OCD Symptoms Checklist

We all have the tendency to overthink and over-worry about things in our life. It’s a common human trait, and we all worry about things like relationships, work, or social interactions. 

But there’s a difference between being a little worried about your work presentation and letting anxiety affect getting the presentation done. And when that worry affects your behaviors in your daily life, you could have obsessive-compulsive disorder, or OCD.

Obsessive-compulsive disorder affects up to 3 percent of adults in the U.S., and many have obsessive thoughts that consume much of their time each day.

Consider this a useful OCD symptoms checklist as we go over what this disorder actually is, as well as the symptoms of obsessive-compulsive disorder.

OCD is a common and chronic disorder characterized by recurring thoughts and fears that lead to compulsive or repetitive behaviors.

Obsessive-compulsive disorder can often be described as compulsive behaviors that result from intrusive or uncontrollable thoughts — together, these compulsives and thoughts impact your quality of life and cause distress.

OCD is a type of anxiety disorder, and as many as 30 percent of people with obsessive-compulsive disorder may also experience generalized anxiety disorder.

While excessive worry is a common symptom of both, the difference between these two disorders is where the worry and anxiety come from and how they’re dealt with.

Our guide on the difference between OCD and anxiety goes into more detail to help you determine which you may have.

The exact causes of obsessive-compulsive disorder are unknown, but multiple controlled studies have shown that genetics can play a role.

Imaging studies of the brain have also shown differences in brain structure in those with OCD versus people without OCD, although the reason why is still unclear.

Some evidence suggests that OCD may be related to how your brain responds to the neurotransmitter serotonin, which regulates mood, appetite and sleep, among other important body functions.

The difference between obsessive-compulsive disorder and everyday worrying is the amount of time spent on worrying thoughts and if they result in repetitive behaviors.

Many people may check twice to make sure they locked the front door or wear a lucky shirt for an exam. But for those diagnosed with OCD, these rituals or habits aren’t a matter of personal choice. Instead, these actions are compulsions that interfere with daily life.

Obsessive-compulsive disorder has many symptoms. The two main obsessive-compulsive symptoms in adults are obsessions and compulsions. Those with OCD can have obsessions, compulsions or both.

Obsessions are repeated thoughts or urges that cause anxiety. These can include:

• Fear of germs or contamination

• Desiring things in perfect order

• Fear of saying something offensive

• Explicit sexual or violent thoughts

• Harmful thoughts towards yourself or others

• Questioning your sexual orientation or desires

• Worrying about the health and safety of yourself or your loved ones

• Intrusive images, words or sounds

Compulsions are repetitive behaviors that someone with OCD feels they need to do because of obsessive thoughts. Some common compulsions can be:

• Excessive cleaning or hand washing

• Arranging things in a precise way

• Compulsive counting

• Touching something a certain number of times

• Seeking reassurance from others

• Repeating specific phrases

• Mentally going over your actions to make sure you haven’t harmed anyone

• Hiding objects you could use to harm yourself or others

Those with OCD may recognize their obsessive thoughts as illogical or unlikely to happen but still act on their compulsions to find temporary relief from the anxiety or stress caused by the thoughts. They don’t find joy in performing these compulsions and may spend over an hour at a time on their worrying thoughts.

OCD symptoms aren’t typically short-lasting or fleeting — they often take up a significant part of your day-to-day life.

OCD can appear in different ways and while there are no official classifications, research suggests four main categories of OCD, based on symptoms. These four types are:

• Cleaning and contamination. This type of OCD may involve a persistent worry about germs or sickness, fear of exposure to contamination, compulsion to clean contaminated items or specific cleaning rituals.

• Forbidden thoughts and impulses. Symptoms can involve frequent intrusive thoughts that are sexual or violent in nature, guilt or shame about your thoughts, persistent questioning of your sexual interests or orientation, persistent feelings of responsibility for causing bad things to happen, mental rituals to cancel out your thoughts and more.

• Ordering or symmetry. This OCD symptom is typically characterized as needing items to be aligned in a certain way, need for symmetry in actions (such as scratching both knees), feeling incomplete when items aren’t exact, counting rituals or organizing rituals.

• Hoarding. Symptoms of this OCD category can include a persistent worry that something bad will happen if an item is thrown away, needing to collect a certain number of items to protect yourself or others, a compulsion to buy multiples of the same item, feeling incomplete if you can’t find a possession or having a compulsion to check your possessions.

Another subtype of OCD involves behavioral tics. These could be motor tics — sudden, brief, repetitive movements — such as eye movements, facial grimacing or shoulder jerking, or vocal tics like repetitive throat clearing or sniffing.

These tics are often more common in those who have OCD as children, which is about half of those who live with this condition. 

Every person who has obsessive-compulsive disorder experiences it in different ways, and OCD symptoms in adults vary widely.

While there isn’t a standard OCD symptoms checklist to diagnose the disorder, there is a checklist to determine the severity of obsessive-compulsive disorder.

A clinician-administered scale known as the Y-BOCS is a 10-item checklist to rate OCD symptom severity. The Y-BOCS provides ratings for obsessions and compulsions, time spent on those obsessions and compulsions, interference with daily life, degree of distress and success in resisting thoughts and behaviors.

The sum of these ratings is measured on a scale of overall severity ranging from mild to severe to extreme.

While symptoms of OCD vary between each person and there is no official diagnosis of “mild” or “severe” OCD, there are differences between mild OCD and severe OCD.

Mild OCD Symptoms

Many people might say they’re a “little OCD.” But does that mean they’re experiencing mild OCD symptoms or simply overthinking like most people tend to?

It turns out that obsessive-compulsive thinking is very common, with a study suggesting that almost 94 percent of people experience intrusive or unwanted thoughts.

In a study of over 770 participants, researchers found that doubting was the most common type of intrusive thought (“Did I leave the front door unlocked?”) while extremely violent or sexual thoughts were the least common.

So, many of us have common obsessions or intrusive thoughts. The difference between that and OCD is what someone makes of the intrusive thoughts.

For example, most people who have an intrusive thought about jumping off a train platform would tell themselves that it's a strange or silly thing to think, whereas a person with OCD may worry that the thought means they're suicidal.

According to the National Institute of Mental Health, 14.6 percent of people with OCD have what's considered mild obsessive-compulsive disorder and 50.6 percent of people with OCD have severe symptoms.

A mild OCD symptoms checklist could include several of the common symptoms of obsessive-compulsive disorder, such as:

• Excessive cleaning

• Double-checking, such as repeatedly making sure the stove is off

• Repeating phrases or words in your head

• Constantly asking for reassurance

• Need for order, neatness or getting things “just right”

If these thoughts or repetitive behaviors occur daily and are difficult to stop, this could be an indicator of mild OCD.

However based on the Y-BOCS scale, someone with mild OCD symptoms would also meet some of the following criteria:

• Spending less than an hour a day on obsessive thoughts or compulsions

• Little to no interference with daily activities

• Thoughts are mildly distressing or not distressing at all

• Having complete or even some control over intrusive or obsessive thoughts

• Feeling little to no anxiety when compulsions can’t be performed

But when thoughts or behaviors negatively affect your daily life, to the point where they may keep you from having healthy relationships or going to work, you could be dealing with severe OCD.

Severe Symptoms of OCD

The most severe obsessive-compulsive symptoms in adults are the most debilitating to daily life.

These compulsions and thoughts interfere with your relationships and responsibilities and affect your overall quality of life. Untreated OCD could also lead to more severe symptoms.

Some examples of severe symptoms of OCD are:

• Excessive hand washing even when the skin is raw

• Debilitating anxiety when things aren’t placed a certain way

• Repeatedly checking things even if you can’t leave the house

Based on the Y-BOCS scale, other severe OCD symptoms could include:

• Spending more than eight hours a day on obsessive thoughts or compulsive behaviors

• Having nearly constant distress from obsessive thoughts 

• Not being able to control these thoughts

• Experiencing near constant anxiety from not being able to perform compulsive behaviors

Severe OCD can be so debilitating that many people miss school or work, can’t have functioning relationships, are riddled with guilt or shame, may develop other health conditions from their OCD (dermatitis from excessive hand washing) and more.

Studies have even found that people with severe OCD miss an average of 46 work days each year.

The scale is just a guideline, so you should talk to a healthcare provider to determine how severe your OCD may be and what course of treatment would be best for you. But, the good news is that with the right plan and patience, OCD and its symptoms can be treated.

While OCD can’t be cured entirely, it’s possible to go from a place where OCD severely impacts your life to a place where the condition is more manageable.

No matter how mild or severe your OCD, you deserve treatment.

Therapy

Working with a therapist who has experience treating OCD is a good first step. Through therapy, you can learn tools to manage intrusive thoughts and strategies to deal with emotional distress.

One of the most effective methods of therapy to cope with OCD is cognitive behavioral therapy, or CBT.

CBT involves identifying false beliefs and thought patterns and adjusting them to change the effects they can have on your feelings and behavior.

Other methods of therapy that may help with obsessive-compulsive disorder are mindful-based cognitive therapy and exposure and response prevention. 

Group therapy can also be a great support system to discuss your symptoms and make progress with others.

You can learn more about the types of therapy for OCD in our guide, or schedule a consultation to find a therapist who’s right for you with our online services.

Medication

Some medications can also help with the symptoms of OCD, especially when used in combination with therapy.

One type of medication used to treat obsessive-compulsive disorder is a class of antidepressants also known as a selective serotonin reuptake inhibitor, or SSRIs. These can adjust the level of certain neurotransmitters in the brain and help regulate mood, sleep and other body functions.

These antidepressants have been shown to be effective at treating OCD:

• Citalopram (sold as Celexa®)

• Escitalopram (Lexapro®)

• Fluoxetine (Prozac®)

• Sertraline (Zoloft®)

• Paroxetine (Paxil®)

• Venlafaxine (Effexor®)

It can take eight to 12 weeks to see improvements from medications. Be sure to take your prescribed dosage at the correct time and let your healthcare provider know if you experience any side effects.

Self-Care

While therapy and medication are the first lines of treatment for OCD, remembering to treat yourself with care is also an important treatment method.

Remind yourself that you’re not “going crazy” — OCD is a common mental illness that you can manage.

Overall, be patient with yourself and focus on making gradual improvements.

Plenty of people might have a preference for how things on their desk are arranged or prefer to wash the dishes after every meal. But OCD is much more than a personal preference for order or cleanliness.

While many of us can check an item or two off an OCD symptoms checklist, this doesn’t mean we have obsessive-compulsive disorder.

OCD is a mental illness characterized by obsessive thoughts or compulsive behaviors, or a combination of both. A general OCD symptoms checklist can include some of the following symptoms:

• Fear of germs

• Desiring things in perfect order

• Fear of saying something offensive

• Explicit sexual or violent thoughts

• Intrusive images, words or sounds

While there’s no official way to determine how severe obsessive-compulsive disorder is (mild, moderate or extreme), the difference between more mild cases of OCD and severe cases is the negative impact on your daily life, including your relationships and responsibilities.

Fortunately, obsessive-compulsive disorder can be treated with a combination of medication, psychotherapy and self-care.