OCD is not having quirks: how to recognise the difference
Preferring order, checking a door once or following a routine is not enough to indicate OCD. The disorder involves obsessions, compulsions or both, and these take time, cause distress or interfere with life. Some compulsions are intended to prevent harm; others respond to a sense of incompleteness. Diagnosis depends on the function and consequences of behaviour, not what it looks like.
The same action can have different functions
Two people check a door. One confirms that it is locked and leaves. The other returns, photographs the lock, seeks reassurance and mentally reviews whether they turned the key. Checking itself does not indicate OCD; repeated doubt, urgency, ritual and interference do.
A preferred routine may be upsetting when changed without being a compulsion. At the same time, some people with OCD do not describe a specific fear: they repeat until something feels complete or ‘right’. The distinction cannot always be reduced to ‘preference versus need’.
What clinicians assess
- Which thoughts, images, urges or sensations appear.
- What the person does to neutralise them or prevent an outcome.
- How much time the responses take.
- Which activities are avoided and how the family is involved.
- How much distress or interference results.
- Whether another condition, a substance or a medical problem better explains the symptoms.
Why ‘I have quirks too’ can confuse the issue
The phrase is usually intended to normalise the experience, but it can minimise hours of rituals, avoidance or doubt. It is more useful to ask what happens if the action is not performed and how it affects the person’s day.
Treatment and course
Cognitive behavioural therapy with exposure and response prevention is one of the main treatments. Depending on severity and preference, it may be combined with a selective serotonin reuptake inhibitor prescribed by a clinician.
It is not accurate to say that OCD never disappears. Some people reach remission and others continue to have symptoms they learn to manage; relapses can also occur. Outcome depends on severity, access to treatment and other factors.
Frequently asked questions
Is being very tidy OCD?
Not on its own. Obsessions, compulsions, distress, time and interference all need to be assessed.
Can OCD occur without fear of a catastrophe?
Yes. Some compulsions are performed to correct a sense of incompleteness or that something is not ‘right’.
How is it diagnosed?
Through a clinical assessment. Checklists and scales help describe symptoms and severity but do not replace an interview and differential diagnosis.
Can OCD improve substantially?
Yes. Treatment can substantially reduce symptoms and interference, and some people reach remission.
Sources
DSM-5-TR: diagnostic criteria for obsessive-compulsive disorder. · NHS: OCD treatment. · NICE guidance on assessing and treating OCD.
Living with OCD at Home
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Writes about neurodivergence: practical guides for families, teachers and adults, and illustrated fiction. About me