What’s the Difference Between OCD and Perfectionism?

You’ve probably seen the memes and heard the jokes. Someone will say they’re “so OCD” when they have a need to complete a task to perfection. They’ll describe it as “OCD” when they like their surroundings to be neat and orderly or their closet color-coordinated.

But in reality, OCD and perfectionism are not the same thing – while one is a personality trait, the other is a serious health condition. And describing a perfectionistic personality as “OCD” is harmful because it perpetuates misconceptions about OCD that keep people from getting the support they need.

But how, exactly, are perfectionism and OCD different? Read on to learn more.

What is OCD?

Obsessive-compulsive disorder, or OCD, is a very serious psychiatric disorder that affects around 1 to 2% of the population^[1].

People with OCD experience obsessions and compulsions. Obsessions are severe, disturbing, and unwanted intrusive thoughts. People with OCD can have obsessions about anything from whether or not they’ve turned off an appliance to worrying about getting sick (or getting others sick).

Most people experience intrusive thoughts. But for people with OCD, these thoughts create an intense, almost intolerable level of anxiety and distress. The thoughts get “stuck” and the person with OCD isn’t able to let them go.

Compulsions are OCD’s response to obsessions. Any repetitive or ritualistic behavior can be a compulsion if it’s done in an effort to make the obsession or anxiety go away. Some compulsions are physical behaviors that are easily visible to other people, while others are mental.

People with OCD lose hours of their lives performing compulsions. This is why OCD is such a debilitating disease for many. People don’t want to perform the compulsion, but they feel like they need to, either to reduce anxiety or to prevent the worry that something bad could happen if they don’t do the compulsion. They can’t let go of the “what if,” which has led OCD to be called “the doubting disease.”

For example, someone with OCD could have the obsession, “What if I run some over someone and kill them?” They could have certain ritualistic compulsions, like compulsive prayer or checking the car, in an effort to try to “prevent” running someone over. They might also compulsively seek reassurance from others that they’re a good driver and would not run anyone over, to reduce anxiety.

There’s no single cause of OCD. Rather, several different factors can increase your chance of having OCD. These include:

• Genetics
• Family history
• Brain chemistry
• Personality traits like intolerance for uncertainty and perfectionism

What is perfectionism?

Perfectionism, on the other hand, isn’t a mental illness. It’s a personality trait that describes people who set very high standards for themselves. People who are perfectionists also tend to be very critical of themselves (or others) when they aren’t able to meet the sometimes excessively high standards they’ve set.

Anyone can be a perfectionist, and it’s not a cause or effect of any mental health condition, including OCD.

Unlike OCD, perfectionism isn’t always harmful. How harmful it is depends on the extremity and inflexibility of the perfectionistic tendencies.

Sometimes, perfectionistic tendencies can help people both set and meet impressive goals. Striving for excellence and setting high standards, when they’re achievable, can motivate you to accomplish great things in both your personal and professional life.

However, for most people, perfectionism becomes both unattainable and unhealthy. Perfectionism, when it’s unhealthy, can cause behaviors and attitudes like:

• Procrastination
• Low self-esteem
• Overcompensation
• Excessive organization
• Difficulty making decisions
• Giving up
• Being unable to delegate tasks or ask for help

Perfectionism isn’t a cause or an effect of any mental health condition. But it can lead to increased stress, which can then contribute to higher rates of anxiety and depression.

While perfectionism itself is not a diagnosable mental health condition, that doesn’t mean overly perfectionistic people don’t need support to change their habits.

Differences between OCD and perfectionism

As you’ve probably already noticed, there are more differences than similarities between OCD and perfectionism.

But OCD and perfectionism are related in some ways. One study^[2] found that more severe perfectionism was associated with more severe OCD symptoms in children and adults.

But both OCD and perfectionism can and do exist outside of the confines of the other. Most people who have a perfectionistic personality do not have OCD. There are very clear differences between these two things.

Compulsions vs perfectionism

Some people with certain subtypes of OCD are sometimes also perfectionists. For example, someone with “just right” OCD needs to perform compulsions until things feel “just right.” They have obsessions about organization and symmetry that are extremely distressing to them. They could, among other things, organize items around them until everything feels “just right” to them.

But many people with OCD do not have perfectionistic personalities in general. They may repeatedly perform compulsions until it’s “just right.” But outside of these compulsions, people with OCD may not have any perfectionistic tendencies at all. For example, they may be perfectly able to delegate tasks at work without expecting perfection from themselves or others.

Perfectionism, on the other hand, tends to permeate people’s lives. People who are perfectionists may expect perfection from themselves and others in every area, not only when they’re performing specific behaviors like a compulsion.

Desire vs. no desire

To others, however, it often seems like people with OCD are perfectionists because of their need to perform compulsions. Someone with a contamination obsession might repeatedly wash their hands. They need to get their hands “perfectly” clean.

However, unlike perfectionists, this need to wash their hands does not come from a desire for or standard of perfection.

For people with OCD, handwashing (if they have this type of obsession) is a compulsion, and a reaction to obsessive thoughts. They are so overwhelmed with anxiety and doubt their obsession brings, they feel they need to perform the compulsion to ease their distress.

People with OCD don’t want to perform the compulsion. They feel they need to.

On the contrary, perfectionists may have the desire to complete tasks “perfectly” to feel good about themselves.

Personality trait vs. mental illness

Perhaps the most important difference between perfectionism and OCD is that perfectionism is a broad personality trait, while OCD is a mental illness.

All mental illnesses, including OCD, inherently cause significant distress to people who live with them. People with OCD experience serious impairments to their functioning in multiple areas across their lives, including social, professional, and personal. Additionally, mental illnesses like OCD require professional treatment to improve.

Although perfectionism is also often very harmful to self-esteem, it doesn’t cause the same impairment to functioning. Perfectionists can benefit from therapy, but they don’t necessarily require it.

Example

To further illustrate the differences between OCD and perfectionism, take the examples of two characters: Neva and Sage.

Neva is a perfectionist. She strives for perfection in everything she does, including at work and in her home life. She checks all of her projects over multiple times before submitting them, and has a very hard time letting go of tasks to delegate them to other people.

She’s also a perfectionist about driving. She follows every traffic rule, and makes sure her car is always clean and organized. She’s very hard on herself when she’s unable to meet her standards of perfection, like when she got a parking ticket. She also can be hard on other people when they make mistakes.

Sage has OCD. Her obsessions revolve around driving; she worries, “What if I haven’t checked my car well enough and I end up running someone over because my brakes give out?” Deep down, Sage knows that this worry is irrational, but she can’t get it out of her head. It feels so real.

This causes Sage to check her car compulsively before driving. She is often late for work because she spends hours checking and rechecking her brakes.

After checking “enough,” Sage feels safe enough to drive – but as she’s backing out of the driveway, the obsession returns. She stops the car to check the brakes again. Eventually, Sage feels so distressed that she stops driving altogether. She wants, more than anything, for these obsessions to go away.

OCPD and perfectionism

People who view OCD as an extreme case of perfectionism may be confusing OCD for a related disorder, obsessive-compulsive personality disorder (OCPD). These two disorders share a similar name, but they actually are very different.

OCPD is a personality disorder that causes people to be extremely perfectionistic^[3]. In many ways, OCPD is the epitome of unhealthy perfectionism. People with OCPD have an intense need for perfectionism in all areas of their lives. They live by very specific rules and expectations, and expect others to follow these expectations as well.

The need for perfection takes precedence over everything else for people who have OCPD. This can negatively affect their relationships and work lives.

People with OCPD do not experience any obsessions or compulsions. While people with OCD are motivated by fear and doubt, people with OCPD are more similar to perfectionists in that they are motivated by the need for perfection.

Treatment for OCD

People who are perfectionists often benefit from therapy, but they can also change their habits and thinking patterns through self-help techniques.

For people with OCD, their symptoms are likely to only get worse without professional treatment. Luckily, there are many different types of OCD treatment that are very effective.

Some of the main treatments for OCD include:

• Cognitive-behavioral therapy (specifically, a type called Exposure and Response Prevention or ERP)
• Medication
• Transcranial magnetic stimulation (TMS)
• Holistic treatment methods like mindfulness-based therapy

The OCD treatment program at The Center ● A Place of HOPE is located in Edmonds overlooking the Puget Sound. Our clinical team uses a unique and proven Whole Person Care approach, which means that we understand that you are more than your OCD. It also means that we don’t just focus on your mental health, but also on helping you heal your physical, spiritual, social, and intellectual health as well.

OCD won’t go away on its own. But together, we can beat it. Get in touch with us for more information about admissions.

[1] https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650182/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709690/