OCD is diagnosed by a specialized therapist using tools like the DSM-5 criteria, Yale-Brown Obsessive Compulsive Scales (Y-BOCS), and the Dimensional Obsessive-Compulsive scale (DOCS). Self-identification can be a helpful tool, but an OCD diagnosis from a clinician is still important for accessing effective treatments like exposure and response prevention (ERP) therapy.
Mental health can ebb and flow—some days feel manageable, while others can be overwhelming. If you’re dealing with intrusive thoughts, obsessions, or compulsive behaviors, you might wonder if you’re experiencing obsessive-compulsive disorder (OCD). Maybe you find yourself googling symptoms, trying to piece together a diagnosis on your own, or feeling unsure of what to do next.
If you think you might have OCD, know that you’re not alone. OCD affects one in 40 people and getting the right diagnosis is an important first step toward finding the support you deserve. Keep reading to learn why getting diagnosed matters, and what the process typically involves.
What does an OCD diagnosis look like?
OCD is a complex mental health condition characterized by obsessions and compulsions. Obsessions are persistent, intrusive thoughts, sensations, images, feelings, or urges that cause distress, or anxiety. In response to obsessions, people with OCD perform compulsions—physical or mental acts meant to relieve negative emotions, or prevent a bad thing from happening. However, compulsions only provide temporary relief, ultimately prolonging the OCD cycle.
Unlike some mental health conditions, there are no brain scans or blood tests that can identify OCD. Instead, therapists diagnose OCD using criteria from the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). According to Dr. Patrick McGrath, Chief Clinical Officer at NOCD, “all diagnoses come from the DSM-5.” Therapists use diagnostic interviews, such as the Structured Clinical Interview for DSM-5 (SCID-5) or the Anxiety and Related Disorders Interview Schedule (ADIS-5), to assess whether someone meets the DSM-5 criteria for OCD.
It’s important not to feel intimidated about seeking a diagnosis or worrying about meeting the criteria for OCD. If you’re experiencing signs and symptoms, a specialist will work with you to understand your experiences and develop a plan to help you. Even if you’re not diagnosed with OCD, OCD specialists will still support you in finding the right path forward by either using their expertise to address your challenges or help coordinate care with someone better suited to your needs.
No matter what, you won’t be left without guidance—they’ll ensure you have the tools and support to get better. Diagnostic interviews are simply a tool to help determine the most effective approach for your treatment and care.
What if I’m not certain I have OCD?
It’s common to feel uncertain about what you’re experiencing. In fact, many people feel fear being diagnosed with OCD—which can lead you to doubt the validity of your symptoms. It doesn’t help that misdiagnoses are common for people with OCD. Know that even if you haven’t been diagnosed with OCD by previous clinicians, it doesn’t mean you aren’t living with the condition. OCD diagnoses can take 14 to 17 years on average due to stigmas, misconceptions, and lack of widespread clinical training. Working with a specialized therapist who understands the condition is important for getting accurately diagnosed.
Uncertainty can be overwhelming, but you don’t need to be 100% sure to seek an assessment. Therapists are trained to help you understand what’s going on and provide clarity and support. If there’s uncertainty, your therapist may use tools like the SCID-5, a structured clinical interview designed to explore and narrow down symptoms across various mental health conditions.
“[Clinicians] use structured diagnostic interviews or other inventories to assess symptoms of various mental health diagnoses to rule out other differential diagnoses,” explains Dr. Keara Valentine, a clinical assistant professor at Stanford University School of Medicine in the Psychosocial Treatment Clinic and OCD Clinic.
Remember, seeking help doesn’t require certainty—just a willingness to take the first step.
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All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
What if I already believe I have OCD?
If you feel fairly certain that you have OCD, sharing the specifics of your experience with your provider is key. What thoughts or behaviors are you noticing? How do they affect your daily life? This information will help your therapist get a clearer picture of your symptoms and tailor treatment accordingly. Despite how certain you may feel about having OCD, a formal diagnosis is still important for ruling out other conditions and accessing treatment.
If the idea of being officially diagnosed feels intimidating, or you worry about failing to meet the criteria, know that your fears are understandable—but, a diagnosis is not a test you can fail; it’s a tool to understand your experiences so you can get the right help.
How an OCD diagnosis can help
At its core, a diagnosis helps to validate what you’re experiencing and provide direction for the next steps in your mental health journey. In many ways, diagnosis is actually the first step toward treatment and recovery. Getting diagnosed helps your therapist identify the specific types of obsessions and compulsions you experience, which will inform how they treat you. Exposure and response prevention (ERP) therapy, a type of cognitive behavioral therapy designed specifically for OCD, works by addressing your unique symptoms and helping you reduce the need to respond to fears with compulsions. A diagnosis is a crucial starting point for this treatment.
There is power in knowledge, and receiving an accurate diagnosis can help ensure you are receiving the right treatment.
Dr. Keara Valentine
Once your therapist confirms an OCD diagnosis, they may use standardized assessment tools to gain deeper insight into the severity and specific nature of your symptoms. These tools are not used to diagnose OCD but to enhance understanding, and track progress in treatment. “Scales can be used to measure the severity of symptoms, track progress in treatment, or evaluate how OCD is interfering with a person’s life,” explains Dr. McGrath. The most commonly used scales include:
- Yale-Brown Obsessive Compulsive Scale (Y-BOCS): A clinician-administered scale that measures the severity of obsessive-compulsive symptoms. It includes 10 questions about your experiences with obsessions and compulsions, rated on a scale from 0 to 4, along with a checklist where you can note current or past obsessions. While a score of 18 or higher is typical for those with OCD, Dr. McGrath explains, “You might have a score of 17 in just one category, and that’s still significant because it reflects a big impact in that area.”
- Dimensional Obsessive-Compulsive Scale (DOCS): A 20-item self-report instrument that assesses the severity of OCD symptoms across four dimensions: contamination, responsibility for harm, unacceptable thoughts, and symmetry/completeness. Each dimension is evaluated to understand the specific nature of your symptoms.
- Obsessive-Compulsive Inventory-Revised (OCI-R): An 18-item self-report questionnaire that measures OCD symptoms across six subscales, including washing, checking, neutralizing, obsessing, ordering, and hoarding. It helps in identifying the presence and severity of symptoms in these areas.
These scales help therapists assess your progress and adjust your treatment plan as needed. If you have questions about any of these tools, ask your therapist. Remember, you can take an active role in your treatment journey.
Can I diagnose myself with OCD?
It’s common to recognize certain symptoms in yourself that align with OCD. Self-identification can be an important first step for understanding your experiences and finding a provider. That said, it’s still often helpful to receive a diagnosis from a clinician. A specialized therapist can rule out other potential conditions, and help you get started on treatment.
If you want to learn more before reaching out to a professional, this OCD screening quiz formulated by OCD experts Dr. Jamie Feusner and Dr. Stephanie Lonsway may help. However, keep in mind that the only way to truly be diagnosed is through seeing a therapist.
Who should I go to if I think I have OCD?
If you think you might have OCD, reaching out to a licensed mental health professional, such as a therapist or psychologist, is a great first step. “No one knows you better than you, but no one knows OCD better than the experts,” says Valentine. It’s important to look for someone who has specialized training in OCD and experience with ERP.
No one knows you better than you, but no one knows OCD better than the experts.
Dr. Keara Valentine
You can also start by seeing a general practitioner (GP) to rule out other medical conditions, get an initial evaluation, and ask for any necessary referrals. While a GP can help you take the first step, working with a specialized therapist is key to getting the right support.
Misdiagnosis and the importance of a specialized therapist
OCD is often misdiagnosed. One study found that family physicians misdiagnosed 50.5% of OCD cases. This sometimes happens because OCD symptoms can overlap with and may look like other conditions—such as generalized anxiety disorder, depression, or ADHD. In other cases, people with OCD feel too scared or ashamed to share their intrusive thoughts—making it hard for providers to accurately assess what’s going on.
This is why working with a mental health professional who specializes in OCD is so important. A specialized therapist is trained to create a safe, nonjudgmental space where you can openly share your experiences. Specialized therapists also know how to look beyond visible compulsions, which are often the focus of general practitioners, to identify the intrusive thoughts and obsessions that drive the OCD cycle. “Diagnosis can be difficult, and I always recommend being evaluated by a therapist with specialized training,” explains Dr. Valentine.
Common questions about OCD
- Is OCD hereditary?
- OCD can have a genetic component, but it’s not guaranteed to be passed down. A 2013 study found that the risk of OCD increases when close blood family members have OCD, tic disorders, or other related conditions like anxiety or affective disorders. However, Dr. Valentine reminds us that “research has not identified specific genes associated with OCD.”
- OCD can have a genetic component, but it’s not guaranteed to be passed down. A 2013 study found that the risk of OCD increases when close blood family members have OCD, tic disorders, or other related conditions like anxiety or affective disorders. However, Dr. Valentine reminds us that “research has not identified specific genes associated with OCD.”
- What if you feel nervous talking about your OCD symptoms?
- It’s understandable to feel nervous about sharing personal details, especially when it comes to topics that may feel taboo. That said, therapists who specialize in OCD are experienced and compassionate. “When you are being evaluated for OCD by a trained professional with a specialty in OCD, you are not going to say anything we haven’t heard before,” Dr. Valentine explains.
- It’s understandable to feel nervous about sharing personal details, especially when it comes to topics that may feel taboo. That said, therapists who specialize in OCD are experienced and compassionate. “When you are being evaluated for OCD by a trained professional with a specialty in OCD, you are not going to say anything we haven’t heard before,” Dr. Valentine explains.
- What are good resources for getting diagnosed?
- If you’re looking to get diagnosed, finding the right professional is key. Dr. Valentine recommends the International OCD Foundation’s list of OCD-specialist therapists. NOCD’s site also includes licensed providers who take insurance, and a digital library of helpful content to learn more.
- If you’re looking to get diagnosed, finding the right professional is key. Dr. Valentine recommends the International OCD Foundation’s list of OCD-specialist therapists. NOCD’s site also includes licensed providers who take insurance, and a digital library of helpful content to learn more.
- What happens after an OCD diagnosis?
- A diagnosis is the first step toward recovery. “There is power in knowledge, and receiving an accurate diagnosis can help ensure you are receiving the right treatment,” says Dr. Valentine.
When you are being evaluated for OCD by a trained professional with a specialty in OCD, you are not going to say anything we haven’t heard before
Dr. Keara Valentine
After diagnosis, you’ll embark on ERP therapy—which can help you gradually face your fears while resisting the urge to respond with compulsions.
Bottom line
Understanding if you have OCD is an important step toward gaining clarity and control over your mental health. While seeking a diagnosis might feel daunting, it ensures that you’re addressing the right condition, and can gain access to effective treatment. By working with a therapist who specializes in OCD, you can begin to navigate your symptoms with confidence.
Key takeaways
- OCD is diagnosed through a professional evaluation using criteria from the DSM-5. Assessments like the Y-BOCS, DOCS, and OCI-R can provide further information about an individual’s experience with OCD.
- There’s no single medical test for OCD; diagnosis involves conversations with a trained therapist to understand your symptoms and rule out other conditions.
- Self-diagnosis can be helpful in identifying OCD symptoms, but a diagnosis from a specialized OCD therapist can help you access effective treatments like ERP and learn more about how to manage your condition.
- Misdiagnosis is common, so seeking an expert with experience in OCD and ERP can make all the difference in starting the right treatment.
