Can OCD and OCDP walk hand in hand?
Thank you for reaching out to us!
It is totally possible for OCD and OCPD to occur together! Although the two disorders have common features and people often assume that OCPD is much like OCD, there are some very important differences. It is rather uncommon for OCD and OCPD to occur together, but it is definitely possible and not unheard of.
To give you an idea as to what OCD might look like, here are the diagnostic criteria for that:
Significant impairments in personality functioning manifest by:
Impairments in self functioning (a or b):
a. Identity: Sense of self derived predominantly from work or productivity; constricted experience and expression of strong emotions.
b. Self-direction: Difficulty completing tasks and realizing goals associated with rigid and unreasonably high and inflexible internal standards of behaviour; overly conscientious and moralistic attitudes.
Impairments in Interpersonal functioning (a or b):
a. Empathy: Difficulty understanding and appreciating the ideas, feelings, or behaviours of others.
b. Intimacy: Relationships seen as secondary to work and productivity; rigidity and stubbornness negatively affect relationships with others.
Pathological personality traits in the following domains:
1. Compulsivity, characterized by: Rigid perfectionism: Rigid insistence on everything being flawless, perfect, without errors or faults, including one's own and others' performance; sacrificing of timeliness to ensure correctness in every detail; believing that there is only one right way to do things; difficulty changing ideas and/or viewpoint; preoccupation with details, organization, and order.
2. Negative Affectivity, characterized by: a. Perseveration: Persistence at tasks long after the behaviour has ceased to be functional or effective; continuance of the same behaviour despite repeated failures.
The impairments in personality functioning and the individual’s personality trait expression are relatively stable across time and consistent across situations.
The impairments in personality functioning and the individual’s personality trait expression are not better understood as normative for the individual’s developmental stage or socio-cultural environment.
The impairments in personality functioning and the individual’s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).
The diagnostic criteria for OCD are:
A. Either obsessions or compulsions:
Obsessions as defined by:
Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
The thoughts, impulses, or images are not simply excessive worries about real-life problems
The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)
Compulsions as defined by:
Repetitive behaviours (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
The behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviours or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.
The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.
If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an Eating Disorders; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).
The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
So this is all pretty ‘formal’ and abstract. The main difference between OCD and OCPD is the fact that anxiety is involved in OCD but not in OCPD. Whilst an individual with OCD might get really anxious when they are unable to act on their compulsion, individuals with OCPD won’t get as distressed by it. They may think it will affect their productivity and organisation, and it could therefore cause a bit stress, but they don’t act on their compulsions to ease their anxiety. Furthermore, and partially because of that, individuals with OCPD often don’t regard their behaviour as something that is worrying and they won’t ask for help as quickly because it doesn’t cause as much distress and they don’t see it as something that is a ‘problem’. People with OCD however do experience a lot of distress and often want their symptoms to be gone. One other big difference is that OCPD often has to do with perfectionism and the need for control. This is less often the case in people with OCD.
Still, it is possible that you have both of these disorders. In people that have comorbid OCD and OCPD, the number of obsessions and compulsions is often greater than the number of obsessions and compulsion in people with only OCD. Source (https://www.ncbi.nlm.nih.gov/pubmed/20163876) Furthermore, because OCPD is driven from perfectionism and it can be hard for people with OCPD to recognise or accept that their behaviour is ‘abnormal’, it can be harder for people with comorbid OCD and OCPD to have a good insight as to whether their obsessions and compulsions are normal or not. (Source)
If you are wondering if you have either of the two or if you have both, it is probably best to seek professional help. Because of the similarities between the two disorders, it can be hard to distinguish the two without the help of a professional, whilst that does seem important due to the different treatment options available.
I hope this helps!Take care, Bobbie