Obsessive-compulsive disorder is characterized by unwanted obsessions, ritualistic compulsions, and daily anxiety brought on by the feeling that symptoms are taking over your life. Stereotypes abound about the condition, but the reality is far from straightforward. Since obsessions and compulsions can take on any form — and OCD varies widely in severity — diagnosis can be difficult, and usually requires a therapist specially trained in the condition.
What does OCD look like? From an outsider’s perspective, it may not look like much. Symptoms of OCD are primarily internal (though some compulsions can be observed by others), so concerned family members or therapists may need to do a little digging to determine if it is, in fact, OCD.
In general, OCD symptoms look like this:
- Fear of harming self
- Fear of harming others
- Fear of being “contaminated”
- Fear of infecting others
- Recurrent sexual or violent thoughts
- Fear of saying certain things (“unlucky” words, comments that disrespect a dead person, etc.)
- Intrusive nonsense sounds
- Excessive washing
- Checking locks, stoves, appliances, etc.
- Repeatedly taking your own pulse, blood pressure, or temperature
- Re-reading pages several times before moving on
- Need to touch objects or other people
- Calling friends or family members to make sure they’re safe
- Ritualized eating behaviors
In many cases, people with OCD feel a large amount of shame about their disorder — and, as a result, they may go to great lengths to hide it from those close to them. In these instances, secondary symptoms may include anxiety, depression, insomnia, restlessness, and sensitivity to sound, touch, or other external stimuli.
The typical age of diagnosis varies with OCD. In some cases, it can be diagnosed as young as six, with parents reporting traits in their child from a very early age that include obsessive cleanliness, tantrums if something gets “out of order,” and close attention to rituals,. For those who also have a comorbid condition like ADHD, depression, or Tourette’s Syndrome, the symptoms tend to flare up earlier. In the majority of cases, however, OCD symptoms begin to manifest in the teen years and early adulthood.
When it comes to diagnosis, it’s important to see someone who specializes in OCD. Since no definitive medical test exists for OCD, it’s not an easy disorder to diagnose, and diagnosis should not be made lightly. Most mental health professionals will use a rating scale called the Y-BOCS, which stands for Yale-Brown Obsessive Compulsive Scale. The Y-BOCS is a comprehensive questionnaire outlining the nature of a patient’s obsessions or compulsions, how long they have presented themselves, and how intrusive they are to a patient’s life.
Professionals will also take a detailed medical history as well as a comprehensive mental health history to determine if it’s OCD, a disorder on the OCD spectrum, or even generalized anxiety disorder.