It is normal for an individual to occasionally experience doubts and/ or fears that lead to certain behaviors. These are generally fleeting occurrences that are not uncommonly experienced by neurotypical individuals. OCD is a debilitating condition that greatly affects an individual’s quality of life as the symptoms of this condition make completing everyday tasks extremely challenging, if not impossible. Obsessive-compulsive disorder (OCD) is a mental health disorder that is characterized by intrusive, unreasonable thoughts and/ or fears (obsessions) that commonly lead to compulsive, repetitive behaviors. OCD can manifest and affect people of all ages. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) provides clear criteria for mental health professionals when diagnosing obsessive-compulsive disorder. 

Risk Factors

The precise cause as to why an individual may develop obsessive-compulsive disorder remains unknown. There are, however several risk factors that can indicate one’s predisposition for potentially developing OCD, including:

  • Presence of other mental health disorder (i.e. depression, anxiety, posttraumatic stress disorder…etc.)
  • Family history of OCD (i.e. parent, child, and/ or sibling diagnosed with OCD)
  • Differences in the makeup of one’s brain
  • History of child abuse (physical, verbal, and/ or sexual)
  • Experience with trauma

It is also possible for OCD to develop in children as a result of a streptococcal infection. This is referred to as PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections). 

OCD Categories

Obsessive-compulsive disorder can manifest if a variety of different ways. As such, several OCD categories have been established. The most common OCD categories individuals fall into include the following: 

  • Checkers: repeatedly looking at and checking things such as alarm systems, lights, locks…etc.
  • Washers: fearing contamination, compulsively engaging in personal hygiene rituals (i.e. washing hands, showering, washing feet…etc.)
  • Hoarders: collecting things for fear that something bad may occur directly as a result of throwing items away. 
  • Doubters: continuously afraid that if something is not done perfectly the individual will be punished and/ or it will result in something terrible occurring.
  • Counters: the need to compulsively count things (i.e. steps, bottles, letters…etc.) and/ or have irrational superstitions connected to certain numbers.
  • Arrangers: must have everything arranged to perfectly reflect order and symmetry. 

Some individuals may exhibit symptoms related to multiple categories, although it is most common for an individual to experience symptoms as they primarily relate to one of the above categories. 

Signs And Symptoms

Every individual is different and may exhibit a unique set of OCD symptoms. As provided by the National Institute of Mental Health, examples of common symptoms related to OCD can include any of the following:

  • Compulsive counting
  • Arranging and/ or ordering items in the same, symmetrical, precise way
  • Excessive cleaning and/ or hand washing
  • Repeatedly checking on things
  • Irrational fear of oneself or others getting hurt
  • Religiously preoccupied
  • Avoiding touching things for fear of contamination 

While some individuals may only experience one component of OCD (obsession or compulsions) many individuals with OCD to have both obsessions and compulsions. Research has indicated that stress itself does not induce OCD, it can, however, lead to the worsening of symptoms.

How OCD Is Diagnosed

The diagnosis process for obsessive-compulsive disorder typically includes several components. The initial steps generally include a thorough physical exam as well as conducting various blood tests to ensure symptoms aren’t being caused by something else. A psychological evaluation occurs to enable the clinician to gain insights into an individual’s behavior patterns, symptoms, thoughts, and feelings. This can help the evaluating clinician determine if the individual’s obsessions and/ or compulsions are actively interfering with his or her ability to function and quality of life. Many mental health professionals that are capable of diagnosing OCD closely adhere to the criteria provided by the American Psychiatric Association published in the DSM-5 listed under the category Obsessive-Compulsive and Related Disorders. The current diagnostic criteria for OCD include:

  1. The presence of obsessions, compulsions, or both
  2. Obsessions and/ or compulsions are time-consuming (at least an hour per day) and/ or result in clinically significant distress and/ or impairment in occupational, social, and/ or other areas of functioning
  3. OCD symptoms are not attributable to physiological effects of another mental condition (i.e. side effects of medication, substance use disorder…etc.)
  4. The obsessive-compulsive disturbances are not better explained as symptoms of another mental disorder

Any mental health disorder diagnosis should be established through a proper evaluation conducted by a qualified mental health professional. If there is any concern that a loved one may be struggling with OCD, it is best to seek the guidance of a mental health professional as soon as possible. Treatment for OCD can help an individual learn tools to effectively manage his or her symptoms and go on to lead a healthy and fulfilling life.