OCD Test: Do I Have OCD?

OCD has two moving parts. Obsessions are unwanted thoughts, images, or urges that show up on their own and cause distress. Compulsions are whatever you do to bring that distress down, either out loud or quietly in your head.

It's one of the most misunderstood conditions out there. "I'm so OCD about my desk" turns something that can eat hours of your day into a personality quirk.

For a diagnosis, the symptoms usually take up an hour or more a day, cause distress, or get in the way of your life. OCD affects roughly 1 in 40 adults at some point, and it often goes years without being recognized.

Whatever the theme is, the pattern underneath it is the same.

• Trigger. A thought, an image, a feeling in your body, or a situation sets things off.
• Obsession. The thought digs in and starts to feel urgent.
• Anxiety. Dread, discomfort, or a sense that something's wrong.
• Compulsion. You check, wash, review, confess, or ask someone to tell you it's fine.
• Short relief. The anxiety drops for a minute, then the thought comes back louder.

The compulsion is what keeps it going. Every time you do it, your brain learns the thought was worth taking seriously, and that relief only comes from the ritual. Over time the rituals get bigger and the relief gets shorter. Breaking that loop is what treatment is about.

A big reason OCD goes unnoticed for years is that the stereotype is all anyone knows. OCD can latch onto almost any fear. Some of the themes that come up the most:

Themes shift over the years, and it's common to deal with more than one at a time. What the thoughts are about matters less than the pattern they follow. That pattern is OCD no matter what the content is.

Two people with OCD can look nothing alike. These signs show up across all of it.

• Unwanted thoughts, images, or urges that won't drop
• Rituals you repeat, out loud or in your head, to bring the anxiety down
• An hour or more a day going to obsessions and compulsions
• Steering around people, places, and situations that might set it off
• Asking for reassurance again and again, from people, from Google, or from your own memory
• Knowing it's too much and still not being able to stop
• Relief that only lasts a few minutes
• Work, relationships, or sleep taking the hit

OCD responds to treatment. The approach with the most research behind it is exposure and response prevention, or ERP, a type of CBT made for OCD. You go toward the thought or situation on purpose, in steps you can handle, and skip the ritual that usually follows. Over time your brain stops treating the thought as an emergency.

I know, facing the thing that scares you on purpose sounds like the worst plan ever. That part is what makes it work.

Working with someone who specializes in OCD matters. A therapist without OCD training can end up handing out reassurance, which feeds the loop instead of loosening it. A specialist can spot the quiet compulsions, including the ones that happen in your head.

Medication, usually an SSRI, is also an established treatment and is often used alongside therapy. That's a conversation for your doctor.

I'm Nathan Peterson, LCSW, a licensed therapist who specializes in OCD and anxiety, and I wrote this free screening. It looks at four things: unwanted thoughts, compulsions, avoidance, and how much of your life it's taking up.

It isn't a diagnosis. Only a licensed professional can give you that. What it can do is show you whether what you're dealing with follows the OCD pattern, and how loud it's gotten. Use it as a place to start.