Seeking an OCD assessment can be one of the most important steps you’ll take on your journey toward better mental health. Obsessive-compulsive disorder affects approximately 1.6% to 2.3% of the population at some point in their lives, yet many people live with symptoms for years or decades before receiving proper diagnosis and treatment.
This comprehensive guide walks you through the process of getting diagnosed with OCD, from recognizing symptoms to understanding what happens during professional evaluations. Whether you’ve been struggling with intrusive thoughts or repetitive behaviors for years or just started noticing patterns that concern you, knowing how to navigate the diagnosis process can help you access the support you need sooner rather than later.
Symptoms of OCD
Obsessive-compulsive disorder consists of two main components that often work in a cycle: obsessions and compulsions. Understanding these components in depth can help you recognize whether what you’re experiencing might be OCD.
Obsessions
Obsessions are unwanted, intrusive thoughts, images or urges that cause distress. They often feel impossible to control or dismiss and can create significant anxiety. Common obsessions include:
- Fear of contamination or germs
- Unwanted, forbidden or taboo thoughts involving sex, religion or harm
- An overwhelming feeling that things must be arranged in a specific way or according to certain patterns
- Fear of losing or not having things you might need
- Excessive concern with religious or moral ideas
- Fear of harming yourself or others through carelessness
Compulsions
Compulsions are repetitive behaviors or mental acts that you feel driven to perform in response to an obsession, often according to rigid rules. These behaviors are meant to reduce anxiety or prevent a dreaded event, but they’re excessive and not realistically connected to what they’re intended to prevent. Common compulsions include:
- Excessive cleaning or handwashing
- Ordering and arranging things in a precise way
- Repeatedly checking things, like making sure doors are locked
- Counting, tapping or repeating certain words
- Repeatedly seeking reassurance
- Silently repeating prayers, phrases or numbers in your head
It’s important to understand the relationship between obsessions and compulsions. Typically, an obsession triggers intense anxiety and the compulsion temporarily relieves that anxiety. However, this relief is short-lived and the cycle quickly begins again, often growing more intense over time.
It’s important to note that OCD symptoms can come and go over time and may change in content. Someone who initially fears contamination might later develop checking rituals or religious obsessions. This shifting nature can sometimes make OCD difficult to identify without professional help.
Who Do You See About an OCD Assessment?
When seeking help for possible OCD, you have several options for where to start, each with different advantages and considerations. Your primary care doctor can be a good first step in the OCD assessment and diagnosis process. They can rule out medical conditions that might mimic OCD symptoms like thyroid disorders or certain neurological conditions and provide a referral to mental health specialists, such as:
- Psychiatrists. These are medical doctors who can provide comprehensive evaluations, prescribe and monitor psychiatric medications and differentiate OCD from other conditions with similar symptoms. Some psychiatrists also provide therapy, but many focus primarily on medication management.
- Psychologists. These professionals can diagnose OCD and provide therapy but can’t prescribe medication in most states. They often have specialized training in evidence-based therapies for OCD and can conduct detailed psychological assessments. Many of them may work collaboratively with psychiatrists when medication is needed, and they typically provide more extended therapy sessions than psychiatrists.
- Licensed clinical social workers or professional counselors. These professionals can identify OCD symptoms and provide therapy. They often have lower session costs than psychiatrists or psychologists, and they may be more accessible in terms of appointment availability. If medications are needed, they’ll typically coordinate with prescribers.
Standard Evaluations for OCD
The mental health screening process for OCD typically involves several components designed to understand your symptoms thoroughly and rule out other conditions.
Initial Assessment Interview
During your first appointment, your provider will typically conduct a comprehensive evaluation. Your provider will likely ask you to describe specific examples of your obsessions and compulsions. While this might feel uncomfortable, remember that mental health professionals have heard these types of thoughts before and won’t judge you for them. The more honest and detailed you can be, the more accurately they can diagnose and treat your condition.
Standardized Assessments
Your provider may use established tools for obsessive-compulsive disorder testing, such as:
- Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
- Obsessive-Compulsive Inventory–Revised (OCI-R)
- Florida Obsessive-Compulsive Inventory (FOCI)
These assessments help clinicians understand your specific symptom patterns and severity for the OCD diagnosis process. They provide a standardized way to measure symptoms and can help guide treatment planning. Your provider will likely use a combination of these tools along with their clinical judgment to make a diagnosis.
Medical Evaluation
In some cases, your provider might recommend additional medical tests to rule out physical causes for your symptoms. For example, they might order blood tests to check thyroid function, as thyroid disorders can sometimes cause anxiety-like symptoms, or perform tests to rule out autoimmune conditions that can cause sudden-onset OCD symptoms. They may also order neurological exams if there are concerns about other conditions or drug screens if substance-induced anxiety is suspected. These tests aren’t always necessary but may be recommended based on your specific symptoms and medical history.
The Diagnostic Criteria
To be diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), you must meet specific criteria:
- Obsessions, compulsions or both are present.
- The obsessions or compulsions are time-consuming, taking up more than 1 hour per day or causing clinically significant distress or impairment.
- The symptoms are not attributable to the physiological effects of a substance or another medical condition.
- The disturbance is not better explained by another mental disorder.
Let Us Help
Taking the step to seek an OCD diagnosis can feel overwhelming, but it’s the beginning of your journey toward relief and better management of your symptoms. With proper diagnosis comes access to effective treatments and medication options that have helped millions regain control of their lives.
If you’re experiencing symptoms that might be OCD, don’t wait. Reach out for help today. The Mental Health Hotline is available to provide support, answer questions about the diagnosis process and connect you with appropriate resources. Our trained counselors understand the challenges of OCD and can guide you toward the help you need.
