OCD vs OCPD

OCD stands for obsessive-compulsive disorder, while OCPD stands for obsessive-compulsive personality disorder. Each has a different clinical definition, as OCD is an anxiety disorder, while OCPD is a personality disorder. They have different symptoms, treatment options, and prognoses for recovery.

What Is OCD?

Image via Flickr by focusonmore.com

Obsessive-compulsive disorder (OCD) is a disorder with the main symptoms being obsessions and compulsions. These are often time-consuming and cause significant distress to the person suffering from the disorder. A cluster of common symptoms with the obsessive part of OCD can involve repeating thoughts, excessive worrying, or intrusive mental images that are unwanted and persistent. Counting or checking things repeatedly to mitigate the sense of worry is a common symptom. While many people may check to see if the stove is still on, a person with OCD may check it repeatedly, feeling they must check again and again.

The compulsive part of OCD consists of repeating behaviors that a person with the disorder feels that they must perform. There’s a drive and urgency behind the behaviors to make it challenging to stop committing them. Hence, it’s a compulsion, which feels like it can’t be helped and necessary to the person doing them. The driving force behind performing compulsive behaviors is managing anxiety or perceived risk. For example, someone with OCD may be fearful of germs or contamination and will wash their hands to an excessive degree.

How Is OCD Diagnosed?

A clinician will consult the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to decide that a person has OCD. They’ll be looking for the following symptoms:

• Does the person have obsessions or compulsions (or both)?
• Are obsessions or compulsions occurring due to a person trying to avoid distress, prevent anxiety, or avoid a potentially triggering situation?
• Are these obsessions or compulsions excessive?
• Are they time-consuming, taking up more than one hour a day in the person’s life, or causing them distress?
• Do the person’s obsessions or compulsions impair their ability to function socially or affect them at work?

How Is OCD Treated?

OCD is usually treated with a combination of medication and therapy. Often the first line of treatment is the prescription of an SSRI, selective serotonin reuptake inhibitor, to adjust brain chemistry to help lessen or eliminate symptoms. This SSRI is most effective when combined with psychotherapy. Cognitive-behavioral therapy (CBT) allows the person to examine how their thoughts, especially their negative ones, affect their behavior and how to respond differently.

The other main therapy used to treat OCD is exposure and response prevention (ERP) which exposes the sufferer to the anxiety-provoking triggers causing their obsessions and compulsions to lessen the response to the triggering stimuli over time. For example, if a person is concerned with contamination from germs, the therapist will safely expose the person to their triggers. In this case, the therapist will instruct the person to touch something dirty but safe and assist the person in delaying hand washing to prove that nothing bad will happen.

What’s the Prognosis for OCD?

People with OCD can recover. With treatment, their symptoms can be reduced or eliminated. Exposure and response therapy treatment can reduce OCD symptoms from 50% to 65% after just 14 therapy sessions. Moreover, benefits from talk therapy last for months after the end of treatment. 

What Is OCPD?

Rather than a disorder of anxiety, OCPD is a personality disorder. Its main feature is perfectionism, with the person expecting perfection from themselves and the other people around them.

How is OCPD Diagnosed?

To determine a diagnosis, a clinician will consult the DSM-5 looking for the following traits and symptoms associated with OCPD: 

• A continual pattern of order and control that can prevent the person from being flexible, open, and efficient.
• A high level of perfectionism, to the degree, that a person may not be able to complete tasks, especially if they feel their standards aren’t being met.
• Excessive preoccupation with rules, order, details, organization, and schedules.
• Hoarding money past the point of financial need.
• A devotion to work that comes at the cost of everything else, choosing career over personal relationships.
• Great difficulty being flexible with their ideas and plans for completing tasks.
• Difficulty throwing away items, even if they’re old and worthless.
• Being morally and ethically inflexible or seeing things in absolute terms, black and white thinking.

How Is OCPD Treated? 

There are significant challenges in treating OCPD. As it’s a personality disorder, the person who has it is often unaware of it. It’s a deeply ingrained part of their personality, to the point that they’re like to feel like it’s just how they are. Most commonly, they think others around them are the problem, as no one can meet their high standards of perfectionism. They’re more likely to suggest that those around them seek therapy. They don’t think they have a problem, a significant obstacle to treating someone with OCPD.

A person with OCPD is unlikely to seek treatment independently and may only get help due to a request from a spouse, boss, or family member. If the hurdle of getting a person with OCPD into treatment is overcome, some of the same treatments used for OCD may help. SSRI Medication can be used in treating OCPD, combined with cognitive-behavioral therapy. While talk therapy can help, it’s challenging and time-consuming, as changes in thinking don’t come easily to someone with OCPD. Treatment will be focused on examining their need for perfectionism and control.

What’s the Prognosis for OCPD?

Since it’s a personality disorder, the outcome of OCPD treatment is less predictable than the prognosis for someone with OCD. Treatment can help someone with OCPD reduce their need for perfectionism and control, but it may take a long time since these traits are deeply ingrained in their personality.

People who suffer from OCD or OCPD can both recover, but each disorder has its challenges in treatment. OCD is easier to treat, as OCD is often distressed and wants help. OCPD is harder to treat, as the person with OCPD doesn’t think they have a problem and are unlikely to seek help unless spurred on by others in their life.

Contact NeuroHealth in Arlington Heights, IL

If you or someone you love would like more information on OCD treatment options, reach out to the knowledgeable team at NeuroHealth Arlington Heights. You can reach us via our secure online contact form or at 847-584-1824. A member of our team would be happy to assist you.