- You may have OCD if you have symptoms like intense, repetitive obsessions that compel you to act irrationally.
- Some of the risk factors for OCD include having another mental health condition, a family history of OCD, and trauma or stressful life events.
- You can treat OCD with therapy and medication.
- This article was medically reviewed by Mayra Mendez, Ph.D., LMFT, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center in Santa Monica, California.
- Visit Insider’s Health Reference library for more advice.
Obsessive-Compulsive Disorder (OCD) is a mental health disorder that affects about two to three million adults in the US. It can range from moderate to debilitating, and it has the potential to seriously affect the quality of one’s life.
“Full-blown OCD is characterized by causing significant distress, is time-consuming and interferes significantly with one’s life — family, social, work, health, or recreational activities,” says Lawrence Needleman, PhD, a psychologist in the Department of Psychiatry and Behavioral Health at The Ohio State University Wexner Medical Center.
If you’re wondering if you are exhibiting signs of OCD, here are the common symptoms and how to go about getting a diagnosis.
Symptoms of OCD
The main symptoms of OCD are having intense, repetitive obsessions that compel you to act irrationally. According to the National Institute of Mental Health, many people with OCD spend over an hour every day thinking about their obsessions and carrying out compulsions.
Additionally, people with OCD don’t usually find their compulsions enjoyable. Rather, it provides temporary relief from the anxiety that comes with their obsessions.
There are many different expressions of OCD symptoms and traits. Some themes include:
Contamination and cleaning
People with this type of OCD are very fearful of getting sick or contaminated with germs. They might also be afraid of infecting others around them. Oftentimes, these people are compelled to excessively wash their hands and avoid others for fear of contracting infection.
There are several different “forbidden” thought obsessions including perverse sexual thoughts, violent thoughts, or religious thoughts. People with these types of obsessions try very hard to suppress these thoughts, even to the point of avoiding people or places that they fear may trigger these thoughts. .
Some people have an obsession with making sure things are perfectly symmetric. They may spend a lot of time counting objects or arranging and rearranging things until they are “perfect” in their eyes.
Those with harm-focused OCD have intrusive thoughts about harming themselves or others, and they deeply fear that they will lose control and act on the thoughts. They will likely avoid scenarios where they could potentially hurt themselves or others.
Hoarders feel strong emotional attachments to inanimate objects and have trouble throwing out possessions, even junk mail and old containers. They may fear that throwing the items out could result in something bad happening, so they hold onto seemingly worthless possessions.
Some people with OCD may feel the need to check something over and over again. Door checking is a common example here. “When ‘OCD checkers’ lock a door, they can see the key turn, hear it lock, and see the deadbolt but not trust their senses or their memory. Because they don’t trust their senses, they tend to re-check according to rules, such as, check it 7 times, saying to themselves ‘It’s locked,’ and then if it feels right, you can stop checking,” says Needleman.
How is OCD diagnosed?
OCD is typically diagnosed by a mental health professional like a psychologist or psychiatrist based on criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
A clinician will likely ask you a series of questions that will compare your symptoms to symptoms of other similar disorders. For example, some OCD symptoms — like paranoia and panic — may manifest similarly to symptoms of other anxiety disorders, depression, or schizophrenia. So, it’s important that you receive the correct diagnosis for the proper treatment.
A doctor will also look at how OCD-like behaviors disrupt your life. For example, someone may have an obsessive fear of germs that may cause them to clean everything in sight, so much so that they may clean until they bleed. It’s these extreme, dramatic disruptions or, even, injuries that make the difference between a “neat freak” and someone with clinical OCD.
Here is a quiz, based on the Yale-Brown Obsessive Scale to see if you have behaviors consistent with OCD, although only a doctor can give you a diagnosis:
Editor’s note: The results of this quiz should not be read as a diagnosis. To truly diagnose OCD, a clinician must also determine whether your symptoms are the result of another mental or physical condition
Risk Factors for OCD
Though it’s possible to develop OCD without any of the following risk factors, there are certain traits that may increase the chance that you have the condition. These risk factors are:
- Having another mental health condition: In fact, it’s estimated that 90% of people with OCD have co-occurring mental health conditions. Some mental health conditions that may occur in conjunction with OCD are:
- Eating disorders, like anorexia or bulimia
- Tourette syndrome
- Attention deficit/hyperactivity disorder (ADHD)
- Substance abuse
- Family history of OCD: If your parents or other family members have OCD, you are at higher risk to develop OCD yourself.
- Trauma or stressful life events: OCD may be more likely to develop if you have been through trauma that raises overall stress levels and triggers intrusive thoughts.
- Age: OCD is most likely to show up in someone between ages eight through twelve or late teen years/early adulthood. However, the condition is diagnosable any time from preschool to adulthood.
Treatment of OCD
Treatment for OCD is typically twofold, including both medication and therapy. Specifically, a type of therapy called Exposure and Response Prevention (ERP), has been shown to be effective.
How Exposure and Response Prevention therapy helps OCD
During ERP, people are confronted with their OCD triggers, but instead of alleviating the trigger with their usual compulsive behavior, they learn to overcome the trigger through other means.
One example Needleman gives is a scenario where somebody is afraid that if they don’t check their stove, the house will burn down. In their ERP therapy, they will practice leaving the house without checking the stove, doing this on different days and with different variations. Eventually, with practice, they learn that the risk is low and that the house will not burn down even if they don’t do their stove-checking rituals.
“ERP sounds simpler than it is because people with OCD often engage in a large number of subtle external and internal compulsions and avoidances that interfere with changing their beliefs that need to be detected and blocked,” says Needleman.
Medications are often used in combination with therapy. Meds can take the edge off the anxiety somebody with OCD may feel, making it easier for someone to face their triggers during ERP therapy.
Medication-wise, the first line of treatment for OCD is a drug class called selective serotonin uptake inhibitors (SSRIs), says Needleman. Commonly prescribed SSRIs for OCD are:
- Zoloft: For ages 6 and up
- Prozac: For ages 7 and up
- Luvox: For ages 8 and up
- Paxil: For adults only
Additionally, Needleman says that an atypical antipsychotic medication can be added to be taken with the SSRIs if the SSRI alone isn’t fully effective.
If patients do not respond to SSRI antidepressants, another option is Anafranil, which is a tricyclic antidepressant (TCA). This is a different class of antidepressants that works by a different mechanism than SSRIs. TCAs are typically only prescribed for OCD after SSRIs have proven not to work for the patient.
The Bottom Line
OCD is a mental health disorder that can be debilitating and disrupt quality of life. But with treatment, it can be managed.
If you believe you may have OCD, make an appointment with a mental health professional so you can get a diagnosis and get on track to feeling better.