OCD has one of the longest
exclusions list of any disorder I’ve ever come across... because, yep... a whole helluva lot of other things come along with obsessions, compulsions, or both. And it’s not a complete list, by any means. It’s just exemplifying.
(Bold is standard, found in almost every other criterion list. The mile and an half long list that follows? Isn’t.)
D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).
Essentially... your obsessions, compulsions, etc. have to exist
without any other causal factors that explain why you’re doing them (like anxiety, trauma, grief, etc., causing them.). It has to be its own thing. Independent and existing regardless of what else is going on.
In much the same way that people with ptsd are frequently citing CriterionA (cause matters), people with OCD are frequently citing Criterion D (it really, really matters). Because if one
just looks at the foundation?
OCD is diagnosed when obsessions and compulsions
- Consume excessive amounts of time (an hour or more each day)
- Cause significant distress
- Interfere with daily functioning at work or school, or with social activities, family relationships and/or normal routines.
Then half the disorders in the DSM, and half of the normal/expected fallout from major life events = OCD. When they’re not, and don’t.
ETA
Which isn’t to say that people with OCD don’t have life happen (exacerbating symptoms), or comorbid diagnoses. Just that someone with OCD won’t
just be symptomatic during certain periods of time when life is hard, but also on any random Tuesday afternoon when life is good and absolutely nothing is on.
