How to tell if you really have OCD

• ‘He’s obsessed with cleaning. It’s like he has OCD or something.’
• ‘She keeps rearranging her furniture until it’s just right. Classic OCD behaviour.’
• ‘I need to check the lights exactly three times before I leave my house. Could I be more OCD?’

While the above commonly-heard statements can certainly be symptoms of OCD, they are not a confirmation of clinical OCD. 

In this context, we feel it’s important to clarify what OCD is NOT. 

OCD is not about being neat and organised, and enjoying cleanliness in general.

OCD is not about having some minor quirk or preference like wanting to arrange your stuff in a certain way.

OCD is not about being picky or selective about things like food, movies, clothes, or places.

Someone with clinical OCD doesn’t just clean or rearrange things because it gives them momentary joy or relief; they do it because they truly believe that not doing it will result in some unforeseeable disaster and cause their world to come crashing down. They do it because the stress and distress of not doing it are unbearable. They get so preoccupied with a certain thought or action that it prevents them from functioning normally and disrupts their daily activities.

What is Obsessive-Compulsive Disorder (OCD)?

As the name suggests, Obsessive-Compulsive Disorder (OCD) is a mental illness characterised by two major themes: obsessions and compulsions.

Obsessions are persistent thoughts, urges, or images that pop up in a person’s head, causing them anxiety or distress. The person can’t control these thoughts, and they keep coming back even when the person tries to ignore them. Obsessions often revolve around themes like cleanliness, safety, or order. For instance:

• Someone with a persistent fear of germs might constantly worry about viruses and contamination, thinking that touching a doorknob or shaking someone’s hand will make them sick.
• Someone obsessed with causing potential harm, either to themselves or others, might worry about leaving the stove on or hitting someone with their car.

These thoughts can be extremely disturbing and cause significant anxiety, even though the person knows they are irrational.

Compulsions are repetitive behaviours or actions that a person feels driven to do in response to their obsessions. They might do these things to try to ease the anxiety caused by their obsessions, but it only provides temporary relief. For instance:

• Someone with contamination fears might engage in excessive hand-washing or cleaning rituals, or spend hours scrubbing themselves or their surroundings to rid them of imagined germs.
• Someone hounded by harm-related obsessions might engage in constant checking rituals, repeatedly checking locks or appliances to ensure they’re off, even though they logically know they are.
• Other common compulsions include counting, arranging objects in a specific order, or seeking reassurance from others to alleviate anxiety.

While these compulsions provide some relief from the distress caused by obsessions, they don’t address the root problem and ultimately perpetuate the vicious cycle of OCD.

Symptoms of Obsessive-Compulsive Disorder (OCD)

Most people with OCD usually have both obsessions and compulsions. However, they could have either one as well. Let’s look at some of the most common symptoms for both:

Obsession Symptoms

• Intrusive thoughts: Persistent and unwanted thoughts that take over the mind, like fears of harming loved ones, concerns about making mistakes, or doubts about one’s sexuality or morality.
• Fear of contamination: Excessive worry about germs, dirt, or illness, leading to avoidance behaviours.
• Need for symmetry: Feeling compelled to arrange or organise items until they feel “just right.”
• Unwanted impulses: Sudden urges to perform actions that go against personal values or beliefs.
• Disturbing images: Intrusive mental images or visions that cause distress or anxiety.
• Fear of harm: Constant worry about accidentally causing harm to oneself or others.
• Unpleasant sexual thoughts: Intrusive thoughts of a sexual nature that cause distress or shame.
• Fear of making a mistake: Anxiety about making errors or causing harm due to negligence.
• Preoccupation with religion or morality: Obsessive concerns about moral or religious issues, often involving fear of punishment.
• Need for perfection: Striving for flawlessness in tasks or behaviours, leading to excessive self-criticism or dissatisfaction.

Compulsion Symptoms

• Excessive hand-washing: Repeatedly washing hands in response to contamination fears, often until they are raw or irritated.
• Repeated checking: Checking and rechecking locks, appliances, or other objects to ensure safety or prevent harm.
• Counting or arranging: Engaging in repetitive counting or arranging of objects to alleviate anxiety.
• Mental rituals: Performing mental acts or prayers in an attempt to neutralise obsessive thoughts.
• Hoarding objects: Compulsively collecting and saving items, even if they have little or no value.
• Seeking reassurance: Constantly seeking validation or reassurance from others to alleviate anxiety.
• Avoidance behaviours: Avoiding situations or triggers that provoke obsessive thoughts or anxiety.
• Repetitive prayers or rituals: Engaging in repetitive religious or superstitious rituals to ward off harm or anxiety.
• Touching or tapping rituals: Touching or tapping objects or body parts a certain number of times to prevent harm or discomfort.
• Excessive cleaning or grooming: Spending excessive time and effort on cleaning or grooming behaviours, often in response to contamination fears.

Note: Interestingly, in a 2017 study to understand the prevalence of OCD among Indian adolescents, the two most common OCD symptoms found were taboo thoughts (67.1%) and mental rituals (57.4%).