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Summary
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A parent struggling with anxiety and perfectionism asks how Obsessive-compulsive disorder (OCD) differs from obsessive-compulsive personality disorder. Conflicting descriptions have made the reader uncertain whether a precise diagnosis matters for treatment.
The response contrasts distressing repetitive doubts and rituals with a more pervasive pattern of rigidity and strict rules, using examples to explain its framework.
It discusses behavioral and cognitive therapy and medication in relation to OCD, and notes that the reader’s own assessment belongs with a professional rather than being settled by the letter.
Question
Reader · Identity withheldI’m confused about the difference between anxiety disorders and personality disorders, especially when it comes to OCD and OCPD. I’ve been struggling to manage the house and kids, feeling overwhelmed, and getting little to nothing done each day. I assumed it was depression, but my counselor helped me realize that it’s actually extreme anxiety and perfectionism. It’s more about a fear of failure that causes me to freeze up.
\nMany traits linked to OCPD seem to fit me, but my counselor called it OCD, even though I don’t have the typical symptoms usually associated with it. I’ve read that a lot of sources try to explain the differences between OCD and OCPD, but to me, they still seem very similar.
\nHow can someone tell which one they’re dealing with? Does it really matter to have an exact diagnosis? Do different diagnoses lead to different medications or treatments?
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Answer
Allan Schwartz, Ph.D.You are asking some very good questions that confuse many people. There are vast differences between Obsessive Compulsive Disorder (OCD) versus Obsessional Personality Disorder (OCPD).
\nPeople with OCD are keenly aware of their problem. They know they are anxious and fearful. They know they are doing some strange things to attempt to control their fears, such as repeatedly checking the front door to be sure it is locked when they know they locked it. Yet, they will check over and over again, plagued by doubts that it could still be unlocked. This is just one example.
\nPeople with an Obsessional Personality Disorder are totally unaware that they have a disorder. They may live very narrow lives, living in rigid daily patterns that wll not deviate under any conditions. For example, if they go to the gym at 6pm everyday, they will not change that even if they have the chance to have sex. This is just one example. To them, this makes sense and they see nothing wrong. They are not even aware that they are rigid or that they have anxiety.
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There are several treatments for OCD, such as being prohibited from doing the repetitive behavior and, thereby, learning that nothing bad will happen. This is a behavioral type of therapy. There is also anti depressant medication that reduces anxiety, depression and OCD symptoms. Lets not forget Cognitive-Behavioral Therapy as well.
\nIt is difficult to get someone with an Obsessional Personality disorder to consider psychotherapy because they believe they are fine and everyone else has problems. If they get into therapy they are difficult to treat because of their rigidity and defensiveness. However, there are those who do benefit from therapy.
\nDepression, which has to do with feeling sad and hopeless, goes along with OCD and is not separate. Being a perfectionist is also not unusual with OCD. With the Obsessional Personality Disorder, there is perfectionism in the form of following strict rules. However, the rules are followed for the sake of the rules with no regard to their purpose. With this personality disorder, there are no grey areas in life, only black and white, right and wrong.
\nI hope this helps.
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