By Dr. Sarah Gaumer

If you’ve made it to this page, you are probably looking for answers. Perhaps you are concerned that you or a loved one may be experiencing symptoms of obsessive-compulsive disorder (OCD). You’ve come to the right place, read on to learn more about OCD!

OCD is often misdiagnosed or misunderstood, leaving people feeling lost and receiving the wrong type of treatment. Many assume OCD simply means wanting to be clean or liking things to be neat and organized. In reality, OCD isn’t just about wanting things to be aligned or wanting clean hands. Whether someone has OCD or not, most people like to be hygienic or for their house to be neat to some degree. That alone is normal and not a sign of a diagnosable condition nor a sign that you need OCD the therapy. 

So, when is it OCD?

True OCD is more severe and significant, causing marked distress and impairment. For someone to be diagnosed with OCD, the important distinguishing factor is the “D” part, meaning it is a clinical disorder and greatly impacts daily life and functioning. 

For example, someone who has Contamination OCD fears germs or feeling dirty so they wash their hands for an hour straight (maybe multiple times a day) until they feel clean, causing their skin to become dry, cracked, and painful over time. They may be unable to attend school, work, or social events because their time is spent washing their hands or they are avoiding contaminated areas or objects. 

Someone with Perfectionism OCD may fear being a failure and take hours to write a one page paper that may take others 30 minutes to write. If they make a mistake, they may delete the whole essay and start over completely, even if they made a mistake typing the very last word. Maybe they avoid doing the assignment all together. They might turn in work late or be unable to finish exams or work assignments.    

Obsessions vs Compulsions 

The main symptoms of OCD are in its name: obsessions and compulsions. Officially, it is defined as a mental health disorder characterized by a cycle of obsessions and compulsions. 

• Obsessions are involuntary and undesirable thoughts, images, sensations, or impulses. They are often disturbing, alarming, and violent in nature, and leave one feeling guilty, afraid, disgusted, embarrassed, or ashamed. 

• Compulsions are any action or behavior used to reduce the anxiety and distress  caused by obsessive thoughts. Compulsions can be observable (e.g., hand washing, avoidance) or not observable (e.g., mentally reviewing events). Compulsions are frequently repeated over and over until the worry or pain subsides and everything seems ok again. Yet, the relief is fleeting, and the cycle begins again. 

People with OCD gradually develop symptoms over the course of a period of time. They do not just appear overnight, and they become progressively worse over time if not addressed. Some people are born with it, others develop it later in life. It can manifest at any age, but it most commonly develops between the ages of 8 and 12, as well as between late adolescence and early adulthood. 

OCD Signs and Symptoms

Example obsessions:

• Fear of germs, feeling dirty, or being contaminated.
• Fear you may harm yourself or others.
• Fear of acting on an unwanted, violent impulse.
• Intrusive sexual thoughts, images, or urges.
• Intrusive violent images, thoughts, or urges.
• Fear of making a mistake or failing.
• Fear of being attracted to kids (e.g., pedophile).
• Constantly look for a “just right” feeling.
• Excessive concern with right and wrong (e.g., morality).  
• Fear of sinning and being punished by a religious deity or condemned to hell. 
• Fear of being an awful person.
• Excessive worry about your sexual preference. 
• Need for symmetry or exactness.
• Need to tell, narrate, or confess to others.
• Needings to recall every detail such as facts, dates, events, etc.
• Excessive concentration on body sensations (such as blinking, swallowing, breathing, etc.)

Example compulsions:

• Avoidance of triggers such as other people, objects, images, numbers, colors, etc.
• Constantly asking for reassurance from others.
• Reassuring yourself.
• Arranging, organizing, or aligning objects in a particular way.
• Rereading, erasing, redoing, or rewriting texts, emails, essays, social media posts, etc.
• Excessive grooming and cleaning rituals like bathing, showering, cleaning, or washing your hands.
• Repeatedly checking that appliances are turned off or that objects are in a particular place.
• Physically or mentally checking you haven’t engaged in a certain behavior.
• Tapping or rubbing an object a certain amount of times or until it feels right.
• Constant mental review of previous behaviors or conversations.
• Repeating routine movements like standing up and sitting down, walking in a certain pattern, opening and closing doors, etc.
• Repeating  phrases or prayers.

OCD Themes:

Intrusive thoughts commonly relate to specific topics and concepts. Though there are many types of OCD, they follow the same pattern and cycle of obsessions and compulsions, meaning the same treatment can be used for all of them. People may exhibit multiple subtypes of OCD at the same time. It is also common for someone’s subtype to change over time. 

If you related to any of the information on this page, the good news is there is help available and effective treatment options. If you feel you may experience obsessions and compulsions, don’t hesitate to reach out for a free consultation. 

If you still are unsure if you experience symptoms of OCD, take this helpful OCD screener tool to help guide you. While the screening tool cannot make an official diagnosis of OCD, it can still be used to inform next steps and help make a decision to attend treatment.

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