How do you know if you have obsessive-compulsive disorder?

Ann MacDonald

Contributor, Harvard Health

When I leave for work in the morning, I go through my precommute checklist. Train pass, check. Wallet, check. Coffee mug, check. Smart phone, check. Keys to the house, check. Only when I’m sure that I have everything I need do I open the door and head outside.

Sometimes I worry that this morning routine is becoming too much of a ritual. Is it possible that I have obsessive-compulsive disorder (OCD for short)?

Probably not. The fact that I am able to get out the door every morning means that my daily ritual isn’t interfering with my ability to function, says Dr. Jeff Szymanski, a clinical instructor in psychology at Harvard Medical School.

You have OCD when obsessions and compulsive behavior become so severe that they interfere with your ability to work or have relationships. Someone with OCD might spend so much time straightening closet hangers or smoothing down rugs—or going over mental checklists like mine—that he or she risks losing jobs and ruining relationships.

That may seem strange to someone without OCD. But as Dr. Szymanski explains in the video below, people with OCD engage in compulsive behaviors as a way to deal with overwhelming feelings of anxiety that are usually triggered by intrusive images and thoughts. As executive director of the International OCD Foundation, Dr. Szymanski knows a lot about this condition.

Fortunately, a combination of medications and psychotherapy can help many people with OCD to live more balanced lives, Dr. Szymanski explains in the video. A mainstay of treatment is called exposure and response prevention—a sort of “face your fears” therapy. A therapist gradually exposes someone with OCD to whatever is causing anxiety, and then suggests better ways of dealing with the fear. It takes time, and the person’s anxiety levels usually increase at first. But over time, the individual becomes less anxious as he or she gains confidence and learns new coping methods.

Note: Dr. Szymanski is also the author of an upcoming Harvard Medical School book, The Perfectionist’s Handbook, which will be published in September.


Related Information: Coping with Anxiety and Phobias


  1. Tom

    Anyone who’s ever suffered from a fear attack could have had the feeling prefer they have been happening to pass out or couldn’t swallow. Thankfully, fear attacks can be easy solved in many instances by generating a few minor life style adjustments.

  2. Nathan S.

    I completely agree with ‘facing your fears’, but disagree with the use of medication. Doctors (being taught by an outdated medical system) are far too trigger-happy when prescribing medication. When depression, GAD, panic attacks and OCD are concerned, you should never touch medication – unless it’s a mild sedative in severe cases. All these ‘conditions’ can be easily treated with the right method without drugs.

    As an ex-OCD and panic attack sufferer (of over 13 years), I had to do an incredible amount of research to find a way to find a solution which wasn’t readily available from doctors – particularly for my dibilitating panic attacks.

    If there’s anything I can relate to in the above content, it is to ‘face your fears’. Experience them and don’t be afraid of them. The moment you stop fearing them and start letting them in, is the moment you stop feeling anxious.

    With the right information you can end you panic attacks within a day (which is what I did after 13 years) and OCD in a few weeks.

    If there’s anything else I can personally recommend (note: I am not a doctor nor a medical professional), it is to not use medication.

    • dursun

      Dear Nathan,
      ı would be very greatful if you share your experience and recommendations with me.ı would like to try any way to overcome obsession without using medicine,so your experience and recomendations would be so important for me.Thank you very much for your help,

  3. Herbert Peters

    Perfectionism as an approach to problem solving and quality?
    A perfectionist is one who endeavours to give more than he has. Whereas a business man is one who competes by giving slightly more than what market/others give. While perfectionists like Rudolf Diesel, or Ernst Hemmingway had to commit suicide; businessmen becomes the great guys on earth. So it makes sense to classify perfectionism as pathology?
    Now to strategy as the key to aid to perfectionism vs Perfectionism as an approach to solving problem. The perfectionist’s goals have to come from the problem he is aiming to solve or perfectionism is the way to better quality.
    For writers, writing by editing or rewriting existing works is one approach or strategy to succeed. The new writer has to be a perfectionist who employs better strategies. Imagine all the learning and changes that can come around in writing and media. Other industries are very good at this approach.

  4. santwana

    OCD can be treated by medicines and psychotherapy,only needed to be detected.

  5. Voice of Experience

    This article lacks a sense of how intense this disorder can be. My former husband had undiagnosed OCD, and living with him was a nightmare. I did not know until much later that I had become enmeshed in his compulsions; I only knew that when he was in the grip of one (we can only eat this food which you must prepare a certain way, you must stop what you are doing and stroke my arm RIGHT NOW, make our guests go home before dessert, etc.) that I felt I had to cave in or something awful might happen. The marriage counselors we saw seemed clueless, but finally I found a therapist who helped me break away.

    As far as I know, he has never been treated, and he is respected in a profession where precision is highly valued.

    He had a sibling who was similarly afflicted, and I’ve always wondered if it was genetic or if they underwent some childhood trauma.

  6. Jeffie Croft

    I want to appreciate this extremely excellent read!! I certainly loved every small bit of it. I have you bookmarked your site to have a look at the fresh stuff you post.

  7. Anonymous

    I think this affects more people than we realise, to differing degrees. When I was quite young a friend of mine used to have all sorts of little things she used to do repetitively, many of which seemed pointless and,well, weird. To her though it was necessary and she feared that there would be ‘consequences’ if she didn’t do these things. Gradually she seemed to just grow out of it and as far as I know there have been no ill effects.

  8. Jael

    Really great ! It helps me also to know if I have that disorder too. 🙂
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  9. Alzheimer Care

    Many of the people thinks that obsession is a normal think. But when it increase more and more in human nature then it one of the most danger disorder. The definition given Dr. Szymanski is very perfect, i totally agree with him.

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  10. DHEA Labosante

    Many people with Obsessive Compulsive Disorder felt alone until they witnessed the story of someone like themselves. They thought they were losing their mind until they realized they were suffering from a legitimate brain-based illness. They didn’t know how to describe their experience until they heard it described by someone else who gave it a name.

  11. newport

    thanx for share nice post…

    Obsessions are extremely upsetting and anxiety-provoking thoughts that are completely foreign to your usual sense of self and what you should be thinking about. Obsessions seem to come from nowhere, are outside your control, and are experienced as intrusive, inappropriate, and not making any sense. The most common obsessions involve contamination, doubting, ordering, and aggressive or sexual impulses.

    Compulsions refer only to those repetitive behaviors that are performed in order to neutralize the anxiety that accompanies an obsession. For example, nonstop hand-washing is an attempt to alleviate the anxiety triggered by the obsession that one is contaminated. The most poignant aspect of obsessive compulsive disorder is your inability to control the ritualistic behavior despite the realization that it is maladaptive and self-destructive.

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  12. jose garcia

    Nice! I like this post, I think many of us don’t consider ourselves to have these things, but after reading this article it makes us reflect in everything that we do.

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