How do I know if I have OCD?

There is no laboratory test available to diagnose OCD. The diagnosis is usually based on a thorough face-to-face interview conducted by an experienced mental health professional. Perhaps someday, as we learn more about the underlying biology of OCD, there will be genetic markers or characteristic patterns on brain scans that will confirm diagnosis. But we are not there yet. On the other hand, obtaining some medical tests may be appropriate to rule out neurological conditions that may produce obsessive-compulsive symptoms.

The essential features of OCD are recurrent obsessions or compulsions that are severe enough to be time consuming (take more than 1 hour per day), cause marked distress, or significantly interfere with an individual's normal routine, occupational functioning, or usual social activities or relationships with others. At some point during the course of the disorder, the individual has recognized that the obsessions or compulsions are excessive or unreasonable.

Most of us have little rituals or superstitions – like checking the lock on the door once before going to bed to make sure it’s locked. Many people are neat or super-organized and it helps them be more productive. That’s not OCD. These behaviors and others like them may turn into OCD if they go to extremes. For example, if a person checks the lock three times and gets out of bed to check it another three times. If thoughts haunt a person throughout the day (“Did I lock the door? Did I shut the iron off?), if rituals begin to take up a lot of time or mental energy, if a person avoids certain things that seem unlucky or scary - but only to them - then it might be OCD.

There are some things you can do to determine if you have OCD. In fact, the majority of individuals who are diagnosed as having OCD first make the diagnosis themselves. The process of discovering OCD often starts with watching a TV talk show or news segment, or reading a newspaper, magazine or internet article, like you are doing right now. Awareness about OCD grew following a segment on OCD broadcast by the ABC-TV network program "20/20." That coverage triggered a cascade of media attention on OCD that stimulated clinical and research activity and galvanized an advocacy movement-culminating in the formation of the Obsessive Compulsive Foundation, Inc.

Many people with OCD 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. They finally had hope because scientists were making progress in treating this unwelcome ruler of their inner domain.

It often takes people a long time to seek out help for OCD, even after they learn it is a treatable illness. When asked why it took so long, the reason usually given is embarrassment. The symptoms of OCD can be so disagreeable and so private that they are very difficult to share with anyone, including loved ones and trained professionals. A simple device used to reduce the shame of sharing such sensitive material is a checklist featuring examples of obsessive-compulsive behavior. Although it is best to do this in person, some people prefer to fill out a questionnaire initially on their own. Sometimes the examples seem absurd and one can't imagine how anyone in her right mind could have such thoughts or engage in such ludicrous behaviors. Other times, the questions are right on target and it feels like the checklist was written just for the individual completing it.

To begin your inquiry into OCD there is a relatively short self-test called the Florida Obsessive-Compulsive Inventory (FOCI). The questions are designed to identify some of the common symptoms of OCD. Keep in mind, a high score on this questionnaire does not necessarily mean you have OCD. Only an evaluation by a health professional can make this determination.

Answer the questions as accurately as you can. If you answer yes to 3 or more questions in Part A, then go on to Part B. After answering the questions in Part B, total your score (the range is from 0 to 20). If you score 8 or more, it is recommended that you consider consulting a mental health professional. Try the FOCI, recognizing its limitations; namely: 1) "false negatives," it may underestimate likelihood of having OCD; 2) "false positives," it may overestimate likelihood of having OCD; and 3) it is not a substitute for a face-to-face clinical interview.