Despite there being many different variants of obsessive-compulsive disorder, there are specific core signs of OCD that can be seen in all forms. In this article, you will learn about these indicators to be aware of them for yourself or notice them in others so that you or a loved one can get diagnosed and start treatment.
What Are The Early Symptoms Of OCD?
Obsessive-compulsive disorder, often shortened to simply OCD, is a common mental health condition that is characterized by two primary features - obsessions, which are unwanted thoughts or mental images that cause distress (also known as intrusive thoughts), and compulsions, which are behaviors or actions that people are compelled or driven to perform and are used to try to neutralize or provide relief for the stress and anxiety that the obsessions cause.
Unfortunately, due to the media, the public perception surrounding OCD is that it is a disorder that involves cleanliness or organization. The truth is, there are many obsessional themes for OCD, and it can involve just about anything that a person finds distressing.
However, in general, they can be placed in broader categories or subtypes. For example, there is: [1]
- Contamination OCD (i.e., fear of germs or catching a disease)
- Harm OCD (i.e., unwanted violent thoughts)
- Symmetry OCD (i.e., needing to have things placed perfectly or in a specific order)
- Sexual Orientation OCD (i.e., having obsessions that can lead to people questioning their sexual orientation)
- Pedophilia OCD (i.e., unwanted sexual thoughts involving minors)
- Relationship OCD (i.e., questioning if their partner is right for them or vice-versa)
- Religious OCD (i.e., worrying that something they did is against their belief system)
One important aspect of these OCD examples is that these thoughts are not secret desires that people have deep-down, nor is it a reflection of their character. For instance, someone who has an intrusive thought about stabbing their spouse with a kitchen knife doesn't truly want to do this. This is an example of Harm OCD.
In fact, this is what causes OCD to happen in the first place. People don't want these thoughts and images, and they find them disgusting and repulsive, so they perform compulsions to try to counter the things that pop into their minds.
Despite the stress it brings, people with OCT will never act on their thoughts, and these compulsions are what cause OCD to be one of the most persistent mental health conditions. Like the themes that people can obsess about, there are just as many, if not more, compulsions that people can carry out either physically or mentally.
There are many cases of people where these compulsions aren't apparent to others, and instead, they have what is known as Pure-O, or pure obsessional, OCD.
This name is somewhat of a misnomer, and people with this type of OCD will still have mental rituals to cope with their intrusive thoughts. Therefore, they still have compulsions, not just obsessions.
As you continue to read, you will learn more about the signs and symptoms of OCD, including the types of compulsions people depend on, which reinforce the disorder.
What Are The Symptoms Of OCD?
Although the previous section gave an overview of OCD, many specifics are used to diagnose OCD. According to the DSM-5 (Diagnostic and Statistical Manual 5th edition) by the American Psychiatric Association, the criteria goes as follows: [2]
Presence of obsessions, compulsions, or both:
Obsessions Are Defined By (1) And (2):
- Recurrent and persistent thoughts urge, or images that are experienced, at some time during the disturbance, as intrusive, unwanted, and that in most individuals cause marked anxiety or distress.
- The individual attempts to ignore or suppress such thoughts, urges, or images or neutralize them with some thought or action (i.e., by performing a compulsion).
Compulsions Are Defined By (1) And (2):
- Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession according to the rules that must be applied rigidly.
- The behaviors or mental acts aim to prevent or reduce distress or prevent some dreaded event or situation. However, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are excessive.
- The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important functioning areas.
- The symptoms of another mental disorder do not better explain the disturbance (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possession, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder); stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).
- The disturbance is not due to the direct physiological effects (e.g., the drug of abuse, a medication) or a general medical condition.
- Specify if:
With good or fair insight: The individual recognizes that obsessive-compulsive beliefs are definitely or probably not true or that they may or may not be true.
With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true.
With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true.
- Specify if:
Tic related: The individual has a current or past history of a tic disorder.
Symptoms of OCD: What Are Examples Of Compulsions?
Like the various themes that people can have obsessions about, compulsions can be just as diverse.
However, they can also be grouped into general categories, and within these people can have the unique compulsions that they use to quell their anxiety. These are the most common ones: [3]
- Checking (i.e., making sure the stove or other appliances are turned off or making sure doors are locked.
- Cleaning and washing (i.e., Excessive hand-washing until satisfied or always cleaning the house)
- Mental compulsions (i.e., counting or having a special mantra or prayer to neutralize a thought or replaying an event in their mind to or reassure themselves nothing bad happened)
- Order and symmetry (i.e., arranging or organizing things until they are deemed just right)
- Avoidance (i.e., staying away from people, places, or things that can trigger unwanted thoughts)
Of course, compulsions can become much more specific, depending on the individual, and they are not limited to these. It's also possible to also have multiple ones.
For example, someone with sexual orientation OCD might try to look at pictures of the preferred sex or gender to make sure they are still attracted to them or ask others what they perceive them. They may also check to make sure that the same sex does not arouse them, and in some cases, they might go as far as to avoid people of the same sex as them to avoid confusion [1]
While the obsessions and compulsions people can have are virtually endless, treating OCD essentially involves the same strategies regardless of the obsessions and compulsions' content. In the next section, you will understand why that is the case and how people can get help with OCD.
How are Symptoms of OCD Treated
One of the first aspects of treating OCD is understanding why it happens and is incredibly persistent, which can be done by becoming familiar with the OCD cycle.
It all begins with an intrusive thought; this thought or image will create a sense of anxiety because it's something that they don't want in their minds, especially if they find it disgusting, morally wrong, or harmful.
This anxiety is what leads to the compulsions that make up the second half of the disorder. While they provide relief, it's always temporary, and the distressing thought will return and become an obsession.
The response to the anxiety with compulsions is perhaps the most important part of the OCD cycle and is why OCD gets stronger, and the symptoms become worse over time.
Everyone has intrusive thoughts, but the way a person responds to them will determine whether they will develop OCD.
It's possible to acknowledge the thoughts, but those who don't have OCD won't respond with any compulsion. There is no importance placed on the intrusive thought, and more than likely, it doesn't return to become an obsession.
For those with OCD, this is important to understand when beginning treatment; people will need to learn to not respond to their obsessive thoughts with compulsions and rituals. It will be very uncomfortable at first because of the powerful desire to find relief, but it's necessary to overcome it.
Psychotherapy is highly recommended in the treatment for OCD, and the guidance of a mental health professional can make the entire process less stressful and more encouraging instead.
Techniques such as cognitive behavioral therapy, and more specifically, exposure and response prevention, are excellent ways to overcome OCD because it can gradually decrease the need to perform compulsions and rituals, making the obsessive thoughts less burdensome and distressing.
However, as the name suggests, you will need to expose yourself to the thoughts, and in cases where they cannot be done, such as Harm OCD thoughts, they will need to be imagined. Imagined exposure is still effective in desensitizing people to intrusive thoughts and preventing compulsions and is important in all types of scenarios that can't or shouldn't be recreated.
This type of therapy will be a gradual process, but it will require you to work closely with your therapist and follow their instructions carefully to see the most improvement in your OCD symptoms.
People may also be prescribed medication to help manage these symptoms. They can also make exposure therapy less daunting and let you approach other daily responsibilities with more confidence.
Lastly, basic relaxation techniques, such as deep breathing, can also make you calmer in the event you are experiencing anxiety, especially the physical symptoms associated with the fight-or-flight response (increased heart-rate, sweating, tremors, etc.)
Symptoms of OCD: Do You Have OCD?
Many people who have OCD don't realize what is happening to them. Sometimes, unwanted thoughts and repetitive compulsions can make people question if they are losing control of themselves or losing touch with reality.
However, OCD is not a psychotic disorder. While the intrusive thoughts can seem vivid and realistic, people who have OCD recognize these thoughts' absurdity and are not delusional.
Simply understanding the symptoms and what is happening to them can provide relief because they learn that they have OCD. This very common condition can potentially be treated without medication, unlike bipolar disorder or schizophrenia.
Usually, when people read the signs and symptoms, they find that it matches their experiences. Then they reach out to a doctor or mental health professional who can give them a diagnosis using the criteria mentioned earlier then receive treatment.
If you've looked through the criteria and you're still uncertain if you have OCD, you can take this free obsessive-compulsive disorder test and find out, and perhaps it will encourage you to start getting help for OCD as soon as possible.
Conclusion
By learning about the signs and symptoms of OCD, you are taking one of the most important steps in overcoming it. Once you know why it occurs, you can start addressing it, and with the help of a therapist and effort on your part, you can beat OCD and regain control over your life.
References
- Carey, P. (2020, August 18). 7 Different Types of OCD & Intrusive Thoughts: OCD Subtypes. Retrieved from https://www.treatmyocd.com/education/different-types-of-ocd/
- Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 3.13, DSM-IV to DSM-5 Obsessive-Compulsive Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t13/
- OCD UK. (2020). What are compulsions? Retrieved from https://www.ocduk.org/ocd/compulsions/
- American Psychiatric Association. (2017, July). What Is Obsessive-Compulsive Disorder? Retrieved from https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder
