Obsessive Compulsive Disorder: Symptoms and Diagnosis

Anxiety Disorders

Obsessive Compulsive Disorder: Symptoms and Diagnosis

An Official Diagnosis

Obsessive-compulsive disorder is recognized by its symptoms, not by particular personality traits. The World Health Organization gives this as the main diagnostic criteria: “Recurrent obsessional thoughts or compulsive acts”.

A diagnosis also requires that the perceived quality of life be being adversely affected. If a sufferer has some compulsions, but is largely happy and feels free to enjoy their life, then they may merely have a problem. If, however, they feel unhappy and trapped, disorder is the appropriate term.

Most Common Manifestations

Two forms of obsessive-compulsive disorder are by far the most common.

Washing and cleaning: An obsessive fear of dirt, germs or contamination leads to compulsive scrubbing, cleaning, avoidance of public spaces or surfaces etc. In extreme cases, a sufferer may spend all day at the kitchen sink, before falling asleep exhausted.
Checking: An obsessive worry about harming oneself, others or personal property leads to compulsive checking of stovetops, taps, light switches, car engines, tires etc. One sufferer reported that it took up to an hour for him to finish checking his car before work each morning.

Less Common Manifestations

Other manifestations of obsessive compulsive disorder are less common, but still prevalent.

Obsessional slowness: An obsessive desire to do things the ‘right’ or ‘correct’ way leads to extreme, meticulous slowness. A sufferer does not necessarily mind being interrupted, but will take an extremely slow, methodical approach to certain tasks. For example, drying after a shower might take an hour.
Symmetry/Order obsession: An obsessive drive for order leads to compulsive tidying, arranging and rearranging. Distress often results if the pattern or routine is interrupted. A sufferer may feel that a mess means that they are lazy or even thoughtless. Tidying may even develop into a sort of superstition, to ward off feared, unrelated events.
Hoarding: An obsessive desire to collect or store leads to compulsive hoarding. For instance, a hoarder may fill their pantry to overflowing, or feel that they must keep every ticket stub and receipt they ever receive.
Morbid preoccupations: An obsessive thought life gives rise to terrifying thoughts about loved ones. Usually, a sufferer will need to perform an elaborate mental ritual to ‘counter’ the offending thoughts.
Seeking reassurance: Obsessive worries leads to compulsive checking for reassurance from others. An obsessive older mother staying with her daughter, for instance, might constantly ask whether she was imposing, checking for reassurance.