Getting a Diagnosis
If you suspect you have OCD, or that someone you care about does, the first thing to do is find out for sure so you can decide on and begin treatment. The best way to do this is to see a qualified therapist, preferably one who specializes in OCD or anxiety disorders. You can also get in touch with the International OCD Foundation or other organizations that help people who have OCD. In addition, there are self-assessments you can try (you'll learn about these in the next section).
Your therapist may ask you to discuss your worries, and may give you a test (or several), asking you to rate your discomfort level in certain situations. However, there are a few indicators you can use in the meantime. One is the amount of discomfort you feel when prevented from practicing your obsessive behavior (sometimes called a “ritual”)
For instance, if you were being interviewed for a desirable job and had to shake the prospective boss's hand, would you become so preoccupied thinking about when you might get to wash that you wouldn't be able to focus on the conversation? If so, it's possible that you have OCD.
Being honest with your therapist will help her determine whether you have OCD and, if so, to what degree. There's no need to feel afraid or embarrassed. “Yes” answers about obsessive thoughts or “ritual” behaviors do not mean you're “crazy.” Nor, believe it or not, will the answers be anything the therapist hasn't heard before.
Some studies find that women more often start to experience OCD symptoms in their early twenties, while for men, it's usually their teens. Although OCD is a brain disorder, many researchers believe traumatic events often set off the first episode. Some also believe that growing up with rigid rules for behavior may influence whether a predisposed person will develop OCD.
Your OCD Self-Assessment
Your therapist may also give you a test (either to take home, fill out, and bring back to your next session, or to complete in her office, verbally). There are also several OCD self-assessment quizzes available in books, online, and through therapists. Additionally, there are tests (one of which is available through the OCD Centre's Web site) that family members and others close to the individual in question may take.
While these tests may help you determine whether or not you have OCD, it's still best to get a diagnosis from a professional.
The following is the OC Centre's test:
Score questions as follows:
- Never — 1
- Sometimes — 2
- Often — 3
- Very Often — 4
- All the Time — 5
(If you're not sure of an answer, just give your best guess.)
How often does the following happen to you?
Repeat tasks because they don't “feel right” the first time, e.g. switching off lights, putting things down, locking or closing doors
Collect items that have no value, e.g. magazines, newspapers, etc.
Repeat tasks according to a “lucky number”
Get anxious about certain words, phrases, or numbers
Have rituals for leaving the house, e.g. locking door, touching door, checking bag, windows, etc.
Find difficulty reading due to having to frequently re-read sections
Find yourself retracing your steps when walking in public
Find it difficult to stop doing tasks which are naturally repetitive, e.g. cleaning teeth, flicking through TV remote, pushing buttons, typing on keyboard
Regularly feel the need to arrange objects according to a certain pattern, e.g. color code, alphabetical order or symmetry
Have to think of a “good thought” to counteract a “bad thought”
Distressing images popping into your head for no reason, e.g. harm coming to others, unwanted sexual or violent images
Start most of your reasoning with “what if….”
Spend long periods of time researching matters that worry you on the Internet
Mentally go over and over situations that have already occurred or might occur
Clean personal objects such as keys, remote controls, purses, wallets, bags, credit cards
Pull your sleeves over your hands before touching handles
Spend an unreasonably long time in the bathroom (say, more than 20 minutes or so)
Avoid putting dirty washing in with the rest of your immediate household's
Worry that you are attracted to the same sex (if you're basically heterosexual)
Have sore, chapped, red hands from washing them too much
Have difficulty eating food or drink served in public places for fear of germs, disease, or other contamination
Outside, walk with head down, scanning for danger
Ask others for reassurance about things which only seem to matter to you
Worry about loved ones when they leave the house to do everyday tasks
Avoid driving because you are fearful of causing an accident
Avoid vulnerable groups of people, e.g. children, the elderly, the disabled, etc.
Overly check that electrical/gas appliances and taps are turned off
Become anxious around knives or other potentially harmful objects
Check e-mails to ensure you haven't said something inappropriate
Do you have difficulty throwing items away because you may need them in the future?
Please add up your total scores. (Please note that this assessment is a useful guideline only and should not replace a full assessment with a licensed professional, either employed by the OCD Centre or elsewhere.)
Reprinted with the permission of the OCD Centre, Belgravia, London and New York, NY; OCDCentre.com.
0 – 50: Unlikely to have OCD; if so it is probably mild and not currently intruding upon your life.
51 – 100: It is possible you have OCD and that it is affecting your life. We recommend that you carry out a full assessment (you could try our full version) or seek diagnosis from a mental health professional.
101 – 150: It is highly likely that you have OCD and it is causing you considerable discomfort (possibly to those around you). Please don't suffer further and seek help as soon as possible.
Listening to Others
Whether or not you have OCD, if friends, family members, and others who care about you tell you that something's wrong, it's probably best to take their remarks seriously.
You may feel as if your behaviors are perfectly reasonable and that those folks don't understand. Okay. But as a wise person once said, “If three people tell you you're drunk, lie down.”