People with high functioning OCD can do well, despite significant distress. Treatment can help with symptom management and improve quality of life.
People who don’t have obsessive-compulsive disorder (OCD) may negatively perceive the condition. They may assume someone with OCD can’t work or have relationships.
While many people with OCD experience barriers to job success and healthy relationships, others may achieve great professional and personal success.
Nonetheless, they still live with the daily reality of OCD. The mental health advocacy group Made of Millions calls this “high functioning OCD.”
Many people with high functioning OCD don’t seek treatment or may not even recognize they live with a treatable condition. But treatment options, such as talk therapy and medication, can help people with OCD cope with their symptoms.
OCD can be a debilitating condition, but if you experience symptoms, help is available. You’re not alone.
According to the Anxiety and Depression Association of America (ADAA), about 2.2 million people in the United States live with OCD. Some are “high functioning.”
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) doesn’t use the term “high functioning OCD” in its diagnostic criteria. Nevertheless, some scales help define the severity of OCD, such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).
High functioning OCD isn’t the same as mild or moderate OCD. But the Y-BOCS scale can give a picture of how the experience of OCD is different from person to person.
The advocacy group OCD Action notes that it’s very common for people with OCD to hide their symptoms. They may engage in invisible compulsions when around others but feel overwhelmed by the need for outward compulsions while alone.
People with high functioning OCD may regularly experience intrusive thoughts. Because they can maintain the outward appearance that everything is OK, they may not seek help for OCD. Their friends and family may also have no idea there’s anything wrong.
Even though OCD is different for everyone, there are some common signs and symptoms. If you think you have high functioning OCD, a doctor may first assess whether you meet the general diagnosis.
These are the criteria for an OCD diagnosis:
- Having obsessions, compulsions, or both. Obsessions are distressing thoughts that regularly come back. The person tries to suppress the thoughts, for example, by engaging in a compulsion.
- Compulsions are repetitive mental or physical behaviors in response to an obsession. They’re meant to resolve anxiety but are excessive or unrelated to the harm one wants to prevent.
- Obsessions are time-consuming or cause significant distress. Alternatively, the obsessions may cause impairment in social, occupational, or other functioning.
Therefore, someone with high functioning OCD may have compulsions that cause distress but don’t impair functioning.
Indeed, compulsions aren’t necessary to get an OCD diagnosis. Some people may experience obsessions and take action to suppress them that doesn’t involve compulsions.
There are many ways to experience OCD. Common obsessions and compulsions often define types of OCD. The International OCD Foundation offers these examples, but you may have others:
- Contamination: such as from germs, disease, or dirt
- Losing control: such as acting on impulse to cause harm, stealing, or violent images
- Unwanted sexual thoughts: such as forbidden or perverse sexual thoughts
- Religious obsessions: such as concern about morality or offending God
- Harm: such as fear of being responsible for harm to others
- Perfectionism: such as concern with being exact, or fear of losing things
According to Made of Millions, someone with high functioning OCD may avoid conference rooms or work restrooms because of contamination fears or worry constantly about co-workers’ perception of them.
- Washing and cleaning: such as excessive handwashing
- Mental compulsions: such as counting during a task to end on a “good” number
- Checking: making sure not to make a mistake or cause harm
- Repeating: such as repeating body movements like tapping or repeating activities in multiple
Many people with OCD can benefit from treatment, which may involve:
- Cognitive behavioral therapy (CBT). Exposure and response prevention is a form of CBT for OCD. People are exposed to the object of their obsessions but don’t engage in compulsions. They gradually gain the skills to cope with obsessions, and anxiety goes down over time.
- Medication. Selective serotonin reuptake inhibitors (SSRIs), commonly used for depression, can be an effective OCD treatment.
Each treatment plan is tailored to a particular person. Therefore, someone with high functioning OCD will develop a plan with a therapist that works for their symptoms.
Obsessive-compulsive disorder involves intrusive thoughts that result in distress. Many people with OCD also use compulsions to cope with these obsessions.
Someone has “high functioning” OCD if they’re able to carry on with their work and home life despite the symptoms of OCD.
People with high functioning OCD can benefit from treatment, including CBT and medication. Through treatment, people begin to manage their obsessions, resulting in less anxiety.
You can get started by visiting the American Psychiatric Association’s Help with Obsessive-Compulsive Disorder page.
You can also visit Psych Central’s Find Help page for more ways to connect for support, both online and in your community.