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How Can I Tell If I Have High-Functioning OCD?

Obsessive-compulsive disorder (OCD) may very well be one of the most misunderstood mental health conditions today. In fact, this anxiety condition is shrouded in mysteries, myths, and unfair and inaccurate stigmas and labels. Regardless, OCD is a real diagnosable condition that can negatively affect your self-esteem, wallet, relationships, and well-being. Contrary to popular belief OCD does not solely consist of being “too tidy, orderly, or perfect,” or being afraid of germs, though those behaviors can be a sign or symptoms of OCD. 

The point is OCD is broader than just being a “neat freak” or “germaphobe.” It is the intrusive thoughts, urges, fears, doubts, emotions, images, and/or compulsive behaviors (rituals or routines) that truly define this condition. A compulsion (ritual or routine) is designed to ease an obsession (i.e., intrusive thoughts). But similar to other mental health conditions, OCD exists on a spectrum – from low-functioning to high-functioning. The intensity of your OCD symptoms and how well you function with the condition depends on where you fall on the OCD spectrum. 

If you have been able to function fairly well with OCD, there is a good chance you have high-functioning OCD. However, the only way you will know for sure is to read this article and talk to your doctor. The good news is if you have high-functioning OCD, there is still help available – to keep you on track and help you accomplish your goals. Just because you have high-functioning OCD does not mean you have to “go it alone” with your OCD. OCD treatments can help you keep your OCD symptoms in control, so you continue to make strides in this world. 

How can you tell if you have high-functioning OCD? Keep reading and you will find out!

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What is High-Functioning OCD?

Approximately 2.5 million people in the US live with OCD – with a good proportion of these individuals being “high-functioning.” 

First, let me preface, by saying that the DSM-5 does not include the term, “high-functioning” or even “low-functioning” in its criteria for OCD. These labels (“high-functioning” and “low-functioning” most likely stem from OCD severity scales, like the Yale-Brown Obsessive Compulsive Scale (Y-BOCS)

The Y-BOCS scale is designed to assess the severity of OCD symptoms – and how well each person functions with these symptoms. Keep in mind that OCD presents differently for each person with the condition, so what may look and feel like “high-functioning” to one person may look and feel “mild-” or “moderate-functioning” to another one. 

Also, understand that it is quite common for people with OCD to hide their symptoms from others – out of a fear of being stigmatized or “shunned” by others. This is especially true with high-functioning OCD sufferers. High-functioning OCD sufferers tend to engage in mental compulsions while in the presence of others but engage physical compulsions while alone. Because no one can “see” high-functioning OCD sufferers’ compulsions, they often go undetected. 

Regardless, all people with diagnosable OCD can experience obsessions (i.e., intrusive thoughts, urges, fears, emotions, etc.). But because their obsessions and compulsions are undetectable, many people with high-functioning OCD neglect to seek help for it. These individuals believe that they can manage their symptoms by themselves – without OCD treatment. That is not true. Another sect of high-functioning OCD sufferers dismiss or ignore their symptoms because the symptoms are not “bothering them too much.” 

These individuals simply chalk up the “signs” as just a part of who they are – a facet of their personalities. So, they do not seek OCD help. As a result, many times, friends, family, and/or romantic partners have no clue that their loved one is grappling with OCD. It is easier to detect that something is “off” when the person is struggling with low-functioning OCD because the signs and symptoms are more pronounced and debilitating.

So, to sum it up, with low-functioning OCD, individuals are “engulfed” by OCD symptoms, while people with high-functioning OCD have more manageable symptoms. But, understand that these individuals still have to work to keep these symptoms under control. If not, high-functioning OCD can turn into low-functioning OCD. So, regardless of where a person falls on the OCD spectrum, OCD treatment is still needed to live a happy and productive life.

What Are the Signs & Symptoms of High-Functioning OCD?

Overall, the main symptom(s) of OCD is intrusive thoughts and/or compulsive behaviors (in response to the intrusive thoughts or obsession). The goal of compulsions is to ease the stress and anxiety causing the intrusive thoughts (so the obsession goes away). 

Ruminating Thoughts 

For a person with mild-, moderate-, or low-functioning OCD, intrusive thoughts, along with ruminations, ritualistic behaviors, and crippling stress and anxiety are almost continuous. While a person with high-functioning OCD may have similar symptoms (i.e., ruminating thoughts) to other “levels” of OCD, these symptoms are not as evident. 

Work or School Sucess

People with high-functioning OCD may have distressing symptoms, but still, be able to complete school or work tasks, pay bills, cook, clean, get to work or school on time, take care of bills, spend time with friends, and family, etc. In other words, these individuals can still be productive and successful. 

Surprisingly, high-functioning OCD and anxiety can be a benefit in some occupations, like detail-oriented accounting jobs, but in jobs that require highly stressful or fast-paced jobs, it could be a disadvantage. So, even high-functioning OCD sufferers can experience high levels of anxiety that could impede the completion of school or work tasks, especially if they start to obsess over aspects of the job. 

Excessive Worrying

OCD thought processes are “distinctive.” People with OCD, even high-functioning OCD, are inundated with intrusive thoughts, urges, fears, emotions, images, doubts, etc., that they are unable to get out of their minds. For instance, you see a car crash. Because it is so disturbing, you are unable to “unsee it” or get it out of your mind. 

You keep thinking about it and worrying about the occupants inside of the smashed-up cars. These thoughts and fears trigger your anxiety to the point that you feel compelled to do something to “turn off” those thoughts and fears. If you have high-functioning OCD, you still experience the stress and angst but can cope with it in a way that does not disrupt your life.

Background Lurking

OCD, even high-functioning OCD, can begin in early childhood (between 8-12 years old), but it can also begin in early adulthood (the 20s). It can also arise after a bout of strep (PANDAS) or following a traumatic brain injury. More research is needed to determine what triggers high-functioning OCD, and how it functions in the brain. 

Clandestine Coping Mechanisms

The big difference between the various types of OCD is the behaviors. In high-functioning OCD, obsessions are pronounced and upsetting, however, the behaviors are less time-consuming, life-altering, and visible. For instance, high-functioning OCD sufferers tend to have a habit of constantly monitoring things – i.e., these individuals tend to be “micro-manager” bosses at work. 

Runs in Families

People with OCD, in general, have brains that function “differently” the most of the general population. These individuals have neurodivergent thought processes, which means their brains develop and function “differently” than most people. High-functioning OCD sufferers are no exception. Researchers have discovered that OCD, even high-functioning OCD, runs in families. So, if you have noticed that other family members have similar thought processes and/or behaviors, it is not a coincidence. You and your relatives may have high-functioning OCD. 

A Feeling of Being “Different” Than Other OCD Sufferers

Many high-functioning OCD sufferers feel like they are different than other lower-functioning OCD sufferers. Because there is no official OCD blood test, it is hard to determine if a person has high-functioning OCD or if he or she has a lower functioning level of OCD. Thus, OCD and the functioning level of OCD are typically diagnosed through assessments and interviews by an OCD therapist. 

There are also OCD screening tests, like the one found on the Impulse Therapy website. But keep in mind that scoring how on an OCD screening test does not automatically mean that you have OCD. Nowadays, people like to go online and google OCD symptoms. Then, they rule out OCD, even though they may have it. So, to be properly diagnosed with the condition, a person must be assessed by a trained and licensed OCD therapist.

Note: Understand that just because someone says, “You don’t look like you have OCD,” does not mean that you do not have it. High-functioning OCD sufferers may not present like the traditional OCD sufferer but still have it. Remember, no two OCD sufferers are the exact same, so everyone’s experience is different – and valid. Thus, it is important to create more awareness about the different “types” and function levels of OCD to ensure that everyone receives the OCD support and help they need to get a grip on their symptoms.

What is it Like to Have High-Functioning OCD?

Sometimes, it is hard to really understand what someone is going through unless you have it or hear about it from someone, who is also going through the same thing. 

Listed below are real-life accounts of what it is like to live with high-functioning OCD:

Liz

“No one takes high-functioning OCD seriously.

I have a history of anxiety and depression. I’ve always been a very Type-A personality, but in the last 7 years, it has gone into OCD territory. However, since I was always able to keep up in school and at work, graduate, and get a good-paying job, no one took it seriously. I had one very bad bout of OCD in college that was chalked up to stress and anxiety and I was never diagnosed. Zoloft made it go away for some time so it was all good.

However, within the last 2 years, things have been more frequent. Instead of intermittent bouts of anxiety, it is now always present. In fact, it has gotten so bad that changing my meds alone is no longer helping. So, I recently started seeing a psychiatrist. However, I was not properly diagnosed, but then my psychiatrist went on maternity leave. Then, I was referred to the psychiatrist I am seeing now. I had to ask for a focused diagnosis so that some progress could be made. 

After a long observation period, my new psychiatrist finally diagnosed me with OCD. I think part of the reason it took so long is that I wasn’t good at communicating what was going on with me. Apparently, I have high-functioning OCD so my obsessions and compulsions are not super obvious or “typical” for OCD. I hate the mentality that a person has to be suicidal for his/her misery to be taken seriously. Or, a person’s life needs to be falling to pieces to be taken seriously. 

I am finally getting the treatment I need, but I have been miserable for 2 years. I have been doing everything possible to keep my life together. But the truth is I want to step out of my life, not in a suicidal way, but in a vacation from life kind of way. I am unhappy and stressed all of the time, but I am not suicidal, so people assume I can handle anything and I am fine when I am not. But I am not trying to dismiss OCD sufferers, who are suicidal. 

I just know that I am lucky that I have never felt suicidal. The truth is I am just trying to explain that mental illness should always be taken seriously, especially early on. I mean…why isn’t being miserable enough to garner OCD help? I guess I am just so sick and tired of being sick and tired – without anyone knowing. It is a lot. And, it is probably worse than being overwhelmed with obvious OCD symptoms. I just wish people understand that I am NOT alright – even if I say and act like I am.”

Matt

“I consider myself high-functioning nowadays, however, I had to battle between my intrusive thoughts and my university studies. It was hard, but I somehow made it while passing the first semester. So, I like to remind myself that I have basically gone through hell before (thinking back that was probably a compulsion). I signed up for OCD therapy around that time and got in this month.

Communication has been a real issue for me. I have anxieties about communicating my thoughts – things I find too uncomfortable to talk about. I am always thinking what if I had not said this or that, or explained things like this or that? I think what if I did not have this or that thought, then I would not have been able to get therapy. Thankfully, that was not the case. I told my therapist about even some of the worst thoughts and behaviors – things I used to be afraid to talk about. 

No one knows that I have OCD because I hide it. No one knows, but my therapist. I am just thankful that I have been able to function in my daily life and at work. Some people with OCD are not that lucky. But it is still really hard. But what can a person do but live with and that is what I do.”

How is High-Functioning OCD Treated?

High-functioning OCD is treated like any other function level of OCD – with OCD therapies, and/or medications (i.e., SSRIs), along with lifestyle changes, natural remedies, and self-help tools. 

OCD Therapies
Medications
Lifestyle Changes
  • A consistent bedtime routine to promote quality sleep and reduce the risk of insomnia
  • A healthy diet with lots of fresh fruits and veggies
  • Regular exercise – i.e., joining a gym, jogging, swimming, joining a sports team, etc. 
  • Staying busy by adopting a new hobby, volunteering at a domestic violence, animal, or homelessness shelter, signing up for a class, etc.
Natural Remedies & Alternative Treatments
Self-Help Tools

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Is There Anything Else People Should Know About High-Functioning OCD?

Yes, there are a couple of things people should know about this anxiety condition, such as: 

High-functioning OCD is sometimes worse than low-functioning OCD. How? Well, because this level of OCD often goes unnoticed, it can go untreated for years, decades, or even forever. When it is not apparent, it becomes ingrained in you and dismissed. 

However, when something is severe and obvious, as in the case of low-functioning OCD, there is more of a need to seek treatment of it. Why? Because it is making you miserable and you want it to stop. So, with high-functioning OCD, you run the risk of going through your whole life with undiagnosed and/or untreated OCD.

It is also important to understand that people with high-functioning OCD can be extremely successful and accomplished. Why? Because to the outside world, the behaviors associated with OCD may be linked to “being driven” or passionate” about their jobs or endeavors. These types of behaviors are often celebrated by society because they tend to lead to wealth, celebrity, success, and/or popularity.

The result? OCD remains hidden. 

References

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Author

DR. R. Y. Langham

Dr. R. Y. Langham has a B.A. in English, an M.M.F.T in Marriage and Family Therapy (Psychology), and a Ph.D. in Family Psychology. She is currently a medical, health & wellness contributor, copywriter, and psychological consultant

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