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Identifying OCD depends on the symptoms.
By Paul Greene
Last updated on Jan 10, 2024
Did you know that 1.2 percent of Americans suffer from obsessive-compulsive disorder (OCD)? That might not sound like a lot, but it's about the same number of Americans that live in Los Angeles.
OCD and OCD symptoms can be challenging for therapists to recognize, as well as for those who suffer from them. I’ve diagnosed people who lived with OCD for decades but had no idea that’s what the problem was.
So, how can you know if you have OCD?
Here are 12 tiny subtle symptoms of OCD and what to do about it.
1. You have relationship obsessions
It’s normal to have doubts about your romantic relationship at times. However, if you have OCD, these doubts may lead to constant anxiety.
You may become fixated on whether you really love your partner or whether you truly know if they are the one for you. These obsessions can be so unsettling they could cause you to end a relationship to not deal with the anxiety.
2. You compulsively wash your hands
It’s good to wash your hands before eating, after using the bathroom, and before preparing food.
Do you often have trouble limiting hand washing to the recommended 20 seconds? Do you often not feel right unless you wash your hands repeatedly?
3. Door- and oven-checking.
If you check the stove, oven, or door before leaving home, it probably won't impact your day too much. But if you need to spend significant time repeatedly checking, it may be a sign of OCD.
4. Counting
Compulsive counting can be a frustrating symptom of OCD. The counting is often of random objects you see around you, which feels involuntary.
5. Contamination concerns
In the age of COVID-19, it's good to consider how to stay safe from virus exposure.
However, if you take more extreme steps than most people to avoid germs (coronavirus or otherwise), HIV, sexually transmitted infections, or other illnesses, it may be a symptom of OCD.
6. Superstitious thinking
All of us are prone to superstitious thinking now and then. But if this kind of thinking plays an outsized role in your life, it could be OCD.
Sometimes, this takes the form of specific numbers feeling unlucky, which can lead to avoiding anything to do with those numbers.
7. Rule-following
Usually, rule-following is good! In some cases of OCD, however, rule-following becomes an unhealthy obsession that can drastically affect your life.
This symptom is often centered on religious rules, but only sometimes.
8. Needing to feel just right
This symptom involves the need to do something repeatedly until it feels absolutely right. This feeling can be either physical or mental, and it feels essential to achieve it before you can move on.
9. Constantly seeking reassurance
This common symptom of OCD involves asking a loved one (or the internet) to assure you that something you’re afraid of isn’t true.
We all like being reassured by our loved ones. However, if you have OCD, asking for reassurance can become a habit that feels increasingly essential for you to move on from anxiety and can hurt your relationships with loved ones.
10. Harm obsessions
These are fears you have harmed or will harm others without meaning to cause harm.
For example, you wonder if you accidentally hit a pedestrian on your morning commute that you failed to notice. Or you fear you may punch an older person when walking down the street if you don’t put your hands in your pockets.
11. Re-reading
You have had the experience of reading a paragraph, realizing you were distracted, and thus rereading it.
For some people with OCD, this can become more the norm than the exception. It makes getting through a book or news article extremely time-consuming or impossible.
12. Mentally reviewing conversations
OCD can also take the form of repeated mental efforts to review conversations that happened earlier. Often, you do this to ensure you didn’t say anything offensive or dumb.
Even though there were no adverse reactions from others during the conversation.
Photo: andrey_l via Shutterstock
What should you do if you have one or more warning signs?
As you can tell from the list above, OCD can be easy to identify or complicated, depending on the symptoms.
If any of these items are a problem, you don't necessarily have OCD.
It is, however, recommended that you consider getting an evaluation from a mental health professional with experience diagnosing OCD. A professional can provide helpful clarity on the nature of the problem — whether or not it turns out to be OCD.
The recommended treatments for OCD are either a specific therapy called exposure and response prevention or certain medications. Both types of treatment can be significantly helpful.
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Dr. Paul Greene is a clinical psychologist with expertise in the treatment of posttraumatic stress disorder (PTSD), OCD, anxiety, trichotillomania, panic attacks, hypochondria, and the applications of mindfulness and meditation in the treatment of anxiety. He's the director of the Manhattan Center for Cognitive-Behavioral Therapy.