How do you know if you have obsessive-compulsive disorder?

When I leave for work in the morning, I go through my precommute checklist. Train pass, check. Wallet, check. Coffee mug, check. Smart phone, check. Keys to the house, check. Only when I’m sure that I have everything I need do I open the door and head outside.

Sometimes I worry that this morning routine is becoming too much of a ritual. Is it possible that I have obsessive-compulsive disorder (OCD for short)?

Probably not. The fact that I am able to get out the door every morning means that my daily ritual isn’t interfering with my ability to function, says Dr. Jeff Szymanski, a clinical instructor in psychology at Harvard Medical School.

You have OCD when obsessions and compulsive behavior become so severe that they interfere with your ability to work or have relationships. Someone with OCD might spend so much time straightening closet hangers or smoothing down rugs—or going over mental checklists like mine—that he or she risks losing jobs and ruining relationships.

That may seem strange to someone without OCD. But as Dr. Szymanski explains in the video below, people with OCD engage in compulsive behaviors as a way to deal with overwhelming feelings of anxiety that are usually triggered by intrusive images and thoughts. As executive director of the International OCD Foundation, Dr. Szymanski knows a lot about this condition.

Fortunately, a combination of medications and psychotherapy can help many people with OCD to live more balanced lives, Dr. Szymanski explains in the video. A mainstay of treatment is called exposure and response prevention—a sort of “face your fears” therapy. A therapist gradually exposes someone with OCD to whatever is causing anxiety, and then suggests better ways of dealing with the fear. It takes time, and the person’s anxiety levels usually increase at first. But over time, the individual becomes less anxious as he or she gains confidence and learns new coping methods.

Note: Dr. Szymanski is also the author of an upcoming Harvard Medical School book, The Perfectionist’s Handbook, which will be published in September.

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