetry OCD was on the opposite side of the spectrum, with feedback reports like, “John is a really nice guy, but he’s got issues” or “John is obsessed with small stuff”(Ponzini et al., 2024). In both these cases, John is being judged or stigmatized based on thoughts he really has no control over. It’s just how his brain is wired. The feedback of, “John needs to relax and stop worrying so much…”(Ponzini et al., 2024) that was common in the results of the study is advice that really cannot be taken. For someone with OCD to “stop worrying”, it literally takes a rewiring of their brain’s functions.
The last major concept of stigma that has been studied comes from very close range—ourselves.
People that suffer from mental illness have been found to have ideas of what people think of them. This is called self-stigma. (Chasson & Bates) People with OCD are not exempt from this. In a study conducted by German psychologists in 2003, 51 people who have OCD, depression, or schizophrenia were surveyed about the levels of anticipated stigma and the actual amount of stigma they receive. Around 65% of those with OCD expected rejection in their interpersonal interactions, which was higher than both schizophrenia and depression by an average of six percent. Also, around two-thirds of the participants identified anticipated stigma from media and films, which they believed to incorrectly portray OCD. For the most part, this number was seen across the board in this category. What was really interesting to me was the expected stigmatization of the last category: access to social roles. The study reported that 82% of people with OCD expect to be denied a job because of their mental illness, and 64% believe they will be rejected in a relationship for sharing about their OCD. (Stengler-Wenzke et al., 2004)
I find these numbers alarming, but I honestly can understand where they come from. I have realized that I share some of these same thoughts. “Oh, I won’t be thought of the same if they knew what I’m going through.” “If I go to therapy, then people will think I’m mentally unstable.” “Only weird people go to counseling.” These thoughts are three examples where I self-stigmatized myself, and I have heard them from many others, too. I started going to counseling when I was 17 because I couldn’t live anymore. My OCD had begun to overtake my life. I let it get to this point because I had this idea that counseling was for insane people. That’s how I expected the world to see me if I started counseling. I hid it. I wouldn’t even tell my family where I was going. I thought they would think differently of me. On top of that, going to counseling meant admitting that there was something wrong with me that I wasn’t able to handle on my own. This was a big hit in my pride. Turns out I’m not alone. Many people with OCD have tried to cope with their self-stigma in similar ways I did. About three-quarters of those with OCD reported trying to keep their disorder a secret. About 80% said that they would recommend not even bringing the subject up to an employer and about 50% said they would not discuss it at the beginning of a relationship. Some were even turned off from finding a partner because they felt they would be rejected because of their OCD. These numbers were significantly higher than those with depression and schizophrenia. (Stengler-Wenzke et al., 2004)
Luckily, the harrowing reality of these statistics is not set in stone. With educational efforts from various organizations, such as the International OCD Foundation (IOCDF), people are starting to understand that OCD is more than they thought. In a study by the IOCDF, they asked around 600 US adults about those with OCD and Hoarding Disorder, with other mental illnesses as control groups. What they found is that OCD is seen more in a “difference” way instead of a “distain” or “blame” way. In other words, those with OCD were seen as different but not necessarily bad or at fault. (Chasson & Bates) Even among those polled in the German study referenced above, the majority of those with OCD reported much lower actual stigma. (Stengler-Wenzke et al., 2004) For the most part, things are starting to look up for those with OCD.
Will John ever be able to ride a roller coaster again? Who knows? John’s future is still unwritten.
What happens to him will depend on us as friends, as teachers, as parents, as acquaintances, and as Johns ourselves. For those of you with OCD, there is hope. Take it from me—you are a fighter. You may never be able to fully rid your life of OCD. Others may never know the cross you have to bear, but don’t give up! I still struggle with OCD on the daily, but as I’ve come to understand how it works and how to manage it, my life has improved a hundredfold. It can for you, too.
References
Breaking the stigma: Myths and facts about OCD (2023, October 2). Retrieved Oct 13, 2025, from https://www.claritycarenj.com/post/breaking-the-stigma-myths-and-facts-about-ocd
Chasson, G. S., & Bates, S. They aren’t like me, they are bad, and they are to blame: Different kinds of stigma experienced by individuals with obsessive-compulsive disorder and hoarding disorder. International OCD Foundation. Retrieved Oct 13, 2025, from https://iocdf.org/expertopinions/they-arent-like-me-they-are-bad-and-they-are-to-blame-different-kinds-of-stigma-experienced-by-individuals-with-obsessive-compulsive-disorder-and-hoarding-disorder/
International OCD Foundation. (2024). Who gets OCD? https://iocdf.org/about-ocd/who-gets-ocd/
Know your brain: Obsessive-compulsive disorder (OCD) . Retrieved Oct 13, 2025, from https://neuroscientificallychallenged.com/posts/know-your-brain-obsessive-compulsive-disorder-ocd
Lee, H., Kwon, S., Kwon, J. S., & Telch, M. J. (2005). Testing the autogenous–reactive model of obsessions. Depression & Anxiety (1091-4269), 21(3), 118–129. https://doi.org/10.1002/da.20063
Menzies, L., Chamberlain, S. R., Laird, A. R., Thelen, S. M., Sahakian, B. J., & Bullmore, E. T. (2008). Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: The orbitofronto-striatal model revisited. Elsevier BV. https://doi.org/10.1016/j.neubiorev.2007.09.005
Neuroscientifically Challenged. (2021). 2-Minute Neuroscience: Obsessive-Compulsive Disorder (OCD). YouTube. https://youtu.be/BJshegpcFv8?si=S5QKuEBlsDjT9nIB
Ponzini, G. T., Signorelli, M., Claydon, E. A., Lilly, C., & Steinman, S. A. (2024). Stereotypes and OCD symptom presentations: A mixed-methods evaluation using male-character vignettes. Clinical Psychological Science, 12(4), 663–685. https://doi.org/10.1177/21677026231192893
Saxena, S., Brody, A. L., Schwartz, J. M., & Baxter, L. R. Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder STUDIES OF BRAIN STRUCTURE IN OCD PATIENTS CT studies of OCD.
Simone, K. (2024, Jan 22). The “invisible” disorder: OCD stigma & how we move forward | anxiety and depression association of america, ADAA. aada.org. Retrieved Oct 13, 2025, from https://adaa.org/learn-from-us/from-the-experts/blog-posts/professional/invisible-disorder-ocdstigma-how-we-move
Stengler-Wenzke, K., Beck, M., Holzinger, A., & Angermeyer, M. C. (2004). Stigmatisierungserfahrungen von patienten mit zwangserkrankungen. Georg Thieme Verlag KG. https://doi.org/10.1055/s-2003-812450
Understanding the stigma surrounding OCD: Latest research and ways to break the cycle | greenwich anxiety | connecticut OCD, anxiety, & tics specialists): Dr. Matthew Specht (2023, -08-26). greenwichanxiety.org. Retrieved Oct 13, 2025, from https://greenwichanxiety.org/understandingthe-stigma-surrounding-ocd-latest-research-and-ways-to-break-the-cycle/
Decreasing OCD Stigma Through Sharing Personal Experience
Let’s face it. After being diagnosed with OCD, you’re in for the long haul. It’s a difficult road to travel, but I’m on it with you. I have OCD, too. This uphill battle will most likely stay with us the rest of our lives, and it’s an uphill battle that will go unknown to many of those we associate with. It’s natural to be hesitant to share personal things. One does not simply go about sharing their whole life story to random strangers. That could create a bad reputation. It’s common sense. But, yet, when does it cross the line? When can we become too protective of our inner feelings? How do we know when it is ok to share our story and when to protect it?
Living with OCD, you may have realized that people don’t understand it very much. To them it may seem like a “personal quirk or a minor inconvenience, rather than a serious mental issue.1” They may make fun or mislabel it. Perhaps they will think differently of you because you have OCD. These are all stigmas I have been the recipient of, and most likely you have been or will be, too. This stigma is what o en drives us to hide our illness. “Ignorance is bliss,” right? In fact, a study done in 2003 reported that almost three-quarters of those with OCD keep their illness to themselves. 80% said they would not bring it up with their employer.2 We tend to try to minimize the stigma we receive by burying our mental infirmities six feet below. The truth is the only way anyone will really come to know what OCD actually means is to speak openly about it in the right settings.
Now I understand that this is nerve-racking. Sharing your inner feelings opens the floor up to judgement, but it also opens the floor up to understanding. Brené Brown, a professor at the University of Houston, explains that in order for us to truly have empathy for someone, we have to be able to connect with them. We need to pull from inside ourselves the feeling someone else is feeling. It requires a vulnerability of both sides to create empathy.3 Silence is not going to accomplish this. Silence closes the door on empathy.4 Believe me. A er going all through middle and high school never having any friends, I came to learn that if I want people to understand me as I actually am, I will have to share that side of me—including my OCD.
“Well,” you may be thinking, “I can still be a fun person and have lots of friends without sharing my mental struggles.” True, not everyone with OCD ends up being lonely their whole lives, but if we never talk about our OCD, we can never truly create the deep connection that comes with lasting friendship. Maybe instead you’re thinking, “Actually, that doesn’t sound like fun. I don’t like being vulnerable.” I completely understand that. What I’m sensing is that you may be afraid of the stigma. You don’t want the judgement.5 Let me tell you that when I started sharing my OCD more freely, I received a lot less stigma than I expected. For the most part, people listened and were respectful of me. Many replied that they were thinking about OCD in the wrong way. Some even began to share some of their own personal struggles. As I shared my experiences, I began to be more confident in myself and saw myself as someone worth liking. The comments “Sorry, my OCD is going crazy again,” or “Oh, that’s just my OCD,” began to decrease. The stigma I received and expected to receive both decreased because I let myself be a little vulnerable.1
Now there is a catch. (There’s always a catch, isn’t there?) It won’t always be the right me and place to share about your OCD. You will have to judge if the reception of your comments will be taken in the right way. Just like any illness, you need to share your experiences with the right people and in the right places. If you had the flu, would you go around Walmart yelling, “Hey, everybody! I have the flu!” No. Not only would that make people think you’re crazy, it would be a little too much information. These strangers don’t even know you, and now they have made a judgement call to stay far away from you. On the contrast, if your friend calls you up, asking if you want to go golfing together, and you decline, explaining that you have the flu, chances are he would not have the same reaction as the shoppers in Walmart. Why? Because he cares about and has a relationship with you.
Even in that safe space, though, you don’t need to share everything. Your friend probably doesn’t want to know that you threw up twice this morning and have a fever of 102. Now if he asks, you can probably tell him, or if he happens to be your doctor, you can tell him, but otherwise, it might be best to keep that to yourself. The same goes for OCD. Look for opportunities to explain your struggles to people who care about you and want the best for you. Do it in natural and normal ways. Share what you feel needs to be shared.
The future is in our hands, friends. Only me can tell what will occur, but if we do all we can to educate the world about OCD, we will see a greater increase in confidence within ourselves, a greater increase in understanding and connection, and a greater decrease in stigma. I have great hope for the future. I imagine a world where the word OCD receives the same concern as the words depression or anxiety do. I imagine a world where people study OCD just as intently as they study cancer. I imagine a world where everyone is given the benefit of the doubt. Do it for us, friends! Do it for yourself! Do it for the future generation! Do it for the good of mankind! Stigma sprouts from the roots of silence; connection flourishes on the grounds of understanding.
References
- Understanding the stigma surrounding OCD: Latest research and ways to break the cycle | greenwich anxiety | connecticut OCD, anxiety, & tics specialists): Dr. matthew spechtgreenwichanxiety.org Web site. https://greenwichanxiety.org/understanding-the-stigma-surrounding-ocd-latest-research-andways-to-break-the-cycle/. Updated 2023. Accessed Oct 13, 2025.
- Stengler-Wenzke K, Beck M, Holzinger A, Angermeyer MC. Stigmatisierungserfahrungen von patienten mit zwangserkrankungen. Fortschr Neurol Psychiatr. 2004;72(1). doi: 10.1055/s-2003-812450.
- Brené Brown. The power of vulnerability by brene brown (transcript). Farnam Street. https://fs.blog/great-talks/power-vulnerability-brene-brown/. Accessed Nov 22, 2025.
- Ponzini GT, Signorelli M, Claydon EA, Lilly C, Steinman SA. Stereotypes and OCD-symptom presentations: A mixed-methods evaluation using male-character vignettes. Clinical Psychological Science. 2024;12(4):663–685. https://doi.org/10.1177/21677026231192893. Accessed Oct 24, 2025. doi: 10.1177/21677026231192893.
- Chasson GS, Bates S. They aren’t like me, they are bad, and they are to blame: Different kinds of stigma experienced by individuals with obsessive-compulsive disorder and hoarding disorder. International OCD Foundation Web site. https://iocdf.org/expert-opinions/they-arent-like-me-they-arebad-and-they-are-to-blame-different-kinds-of-stigma-experienced-by-individuals-with-obsessivecompulsive-disorder-and-hoarding-disorder/. Accessed Oct 13, 2025.
