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With nearly identical names, obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) sound like they should be closely related.

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But they’re actually two different mental health conditions. Think of them more like cousins than siblings.

“The biggest difference is that OCD involves unwanted thoughts and repetitive behaviors that you don’t want to have,” says psychologist Dawn Potter, PsyD. “With OCPD, you’re generally obsessive about perfectionism, being in control and doing things correctly because it’s part of your personality.”

If the distinction still isn’t clear, you’re not alone. To help, Dr. Potter compares and contrasts these two conditions and how they can affect your life.

OCD vs. OCPD

When it comes to OCD and OCPD, it can be easy to get confused. On the surface, they can both look like a rigid need for neatness, control or exactness.

The key difference is why the behaviors happen:

OCD makes you do certain actions (compulsions) to help quiet unwanted thoughts (obsessions). It typically stems from anxiety or distress.
OCPD is a pattern of certain personality traits that are taken to the extreme. The driving force behind it is a need for control and order.

“The behaviors of OCPD are general and show up in all aspects of life,” Dr. Potter explains. “On the other hand, specific situations and thoughts trigger OCD behaviors.

“With OCD, the behaviors are typically senseless or repetitive and may not be rationally connected to the unwanted thoughts,” she continues. “With OCPD, you’re doing something meaningful, but it may be inefficient.”

To help see the difference, let’s look at a behavior such as writing a list:

With OCD, you may have thoughts that something bad will happen to your mom if you don’t write out a list of items perfectly. You keep rewriting the list until you feel OK enough to move on.
With OCPD, you may spend a long time making a list of steps for a work project because you want to get it exactly right. You do this because you don’t want to make a mistake once you start the project.

Another key difference is the level of insight or self-awareness you have with each condition, Dr. Potter says.

If you have OCD, you often want to stop the behavior but simply can’t. It feels out of your control and doesn’t align with how you see yourself.

With OCPD, you don’t see anything wrong with how you think and behave because you feel it’s the correct way to be.

OCD symptoms vs. OCPD symptoms

OCD symptoms fall into two categories: obsessions and compulsions.

Some examples of obsessions include:

Fear of germs, dirt or body fluids
Fear of hurting yourself or others
Intrusive sexual thoughts that are out of character for you

Some examples of compulsions include:

Putting items in a very specific order until it feels right
Saying words or phrases in your head while doing unrelated tasks
Repeating actions, like tapping, a certain number of times

“Many people think OCD is only about cleanliness or keeping things organized, but that’s not the case,” says Dr. Potter. “Obsessions and compulsions can take many different forms.”

Symptoms of OCPD are ongoing and affect work, relationships and everyday situations. Some signs include:

Being obsessive with details, rules, lists, order and organization
Perfectionism that interferes with completing tasks
Avoiding what you perceive to be failure at all costs
Being rigid and stubborn in your beliefs and ways of doing things
Being unwilling to compromise

“You have these OCPD traits from sunrise to sundown — they’re constant,” she adds.

OCD treatment vs. OCPD treatment

While both conditions are typically treated with talk therapy, the approaches aren’t the same.

“Exposure and response prevention therapy is the gold-standard treatment for OCD to help you face fears without doing compulsions,” says Dr. Potter. “For OCPD, cognitive behavioral therapy can help you identify and change unhelpful patterns of thinking and acting.”

Sometimes, your healthcare provider may suggest antidepressants to help limit obsessive thoughts linked with OCD. Currently, there aren’t medications that directly treat OCPD.

Is one worse than the other?

If you’re wondering whether OCPD is simply a milder form of OCD, the answer is no.

“They’re two distinct conditions,” Dr. Potter emphasizes. “One isn’t a mild or more extreme version of the other. But it is possible to have both at the same time.”

Without treatment, both can significantly affect your daily life. OCD is more likely to cause internal distress from intrusive thoughts and compulsions. OCPD is more likely to create tension in relationships and with work.

The bottom line

If intrusive thoughts, repetitive behaviors or perfectionism are making it harder to get through your day, you have to try to figure it out on your own. A healthcare provider or mental health professional can help determine what’s going on and connect you with the right treatment.

“It’s very difficult to recover from either condition on your own,” Dr. Potter stresses. “But with time, treatment can be very effective in helping you feel better.”