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Is it OCD?

I have been in the practice of therapy for nearly 17 years now. Never before have I heard so many people refer to themselves as "obsessive" or "ocd."

This reflects an overall increase in access to information for consumers, which I'm all for. I prefer to be an informed consumer when it comes to most things. With the media, and particularly due to the world wide web, we have access to more information at the click of a mouse than ever before.

Unfortunately and fortunately the information on the web both broadens definitions of disorders like OCD and dilutes them at the same time.

Here is the official diagnostic criteria from the Diagnostic Criteria From DSM-IV (American Psychiatric Association).

A. Either obsessions or compulsions:

Obsessions as defined by (1), (2), (3) and (4):

(1) recurrent and persistent thoughts, impulses, or
     images that are experienced at some time during
    the disturbance, as intrusive and inappropriate and
    that cause marked anxiety or distress
(2) the thoughts, impulses, or images are not simply
     excessive worries about real-life problems
(3) the person attempts to ignore or suppress such 
     thoughts, impulses, or images, or to neutralize
     them with some other thought or action
(4) the person recognizes that the obsessional 
      thoughts, impulses, or images are a product of his
      or her own mind (not imposed from without as in
      thought insertion)

Compulsions as defined by (1) and (2):

(1) 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, or 
     according to rules that must be applied rigidly
(2) the behaviors or mental acts are aimed at prevent-
     ing or reducing distress or preventing some dreaded
     event or situation; however, these behaviors or 
     mental acts either are not connected in a realistic
     way with what they are designed to neutralize or 
     prevent or are clearly excessive

B. At some point during the course of the disorder, the
     person has recognized that the obsessions or 
     compulsions are excessive or unreasonable. NOTE: 
     This does apply to children.

C. The obsessions or compulsions cause marked
    distress,  are time consuming (taking more than
    1 hour a day),  or significantly interfere with the
    person's normal  routine, occupational
    (or academic) functioning, or  usual social
    activities or relationships.

D. If another Axis I disorder is present, the content 
     of the obsessions or compulsions is not restricted 
     to it (e.g., preoccupation with food in the presence
     of an Eating Disorder; hair pulling in the presence 
     of Trichotillomania; concern with appearance in the 
     presence of Body Dysmorphic Disorder; preoccupation
     with drugs in the presence of a Substance Use
     Disorder; preoccupation with having a serious
     illness in the presence of Hypochondriasis;
     preoccupation with sexual urges or fantasies in the
     presence of a paraphilia; or guilty ruminations in
     the presence of Major Depressive Disorder).

E. The disturbance is not due to the direct
    physiological effects of a substance (e.g., a drug
    of abuse, a medication) or a general medical

I hope this information is helpful to you. OCD is a complex diagnosis to make. The information shared above may be helpful, but it in no way can take the place of a professional evaluation. An incorrect diagnosis can be as harmful as not knowing what the issue is or having incorrect information about OCD.

Each of the conditions in part "D" above absolutely have to ruled out BEFORE a correct diagnosis can be made. 

Dave Turo-Shields (email)
Veteran Psychotherapist, Trainer & Life Coach

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