What Are the Four Types of OCD?

Obsessive-compulsive disorder (OCD) is a mental health condition that can affect people from all walks of life. According to the National Institutes of Health and International OCD Foundation, this mental disorder affects about 1.2% of the population in the United States and around 2% of the population worldwide. The prevalence is slightly higher in women than men. OCD symptoms usually start in a person’s 20s, but this mental health condition has also been documented in children.

Continue reading to learn more about obsessive-compulsive disorder, including why it is so difficult to diagnose OCD and the different types of OCD.

What is obsessive-compulsive disorder OCD?

Obsessive-compulsive disorder is a mental disorder characterized by a cycle of obsessions and compulsions. Obsessions are recurrent, unwanted, or intrusive thoughts or urges that trigger anxiety and distressing feelings. Compulsions are behaviors performed in an attempt to get rid of obsessions and reduce anxiety.

OCD is sometimes thought to be a type of anxiety disorder. However, in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., OCD is separate from anxiety disorders. (The Diagnostic and Statistical Manual of Mental Disorders is a handbook used by mental health professionals as a guide to diagnosing mental disorders.)

It is worth noting that feelings of secrecy and shame often accompany OCD symptoms. Also, the condition can have diverse manifestations and look very different in different people. This makes it harder for mental health professionals to recognize it and offer OCD treatment. As a result, there is often a delay in the diagnosis of obsessive-compulsive disorder. Indeed, it takes an average of 11 years for an OCD sufferer to receive OCD treatments after meeting the criteria for OCD diagnosis.

What are OCD symptoms?

As mentioned, OCD is characterized by unwanted obsessions and compulsions. Obsessions are thoughts or urges that occur repeatedly and are outside the control of the affected individual. These intrusive thoughts can take the form of intense feelings like disgust, fear, doubt, or perfection. A person’s obsessions can create anxiety and be time-consuming to the point that they take over their lives, preventing them from doing important activities.

Compulsions are repetitive behaviors performed in an attempt to counteract or neutralize the anxiety caused by obsessions. They are a temporary solution or escape that OCD sufferers perform to reduce the distress from obsessions. Compulsions can also be time-consuming and get in the way of everyday activities.

What are the different types of OCD?

There are several OCD subtypes. Some of the common ones outlined by the American Psychiatric Association are described briefly below.

Contamination OCD

This type of OCD is characterized by an extreme fear of germs or contamination. People with this disorder go to great lengths to disinfect, sterilize, and clean. The persistent worry about germs can lead to compulsions that can manifest as excessive hand-washing, frequent changing of clothes, creating clean zones, and throwing away objects perceived as dirty.

Perfection OCD

People with these OCD types are overwhelmingly preoccupied with putting things in order or getting things “just right.” The compulsions can manifest as spending inordinate amounts of time counting, arranging, or moving things to alleviate the distress or anxiety caused by intrusive thoughts. Some people with these types of OCD have fixations about specific patterns, numbers, or symmetry. Others develop excessive attachments and hoard certain objects. The quest for perfection can take an immense physical and mental effort in these types of OCD. This can lead to significant impairment in daily life. In severe cases, such compulsive behaviors may cause the person to avoid socializing at home to not disrupt the order, which can have a devastating effect on relationships.

Doubt and Harm OCD

People with these OCD types experience symptoms that consist of checking and re-checking things. Such individuals have a fear of harming themselves or others due to negligence or carelessness. The OCD symptoms can manifest as mental rituals. For example, a person may have an obsessive fear of leaving on the gas stove and causing a fire. This can lead to compulsive behaviors like checking and rechecking the stove. Other examples include checking and re-checking door locks, light switches, windows, etc. The compulsive behaviors may include a symmetrical component, i.e., checking something a fixed number of times.

Intrusive Thoughts OCD

This symptom dimension of OCD is characterized by unwanted thoughts of a religious, sexual, or violent nature. People with these types of OCD engage in behavioral rituals to try and manage the intrusive religious or sexual thoughts. The compulsions or neutralizing behaviors can take the form of mental rituals like excessive praying, magical thinking, avoiding situations that are perceived to be triggers, and seeking reassurance to reduce the distress from religious ideas or sexual obsessions.

It is worth noting that while the OCD symptoms affect thoughts, these thoughts are purely obsessional. People with these types of OCD do not usually have a history of violence or act on their urges.

What is the most common type of OCD?

The different types of OCD are not mutually exclusive. A person can have elements of one or more symptom dimensions. In other words, each OCD sufferer has a unique blend of symptoms, and people with OCD struggle in different ways.

Nonetheless, some of the most common types of OCD include obsessions around organization, contamination, and checking.
Notably, OCD can occur with other mental health conditions like body dysmorphic disorder, anxiety disorder, mood disorders, hair-pulling disorder (trichomania), substance abuse, and other related disorders.

Getting treatment for mental disorders

Most people have unwanted obsessive thoughts at some point in their lives. This does not mean they have obsessive-compulsive disorder. For a diagnosis of OCD to be made, the cycle of obsessions and compulsions should be severe enough to become exceedingly time-consuming and interfere with daily life.

Unfortunately, “being obsessed” is a term that is used lightly in daily language. The casual use of this word usually refers to a preoccupation with an idea or person. However, when used in an everyday sense, the obsession does not get in the way of day-to-day living. For example, you can be “obsessed” with a new song and listen to it again and again, but you can still exercise in the morning, go to work, and meet your friends in the evening.

Obsessive-compulsive disorder is a complex mental health disorder that can cause significant distress and disability. OCD symptoms can have a variety of symptom dimensions and manifestations, making it one of the most under-recognized mental health conditions.

Diagnosing and treating OCD with specific therapies can help to manage symptoms and improve outcomes. Effective OCD treatments are available, including cognitive behavior therapy (CBT) for exposure and response prevention. Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are also effective.

Besides cognitive behavioral therapy and SSRIs, which are usually first-line OCD treatments, deep brain stimulation and transcranial magnetic stimulation have been found to be effective in people with refractory obsessive-compulsive disorder. Many patients get significant improvement with OCD treatment, and some can even achieve remission.

References: