Resource CenterObsessive-Compulsive Disorder Symptoms, Diagnosis, and Treatment

Obsessive-Compulsive Disorder Symptoms, Diagnosis, and Treatment

A young person with a blanket wrapped around their shoulders sits and talks to a mental health professional in a cozy room.

By Lauren Krouse

Life with untreated obsessive-compulsive disorder (OCD) can feel overwhelming. Unwanted thoughts or mental images, known as obsessions, and repetitive urges and behaviors, known as compulsions, can cause persistent distress that makes daily life hard.

One of the main reasons people with OCD reach out for help is the intense anxiety the condition can cause. If you think you may have OCD, connecting with a health-care professional is the first step toward creating a treatment plan, managing your recurring thoughts, and feeling better.

Facing a potential diagnosis takes strength and courage, but you don’t have to do it alone. Learn how to get help and what to expect when treating OCD.

How Would You Know If You Have OCD?

An indication of OCD is when obsessions and compulsions have a negative impact on your life. Obsessions are thoughts or mental images you have over and over, despite not wanting them and trying to stop them. Compulsions are behaviors you feel you must do, or else something bad will happen or you feel intense distress.

It’s OK to have repeated thoughts from time to time or have habits you frequently engage in — it’s when those thoughts and habits start to take over your life that OCD may be at play. According to the National Institute of Mental Health, some signs that your symptoms could be OCD include feeling like you can’t control your obsessions or compulsions despite knowing they are excessive, and experiencing temporary relief from your anxiety — but no satisfaction — from engaging in compulsions.

You may have heard others say — or have said yourself — “I’m so OCD” when engaging in habits having to do with cleanliness, organization, or something else, when they do not actually have the disorder. It can be harmful to say that, because it can perpetuate misconceptions about OCD and be invalidating to those who have an OCD diagnosis. It’s important to avoid labeling thoughts or habits as “OCD” without a proper diagnosis.

How Is OCD Diagnosed?

To determine if you have OCD, you’ll need to meet with a mental health professional, such as a therapist or psychiatrist, who specializes in treating the disorder. During a formal assessment, they’ll ask you questions to see if you meet criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a guidebook used by U.S. mental health professionals to diagnose and treat mental health and brain-related conditions. Be prepared to talk about your health history, your symptoms, and their impact on your life.

Some questions you may be asked include:

Are there things you feel you have to do, and something bad will happen if you don’t?
Do you need to check that things are turned off or locked multiple times and still feel anxious despite having checked many times?
Do you have rituals you feel compelled to do to avoid discomfort?
Are there certain numbers of times you need to do things or ways you need to arrange things to feel comfortable?
Do you have aggressive or sexual thoughts you don’t want but keep having that make you uncomfortable?
Do you ever think an action you take or thought you have will affect someone or something unrelated, such as fearing that thinking about a traffic accident will cause one to occur.

The defining features of OCD are obsessions and compulsions. To qualify for a diagnosis, you must:

Experience obsessions, compulsions, or both
Experience obsessions or compulsions that take up more than an hour per day
Experience obsessions or compulsions that cause distress or affect your ability to show up for social activities, work, school, or other life events

Your health-care provider will also need to rule out other possibilities, including symptoms caused by drugs, alcohol, medications, or a different mental health condition such as anxiety or an eating disorder.

Learn more about indicators of OCD and how it can be related to other mental health conditions.

Watch: OCD: Symptoms, Common Behaviors, and Effective Treatments

How Is OCD Treated?

OCD can be treated with therapy or medication. A form of cognitive behavior therapy known as exposure and response prevention (ERP) is the most research-backed therapy for OCD. Antidepressant medications can also be helpful.

Therapy

ERP therapy can be provided by a mental health professional who specializes in OCD. You may schedule appointments once a week or a few times a week.

As the name suggests, there are two parts to the therapy: exposure and response prevention. Exposure involves gradually and safely exposing yourself to situations, thoughts, or images that bring up anxiety due to your OCD. Response prevention involves learning strategies to cope with the distress without using compulsions and handle anxiety without engaging in rituals

You’ll start slow. First, you and your therapist will come up with a list of feared situations, thoughts, or images. Then you’ll expose yourself to increasingly distressing items on your list.

If you have contamination obsessions and you feel anxious if you do not wash your hands after touching a doorknob, for example, your therapist will set up an exposure in session and ask you to stop yourself from washing your hands for five minutes afterward, then 10 minutes, and so on. In time, you’ll learn how to ride the wave of anxiety without turning to compulsions. The goal isn’t to stop your thoughts (something none of us can do), but to learn how to deal with obsessive thoughts.

If ERP isn’t effective, there are other options. Other types of cognitive behavioral therapy, such as acceptance and commitment therapy (ACT), may also be helpful for OCD.

Learn more about the different types of therapy.

Medication

Along with therapy, medication can help ease OCD symptoms. Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), are the most common type of medication prescribed for OCD.

Learn more about mental health medications.

Find Peace of Mind Again

It’s common for OCD symptoms to fade, only to return during stressful periods of your life. But with support, you can learn how to manage OCD and begin to feel better. You’re not alone in this, and, with the right toolkit and support system, you can manage OCD.