OCPD vs OCD: Causes, similarities, and differences

When it comes to finding the right mental health support, getting an accurate diagnosis is an important first step. But since many mental health conditions share similar symptoms, people are often understandably confused about their experience.  For example, obsessive, intrusive thoughts and compulsive behaviors are usually associated with obsessive-compulsive disorder (OCD). But they’re also features of a similar condition called obsessive-compulsive personality disorder (OCPD).  So how can you tell the difference between the two? While it may seem complicated, you don’t have to figure it out on your own. A mental health professional can provide an evaluation and diagnosis to ensure that your treatment plan accurately reflects your needs. 

What is OCD?

According to the National Institute of Mental Health, OCD is “a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (“obsessions”) or behaviors (“compulsions”) that they feel the need to repeat over and over.”  Everyone experiences unwanted, negative, or “nagging,” thoughts from time to time. But the pervasive cycle of obsessions and compulsions caused by OCD can make it difficult to manage your daily responsibilities and enjoy life. Obsessions and intrusive thoughts can take many forms, depending on the individual. Some of the most common include:

• Fears of being hurt or harming someone else
• Repeated sexual or inappropriate thoughts 
• Fears of saying or doing something embarrassing
• Worries that you did or didn’t do something that could have a negative result (like not turning off the stove)

Having intrusive thoughts is a deeply uncomfortable experience. So in order to resolve that discomfort, a person living with OCD engages in ritualistic or compulsive behaviors. These behaviors are considered compulsive because, to the affected person, they don’t feel optional, even if there are negative consequences. Some examples of compulsions that may occur after someone experiences one of the intrusive thoughts listed above include:

• Repeatedly sanitizing surfaces for fear of infection or germs
• Performing mental rituals to “cleanse” oneself of inappropriate thoughts
• Repeatedly asking for reassurance or repeating certain words over and over in your head
• Making frequent checks, sometimes multiple times per day, to ensure doors are locked, the stove is turned off, etc. 

While the underlying cause of OCD is still not fully understood, research has shown that genetics may play a significant role. One study found that if a person has OCD there’s a greater chance that a close relative will also develop the condition. In addition, researchers have identified certain brain abnormalities that may be linked to OCD.

What is OCPD?

According to the International OCD Foundation, OCPD is characterized by a rigid adherence to rules, an overwhelming need for order, and an inflexible belief about the “way things should be done.” At first glance, you can probably see why OCPD is often confused with OCD. But having OCPD isn’t just about having a strong point of view or seeing yourself as a perfectionist. OCPD is a personality disorder whose trademark rigidity is so entrenched that it typically leads to significant problems in your professional and personal life. Some common symptoms of OCPD include:

• Preoccupation with rules and details
• Rigidity and stubbornness
• Constantly prioritizing work over pleasure or important relationships
• Hoarding behaviors
• Extreme frugality (without actual need)
• Fixation with order and minor details
• Difficulty finishing tasks due to perfectionist tendencies

The exact causes of OCPD aren’t fully understood and more research is needed to help us better understand the condition. But, like OCD, it’s likely that genetics, brain development, and environment play a role in the development of OCPD.

Key differences between OCPD and OCD 

Two of the main differentiators between OCPD and OCD involve the level of awareness and a desire for control. Often, people living with OCD recognize that their intrusive thoughts and compulsions are irrational and they aren’t fixated on controlling others. They may feel trapped by their thoughts and behaviors. But people living with OCPD tend to see their rigid desire for order and doing things “their way” as completely rational.  For example, a person living with OCD might spend hours putting their books on their bookshelves in the “right” order because they worry something bad will happen if they’re out of place. The person knows that their fear is irrational and they wish they didn’t have these strong feelings. But in order to avoid discomfort, they maintain their ritual of organizing their books over and over again, sometimes for hours at a time. On the other hand, a person living with OCPD might believe they know the “right” way to organize books, seeing any other method as “wrong.” They spend hours organizing their books to their standard and they get angry or upset if anyone touches their books. They also judge other people who organize their books in a different way and see no issue with their behavior. Unlike the person living with OCD, they don’t feel trapped by their thoughts or behaviors and they may even feel proud of them.

Get the support you need with Rula 

Left untreated, both OCD and OCPD can lead to mental, emotional, and behavioral problems that can disrupt daily functioning and leave a lasting impact on your life.  But with help from Rula, you can connect with a therapist who offers the specialized care you need to manage your condition and strengthen your mental health. With over 5,000 licensed therapists to choose from, our team can match you with a provider who takes your insurance and offers support for OCD, OCPD, and over 80 other clinical specialties.  Through talk therapy, you can gain insight into how OCD or OCPD is affecting your life and learn the coping tools you need to manage your condition. Learn more about Rula, and access care in as little as two days.