How Many Types of OCD are There, and What are the Different Types?

Obsessive-compulsive disorder, or OCD, is a serious mental health condition that can become debilitating if left untreated.

People with OCD experience two core symptoms: obsessions and compulsions. Obsessions are intrusive and unwanted thoughts, and compulsions are repetitive behaviors the person does to try to rid themselves of the anxiety of the obsessions.

All people with OCD experience obsessions and compulsions. But the central theme OCD revolves around can be different for each person. OCD themes can be about anything, but experts have identified several common types of OCD that seem to appear more frequently.

But any type of OCD can be treated – here’s important information you need to know.

Are there different types of OCD?

When people talk about OCD subtypes, they’re referring to common themes of OCD obsessions that are shared among many people. Unlike generalized anxiety disorder, which causes people to worry about a wide variety of different things, OCD often causes people to experience intrusive thoughts around one specific theme or idea

For example, many people know that some people with OCD become very worried they are going to contract germs. This is a common theme – or subtype – of OCD obsessions.

Experts have identified several common OCD subtypes, or themes. But these subtypes don’t make a difference in diagnosis. Everyone who has the symptoms of OCD (obsessions and compulsions) is diagnosed with OCD, no matter what theme their obsessions revolve around. Identifying the types of OCD can help with categorization, but there aren’t separate diagnoses, or even diagnostic qualifiers, for each of these themes.

In other words, they aren’t separate disorders. No matter what theme, OCD is OCD. And everyone with OCD experiences the same core symptoms: obsessions and compulsions.

In reality, there are too many OCD “subtypes” to count. A person with OCD can experience obsessions about anything in life. While the OCD subtypes have been identified as the more common OCD themes, this doesn’t mean they’re the only possible things OCD can revolve around.

These are all reasons why clinicians often try to avoid talking about OCD subtypes. There is no way to create an exhaustive list of OCD themes. And no matter what “subtype” of OCD you experience, the treatment remains the same.

Different types of OCD

There are several common OCD themes that have been identified. In this article, we’ll go over four of the most common types:

1. Contamination OCD
2. “Just Right” OCD
3. Harm OCD
4. Sexual orientation OCD

Remember, this is not an exhaustive list of all of the different types of obsessions and compulsions someone with OCD can experience. It’s simply a way to categorize some common themes.

Contamination OCD

Contamination OCD is the most common subtype of OCD in the world, and affects 25% of people with OCD in the U.S.^[1] People who have the contamination subtype of OCD worry a lot about contamination, dirtiness, and illness. This is one of the most well-known types of OCD; someone who washes their hands excessively due to a fear of germs (a classic illustration of OCD) would fall into this category.

People with contamination OCD worry they will be contaminated in some way. They might also worry about unintentionally contaminating someone else.

Although germs are a common fear for people with contamination OCD, it’s not the only thing they worry about. People with contamination may have an obsessive fear of:

• Body fluids
• Blood
• Dirt or dust
• Cleaning chemicals
• Lead or asbestos
• Air pollution
• Food poisoning

While many people worry about physical contamination, people with this subtype of OCD may also experience “magical thinking” about mental contamination as well. For example, they may think that just hearing the word “cancer” will cause them to become sick with cancer.

Some common obsessions that people with contamination OCD experience include:

• That doorknob could be dirty. If I touch it, I could become dirty, too.
• If I shake that person’s hand, I could give them all of my germs.
• I feel like there are still germs on my hands. If I don’t wash them again, I could become deathly ill.
• I smell something. There may be some chemicals in the air that will make me sick.
• What if someone who is HIV+ sat in this chair before me, and I get sick too?

Like with anyone who has OCD, these obsessions bring with them an almost unbearable level of anxiety and distress. The person with OCD may even know their obsessions are unreasonable, but they can’t help doubting themselves.

Some compulsions a person with contamination OCD may use to try to reduce their anxiety include:

• Excessive hand-washing, often to the point of raw skin
• Excessive showering
• Avoidance (like refusing to shake hands with someone)
• Reassurance-seeking (like asking a friend to reassure them the food they ate together wasn’t poisoned)
• Mental review (checking their memories to try to remember exactly what they touched that day)
• Rituals like prayer, counting, or knocking in order to avoid contamination or illness

“Just right” OCD

Another commonly known OCD theme is “just right” OCD. People with “just right” OCD tend to become fixated on symmetry and order. Rather than specific thoughts, their obsessions tend to appear as a general sense of “wrongness” or “incompleteness” that causes a lot of anxiety for them. They need to redo or organize things until those things feel “just right” to them and the anxiety goes away.

For example, a person with “just right” OCD may:

Feel that a musical note they hear is “wrong” and need to replay it over and over until it feels “right” to them (although in reality, the note hasn’t changed)
Need to knock or tap on the table until they feel “just right”
Review an email over and over again (beyond reasonable proofreading) to make sure the words they used are “just right”
Organize their pencils for a long period of time until the sense of wrongness goes away

“Just right” OCD is unique among the subtypes of OCD in that people with “just right” OCD don’t engage compulsions to prevent harm from coming to themselves or others (which is the case for other types of OCD). They simply need to perform compulsions to make the internal sense of “wrongness” go away.

Experts say that over 50% of people with OCD experience some type of “just right” obsessions or compulsions^[2].

Harm OCD

Many people with OCD worry about causing harm to another person. People with harm OCD have obsessions about intentionally or unintentionally hurting someone else or themselves.

For example, someone with harm OCD may have obsessions like:

• What if I picked up this knife and stabbed my mother?
• What if I ran that person over and I didn’t even realize it?
• What if I accidentally poisoned my entire family by not washing the vegetables well enough?
• What if I’m secretly a sociopath and I murder someone?
• What if I act on an impulse to smother my baby?
• What if I jumped off this bridge?

Most people have intrusive, random thoughts about the risk of harming someone. But a person without OCD is able to brush these thoughts off as unreasonable. People with OCD become fixated on these thoughts, which makes them obsessions.

To try to avoid or decrease the anxiety these obsessions bring, a person with harm OCD may engage in compulsions such as:

• Avoidance (throwing out all of the knives in the house so they never have to look at them and feel anxious)
• Reassurance-seeking (asking their loved ones to reassure them they aren’t a sociopath)
• Checking (cleaning to make sure the stove is off over and over again because they’re worried they will burn the house down)
• Mental review (checking their memories to try to remember if they may have run someone over)
• Mental rituals (counting to a lucky number to keep bad things from happening)

Sexual orientation OCD

Many people with OCD have intrusive thoughts about “taboo” topics. They may become fixated on these intrusive thoughts and wonder what it means about them to experience these thoughts. In reality, everyone experiences intrusive thoughts, and they don’t necessarily mean anything – but people with OCD attach disproportionate meaning to these thoughts.

One common example is sexual orientation OCD. This lesser-known OCD theme is when someone has the frequent obsession they are actually of a different sexual orientation from which they’ve identified their entire lives.

For example, a heterosexual person may suddenly start obsessing over the thought, “What if I’m actually gay?” Likewise, a gay person may have the obsession, “What if I’m really straight?”

People with sexual orientation OCD aren’t actually questioning their sexuality. They also don’t have any resistance to identifying with another sexual orientation – it’s the doubt and not knowing that causes anxiety for them.

Some examples of obsessions someone with sexual orientation OCD can have include:

• What if I’m actually straight and I need to leave my marriage?
• What if I’ve been lying to my partner all these years?
• I noticed that girl’s outfit. Does that mean I’m gay?
• What if I just woke up one day and realized I’d been lying to myself my whole life?
• What does it mean that I got aroused watching those two men kiss?
• What if I’m actually attracted to my best friend? What if that ruins our friendship?

Some common compulsions a person with sexual orientation OCD may engage in to try to reduce anxiety and doubt are:

• Physical review (many people with sexual orientation OCD hyperfocus on their groinal reactions to “check” whether or not they feel aroused in certain scenarios to find “proof” of their sexual orientation)
• Avoidance (they may avoid any situation that makes them worry about or doubt their sexual orientation, including media as well as other people)
• Reassurance-seeking (they may compulsively look for “coming out stories” or check other people’s sexual experiences against their own)
• Compulsive dating (people who experience this OCD theme may date many people in an effort to check who they feel most attracted to)

Treatment for OCD

No matter what OCD theme you experience, there is hope for recovery.

The OCD treatment program at The Center ● A Place of HOPE uses a unique and proven Whole Person Care approach. This means we understand you are more than your OCD. It also means we don’t just focus on your mental health, but also on helping you heal your physical, spiritual, social, and intellectual health as well.

Together, we can beat OCD. Get in touch with us for more information about admissions.

[1] https://www.madeofmillions.com/ocd/contamination-ocd
[2] https://iocdf.org/wp-content/uploads/2014/10/Just-right-OCD-Fact-Sheet.pdf