How can I understand if it is my OCD or real?

How can I understand if it is my OCD or real?

How can I understand if it is my OCD or real?

When intrusive thoughts sneak in uninvited and shackles of compulsive behaviours chain us down, the ghost of Obsessive-Compulsive Disorder (OCD) may have subtly crept into our psyche. Caught in a maelstrom of uncertainty, how do we separate reality from the ghoul of OCD? Can we distinguish the genuine worries of daily life from the constant drumbeat of OCD? This undulating terrain of uncertainty can be a lonesome journey, but you’re not alone. As we navigate this labyrinth, let’s unravel the answers to this bewildering question: ‘How can I understand if it is my OCD or real?’ Equipping ourselves with a better understanding of OCD can be the torchlight that shines through the murk, offering hope and clarity amidst the confusion. So, join us on this cognitive exploration as we shed light on coping strategies, expert insights, and practical advice to help you seize the reins of your mental well-being.

Understanding Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder, commonly abbreviated as OCD, is a mental health condition that is characterised by recurring and unwanted thoughts, urges, or mental images (obsessions) and repetitive behaviours or mental acts that an individual feels compelled to perform (compulsions).

In essence, OCD is like a record that’s stuck in a loop. That nagging voice in your head continually questions your actions, creating doubt and unease. The individual may recognise that their obsessions and compulsions seem excessive or unreasonable, but they often feel powerless to control them.

It’s important to note, however, that OCD is more than just being overly tidy or disliking disorder. The condition can be debilitating and time-consuming, often causing significant distress and impairing daily functioning.

Differentiating between OCD and reality

Distinguishing between OCD and reality can be a daunting task, primarily because OCD has a crafty knack for blurring the lines between the two. The intrusive thoughts and compulsions that characterise OCD can seem genuine, often leading individuals to question their perceptions of reality.

In a sense, OCD can be likened to a deceptive illusionist, conjuring convincing illusions that can make it challenging to discern what’s real from what’s not. It’s important to understand that everyone has passing thoughts that may seem odd or out of character. The difference with OCD is that these thoughts are persistent and distressing and often lead to compulsive behaviours in an attempt to alleviate the anxiety they cause.

A key element in differentiating between OCD and reality is understanding that OCD thoughts are not a reflection of your desires or intentions. They are merely symptoms of a disorder that causes your brain to get stuck on a particular thought or urge.

Identifying OCD triggers

Identifying the triggers that spark your OCD symptoms can be an effective strategy in distinguishing OCD from reality. Triggers vary widely between individuals but include specific places, situations, objects, or thoughts.

For instance, someone with contamination obsessions might find their symptoms triggered when they encounter dirt or germs. In contrast, someone with symmetry obsessions might be triggered by uneven or misaligned things.

Keeping a record of when your symptoms occur, what you were doing at the time, and how you felt can help you identify patterns and triggers. Over time, this can help you anticipate and manage your symptoms more effectively.

The role of intrusive thoughts in OCD

Intrusive thoughts play a central role in OCD. They are unwanted, distressing, and often disturbing thoughts that pop into your mind seemingly out of nowhere. These thoughts can revolve around many themes, including fears about contamination, harm, religious, or sexual themes.

Importantly, having intrusive thoughts does not mean you are terrible or will act on these thoughts. People with OCD are often deeply disturbed by their intrusive thoughts, which is why they go to great lengths to suppress or neutralise them.

Understanding this can be crucial in differentiating OCD thoughts from reality. Remember, just because a thought pops into your head doesn’t make it true, important, or reflective of your real intentions.

How OCD affects the perception of reality

OCD can significantly warp an individual’s perception of reality. The intrusive thoughts and compulsions that characterise the condition can feel incredibly real, often leading individuals to question their sanity or reality.

In some cases, individuals with OCD may struggle to trust their senses or memory, leading to a phenomenon known as ‘false memories’. This can add another layer of confusion and distress, making it even more challenging to separate OCD from reality.

However, with the right strategies and professional support, it is possible to navigate this complex landscape and learn to distinguish OCD thoughts from reality.

Practical steps to differentiate OCD thoughts from reality

Differentiating between OCD thoughts and reality can feel like trying to untangle a knotted ball of string. However, you can take several practical steps to help make this process easier.

Firstly, try to identify the characteristics of your OCD thoughts. These might include being repetitive, intrusive, distressing, and not fitting with your usual thought patterns or values. Secondly, challenge these thoughts by asking yourself whether they are based on fact or fear. Remember, just because a thought feels real doesn’t mean it is.

Another helpful strategy is mindfulness, which involves focusing on the present moment without judgment. This can help you distance yourself from your thoughts and view them as separate from yourself.

Professional help for OCD: Therapies and Treatments

Seeking professional help can be invaluable in managing OCD and differentiating it from reality. Cognitive Behavioural Therapy (CBT), particularly a type of CBT called Exposure and Response Prevention (ERP), is considered the gold standard treatment for OCD.

ERP involves gradually exposing you to the thoughts, images, and situations that make you anxious and helping you develop healthier responses to them. The aim is to reduce the fear and anxiety associated with your obsessions, thereby reducing the need for compulsive behaviours.

In addition to therapy, medication can also be an effective treatment for OCD. Selective serotonin reuptake inhibitors (SSRIs) are commonly used, often in combination with therapy.

Coping strategies for managing OCD

In addition to professional treatment, several coping strategies can help manage OCD symptoms. Regular exercise, adequate sleep, and a healthy diet can all play a role in reducing anxiety and improving mood.

Mindfulness and relaxation techniques, such as deep breathing and progressive muscle relaxation, can also be helpful. Additionally, joining a support group can provide a safe space to share experiences, learn from others, and feel less alone in your journey.

Remember, being patient and kind to yourself throughout this process is essential. Overcoming OCD is not about ‘getting rid’ of your thoughts but learning to live with them more healthily.

When to seek help for OCD symptoms

If you’re struggling to differentiate between OCD and reality, or if your symptoms are causing significant distress or impacting your daily life, it’s essential to seek professional help. This can include a mental health professional, such as a psychologist or psychiatrist, or a trusted healthcare provider.

Remember, it’s never too early or too late to reach out for help. OCD is a treatable condition, and with the proper support and treatment, it is possible to regain control over your thoughts and live a fulfilling life.

Don’t let the fear of stigma or judgment hold you back. Seeking help is a sign of strength, not weakness, and is the first step towards recovery.


Navigating the uncertain terrain of OCD can be a daunting journey. Still, with a better understanding of the condition, practical strategies, and the proper professional support, it is possible to distinguish OCD from reality. Remember, you are not alone in this journey, and help is available.

While OCD can cast a long shadow, it does not have to define you or dictate your life. By learning to differentiate between OCD thoughts and reality, you can gain the upper hand over your symptoms and reclaim control over your thoughts, your actions, and your life.

The journey may be challenging and filled with twists and turns, but every step forward is a step towards a healthier, happier you. So, keep going. You’re stronger than you think and have the power to overcome.

Further readings:

Cavedini, P., Gorini, A., & Bellodi, L. (2006). Understanding obsessive–compulsive disorder: focus on decision making. Neuropsychology review, 16, 3-15.

LeJeune, C. (2023). ” Pure O” OCD: Letting Go of Obsessive Thoughts with Acceptance and Commitment Therapy. New Harbinger Publications.

OCD Action’s Online Support Groups

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Federico Ferrarese Federico Ferrarese - Chartered Psychologist and Cognitive Behavioural Therapist
I am deeply committed to my role as a cognitive behavioural therapist, aiding clients in their journey towards recovery and sustainable, positive changes in their lives.