How much are the thoughts costing you?

1)What is OCD?

Obsessive-compulsive disorder has two halves that feed each other. Obsessions are unwanted, intrusive thoughts, images, or urges that turn up repeatedly and cause real distress. Compulsions are the things you do to make that distress go away: checking, washing, counting, arranging, repeating, or mentally reviewing. The relief works, which is precisely the problem. Each time a compulsion settles the anxiety, it teaches the brain that the obsession was a genuine threat and that the ritual is what averted it, so both come back stronger.

The popular picture of OCD as tidiness or hand-washing is a small and misleading slice of it. Many people with OCD have no visible rituals at all, and their compulsions are entirely mental. Common themes include fears of harm or contamination, intrusive violent or sexual thoughts that are the opposite of what the person values, a need for symmetry or rightness, and an inability to tolerate uncertainty about whether something bad has happened. Distressing intrusive thoughts are near-universal in the general population; what distinguishes OCD is not having them but how much meaning they get, and how much effort goes into neutralising them.

2)Signs of OCD

The clearest signal is not the content of a habit but how it feels from the inside: something you have to do, on someone else's terms, rather than something you prefer.

• Obsessions: recurring intrusive thoughts or images you do not want, that feel disturbing or out of character, and that are hard to dismiss.
• Compulsions: checking, washing, counting, arranging, repeating actions, or seeking reassurance, done to reduce anxiety rather than because you want to.
• Mental rituals: silently reviewing memories, praying to a formula, counting, or arguing with a thought until it feels resolved.
• Avoidance: steering around places, objects, people, or topics that set the thoughts off.
• Cost: the time it takes, the distress it causes, and the parts of life that get smaller to accommodate it.

One useful distinction: liking things neat is a preference, and it usually feels good. A compulsion feels like relief from something bad rather than pleasure in something good, and stopping it produces anxiety rather than mild annoyance.

3)How the scoring works

Each of the 18 items scores from 0 (not at all) to 4 (extremely), so your total runs from 0 to 72. The items cover six symptom areas, three questions each: washing, checking, ordering, obsessing, hoarding, and mental neutralising. A higher total points to more symptom distress. The scale has a validated screening cut-off of 21, which the bands below use as a boundary:

Because the score spreads across six areas, two people with the same total can look completely different. A total of 24 concentrated entirely in checking is a different picture from 24 spread thinly across all six, and the pattern is often more informative than the number.

4)What your score means, and what it doesn't

A single score is a snapshot of the past month, not a label and not a diagnosis. Symptoms rise and fall with stress, sleep, and life events, so the direction your score moves matters more than any one reading. A score above the threshold means an assessment is worth having, not that you have OCD.

Two limits are worth naming. First, the hoarding items on this scale predate the recognition of hoarding disorder as a separate condition, so a total driven mainly by those three questions may point somewhere other than OCD. Second, obsessive-compulsive disorder is not the same as obsessive-compulsive personality disorder, despite the names: OCPD is a pervasive style of perfectionism and control that the person generally does not experience as unwanted, whereas OCD symptoms feel intrusive and unwelcome to the person having them. The scale also cannot see how much of your day this takes, which is a large part of how severity is actually judged.

5)What to do next

• Minimal or mild: it is worth watching whether any habit is drifting from preference towards obligation, particularly if it is growing in time or spreading to new situations.
• At or above the threshold: speak with a doctor or therapist and ask specifically about OCD. Bring the score and, more usefully, a rough estimate of how much time per day the thoughts and rituals take.
• High: the same step, sooner. Exposure and response prevention, a specific form of CBT, is the leading psychological treatment, and SSRIs are an established medical option. Both work, and they work better together than either alone for many people.
• In every case, resist the pull to research reassurance online. For OCD specifically, compulsive checking and reassurance-seeking make symptoms worse, and searching symptoms is one of the most common forms it takes.

OCD overlaps heavily with anxiety, and intrusive worry is a common thread through both. If general worry rather than rituals is the bigger part of your picture, the free anxiety test (GAD-7) and the free overthinking test are better starting points.

If you are struggling to cope, or you are having thoughts of harming yourself or feel in immediate danger, please contact local emergency services or a crisis line you trust right now. You do not have to manage this alone, and reaching out is a sign of strength, not weakness.

6)Why tracking symptoms over time helps

OCD is unusually responsive to context, and that is easy to miss while you are inside it. Symptoms tend to climb with stress, poor sleep, and uncertainty, and to ease when those settle, but the climb is gradual enough that the current level always feels like the normal one. A record makes the slope visible. Tracking your anxiety and mood alongside everyday factors also gives a therapist something far more useful than recollection to work from, since treatment progress in exposure work is measured in exactly this kind of week-to-week movement. Andy is built around that loop: a quick daily check-in, and a clear view of how your mood and anxiety move over the weeks.

7)About this test

This test uses the Obsessive-Compulsive Inventory–Revised, an 18-item self-report measure validated for screening and symptom monitoring. This page is intended for self-check and education only. It does not store your answers and is not a substitute for professional care or diagnosis. Source: Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, Salkovskis PM (2002), The Obsessive-Compulsive Inventory: Development and validation of a short version, Psychological Assessment. Last reviewed September 2026.