Disclaimer: The information contained in this article is for informational purposes only and is not a replacement for professional medical advice. Every case is unique, and this article may not apply to your specific situation. Should you require medical advice, it is crucial to consult with a trained healthcare professional such as a psychiatrist, who can provide you with tailored recommendations.

Obsessive-compulsive disorder, or OCD, is a psychiatric disorder that can cause significant distress and impairment to individuals and their families. Fortunately, there are many ways to help individuals with OCD. However, identifying OCD is not as straightforward as it might seem due to the existence of many other conditions that share similarities with OCD.

What is OCD?

OCD comprises two components: obsessions and compulsions. Obsessions are intrusive, unwanted, repetitive thoughts that generate feelings of anxiety. Compulsions are repetitive behaviors that temporarily alleviate the obsessions. However, in OCD, the obsessions always return when they’re banished in this manner, and engaging in the compulsions only strengthens OCD over time.

People with OCD often feel like they are under the control of an external entity, which can be very frustrating and frightening. OCD can interfere with school and work, as obsessions can be distracting and compulsions can consume a significant amount of time. OCD can also affect relationships, as loved ones may be upset with the compulsive behaviors and may not understand the experience of the individual with OCD.

A common example is an individual with contamination OCD who has distressing thoughts of uncleanliness, and feels compelled to wash their hands so frequently that it takes them away from other activities. However, there are many different types of OCD.

Evaluation for OCD

The first step for those who suspect they have OCD is to determine whether it’s really OCD that is causing their suffering. Psychiatrists and psychologists often have the training needed to diagnose OCD. We also frequently use structured tools such as the YBOCS or CYBOCS to help understand an individual’s OCD.

If you are looking for help with OCD near Menlo Park or Palo Alto, or via telehealth anywhere in California, you are welcome to request an appointment with me. If you are not near these areas, IOCDF maintains a directory of mental healthcare professionals with training and experience with OCD.

For OCD, I don’t recommend seeing a primary care provider or other types of healthcare professionals who are not specifically trained in helping individuals with OCD, as diagnosing and treating OCD requires a nuanced approach. For example, there are many other mental health challenges that can resemble OCD but are not the same.

Mental Health Challenges Commonly Confused with OCD

One common example of a psychiatric issue that can easily be confused with OCD is an autism spectrum disorder. Individuals with autism spectrum disorders often have repetitive behaviors, and on a superficial level those behaviors can look exactly the same as those seen in OCD. Individuals with autism spectrum disorders often enjoy those behaviors and feel soothed by them in contrast to the distress and sense of loss of control experienced by individuals with OCD. However, no two people are the same, and autism and OCD can even coexist as “comorbid” conditions.

Tic disorders and Tourette syndrome (which involves both motor and vocal tics) can also be confused with OCD. Tics are repetitive behaviors that involve performing a specific motion or making a certain vocal sound. Individuals with tics often feel a tickling or other body sensation prior to the tic occurring rather than experiencing a distressing, repetitive thought. The distinction between tics and OCD is very important, as the treatments are not the same.

Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Acute-onset Neuropsychiatric Disorders Associated with Streptococcus (PANDAS) are immune system disorders that involve rapid onset of OCD-like and other symptoms after an infection. Physicians and scientists are still learning about these disorders, and compared to OCD there is still lot of missing information. The scientific evidence that exists thus far tells us that some of the same treatments for OCD can help, but there are other treatments that are unique to PANS and PANDAS.

In some cases, schizophrenia spectrum disorders can resemble OCD. Individuals with schizophrenia spectrum disorders can experience auditory phenomena such as hearing voices, and can have fixed ideas that are not based on reality. In some cases these phenomena can manifest very similarly to obsessions of OCD. In other cases individuals with schizophrenia can experience voices telling them to do specific actions, which can appear similar to compulsions. Differentiating between these two disorders can require significant clinical experience with both. This is extremely important, as the treatment approaches required by OCD and schizophrenia are markedly different.

Obsessive-compulsive personality disorder, or OCPD, may sound similar to OCD, but it’s actually completely different. People with OCPD can be perfectionistic and highly focused on details, rules, order, and doing things in exactly a certain way. By comparison to OCD, OCPD does not involve repetitive thoughts or behaviors. OCPD is usually best treated by psychodynamic psychotherapy.

Finally, a special note about chronic suicidal thoughts and self-harm behaviors. While on a superficial level these challenges involve repetitive, intrusive thoughts and repetitive behaviors, OCD is usually not the correct explanation for these behaviors. Rather, individuals with these challenges often feel overwhelmed by painful emotions, and are coping with those emotions in a way that does not support their goals. They can often benefit from dialectical behavioral therapy (DBT), which focuses on teaching other ways to regulate emotions and choose a life worth living.

Conclusion

These are only some of the common mental health challenges that can be confused with OCD, but there are others. It is important for individuals who think they might have OCD to seek an evaluation from a professional who is trained in OCD, such as a psychiatrist or psychologist. OCD can cause a lot of suffering, but help is available.