Explainer Link Copied 01.29.24

So What’s the Difference Between OCD and OCPD?

Basically, OCPD is perfectionism that destroys your life. BySam Brodsky

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Everybody knows someone who sets very high standards for themselves and the people around them. They re-do the bed after you’ve made it. They correct your grammar when you say “my brother and me” (like, does it really  matter?!). They never use the words “good” and “enough” back to back. Maybe that annoying person is actually you! Whatever the case, most of the time, that perfectionistic lifestyle is just a pain, but when perfectionism starts to mess with how you do life, it can teeter into OCPD territory—aka obsessive-compulsive personality disorder. 

Like the name implies, OCPD is a type of personality disorder, just like avoidant personality disorder or borderline personality disorder. Though the acronym kinda sounds like OCD, the two have less in common than you’d assume, says licensed clinical psychologist Sam Greenblatt, PsyD, who specializes in treating OCD and OCPD. (More on that in a sec.)

In case you’re not a psychologist (same), a personality disorder is a mental health condition that messes with your unique quirks, traits, and behaviors (in other words, your personality) in a way that negatively impacts how you interact in the world, explains psychologist and program director of the Northwell Health OCD Center Anthony Pinto, PhD, who studies OCPD and treats people with the disorder. “There’s an enduring pattern [of behavior] that’s creating problems for the person, either interfering with their relationships or creating a feeling of stuckness where they’re not able to advance toward the life they want,” Dr. Pinto adds.

With OCPD, people want things to go a certain way (whether it’s in their control or not)—and this inflexible kind of thinking can cause a ton of stress at work or at home. So it’s common for others to feel like they’re being controlled by someone with OCPD, Dr. Pinto says. And it’s not fun for the person with OCPD either: They can get really down on themselves for feeling like they’ll never meet their own expectations, Dr. Pinto explains. 

So, here, we explain more about OCPD, what causes it, and how it’s treated. Let’s go.

One quick thing before we dive into the details: Mental health is complex and everyone has a unique experience, so don’t go diagnosing yourself just because you read a few articles on the internet (though, we do appreciate you stopping by to learn a few things). If this resonates with you, consider it a jumping-off point in your journey to getting care. OK, let’s get into it...

What is OCPD?

In clinical terms, OCPD is, “a personality disorder characterized by a pervasive pattern of excessive perfectionism, orderliness, mental and interpersonal control, inability to compromise, and an exaggerated sense of moral responsibility,” according to the American Psychological Association. Ultimately, all of that makes life a lot harder.

OCPD is diagnosed in about 2% to 7.9% of people, though it could be higher since people with undiagnosed OCPD might just think how they do things is right and everyone else is the problem, says Dr. Greenblatt. In Dr. Pinto’s opinion, OCPD might be one of the most common personality disorders out there.

That said, OCPD can look different from person to person. To be diagnosed, you’d have to meet at least four out of eight criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). One is that you’re so preoccupied with details, rules, lists, or schedules that you lose sight of what you’re trying to do. Other benchmarks include being so focused on making something perfect that you can’t get it done; dedicating so much time to work that you don’t make time for hobbies and friends; and doing everything yourself—unless someone can do it the way you want it. (Heads up: not all mental health pros agree with how the DSM-5-TR  classifies personality disorders, and this includes OCPD, says Dr. Pinto. But it’s what we’ve got for now.) 

All of that, plus the other criteria in the DSM-5-TR, can make time management and indecisiveness a real problem, Dr. Pinto says. Plus, this rigid way of seeing and doing life can make someone with OCPD base their worth on productivity and doing stuff correctly. That sometimes leads to depression when things aren’t turning out, says Dr. Pinto. And, like we said earlier, OCPD can affect relationships, especially in a world where shit changes and people do things in…their…own…ways.

Sure, this might sound like a lot of people in your life—or a lot like you—but to get diagnosed, this should’ve been going on for a while (usually at least five years) and damage your relationships, work, general life, or all the above, says Dr. Pinto.

OCPD vs OCD

To non-mental health pros, OCPD and OCD can sometimes look similar IRL since perfectionism can be a thing with OCD too, Dr. Pinto says. But OCD is a mental health condition where you have intrusive thoughts or images (called obsessions) that trigger repetitive behaviors (compulsions) to stop thinking about that or to just feel less anxious, explains Dr. Pinto. Let’s say your couch moved an inch out of place. If you have OCD, you might feel like you need to fix it because of an intrusive thought—something bad happening to you or your family, for example, says Dr. Pinto. With OCPD, you’d fix the couch because you want order and that’s how you think it should be, he says.  

What causes OCPD?

We don’t really know what leads to OCPD right now, says Dr. Pinto. That said, like a lot of mental diagnoses, it’s probably a mix of genetics and the way you were brought up, he notes. 

Based on Dr. Pinto’s experience, clients with OCPD sometimes have stressful childhoods, where maybe they had an inconsistent parent or someone in the home struggled with addiction. “Sometimes these rules and very rigid ways of doing things come as a way to compensate for some elements in their upbringing that were unpredictable,” he says. Other times, you just learn to be this way from your family, he adds.

How is OCPD treated?

OCPD sounds like a lot, and it is—but Dr. Pinto says therapy and medication can help. Antidepressants like SSRIs may help people with OCPD manage the anxiety and depression triggered by their high standards, says Dr. Pinto. And cognitive behavioral therapy, which focuses on understanding our thoughts, emotions, and behaviors, can help someone learn to be OK not  doing things perfectly or to their standard, he says. With the help of a mental health pro, they can experiment doing things “wrong”—like putting dirty dishes in the dishwasher instead of rinsing them first, he explains. 

Sometimes Dr. Pinto’s patients say they’re scared getting help will turn them into people who are sloppy or lack motivation, but that’s not quite the case. Instead, therapy helps people with OCPD learn to be more flexible, improving their lives overall, he says. 

In Dr. Greenblatt’s experience, group therapy can help too because you feel seen by people going through similar things and you learn more about yourself. “Somebody … finally put words to something that you knew in the back of your head you did struggle with, but you've never been able to explain it,” he says. You feel less alone.

Speaking of feeling seen and less alone, you can look into support groups like You, Me & OCPD. You can also check out other resources on the OCPD Foundation website, which Dr. Pinto says is a new organization trying to raise awareness about the disorder and help people affected by it.  

At the end of the day, with the right treatment and support, change is possible for those with OCPD. “I have seen many patients [with OCPD] make changes and reclaim their lives—and live with much greater balance and meaning,” says Dr. Pinto.