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Mental Health Awareness: OCD and OCPD

The American Psychiatric Association describes Obsessive-Compulsive Disorder as “an anxiety disorder in which time people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.”

In the United States, about 1 in 40 adults and 1 in 100 children have OCD. And according to the World Health Organization, OCD is one of the top 20 causes of illness-related disability for individuals between 15 and 44 years of age worldwide.

The International OCD Foundation explains that “having OCD is not simply an overreaction to the stresses of life. While stressful situations can make things worse for people with OCD, they do not cause OCD. People with OCD face severe, often debilitating anxiety over any number of things, called “obsessions.” This level of extreme worry and fear can be so overwhelming that it gets in the way of their ability to function. To try to overcome this anxiety, people with OCD use “compulsions” or rituals, which are specific actions or behaviors. These compulsions are not activities a person with OCD does because they want to, but rather because they feel they have to in order to ease their fears. OCD is not about logic — it is about anxiety and trying to get relief from that anxiety.”

OCD is one of the most common mental illnesses that is frequently referred to in a casual, and incorrect, manner. People will refer to their “OCD” being “triggered” if a picture is crooked or their home isn’t to their standard of cleanliness.  This has diminished what those with OCD go through every day.

“Triggers related to cleanliness and symptoms related to washing make up only a small part of the range of OCD triggers and symptoms,” states the IOCDF. “People with OCD can have obsessions related to a wide variety of things, including losing control, hurting others, unwanted sexual thoughts, and many more. Similarly, the anxiety caused by these obsessions can be lessened by different compulsions, such as “checking” (e.g., re-checking door locks, repeatedly making sure the oven is off), “repeating” (e.g., doing the same action or ritual over and over to be sure it was done “correctly”), and “counting” (e.g., doing things in certain numbers, counting items to certain numbers).”

Obsessive-Compulsive Personality Disorder

Obsessive-Compulsive Personality Disorder (OCPD) is a personality disorder defined by a strict adherence to control, order, perfectionism, and control over one’s environment. This often is at the expense of flexibility and openness to new experiences. Those with OCPD tend to impose the same standards on others. If these standards are not met they may become extremely angry, indignant, or depressed.

It can be difficult for a person with OCPD to express their feelings, for form meaningful relationships.  Those with OCPD may withdrawal from social settings and become isolated.

Some of OCPD symptoms are:

• Excessive devotion to work that impairs social and family activities
• Excessive fixation with lists, rules, and minor details
• Perfectionism that interferes with finishing tasks
• Rigid following of moral and ethical codes
• Unwillingness to assign tasks unless others perform exactly as asked
• Lack of generosity; extreme frugality without reason
• Hoarding behaviors
(Provided by IOCDF)

OCPD affects an estimated 1 in 100 people in the United States.

OCD vs. OCPD 

Despite having similar names, OCD and OCPD are two separate and distinct mental illnesses, each with their own specific symptoms and characteristics.  The main difference between the two is that OCD is designated in the DSM within its own category called Obsessive-Compulsive and related disorders, while OCPD is considered a personality disorder.

IOCDF lists these comparisons for OCD vs OCPD:

What is the difference between OCPD and OCD?
• People with OCD have insight, meaning they are aware that their unwanted thoughts are unreasonable. People with OCPD think their way is the “right and best way” and usually feel comfortable with such self-imposed systems of rules.

• The thoughts, behaviors and feared consequences common to OCD are typically not relevant to real-life concerns; people with OCPD are fixated with following procedures to manage daily tasks.

• Often OCD interferes in several areas in the person’s life including work, social, and/or family life. OCPD usually interferes with interpersonal relationships but makes work functioning more efficient. It is not the job itself that is hurt by OCPD traits, but the
relationships with co-workers, or even employers can be strained.

• Typically, people with OCPD don’t believe they require treatment. They believe that if
everyone else conformed to their strict rules, things would be fine! The threat of losing a job or a relationship due to interpersonal conflict may be the motivator for therapy. This is in contrast to people with OCD who feel tortured by their unwanted thoughts and rituals, and are more aware of the unreasonable demands that the symptoms place on others, often feeling guilty because of this.

• Family members of people with OCPD often feel extremely criticized and controlled by people with OCPD. Similar to living with someone with OCD, being ruled under OCPD demands can be very frustrating and upsetting, often leading to conflict.

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