OCD vs. OCPD: A Comparison

Obsessive-compulsive disorder is receiving a great deal of attention, both professionally and from the general public. With more individuals wondering whether they might be suffering from this disorder (and about possible treatment options), the somewhat related obsessive-compulsive personality disorder is also being considered by patients and their treating mental health professionals. OCD vs. OCPD: how do they compare and contrast? Read on to find out.

OCD vs. OCPD

Obsessive-Compulsive Disorder: A Nagging, Disturbing Fixation

According to the American Psychiatric Association (APA), obsessive-compulsive disorder, or OCD, is a mental health disorder that combines anxiety-inducing thoughts and behaviors.

OCD acts like an overactive survival system: instead of registering a concerning thought or stimulus, the individual experiencing this condition begins to obsess over them: noticing some dirt under one’s fingernails triggers hysteria that all the food in the refrigerator has been spoiled; forgetting to wear a coat causes them to believe they will catch pneumonia and die. A benign issue can become the center of their focus, exhausting them with an unrelenting fear or rumination.

The four most common OCD-related obsessions are:

  • Cleanliness and contamination concerns.
  • Symmetry and “just right” thinking.
  • Catastrophizing that a terrible occurrence will befall themselves or a loved one.
  • Taboo thoughts about socially transgressive or unacceptable actions.

Obsessive-Compulsive Disorder

In an effort to assuage their overwhelming and adverse obsessions, individuals with OCD often begin carrying out certain rituals, aimed at distracting them and calming their anxiety. While at first such actions—which can include anything from repeatedly touching the doorknob to locking and unlocking their phone—do offer some relief, eventually these ceremonies are incorporated into their OCD pattern. At this point, instead of calming them down, individuals contending with OCD feel compelled to continue repeating these actions, believing that otherwise they will face the intolerable angst and anxiety brought on by their condition. An incredibly frustrating cycle of obsessive thoughts and compulsive patterns is then established.

As can be gleaned from the above description, OCD can be a very unpleasant disorder to experience. The resulting disruption to one’s day can become incredibly time-consuming, completely take over their thinking, exhaust them through repetitive ceremonies and rituals, and impair their ability to function in familial, occupational, and other significant social spheres.

2.3% of US adults, as well as 1%-2.3% of US children and adolescents, experience OCD. It is yet unclear whether OCD appears equally in males and females, or whether females are slightly more affected than males. The condition’s symptoms usually appear between ten years of age and early adulthood. Due to it often being mistaken for harmless eccentricity, on average patients with OCD are only diagnosed and begin receiving treatment around ages 14-17.

Obsessive-Compulsive Personality Disorder

A more encompassing disorder than OCD, obsessive-compulsive personality disorder, or OCPD, affects the very core of how the individual experiencing it views and understands themselves and the world around them. It is characterized by perfectionism, order, and ironclad control.

Those with OCPD are usually described as being incredibly focused on rules, lists and schedules, constantly hammering home their importance to themselves and to those around them. They reject any chance (or request) that they show a little flexibility, and instead insist that every chore and assignment be carried out flawlessly. They will be unwilling to “let go” and be satisfied with an adequate result, even at the expense of not completing a task in time. They will often refuse to delegate an assignment to others, unless they are guaranteed that its specifics will be carried out exactly according to their own vision.

As a result of their strict, perfectionist and inflexible attitude, those with OCPD tend to forgo leisurely activities and either do not leave time for cultivating meaningful friendships or are unable to do so.

Individuals with OCPD are often judgmental, moralistic, and willing to entertain the possibility of special circumstances warranting greater lenience. They can also be miserly, stubborn, and unwilling to budge from a certain stance or way of doing things.

All of this is to say that OCPD can be an incredibly unpleasant condition—but not necessarily to the individual experiencing it, as much as it is to those around them. Having to deal with a “control freak” who will not relinquish a bit of control can cause others to feel helpless, infuriated, worthless, or paranoid as a result.

The individual with OCPD, however? They often remain ensconced in their original position, believing themselves to be completely in the right, about everything, viewing those around them as lazy, dirty, incompetent, or some other description that positions themselves above the rest.

Time can go by without progressing in a given task, due to an individual with OCPD painstakingly going over each and every detail, again and again, to make sure it cannot be improved upon. Others around them may be driven out of their minds as their group efforts are delayed, but there is no convincing them; all must be perfect before they will sign off on it. Situations that require flexibility or compromise can leave them incredibly distressed and unable to proceed.

Individuals with OCPD typically adopt a reserved, and standoffish attitude, even toward those they care about. They can be uncomfortable with public displays of affection and express their feelings in a controlled and stilted manner.

Their interpersonal need for control can be even more oppressive as a parent: every bicycle ride, every homework assignment, every school play, become a hyper-critical opportunity to teach their child the value of “getting it right,” i.e., carrying out a certain goal without making a mistake. No complaining is tolerated, since children must learn how to excel from a young age in order to make it in the real world.

As tyrannical as all that might sound, those with OCPD can be the most critical toward themselves. They must defer to all forms of authority, regardless of how they are treated by them. All of their own mistakes are internally rehashed, dissected and reviewed, so they may never happen again. They must uphold the strictest forms of morality, and never waver in their devotion to their own code of ethics. They also find it difficult to come to a final decision, finding the decision-making process to be incredibly unnerving and destabilizing, to the point where important deadlines are missed and goals are never realized.

OCPD is one of the most common personality disorders in the general population, with estimated 2.1% to 7.9% prevalence. It has been found to be twice as common among males than females.

Obsessive-Compulsive Personality Disorder

OCD and OCPD Comorbidity

Individuals with OCD have an increased likelihood of also having OCPD. That said, the majority of those with OCD do not have a pattern of behavior that fits with OCPD.

A key difference between OCD and OCPD has to do with whether the individual themselves feels they have a problem: those with OCD often do. Many of those with OCPD, though, despite contending with a great deal of self-criticism and self-inflicted pressure, believe the only problem is that they are not always able to meet the high standards they and everyone else must reach. It is this perception of imperfection as unacceptable, as opposed to a disturbing area of thought that is forced upon them, that truly separates the overarching OCPD from the more specific OCD.