OCD vs. OCPD: What’s the Difference?

Mental health care providers use the manual known as the DSM-5 to guide their diagnoses. This book is published and frequently updated by the American Psychiatric Association (APA). It contains information on symptoms, risk factors, diagnostic criteria, and more about all known mental health conditions.

The DSM-5 classifies OCD and OCPD differently, despite their similar names. While the classifications may seem meaningless at first, they help providers and patients alike understand these conditions.

What is OCD?

OCD is a mental health disorder characterized by obsessive thoughts and compulsive behaviors. Importantly, these intrusive thoughts and rituals make the patient feel distressed. This disorder can affect people across demographics

Until recently, the DSM-5 classified OCD under the umbrella of “anxiety disorders.” However, more research has shown that it is unlike any other anxiety disorder in many ways, so the APA moved it into a category of its own.

Obsessive thoughts are a hallmark of OCD. People with OCD have these thoughts about a variety of subjects. What distresses one person may not affect another. Obsessive thoughts may include:

• Fear of germs, dirt, or other contamination
• Unwanted intrusive thoughts, including those involving aggression, sex, or religion
• Intense stress when things aren’t where the patient believes they should be
• Trouble accepting uncertainty
• Unwanted thoughts about acting inappropriately or dangerously

People with OCD experience compulsions that are usually related to their obsessive thoughts. The compulsions lead people with OCD to perform rituals in hopes of relieving the anxiety from the obsessive thoughts. People with OCD feel compelled to complete these rituals, even if it negatively impacts their lives.

What is OCPD?

OCPD is a personality disorder that causes people to need rigid rules, order, and control over all situations. People with this disorder often feel righteous for doing everything the “right way,” and expect others to adhere to their strict standards.

As the name suggests, the DSM-5 classifies OCPD under the category of personality disorders. This umbrella term includes three subcategories: suspicious, emotional/impulsive, and anxious personality disorders. OCPD falls into the anxious subcategory alongside avoidant personality disorder and dependent personality disorder.

People with OCPD may:

• Work to the point of ignoring social and family obligations
• Exhibit hoarding behaviors
• Fixate on rules, lists, and small details
• Not give generously or spend frivolously, even when they can
• Have such perfectionistic tendencies that it’s hard to complete tasks
• Follow a rigid set of values and morals
• Not delegate tasks unless someone completes the task exactly “right”

Unlike OCD, OCPD does not include a pattern of intrusive obsessions that lead to specific compulsions. Instead, the symptoms of OCPD tend to affect every aspect of the individual’s personality.

At first glance, these symptoms may seem rather similar. Both OCD and OCPD cause people to obsess over things that other people would find mundane. The key differences between these disorders are:

• Patient Perception of Symptoms – Patients with OCD are distressed by the symptoms they experience and aware that their behaviors are unreasonable. However, people with OCPD often do not believe they need help or don’t see how their worldview is abnormal.
• Reasons for Behaviors – People with OCD carry out rituals because they fear something tangible and negative will happen if they do not. Their fears are tied to real-world consequences, whether real or imagined. OCPD causes people to adhere to rules and procedures with no consideration of the consequences.
• Effects on Work – Both OCD and OCPD can negatively affect a person’s social and family lives. However, OCD tends to harm a person’s work life while OCPD can actually make people excel in many careers. Because of their strict adhesion to rules, people with OCPD often perform well in roles that require this behavior.
• Expectations of Others – Because people with OCD know that their behaviors are distressing, they are unlikely to expect people in their lives to behave the same way. However, people with OCPD often expect everyone else to live up to the same rigid standards they set for themselves.
• Willingness to Get Help – People with OCD are so upset by their obsessions and compulsions that they want help, even if they don’t know where to look. People with OCPD believe they do not need help and typically only seek mental health care if their job or relationship is at stake due to personal conflict.

One thing that OCD and OCPD have in common is their treatment options. Therapy, psychiatric medication, and lifestyle changes can all help people with these disorders. If you or a loved one shows signs of either OCD or OCPD, know that a happier life is possible. Set up an appointment with a LifeStance Health provider near you to get started.

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