Reviewed by Whitney White, MS CMHC, NCC., LPC
All of the information online and otherwise about obsessive-compulsive disorder (OCD) can get confusing. People have ideas about what it is or should be, and not everything you hear will be correct. Luckily, most everyone agrees that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the authority on defining anything and everything related to mental disorders such as OCD.
What Is The DSM-5? Why Does It Matter?
The DSM-5 is the fifth edition update to the diagnostic tool (traditionally a book, but now available in many formats) that medical professionals use to differentiate between and diagnose mental conditions. This fifth update was published in 2013 by the American Psychiatric Association, and it contains fairly universally accepted practices for mental health professionals. Even professionals who claim to question or disagree with these definitions must refer to their own theories as departures from this standard.
The DSM-5 is the first version of the DSM that is a “living document,” meaning that if its contents can be viably disproven, it may be updated and edited to better suit modern research.
Individuals questioning if they have any kind of psychiatric condition will find the DSM-5 to be a valuable diagnostic tool. From psychology students to professors, individuals with diagnosed mental illnesses to those simply wondering about their own experiences, the DSM-5 will be able to provide some verifiable answers.
OCD is often casually referenced in pop culture and everyday life, but its specific medical definition can be misunderstood. Far from the flippant and often incorrect references to OCD that pepper casual speech, the mental condition itself has specific symptoms. Actual OCD criteria are narrowed down in the DSM-5 for diagnostic purposes.
One might wonder when a preference for order and little tics or habits can become a medically recognized form of OCD. Look no further than to the DSM-5 obsessive-compulsive disorder (or DSM V OCD) definition.
DSM-5 Obsessive-Compulsive Disorder
Since clinicians use the DSM-5 as a diagnostic tool, OCD is mainly defined by its symptoms. The DSM-5 narrows down OCD diagnostic criteria.
As you may guess from the name, the presence of obsession and compulsion is the first step, but not enough to diagnose OCD. These behaviors are often repetitive and intended to reduce the individuals' anxiety, even if there is no connection between the actions and the consequences they imagine. These obsessive or compulsive behaviors get to the point where they interfere with someone’s ability to live life uninterrupted and tend to take up time and mental and physical energy.
The degree of control that an individual has over their obsessive thoughts or physical compulsions is also an indicator of the presence of OCD. Upsetting thoughts and actions take a toll on an individual’s mental health and negatively affect their physical health when compulsions take up time and energy. The inability to stop can be distressing.
Obsessive thoughts and actions can indicate OCD, and determining if an individual could have the disorder is an important step toward dealing with this mental illness.
OCD Diagnostic Criteria
While DSM OCD specifications can change over time, the most up-to-date DSM-5 definition identifies common symptoms in the description for OCD. Take a look at this checklist for some examples:
- Distressing or anxiety-inducing thoughts or impulses that seem repetitive
- Desire to ignore those thoughts, whether or not the attempt is successful
- Internal rules (which may or may not be grounded in reality) that govern some kind of repetitive action
- Sometimes, the belief that not following one’s rules will lead to a horrible outcome that is not concretely related to the compulsion.
- These compulsions are not harmless.
- They may take up an unreasonable amount of time (more than an hour) and negatively impact the individual’s life (mental distress, lack of participation in social activities, avoidance of others due to shame or worry, etc.)
The OCD criteria in the DSM-5 do also contain some qualifications. Some symptoms of OCD could be better explained by a different mental illness or attributed to a substance abuse disorder. If you suspect yourself or a loved one of having OCD symptoms, be sure to ask what else may be going on in their life.
Do These Symptoms Sound Familiar?
The DSM-5 is an important resource for clinicians who diagnose patients and can serve as a valuable reference tool for anyone. But what about a regular person just looking for some more accessible insight into his, her, or their own situation?
Taking this quick, free, self-administered test can help you determine if you could have OCD. You get your results instantly, and you can begin to understand your individual needs going forward. Quantifying your thoughts and actions helps you narrow down how to go about your own unique situation and be reassuring in teaching you how to talk about your symptoms. Sharing your results with a health care provider can be a good starting point for you as a patient. This test is a resource for understanding whether or not further help could be useful, but it is not meant to replace an official diagnosis from a professional.
Identifying any condition can be difficult, and knowing to what degree you may be experiencing OCD is the first step in controlling it. If you suspect that you may have OCD, researching it for yourself can help set you on the path to consulting a medical professional. Seeing a doctor can lift the weight of wondering when uncontrollable thoughts become obsessive. For all guidance regarding treatment, please consult a licensed medical professional.
Looking At OCD
Individuals with OCD or any other mental health condition can often have a hard time accepting their diagnoses. Still, understanding OCD in one’s self is key to reaching out and getting help. If an individual is convinced that these obsessions and/or compulsions are grounded in reality, it can be harder to recognize the presence of a mental disorder. It’s important to remember that reaching out for help is an act of bravery, and you have nothing to be ashamed of.
In pop culture or everyday slang, people may use OCD as a catch-all word for liking things a certain way or preferring their surroundings neat, clean, or orderly. The realities of OCD, as defined by the DSM-5, are of an actual, serious condition that can cause extreme distress in those who experience it. Understanding the specific diagnostic criteria from the DSM-5 can help differentiate between the stereotype of OCD often perpetuated in our society and the actual medical condition that should not be trivialized.
Identifying Compulsive Behavior
To people struggling with whether or not their behavior fits the DSM OCD criteria, it may be a fine line between what qualifies as acceptable habits versus uncontrollable compulsions. Thoughts, behaviors, and mental rituals can be harmless or harmful, depending on the degree to which they affect one’s life.
The degree to which an individual is convinced that obsessive beliefs are true can indicate the severity of OCD. Some individuals can recognize that their obsessive thoughts are probably not true or can even stop themselves from performing compulsions by reasoning them out.
Others are convinced that their obsessive beliefs are probably true or even wholly believe that delusional thoughts are definitely true. Medical professionals adhering to DSM-5 OCD diagnostic criteria are encouraged to specify these levels.
Physical behaviors like hand washing repetitively, more than hygiene requires, or counting mentally, in situations in which it is uncalled for or irrelevant exemplify compulsive behaviors that can stem from mental obsession or internalized rules to prevent anxiety or hypothetical occurrences.
A mental component of OCD can include a perceived connection between the compulsive actions individuals feel they must take to prevent a horrible event from happening to themself or loved ones. The lack of ability to unlink these events in mind, even when faced with logical arguments that disprove them, would indicate a likely diagnosis for OCD according to the DSM-5 diagnostic criteria.
Taking The Next Steps
Taking at-home tests, like the one linked above, can help you determine if you should arrange to seek further professional help.
Taking that step to seek professional help for OCD can be intimidating! You should never feel scared or embarrassed to ask for help. Many types of doctors provide treatment for OCD or referrals to those who can help. Consider seeking further insight from your family medicine doctor/general practitioner, who you likely already have a relationship with, and who can recommend a psychiatrist or a psychologist if needed. Evaluating and treating OCD will be nothing new to a doctor, and they will be able to help you determine what is needed in your specific case.
Many patients experience silence or isolation for too many years due to feelings of shame or self-consciousness. In some cases, family members or parents may even internalize that same shame and discourage you from reaching out and getting help. It is important to remember how necessary it is to seek help and not attempt to deal with obsessions and compulsions on your own, no matter the severity.
Just like you likely could not heal a broken bone or an infection through sheer force of will, seeing a doctor for mental illness is the recommended course of action.
A doctor will be able to help and recommend further resources after you do your own research. Differentiating between anxiety and neuropsychiatric disorders such as OCD can be difficult for one’s self. Never hesitate to reach out for help.