How to Tell If Your Anxiety and Constant Rumination Is Actually OCD
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People often told Elona Washington, a publisher from the Nashville area, that she “acted like she had OCD.” She would panic if bobby pins in her hair faced different directions or would be so afraid that client calls might go poorly that she’d call out of work or cancel plans. So when Washington was finally diagnosed with actual obsessive-compulsive disorder, or OCD, at 51, “it felt like everything finally made sense,” she tells SELF.
It’s common to throw around the term “OCD” in a casual way, like Washington’s family and friends did, as if it’s some sort of personality quirk. But OCD is a serious, often debilitating mental health disorder that can cause intrusive, repetitive, and obsessive thoughts and behaviors. Perhaps most frustrating of all? If you have OCD, you might fully recognize that your thoughts or actions are off but feel powerless to change things even if they majorly impact your work and relationships.
While symptoms can show up at any point, they usually begin in childhood or early adulthood. They can wax and wane over time, sometimes going into high gear when you are under serious stress. OCD can also be easily misdiagnosed for other issues like anxiety or a personality disorder, meaning it can take up to 17 years after your symptoms appear to get an accurate diagnosis. While OCD can look different from person to person, there are a few different types of thoughts and behaviors that suggest you might have it. Here are some of the most common.
You’re hyper-concerned about safety.
Anthony Pinto, PhD, the director of the Northwell Health OCD Center, tells SELF that if you have OCD you might engage in repeated, often unwanted, behaviors—known as compulsions. Basically, you feel compelled to do things to try to prevent what feels like a bad, dangerous situation. Maybe you’re scared of germs, so you shower multiple times a day. Or perhaps you constantly swing by your (perfectly healthy) kid’s room to ensure they’re breathing throughout the night, Dr. Pinto says. You don’t do it just once—but over and over—stuck in an endless loop where the “safety” behavior never seems to alleviate the anxiety or stop the urge.
But how do you differentiate that behavior from, say, new-parent jitters and bracing for cold and flu season? It’s a red flag if those fears seriously disrupt your life—maybe you lose sleep because you are spending hours checking on your kid, or you refrain from all social plans to avoid an infection. “You may become very distressed by these irrational thoughts and how much time and effort you have to put into doing these behaviors to make the anxiety come down,” Dr. Pinto says.
Imbalances and imperfections make your skin crawl.
It’s also common to notice, fixate on, or feel uncomfortable when things feel out of place. Megan Piesman, PhD, a clinical psychologist who specializes in OCD, notes that you might want pens to be arranged in a certain way or T-shirts folded in the same direction, for example. This desire for balance can extend to physical sensations too: When Washington, who’s now 53, touches or hits one side of her body—like her left leg—she needs to do the same to her right leg too. She also tries to walk to a count of 10 whenever she can. (So if it only takes her nine steps to get to her bathroom, she’ll take one more arbitrary step.)
Dr. Piesman says you may struggle to focus on tasks or agonize if things are asymmetrical. “I like to tell people it’s the urgency of it,” she notes. Naturally, this can take a huge toll on loved ones as well. In the past, Washington didn’t want her daughter to use her toy box because it stressed her out to have the playthings anywhere else than their designated spot. “If you need everything done a certain way in your home—maybe the bed needs to be arranged in a specific way with the pillows displayed evenly—you might take over household tasks and cause friction in your relationship if and when the other person does things differently,” Dr. Piesman says.
You may have a tendency to isolate yourself.
According to Dr. Piesman, people with OCD often go to extremes to steer clear of people and environments if they fear something bad might happen. If, say, you hear about a friend who got sick from chicken tenders, you might never eat chicken again, Dr. Piesman explains. In fact, you might start skipping dinners with friends just in case there could be chicken on the menu. For many people, the behavior doesn’t fix the compulsion, it actually keeps reinforcing the thought and making it worse, Dr. Piesman says. “The more you do it, the more you’re telling your brain, ‘This thought is important,’ and the more it comes back,” she said.
Washington spends so many hours dwelling on worst-case scenarios that she ends up avoiding all kinds of situations. She becomes so distressed obsessing over how things could go wrong that she freezes up, stays home and doesn’t do anything. “I avoid doing things that bring up negative thoughts, because once the negative thoughts are in my head, they just stay there,” she says.
You crave certainty, so you plan to excess.
People with OCD tend to over-prepare to reduce the chances of winding up in distressing spots. “You could spend hours mapping out every detail of your day or planning simple errands just to ensure you won’t run into something that might be triggering,” Dr. Piesman says.
One of Dr. Piesman’s patients was terrified of not getting enough sleep on a vacation. The fear started to consume them, so they went way beyond what people normally do to snooze peacefully—they sifted through tons of online reviews for hotels with zero noise complaints, brought along extra earplugs, and packed a sound machine. Again, this can all affect the people close to you. Dr. Piesman’s patient’s obsession really frustrated their partner because the vacation became all about getting enough rest and less about the trip itself.
You’re worried you can’t control yourself.
If you have OCD, you might have repetitive thoughts—and a fear of—randomly doing something disturbing or harmful. For example, you think you’ll shove a random stranger on the sidewalk or punch a loved one at dinner (even if you have zero intention of being violent), Dr. Pinto says. You might mull over your past actions for hours and hours to make sure you didn’t do or say anything awful or out of the norm, Dr. Pinto says. And, again, obsessing over these unlikely scenarios can derail your life. You might avoid various circumstances where you could act out—Dr. Pinto says people who are afraid of punching someone on the street may avoid walking near other people. Those who are terrified they might stab someone may lock up their knives at home. If you’re intensely worried you might hit someone with your car, you may stop driving altogether, and if you have a fear of acting out sexually, you may avoid dating and isolate yourself at home.
What to do if you think you might have OCD.
The giveaway it’s OCD and not something else like anxiety or a personality trait? Your thoughts and behaviors majorly impact your ability to live your life. If you spend at least one hour each day ruminating on distressing thoughts and images or doing compulsions, it’s worth getting checked out by a certified therapist who specializes in OCD, Dr. Pinto says. You might have anxiety or some obsessive personality traits, which can look similar to OCD, but a doc will help you know for sure. If you do end up having it, there are treatments, including cognitive behavioral therapy and medications like SSRIs, that may help.
With therapy, Washington learned to recognize her triggers, manage her underlying anxiety, and get through a task when her symptoms flare-up and take over. She stopped fighting her OCD, and with time and practice, eventually learned how to live with it. “Once you put a name to something,” she says, “you can do what you can to mitigate it or find ways to heal or cope.”
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Originally Appeared on SELF
