Not sure if your symptoms are OCD or something else? Here’s how you can distinguish OCD from other conditions.
While some symptoms of obsessive-compulsive disorder (OCD) can be clear, others can appear in a number of other mental health conditions, like anxiety disorders, depression, schizophrenia, and autism.
It’s natural to have many questions about OCD, but getting the appropriate diagnosis is the first step toward finding the most effective treatment options.
OCD is an often misunderstood and mislabeled mental health condition.
The term “OCD” has become shorthand for being detail-oriented or keeping things very neat and tidy. But having these as character traits isn’t the same as having OCD.
The difference is the degree to which your obsessive thoughts and compulsive actions interrupt your daily life and your self-image.
OCD is defined by the presence of obsessions, compulsions, or both:
- Obsessions are frequent and overwhelming thoughts that cause anxiety and aren’t easily overcome. For example, you may constant wonder whether you locked your doors securely.
- Compulsions are strong urges to do ritualistic actions that can ease your anxiety and obsessive thoughts. For example, you may frequently get up and check that you haven’t left the oven on.
If you can’t physically check on the things you’re concerned about, you may start worrying — or ruminating — about them, finding yourself going down a rabbit hole of “what ifs.”
The symptoms of OCD can overlap with the symptoms of other mental health conditions, meaning that one mental health professional might diagnose one condition, and another might find a different diagnosis more appropriate.
“It is important to rule out other disorders,” explains Dr. Holly Schiff, a licensed clinical psychologist based in Connecticut, “so you can get the appropriate diagnosis and treatment.”
This is why it’s important to talk to a mental health professional familiar with OCD, as they can better evaluate your symptoms. Mental health treatments can be very targeted to a specific disorder, and if you receive a diagnosis that doesn’t adequately fit your symptoms, you might not have access to the most appropriate treatments.
“OCD will be diagnosed through a psychological evaluation or assessment that looks at your thoughts, feelings, symptoms, and behavior in order to determine if your obsessions and compulsions interfere with your quality of life,” explains Schiff.
“There are also diagnostic criteria for OCD in the [Diagnostic and Statistical Manual of Mental Disorders, fifth edition] DSM-5 that a licensed professional will see if the individual meets.”
There are several other mental health disorders with overlapping symptoms similar to OCD. Here’s a list of some of the most similar disorders.
Anxiety disorders
OCD and anxiety disorders have many similarities. In fact, until recently, OCD was classified as an anxiety disorder in the DSM-5.
Anxiety disorders are common, with an estimated
Anxiety is a major component of OCD. Obsessive thoughts drive anxiety, and it’s common to engage in compulsions in an attempt to relieve feelings of anxiety.
A key feature of OCD that isn’t present in anxiety disorders — is engaging in compulsions that take up a significant amount of time, such as more than 1 hour a day, cause distress, and get in the way of your work or social life.
According to the American Psychiatric Association, an OCD diagnosis requires “obsessions and/or compulsions that are time-consuming (more than 1 hour a day), cause significant distress, and impair work or social functioning.”
Depression
OCD is a highly distressing mental health condition. It can have severe impacts on your personal, social, work life, and overall quality of life.
According to the International OCD Foundation (IOCDF), because obsessions and compulsions are so difficult to deal with, many people with OCD also meet the diagnostic criteria for depression.
The symptoms of depression can include:
- feeling down for
2 weeks or more - losing pleasure in usual activities
- experiencing fatigue or tiredness
- having trouble eating or sleeping
- experiencing feelings of hopelessness or worthlessness
If you suspect you are living with both depression and OCD, a mental health professional can help you create a treatment plan that helps with both conditions.
Obsessive-compulsive personality disorder (OCPD)
Despite having similar-sounding names, OCPD is very different from OCD.
Like with OCD, people with OCPD experience obsessions, such as cleanliness and organization, spending hours cleaning one area or reorganizing something until they believe it’s perfect.
The biggest difference is that people with OCD generally acknowledge that their obsessive thoughts and compulsions are unrealistic and excessive but are still unable to settle their anxious thoughts or break out of the cycle of worrying and ruminating.
People with OCPD don’t tend to recognize that their obsessions and compulsions are unrealistic, seeing them as rational.
Schizophrenia
Schizophrenia is a complex chronic mental health condition that can be confused with OCD.
There are several symptoms that must be present for a schizophrenia diagnosis, but the three primary symptoms are:
- hallucinations
- delusions
- speech patterns that are erratic and disorganized
Delusions in schizophrenia mean that someone perceives and believes a false reality. They believe things about the world around them that aren’t real.
On the other hand, someone with OCD can have unrealistic thoughts, but they’re aware that their thoughts aren’t grounded in reality. While they may feel like something unrealistically bad could happen, they know it’s actually irrational and impossible.
People with schizophrenia, though, believe the delusion is real, no matter how unbelievable it sounds to others.
According to the National Health Service in the United Kingdom, the following conditions can share characteristics with OCD:
- Tourette syndrome
- autism spectrum disorder (ASD)
- frontal lobe lesions
There are also a number of obsessive-compulsive-related disorders (OCRD), including:
- body dysmorphic disorder
- hypochondriasis or illness anxiety disorder
- eating disorders
- trichotillomania, or hair-pulling
- excoriation disorder, also known as skin-picking or dermatillomania
Because OCD symptoms can overlap with other disorders, it is possible to have OCD and another comorbid disorder.
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If you believe that you’re experiencing OCD, it is possible that another disorder might also be present or presenting as OCD.
Treating OCD is possible, but it can take time to truly address the symptoms and causes.
“There is no cure for OCD,” explains Schiff, “but there are treatment options that can help someone manage their symptoms and bring them under control.”
Cognitive behavioral therapy
This type of therapy focuses on talking through your anxiety and what you think might happen if you don’t follow through with your compulsions.
The goal of cognitive behavioral therapy (CBT) is to change your perspective on negative thoughts and tries to reframe that negativity in a positive way.
In this case, CBT focuses on breaking down the link between obsession and compulsion in a safe way. By exploring what obsessions cause your anxiety and why they lead to compulsions, you will be slower to act out your compulsive ritual.
One technique within CBT is known as exposure and response prevention (ERP), which
Schiff explains that ERP is a technique “where the individual is exposed to situations that provoke their obsessions and the resulting distress, while preventing them from engaging in their compulsive responses. Eventually, they are systematically desensitized to their fears, and anxiety is decreased.”
If ERP sounds a little too intense for you, there’s a less intense technique called imaginal exposure (IE).
This method is similar to ERP but doesn’t involve direct exposure. Instead, your therapist will ask you to visualize the thing that causes your anxiety and asks you to picture what it would feel like to not act compulsively.
Ideally, after several successful rounds of IE, you’ll be more prepared to begin ERP therapy.
If you suspect that you have OCD or you’re experiencing anxiety to a level that is preventing you from accomplishing tasks in your daily life, consider talking to a mental health professional.
Even if your symptoms don’t perfectly align with OCD symptoms, someone who specializes in these types of disorders should be able to evaluate what’s causing your anxiety and stress.
The good news is that OCD (and many similar disorders) are treatable with therapy or medication, so if you want to begin improving your mental health or just want to talk with a professional, help is available.