Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Undetected OCD symptoms: Signs you might be missing

By Taneia Surles, MPH

Aug 14, 2025

Reviewed byApril Kilduff, MA, LCPC

the symptoms of OCD: a cycle of obsessions and compulsions

Undetected OCD symptoms are signs of obsessive-compulsive disorder that may go unnoticed because they don’t match the common stereotypes of OCD. Instead of the more obvious symptoms, such as handwashing or repeated checking, these symptoms can be subtle, internal, or mistaken for personality quirks. When they’re missed, people may go years—sometimes decades—without a diagnosis or effective treatment.

OCD affects about 1 in 40 people, but studies show that many live with symptoms for 14 to 17 years before getting the right help. Understanding the lesser-known signs is the first step toward finding relief.

What are undetected OCD symptoms?

Undetected OCD symptoms are obsessive thoughts and/or compulsions that aren’t immediately recognized as OCD.

This can happen when:

  • The compulsions are mental instead of physical
  • The symptoms overlap with other conditions
  • The fears are taboo, embarrassing, or difficult to describe

Because these symptoms don’t match the “neat and tidy” stereotype, they can be misdiagnosed—or not diagnosed at all.

Examples of OCD symptoms that might go unnoticed

Here are a few OCD symptoms that may go undetected:

1. Compulsive rereading

Some people with OCD feel the need to excessively re-read text messages, books, or work documents, to make sure they didn’t miss anything important or make a mistake. This can consume significant time and cause frustration, even though the content was understood the first time it was presented.

2. Constant scrolling

Endlessly scrolling through social media or Google search results can be more than a bad habit—it can be a compulsion driven by the desire to find reassurance, certainty, or the “perfect” answer to an intrusive doubt.

3. Excessive confession

OCD can cause people to confess perceived mistakes, flaws, or intrusive thoughts to friends, family, or partners repeatedly. “It feels urgent and that you’re ‘not being totally honest’ if you don’t do it,” says Tracie Ibrahim, LMFT, CST, NOCD’s Chief Compliance Officer. 

4. Sleep disturbances

OCD can make it hard to fall asleep or stay asleep due to racing, intrusive thoughts. You may lie awake replaying conversations, mentally checking for mistakes, or seeking certainty before you can rest.

5. Disturbing “what if” thoughts

OCD can cause vivid, unwanted mental images or scenarios—like harming a loved one or blurting something offensive—that feel shocking and out of character. Because there are no outward behaviors, others may have no idea these thoughts are happening.

6. Doubts about identity or relationships

Some people experience obsessive doubts about their sexuality, gender identity, or whether they truly love their partner. These intrusive questions often lead to many hours of mental checking and reassurance-seeking that others are never aware of.

Who is most likely to have undetected OCD?

It’s more common in people who:

  • Experience mostly mental compulsions
  • Have intrusive thoughts that they feel ashamed of
  • Live in cultures or families where mental health isn’t openly discussed
  • Have overlapping symptoms with other conditions

How is undetected OCD diagnosed?

A trained mental health professional can diagnose OCD through:

  • Structured interviews about intrusive thoughts and compulsive behaviors
  • Assessment tools like the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Dimensional Obsessive-Compulsive Scale (DOCS), and Obsessive-Compulsive Inventory-Revised (OCI-R)
  • Differential diagnosis to rule out other conditions

Treatment for undetected OCD symptoms

The most effective treatment for OCD—including undetected symptoms—is exposure and response prevention (ERP) therapy. ERP is a specialized form of cognitive behavioral therapy (CBT) proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms. ERP helps you face your fears and resist compulsions in a structured way.

Studies show that ERP therapy is highly effective, with 80% of people with OCD experiencing a significant reduction in their symptoms.

Other approaches that may help include:

These are typically done in combination with ERP therapy, depending on the individual’s needs.

Severe or treatment-resistant OCD may benefit from the following therapies:

  • Intensive outpatient programs (IOPs)
  • Partial hospital programs (PHPs)
  • Residential treatment centers (RTCs)
  • Transcranial magnetic stimulation (TMS)
  • Deep brain stimulation (DBS)
  • Gamma knife radiosurgery (GKRS)

Find the right OCD therapist for you

All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.

Can OCD get worse if left untreated?

Yes. Without treatment, OCD symptoms can become more severe, time-consuming, and disruptive to daily life.

How to talk to a professional if you suspect you have OCD

When reaching out to a therapist or psychiatrist:

  1. Describe your thoughts and behaviors in detail
  2. Mention patterns, triggers, and how long they’ve been happening
  3. Share how much time you spend on them daily

Bottom line

Undetected OCD symptoms can be just as distressing as the ones people expect, but they often hide in plain sight—like compulsive rereading, constant scrolling, or intrusive thoughts about harm, identity, or relationships. Recognizing these signs early can shorten the time to diagnosis and make treatment more effective.

Key takeaways

  • Undetected OCD symptoms are often subtle, internal, or mistaken for habits.
  • Commonly missed signs include compulsive rereading, constant scrolling, excessive confession, sleep disturbances from rumination, and taboo intrusive thoughts.
  • Evidence-based treatments, like ERP therapy, medication, and ACT, can help address undetected OCD symptoms and put you on the path to recovery.

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