The Different Subtypes of OCD

Common OCD Subtypes

The OCD spectrum is wide, as the disorder may affect everyone differently. While obsessions refer to intrusive and unwanted thoughts that cause distress, compulsions are the actions the individual feels they must complete to alleviate their distress. However, this relief is only temporary.

Although specific symptoms of OCD subtypes appear to be relatively stable over time, people with OCD can experience a change in the focus of their obsessions and compulsions. It’s possible to experience symptoms of other types of OCD simultaneously, as well. Below are some common subtypes of OCD, including rare and atypical OCD types.

Contamination Obsessions with Washing/Cleaning Compulsions

People with OCD who experience contamination obsessions and perform washing and cleaning compulsions usually focus on feelings of discomfort associated with contamination, uncleanliness, or germs. They may wash or clean themselves excessively, often to the point of skin damage.

A common contamination obsession or intrusive thought is feeling as if your hand is dirty or contaminated or worrying that you’ll contaminate others with your hands after touching a doorknob in a public area. To get rid of these feelings, this individual might wash their hands several times or even for hours.

Harm Obsessions with Checking Compulsions

Often individuals who experience this OCD subtype have intense thoughts related to possibly harming themselves or others. They might use checking rituals to alleviate their distress.

For instance, a person with harm-related OCD might imagine a friend’s house is burning down and then drive past the house several times to make sure it’s not. Or they might feel that just by thinking of a terrible event, they’re increasing the chances of it ever happening.

Obsessions Without Noticeable Compulsions

Some people with OCD experience obsessions or intrusive thoughts that are sexual, religious, or aggressive but don’t perform any visible compulsions. For instance, they might experience intrusive thoughts about hurting someone or that they will attack someone.

They usually use mental rituals or compulsions to alleviate their distress, such as repeating mantras to themselves or reciting particular words, counting in their head, or praying. They’ll usually avoid triggers related to their obsessive thoughts at all costs, as well.

Symmetry Obsessions with Arranging, Organizing, and Counting Compulsions

Symmetry obsessions and reorganizing OCD is one of the most common OCD themes and one that most people think of whenever they hear of obsessive-compulsive disorder. Many people even refer to themselves or others who are overly organized as having OCD, although this has contributed to much stigma surrounding the disorder.

Those with symmetry and organizing-related OCD may feel a strong need to arrange and rearrange things until they’re “just right.” For instance, they might rearrange their shirts, so they’re perfectly color-coordinated.

This subtype of OCD can also include thinking or saying sentences or words repeatedly or compulsions that are repetitive movements, such as flicking the light switch on and off a certain number of times until the task is accomplished perfectly. Sometimes these organizing and counting compulsions are performed to ward off potential danger. For instance, the person might think if they arrange their closet perfectly, their partner won’t get into a car accident.

Hoarding

Another obsession that’s long been considered a type of obsessive-compulsive disorder is hoarding, or the inability or difficulty to discard possessions due to a perceived need to save them. A person who hoards, or hoarders, may save various items to the point where they’re stacked up to the ceiling inside their living room, bedroom, bathrooms, kitchen, and back and front yards.

These individuals usually believe these items are unique and will be needed in the future, which makes them hesitant to throw out even the rattiest or unused items they own. Items may also have a deeper, emotional significance to them, making them feel safer or possibly reminding them of a happy memory.

Lesser-Known Types of OCD-Related Disorders

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) included new definitions of the disorders or moved them to the OCD category.

• Skin picking disorder (excoriation): This disorder is one of the rare forms of OCD, affecting only 1% to 2% of the population. Excoriation refers to persistent skin picking that results in lesions, infections, clinical, and significant distress.
• Hair-pulling disorder (trichotillomania): People with this OCD-related disorder have a strong urge to pull the hair from their heads, eyebrows, eyelashes, or somewhere else on their bodies. It’s usually a treatable and reversible habit with training and cognitive behavioral therapy (CBT).
• Body dysmorphic disorder (BDD): Although it’s bucketed with eating disorders, BDD is a preoccupation with one or more perceived flaws in appearance that aren’t noticeable or appear slight to others. This OCD subtype includes repetitive grooming behaviors or checking appearance, as well as mental actions like constantly comparing your appearance to others.

In addition to the clinically recognized types of OCD, there’s also a long list of obsessions and compulsions that aren’t commonly discussed. Some of these include religious OCD (scrupulosity), hit-and-run OCD, real events OCD, relationship OCD, pedophilia OCD, and more.