Most people are familiar with the most common signs of OCD; excessive hand washing, counting, checking things over and over again. But OCD can come in many different forms, and individual symptoms vary greatly from person to person. Because the full range of OCD symptoms are so poorly recognized, many who are struggling with OCD are misdiagnosed, diagnosed late, and often subjected to treatments that cause more harm than good. Whether you are wondering about your own symptoms or those of someone else, here’s a list of some of the lesser known (but still common) symptoms of OCD to look out for.

Checking for signs of a Hit and Run: Have you ever been driving your car and experienced the worry that you may have accidentally run over someone and unknowingly left the scene of an accident? If so, you’ve experienced a fairly common symptom of OCD. For people experiencing the fear of having left the scene of an accident, it can be impossible to shake the doubts that one of those bumps along their journey could have resulted from running over an actual person. These recurring doubts can force them to retrace their driving route over and over again, seeking assurance and certainty that they didn’t actually hit someone.

Figuring it Out: “Figuring it out” is a mental ritual that many people with OCD feel compelled to do. The goal is usually to think about things fully to the point of removing all doubt about certain OCD worries. For example, if you are struggling with doubts about your mental health, you may feel the need to “figure out” every single emotion and behavior you experience. You may ask yourself: Why was I sad this morning? Why do I seem to be confused right now? Why did I have trouble remembering that word just then? Given that these questions can be impossible to answer with absolute certainty, the “figuring it out” ritual can completely take over one’s thinking.

Acting as meek, quiet, and non-aggressive as possible: If you are struggling with the OCD fear that you might be a violent person who wants to hurt other people, you are probably feeling a strong urge to prove to yourself that you are not, in fact, going to hurt anyone. This can lead to developing a range of behaviors all aimed at removing all doubt about your peaceful nature. You may develop a quiet, whispered talking style, adopt a slow, non-aggressive manner of moving, and/or make efforts to avoid experiencing any aggressive emotions such as anger and agitation.

Re-reading: When you are struggling with OCD perfectionism around reading, you live with the need to “perfectly” understand whatever it is you are reading. This usually means reading each section of text over and over again until you fully, completely, perfectly understand it. Once your OCD is satisfied with your understanding, you can then move onto the next section of text only to begin the re-reading ritual over again with this next section. This can turn a short reading assignment into an hours-long exercise, and make it nearly impossible to read long chapters, essays, and books.

Re-writing: OCD can also make you feel the need to rewrite things over and over again until they are “perfect.” This can involve physically rewriting until your handwriting looks perfect. Or it can involve getting the language and verbiage perfect. Given that language is such an imperfect medium, having the goal of getting one’s writing “perfect” can make writing assignments virtually impossible to complete up to OCD’s standards.

Obsessive slowness: Some people struggling with perfectionism take a different strategy than repeating things over and over again until they are perfect. If you are someone struggling with obsessive slowness, you do things extremely slowly as a way to avoid making any mistakes. Over time, this behavior can generalize to the point where all actions are done slowly and it can begin to feel strange and unsafe to do anything at a normal or brisk pace.

Confessing: Individuals struggling with scrupulosity (fears of going to hell, of disappointing God, etc.) can sometimes develop a ritual of confessing every potential sin to another person (often a parent or spouse). Every time you don’t say the exact truth, every time you have a “bad thought,” every time you don’t say “bless you” after a sneeze, you get the urge to share this information with your designated person. For parents of children struggling with this form of OCD, the ritual can initially seem like a sign of good communication and honesty. That is, until it becomes an every day, or even an every hour, thing.

Conversational Rituals (making others say things a certain way, correcting others, etc): Conversations are an area of life where we have very little control. Sure, we control our part, but we have little to no control over what others say in response to us, and how they say it. If you are struggling with an OCD need to have things said a certain way, conversations can be severely frustrating experiences. You may develop a ritual of repetitively correcting the words and statements of others whenever they don’t meet certain standards. You may even train the people in your life to say things a certain way every time they interact with you. Unfortunately, these rituals can lead those around you to feel overly controlled, and can result in problems with social functioning.

Self-reassurance: Individuals struggling with OCD worries will often try to talk themselves out of their fears. For others observing this ritual, it can initially appear to be a good thing. A person saying “well, I don’t think I’m a bad person, because I’m usually very polite to everyone I meet” can appear to be practicing good reasoning skills, but in the case of OCD this is actually a ritual that is making OCD stronger. The problem is that the reassurance ritual is an attempt to achieve absolute certainty about the worry, and absolute certainty is almost never achievable. As a result, the reassurance ritual gets repeated over and over again, never actually achieving any lasting certainty.

Reassurance-seeking: One of the most common rituals for many sufferers of OCD is reassurance-seeking. This involves getting assurance from others in one’s environment that one’s OCD worries are unfounded. For some, this can involve asking direct questions (“Do I have a fever?”), but it can also be done by making statements and hoping others respond (“I hope I don’t fail this test.”). It can also involve simply being near others and paying attention to whether or not they appear anxious about anything (well, no one else seems concerned with the thunderstorm, so I guess I’ll be alright).

Policing others: When you are struggling with an OCD “need for fairness,” everyday situations that are not perfectly, completely fair can be highly triggering. A bad call during a dodgeball game at recess, someone else getting a nicer present than you, another child misbehaving and not getting punished for it; all of these things can be very distressing. And it can cause you to feel like you need to do something about it, whether that means confronting the perpetrator of the injustice, or telling a teacher or parent every time something “unfair” happens. Since the old adage that ‘life isn’t fair’ carries more than a grain of truth, not being able to tolerate unfairness can lead to severe and persistent problems in life, particularly in the social environment.

This is intended as a brief (and in no way exhaustive) introduction to the broad range of symptoms with which persons with OCD can present. If you, or someone you know, is struggling with any of these symptoms to the point that they are significantly interfering with life, this could be a sign of OCD and should be shared with a mental health or medical professional for further evaluation. Once properly identified, OCD is a highly treatable mental health issue, with most people experiencing significant relief from their symptoms with proper treatment.