Before my diagnosis and, hence, before I’d done a lot of personal research on obsessive compulsive disorder, I thought of OCD as “that disorder where you wash your hands a lot” or “the one where people tap the doorknobs” or “when you’re a really big neat freak.” In some ways, my diagnosis was a surprise to me because I didn’t do any of those things. But on the other hand, just the term obsessive sounded so much like my situation that I was willing to listen.
Maybe a year or so into my original search for medication (I ended up taking a year-long hiatus from the search after Luvox stole all my energy), I suddenly started worrying (or maybe even obsessing) that what I had wasn’t really OCD. I seem to talk to a fair amount of obsessive-compulsives who also reach this point, worrying that maybe someone has plastered a name on them that is incorrect. The interesting thing about this is that the OC usually feels guilty about it– as if they are receiving compassion and medical advice and help from friends and family for nothing, or what they are worried is nothing.
Interestingly, such a huge worry and incredible guilt only point to OCD all the more.
The more I have learned about OCD, the easier it is for me to see it in others. Though I am by no means a doctor, I now believe that OCD is pretty easy to diagnose.
It’s all in the name.
1) Do you have obsessions? Basically, do you have intrusive thoughts that you find ugly or disturbing but that you can’t seem to stop thinking about? Common themes center around questioning your sexual orientation or if you really love your significant other, thoughts about harming yourself or others (even children), blasphemous or sinful thoughts, worries that you or people you love are going to die, sexual obsessions, intense fears about contracting a disease. Ask yourself, do I have intrusive thoughts that cause me serious anxiety?
2) Do you have compulsions? The answer to this question might not come as easily, but what it is really asking is this: when I have those intrusive, anxiety-causing thoughts, what do I do to attempt to relieve that anxiety? Maybe your fears about germs cause you to wash your hands, making you temporarily feel a bit of relief about that possibility. Maybe your fear about harming a child means that you won’t allow yourself to hold your baby girl. Maybe it even means that you avoid driving down the street where a lot of children play. If you have blasphemous thoughts, perhaps you repeatedly ask God for forgiveness or you’ll ask other people if you think that means you are now going to hell. Sometimes compulsions seem a little “magical” too– for example, you relieve the anxiety caused by your intrusive thought by tapping your foot a certain number of times or by avoiding stepping on cracks. Even if it doesn’t logically make sense, it’s still something providing you some temporary relief. Seeking reassurance is a huge compulsion for a lot of different kinds of obsessions: we glimpse relief when friends reassure us, No, you’re not gay. No, you’re not going to get sick. No, you would never hurt a child. No, you’re not going to hell for that.
There is a third question to ask too, although this one may or may not be reached immediately, which is
3) Have your compulsions gotten out of control?
Most obsessive-compulsives reach a stage where the compulsions (that began as an anxiety-reliever) become too much and begin to add to the anxiety: you can’t stop washing your hands, you ask for reassurance so constantly that your friends are annoyed, you are driving a long way out of your way to avoid the street with children, you are tapping doorknobs and counting and repeating phrases in your head to the point that you’re starting to look a little silly.
Like I said, I’m no doctor, but when I talk to someone who wonders if they have OCD, these are the three simple questions I ask. If you can answer yes to the first two, then you have OCD.
So, what next?
1. Get an official diagnosis from someone who went to school for it. 🙂
2. Skip the talk therapy and go right for cognitive-behavioral therapy. This is treatable.