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“A lot of people assume that having OCD means liking things organized or hating germs. It tends to be treated like a quirk or an endearing trait. But it’s so much more than that. It’s the one thing that prohibits me from being free of myself.”
- Whitney Amazeen
Many people see obsessive-compulsive disorder (OCD) as a compulsion to organize or avoid germs, but that isn't the only possible manifestation of this condition. OCD is a type of anxiety disorder that impacts 1 to 3% of the population. This means, at minimum, over 45,000 Kentuckians have been diagnosed with this disorder. What that looks like for each individual varies significantly.
SUN Behavioral Health Kentucky helps patients learn about their diagnoses and how they might differ from the stereotyped version they have been exposed to. Today, we are going to look at 6 types of OCD that we often see here.
Officially, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) does not recognize different types of OCD. Instead, it recognizes it as a general mental health condition that is made up of uncontrollable thoughts known as obsessions and repetitive and excessive behaviors known as compulsions.
With that said, there is variety in the themes that different people might focus on. These themes evolve or change as someone ages and are often translated as categories or types of obsessions and compulsions. Below are a few of the most common ones that someone might have. Keep in mind that these aren't the only possibilities. It is entirely valid to experience an OCD theme or type different from what is described here.
Someone who is living with Harm OCD has fears of potential harm to themselves or others. This type involves intensive, intrusive thoughts that do not go away about themselves being seriously harmed by someone or something, including themselves, or the same happening to someone else, like a loved one.
For example, people with this type might think that their house has burned down while they are away running errands. As a result, they might feel compelled to drive by their house repeatedly to ensure it is still standing. Depending on where their home is and the errands they have to run, this might be time-consuming and constantly out of their way. Still, it is the only way to temporarily ease their concerns.
It might also look like a fear that they will accidentally harm themselves or a loved one, and they will constantly make sure that can't happen by checking locks to weapons or cabinets or preparing for the worst. Others might find themselves continually thinking that a disastrous event will happen and that the more they think about it, the higher the chance it will happen. However, they are unable to stop themselves from thinking about it, causing them to have intense distress and worry that prevents them from being able to function.
Relationship OCD is a type that includes intrusive thoughts and compulsive behaviors associated with a romantic partner. Often, these thoughts are driven by doubts and fear that their partner doesn't love them or that it is destined to fail. Even if these are not true, someone with this type of OCD is unable to control these thoughts and will act on behaviors designed to gain reassurance. It can be incredibly stressful for both the person with the condition and their partner.
Someone with this condition might constantly worry that their partner doesn't love them, isn't happy, or doesn't deserve to be in a relationship with them. They might try to seek reassurance from their partner regularly. It might also look like the person themselves thinking they could do better than their current relationship and obsessing over their partner's flaws.
The partner of someone with Relationship OCD might feel overwhelmed by the condition, especially if they don't understand it. They might become confused or frustrated by the constant need for reassurance and feel like their partner is needy or not respecting their personal boundaries within the relationship. This might make it difficult for the person with this type of OCD to establish and maintain relationships in the long term.
Most people consider this type of OCD when they think of the condition. It involves making sure everything is perfectly in line. For example, they might arrange their cupboards so that all labels face the same direction. It might also involve organizing their closet so that all items are arranged by clothing type and color. When things are positioned perfectly, they will prevent whatever danger their obsessions believe will happen if they are not. This danger or avoided potential experience looks different for everyone.
Symmetry and Ordering OCD doesn't have to physically represent order and arrangement. It can also look like saying sentences or words repeatedly until they are said perfectly. The act of either version of this type is time-consuming. They might believe that failure to make things perfect will result in horrible consequences that they are trying to avoid.
Contamination OCD is when someone experiences intense anxiety surrounding the idea of things that are dirty or contaminated with germs, most of the time, to avoid a serious illness that might lead to death. Like with Symmetry and Ordering OCD, this theme is a familiar one people might think of when it comes to the idea of OCD. Someone with Contamination OCD will often feel consumed with fear that they will be exposed to dirt, viruses, and bacteria to the point that they might need to clean surfaces or clean their hands constantly.
Someone living with this condition might spend hours cleaning their house or washing their hands to the point that they become dry and cracked from the rigorous methods and harsh soaps. They may also try to avoid public places or social interactions that put them at a high risk of coming into contact with the dirt or germs they fear. Suppose they do feel like they have been contaminated. In that case, they might throw those objects away or excessively clean and disinfect themselves, surfaces, or personal items to ensure their fears will not come true.
These compulsions take up a lot of time and energy and often reduce a person's ability to function not only in their own lives but also in the eyes of others. They might aim to stay home where they know they are safe because of their rigorous cleaning routines. If they do have to go out, it can be highly distressing, and they might bring their own cleaning equipment.
In many ways, Hoarding OCD may feel like the opposite of Symmetry and Ordering OCD and Contamination OCD, though sometimes it can be related, just a different manifestation of compulsions. Someone with Hoarding OCD will not throw items away, and they often feel the urge to acquire more. If they don't achieve these compulsions, they will have intense fears and discomfort that something terrible will happen.
It is important to note that someone with Hoarding OCD doesn't necessarily see the items they hold onto as valuable. Instead, they see getting rid of those items as dangerous. For example, they might see that throwing out a gift someone gave them will result in that person being harmed in some way. Even if they don't like the gift, they will hold onto it to protect the person who gave it to them. They might also constantly check that the item and all other items they have held onto have not been lost or thrown out.
Some people with this type might believe that something has been contaminated. While someone with Contamination OCD would throw that item out and clean every surface, someone with Hoarding OCD would hold onto it to protect someone else. Suppose they believe they have contaminated an item in the store. In that case, they will purchase it, even if they don't want it, as it prevents them from contaminating a stranger.
This theme of OCD is centered around many other different themes. It can be considered the overarching theme associated with Harm OCD. It might also be associated with other subthemes like Scrupulosity OCD and Sexual OCD. Scrupulosity OCD is related to religious or moral thoughts, while Sexual OCD involves thoughts regarding sexual activity.
In general, Taboo Thoughts OCD will involve an intense fear of intentionally or unintentionally harming someone or that they will cause a natural disaster. They might even have guilt or shame about their obsessions and constantly question things about themselves and their behaviors. People with this type will review their daily activities for hours to make sure that they did not hurt anyone and will take extreme measures to ensure their fears do not happen.
Having Taboo Thoughts OCD does not mean that the person will actually hurt someone or engage in certain behaviors. The most significant component is the feelings of fear and guilt that they accidentally will do something they don't want to do.
OCD types and OCD specifiers are not the same thing. OCD types refer to the themes that are associated with a person's OCD and are not officially recognized by the DSM-5. OCD specifiers are recognized by the DSM-5 and are part of a person's official diagnosis. They provide technical information on the impact a person's OCD symptoms have. Below are the 4 most common OCD specifiers that someone will have:
No matter the OCD type or theme you have, it can be very time-consuming and debilitating for you to try and manage on your own. Treatment for OCD gives many people the opportunity to take back control and find healing from this condition, no matter what their obsessions or compulsions look like.
SUN Behavioral Health Kentucky solves unmet needs for adolescents and adults in Erlanger. Our no-cost care assessments are designed to allow our team to meet with you to determine the best way that we can help you recover from OCD, regardless of the type or specifiers you might have. To schedule a consultation or for more information, contact us at 859-429-5188.
820 Dolwick Drive
Erlanger, Kentucky 41018
Open 24 hours
