These Are Diagnoses, Not Adjectives: OCD
- Katie Davin
- 8 hours ago
- 5 min read
This series intends to provide psychoeducation on a handful of diagnoses that are often used casually in everyday vernacular. Each article will focus on what these disorders actually look like symptom-wise and available evidence-based treatment options. Our hope? That by the end, you'll have both a better understanding of these conditions and a newfound appreciation for your thesaurus. First up: obsessive compulsive disorder.
“I’m so OCD about _______ (fill in the blank).”
You’ve probably heard some form of this statement said before by a friend, family member, or colleague. Maybe you’ve used it yourself. It’s usually used in jest and in an attempt to explain an individual’s personal quirks and preferences. While it gets the point across, it also plays into stereotypes and perpetuates stigmas. The acronym for obsessive compulsive disorder is not merely a descriptor for being particular about the way you organize your closet or clean your kitchen; it’s a debilitating mental health diagnosis that affects individuals of various ages and backgrounds and, most often, for their whole lives.
So, what is it actually? Let’s break it down.
OCD has three core components:
Obsessions - Thoughts, images, or urges that are persistent, involuntary, and unwanted. They can span a range of themes, including but not limited to: harm, aggression, health/illness, sexual content, contamination, symmetry/order, religion, and morality. Most individuals diagnosed with OCD experience intrusive thoughts involving several themes. This is because OCD fixates on what is important to an individual — a hallmark feature of the disorder that makes the intrusive content almost feel impossible to ignore or brush off.
Compulsions - Repetitive behaviors or mental acts* that are performed in order to (1) alleviate the distress and anxiety caused by the obsession and/or (2) prevent a catastrophic outcome. These behaviors are excessive and bear no realistic connection to the outcome they aim to prevent. Here are some examples:
Overt compulsions: Repeatedly checking the locks on the door in series of 5s, looking up news articles after every drive to make certain a hit-and-run was not committed, and continuously asking friends about a romantic relationship (“Do you think we really are a good match?”)
Covert compulsions: Counting every step while walking up the stairs and on the sidewalk, reciting a certain word to prevent harm, making a list of all items touched throughout the day, and providing reassurance to self that a negative outcome won’t or did not happen.
*There is no such thing as “Pure-O OCD.” The compulsions are covert, mental acts instead of observable behaviors.
Distress and Impairment - These persistent intrusive thoughts cause distress to the individual and are actively fought against (via compulsions). Obsessions and compulsions can take up a significant chunk of the day (more than an hour) or interfere with an individual's everyday functioning, resulting in an inability to fulfill demands and responsibilities.
Some quick facts about OCD:
OCD usually has two peak times of onset: pre-adolescence (ages 9–11) and early adulthood (early 20s).
OCD has a 2.5% lifetime prevalence, which is roughly equivalent to the population of New York City.
On average, an individual with OCD can spend upwards of 13 years with symptoms prior to getting a proper diagnosis.
OCD is thought to result from a combination of genetic and environmental factors.
OCD is a neurobiological disorder — brain imaging research has confirmed structural and functional differences in the brains of individuals with OCD compared to those without the diagnosis.
75-80% of OCD cases go undiagnosed (!!!)
There are effective treatments available for OCD, but it is important that an individual with this diagnosis be treated by someone who is trained in these modalities:
First-line Treatments: Exposure and Response Prevention (ERP) is the proven, most effective first-line therapy for OCD in adults, children, and adolescents. It is a specific type of cognitive-behavioral therapy (CBT) that involves gradual, structured exposure to feared thoughts or situations while refraining from engaging in compulsions, allowing the brain to learn that the feared outcome does not occur and that distress naturally decreases over time.
Second-line Treatments: If first-line treatments don’t relieve symptoms or cannot be tolerated, second-line therapies offer alternative approaches. These include:
Acceptance and Commitment Therapy (ACT), which helps individuals change their relationship with OCD symptoms and move toward a more values-driven life.
Inference-Based Cognitive Behavioral Therapy (I-CBT), which focuses on identifying and resolving the reasoning patterns that fuel obsessional doubt.
Metacognitive Therapy, which helps individuals change how they relate to intrusive thoughts rather than focusing on their content.
Third-line Treatments: Reserved for severe, treatment-resistant OCD, third-line options include Transcranial Magnetic Stimulation (TMS), a non-invasive procedure that uses magnetic fields to target brain regions involved in OCD symptoms.
Want to learn even more?
The International OCD Foundation (IOCDF) is the leading authority on OCD and related disorders and an excellent place to find credible information about the diagnosis, whether you are a clinician, a loved one, or someone navigating a diagnosis yourself. Additionally, below is an assortment of resources to review to get a better sense of what OCD is, what it’s not, and treatment options:
The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive
Disorder 3rd Edition
Bruce Hyman & Cherlene Pedrick
Getting Control: Overcoming Your Obsessions and Compulsions
Lee Baer
Overcoming Unwanted Intrusive Thoughts
References:
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Deusser, R., Saxena, S., McCracken, A., Tentoni, N., Cogen, S., Crofut, R., Litvin, B., & Arfanakis, J. (2025). America's OCD care crisis: National findings on the failure of effective OCD treatment to reach patients. International OCD Foundation. https://iocdf.org/wp-content/uploads/2025/12/Full-Report-Americas-OCD-Care-Crisis-12-9-2025.pdf
Geller, D. A., Homayoun, S., & Johnson, G. (2021). Developmental considerations in obsessive compulsive disorder: Comparing pediatric and adult-onset cases. Frontiers in Psychiatry, 12, 678538. https://doi.org/10.3389/fpsyt.2021.678538
International OCD Foundation. (2026, May 14). OCD treatment guide: Best evidence-based therapies, medications, and new advances. https://iocdf.org/about-ocd/ocd-treatment-guide/
Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53–63. doi.org [1]
Katie Davin, LCMHC
Katie is motivated to assist individuals in tackling the obstacles that prevent them from connecting with others and experiencing life in the ways they want to. Katie helps clients achieve this by equipping them with knowledge and strategic, practical skills. Fueled by her love of all things science, Katie’s counseling is greatly informed by current research in the field as well as her own life experiences. She takes an eclectic approach and utilizes a variety of techniques best suited to each client. Ultimately, Katie aspires to make therapy an organic process by cultivating collaboration and acceptance within every session.
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