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Written by:Jill E. Daino, LCSW-R

Published On: May 31, 2022

Medically reviewed by: Bisma Anwar, MA, MSc, LMHC

Reviewed On: June 1, 2022

Updated On: July 17, 2023


Marked by neurotic thoughts and resulting irrational behaviors, obsessive compulsive disorder (OCD) can be challenging to live with. If you think you may have this treatable mental health condition, it’s important to avoid self-diagnosis. Instead, write down your symptoms and connect with a mental health professional to get an accurate OCD diagnosis.

With the help of a therapist, you’ll be able to learn effective coping strategies that can allow you to move forward with improved mental health. There are several various effective OCD treatment options, but getting diagnosed is the first step.

Keep reading to learn more about diagnosing OCD.

How is OCD Diagnosed?

Only a skilled clinician or psychiatrist knows how to diagnose OCD and pinpoint what causes OCD. There are no medical, biological, or genetic tests that can definitively indicate obsessive-compulsive disorder. Rather, an OCD diagnosis is based on the results of psychological assays and interviews with clinicians.

It’s really important to understand that everybody experiences obsessive thoughts and compulsive behaviors periodically. For instance, it’s not uncommon or unusual to go back to double check that you shut the stove off, or you locked the door. Maybe you’re what others see as a “neat freak,” someone who simply likes everything orderly and nicely kept. These aren’t cause for worry or necessarily a problem.

However, OCD is much more intense. The worrisome, scary, or otherwise dreadful thoughts may consume many hours of your day, every day, until they seriously impact and interfere with your quality of life.

OCD causes long-term anxiousness that traps people in cycles of repetitive obsessions (intrusive thought/sensations). Often, these obsessions will result in engaging in compulsive behaviors in a desperate attempt to try and break free from or stop things they’re obsessing over.

It might be easier to think of it like this: someone with obsessive-compulsive disorder experiences repetitive, intense urges and fears they’re unable to control. Those urges cause them extreme anxiety. To deal with that anxiety, they may begin partaking in certain compulsive rituals or routines.

DSM-5 criteria for OCD

These days, it’s common to hear phrases like “OCD,” “obsessive,” “obsessed,” and related terms in casual conversations. Of course, most people are using them flippantly, and don’t actually know how to diagnose OCD.

That’s why the Diagnostic and Statistical Manual of Mental Disorders, 5th ed (DSM-5TR) exists. Skilled clinicians use the OCD diagnosis criteria set forth in the DSM-5TR to diagnose obsessive-compulsive disorder and other mental health conditions.

Diagnosis of OCD criteria includes:

  • The person experiences repetitive obsessions, compulsions, or both
  • The obsessions or compulsions occupy considerable time every day, lasting more than an hour
  • OCD symptoms are not caused by overuse of alcohol, illicit drugs, or prescription medication
  • Obsessive thoughts and compulsive behaviors negatively affect the ability to participate in work, social activities, or other areas of life.

Additionally, a clinician will also ensure that OCD symptoms are not caused by another mental health condition like an eating disorder, generalized anxiety disorder, or depression.

Identifying obsessions & compulsions

The diagnosis of OCD is based on the presence of obsessions and compulsions that detract from a basic quality of life by interfering with an ability to perform normal activities.

People with OCD truly believe that if they don’t engage in (usually irrational) behaviors, which they get no pleasure from, things will worsen, or something tragic, dire, and unthinkable will happen.

Compulsive behaviors might seem to help lessen obsessive thoughts, but they usually start a vicious cycle. The intrusive thought returns, and the acts continue. The constant loop of anxiety, followed by negative behaviors, followed by more anxiety, can be unbearable. The cycle can interfere in daily functioning, relationships, professional work, and more.

According to the International OCD Foundation, OCD is common, affecting about 1 in 100 Americans adults. It affects both sexes about equally, and occurs in people of all backgrounds, races, and socioeconomic statuses.

When diagnosing OCD, clinicians assess you for intrusive thoughts or unwanted sensations that are causing anxiety.

Some examples of such thoughts and feelings include:

  • Needing constant reassurance
  • Fearing that you’ll fail at a task you attempt
  • Needing excessive symmetry, neatness, or order
  • Fearing you’ll hurt somebody else or yourself
  • Feeling like you’ll be embarrassed in front of others
  • Fearing contamination from germs, dirt, or contact with others
  • Repetitively thinking about religion or sex in ways that society may not accept

Again, these are not the typical experiences that most people feel. People with OCD experience these thoughts and sensations on a much more intense level.

In addition to identifying obsessions, an accurate OCD diagnosis also assesses for compulsive behaviors that someone might use to try and alleviate or cope with their repetitive obsessions.

Some examples of compulsive behaviors include:

  • Checking repeatedly that you haven’t caused someone else harm
  • Cleaning the house, showering, bathing, or washing your hands repetitively
  • Arranging and rearranging things (like the items on your desk) very specifically
  • Holding onto or hoarding items that have no financial, personal, or other value
  • Performing specific tasks a certain number of times — like locking the door 4 times
  • Repetitively counting or saying certain phrases or mantras while performing other tasks
  • Avoiding shaking hands or touching objects that could be contaminated, like door handles

Some people with obsessive-compulsive disorder might also experience brief, uncontrollable, repetitive actions. They may seem to be constantly clearing their throat, grunting, shrugging their shoulders, blinking their eyes, or sniffing.

“OCD does not go away on its own. It’s not your fault that the intrusive thoughts and behaviors don’t stop. These thoughts, feelings, and behaviors are often overwhelming and get in the way of daily life, but treatment is available. OCD can be managed — you don’t have to struggle with these thoughts and behaviors on your own.”

Licensed Clinical Social Worker (LCSW-R), BC-TMH Jill Daino

Who Can Diagnose OCD?

Only a licensed clinician, therapist, or psychiatrist can assess someone, using OCD diagnosis criteria, to determine if an obsessive compulsive disorder diagnosis is appropriate. If you have obsessions, compulsions, or both, diagnosing OCD will in part depend on how much time you lose due to these sensations and behaviors. Other considerations will include the degree that your work, school, socialization, or home life is affected.

What to Do If You Get Diagnosed with OCD

If you receive an OCD diagnosis, know that this condition is both common and treatable. A diagnosis of OCD can be looked at as a positive turning point in your life. It can open up roads to recovery that you may never have found otherwise.

Medication: Many people with OCD are prescribed prescription OCD medications, including selective serotonin reuptake inhibitors (SSRI’s) like *Prozac (fluoxetine), Celexa (Citalopram), *Luvox (fluvoxamine), *Paxil (paroxetine), and *Zoloft (sertraline). In cases where SSRIs aren’t effective, other medications, such as tricyclic antidepressants (TCAs) or benzodiazepines, may be attempted.

*Note that only Prozac, Luvox, Paxil, and Zoloft are FDA-approved to treat OCD. 

Therapy: Mindfulness therapy — like mindfulness-based cognitive behavioral therapy (MCBT) — and exposure and response prevention therapy (ERP) are two types of talk therapy commonly used to treat people with OCD. These therapeutic modalities work by encouraging and teaching you to better understand your thoughts and feelings so you can become able to resist engaging in negative or harmful behaviors.

The goal with any in person or online therapy for OCD is to help you not engage in negative behaviors when you experience obsessive thoughts. An experienced OCD therapist can teach you methods for replacing negative habits with healthier options.

“While it can be overwhelming at first to receive an OCD diagnosis, it’s important to remember there are treatments and support available. Speaking with a licensed mental health professional provides support and guidance to manage OCD symptoms.”

Licensed Clinical Social Worker (LCSW-R), BC-TMH Jill Daino

Any mental health diagnosis you get can be scary, but the most important part of being diagnosed is understanding that you’re now able to get help. Remember, the help is out there…you just need to be ready and willing to seek it out. 

Jill E. Daino, LCSW-R

Jill E. Daino, LCSW-R, BC-TMH, is a clinical social worker with over 25 years of experience as a therapist, clinical supervisor, and program director. She works to support quality clinical care at Talkspace. Her work as a clinician and trainer focuses on the mental health impact of body image concerns and eating disorders across the lifespan.

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