OCD is more than frequent handwashing. There can be several types — each with varying behaviors and symptoms.
Obsessive-compulsive disorder (OCD) is a mental health condition that’s characterized by recurring thoughts (obsessions) and uncontrollable behaviors (compulsions) that a person feels the urge to repeat.
According to the National Institute of Mental Health,
OCD is frequently misunderstood and misrepresented in the media. People with OCD are often portrayed as or assumed to be exceptionally tidy and fearful of germs. While this is true for some people with OCD, there are other types of OCD that have nothing to do with cleanliness at all.
There are many types of OCD. While each one still has both obsessions and compulsions, these behaviors can look different.
Harm OCD involves intrusive thoughts of inflicting violence onto someone else or oneself.
Having violent or aggressive thoughts every now and then is not uncommon. However, if you have harm OCD, you might be deeply disturbed to have these thoughts and need reassurance that you won‘t act on them.
You may perform a ritual or engage in compulsive behaviors to decrease the anxiety caused by these violent thoughts.
It’s important to note that having these thoughts doesn’t mean you’ll act on them.
Obsessions, or intrusive thoughts, for this type of OCD might include:
- fear of having suicidal thoughts or behaviors
- fear of committing violent acts
- fear of harming a loved one or yourself
- fear of unconsciously harming someone without being aware of it
- fear of violent urges
Some examples of compulsions might include:
- avoiding knives or other sharp objects
- repeatedly checking yourself and others to see if you’ve harmed someone
- ruminating over past events to ensure you haven’t harmed someone
- avoiding situations or people that may trigger these obsessions or thoughts
This type involves behaviors concerning a person‘s sexual orientation. While it‘s sometimes called homosexual OCD, a person with any sexual orientation can experience it.
If you have this type of OCD, you might obsessively question your sexual orientation and how it‘s perceived by others.
Obsessive thoughts of this type might include:
- What if someone incorrectly assumes my sexual orientation?
- What if I‘m in denial about my true sexual orientation?
- Will my sexual orientation abruptly change and affect my relationship?
Compulsions associated with this OCD might look something like:
- repeatedly asking others how they perceive your sexual orientation
- looking at pictures of the same or opposite sex to see who you’re attracted to
- avoiding people of the same or opposite sex
Pedophilic disorder is a mental health condition involving sexual attraction to children. Pedophilia OCD is characterized by unwanted thoughts or urges about pedophilia that correlate with compulsions to alleviate anxiety.
Pedophilia OCD is not the same thing as actual pedophilia.
Obsessive thoughts of this type might look something like:
- What if I have sexual thoughts about children?
- Am I a pedophile?
- What if I acted on my urges and don‘t remember?
Examples of compulsions might include:
- avoiding children altogether or looking at children to prove you‘re not attracted to them
- seeking evidence for reassurance that you‘re not a pedophile
- punishing yourself for having these thoughts
Remember that just because you may have these thoughts, it doesn’t mean you’ll carry them out.
Thoughts and behaviors from relationship OCD center around the validity of your relationship.
If you have this type of OCD, you might frequently worry that your relationship isn‘t genuine and doubt your partner‘s true feelings. This can manifest in needing reassurance from your partner and people outside the relationship, as well as comparing your relationship to others.
Examples of obsessive thoughts for this type might include:
- Am I truly in love with my significant other?
- What if there is someone better for me out there?
- What if my relationship isn‘t as genuine as someone else‘s?
Compulsions might include the following:
- asking your partner about previous relationships
- seeking reassurance from others
- examining and comparing other people‘s relationships to your own
It‘s more simple to identify an underlying fear in some types of OCD, but it isn‘t as easy with “just right“ OCD. This subtype of OCD is one that‘s often portrayed in the media.
If you have “just right“ OCD, you may feel the urge to have things a certain way when it comes to organization and perfection.
Examples of obsessions, or thoughts, for this type might include:
- fixating on perfectionism
- fixating on your appearance
- performing an action a specific number of times
Some compulsions might include:
- ensuring that things are the same
- avoiding situations or environments where you may feel compelled to perform an action repeatedly
Along with “just right“ OCD, contamination OCD is a common type portrayed in the media. If you have contamination OCD, you may fear getting sick or spreading sickness to others.
Some obsessions of this type might be:
- intense fear of coming into contact with germs
- fear of contracting a disease or illness
Examples of compulsions you might have include:
- avoiding places like public bathrooms
- disposing items that may have come into contact with germs or contagions
- washing your hands repeatedly
- researching symptoms of diseases and illnesses online
Pure-obsessional, or pure-O, OCD involves intrusive thoughts and compulsive behaviors, but the compulsive behaviors may not be obvious. It‘s also often called “predominantly obsessive.“
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People who identify as having pure-O OCD might have inward compulsions (ones that can‘t be seen) instead of outward ones (those that can be seen).
The obsessions for this type can focus on anything, such as sex, harm, religion, and more.
Examples of obsessive thoughts might include:
- What if I hurt someone?
- What if my significant other isn‘t right for me?
- Intrusive sexual images appearing in your head.
Compulsions might look like the following:
- mental rituals to reduce anxiety around intrusive thoughts or images
- self-reassurance
- looking for signs that you would never act on your intrusive thoughts
With this type of OCD, religion may turn into a source of anxiety instead of a source of comfort.
Obsessive thoughts of this type might be:
- Am I going to Hell?
- What if I‘m a sinner?
- Is what I‘m doing morally wrong or right?
Compulsions might include:
- seeking assurance from religious leaders
- performing acts of self-sacrifice to cleanse oneself
- attending religious services more frequently than usual
It‘s not uncommon to reflect on the past from time to time. But if you have real events OCD, you might have obsessions and compulsions surrounding past events more than usual.
You might experience extreme guilt over past actions. Fear and doubts about the past might occupy your mind to the point that you can‘t concentrate on anything else.
If you have this type of OCD, your obsessive thoughts might include:
- What if my past actions are the cause of immense suffering?
- What if someone is miserable because of something I said or did?
Your compulsions might look like the following:
- replaying the event in your mind over and over
- seeking reassurance from others
- confessing guilt to an authority figure
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) doesn‘t distinguish specific types of OCD.
However, there are common symptoms of OCD, and the way those symptoms present themselves can be described as types. Since symptoms manifest in different ways, there can be an infinite number of types of OCD.
If you think your OCD might be specific to a certain type, you might consider discussing this with a mental health professional. They can evaluate your symptoms and work with you to develop a plan of treatment, if needed.
OCD can affect your daily activities and social interactions. While there can be numerous types of OCD, the treatment options are often very similar.
Exposure response prevention (ERP) therapy — a type of cognitive behavioral therapy (CBT) — is the most common treatment for various forms of OCD.
While it’s not uncommon to have intrusive thoughts or double check something from time to time, if you have OCD, these thoughts and behaviors often interfere with daily life. According to the
If you think you may have OCD, you might want to consider talking with a mental health professional. They can guide you on the best treatment option for you.
Support groups can also be helpful. You can try searching in the International OCD Foundation (IOCDF) support groups directory for a group near you. They also have a resource for online or telephone support groups.
Other helpful resources include books, podcasts, workbooks, and articles that can help you learn about living with OCD. The IODCF has a list of books and multimedia that might be helpful.