How to Know When It’s More than Just “Spring Cleaning”

Differentiating a true OCD diagnosis from typical cleaning

Posted Apr 18, 2019

We all like to spend time cleaning during this time of year. But for some people with cleanliness-related obsessions and compulsions, the desire to keep a clean home might be a signal of a deeper problem. When do you know that it's time to see a doctor regarding your mental health?

This decision can often be a difficult one, but the biggest sign that it is time to seek help is when your obsessions and/or compulsions start to impair your ability to live your life—in other words, the obsessions or compulsions are consuming over an hour of your day or impairing your ability to function at home, school, or work. Regardless of how minor or severe you may think your symptoms are, if your anxiety is either causing you significant distress or making it difficult to attend to your daily responsibilities, that’s a good sign that you should seek out help.

(This article is in no way meant to serve as a method for diagnosing OCD; it is simply meant to guide your thinking and to help you determine if it may be an appropriate time to see a mental health clinician.)

Below are four guiding principles to help you decide if you should seek help.

1. Are you able to stop cleaning without becoming anxious and fearful?

It’s normal to want to do a deep clean of your home every so often (especially during the spring-cleaning time of year). Sometimes the chore of cleaning gets in the way of doing other things—we’ve all been there. However, a good sign that your need to clean is a mental health problem is if you become anxious and fearful when you stop cleaning. The inability to stop without experiencing severe stress is a signal that this activity has become a compulsion.

Though OCD is often stereotyped to focus only on cleaning, in actuality it encompasses other obsessions as well—and this general point holds for them, too. If you cannot stop counting, or checking to make sure that the stove or lights are off, or that the door is locked without becoming extremely anxious, this is a signal that there is a clinically significant impairment in functioning and it might be good to seek out the help of a professional.

2. Are you able to think logically about your obsessions and compulsions?

Many people have superstitions or rituals that they perform, but because they are logically able to separate the superstition from reality, these aren’t considered obsessions or compulsions. For example, someone could have a “lucky pen” she uses to take every exam. If one day this person lost the pen, she might be a bit upset, but she would know that it wasn’t really the pen giving her good grades; she would proceed to take the test as scheduled. If, however, this person refused to take the exam because she didn’t have her pen or became so fixated on finding the pen that she was unable to properly prepare for the exam, that might be considered a symptom of something bigger than just a superstition.

3. Have your “want to’s” become “have to’s”?

Many of us want a tidy home where things are organized in a certain way. It is when this “want” becomes a “must” that it becomes a more serious issue. There is a clear difference between people who enjoy having a tidy space and find it beneficial to their overall well-being and those who feel they must clean their home in order to relieve their anxiety. It is this difference between preferring something a certain way and feeling you must keep something that way in order to alleviate intrusive thoughts that can signal a potential case of OCD.

4. Are your obsessions keeping you from living your normal life?

As mentioned earlier, one of the most important factors in determining if you need to seek help from a mental health practitioner is if your obsessions and/or compulsions are interfering with your daily life and well-being. Is your inability to leave your home without checking five times to be sure your stove is off or your front door is locked making you late for work multiple times a week? Is your fear of germs forcing you to wash your hands so many times a day that your hands become cracked and dry? Do constant irrational thoughts of being mugged keep you from taking the fastest route home in the evening? If your obsessions are beginning to take control of your life in this manner, that’s a clear sign it may be time to get some help.

If you fear you might have OCD, it’s important to not lose hope. There are many treatment options available for today’s OCD patients. The American Psychiatric Association implemented an OCD treatment algorithm that suggests a specific type of cognitive behavioral therapy (CBT) known as exposure-response prevention (ERP) and selective serotonin reuptake inhibitors (SSRIs) as first line treatments. Additionally, neuromodulation, including deep transcranial magnetic stimulation, may be implemented when other treatments have not been effective.

If you do feel like it’s time to find some support, the Psychology Today “Find a Therapist” function is a great place to start.

By Eric Hollander MD and Kasey Siegel MA, Spectrum Neuroscience and Treatment Institute

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