What is the Difference Between OCD and OCPD?

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Obsessive compulsive disorder, or OCD, affects about 1 in 40 adults [1], making it fairly common. Despite its prevalence, though, people often misunderstand the complexities of this mental health condition due to misinformation, stereotypes, and lack of mental health education. Additionally, OCD and OCPD—Obsessive-Compulsive Personality Disorder—often get lumped together as the “same” condition. Although these disorders share some commonalities, they are different disorders and should be treated as such. In this blog, we’ll dive into the world of OCD and OCPD, explaining each disorder and tips for treatment. 

What is OCD?

OCD is a mental health disorder that occurs when a person has persistent and distressing unwanted thoughts (obsessions) that lead them to perform a series of repetitive behaviors (behaviors) to relieve the anxiety that comes with the thoughts [2]. This creates a time-consuming cycle based on doubt and fear, which is why struggling with OCD makes day-to-day activities so difficult for people struggling with OCD. 

There are many different types of OCD. One type you’ve likely heard of due to its common portrayal in the media is “Contamination OCD” [3]. This type of OCD manifests itself in fear of becoming “contaminated” by germs, dirt, or disease. It also often involves a fear of possibly contaminating others. Someone with Contamination OCD may experience persistent intrusive thoughts about catching a serious illness or passing this illness to a person they love, resulting in repetitive behavior of washing their hands whenever they have this thought.

Other types of OCD are less commonly known, like “Symmetry and Order OCD” or “Taboo OCD” [4]. People with the symmetry and order type of OCD feel an incessant need for certain things to be arranged in a very particular way for things to feel “just right.” This isn’t based on neatness—it’s based on alleviating distressing thoughts. For example, someone with this type of OCD can have any sort of fear and attempt to alleviate the anxiety they get from this fear by making sure their handwriting lines up the height of each letter, their shoes are tied in the exact same way, or their car is parked perfectly straight in their driveway. Even though the fear and the action may not be related, their brain makes sense that this action will “prevent” the thought from coming true. Taboo OCD works in the same way—people with this type of OCD may have a random thought come into their head about them doing something dangerous or morally unlike them, and try to prevent the thought from “becoming true” by performing compulsions. 

It is important to note that people with OCD often understand that their obsessions and compulsions are irrational [5]. However, logic does not ease the anxiety in their minds. They still feel the unbearable urge to perform compulsions. The unfortunate thing is that the more one participates in compulsions, the worse their anxiety becomes. This is because every time they perform the action and it results in a small, but fleeting, relief from the anxiety, it reinforces that the compulsion makes the anxiety go away [5]. So, when an anxiety-inducing thought inevitably returns, their brain and body will think that the only way to get rid of the anxiety is to perform the compulsion—creating an endless cycle. 

What is OCPD?

Obsessive-Compulsive Personality Disorder is marked by an extreme preoccupation with orderliness, control, and perfectionism [6]. They have strict beliefs that things need to be done correctly and perfectly. While people with OCD struggle with unwanted thoughts, people with OCPD don’t exactly view their thoughts as unwanted—they have very black-and-white thinking and simply view their thoughts as correct. People with OCPD often lack insight that they even have the disorder. They don’t realize that their behavior or way of thinking is out of the ordinary or problematic. 

Someone with OCPD often has an overarching fear of doing something wrong or failing. To combat this, they practice extreme perfectionism—following rules and instructions to a T, experiencing excessive doubt or trouble making decisions, being unwilling to compromise, and becoming overly fixated on a particular task or idea. They are often high achievers due to their devotion to doing things “right.” But, their rigidity and inability to compromise often make them difficult to work with. 

Where do they overlap?

OCD and OCPD share a few commonalities, although they are different disorders. For one, people with OCD and people with OCPD often share an intense need for perfection and control. People with OCD feel this need for perfection to prevent intrusive thoughts from coming true or causing immense anxiety, while people with OCPD feel this need for perfection because they believe this is the only right way to do things. 

Both disorders involve anxiety and distress as a symptom. When someone with OCD isn’t able to perform their compulsion correctly or at all, they feel excruciating anxiety and distress. When someone with OCPD isn’t able to do things in the way they think is correct, they can become extremely anxious and distressed as well. 

Finally, both disorders can create difficulties in relationships. Many people have a hard time understanding the diversion from logic that comes with OCD and OCPD, which can make it hard for them to tolerate. OCD and OCPD can be very time-consuming, which can put a strain on relationships, as well. 

Where do they differ? [7]

The main difference between OCD and OCPD is that OCD consists of intrusive and unwanted obsessions, leading to compulsions, while OCPD consists of rigid and perfectionistic personality traits. While people with OCPD may partake in similar compulsive behaviors to people with OCD, they do not experience the same intrusive thoughts and unwavering need to complete compulsions to disprove or get rid of the thought. 

People with OCD suffer with their intrusive thoughts, desperately wanting them to go away or not come true. On the other hand, people with OCPD think that their beliefs help them reach their goals and live life the “correct” way. 

OCD also tends to fluctuate throughout one’s life, flaring up in times of high stress and winding down when someone is in a calm and healthy mental state. OCPD symptoms, on the other hand, tend to stay the same throughout one’s life.

Tips for OCD treatment

Exposure and Response Prevention (ERP) Therapy is known as the “gold standard” for treating OCD [8]. In this type of therapy, the therapist will gradually expose you to the fears present in their intrusive thoughts without allowing you to perform compulsions [9]. This slowly un-associates the behavior with the thought/anxiety and teaches you to sit in discomfort and anxiety without feeling a need to perform compulsions. 

Many professionals will also prescribe selective serotonin reuptake inhibitors (SSRIs) to those struggling with OCD to help alleviate anxiety and decrease the number of intrusive thoughts that “stick”. 

Other things can help improve OCD, which can be done in tandem with therapy. Getting quality sleep, practicing mindfulness, talking to a supportive loved one, and being patient with yourself can all help with coping with the anxiety that comes with OCD. 

Tips for OCPD treatment

Psychotherapy is often the type of therapy most recommended to those with personality disorders, as it helps uncover the unconscious or subconscious motivations behind their beliefs and behaviors [10]. This is often paired with medications, like SSRIs and other anti-anxiety medications [11]. 

It is also recommended that, along with therapy, people with OCPD practice a few healthy habits on their own. They can practice self-compassion, regulate their emotions healthily, and reach out for help from their support system. However, it is important to note that OCPD, like other personality disorders, may be harder to treat than anxiety disorders. This is because people with personality disorders see fewer flaws in their thought patterns and behaviors, and are often less susceptible to changing [12]. But, with hard work and persistence, treatment may be successful. 

All in all, there are many differences between OCD and OCPD. Hopefully, you now understand the intricacies of these 2 disorders and can distinguish them!

To discuss how therapy could help you during this season of your life, please contact me or schedule your free 15-minute consultation.

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