Obsessive-compulsive disorder, or OCD, is often depicted as being a mental health condition that causes a severe amount of impairment. We might think of someone who needs to tap every door frame dozens of times before walking through it, or someone who loses hours of their days to rituals. And certainly, OCD can be and often is a severe condition that requires treatment.
But for some people, OCD isn’t so severe. So what does a more mild presentation of OCD look like, and what should you do if you think you may be experiencing this?
What can mild OCD look like?
OCD is a mental health condition that affects 1 to 2% of the population. OCD is often a very disruptive disorder that can interfere with quality-of-life. It is highly treatable, but is unlikely to get better without treatment.
The core symptoms of OCD are obsessions and compulsions. Obsessions are intrusive thoughts that cause anxiety, and compulsions are repetitive or ritualistic behaviors that are performed in an effort to feel less anxious or gain certainty.
Just like any health condition, people can experience OCD on a range of severity levels. Some people may experience severe symptoms that leave them virtually incapable of living a functional or fulfilling life. Others may experience OCD on a milder scale, and be able to cope with or manage their symptoms even without treatment.
To illustrate, let’s take two people, both of whom experience varying levels of OCD.
One may experience symptoms on a more severe scale. They have the obsession, “What if I’m still dirty?”
In response, they might spend hours of their day washing their hands and showering, which makes them late for work. They may have a strong need to perform ritualistic compulsions, like taking off their clothes every time they come inside; in some cases, these compulsions could cause serious friction in relationships.
They may even cause themselves physical harm – for example, by washing their hands until they’re raw and cracked. This person lives with so much constant distress that it’s difficult to think about anything else.
Another person could also have what is referred to as contamination OCD. They also have the obsessions, “What if I’m still dirty?” and also experience distress due to this thought.
But this person only has mild impairment. They may wash their hands repeatedly, but are able to force themselves to stop in order to get to work on time. They have some insight that their compulsions are illogical, and don’t force them upon others. They perform compulsive hand-washing when they experience the obsession, but are otherwise able to go about their day.
Clearly, there is a difference in severity between these two individuals’ OCD symptoms.
How common is mild OCD?
According to the National Institute of Mental Health, around 15% of people with OCD have mild impairment. Around 50% have severe impairment, while the other 35% have moderate impairment.
Some experts say that mild OCD symptoms are much more common than OCD itself, and appear in up to 30% of the population. Mild symptoms may present as recurring thoughts about daily activities, like whether or not they locked the door, turned off the stove, and so on. The person may have mildly compulsive behaviors, like cleaning frequently, that don’t get in the way of daily functioning.
Is mild OCD still OCD?
To meet the criteria for a diagnosis of OCD, you must experience obsessions and compulsions. The Diagnostic Statistical Manual (DSM-V) also states that these obsessions and compulsions must also be time-consuming and cause “clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
This begs the question: If someone’s OCD is so mild that it doesn’t cause true impairment in any of these areas – in other words, if they continue to be able to work, have healthy relationships, and live a relatively functional life – then do they meet the diagnostic criteria for OCD?
Someone who doesn’t face impairment due to their symptoms likely wouldn’t be diagnosed with OCD. In some research, someone who experiences OCD symptoms but not functional impairment is described as having “subclinical OCD”.
Subclinical is a medical term that’s used to describe disease or injury that either aren’t detectable or doesn’t meet all of the clinical criteria for a diagnosis.
Not all mild OCD is subclinical OCD. You could experience mild impairment in your life due to your symptoms, which would still qualify you for a diagnosis of OCD.
This doesn’t mean that people whose OCD symptoms aren’t as severe don’t need treatment. Whether you have mild or subclinical OCD, then you could still benefit from a treatment program such as exposure and response prevention. It just means that you may not receive a diagnosis of OCD because your symptoms aren’t severe enough.
How is OCD severity measured?
There are various tools and clinical questionnaires that are used to measure the severity of someone’s OCD symptoms.
One commonly used tool is the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). This is a questionnaire that asks people to read 10 questions and rate themselves on a scale of 0 to 4.
For example, the first question on this scale is: “How much of your time was occupied by obsessive thoughts?” The person must answer between “0: None,” to “4: More than 8 hours a day, or near-constant intrusions.”
The maximum score of the Y-BOCS (indicating severe OCD) is 40. People who score between 8 to 15 are typically considered as having mild OCD. However, only people who score 16 or higher on this scale are typically considered as having OCD in research studies.
One other factor that may or may not indicate severity is the “insight qualifier,” which is included in the DSM. As part of an OCD diagnosis, health professionals can indicate whether the person with OCD has:
Fair or good insight: The person realizes that their OCD beliefs may not be true
Poor insight: The person thinks that their OCD beliefs are probably true
Absent insight or delusional beliefs: The person is completely convinced that their OCD beliefs are true
Although this isn’t always the case, people with mild OCD often have fair or good insight into their symptoms.
Whether or not your OCD symptoms are “too mild” for a diagnosis depends on many factors. Try to keep in mind that the main reason for seeking a diagnosis is to receive treatment. If your OCD problems are interfering with your life in any way, then it’s a good idea to get treatment – whether or not you meet the clinical threshold for OCD.
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The discussion about mild OCD often leads to the claim that “everyone’s a little bit OCD.” This is a phrase that is commonly seen on the internet, and is often the fodder for jokes and memes. It refers to the idea that OCD symptoms (like intrusive thoughts) are so common that everyone experiences them to a certain extent.
In some ways, this is true. One international study showed that a great majority of their participants – across 6 continents – experienced at least one intrusive thought in the previous 3 months.
So what does that mean? Do all of these people have a mild form of OCD?
Experts say no. Intrusive thoughts may be a common part of the human experience, but intrusive thoughts alone do not mean one has OCD.
People without OCD may have an intrusive thought, but are able to either ignore it or brush it off – especially if they’re benign. For example, someone without OCD could have the intrusive thought: “What if I’m a sociopath?” This thought might be uncomfortable or annoying, but it doesn’t affect them for a very long time. They realize, quickly, that this is a random thought that has no real meaning.
Someone with OCD could have the same intrusive thought: “What if I’m a sociopath?” But for them, this thought becomes lodged in their brain. It becomes an obsession. They may start to spiral into other thoughts: “If I am a sociopath, then what if that means I don’t really love my family? What if I lose it one day and murder everyone I love?”
These thoughts feel real to the person with OCD, and cause a great deal of fear. To alleviate the fear, they feel the need to perform compulsions.
For example, they might spend hours reading about or taking online quizzes on whether they might be a sociopath. They might ask their loved ones, over and over again, for reassurance that they are a “good person.” They might say prayers or perform rituals to protect themselves from becoming a sociopath in the future.
This is what happens for people who have OCD. Even people with mild OCD would perform compulsions to a certain degree, although it may not cause as much impairment. For example, they might do research about sociopathy on their phone while at work rather than missing work in order to do so.
The point is this: Not everyone who has intrusive or unwanted thoughts has OCD. Even people with a mild form of OCD experience both obsessions and compulsions, which are core features of this disorder.
OCD is a health condition, not a nuisance.
What to do if you think you have mild OCD: Next steps
If you think you have OCD, even if your symptoms are mild, it’s important to see a mental health professional. For some people, mild OCD continues to be manageable, and never interferes with daily life. But stressful events could trigger more severe symptoms for others.
On top of that, mild OCD can cause an incredible amount of distress. You may still be able to continue with your life – going to work everyday, and keeping up with your relationships – but that doesn’t mean you’re not in emotional pain.
Many people with mild OCD (or a mild form of any mental health condition) tell themselves that they don’t need treatment, or even that they don’t deserve treatment. But whether your OCD is mild or severe, you deserve to feel better. This isn’t as good as it gets. There is life beyond OCD. And treatment can help you get there.
Our OCD treatment program at the The Center • A Place of HOPE has helped people recover from this disruptive condition for many years. No matter if you live with mild, moderate, or severe OCD, our clinical team can help.
Pioneering Whole Person Care over thirty years ago, Dr. Gregory Jantz is an innovator in the treatment of mental health. He is a best-selling author of over 45 books, and a go-to media authority on behavioral health afflictions, appearing on CBS, ABC, NBC, Fox, and CNN. Dr. Jantz leads a team of world-class, licensed, and...
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