Sometimes, people’s understanding of the symptoms and obsessions of Obsessive Compulsive Disorder (OCD) can be a little misplaced. ‘’Oh, I’m so OCD’’, a friend proclaims, as they put a plate in the dishwasher or rearrange a skew-whiff picture frame in a completely standard fashion.
Perhaps some of these misconceptions stem from a lack of understanding about various OCD subtypes. Nope, this thing certainly isn’t a catch-all term for a general preference for tidiness. Rather, it goes deeper and gets far more complex.
Indeed, it’s easy to assume that the disorder revolves solely around germophobia and cleanliness, but OCD is a very complex and multifaceted illness, and can cause obsessions around relationships, symmetry and order, and endless other hyper-fixations. As a result, sufferers can exhibit compulsive behaviour intended to reduce their anxiety and prevent their fears from becoming a reality, only to continue their cycle of anxiety all over again.
OCD is a subjective disorder, which is why it can take multiple forms, and there’s no definitive list of OCD subtypes. However, here are six of the most commonly observed OCD subtypes and their symptoms.
Checking OCD
Checking OCD involves compulsions regarding mental checklists, typically revolving around their loved ones or their own safety. That can range from checking if the door is locked to ensuring they turn the stove off. Patients with OCD perform these checks repeatedly, often feeling an all-consuming need to check, even if they just checked a few moments ago.
Obsessions in checking OCD can revolve around burglary, theft, fires, flooding, car accidents, reading and understanding, diseases, and upsetting loved ones. Here are a few commonly seen symptoms of checking OCD:
- Checking whether all doors and windows are closed
- Checking stoves, lights, and electronic appliances have been turned off
- Checking taps have been turned off, even in workspaces
- Repeatedly asking loved ones if you have upset them
- Calling and texting family and friends to see if they are okay
- Meticulously and extensively planning routes in advance
- Re-reading sentences over and over again
- Hyper analysing symptoms
Contamination OCD
Contamination OCD is one of the most common (and commonly stereotyped) subtypes of OCD, with obsessions revolving around germs and cleanliness. A person suffering from contamination OCD may fear that being contaminated by an external source could lead to sickness or death. Therefore, they may perform excessive cleaning rituals as their compulsion to prevent contamination.
Obsessions in contamination OCD can revolve around becoming sick, and compulsions may manifest as:
- Washing hands excessively
- Avoiding contact with strangers
- Avoiding vaccinations and injections at all costs
- Avoiding red blood-like stains
- Excessive and extended tooth brushing and flossing
In rare cases, contamination OCD may also cause fear of mental contamination, such as infidelity, crime, and abuse. It can show up in symptoms like:
- Avoiding anything that reminds them of their partner
- Performing good deeds counteract internal uncleanliness
- Repenting or asking God for forgiveness for their crimes
- Avoiding reminders of a traumatic experience
- Washing hands or body excessively to rid themselves of a dirty feeling
Religious or Scrupulosity OCD
Religious OCD, also known as scrupulosity, is one of the oldest recorded subtypes of OCD, creating intense fear of breaking religious rules and upsetting God and religious authorities. Their compulsions can revolve around living sin or performing sinful acts, prayers being recited incorrectly, unholy or blasphemous thoughts, and similar actions.
Here’s how religious OCD can manifest:
- Excessive prayer to repent for their sins
- Spending too much time in holy places
- Excessively reciting prayers for correction
- Analysing every single sentence of the prayer
- Reading religious texts excessively
- Looking for reassurance from friends and family
- Constantly asking, “Did I commit a sin?”
Symmetry & Ordering OCD
Symmetry and order OCD is another common subtype, causing the patients to feel anxious about perfectionism, especially in visual forms. Typically, they feel the need to achieve perfect symmetry and order, especially in their living spaces. Otherwise, they may feel highly anxious and like something catastrophic may happen.
Patients with symmetry and ordering OCD typically have compulsions surrounding items or objects that are disorderly or uneven, asymmetrical, or unbalanced. Their symptoms may manifest in ways like:
- Rearranging or evening out the items when they become disorderly
- Stopping people from tampering with perfectly ordered items
- Monitoring items to ensure their symmetry
- Holding everything with two hands to ensure balance
- Checking that objects are perfectly balanced on flat surfaces
- Walking everywhere with feet planted in a particular position
Magical Thinking OCD
Magical thinking OCD is a subtype of the disorder, but all OCD patients may suffer through its compulsions. Often considered ‘superstitious’ behaviour, magical thinking OCD causes patients to believe specific actions can protect themselves or their loved ones from catastrophes.
Their compulsions revolve around superstitions like stepping on cracks, certain days of the week, and specific colours, with symptoms like:
- Staying home in fear of stepping on a crack accidentally
- Reciting a prayer or mantra after unintentionally stepping on a crack
- Staying at home on a specific day to prevent accidents
- Asking and advising loved ones not to wear a particular colour
- Reciting a prayer or mantra after seeing a certain number
Relationship OCD
Relationship OCD involves intrusive or upsetting thoughts about one’s partner, causing stress and anxiety and leading to harmful compulsive behaviour. This subtype of OCD typically shows up in early adulthood, especially in romantic relationships. It can cause the patient to obsess over whether they’re with the right person, taking the right steps (marriage, children, etc.), or if their partner is faithful.
Here are a few compulsions seen in patients with relationship OCD:
- Overanalysing time spent with your partner
- Trying to determine for sure if you and your partner are true ‘soulmates.’
- Comparing your previous relationships to your current one
- Obsessing over your partner’s flaws
- Ending relationships due to personal insecurities
- Avoiding being intimate with your partner
- Avoiding hanging out with your single friends
The Bottom Line
Since OCD is a subjective mental disorder, there is no one-size-fits-all way to describe it or exact symptoms to categorise it. OCD has many subtypes with various fixations, making the diagnosis and treatment somewhat complicated.
It’s also worth noting that the list mentioned above is not a comprehensive guide on OCD subtypes, as other unmentioned subtypes are less talked about, such as false memory OCD, maternal OCD, sensorimotor OCD, and more.
Should you be suffering and are keen to get help, it’s sensible to first speak to your GP, who can then refer you to a specialist, whether that’s a therapist, clinical social worker, or psychiatric nurse or other qualified health professional, or recommend the appropriate treatment, which may involve medication.
*This article is not intended to replace medical advice, diagnosis or treatment given by a qualified mental health professional. Instead, this article only provides information, not advice. For any medical enquiries, always consult your GP first*