When OCD starts

In the beginning there are some signs. Small signs.  Then there is a gradual five year meandering slide towards a more intense level.  This post explores the results of a survey of almost 200 people describing when and how they acquired a diagnosis of OCD.  These statistics describe the most common experience and there will of course be people who experience OCD much differently.


Early or late onset

Symptoms of OCD starts to emerge around the age of 11/12 years (early onset) or around 23 years (late onset).  For the early ones OCD tends to become a serious problem around the age of 17 years.   Acquiring OCD either early or late is more than just a timing issue.  The two types are different in other regards.  They differ on severity, male:female ratio, physical brain differences, and the measurable brain performance on tests. This suggests that although the OCD looks the same between the two types perhaps the cause might be different.

If your family is swarming with relatives with OCD then the good news is that it is quite unlikely that you will get OCD if you pass the 18 year mark.  I would also hope that the relatives all had late onset OCD as this halves your chance of inheriting OCD.  Early onset seems much more inheritable.


Five pathways to full blown OCD

OK so you have some of the signs of OCD.  This does not mean that you will grow up to get the full clinical complications of OCD.  You can move into the full blown version one of five ways:

(1) Specific stressors or events: Typical triggers include family member crisis – death, heart attack

(2) Increases in general stress: Typical triggers include job loss, loneliness, multiple life changes, sexual conflict.

(3) Changes in activities/routines: examples include house relocation, new job, starting university or a new school.

(4) Increased recognition of symptoms: examples include realising thoughts and behaviours were signs of OCD.

(5) Increasing concerns regarding negative evaluation because of symptoms: Examples include peer and family conflict regarding OCD behaviours.

The first two, a specific event and a general increase in stress are the two main pathways.



The authors of the paper emphasised that for most there is a slow and anxious winding pathway that leads to a clinical presentation of OCD.  The failure to correctly manage a range of anxious triggers escalates the symptoms over time.  My optimistic reading of the paper suggested that early and repeated interventions around stress/anxiety management when early signs become evident could prolong or limit the onset of clinical levels of OCD.

When OCD has developed then unwinding the stressors will help to reduce the intensity of the OCD symptoms.



Retrospective Reports of the Development of Obsessive Compulsive Disorder: Extending Knowledge of the Protracted
Symptom Phase.

Meredith E. Coles, Emily M. Johnson and Jessica R. Schubert

Behavioural and Cognitive Psychotherapy, 2011, 39, 579–589
First published online 11 March 2011 doi:10.1017/S135246581100004X

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This content is not intended to provide medical or mental health advice.  It is intended to stimulate an increased understanding of OCD.  The content may not be accurate or express the views of the journal article authors.