Do I have obsessive compulsive disorder?

The question

I have recently started checking and rechecking certain things, such as making sure that I've turned off the stove or locked the door, sometimes four or five times. Is this normal?

The answer

Virtually all behaviours – obsessive and compulsive behaviours included – exist on a continuum of severity level, and most people will experience mild forms of most “psychological” symptoms at some point in their life.

Checking and rechecking behaviours are very common, and not necessarily of concern unless they take up a significant period of your time, get in the way of you being able to do other things in your life, and create ongoing distress or anxiety.

Only about 2 per cent of the adult population will experience clinical levels of these symptoms that would constitute a diagnosis of obsessive-compulsive disorder (OCD). True OCD has some very clear markers. First, there are persistent, repetitive and intrusive/interfering thoughts (obsessions), behaviours (compulsions) or both.

• Obsessions include thoughts, urges or visual images that are much more extreme than simple worries about real life problems. Individuals will try very hard to ignore or suppress these thoughts as they create significant anxiety or distress. Common obsessions include: fears of contamination, bodily germs or uncleanliness; sexual-related obsessions; fears of becoming violent or aggressive; and obsessions about exactness/precision.
• Compulsions are repetitive behaviours or actions, and may include mental acts that a person feels driven to engage in due to some obsession or other rigid rule. Common compulsions include: checking; ordering things; hand-washing; praying; counting; and silently repeating words or numbers.
• Symptoms of OCD cause significant disruption in a person’s daily life. They affect one’s quality of life, they interfere with one’s ability to carry out other regular responsibilities (e.g., work, parenting), and they take up an hour or more of one’s day. The obsessions and compulsions feel excessive or inappropriate, and create significant distress and anxiety.
• Experiencing periods of recurring thoughts or behaviours – such as the compulsion of checking/rechecking that you are describing - is very common and completely normal. Often, these behaviours will increase during times of high stress or pressure, and will usually naturally resolve within a few weeks or months.

Try to identify other stressors in your life at the current time, and work to resolve those. It can also be very helpful to actively set limits on the number of times you check or re-check (e.g., setting a maximum limit of 2 or 3 times) as this can effectively reduce the behaviour.

If you find your symptoms may meet criteria for a diagnosis of OCD, speak to a family doctor, psychologist or psychiatrist. There are very effective treatments for OCD.

For most, a combination of cognitive-behavioural therapy (incorporating a treatment approach called “exposure/response prevention”) and medication treatment can lead to very positive improvements in symptoms.

Send psychologist Joti Samra your questions at psychologist@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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