How would I know if I have OCD? Part 1

I get asked this all the time (by people who aren’t clients) and it is the most difficult question to answer.

It’s not that I don’t know what OCD is, having worked with the condition for years, and it’s not that I don’t understand the question, but it always strikes me that it is similar to asking “How do I know if I’ve behaved badly?”.  The answer is: it’s not an exact science, there are degrees of behaving badly and you can change things pretty quickly either way.

The difference between behaving badly or not and developing OCD is that the latter is more of a one-way street.  You can develop OCD suddenly but it’s difficult to undo. No amount of flowers or sorry cards will do the trick. Only self-awareness and hard work will suffice, and that’s if you’re lucky enough to know what’s going on. But doesn’t everyone? Ellen de Generes says “We’ve all got Attention Deficit Disorder or ADD or OCD or one of these disorders with three letters because we don’t have the time or patience to pronounce the entire disorder”

Er……that’s true. We all have elements of ADD or OCD, just as we have the capacity to behave badly however, from where we stand as therapists, OCD doesn’t really come into our field of vision until it starts to have a significant impact upon someone’s life. Just as you can behave badly but only start to catch the attention of the authorities once the misdemeanors have reached a critical point. In this blog we are only really going to be discussing OCD that is impacting upon people’s lives.

So how would you know if that is you?

Currently the term OCD is bandied about much like the phrase “I have issues”.  This is a sure sign that an exact definition is hard to come by. When people think they have a condition en masse, it simply means that few understand what it really is. Even the professionals struggle and misdiagnoses abound. OCD has been mistaken for stress, PTSD, ADD, pre-menstrual syndrome, psychosis, depression, manic-depression, schizophrenia, bi-polar disorder, eating disorders and even Aspergers.  In my experience I am convinced that post-partum OCD is as common as post-partum depression but is all too rarely diagnosed.  It is hardly any wonder then, that the general public often fails to recognize it.

The problem with OCD is that it doesn’t conform to diagnostic criteria in quite the same way as most other mental disorders. Yet, like most, there is no biological test for OCD.  Assessment tools such as the “industry standard” DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) and the Y-BOCS (Yale Brown Obsessive Compulsive Scale) agree that obsessions and compulsions must be jointly present to indicate the existence of OCD.

I would agree. However, it is often tricky to identify compulsions that are cognitive or thinking-based and it takes some experience to recognize some of the more covert forms of mental rumination. Nevertheless, both will exist and it is this very phenomenon which renders a definitive diagnosis so unwieldy and why some people slip straight through the net. By phenomenon I mean the existence of both obsessions and compulsions and how they interrelate.

The lengthy list of common obsessions and common compulsions form a complicated matrix (and these are just the “common” traits (we are regularly surprised by new and unfamiliar symptoms).  As a treatment Centre we have developed our own assessment (www.ocdcentre.com) based upon our classification of OCD sub-types.

Next: Just how complicated can OCD be…………..?