An anxiety disorder, OCD is characterized by recurring, unreasonable, and unwanted thoughts (obsessions) that drive sufferers to engage in repetitive behaviors (compulsions).
For many people, their only conception of OCD — or obsessive compulsive disorder — is as a joke: “I’m so OCD,” someone might say. “I hate it when my books aren’t in alphabetical order!” And while, yes, alphabetizing your entire bookshelves might be a symptom of OCD, the disorder is something that shouldn’t be joked about. To sufferers, obsessive-compulsive disorder can be distressing and debilitating.
At its core, OCD traps you in a cycle of obsessions and compulsions, making it difficult to live your life or behave normally. The disorder is more common than you might think: According to the World Health Organization, about 1 in 40 American adults have OCD, and it’s one of the 20 most common reasons for disability.
Simply because you occasionally obsess over a new favorite TV show, insist on alphabetizing your books, or feel compelled to double-check that you turned off the stove, doesn’t mean you have OCD. Many people engage in infrequent obsessions and compulsions throughout their lives, but it’s not enough for a clinical diagnosis.
To understand what does qualify as OCD, it’s important to understand what obsessions and compulsions actually are.
What Are Obsessions?
An obsession is a thought or idea that occurs constantly and over which you have no control — in fact, sufferers often find these thoughts horrifying, disturbing, or nonsensical. Many times, these obsessions are accompanied by feelings of disgust or anxiety, and they can take up so much mental space that it’s hard to focus on anything else.
Obsessions take many forms. Some people with OCD may be preoccupied with getting sick, and their disorder may take the form of frequent hand-washing, avoiding hospitals, or being frightened of children with runny noses, even if they’re very far away. A person without OCD may be briefly concerned about germs, but that thought is fleeting and quickly dismissed. For a sufferer, these thoughts are an omnipresent obsession.
Other common obsessions include:
- Losing control
- Worrying they may harm themselves or others
- Natural disasters
- Fire or burglary
- Evenness or precision (i.e., ensuring all doors close a certain number of times)
- Loss and death
- Perverse sexual thoughts or impulses
- Extreme religious morality
- Superstitions (i.e., lucky numbers or colors)
Typically, compulsions are what OCD sufferers do in hopes that they will make the obsessions disappear. Sometimes, this is as simple as avoiding triggering locations. Someone frightened of disease may avoid public transportation, for example. But many compulsions come in the form of repetitive behaviors or rituals— like repeatedly washing one’s hands.
The difference between a compulsion and a standard, non-OCD ritual is the belief behind the actions. You might enjoy a cup of tea and a cookie before bedtime every night, but that’s not an OCD ritual. Sufferers often feel like they have to complete these compulsions — or else something bad will happen — in order to ease their obsessions. Often, they don’t want to do them at all.
Do I Have OCD?
If you’re experiencing both obsessions and compulsions, you might have OCD. You also might have OCD if you’re only experiencing obsessions —this is called Purely Obsessional OCD, or “Pure O.” With this variant, sufferers seek reassurance or answers or practice avoidance to calm their obsessions. For example, one common manifestation is “relationship OCD,” where you obsess over whether or not you are with the right person, in a good relationship, and second-guess your love despite these fears being seemingly unfounded.
According to the DSM, an OCD diagnosis must meet a few criteria:
- Obsessions, compulsions, or both
- The obsessions or compulsions are intended to prevent distress or anxiety, or to stop some event from happening—despite there being no realistic connection
- The obsessions or compulsions take up at least an hour each day or cause “clinically significant distress”
The behaviors also must be unexplainable by either drugs, alcohol, medication, or another mental illness — like excoriation disorder, which causes sufferers to pick at their skin.
The best way to know if you have OCD is to discuss your symptoms with a therapist. A mental health professional can diagnose you and develop a course of treatment that can alleviate or significantly mitigate your disorder. Don’t be afraid to talk to a professional — there is plenty of hope out there for OCD sufferers.