OCPD vs. OCD: What’s the Difference?

When you look at OCPD vs OCD, they may sound like very similar conditions thanks to their abbreviated names. However, they are actually two very different conditions with their own set of symptoms and treatment plans. Here, we’ll talk about how to tell the difference between OCD and OCPD. This guide can significantly help you or a loved one get the appropriate treatment for symptoms that may manifest as part of either condition. Let’s explore the differences between obsessive-compulsive disorder and obsessive-compulsive personality disorder.

What is OCPD?

Obsessive-Compulsive Personality Disorder (OCPD) is a personality disorder that is characterized by the need for control, perfectionism, and inflexibility. People with OCPD may experience feelings of distress when they do not meet their own strict standards, which makes it challenging for them to work with others.

OCPD is not the same as Obsessive-Compulsive Disorder (OCD), though the two may sometimes be confused for each other.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a common anxiety disorder that is characterized by intrusive thoughts (obsessions) and repetitive behaviors or rituals (compulsions). These compulsions are used by individuals with the condition to reduce the anxiety caused by their obsessions.

Unlike the perfectionism associated with OCPD, OCD is more about managing the discomfort and distress of intrusive thoughts.

What’s the Difference Between OCD and OCPD?

OCD is classified as a mental health disorder, while OCPD is a personality disorder. The latter is a lifelong disorder that can affect thoughts, moods, and behaviors.

While OCD is marked by intrusive, recurrent, and unwanted thoughts and repetitive behaviors, OCPD is more about the desire to be in control. OCPD traits tend to be persistent over time, while OCD symptoms can fluctuate with anxiety.

OCPD vs. OCD Causes

The cause of OCPD is unknown, but many researchers have hypothesized that a combination of genetics and early childhood experiences causes it. Some studies have reported adults experiencing symptoms of OCPD from a very early age, citing the need to feel like a perfectly obedient child. Such thoughts and behaviors end up carrying over into adulthood [*].

Similar to OCPD, the exact causes of OCD are unknown, but a family history of the condition may play a significant role in its development; people with family members who have OCD are more likely to have it as well. Impairment in certain areas of the brain as well as irregular development, have also been linked to OCD [*]. Other evidence suggests that OCD is also caused by how the brain responds to serotonin [*]. Like OCPD, OCD in children can develop.

OCPD vs. OCD Risk Factors

Some risk factors may make individuals more susceptible to developing this condition, including:

• Having a family history of personality disorders, depression, or anxiety
• Having a pre-existing mental health condition, particularly anxiety disorders
• Experiencing childhood trauma, including child abuse, which may lead to feeling like being “perfect” is the only way to survive

OCD risk factors are similar to OCPD risk factors. They include the following:

• Having a family history of OCD, especially relationships with a first-degree relative who has OCD.
• Brain imaging studies have revealed that there are differences in brain functioning between people with OCD and individuals without the condition [*].
• Childhood trauma, such as child abuse, can influence the severity of OCD later in life [*].

OCPD vs. OCD Symptoms

There are some similarities in the symptoms of OCPD and OCD, such as repetitive thoughts, perfection, and excessive organization. However, symptoms of OCPD can be more intense and disruptive. Let’s look at the differences between these two disorders in terms of symptom expression.

Individuals with OCPD tend to focus on getting perfect results for themselves and others by creating specific rules and maintaining orderliness in their environments. Common symptoms of OCPD include the following:

• Performing at such a level so they can achieve lofty professional and personal goals
• Poorly receiving constructive criticism
• Not being able to grasp others’ points of view fully
• Needing excessive structure and order
• Constantly pursuing perfect results to the point where they are not able to complete the task at hand

The main symptoms of OCD are obsessive thoughts and urges that are followed by compulsive behaviors, which are usually time-consuming and cause anxiety and distress. Some typical OCD obsessive symptoms might include the following:

• Fear of germs or contamination
• Aggression toward the self and others
• The need to make things perfect or symmetrical
• Unwanted harmful, religious, or sexual thoughts

OCD compulsion symptoms may include the following:

• Excessive cleansing, such as hand washing
• Placing things in a very particular order
• Checking things repeatedly, such as locking doors or whether appliances are turned off
• Arranging objects in a specific way
• Constantly counting

Diagnosing OCPD vs. OCD

To diagnose OCD, a mental health professional will ask a series of questions related to specific factors like obsessions and compulsions. They will then assess your symptoms using the Diagnostic and Statistical Manual of Mental Disorders (DSM). To be diagnosed with OCD, obsessions and compulsions must be time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress in various areas of functioning [*].

Diagnosing OCPD will require individuals to answer a screening questionnaire, similar to diagnosing OCD. To receive an OCPD diagnosis, an individual needs to exhibit four or more out of eight symptoms as listed below [*]:

• Perfectionism that causes issues with finishing tasks
• Neglecting relationships due to an over-commitment to work
• Obsessing over values, ethics, and morality
• Hoarding money for worst-case scenarios
• Refusing to assign tasks without a guarantee that they will be performed exactly as asked
• Difficulty parting with worthless items
• A rigid or stubborn disposition
• Obsession with keeping order by using rules, lists, and schedules

In addition to meeting the number of symptoms above, said symptoms must also have been present in a long-term pattern of behavior that formed before early adulthood. Mental health professionals will also rule out similar disorders, such as OCD. They can be difficult to tell apart, but consulting a qualified professional is crucial for you to get a formal diagnosis and take the right steps moving forward.

Treating OCPD vs. OCD

OCPD and OCD have similar treatment methods. Both conditions are treated with psychotherapy, prescription medication, or a combination of both. Lifestyle changes may also be implemented to address the symptoms of OCPD and OCD.

Common medications for OCD include serotonin reuptake inhibitors (SSRIs), such as the following:

• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
• Paroxetine (Paxil or Pexeva)
• Sertraline (Zoloft)

Sometimes, tricyclic antidepressants (TCAs) and benzodiazepines are used to treat OCD if SSRIs are not effective.

As for psychotherapy, cognitive behavioral therapy (CBT) and its subdiscipline called exposure and response prevention (ERP) are very helpful in treating OCD. Both types of therapy help individuals with the condition understand how obsessive thoughts influence their behaviors.

Unfortunately, obsessive-compulsive personality disorder has not been studied as extensively as obsessive-compulsive disorder has been. While there are no medicines created specifically for OCPD, some doctors will prescribe the same SSRIs to treat OCPD symptoms. The same goes for therapeutic interventions, as CBT and ERP are used to treat OCPD as well.

Coping with OCPD vs. OCD

Excessive perfectionism and the inability to delegate tasks that come with OCPD can cause a great deal of stress, while rigidity, high expectations, and low empathy can affect relationships. In addition to seeking treatment, here are some coping strategies you can use for OCPD:

Educate yourself. Learning more about this condition can be an empowering experience, helping you notice your symptoms so you can take the appropriate action steps.

Stress management. Keeping your stress levels low is always good for your mental and physical health. Try developing a plan to reduce stress to cope with different situations.

Practice self-care. For people with OCPD, it may be easy to neglect oneself while focusing on a project. Consider having a self-care routine as part of your day.

Mindfulness and meditation. Mindfulness can help individuals with OCPD recognize when perfectionism is causing anxiety. Meditation can reduce anxiety and obsessive thoughts, making it an effective stress reliever.

Obsessions and compulsions can be disruptive to a person’s daily functioning, so finding effective ways of managing one’s symptoms of OCD is essential. There are several ways that you can cope when it comes to OCD; here are several of them.

Journaling. Journaling about your thoughts is a helpful way to manage getting triggered by an obsession or compulsion. It allows you to get the thoughts out of your head and express them in a healthier way rather than repressing them or allowing the compulsions to take over. This is especially helpful for OCD in teens and adults.

Regular exercise. Research has found that exercise improves mood and reduces anxiety and urges to engage in compulsions [*]. There aren’t many findings on which type of exercise is best, but what is important is to start moving your body.

Can Someone Have Both OCPD and OCD?

While OCPD is more common the OCD, some individuals can be diagnosed with both conditions. People with both OCPD and OCD experience more severe symptoms and greater levels of distress.

Are There Similarities Between OCPD and OCD?

OCPD and OCD symptoms can overlap. For example, some people with either disorder may focus on order, perfectionism, and organization. Despite the overlap, there are ways to distinguish between them.

OCD is a mental disorder that involves obsessions and compulsions, leading to distressing thoughts and behaviors that fluctuate with the level of anxiety. OCPD is a personality disorder that is not driven by obsessions or compulsions with generally persistent behaviors.

The Bottom Line

Distinguishing the difference between OCD and OCPD may be challenging at first, but there are distinct differences between these two disorders that require more nuanced approaches. Aside from the aforementioned treatment options and coping techniques, you can also use tools like anxiety worksheets and CBT worksheets to keep OCD and OCPD at bay, respectively. It is always important to consult a mental health professional regarding any OCD or OCPD-related symptoms to ensure you get the right treatment.

References:

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2. National Institute of Mental Health. Obsessive-Compulsive Disorder. September 2022.
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6. Substance Abuse and Mental Health Services Administration. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health. June 2016.
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8. Landau M. Why It’s Smart to Stay Active When You Have OCD. 3 September 2019.