Do I Have OCD? Understanding Obsessive-Compulsive Disorder

OCD is one of the most misunderstood mental health conditions. Pop culture reduces it to a preference for neatness or color-coding, but the reality is far more complex — and far more distressing. For the roughly 1 in 40 people who live with obsessive-compulsive disorder, the condition involves intrusive, unwanted thoughts and repetitive behaviors that can consume hours of every day.

The good news? OCD is treatable. And getting the right diagnosis is the critical first step.

What Is OCD, Really?

Obsessive-compulsive disorder has two core components:

• Obsessions: Persistent, unwanted thoughts, images, or urges that cause significant anxiety or distress. These aren't worries about realistic problems — they're intrusive thoughts that feel impossible to control.
• Compulsions: Repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession. Compulsions are aimed at reducing anxiety or preventing a dreaded event, even though they're often not logically connected.

Together, obsessions and compulsions create a self-reinforcing cycle: the obsessive thought causes anxiety → the compulsion temporarily relieves it → the relief reinforces the cycle → the pattern repeats and often intensifies.

Common OCD Symptoms

OCD can manifest in many different ways. Some of the more common themes include:

Common Obsessions

• Fear of contamination (germs, dirt, chemicals)
• Fear of harming yourself or others
• Unwanted sexual or violent intrusive thoughts
• Excessive concern with order, symmetry, or "rightness"
• Religious or moral obsessions (scrupulosity)
• Fear of losing things you might need

Common Compulsions

• Excessive hand washing or cleaning
• Repeatedly checking locks, appliances, or switches
• Counting, tapping, or repeating specific words or phrases
• Arranging objects until they feel "just right"
• Seeking reassurance from others
• Mental rituals (praying, reviewing events, counting in your head)

OCD vs. Being Particular

Everyone has quirks. Liking a tidy desk or double-checking that you locked the front door doesn't mean you have OCD. The distinction is about degree, distress, and impairment:

• OCD thoughts feel intrusive and unwanted — you don't enjoy them
• Compulsions feel driven by anxiety, not preference
• The cycle takes up significant time (often an hour or more per day)
• It interferes with work, relationships, or daily functioning

Getting Evaluated for OCD

If the symptoms above sound familiar, a psychiatric evaluation can clarify what's going on. OCD sometimes co-occurs with anxiety disorders, depression, ADHD, and tic disorders, making professional evaluation especially important for accurate diagnosis and appropriate treatment.

At Next Step Psychiatry in Lilburn, GA, Dr. Aneel Ursani and Fathima Chowdhury, PA-C conduct comprehensive assessments and work with patients to develop individualized treatment plans.

Treatment Options for OCD

Effective OCD treatment typically involves one or both of the following:

• Medication: SSRIs (like fluoxetine, sertraline, or fluvoxamine) are the first-line medications for OCD and are often prescribed at higher doses than for depression. Our team manages medication carefully with regular follow-up.
• Exposure and Response Prevention (ERP): A specialized form of cognitive behavioral therapy that's considered the gold standard for OCD. We can refer you to ERP-trained therapists in the Gwinnett County and Atlanta area.

For patients with more severe or treatment-resistant OCD, additional medication strategies or augmentation approaches may be considered.