Obsessive-compulsive disorder (OCD) is a mental health condition that affects just about 1% of the population. There are several types of OCD that all overlap in symptoms but vary in how each person is affected.
Whether you or a family member have OCD or you’re dating someone with OCD, it’s important to understand the condition to know what makes it better and what causes OCD to get worse. When someone has OCD, they’re consumed with intrusive thoughts and obsessions that can interfere with their life — sometimes to the point of significant distress and disruption of daily functioning. Despite the fact that there’s a wide variation in how OCD affects individual people, some of the subtypes (or categories) tend to be more common.
What Are the Different Types of OCD?
All forms of OCD are similar in that a trigger occurs, causing intrusive thoughts, which then cause distress and anxiety and ultimately drive someone to act on a compulsion. Both OCD obsessions and compulsions can have either physical or emotional symptoms.
There are several categories of OCD, but the following four stand out as they’re some of the more commonly seen types.
Cleaning/contamination OCD
People who have a cleaning or contamination OCD tend to focus on fear or intense feelings of discomfort that results from contamination or uncleanliness. Washing excessively is normal and is done in an attempt to relieve the feelings of distress.
A good example of contamination OCD is touching a light switch and convincing yourself that it was dirty and that you’re now contaminated. You may fear that you’ll contaminate others and feel an intense urge to wash your hands repeatedly to try and cleanse yourself.
Order/symmetry or counting compulsions OCD
Order and symmetry and counting compulsions OCD creates a very intense urge to arrange and rearrange things until they’re just right — or at least exactly how you think they should be. In some cases, this could look like a need to constantly rearrange the socks in your drawer to be organized by color or by type.
This subtype might also make you count or say phrases or words over and over again until you feel something is done perfectly. Sometimes the need to order, count, or repeat can be an attempt to stave off danger or bad luck. You may feel like if you get something perfectly arranged, or if you say a certain phrase so many times, perhaps someone won’t die, or they won’t leave you.
Harm OCD
Harm OCD involves extreme feelings or worry that you’ll harm yourself or others. In order to relieve the distress you feel, you might use what’s known as checking rituals.
An example of harm OCD is you may believe that you accidentally hit someone with your car. You can feel so strongly about this that you’ll be compelled to drive back to the place where you thought the accident occurred to prove to yourself nothing happened. You’ll likely do this repeatedly in an attempt to be absolutely sure.
Hoarding OCD
Hoarding OCD is now actually recognized as its own diagnosis in the DSM-5. When someone hoards, they collect items that typically don’t have much value. Magazines, notes, clothing, games, containers — a hoarder may keep so many of these items, their home becomes virtually unlivable as it’s so filled with clutter.
An obsession surrounding the fear of not having something you might one day need is common with hoarding. This OCD subtype has a higher rate of co-existing depression and anxiety than others.
Note that hoarding OCD is a separate condition from compulsive hoarding and can occur on its own without a distinct OCD diagnosis.
“The three most common types of OCD include cleaning/contamination, order/symmetry, and harmful, intrusive thought patterns. Cleaning/contamination involves washing everything excessively as to ward off contamination. Order/symmetry involves organizing items by color, or shape, or category to the point where other areas of our life are impaired. Harmful, intrusive thought patterns can be described as being forced to think about things without having control over the topics.”
Talkspace therapist Meaghan Rice, PsyD, LPC
In addition to these main subtypes, there are also obsessive-compulsive related disorders that can occur.
Hair-pulling disorder (trichotillomania) — Hair pulling disorder causes a strong urge to pull hair from the head, eyelashes, eyebrows, or anywhere else on your body. Habit reversal training or cognitive behavioral therapy (CBT) are often successful treatment techniques.Skin picking disorder (excoriation) — Excoriation disorder causes persistent picking of the skin. It can cause infections, lesions, and extreme distress.Body dysmorphic disorder — Body dysmorphic disorder involves a preoccupation with what you may perceive as a flaw in your own appearance. Most often, the imperfections you see either aren’t observable at all, or they’re only very slightly observed to others. Body dysmorphic disorder causes repetitive behaviors to check your appearance or groom yourself. It also typically involves comparing yourself to others.
How to Treat Different OCD Types
Different types of OCD can have slightly different symptoms, which can make treatment a bit more tricky since it’s not a one-size-fits-all method. You’ll have to consider what your symptoms are, how severe they are, and which forms of treatment will best work to help you.
Most mental health experts agree that OCD therapy, medication, or a combination of the two show the most promising benefits for OCD treatment.
Therapy
Two types of therapies that seem to work better for OCD than others are cognitive behavioral therapy (CBT) and exposure therapy.
Remember that since OCD symptoms vary by individuals and subtypes, not all therapy techniques will be effective in all forms of OCD. For example, in some research, ERP doesn’t appear as effective for treating obsessive thoughts. However, other CBT techniques like mindfulness-based CBT might be better for this OCD type.
OCD Medication
Prescription medication might be another option, and it’s often suggested solely in the beginning as you learn additional coping techniques in therapy. Some of the drugs that have proven effective in treating OCD include antidepressants, anti-psychotics, and selective serotonin reuptake inhibitors (SSRIs).
Note that, again, OCD medication will be dependent on symptoms. Some studies have shown that certain subtypes of OCD (like cleaning and contamination OCD) may not respond as well to SSRIs.
“Treating different OCD types is quite complex. Typically the best rhythm is by incorporating medications before therapeutically diving into both exposure and response prevention (ERP) and cognitive-behavioral therapy (CBT). Focusing on the thoughts that typically drive the compulsions in the specific form that they come out. Challenge dysfunctional belief systems, perspectives, and ideas that have been reinforcing the pattern to continue.”
Talkspace therapist Meaghan Rice, PsyD, LPC
Which Type of OCD Do I Have?
Since there are so many forms of OCD, figuring out which type of OCD you have will be the first step in finding a way to live with your condition. Start with our OCD test to learn more. Then, reach out to a therapist or doctor for a full diagnosis and develop a treatment plan that can help you manage your mental health condition so you can live life to the fullest.
You do not have to let your OCD control you, but you can definitely learn how to deal with OCD. Treatment may not ‘cure’ your OCD, but it can help lessen the symptoms and give you the tools you need to make them manageable.
Sources:
1. NIMH » Obsessive-Compulsive Disorder (OCD). Nimh.nih.gov. https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd. Accessed September 14, 2021.
2. Williams MT, Mugno B, Franklin M, Faber S. Symptom dimensions in obsessive-compulsive disorder: Phenomenology and treatment outcomes with exposure and ritual prevention. Psychopathology. 2013;46(6):365–376. doi:10.1159/000348582. Accessed September 14, 2021.
3. Starcevic V, Brakoulias V. Symptom Subtypes of Obsessive–Compulsive Disorder: Are they Relevant for Treatment?. Australian & New Zealand Journal of Psychiatry. 2008;42(8):651-661. doi:10.1080/00048670802203442/. Accessed September 14, 2021.
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