Obsessive-Compulsive Disorder (OCD)

What is OCD?

OCD is an anxiety disorder characterized by cycles of compulsive behavior and/or obsessive thoughts.

How do I know if I have OCD?

Everyone experiences intrusive thoughts to some degree. For people without OCD, these thoughts typically go away on their own and do not cause distress. For people with OCD, the intrusive thoughts can take on a greater meaning: You may believe the thoughts say something about who you are. This may feel extremely distressing; you may feel compelled to address them rather than simply letting them be.

How is it diagnosed?

OCD is often misunderstood and misdiagnosed by both doctors and therapists. In fact, over 50% of physicians and nearly 40% of mental health professionals misdiagnose OCD. Likely because so many providers fail to recognize OCD, the average length of time between symptom onset and treatment is 10 to 17 years.

Diagnosis involves exploring your symptoms in depth and ruling out other causes, such as trauma and/or other forms of neurodivergence. For example, ADHD is a common misdiagnosis for OCD, and stimulant medications prescribed for ADHD can worsen OCD symptoms.

Prevalence and Symptom Onset.

OCD occurs in about 2.3 percent of the population. Symptoms typically appear around age 6 or 7, but for some people they can emerge at other times such as during pregnancy, after giving birth, or after a strep infection.

OCD and Trauma.

There is a common misconception that trauma causes OCD. That is not quite the case. OCD has a genetic predisposition, and a traumatic event may influence the expression of those genes over time. When OCD symptoms emerge after a traumatic event, the treatment needs to take the trauma history into account and move at a slower pace.

Treatment.

The gold standard for OCD treatment is Exposure and Response Prevention (ERP). ERP also works for treating phobias, anxiety, and even post-traumatic stress disorder (PTSD).

Will other forms of therapy work?

Standard talk therapy often does not work for OCD because people with OCD already have extremely high insight and understand that their intrusive thoughts are not rational.