Common Misconceptions About OCD and Its Symptoms

Common symptoms of OCD include (but are not limited to) anxiety, intrusive thoughts, or images that may be violent or disturbing and don’t go away quickly, excessive reassurance-seeking, avoidance, a fear of losing control, and a need for things to feel “just right.”

Are there different types of the disorder?

OCD is a wily disorder that can take on many different forms or subtypes. Sometimes people will suffer from multiple subtypes of the disorder throughout their lives. Different types include contamination, harm OCD, pure O, scrupulosity or religious OCD, relationship OCD, and postpartum OCD.

Contamination is one of the most common types of OCD. People with OCD who fixate on contamination are likely to wash their hands or shower far more than is necessary to maintain health and hygiene and will avoid coming into contact with certain things that they fear may be contaminated. Contamination is the sort of OCD that is usually depicted in pop culture, which Syzmanski says sometimes leads people to think that compulsions like washing and cleaning are the only symptoms of OCD.

Then there’s harm OCD. “I see a lot of harm OCD,” Maxwell says, which consists of fears that the person will cause harm to others or themselves, or that serious harm will be inflicted on them by others, and so they try to be hypervigilant of their thoughts, words, and behavior in order to prevent doing damage. Maxwell adds that in her work with children who have OCD, it’s common for them to have a fear of being kidnapped, and the accompanying compulsive behaviors are elaborate bedtime rituals in which the child will repeatedly check door locks, windows, alarm systems, and seek reassurance from their parents that they will be okay.

Some OCD patients don’t suffer from compulsive behaviors at all. In cases where someone has pure O — meaning pure obsessions — they will experience disturbing, obsessive thoughts and images, but do not carry out rituals in order to quell their fears.

How long does it take to get diagnosed?

For a variety of reasons, it can often take a really long time for people with OCD to get a proper diagnosis. According to a 2015 article published in the journal American Family Physician, it typically takes 11 years between the onset of OCD symptoms and receiving treatment.

According to Syzmanski, one of the main reasons why it can take such a long time to get a proper diagnosis is due to the fact that people with OCD are often ashamed of their thoughts and behaviors. “Because people [with OCD] recognize, for the most part, that what they’re feeling and their behavior is out of the norm and they don’t want to be doing it, they get ashamed and tend to hide and isolate.” People with harm OCD in particular may be convinced that they have committed or are capable of committing serious offenses against others, and will feel tremendous guilt and shame over things they’ve never done or been accused of. If the person isn’t opening up about their symptoms, it can be a lot harder for anyone, even a professional, to notice that they have the disorder.

It’s also the case that even in the medical community, there are a lot of misunderstandings about OCD. Szymanski says that half of the cases of this particular disorder are misdiagnosed by medical professionals.

How is OCD caused?

As is true with many different mental illnesses, researchers have not found a definitive cause, but notes that there is a neurobiological basis for OCD. That is, the brains of people with OCD work differently than the brains of people without it. Further, research shows that it may be caused by a combination of neurobiological, genetic, environmental, and cognitive and behavioral factors. A quarter of people with OCD also have an immediate family member with OCD.