Obsessive-Compulsive Disorder (OCD) is an anxiety disorder. Many people have a stereotype of the condition in their minds. They think about the person who checks the stove thirty times before leaving the house or washes their hands fifty times per day because they’re afraid of germs. Those things do happen for some people with OCD. However, there are different types of OCD and different levels of severity.
What All OCD Types Have in Common
There are two things that all types of OCD have in common:
Obsessions, which are distressing, undesired thoughts and/or images that don’t go away
Compulsions, which are behaviors the person does in order to try to get rid of the obsessions
For example, in that classic stereotype of OCD as frequent handwashing, the person might constantly have the thought (obsession) that they’ll get violently ill from germs on their hands. They can’t stop thinking about the germs. Therefore, they perform the compulsion of washing their hands, often in a very routine way, as a means to try to get rid of the obsession. However, it never works, so the cycle repeats itself.
5 Types of OCD
The obsessions and compulsions that people have are many and varied. However, they tend to fall into five types of OCD:
1. Contamination
This is the “handwashing” type of OCD, although it’s not limited to that. People with contamination OCD are afraid of getting germs and/or catching illness. They’re often very afraid of potentially terminal illness such as cancer.
Common obsessions in contamination OCD include:
Your hands are always dirty
Doorknobs are filthy
You’ll get sick if you share food or drink with someone
Shaking hands with someone else will give you germs or make you ill
Fear of public transportation due to contamination
Each type of obsession has a corresponding type of compulsion. In contamination OCD, the compulsions are around washing, cleaning, and protecting your health. Examples include:
Handwashing / showering with increasing frequency, duration, and intensity
Using bleach to wash self and/or home
Overuse of gloves and protective gear
Constant use of hand sanitizer
Avoiding objects and situations that you perceive could give you germs
Constantly going to the doctor for tests to make sure you’re not ill
Some people with this type of OCD also have great fear that their loved ones will get sick and die from contamination.
2. Symmetry OCD
People with symmetry OCD want things to be just so. They may specifically want items to be symmetrical. However, they may just have an idea in mind that things should be arranged or completed in a certain way.
All of the obsessions are related to the idea that things have to be a certain way. This can manifest very specifically with thoughts like:
All food pantry labels should face outward
Items in a collection must be alphabetized
Things should be color-coded, like with like
Often the obsession is linked with the thought that something bad will happen if things aren’t just so. For example, obsessions could be:
If I don’t arrange the books by color, then my son will get kidnapped.
My spouse will get in an accident if I don’t have all of the toilet paper facing the “right” way.
If things aren’t just right, then my parents are going to die.
The compulsions in symmetry OCD are related to counting and arranging. Examples in addition to those indicated above include:
Arranging a desk with only specific items in a specific order
Hanging all clothes in a closet facing a certain way, by color
Sometimes the compulsion includes repeating a word or statement as you do the organizing and arranging.
3. Obsessive Fear of Harm or Danger
In this type of OCD, the individual has constant anxiety and fear about the harm that could befall themselves or others.
Common obsessions in Fear of Harm OCD include:
Worrying about your house burning down
Fears that your family will die from a gas leak
Thoughts of natural disaster ruining your area
Fear that worrying about these things will make them more likely to happen
Constant concern that someone is going to break into the house
Worry that someone will attack you
The compulsions in this type of OCD are related to “checking.” For example:
Repeatedly checking that the stove and other appliances are turned off
Driving by your house or child’s school regularly to make sure it’s okay
Rituals involving checking all of the locks before bed
Never allowing candles or fireplace fires in your home
Overusing cameras and home security systems
Constantly checking on valuable items to make sure they’re still there
4. Fear of Harming Others or Sinning
Sometimes people with OCD suffer from the thoughts, ideas, and images about harming others. Alternatively, they may think about acts they consider sinful or taboo. For example, thinking about:
Inappropriate sexual behavior such as incest, molestation, or rape
Attacking someone physically including fantasies of mass destruction
Thoughts of harming yourself
Worry that you’ll accidentally poison or harm someone
Preoccupation with doing the right moral thing at all times, often with a religious bent
It’s important to note that these people are unlikely to act on these thoughts. However, their OCD makes them afraid that they will do so. Therefore, they perform compulsions to counteract those obsessions. Oftentimes, these compulsions aren’t visible to others. Examples include:
Praying, confession, and/or attending church constantly and persistently
Reciting mantras or repeating specific words, phrases, or poems
Hiding objects, such as knives, that could be used to harm others
Repeatedly seeking reassurance from loved ones that you’re not going to hurt them
People with this type of OCD are terrified that they will harm someone or do something inappropriate. Therefore, they also compulsively avoid any potential triggers. Their world may get smaller and smaller as a result.
5. Body-Dysmorphic OCD
This condition, in which you perceive flaws in your body that others don’t see, has recently been recategorized as an OCD subtype.
Obsessions include:
Not being thin enough or muscular enough
Worrying constantly that everyone’s staring at your perceived flaws
Feeling deformed
Compulsions including:
Constantly making changes to appearance
Staring regularly into mirrors and nitpicking
Extreme diet and/or exercise routines
Changing your wardrobe to cover up your “flaws”
Avoiding activities and people because you don’t want them to see your flaws
All types of OCD cause people to suffer due to both their obsessions and compulsions. However, treatment is available. Nobody has to suffer alone.