Obsessive-compulsive disorder (OCD) is a mental health disorder categorized by excessive intrusive thoughts (obsessions) that lead to repetitive — and often irrational — behaviors (compulsions). While many people may double-check that the door is locked or their curling iron is unplugged, OCD goes beyond simply checking things. And even though many people might experience obsessive thoughts or compulsive behaviors at some point in their lives, for a person with OCD, obsessions and compulsions become a vicious cycle that interferes with their daily life.
If you have OCD, you may have noticed that your obsessions and compulsions are centered on a specific theme. These different themes are what are referred to as OCD subtypes. While knowing the different subtypes can be helpful in better understanding your symptoms and seeking treatment, know that it’s not uncommon to experience symptoms of multiple subtypes.
Below you will find a brief description of 18 different OCD subtypes. If you think you may have one of the subtypes listed, it’s best to contact a licensed therapist for an official diagnosis and treatment plan.
Checking OCD is one of the most commonly known subtypes of OCD. It is also often how OCD is stereotypically represented in movies or television shows — which don’t always do a great job of reflecting the reality of OCD. This subtype is categorized by checking-based compulsive behaviors, such as excessively making sure the stove is off. Someone with checking OCD may fear that they may be responsible for something bad happening if they don’t continuously perform their checking rituals.
If you have checking OCD, your obsessions may vary from safety concerns to concerns about making mistakes or behaving inappropriately. You may feel these concerns are never-ending and intrusive. To ease the discomfort, you use checking-based compulsions as a neutralizing behavior. For someone without OCD, these compulsions might appear irrational, but you feel certain something bad will happen if you don’t check.
Contamination OCD is more than just a fear of germs — it is an obsession that causes serious distress and anxiety. A person with contamination OCD may have an intense fear of contracting an illness or spreading germs. They try to relieve the fear by engaging in compulsive behavior.
This subtype can manifest itself in various ways depending on the person. One person may avoid using public restrooms for fear of germs, while another person may feel convinced that they are going to contract an illness and try to neutralize the obsession by aggressively showering after feeling contaminated and researching the illness for hours.
If you think you may have contamination OCD, you may find yourself dwelling on your fears on a daily basis.
Do you find yourself counting in certain patterns to feel “right”? You may have counting OCD.
Counting OCD is characterized by obsessively thinking that something bad may happen and engaging in counting-based compulsions. Even if you recognize that it may not make sense, you may ritualistically count to guarantee safety for both yourself and others.
After being exposed to a triggering event, you may find yourself mentally counting to a certain number over and over again. As the obsessions become more intense, the counting in your head may evolve into tapping to the number, or you may have a ritual that you feel compelled to perform a certain number of times before you leave the house. You may have to brush your teeth for the same amount of time every day or walk the same number of steps in order to feel safe enough to leave.
You may also find that the counting is automatic. Once you become aware of the fact that you are counting, this will then trigger obsessive thoughts, such as “What if I can never stop counting?” As with all subtypes of OCD, the symptoms of counting OCD can manifest in a variety of ways.
Nearly everyone has questioned what their purpose in life is at some point. Although feeling a lack of purpose can be anxiety-inducing for anyone, for someone with existential OCD, this kind of questioning becomes all-consuming. Like the other OCD subtypes, existential OCD is categorized by obsessions and an urge to perform compulsive behaviors.
The compulsions for this subtype are numerous. If you feel you have existential OCD, you may spend hours on end contemplating the purpose of your life or whether you are really here or not. While someone without OCD can move past these questions easily, you may find it nearly impossible. This may lead to even more questions, excessive research to find answers or seeking reassurance from others that you are real.
Because the types of questions you are asking yourself are common, you may delay diagnosis and treatment. You may also be misdiagnosed with depression or generalized anxiety disorder. It’s important to find a therapist with experience treating OCD to better understand how this condition may affect you.
False Memory OCD
Have you ever recalled a memory in your head? When doing this, we often feel the “playback” of these memories is completely accurate. Unfortunately, memories are easily distorted and can be constructed differently each time we recall them.
For someone with false memory OCD, the uncertainty in recalling memories can be extremely anxiety-inducing. If you have this subtype of OCD, you may find yourself compulsively recalling memories. With each new recall, you add to the uncertainty as you might confuse the details, furthering your obsession with the memory. This turns into a vicious cycle where you feel stuck trying to play the memory back accurately, to the point where you may create a “false memory.”
This can be extremely distressing and lead to questioning whether the memory ever happened or happened in the way you remember. Because you begin to doubt your reality, this can lead to any number of compulsions, such as reassurance-seeking, acting on the guilt of what you think you may have done or returning to the physical site of the memory.
Harm OCD is a common OCD subtype that centers on intrusive thoughts of hurting other people. As with other subtypes, someone with harm OCD acts on compulsions to relieve the distress and fear associated with the thoughts.
If you have harm OCD, you likely feel great fear that you could harm the people around you by acting on your obsessions. To ease this fear, you may engage in neutralizing compulsions, such as avoiding objects that may potentially harm someone or the person you fear you may harm, constantly seeking reassurance from your spouse that you won’t harm someone or any number of mental rituals.
Hoarding is a well-known disorder marked by excessively collecting or feeling unable to get rid of items. For someone with hoarding OCD, the inability to discard items may be because they fear something bad may happen if they do. It may also be connected to an obsessive feeling of incompleteness without the item.
Hoarding OCD can also be connected to other OCD subtypes. For instance, you may develop hoarding OCD as a result of compulsively acquiring items to ease the distress caused by other OCD-related obsessions. It can also result from contamination OCD. If you have contamination OCD, the fear of germs on certain items may prevent you from throwing them away. No matter the origin of your symptoms, the good news is that they are highly treatable.
“Just Right” OCD
Another commonly caricatured OCD subtype seen in movies or shows is “just right” OCD. This subtype is different from many other subtypes because of the difficulty in identifying a specific underlying fear. Instead, it’s characterized by a general and intense feeling that something just isn’t right.
As with the other subtypes, someone with “just right” OCD can feel stuck in a cycle of obsessions and compulsions. The obsessions may look like feeling that something isn’t right and feeling the need to start over to make it right. As a result, the compulsions can include continuously redoing activities or rearranging items until things feel “just right.”
Magical Thinking OCD
Most people have engaged in some sort of superstitious behavior, but magical thinking OCD is an intense manifestation of superstitions. While someone without OCD may say “knock on wood” and then be able to move on without fulfilling the superstitions, a person with magical thinking OCD feels compelled to complete the ritual. This inflexibility is a result of feeling that something bad may happen or a good thing will not happen if the ritual is not completed.
Overall, magical thinking OCD is categorized by an extreme belief in your thoughts directly influencing your physical world. For example, you may feel that if you think about a plane crashing, it will actually happen. Despite any concrete evidence to connect your ideas and any such events, you feel driven to do everything in your power to control the outcome.
Like any subtype, pedophilia OCD (POCD) is characterized by intrusive, unwanted thoughts and ritualistic behavior to neutralize the thoughts. In the case of POCD, the obsessions are centered around a very specific theme: unwanted sexual thoughts about children.
If you have POCD, you may feel uncertain as to whether you really would act on your thoughts. Nonetheless, it’s likely that you feel you can’t trust yourself. You may compulsively act to diminish the risk of acting on your obsessions. Because of the shame associated with your obsessions, you might feel uncomfortable disclosing your symptoms to your therapist. You’re not alone in this — research shows that POCD is common but often undiagnosed. While it’s understandable to fear the repercussions of telling someone about your unwanted thoughts, it is the first step to receiving help.
For a new parent, it’s common to feel fear about the safety of your child. However, for someone with perinatal OCD, this fear manifests much more intensely during pregnancy and up to about a year after birth. It follows the same pattern as general OCD: obsessive thoughts and compulsive behaviors to neutralize the thoughts.
If you have perinatal OCD, it’s likely that you had OCD prior and that pregnancy exacerbated your symptoms. At the onset of perinatal OCD, you may suddenly feel gripping fear that your baby is in danger or that you may hurt your baby. You may also feel an irrational urge for symmetry and order or fear of contamination. As a result, you may obsessively check on your baby or sterilize the baby’s bottles over and over. While perinatal OCD is overwhelming, it is treatable.
Similar to perinatal OCD is postpartum OCD, which emerges immediately after childbirth instead of during pregnancy. Like perinatal OCD, this subtype is characterized by obsessive thoughts, such as feeling your child is always in danger, and compulsions, such as seeking reassurance that you’re a good parent or avoiding being alone with your child.
Purely Obsessional OCD
While almost every OCD subtype is categorized by both obsessions and compulsions, purely obsessional OCD (pure OCD) can vary. To an observer, someone with pure OCD seems to have no compulsions. And unlike other subtypes, the theme of their obsessions can be ever-changing. For example, for some time, the obsessions may center on thoughts of harming other people, only to later change to a fear of germs.
Because the obsessions seem to constantly be evolving, someone with pure OCD may not engage in compulsive behaviors in the same way others with OCD do. If you have pure OCD, your compulsions likely aren’t direct actions. Instead, you may perform mental rituals, such as intensely trying to replace negative thoughts with positive thoughts.
While the symptoms might be more subtle, they can still be extremely overwhelming and anxiety-inducing. That’s why this subtype was categorized — to help someone with pure OCD better identify their symptoms and seek treatment.
Real Events OCD
Many manifestations of OCD are future-oriented — there is typically a fear that something bad could happen if certain rituals aren’t performed. This is not the case for real events OCD, which is centered on real events that have already taken place.
Someone with real events OCD twists a real-life scenario into something more harmful or awful than what actually occurred. They may feel that an incident happening now is a result of something they did in the past, even if the two things aren’t necessarily connected. There seems to be an overwhelming sense of responsibility or guilt tied to past events. To relieve these distressing emotions, a person with real events OCD may excessively research things connected to the event or obsessively review the event to see if any wrongdoings were committed.
It can be completely normal to experience doubt in a relationship, but for someone with relationship OCD (ROCD), the uncertainty can feel unbearable. They may constantly question if they’re with the right person or if their partner actually wants to be with them. Any sign of doubt can launch the obsessive-compulsive cycle. It is when these cycles become all-consuming that the doubt moves beyond “normal” into what is likely ROCD.
Scrupulosity (Religious) OCD
Like other subtypes of OCD, someone with religious OCD experiences unwanted thoughts and urges with their obsessions centering on violating their religious, moral or ethical beliefs. They can manifest as a fear of telling a lie, causing harm to someone or committing a sin. To alleviate their distress, they may enact compulsive rituals, such as excessively praying or avoiding places that trigger the obsessions.
As each individual has different beliefs, the symptoms of religious OCD can vary. However, it is overall categorized by anxiety over thoughts or actions and the need to perform compulsive behaviors.
Sexual Orientation OCD
Sexual orientation OCD, often referred to as homosexual OCD, is characterized by obsessions about one’s own sexual orientation. Intrusive thoughts and urges may include a fear that one is in denial about their sexuality or suppressing their true feelings. It may also look like a hyper-awareness of actions and whether they will be perceived by others as “gay” or “straight.”
If you have sexual orientation OCD, you may find yourself constantly seeking reassurance from your partner about your sexuality, analyzing past interactions to see if you acted “gay” or “straight” or avoiding people or activities that you associate with a certain sexuality. This can be extremely distressing and interfere with your relationships and friendships. It’s important to note that having this condition isn’t actually about your sexual orientation, but the sense of doubt that’s common among all subtypes of OCD.
All thoughts of suicide or self-harm should be taken seriously. If you or someone you know has reported thoughts of self-harm, please call 911 or contact your local emergency room number immediately. In the United States, you may also call the National Suicide Prevention Lifeline at 1-800-273-8255. This line is available to you all day, every day.
While people with harm OCD may obsess over harming coming to themselves or others, suicidal OCD centers on an intentional desire to harm oneself. Like with other subtypes, suicidal OCD is characterized by persistent, intrusive thoughts. In this case, these thoughts are suicidal and there may be an attempt to suppress them through repetitive and ritualistic behaviors.
Someone with suicidal ideation may have similar thought patterns, but these thoughts are deliberate and voluntary. If you have suicidal OCD, your thoughts may feel out of your control, and you do not truly want to die. Thus, your obsessions and compulsions are extremely distressing.
How is each subtype treated?
If you think you may have one of the subtypes listed above, know that your OCD is treatable. While each subtype may be categorized by a different central theme, they all entail the same underlying mechanisms and involve the same cycle of obsessions and compulsions. For OCD, exposure and response prevention (ERP) therapy has been found to be the most effective form of treatment for any subtype.
ERP therapy is the gold standard in treatment for OCD, and it’s a form of cognitive behavioral therapy (CBT) that works by exposing you to the things that trigger your specific obsessions to help prevent your compulsive responses — and overall help your distressing feelings become more manageable.
NOCD offers a nationwide network of licensed therapists specializing in ERP. Having OCD may feel overwhelming and all-consuming, but it doesn’t have to be — you can begin seeking treatment today by scheduling a free call with the NOCD clinical team.