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Living with Obsessive-Compulsive Personality Disorder

control freak (OCPD)

This is the ninth article in our series on Dual Diagnosis. 

Obsessive-Compulsive Personality Disorder is a Cluster C personality disorder (in the group of anxious PD, together with avoidant and dependent personality disorders) that is characterized with a long-term pattern of extreme preoccupation with details, orderliness, and rules. These patients are known for their obsession with perfectionism and the need of controlling every situation and person that is part of their lives.

It’s unknown what causes obsessive-compulsive personality disorder. There are many theories that explain the possible origins of the disorder. It is believed that people with a certain form of DRD3 gene are predisposed to OCPD and depression. Traumatic life events, emotional, sexual or physical abuse (especially during childhood) could trigger underlying genetic predispositions. According to the environmental theory, patients can learn OCPD behavior from another person suffering from it. Usually, patients start to show OCPD behaviors in early adulthood or adolescence and they can last for years or a lifetime.OCPD

Symptoms of Obsessive-Compulsive Personality Disorder

As defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an obsessive-compulsive personality disorder is a mental health disorder that characterizes with an extensive pattern of preoccupation with perfectionism, orderliness, and interpersonal and mental control, at the cost of efficiency, flexibility, and openness. Mental health professionals around the world use DSM-5 when diagnosing mental health disorders. The patient is diagnosed with OCPD if he or she shows four of the following symptoms:

  • Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
  • Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).
  • Excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
  • Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).
  • Unable to discard worn-out or worthless objects even when they have no sentimental value.
  • Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
  • Adopts a non spending style towards both self and others; money is viewed as something to be hoarded for future catastrophes.
  • Shows rigidity and stubbornness.

OCPD and OCDThere is a difference between obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD).

OCD is a mental health disorder (anxiety disorder) characterized by repeated actions, routines or thoughts. These patients can’t control their thoughts and activities for a long period of time. Things like obsessive hand washing, checking if the door is locked countless of times or counting things they touch or see are common. Orderliness, need for symmetry, and organization are common for both OCPD and OCD. People with severe OCPS can be diagnosed with OCD as well.

Related: Dual Diagnosis – The Connection Between Mental Health Disorders and Addiction

The Link Between Substance Abuse and OCPD

A study published in the Substance Use and Misuse Journal found that there is a strong connection between alcohol users and OCPD. Around 20.8% of alcohol-dependent patients were also diagnosed with obsessive-compulsive personality disorder. Compared to other personality disorders at alcohol abusers, OCPD was among the most frequently diagnosed PD.

There is a certain paradox between alcohol use and OCPD. People with OCPD look for perfection. They organize every single detail of theirs and other people’s lives. On the way of achieving that perfection, alcohol abuse doesn’t fit in the picture. However, that controlled behavior affects the person’s mental and emotional well-being (known as behavioral health). Especially when the pattern is interrupted, perfection is lacking or alcohol interferes with their work. To these patients, this causes anger and frustration that may lead to depression and substance abuse. However, there is no proven connection between substance abuse and OCPD.

Obsessive-compulsive personality disorderDiagnosis and Treatment

People with obsessive-compulsive personality disorder are usually diagnosed in their adulthood. The disorder is rarely diagnosed in childhood or adolescence because those are the years when the person goes through personality development and maturity. When diagnosed in childhood or teen years the symptoms must be present for at least a year. According to the International OCD Foundation, an obsessive-compulsive personality disorder is diagnosed in twice as many men than women. The Journal of Personality Assessment estimates that in general, between 2.1 and 7.9 percent of the population has OCPD.

As with every personality disorder, OCPD is diagnosed by a trained mental health professional. Usually, by a psychologist or a psychiatrist. It’s recommended to avoid other medical professionals that aren’t specializing in mental health to make a diagnosis.

Treatment Approaches

As with any personality disorder or mental health illness, treatment for OCPD gets tricky. The patient tries to control the therapist, doesn’t open up and accept any treatment approach and is very inflexible. The three most common treatment approaches for OCPD are:

  • Cognitive Behavioral Therapy (CBT). Research shows that this type of therapy is effective when treating OCDP. Namely, 53 percent of the included patients in the research showed “significant reductions in depressive symptoms” and 83 percent of them “exhibited clinically significant reductions in OCDP symptoms severity”. In CBT, the patient meets a mental health professional on a regular basis. The counseling sessions include psychotherapy treatment for any feelings of anxiety, depression or stress. These patients see the world black and white. The mental health professional encourages the patient to work on creating more interpersonal relationships. CBT is a short-term, problem-solving oriented treatment approach helping the patient recognize behaviors and work its way to changing them.
  • Medication. Only short-term use when the patient needs to relieve OCPD’s symptoms.
  • Relaxation Training. This therapy approach helps patients with OCPD relax, using breathing and relaxation techniques. It uses approaches like yoga, tai chi or pilates.

For more information please call our Addiction Treatment Helpline at (844) 439-4765. This is a Free and completely confidential call. We are available 24/7. In many cases, your health insurance company will cover 100% of the treatment cost. So please call now.

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