Obsessive-compulsive disorder (OCD) has two main features: obsessions and compulsions. What’s that mean and how do you find out if you have OCD?
Obsessions are thoughts and urges that are recurring and unwanted. Compulsions are the resulting behaviors, which are repeated over and over to quell the obsessive thought.
According to the National Institute of Mental Health (NIMH), about
OCD can first appear between early childhood and adulthood. But on average, symptoms appear around 19 years of age.
Figuring out whether you have OCD can be difficult, especially if you experience other mental health disorders, too.
OCD has many common misconceptions. You’ve probably heard that people with OCD are extremely neat and organized. This is not always the case. Compulsive cleaning is one of the symptoms for some people, but that’s not true for everyone with OCD.
A major component of OCD is doubt. It’s so central to OCD that it’s sometimes called the “doubting disorder.”
Your brain tricks you into questioning something that you were just completely sure of. This seemingly nonsensical doubt overtakes logic and memory. This leads to compulsive behavior such as checking whether the door is locked a specific number of times or repeatedly washing the same dish.
But if cleanliness and good organizational skills don’t accurately portray OCD, what are the actual signs?
How do I know if I have OCD?
To get a better idea of the psychological and behavioral symptoms of OCD, try asking yourself the following questions:
- Do you have repetitive and intrusive thoughts or impulses that you find disturbing or scary?
- Are you constantly worrying about dirt, germs, chemicals, mold, or other potentially harmful substances?
- Do you have a perpetual fear of getting an illness or disease?
- Do you often think that you’ve forgotten to do something important and worry about the consequences?
- Do you have to repeat actions or phrases over and over again to ease anxiety?
- Are you worried about physically or emotionally harming people, even if you have no intention of or desire to do so?
- Do you need things to be symmetrical or ordered in a specific way?
Consider these questions about physical symptoms as well:
- Do you have motor tics, like rapid eye movements or head jerking?
- Do your legs ever feel tingly or jelly-like when you’re anxious?
- Do you experience insomnia?
- Do you have compulsions like excessive handwashing that lead to physical damage?
Another essential factor to consider is whether your obsessions and compulsions interfere significantly with your ability to function or take up more than an hour every day.
Answering “yes” to one or even many of these questions doesn’t necessarily mean you have OCD. While screening tools and symptom lists can help learn about the disorder, only a mental health professional can make a proper diagnosis.
There is only one type of OCD, but the nature and severity of symptoms can vary widely from person to person.
Still, there are some trends in the obsessions and compulsions people with OCD experience.
Common obsessions include:
- disturbing, unwanted thoughts or images
- fear of contamination, illness, or disease
- fear of acting on violent impulses or urges that you consider immoral
Some common compulsions:
- checking the same thing repeatedly
- excessive cleaning
Keeping a job, socializing, and even having leisure time might be challenging if you’re in this group.
There are also significant differences in the level of insight people with OCD have into their disorder.
Most people with OCD are aware that their obsessions and compulsions are illogical and excessive, leading to great frustration and even shame. Some people with OCD genuinely believe their obsessions are justified.
The only way to accurately diagnose OCD is a psychological evaluation. A mental health professional will likely observe your behavior and ask you a series of questions similar to the ones listed above.
There is no brain imaging or blood test that can diagnose OCD. But your doctor may want to perform further tests to rule out any possible physical conditions.
Initially, it can be hard to tell the difference between OCD and other mental disorders, like anxiety, because of overlapping symptoms.
In fact, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) used to consider OCD a type of anxiety disorder. Until 2013, the DSM-5 designated OCD as a separate condition.
According to Mental Health America, people with OCD spend an average of more than 9 years going to doctors and seeking treatment before receiving a correct diagnosis.
OCD is most often misdiagnosed as:
- anxiety disorders
- body dysmorphic disorder
- eating disorders
- psychotic disorders (e.g., schizophrenia)
It’s common for people with OCD to have co-occurring anxiety, depression, or other disorders. This can make an accurate diagnosis of each condition difficult.
But mental health experts are learning more about OCD and how best to identify it.
OCD can be frustrating and even debilitating. But there are effective treatment options to help you manage your symptoms.
Exposure and response prevention therapy is now widely considered the gold standard in treating OCD. This therapy involves activating your obsessive thoughts and then preventing the compulsive behavior that typically follows. A trained therapist guides these sessions.
Selective serotonin reuptake inhibitors (SSRIs) are also a common and effective treatment for OCD.
So if symptoms of OCD have disrupted your life, relief is possible.
The first step is reaching out to your doctor or mental health professional.
Looking for a therapist but not sure where to start? Psych Central’s How to Find Mental Health Support resource can help.
For more help, you can check out this International OCD Foundation tool to find support groups and practitioners near you.