“Just Right”: Transitioning to College with Obsessive-Compulsive Disorder

Abstract

OCD symptoms often begin in childhood and the prodrome of OCD is typically characterized by nonspecific anxiety symptoms. As a result, OCD in youth can be mistaken for separation anxiety, generalized anxiety disorder, social anxiety, phobias, depression, psychosis, Tourette disorder, and even disruptive behavior disorders. While preoccupations and distress are common to all anxiety-based disorders, OCD is unique with core symptoms of obsessions (recurrent and distressing thoughts, images, or urges that are intrusive, unwanted and often lead to avoidance and/or compulsions) and compulsions (repetitive time-consuming behaviors or mental acts performed according to particular rules that serve to decrease distress from obsessions). This chapter describes a young woman with OCD who was initially misdiagnosed and entered college without a therapeutic support system. OCD symptoms centered around harm-based obsessions and so-called “just right” OCD symptoms. The discussion focuses on the importance of an accurate OCD diagnosis, effective treatments for OCD, and the need for a collaborative team approach to deliver optimal treatment.