The acronym OCD, or obsessive-compulsive disorder, is a common colloquial in everyday speech. Regularly used to describe behavior that is nitpicky or considered slightly neurotic in the public eye, OCD is often viewed as an occasional trait rather than a serious mental health challenge for those who have received a clinical diagnosis. In reality, OCD is not a casual condition; in severe cases, it can be crippling, affecting everything from job performance to the ability to leave the house in the morning.
For those with OCD, proper care, whether in the form of a stay in a mental health rehabilitation center, the use of medication or both, is critical to managing symptoms and minimizing their effects. This is how to know if you have OCD.
OCD Signs and Symptoms
An abbreviation for obsessive-compulsive disorder, OCD is characterized by recurring and omnipresent thoughts, ideas and motivations that stand in the way of everyday life. These intrusive thoughts can result in compulsive behaviors, like washing hands multiple times before leaving the restroom, turning lights on and off repeatedly before leaving a room or cleaning each room in a home multiple times a day. Not doing these things is not a matter of will; failing to accomplish these set routines can cause great stress and anxiety, sometimes to the point of triggering panic attacks. Affected individuals will continue to impose their fears, worries, and compulsions on those around them, falling further into these dangerous thought patterns.
It is important to note that a few random compulsive behaviors do not constitute OCD; for many, this can be a very normal part of life. For a clinical diagnosis, patients must display:
- Time-consuming compulsions interfering with an hour or more each day
- Major distress due to compulsive behavior
- Impairment of work, school or social functions
Around 1.2% of the population lives with OCD (American Psychiatric Association), and the condition affects more women than men.
Manifestation of Obsessive-Compulsive Disorder Traits
OCD often arises early in life, with symptoms appearing in childhood, adolescence or young adulthood in most cases. The average age of diagnosis is 19.
How OCD manifests can be very specific from one person to another, but the first signs often include:
- Fear of germs, illness and dying
- Fears about having made mistakes or not doing things “right”
- Unwanted thoughts about causing harm
- Compulsive activities related to fears, like sterilizing areas to prevent germs, excessive hand washing and repeating actions to make sure situations are correct
- Regular apologizing or explaining benign situations
- Arranging and organizing arbitrary items
- Asking for constant reassurance of safety or acceptance in normal situations
In many cases, these symptoms will come on slowly. Consistent thoughts regarding something like death may result in an obsession with cleanliness, while frequent apologies seemingly out of nowhere can indicate an obsession with correctness. In children, these kinds of things may be easily confused with standard learned behaviors. In very rare cases, symptoms can appear all at once as if out of nowhere, but this is not at all common. In all cases, without proper treatment, these kinds of indicators will only continue to worsen. Obsessions will grow deeper and compulsions will intensify.
Signs of OCD in Adults
Due to the widespread colloquial use of the concept of OCD, noticing true signs in others can be challenging. When considering symptoms to potentially bring up with a friend of loved one, it’s important to detach the common use of OCD from any signs you may believe you are seeing.
Instead, focus on these kinds of incidents:
- An increasing worry about normal circumstances, like catching a cold
- The start of repetitive behaviors, like needing to wash hands multiple times or, in the case of a coworker, compulsively cleaning a workspace
- Obsession with minute details of ordinary life and a fixation on the associated potential consequences, like a sick individual potentially passing on deadly germs
- Insisting on a particular order of items, like keeping clothes color-coded or books alphabetized or put on shelves by height
Again, it is important to note that behavioral idiosyncrasies that an individual displays, like obsessive attention to detail, that may be referred to as OCD behavior in a colloquial manner are not actually a proven sign of a diagnosable case of OCD.
Alternatives to OCD
A shift in behavior is not necessarily always correlated with OCD, and there are other mental illnesses that can be associated with what many people understand as the signs of obsessive-compulsive disorder. Anxiety, for example, can result in unnecessary worry about things like death and dying or the danger of germs, while conditions like schizophrenia can trigger sudden shifts in mood, life perspective and temperament.
For those showing less severe signs, obsessive-compulsive personality disorder may be the issue. OCPD is a distinct personality disorder that is characterized by less severe forms of the habits that define OCD, like concern with orderliness, attention to detail and perfection in results. This can result in some similar behaviors, like consistently organizing home areas and workspaces or a strong need to control a given environment. While OCPD can interfere with relationships and job performance, it doesn’t result in the severe consequences that untreated OCD can cause.
Types of Obsessive-Compulsive Disorder Traits
As with numerous other forms of mental illness, OCD can be broken down into numerous subcategories largely based on symptoms. These differentiations aren’t necessary clinical in nature and aren’t broken out in the DSM-V but are commonly accepted by many OCD counselors and therapists. By identifying subtypes, it’s often easier to create an effective plan of treatment.
Ordering and Symmetry
Those who are obsessive about ordering and symmetry are concerned with keeping possessions and item locations in a neat, orderly manner that exceeds what other people may consider neat or clean. Symptoms can include:
- A compulsive need to organize items in a particular way
- An obsession with symmetry using criteria like size or color
- Counting of objects, sometimes repetitively
- Rituals surrounding organizing objects
- Panic or anxiety when items aren’t properly organized
Contamination and Cleaning
Those with a focus on contamination and cleaning tend to hyperfocus on areas related to germ elimination, disease prevention and cleanliness that goes above and beyond normal human standards. This subtype is often dictated by:
- An obsession with cleanliness, both physical and mental
- Fear of disease and biological materials
- Avoidance of germ-ridden areas, like bathrooms and medical facilities
- Ongoing cleaning of the body, clothing and physical areas
- Washing or cleaning rituals, often related to showering or hand washing
Hoarding can be associated with a number of different mental health issues but can be a component of OCD in some people. Those who hoard have:
- A belief that disposing of items can cause harm
- A strong need to protect personal belongings
- A fear of throwing away potentially important information
- Trouble touching hoarded materials due to the potential for contamination
- A feeling of incompleteness when not surrounded by chosen possessions
Not all forms of OCD involve obsessive actions. In some cases, OCD primarily consists of intrusive thoughts that interfere with daily life. In this case, these thoughts tend to be more forbidden in nature, pertaining to disturbing or uncomfortable topics that cause distress. This form of OCD manifests as:
- Intrusive thoughts that are damaging or upsetting
- Shame surrounding troubling thoughts
- Fear of acting on inappropriate thoughts
- Feelings of responsibility for negative actions
- Fear of harming others, either intentionally or unintentionally
- An ongoing need for reassurance of being a good or worthy person
- Rituals designed to expel or avoid negative thoughts
Behavioral tics are often thought of as a part of conditions like Tourette’s but can also be a part of an OCD diagnosis. How these appear can vary but often include shrugging, twitching, blinking, or throat clearing. Behavioral tics generally accompany other OCD symptoms rather than standing alone.
Diagnosis of OCD requires a meeting with a trained mental health professional, ideally either a psychologist or a psychiatrist. In an appointment, a patient will be asked questions related to behavior and thought patterns, including common symptoms as well as less common manifestations. The extent of these thoughts and behaviors will be evaluated, as well as an analysis of the likelihood of recurrence as well as the impact on daily life. By taking into account all of the criteria outlined in the DSM-V, it is possible to determine whether or not an individual truly has OCD.
It’s possible to believe you have OCD, or that a loved one is showing signs, but all mental health challenges should be properly diagnosed by a health care professional. Self-diagnosis is always discouraged.