Ep. 5: The Difference Between OCD and OCPD

You may not have OCD after all. More than twice as many people have OCPD (obsessive-compulsive personality disorder) than OCD (obsessive-compulsive disorder). And most of them don’t know it. Many people with OCPD, and many clinicians as well, are unaware of the condition and how it differs from OCD. This episode clarifies the differences and offers an example. Click here for the written version on the Healthy Compulsive Blog.  TranscriptYour colleague Mitch works very late hours, insists on perfection in team documents, and can get pretty bent out of shape at meetings, letting people know exactly how they should be doing things. He needs to have things a certain way and his anxiety is palpable if he doesn't.You might think to yourself,  "He's kind of crazy!" but you're not sure exactly what kind of crazy he is. You might think, "Maybe he has OCD."  But you'd be wrong if you did.Mitch has a condition that most people aren’t awareof, the psychiatric diagnosis known as Obsessive-Compulsive Personality Disorder (OCPD).OCPD is different from the more well-known (OCD) Obsessive-compulsive disorder). Most people, including many clinicians, don't know the difference between OCD and OCPD, so too often it's not recognized as a mental illness. And that's really unfortunate because those with OCPD can make themselves--and everyone around them--really miserable.And it doesn't have to be that way.OCPD is treatable, but it needs to be identified as different from OCD--and acknowledged--before work can begin.About 2.3% of the population meet the full criteria for OCD, while estimates for those meeting criteria for OCPD is between 3 and 8%. So, if we split the difference, at least twice as many people actually have OCPD as have OCD. Even some clinicians are not aware of OCPD, and are therefore not able to make a differential diagnosis. This means there are a lot of people running around out there with OCPD who think they have OCD.So what is the difference between OCD and OCPD?What is OCD?OCD is a type of anxiety disorder which has specific, limited, effects on a person’s behavior and thinking. It leads to specific obsessions and compulsions: rituals, checking, and cleaning. In some cases it puts serious constraints on the individual. Sufferers can get lost in cleaning or rituals (compulsions) at the expense of all other areas of their lives. Intrusive thoughts (obsessions) can be violent and extremely disturbing.What is OCPD?In contrast, compulsive personality affects a person’s entire character. For better or worse.People can have an obsessive-compulsive personality style but not have the disorder. At their best, people with a compulsive style are creative, productive and reliable.  In fact you can be compulsive and live quite well on the healthy end of the spectrum. That’s the whole point of this blog.But at its worst the compulsive personality drifts into the personality disorder, (OCPD). People with this condition are rigid, over-controlling, and perfectionistic.  They have difficulty tolerating situations that they find to be unorganized or unethical. They lack flexibility. They have difficulty delegating, sometimes hoard, and are often needlessly frugal. They are all work and no play. They neglect or boss their partners.But to keep it simple, today I’m just going to compare OCD with OCPD, the unhealthy version of compulsive personality.What is the Difference Between OCD and OCPDHere is a chart outlining the differences. Some individuals have both OCD and OCPD, and there is some overlap, but these are still distinct conditions. Variations occur of course, but these are the traits that typically describe the two conditions: | OCD                                                                                                 | OCPD | Anxiety Disorder                                                                             | Personality Disorder | Do not like their symptoms                                                            | Take pride in their personality | Have specific obsessions and compulsions                                |  Entire personality is affected | Motivated by need to prevent catastrophes                                |  Motivated by perfectionism and conscientiousness | Willingly seek professional help                                                    | Resist seeking professional help | Seek help for relief from symptoms                                               | Seek help mostly to salvage relationships or to get relief from depression | Spend time on compulsive rituals (e.g. cleaning & checking)    | Spend time on work projects and planning | Symptoms are generally maladaptive (except hygiene)             | Traits may be adaptive if used consciously | Emotions are not necessarily suppressed                                    | Emotions are controlled and gratification is delayed | Often feel insecure in regard to others                                          | May become domineeringWhile both conditions have a genetic component, the biological origins for OCD appear to be more significant than those for OCPD, which might explain why OCD responds more to medication than OCPD does.  Medicatio...