Obsessive-Compulsive Personality Disorder vs. OCD: What’s the Difference?

obsessive compulsive personality disorder

Obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD) can confuse professionals and patients. When comparing OCPD vs. OCD, they have distinct differences and specific symptoms. For example, OCPD can interfere with daily life causing many people to turn to drugs and alcohol. However, obsessive-compulsive personality disorder treatment can help find balance in life. 

Symptoms of OCPD

OCPD is a personality disorder. It is defined by having a strict order and control over one’s environment. Those with OCPD are also inflexible and miss out on new experiences. Symptoms of OCPD include:

  • An overwhelming need for perfection
  • Requiring control over their environment and relationships
  • Preoccupation with rules, lists, details, and order causing the main activity to be missed
  • Choosing work over family 
  • Rigid and inflexible with morals, ethics, values, and rules
  • Hoarding items of no value
  • Inability to be flexible with others

Symptoms of OCD

OCD is a disorder, but not a personality disorder. It is defined as having obsessions and compulsions. Obsessions are irrational thoughts that continually repeat. However, compulsions are irrational behaviors that are a person repeatedly performs. 

These behaviors sometimes occur at the same time. Although they sometimes occur alone. But either way, they interfere with daily life and the ability to function. 

Obsession Symptoms

Obsessions are more than just worrying about everyday problems. They have very specific symptoms, such as:

  • Irrational thoughts, images, or unwanted ideas, won’t go away and cause severe distress
  • Thoughts that can’t be controlled
  • Thoughts so stressful it causes actions to rid a person of the thoughts, engaging in compulsive behaviors as a distraction

Compulsion Symptoms

Compulsions are not addictions or routines. But they are abnormal behaviors such as:

  • Repeating irrational behaviors, such as hand-washing, cleaning, tapping, or counting
  • Repeating actions in fear that something terrible will happen 
  • Hoarding items out of fear that something terrible will happen
  • Behaviors that are almost ritualistic to get rid of obsessive thoughts
  • The inability to stop repeating irrational behaviors

OCPD vs. OCD: 4 Basic Differences

Although there is an overlap of symptoms, there are 4 basic differences when comparing OCPD vs. OCD. 

Real Obsessions and/or Compulsions: OCPD vs. OCD

Obsessions or compulsions do not define OCPD. Nor is it defined by repeating irrational behaviors. However, ODC is defined by having real obsessions and/or compulsions. Furthermore, people with OCD have repeated irrational behaviors. 

Feelings about Obsessive Thoughts and Actions: OCPD vs. OCD

People struggling with OCPD believe their behaviors have a purpose. Meanwhile, people with OCD find their thoughts and actions very distressing. However, as hard as they try, they still can’t control them. 

Willingness to Seek Help: OCPD vs. OCD

People with OCPD typically don’t see anything wrong with their behaviors. Although, many around them find the behaviors abnormal. For this reason, people rarely seek obsessive-compulsive personality disorder treatment. 

However, people struggling with OCD will often seek treatment. They know their behaviors are irrational. Above all, they are tired of the constant anxiety of OCD. But, some people don’t see their actions as irrational but as useful. Therefore, they don’t seek treatment.

OCPD vs. OCD: Consistency of Symptoms

The symptoms of OCPD are defined by inflexibility. Therefore, the symptoms of OCPD are constant and persistent.  However, the symptoms of OCD tend to change with underlying anxiety. As a result, the symptoms are not consistent. 

Coping With the Symptoms of OCPD

To cope with the stress of OCPD, many people misuse drugs and alcohol. The use of alcohol and other drugs to self-medicate might make a person feel better at first. However, it typically leads to substance use disorder and makes the issue worse. 

As research continues, experts are learning more about the connection between OCPD and addiction. When a person has OCPD and suffers from substance use disorder, it’s known as a dual diagnosis. By gathering information on OCPD and addiction, professionals can create effective obsessive-compulsive personality disorder treatment.  

The Link Between OCPD and Substance Use Disorder

Substance misuse and substance use disorder (SUD) occurs in many different personality disorders. DIsorders such as borderline personality disorder (BPD) and antisocial personality disorder (ASPD) often leads people to self-medicate with drugs and alcohol. But what is the link between OCPD and substance use disorder?

Surprisingly, the symptoms of OCPD tend to discourage substance use, addiction, and recurrence of use. The symptoms of OCPD include a strict set of values and morals, along with a desire to be perfect. As a result, a person with OCPD may see using drugs and alcohol as a moral failure. Additionally, the use of these substances can interfere with their ability to meet their own expectations. 

Although OCPD has a lot of negative symptoms, addiction is not often one. However, this doesn’t mean a person can’t develop substance use disorder along with OCPD. But, what it means is there’s no increased risk compared to the general public. 

OCPD and Alcohol

Even though SUD rates are typically low in people with OCPD, some evidence shows that some people suffer SUD. However, they are likely to suffer from alcohol use disorder (AUD) over any other substances if they do. Similar to depressive disorders, AUD is common in OCPD.

To understand the link between OCPD and alcohol, a person with OCPD might:

  • Consume alcohol to relieve the stress that accompanies trying to be perfect. 
  • Drink after dealing with people viewed as incompetent
  • Misuse alcohol as a way to “fit in” in social situations decrease inhibition

However, the misuse of alcohol can quickly lead to a substance use disorder. Therefore, people should always drink responsibly.

Statistics on OCPD

Of all personality disorder types, OCPD is the most common. It affects up to 8% of the population. In other words, 1 in 100 people struggle with OCPD. Furthermore, OCPD typically affects men more than women. 

An obsessive-compulsive personality disorder is not generally diagnosed in children. It does, however, run in families. Some therapists believe that early diagnosis and obsessive-compulsive personality disorder treatment can help reverse the symptoms at a young age. 

OCPD and Co-Occurring Conditions

Other mental health conditions often co-occur with OCPD. As a result, a person will often experience OCPD and another psychological disorder at the same time. When OCPD co-occurs with another illness, it can make obsessive-compulsive personality disorder hard to manage. For example, the symptoms of OCPD can overlap with other disorders and influence each other. 

Co-Occurring OCPD and Anxiety

It is common for a person to feel out of control and fearful. Anxiety, when co-occurring with OCPD, can severely impact a person’s daily life.  Because OCPD makes a person rigid in thought and behavior, it produces a severe amount of stress when combined with anxiety.

Co-Occurring OCPD and Depression

OCPD and depression can co-occur because of a sense of not being good enough. A person with OCPD has a higher than normal expectation of themself and others. However, this high level of perfectionism is impossible to reach. As a result, a person develops depression and low self-esteem. They often feel resentful and mad because of not meeting their expectations. 

Co-Occurring OCPD and Narcissistic Personality Disorder

Narcissism and OCPD commonly co-occur. Above all, they are very similar and have overlapping symptoms, including:

  • A commitment to perfection
  • A belief that others can’t do things correctly
  • People with OCPD focus on being perfect, but narcissist believes they are beyond perfect

The Spectrum of Obsessive-Compulsive Personality Disorder

According to the DSM-5, 8 criteria qualify a person as having OCPD. However, many people have less than 4 symptoms. These people are considered to have sub-lingual OCPD or traits of OCPD. 

When people meet all 8 criteria for OCPD, they are said to be poorly adapted. However, many people healthily use their compulsions. Their ability to organize and plan with high standards can lead to a fulfilling and rewarding life. 

Obsessive-Compulsive Personality Disorder Treatment

Very little research has been done on obsessive-compulsive personality disorder treatment. As a result, obsessive-compulsive personality disorder treatment is similar to other personality disorders. However, OCPD symptoms such as rigidity and need for control, makes obsessive-compulsive personality disorder treatment challenging. 

Obsessive-compulsive personality disorder treatment may include psychotherapy and holistic relaxation techniques. Medications may also be used in obsessive-compulsive personality disorder treatment. All of these techniques can help alleviate the symptoms of OCPD. 

Psychotherapy in Obsessive-Compulsive Personality Disorder Treatment

The focus of obsessive-compulsive personality disorder treatment is psychotherapy. Therapy helps target and fix the symptoms of OCPD. However, there is very little research into which therapies work best in obsessive-compulsive personality disorder treatment. Therefore, therapists use therapies that work in other personality disorders. 

Cognitive-Behavioral Therapy in Obsessive-Compulsive Personality Disorder Treatment

Cognitive-behavioral therapy (CBT) is a common option to address OCPD and addiction. CBT helps members understand how thoughts, feelings, and behaviors are intertwined. Additionally, the therapist helps members recognize how their beliefs affect their happiness. Their beliefs also interfere with relationships. 

Members with OCPD believe that being perfect is a positive thing. As a result, they feel like they need to control everything to be perfect. A therapist will point out how this thinking is wrong and provide ways to reshape their thoughts.

Medications in Obsessive-Compulsive Personality Disorder Treatment

Over the years, multiple medications such as antipsychotics, benzos, and stimulants have been used in obsessive-compulsive personality disorder treatment. However, none of them are truly effective. Currently, professionals use antidepressants and anticonvulsants for the best treatment benefit. These medicines offer short-term relief of depression symptoms. They can also be used long-term to maintain improvement. 

Alternative Therapies in Obsessive-Compulsive Personality Disorder Treatment

Because traditional methods have not always been successful in treating OCPD, many people explore alternative therapies. There are various relaxation techniques to manage stress and tension triggered by OCPD. Alternative or holistic therapies include:

  • Meditation
  • Yoga
  • Breathing exercises
  • Mindfulness
  • Journaling
  • Nutritional therapy

OCPD vs. OCD: Seeking Help at Sana Lake Recovery Center

The differences between OCPD vs. OCD is minimal. If you or a loved one needs proper diagnosis, we can help. Our obsessive-compulsive personality disorder treatment program can help you find balance and recovery from OCPD. Contact us today and fight out how. 

References:

https://www.merckmanuals.com/professional/psychiatric-disorders/personality-disorders/obsessive-compulsive-personality-disorder-ocpd

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4176677/

https://www.anxiety.org/what-is-the-difference-between-ocpd-and-ocd-and-how-are-they-treated

Article Reviewed by David Sherman, MD

David Sherman, MDDavid Sherman, MD is a Fellow of the American Society of Addiction Medicine (FASAM) and board certified in Addiction Medicine with the American Board of Preventive Medicine. He is a native Missourian and graduated medical school at the University of Missouri-Columbia School of Medicine. Dr. Sherman completed a two-year fellowship in Addiction Medicine at the University of Florida in Gainesville. He leads a highly trained staff of master level certified addiction professionals. Men and women from all over Missouri and the United States come to Sana Lake Recovery Center to get the care they need and deserve.