How to Get an OCD Diagnosis

What to Do if You Think You Might Have OCD

Getting a diagnosis for Obsessive-Compulsive Disorder (OCD) involves a diagnostic evaluation by a mental health professional. Below are the steps you can take when you are looking for a provider and the criteria the provider is using to conclude if an OCD diagnosis is the correct diagnosis for you.

1. Find a Professional

• Primary Care Physician: If you are not sure where to start, discussing your symptoms with your primary care physician can be a helpful first step. They can refer you to a mental health specialist if necessary. That being said, sometimes primary care physicians are unfamiliar with all the symptoms that are under the umbrella of OCD. If they do not refer you to a specialist but you still think what you are experiencing may be OCD, online resources such as the International OCD Foundation website (iocdf.org) have many options for where to find a licensed professional that is familiar with the symptoms of OCD and can offer a diagnosis.
• Mental Health Specialist: The types of providers who are qualified to diagnose OCD are psychiatrists, psychologists, or licensed therapists. When finding a professional that can help you find out if you have OCD, make sure to find a professional that is experienced and knowledgeable in OCD. Online resources such as the International OCD Foundation website (iocdf.org) have many options for where to find a licensed professional that is familiar with the symptoms of OCD and can offer a diagnosis near you.

2. Diagnostic Tools

Once you are in contact with a mental health professional who is knowledgable about OCD, they will typically book an assessment or a psychological evaluation with you. This can include:

• A Detailed Clinical Interview:
  • Symptom Discussion: The clinician will ask detailed questions about the obsessions you may be experiencing (recurring, unwanted thoughts) and the compulsions you may be doing in response (repetitive behaviors or mental acts).
  • Impact on Daily Life: They will assess how these symptoms affect your daily functioning, relationships, work, and quality of life.
  • Duration and Severity: The clinician will consider how long you’ve experienced the symptoms and their intensity.
  • Behavioral Observation: Clinicians may observe your behavior directly and sometimes, with your permission, clinicians will consult with your current provider for their observations on your symptoms.
  • Family and Friends: Sometimes, with your permission, clinicians will consult your loved ones. Input from family members or close friends can provide additional context and details about your symptoms and how they affect your life.
• Psychological Assessments:
  • Structured Questionnaires: Tools like the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) can help quantify the severity of OCD symptoms.
  • Self-Report Inventories: These can provide additional insight into your experiences and symptom patterns.

3. Diagnostic Criteria

The clinician will use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to determine if you meet the requirements for an OCD diagnosis. According to the DSM-5, the criteria include:

• Presence of obsessions, compulsions, or both.
  • The DSM defines obsessions as “Recurrent and persistent thoughts, urges or images that are experienced, at some time during the disturbance, as intrusive, unwanted, and that in most individuals cause marked anxiety or distress.”
• Obsessions and compulsions are time-consuming (e.g., take more than one hour per day) or cause significant distress or impairment in social, occupational, or other important areas of functioning.
  • The DSM defines these obsessions as “Repetitive behaviors (e.g., hand washing, ordering checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession”
  • These behaviors or mental acts are aimed at preventing or reducing distress but are either are not connected to the obsession in a realistic way or are clearly excessive.
• The symptoms are not due to the physiological effects of a substance (e.g., drugs or medications) or another medical condition.
  • To rule out another medical condition, this can sometimes involve a physical exam or lab tests to rule out other causes of symptoms.
• The disturbance is not better explained by the symptoms of another mental disorder (e.g., generalized anxiety disorder, major depressive disorder, Autism Spectrum Disorder). It is important to note individuals can present with separate diagnoses alongside OCD and the existence of one does not exclude the possibility of another and sometimes, one illness may cause another.

Next Steps After Diagnosis

Once diagnosed, the clinician will discuss treatment options, which may include:

• Cognitive Behavioral Therapy (CBT): Particularly Exposure and Response Prevention (ERP) therapy, which is highly effective for OCD.
• Medication: Selective serotonin reuptake inhibitors (SSRIs) or other medications can help manage symptoms.
• Support Groups: Joining OCD support groups can provide community and additional coping strategies.

If you think you have OCD, it is important to seek professional help. While OCD can be extremely debilitating, proper treatment can help you manage your OCD symptoms and start your journey to recovery.