OCPD vs. OCD: What's the Difference?

OCD and OCPD share some similarities, but they are distinct conditions that differ in important ways. OCD is characterized by intrusive thoughts that then compel a person to engage in behaviors to relieve feelings of distress and anxiety. This can be contrasted with OCPD, which is marked by excessive attention to detail and perfectionism. 

Keep reading to learn more about the symptoms of OCPD and how to distinguish between OCPD vs. OCD. It also covers how OCPD is diagnosed, what causes it, and how it is treated.

What Is Obsessive-Compulsive Personality Disorder?

Obsessive-compulsive personality disorder (OCPD) is defined by strict orderliness, control, and perfectionism. Someone with OCPD will likely try to stay in charge of the smallest details of their life, even at the expense of their flexibility and openness to new experiences.

Other personality disorders in this category include narcissistic personality disorder, histrionic personality disorder, and borderline personality disorder.

OCPD is not the same as narcissism, however. People with OCPD dwell on doing things perfectly, while people with narcissistic personality disorder have an exaggerated sense of grandeur and believe they should receive constant praise and attention.

Symptoms of OCPD

The primary symptoms of OCPD focus on an obsession with perfectionism and a need for control. Someone with OCPD may experience symptoms like:

• Acting restrained or restricted with their emotions
• Adherence to rules in an inflexible, rigid way
• Creating order and lists for tasks
• Desire to control their relationships with others
• Difficulty empathizing with others and/or maintaining intimate relationships
• Extreme dedication to their work
• Having trouble giving things to others
• Need for perfection even in the smallest details
• Problems with self-identity and/or self-direction
• Trouble giving up control and delegating tasks

At first glance, OCPD may seem similar to an anal personality type. While someone with an anal personality might share some of these traits, like perfectionism, orderliness, and a need to be in control of their environment, having these quirks isn't the same thing as having a personality disorder.

How Is OCPD Diagnosed?

There is no specific test that can determine if a person has OCPD. In order to make a diagnosis, a clinician will ask questions about your symptoms and the effect they have on your life. They may also conduct lab tests and a physical exam to help rule out other conditions.

It must also be accompanied by at least four of the following symptoms described in the DSM-5-TR:

• Excessive devotion to work at the expense of family or friends
• Extreme need for perfection and relentless control over your environment and interpersonal relationships
• Inability to be generous to others
• Inability to delegate tasks
• Inability to get rid of worn-out or worthless items (even those without sentimental value)
• Over-conscientiousness
• Preoccupation with details, rules, lists, and order, which can result in missing the major objective of an activity
• Rigidity and inflexibility with regards to morals, ethics, values, and/or the adherence to rules

They may also look for additional signs of OCPD. These include the presence of rigid perfectionism and at least two more personality traits:

• Intimacy avoidance
• Getting mentally "stuck" on an idea
• Reduced emotional expression

Your doctor may also check for any difficulty you have with empathy and intimacy. People who have OCPD often struggle to maintain interpersonal relationships, including romantic relationships. They may find it difficult to empathize with others and are sometimes described as cold or aloof. They also struggle with intimacy and find it difficult to show affection or express emotions.

In order to be diagnosed with OCPD, these symptoms must create significant disruptions in a person's ability to function in important life areas, including school, work, family, and other relationships. 

It may take some time for a doctor or therapist to determine if you have OCPD. They may need to meet with you a few times to discuss and observe your symptoms. A doctor or therapist may also need to talk to loved ones to get a better picture of your daily behaviors and interactions before they make a diagnosis.

OCPD vs. OCD

While OCD and OCPD are distinct forms of mental illness with their own unique and specific characteristics, there is considerable overlap between them. There are, however, some basic ways to distinguish between them.

Presence of True Obsessions and/or Compulsions

OCD is defined by the presence of true obsessions (an irrational thought or idea that continually repeats) and/or compulsions (an irrational behavior performed repeatedly). These behaviors can occur together or on their own, and they interfere with a person's quality of life and ability to function.

With OCPD, on the other hand, the personality traits are not directed by uncontrollable thoughts or irrational, repeated behaviors. While people with OCPD often engage in rigid behaviors that may be centered on following certain procedures, they don't have the same intrusive thoughts and overwhelming compulsions that people with OCD do.

Feelings About Obsessive Behaviors or Thoughts

People with OCD often feel distressed by the nature of their behaviors or thoughts, even if they are unable to control them. People with OCPD, however, typically believe that their actions have an aim and purpose.

In some situations, the traits of OCPD can even translate to success—someone who is overly dedicated to their job and conscientious of every detail, for example, might see benefits at work, even if they are struggling in other areas of their life.

Consistency of Symptoms

The symptoms of OCD tend to fluctuate in association with the underlying level of anxiety. People with OCD engage in behaviors as a way to deal with feelings of fear, anxiety, and uncertainty. This means that their symptoms may be less severe during times when they are experiencing less anxiety.

Because OCPD is a personality disorder that's defined by inflexibility, the behaviors tend to be persistent and unchanging over the long term. These symptoms do not fluctuate depending on anxiety levels and are present in almost every area of the person's life.

What Causes OCPD?

We don't yet know what causes OCPD, although there are some theories that explain different possibilities. One theory deals with attachment styles and says that OCPD may develop in children who:

• Had overprotective parents or caregivers who didn't offer much care
• Didn't develop emotionally and empathetically during their childhood
• Weren't able to form secure attachments with their parents or caregivers
  

Risk Factors for OCPD

OCPD is one of the most common personality disorders. Men and women seem to experience it at about the same rate, though it's less common in younger adults. It can occur with several other conditions, like:

• Depression
• Eating disorders
• Illness anxiety disorder (formerly called hypochondriasis)
• Parkinson's disease

How Is OCPD Treated?

Though more research is needed in this area, most treatment plans for personality disorders begin with psychotherapy, while medication might be used as a complement.

Psychotherapy

Therapy options for OCPD can include:

• Cognitive behavior therapy (CBT), which focuses on helping you notice and, eventually, change the negative thought patterns associated with OCPD
• Psychodynamic therapy, which is intended to help you understand your conscious and unconscious thoughts and emotions so you can make healthier choices in your daily life

Medication

There is no specific medication that has been FDA-approved to treat OCPD. However, your doctor might recommend medication to help control some of your OCPD symptoms, especially if you're also experiencing another condition like depression. This might include medication to control your anxiety and/or antidepressants.

Coping With OCPD

The condition can make relating to others much more difficult for a person with OCPD. Excessive perfectionism and an inability to delegate tasks can create a create deal of stress. Being rigid, having high expectations, and struggling to empathize with others can also affect interpersonal relationships. People with the condition may feel isolated and misunderstood as a result.

In addition to seeking treatment, you can learn some coping strategies for OCPD. These could include:

• Educating yourself: Learning more about your condition can be an empowering experience. It may help you notice when a symptom of OCPD is causing your behavior, so you can take steps to cope.
• Managing your stress: Keeping your overall stress levels low is always a good idea. Try developing a plan to reduce stress so you'll be ready to cope with whatever comes your way.
• Practicing self-care: If you have OCPD, it can be easy to neglect yourself while you focus on your current project. Consider making self-care a regular part of your day.
• Trying mindfulness and meditation: Mindfulness can help you spot times when perfectionism is causing anxiety, for example, so you can take steps to calm yourself. Meditation pairs well with mindfulness, and it's an effective stress reliever.

Takeaways

If you have traits of OCPD and you're looking for help, it's important to seek the care of a qualified mental health professional. You may not immediately recognize the detrimental impact of your behavior and how it's affecting different areas of your life. A mental health professional can determine whether or not you have OCPD and help you deal with the symptoms of the condition.