Psychologist talking to a sad female patient

[View original article published in Psych Central here]

Grace is obsessed about order and having things “just so.” She is constantly checking for symmetry in her surroundings. The time she spends ordering and organizing her things is disrupting her life. She spends excessive time on details and often gets stuck while doing or undoing things until she feels “right” about the situation. This causes her a great deal of distress. Her motivation in doing her rituals is to decrease anxiety and uncertainty about her feared consequence (having a panic attack). Does Grace have obsessive-compulsive disorder (OCD)?

Patrick needs things to be perfect and orderly. He is a perfectionist and is preoccupied with details and making lists. His perfectionism gets in the way of completing the tasks at hand. He puts his job ahead of his family and friends. He likes to be in control and doesn’t like to delegate because he believes he can do a better job than anyone else. His friends and relatives believe he is overly judgmental and rigid. They also think he is stingy with his money. He thinks all his friends are wrong. Does Patrick have OCD or obsessive-compulsive personality disorder (OCPD)?

Lisa likes certain things to be in a peculiar way. For example, she likes to color-coordinate her closet. She likes her bedsheets a certain way and every time she finds the toilet paper going the “wrong” way in her bathroom, she fixes it to the “right” way. She gets annoyed when she is not able to have things “right” but is able to move on with her day without major emotional distress. Her friends tease her and ask, “Why are you so OCD?” Does she have OCD, OCPD, or what?

It may be difficult to distinguish the difference between these three cases based on the brief descriptions, but there are significant differences. Many individuals make light of OCD by mistakenly saying they are “so OCD.” Awareness and information about what constitutes the diagnosis for Obsessive-Compulsive Disorder (OCD) needs to be increased and below are some clarifications.

Obsessive-Compulsive Disorder (OCD)

OCD is a genetic predisposition, a neurological and behavioral challenge. It can be triggered by a stressful or traumatic experience. The Y-BOCS (Yale-Brown Obsessive Compulsive Scale) is the scale that measures the severity of OCD. Some people may have a mild case of OCD while others may have severe OCD.

The best way to differentiate OCD from OCPD is the cycle that sufferers experience. For instance, Grace suffers from OCD that targets her need to have order and symmetry rituals. She is constantly noticing things out of place (trigger). She begins obsessing and is unable to focus on other tasks unless she fixes (compulsion) what is out of place. She needs her environment to look perfect. If she is not able to do her compulsions, she fears her anxiety will mount. Once she’s taken the time to “fix” things, she feels relief — until the next trigger appears.

OCD can get in the way of individuals’ proper functioning in all areas of their lives. When individuals have OCD and don’t receive appropriate treatment, their symptoms most likely will increase and become debilitating.

Obsessive-Compulsive Personality Disorder (OCPD)

Individuals who experience OCPD get caught up in getting things right, clean, and exact. They show unhealthy perfectionism and want to be in control of what is going on around them. They are also judgmental, controlling, and stubborn. People with OCPD are difficult to live with and relationships suffer. They may feel paralyzed and unable to make decisions because they fear making the wrong one. They don’t like to delegate unless they know people will do things as well as they do.

People with OCPD also may have hoarding tendencies and are uncharitable and miserly even when they have the money to spend on others or themselves. They are rigid with their moral and ethical codes. They do not believe there is something wrong with their behavior. They don’t understand why others can’t see their way is the right way.

Perfectionism, rituals or compulsions, lack of flexibility, inability to make decisions, and relationship conflicts may be exhibited by both OCPD and OCD sufferers. OCD and OCPD affect individuals’ quality of life.

Individuals with OCD may exhibit similar behaviors to those with OCPD; however, their behaviors are driven by fear, anxiety, and uncertainty. OCD interferes with work, social, and home functioning. Individuals’ obsessions (thoughts) don’t match their core values and standards. They realize their thoughts are irrational, but their fear and anxiety is the reason behind their compulsions. Thus, OCD sufferers seek treatment to alleviate their anxiety.

Individuals with OCPD do not experience an OCD cycle. They care more about completing tasks and their work than their relationships. OCPD sufferers can be over controlling and their rigidity drives their behaviors. OCPD is a personality disorder. Individuals with OCPD may seek treatment when their job or relationships are in jeopardy, though they may do it reluctantly. They may also seek treatment when other illnesses afflict them such as depression.

Peculiar Behaviors and Compulsions

Part of our development is to cultivate behaviors that reinforce rewards. We create certain behaviors due to our own experiences and environment. Most of us develop peculiar behaviors or quirks, but when unable to carry them to completion, we normally don’t fall apart and are able to move on with our day. Lisa, as mentioned earlier, likes to color-code her closet because she gains satisfaction from doing it. When she is unable to keep up with it, she may feel annoyed or upset that her amazing closet is not as color-coded as she wished, but she is able to wait until the weekend to reorganize her closet just like she likes it. Lisa’s behaviors are not symptoms of OCDbecause anxiety, guilt and uncertainty are not involved in her behaviors.

Thus, individuals are not “so OCD” when they exhibit peculiar behaviors or compulsions.

It’s best to cease the habit of making light of OCD or any other mental illnesses, especially if one is not well-informed. Remember that we all have peculiar behaviors, and that they are not necessarily OCD symptoms.

If you discover that anxiety, uncertainty and other feelings are becoming the motivating force in your behaviors, become informed by visiting reputable websites such as Psych Central and the International OCD Foundation.

If you suffer with a mental illness, consider sharing your struggles. It’s possible to decrease the misconceptions and decrease the stigma that seems to still linger in our society. Remember that there is no “normal” and that it’s possible to live with hope and acceptance. You can find joy despite your individual struggles. You can find the relief that you need and live a functioning life.