What are the types of OCD?

A fear of germs or contamination is a common obsession people with OCD experience.

Up to 46% of people with OCD experience fear of contamination. This can cause them to feel distressed by touching objects that are generally harmless, such as doorknobs.

People with contamination OCD may also experience cleaning compulsions. These compulsions can include excessive cleaning of the areas around them and handwashing. People experiencing this type of compulsion can spend so much time cleaning or washing their hands that it leads to physical issues like skin irritation and bleeding.

Some people feel the need to clean so much it keeps them from leaving their house.

It is believed that a combination of disgust, fear, and anxiety may play a role in contamination OCD. People with this type of OCD may find it difficult to disengage with the stimuli that cause them fear and disgust.

Symmetry OCD may also be referred to as “just right” or perfectionism OCD.

Research shows that up to roughly 50% of adults with OCD experience symmetry-related obsessions.

This type of OCD is based on the need for symmetry and orderliness. Symmetry obsessions are another common obsession that people with OCD experience. An example of this may be the need for all the labels of items in a cupboard to be facing the same direction.

Some of the compulsions people with symmetry OCD may experience include:

• ordering and arranging
• evening up or aligning things
• touching or tapping

Checking may be the most common compulsion in those with OCD.

The exact cause of compulsive checking is not known. However, some believe it may be connected to the fear of harming oneself or others, self-doubt, or to help diminish feelings that things are not just right.

Checking compulsions may include frequently checking the door locks, the stove, or the light switches. Other types of checking may include:

• checking the news constantly to be sure a loved one has not been in an accident
• counting text messages from one’s partner to confirm their love
• seeking reassurance from others frequently
• requiring excessive information before making a decision

Rumination involves repeatedly dwelling on or thinking about negative feelings, distress, and their causes or consequences. Many of the obsessions that are associated with OCD involve rumination.

Intrusive thoughts are one of the characteristics of OCD. These thoughts may include:

• thoughts of harming oneself or others
• unpleasant sexual images or thoughts
• unwanted thoughts involving religion
• doubts over having completed something correctly
• fears of saying or doing something inappropriate in public

Many people with intrusive thoughts also experience “mental checking.” This can include avoiding places and situations or thinking “neutralizing thoughts” to counteract the intrusive ones.

Hoarding can be a condition on its own. However, it is often seen in combination with other mental health conditions like OCD.

People with hoarding disorder find it consistently difficult to part with or get rid of possessions. This is generally due, at least in part, to their perceived need to save the items. If they do attempt to get rid of an item, they are typically met with feelings of distress that cause them to save it.

The clutter that results from hoarding can result in an inability to use living spaces. It can also lead to issues in important areas of functioning, such as relationships, social activities, and work. This can include:

• conflicts and strain in relationships
• loneliness and isolation
• unwillingness to allow others to enter the home
• inability to perform daily tasks, such as bathing or cooking

Serious hoarding can also cause:

• fire hazards
• tripping hazards
• health code violations

There are many subtypes of OCD. However, most of them fall under one of the main types.

Pure-O OCD

Pure-O OCD refers to purely obsessional. While it may not be an official subtype of OCD, people use this term to refer to OCD where a person experiences intrusive thoughts and obsessions with no visible signs of compulsions.

However, this does not mean that a person does not experience compulsions. These are typically mental compulsions, such as:

• checking one’s feelings
• checking one’s bodily sensations
• checking how one feels about a thought
• repeating phrases or numbers in one’s head
• checking if the thought is still there

Real events OCD

Another nonofficial subtype is real events or real-life OCD. With this type, a person may obsess about an event that actually happened to them or that they witnessed. This is opposed to the obsessive thoughts that are typically associated with OCD about the consequences of what could happen.

Treatment for OCD typically includes medication, psychotherapy, or a combination of the two.

Medications generally used to treat OCD include serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs). Sometimes if these medications are ineffective, a healthcare or mental health professional may recommend antipsychotic medication to help manage symptoms.

Psychotherapies like cognitive behavioral therapy (CBT) have also been shown to be effective in treating OCD. A specific type of CBT called exposure and response prevention (EX/RP) or exposure therapy is typically effective to help reduce compulsion behaviors. With this therapy, a person spends time in situations that usually trigger compulsions but are prevented from performing the compulsion.

There are various types of OCD. Each type is based on the obsessions and compulsions a person may experience.

These include contamination, symmetry, and checking. Others may include intrusive thoughts and hoarding.

Treatment for OCD typically involves medication, psychotherapy, or both.

If a person believes they may be experiencing signs of OCD, it’s important that they contact a healthcare or mental health professional.