September 22, 2020

OCPD vs. OCD

Although the terms are often used interchangeably, OCPD and OCD are two dramatically different mental health conditions. OCPD is a personality disorder characterized by rigid adherence to rules and order. OCD is an anxiety disorder defined by the desire to suppress or control overwhelming urges.

Both conditions, if left untreated, can be debilitating. They can impact someone’s physical and mental health, relationships, and work performance. Let’s get into what you need to know.

What is OCPD?

OCPD stands for obsessive-compulsive personality disorder. Research shows that about 1% of the US population struggles with this condition. 

Someone with obsessive-compulsive personality disorder (OCPD) often struggles with extreme perfectionism. That said, their behaviors extend beyond just doing things right. They overfocus on minor details, often disregarding the bigger picture. OCPD refers to a persistent pattern of preoccupation with orderliness, perfectionism, and control. This pattern comes at the expense of flexibility, openness, and efficiency.

Some children may experience this condition, but symptoms typically emerge in early adulthood. Since they always want to do everything a certain way, they have to make sure they are prepared with everything they need in specific situations. This rigidity and lack of spontaneity make it hard to form healthy relationships or maintain existing relationships. 

OCPD is an egocentric disorder, which means people enjoy having these rules and rigidity because it helps them avoid discomfort. They may not recognize that their way of living is problematic, particularly if they are high-achieving. 

It differs from OCD because they don’t have true obsessions and compulsions, just a rigid way of thinking and behaving and an unhealthy preoccupation with orderliness.

OCPD Symptoms 

  • Preoccupation with details, rules, lists, order, organization, or schedules.
  • Extreme perfectionism that interferes with task completion.
  • Excessive devotion to work and productivity to the exclusion of leisure activities, relationships, and friendships.
  • Being overconscientious, scrupulous, and inflexible in matters of morals, ethics, or values.
  • Hoarding things and being unable to discard worn-out or worthless items- even when they have no sentimental value.
  • Exhibiting reluctance to delegate tasks or to work with others-unless the group submits to their way of doing things.
  • Demonstrating extreme and irrational frugality and coming across as cheap or stingy in social settings.
  • Exhibiting pervasive patterns of stubbornness and rigidity in ways of thinking. 

What Are The Risk Factors for OCPD? 

Experts agree there isn’t a single cause for OCPD, but common risk factors include: 

  • Background of harsh discipline when growing up.
  • Being the oldest or only child.
  • Other mental health problems.
  • An abusive or unstable upbringing.
  • Traumatic experiences.
  • Genetics and family history. 

What Does Treatment Look Like For OCPD? 

People with personality disorders often struggle to understand how their condition impacts their well-being. As a result, they may not think to ask for help. They usually don’t see a problem with their thoughts or behaviors. 

Sometimes, they will enter treatment for related issues like poor self-esteem, anxiety, or depression. Loved ones may also initiate treatment. They may feel frustrated by the individual’s behavior and insist they pursue professional help.

While the person with OCPD may find comfort in having things done correctly, they may experience guilt or frustration with themselves. Additionally, they don’t want their loved ones suffering at their expense. 

Treatment can help. Talk with a medical professional and your loved ones to decide what the best treatment method would look like for you.

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Individual Therapy

Cognitive-behavioral therapy (CBT) can be extremely useful for individuals struggling with OCPD. CBT helps people identify and isolate distorted thoughts. For example, if someone struggles with believing they need to be perfect, a CBT practitioner may encourage them to reframe this thought to, “I can be good enough.” CBT also provides alternative coping skills and relaxation techniques to manage distress. 

Medication

Antidepressant medication like SSRIs can help with chemical imbalances associated with depression and anxiety. They can improve someone’s overall mood regulation- which can help with OCPD symptoms.

Group Therapy

OCPD can be incredibly isolating and shameful. It can be helpful for clients to understand that others think in similar ways. Group therapy provides a place for learning and practicing useful tools to manage difficult symptoms. It also offers tips for socialization. 

What Is OCD? 

Obsessive-Compulsive Disorder (OCD) is an anxiety disorder characterized by obsessions and intrusive thoughts. The person engages in different compulsions to deal with their anxious thoughts. OCD impacts approximately 2.3% of the US population (about 1 in 40 adults). 

People with OCD are driven by anxiety and typically struggle with inflexibility and rigidity. Their obsessive thoughts and compulsions can be incredibly consuming, which impacts their everyday lives. OCD is an ego-dystonic disorder, meaning people with this condition recognize the irrationality and wish to change it. 

The first part of OCD is obsessions. Obsessions are intrusive, anxious, and recurrent thoughts. Common obsessions include:

  • Having a fear of being contaminated by germs, dirt, or illnesses.
  • Experiencing superstitions about specific patterns, colors, or arrangements.
  • Fears of being punished by God.
  • Unwanted sexual obsessions or sexual urges that feel disturbing.
  • Fear of losing or forgetting something important.
  • Fear of accidentally hurting someone else because of something you didn’t do correctly.
  • Fear of losing control and saying or doing the wrong thing.

These obsessions can feel consuming. The individual often experiences immense guilt, anxiety, and fear over these thoughts. They know they are irrational and disproportionate to the situation- but they can’t seem to “turn them off.”

Compulsions temporarily ease anxiety. However, these compulsions are time-consuming and can also cause problems. For example, it might take an hour to leave the house, because they need to flip the light switch a certain number of times. This causes them to be late for work, so it disrupts their personal and professional life.

Some common compulsive behaviors include:

  • Counting in specific patterns. 
  • Hand washing.
  • Checking things, like a closed door or locked car.
  • Cleaning surfaces.
  • Organizing things symmetrically.  
  • Maintaining a tight, rigid schedule.
  • Turning lights off and on a certain number of times.
  • Repeating any specific action a certain number of times. 

The pattern typically resembles an order like this: 

“I am terrified of germs and getting sick.” (obsession).

I need to clean the toilet at least eight times before using it. If I do that, I will not contract germs (compulsion).

People with OCD struggle to control their thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive or irrational. They don’t experience pleasure when performing these compulsive behaviors but might feel temporary relief from the anxiety that the thoughts were causing.

What Are The Risk Factors for OCD?

Just like with all mental illnesses, there isn’t a single cause for OCD. However, some of the common risk factors include:

  • Having another anxiety disorder.
  • Having depression.
  • Growing up in an abusive or otherwise unstable household. 
  • Traumatic experiences.
  • Genetics and family history. 

It should be noted that OCD needs to cause significant distress in the individual’s life. There is a misconception that enjoying cleaning or organizing means the person has OCD. That isn’t true. In fact, most people struggling with OCD resent or loathe their compulsive behavior. They wish they could stop, but stopping it feels too scary. 

What Does Treatment Look Like For OCD? 

Fortunately, OCD is highly treatable. People with OCD usually want treatment since they experience such high stress levels about their thoughts and behaviors. Health professionals will typically recommend anxiety medication, therapy, or a combination of both. 

Individual Therapy

Exposure and response prevention (ERP)  is one of the most effective ways to treat OCD. ERP is part of CBT. 

Exposure refers to confronting the fears until they eventually subside. This subsiding is known as desensitization.

Response prevention refers to avoiding compulsions- even if the urge to use them is strong. 

Therapists use exposure therapy to help desensitize the obsessive thoughts. They usually achieve this by engaging in a fear hierarchy exercise. In this exercise, you work through a series of steps designed to habituate you to various fears. For example, let’s say you are afraid of burning the house down. As a result, you check to make sure the oven is turned off a dozen times. The therapist may have you practice checking only one time and then leaving the house. 

This therapy focuses on changing cycles that perpetuate the need to perform the compulsion. Therapists will work with the client to break the link and fight the urges and learn to deal with their anxiety and obsessions in different, healthier ways. 

They may also recommend homework, such as journaling or working through a CBT workbook. A CBT workbook helps clients work through their thought processes to eventually find different ways to cope with their anxiety and prevent the compulsive spiral.

Medication

Antidepressant medication, like SSRIs, can help reduce some of the intensity of obsessive thoughts. It can also help with overall mood and emotion regulation. Many people benefit from a combination of both medication and therapy. 

Group Therapy

Lastly, group therapy is beneficial because it helps to know you’re not alone in your anxieties and stress. Socializing in a healthy, supportive group can help clients find different ways of coping. It can help hold them accountable for practicing new behaviors. 

Before deciding on a treatment plan, talk with a trusted health professional about what is best for you and your situation.

How To Support Someone Who Has OCD or OCPD

It can be difficult at times to properly support someone with OCD or OCPD. You might experience feelings of isolation, guilt, shame, confusion, or helplessness. Overall, you want to ensure that your loved one is healthy and comfortable. At the same time, you don’t want to sacrifice your own well-being for their condition.

First, educate yourself about the disorder so you can understand their experiences. Talk to health professionals. Read up about the conditions online. This information helps you recognize their behaviors- it also helps you realize their symptoms are not necessarily intentional. 

When you talk to your loved one about their disorder, be gentle but firm. It’s best to be understanding of their struggles and show support. Avoid making harsh accusations or blaming them for causing you pain. 

Supporting Someone With OCD

Don’t enable the continuation of symptoms. It might be smart to set a boundary so that you don’t accommodate their compulsions.  For example, if you help your loved one clean when they unnecessarily feel the need to do so, you can choose to remove yourself from the situation. 

In this case, make sure you agree with the entire family on not being an accomplice in their behaviors. Present a unified front with others in the house so that they don’t try to accommodate them as well. 

That said, don’t shame the behavior. If you notice it, aim to be gentle.

I’m here for you if you need me.

I love you.

People with OCD already tend to feel bad about themselves. Perpetuating this shaming tends to isolate them further in their behaviors- it’s not an effective approach for sustainable change. 

Supporting Someone With OCPD

Remind your loved one that they don’t need to be perfect and that you love them exactly as they are. If their actions are impacting you, let them know how. That said, be understanding and portray a supportive and unified front with other family members. 

Sometimes, family therapy can help you understand your loved one and can help them learn how to manage their symptoms.  Family therapy also helps with boundaries, healthy communication habits, and emotional regulation skills. It teaches each person to be accountable for their actions within the dynamic. 

Final Thoughts

Understanding the differences between OCPD vs. OCD is important for individuals and their loved ones. It is possible to have both conditions, but most people tend to only fit within one category.

That said, treatment is available. If you or your loved one is struggling, reach out for support. Recovery is possible!

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Disclaimer: This information is not specific medical advice and does not replace information you receive from your healthcare provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or lifestyle choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

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