Question 1

Isn't everyone 'a bit OCD' sometimes? I like to keep my room tidy.

Accepted Answer

This is a common misconception that trivialises the disorder. While many people have preferences for order, clinical OCD is defined by its severity. The diagnostic criteria (DSM-5) state that the obsessions or compulsions must be time-consuming (over an hour a day) and/or cause significant distress and impairment in a person's ability to function at work, school, or in social relationships. A preference for tidiness does not meet this clinical threshold.

Question 2

Do you have to have both obsessions and compulsions to be diagnosed with OCD?

Accepted Answer

No. The primary diagnostic criterion (Criterion A in DSM-5) states that the person must have obsessions, compulsions, or both. While it is most common for individuals to experience both (with compulsions being performed to alleviate the anxiety from obsessions), it is possible to be diagnosed with a presentation that is predominantly obsessional or predominantly compulsive. However, a purely obsessional presentation without any mental compulsions is considered rare.

Question 3

If someone's rituals are comforting, is it still OCD?

Accepted Answer

This is a key distinction. In OCD, compulsions are performed to reduce anxiety or distress, not for pleasure. The individual feels 'driven' to perform them and often finds them to be excessive or irrational. The relief felt is from the reduction of anxiety, which is a negative reinforcement loop. Behaviours that are inherently pleasurable or comforting, such as a hobby or a soothing repetitive action (sometimes seen in autism spectrum disorder), are not considered compulsions in the context of an OCD diagnosis.

Diagnostic criteria for obsessive-compulsive disorder (OCD)

What you need to know

Diagnostic criteria for obsessive-compulsive disorder (OCD)