D is for Diagnosis
The process of getting diagnosed with anything is a pain in the butt (I want to use a ruder word). Healthcare is unaffordable for so many people. Sometimes you can diagnose yourself, and that works too! But if you can, it really really helped me to get a professional diagnosis. I encourage you to go to your appointment with a list of symptoms and any research you’ve done. When I finished reading this list to my therapist on our first appointment, she said, “Well, Claire, you have OCD.” It was that obvious.
OCD is in the DSM-5, and here is the definition:
DSM-5 Diagnostic Criteria for Obsessive-Compulsive Disorder (300.3)
A. Presence of obsessions, compulsions, or both:
Obsessions are defined by (1) and (2):
1. Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
2.The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
2.The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
Basically you have to have both obsessions and compulsions, and they have to be severe enough to take up 1 hour or more a day OR be distressing or impair you from functioning. This is the difference between normal levels of obsessions and having a disorder. Going back to the example of checking to make sure your car door is locked…that’s an obsession/compulsion. But it doesn’t take up more than 1 hour of your day or make your life worse.
You may also see the words “good or fair insight,” “poor insight,” or “absent insight.” This refers to how aware the individual is that their obsessive thoughts stem from OCD and are not actually true. My official diagnosis is “OCD with good or fair insight.” This means that I KNOW my thoughts and compulsions are because of OCD. However, even if you have good insight it doesn’t make it any easier to deal with. I know that seems weird! The tricky part of OCD is KNOWING what you’re doing is irrational (I know logically that stepping on a rock will not prevent me from getting sick), but the FEELING Is so real that you have to do it anyway.
As I mentioned earlier, the average length of time between onset of symptoms (when OCD starts) and diagnosis is 10 years. For me it was 13. That is a long time to deal with an illness and not have a name for it. I thought it was just me being a weirdo. OCD made me feel like I was a horrible person. Getting a name put to that was the first step in me getting better. Diagnosis is so important and was the start to me turning my life around.