What is OCD?
Obsessive-compulsive disorder (OCD) is a disorder where you have recurring intrusive thoughts that create a sensation of deep discomfort and lead to compulsions. Everybody experiences intrusive, unwanted thoughts during their lives, but if you have this condition, you tend to feel completely overwhelmed by these thoughts and react to them with repetitive behaviors or mental acts. According to the official medical definition, the obsessions and/or compulsions take up at least one hour per day and are so inhibiting they may interfere with your well-being and become all-consuming. You can find a full breakdown of the different elements that make up OCD in our article here.
OCD is often misrepresented as something that simply makes you into a very tidy or very clean person, or somebody who is very specific about certain rituals. However, the OCD spectrum is wide and varied, and there is no simple one-size-fits-all approach to it. It’s a disorder that tends to change so much from person to person that specialists categorize it as a “heterogeneous” disorder. So, although you may feel like one of the above examples applies to you, it is possible that you may also experience shades of other types of OCD.
What are the different types of OCD?
There are some symptoms, such as the presence of intrusive thoughts followed by compulsions, that tend to be present in most people’s experience of OCD.. But the way these symptoms manifest, such as the types of things your mind focuses on or the compulsive behaviors that result from it, can be very different from person to person. One individual can have intrusive thoughts about germs and engage in six hours per day of hand-washing. Another can have intrusive thoughts about harming others and engage in three hours of checking/reassurance seeking.
Although there’s a lot of discussion in the medical world about whether there are different set types, categories or subtypes of OCD — and whether it’s a good idea to categorize them in the first place — there are some clear patterns in how OCD may affect you. Some specialists might call them symptom dimensions. It could be helpful for you to be able to identify yourself with a category and to learn that some people feel very similar to how you do, but it isn’t particularly helpful to worry too much about what category you are in if you don’t feel like it’s clean-cut.
Here are some of the most commonly described subtypes of OCD, but there are many other variations of the psychological condition:
- “Just right” OCD: This is the type of OCD most commonly portrayed in the media. It may manifest as a general sense of something being off or not right, and a compulsion to start over and to redo to get it “just right.”
- Checking OCD: Similar to the above, it refers to an obsession for double, triple or repetitive checking of things in the attempt to be reassured about safety, health or mistake concerns.
- Magical thinking OCD: Superstitions or repetition of good-luck mantras become obsessions that leave you feeling that failing to do these certain things in a specific way will be catastrophic.
- Contamination OCD: This one is also quite popular in the media, and it’s often brought up as a joke when somebody is careful about cleanliness. This form of OCD is an obsessive fear of bacteria or illness which leads to a compulsive need to clean, wash your hands or sanitize things.
- Harm OCD: You may find yourself obsessing over violent thoughts of harming others, and you might develop behaviors such as compulsively staying away from knives for fear of stabbing somebody.
- Suicidal OCD: This can lead to obsessing over self-harm rather than harming others, especially because these intrusive thoughts aren’t in line with your state of mind and intentions on suicide. A person with suicidal OCD usually does not want to actually harm themselves, but becomes preoccupied with the thought that they may do so anyway.
- Relationship OCD: You may obsessively question your relationship status, inquiring whether this is really love or just infatuation, breaking down all the elements of your relationship to the point of developing a compulsion around finding answers to these questions.
- Sexual orientation OCD: You may find yourself obsessing over your sexual identity with thoughts such as, “I think she is attractive, therefore I must be a lesbian.” This could lead to behaviours such as compulsively testing yourself to identify a clean-cut sexual orientation or avoiding all intimate contact with women. There are also examples of transgender OCD, leading to obsession over your gender identity.
- Pedophilia OCD: You may obsessively wonder, “What if I become attracted to kids?” and start avoiding children completely.
- Existential OCD: You may feel overwhelmed by existential thoughts about your life, your purpose and the meaning of existence. People with existential OCD often wonder things like, “Would I know if I do not actually exist?” thoughts that are often followed by compulsions that could reassure you about the above doubts.
- Pure-O: This subtype can be harder to categorize because it tends to be purely obsessional (unwanted thoughts, ideas or images) but no following compulsions.
Is it possible to have two different kinds of OCD?
You can absolutely have two or more different types of OCD. Some people only have one subtype, but it is definitely common for people to have more than one.
Over time, the subtypes may change or stay the same. In some cases, there tends to be one specific type of OCD that presents itself throughout a person’s life, with various symptoms changing over time. In other cases, people manifest different subtypes at different points in their lives. For example, “just right” OCD as a child, contamination OCD as an adolescent, and harm OCD as an adult.
There’s no research to show that certain subtypes of OCD necessarily carry stronger or more disruptive symptoms. OCD symptoms usually begin gradually, and they can grow over time, also varying according to the stages of your life and situations. For example, if you’re very stressed, you’re more likely to experience worse effects from your OCD.
In general though, OCD is considered a lifelong psychological condition that can be treated and alleviated through treatment such as medication, cognitive behavioural therapy (CBT) and exposure and response prevention (ERP). You can read all about obsessive-compulsive disorder treatment here.
If you feel you have one or more types of OCD then please know that effective and affordable ERP is available to you. NOCD has licensed therapists in all 50 states and now even offers services in the UK. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment so NOCD can help you regain control of your life.