Types of OCD: Understanding the Many Faces of Obsessive-Compulsive Disorder

It’s such a beautiful thing that the margin of mental health has been expanding beyond overgeneralized textbook definitions. For too long, we were introduced only to the basics—OCD meant germs and symmetry, eating disorders meant throwing up or starving yourself, and anxiety was just nerves before a big event. These oversimplifications have left many of us feeling isolated in our struggles—like we must be broken, because our experiences don’t fit neatly into those narrow boxes.

But the truth is, mental health is far more complex than the outdated textbook definitions we were given. New research continues to reveal the many forms mental health struggles can take, including the lesser-known types of obsessive-compulsive disorder (OCD). 

While I’d love to debunk all mental health misconceptions, today’s focus is on OCD. I want to share not only what OCD is and its many types but also my own journey with it. OCD is currently my main battle, and I hope that by shedding light on its various faces, we can galvanize a more nuanced understanding of this complex disorder.

What Is OCD?

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by persistent, intrusive thoughts (obsessions) and the compulsions (actions or rituals) people feel driven to perform in response to those thoughts. While OCD manifests in many different ways, the cycle remains the same: an intrusive thought creates distress, leading to a compulsion aimed at easing that distress—even if only temporarily.

Despite what textbooks or pop culture has made you believe, OCD isn’t just about washing your hands too much; it’s an all-consuming mental loop that hijacks your thoughts, making life truly exhausting. While some experience obsessive thoughts about contamination, others battle compulsive checking or terrifying intrusive thoughts that make them question who they really are.

To an outsider, OCD can seem like a quirk. But for those living with it, it’s a debilitating disorder, demanding constant mental energy.

Breaking Down The Types of OCD

The first few types of OCD are the ones you’ve likely heard of–Contamination OCD, Symmetry and Order OCD, Counting OCD, and Checking OCD. Let’s break them down:

Contamination OCD

This is the fear of germs, illness, or even intangible “contaminants” (like bad energy or harmful substances). It can lead to excessive cleaning and compulsive hand washing. Some people will avoid public places or even people altogether. A common intrusive thought can be, "If I don’t wash my hands thoroughly, I might spread illness to someone and be responsible for their suffering.”

Symmetry and Order OCD 

People with this type of OCD feel an overwhelming need for things to be perfectly aligned. It’s more than just liking tidiness—it’s an anxiety so intense that even a slight misalignment can cause severe rumination and repetitive arranging. A common intrusive thought might be, “If my books aren’t perfectly aligned, something bad will happen to my family.”

Checking OCD 

Here, the fear is that if you don’t check something repeatedly—locks, appliances, or even past conversations—disaster will strike. Some common thoughts for someone with Checking OCD can include:

• “Did I turn off the stove? If I didn’t, the house might burn down.”

• “If I don’t check my text again, I might have accidentally said something offensive.”

Counting OCD 

Counting OCD involves an overwhelming need to count things a certain way or to a specific number to prevent perceived harm. The numbers often hold no real meaning—except that not counting them triggers overwhelming anxiety. An intrusive thought with Counting OCD can be, "I need to tap my fingers 3 times or someone in my family will get hurt.” 

My First Experiences with OCD

While I currently struggle with a form of OCD I haven’t yet mentioned, my first experiences combined a few of these types. My intrusive thoughts revolved around protecting my family—believing that if I didn’t complete certain actions, something terrible would happen to them.

Some of these compulsions included:

• Touching objects a certain number of times (always in groups of three).

• If I touched or scratched one side of my body, I had to do the same on the other side.

• Adamantly avoiding stepping on cracks in the pavement—“Step on a crack, break your mother’s back” wasn’t just a silly phrase to me; it was a genuine fear. If I did step on a crack, I needed to go back and step over it. 

• Replaying conversations or events obsessively, believing that if I mentally reconstructed them just right, everything would be okay.

  
  

I remember being caught in these compulsions in front of friends, trying to come up with excuses for fear of being the “weird kid.” But no matter how much I tried to hide it, the compulsions were inescapable. Not to mention, I didn’t even understand what I was experiencing at the time. 

The reason I share each of those experiences with you is to show that no two OCD experiences are identical. While these behaviors fit within certain OCD subtypes, they were uniquely my own. The same goes for anyone struggling—your experiences don’t need to fit into one narrow box.

Now that I’ve gone over some of the more widely known types of OCD, I want to introduce some of the lesser-known forms.

Lesser-Known Types of OCD

Beyond the more well-known forms, OCD has many other subtypes that often go unrecognized. These include:

Harm OCD

Harm OCD brings intrusive, violent thoughts that go against a person’s true values (ego-dystonic thoughts). These thoughts can involve harming others or oneself, leading to compulsions like avoiding sharp objects or refusing to be alone with certain people—even though the individual has no actual desire to cause harm. Someone with Harm OCD might think, "What if I lose control and hurt someone I love? I’d never want to—but what if I do?"

Relationship OCD (ROCD) 

ROCD fixates on fears and insecurities within relationships–romantic or otherwise. In a romantic context, you might ruminate over whether you truly love your partner, if they truly love you, or if you should even be together at all.

Non-romantic ROCD can apply to friends and family, or even sometimes professional relationships. You might obsess over if your friends actually enjoy spending time with you, question if you’re being a good son/daughter, or constantly fear your work isn’t good enough and that you’ll be fired.

The compulsions can include analyzing every interaction (from words spoken to body language), constantly seeking reassurance, comparing your relationship to others, or even avoiding deep commitment out of fear of making the wrong choice. ROCD isn’t about real relationship issues; it’s the OCD-fueled doubt that convinces you something is wrong, even when it isn’t. 

Pure O (Purely Obsessional) OCD

Pure O OCD is the kind you don’t see—no overt rituals, just an endless cycle of mental rumination. Instead of physical compulsions, you engage in internal rituals: replaying memories, analyzing your thoughts, or desperately seeking internal reassurance. The mental loops can be relentless, leaving you isolated as you battle thoughts like, “I need to re-read that conversation over and over to ensure I didn’t say something wrong.” It’s exhausting, as there’s no obvious ritual to ameliorate the intrusive thoughts.

Existential OCD

Existential OCD hyper-focuses on life’s biggest questions: What’s the meaning of life? What if I don’t actually exist? What if I’m in a simulation? The need for certainty leads to compulsions like excessive research or ruminating for hours on end.

Hoarding OCD

Hoarding OCD is often confused with Hoarding Disorder, but they are two separate conditions. Hoarding OCD is rooted in intense fear and anxiety about getting rid of objects, whereas Hoarding Disorder is about attachment to objects. 

Those with Hoarding OCD may obsessively worry that getting rid of an item could lead to disastrous consequences. A common intrusive thought can include, "If I throw this away, something bad might happen.”

Scrupulosity OCD (Religious or Moral OCD)

Scrupulosity OCD involves intense fear of being immoral or “bad”. This fear can lead to obsessive praying, repeated confession, excessive guilt, or avoiding anything that feels morally questionable. While it’s often tied to religion, it can also manifest as an extreme focus on ethics or simply being a “good” person. 

There are many more types of OCD, as well as, I’m sure, many still to be learned over time (though, I really wish that statement weren’t true). I say that, one, because it’s sadly the case, and two, so those of you who may read this and have your own unique experiences don't feel isolated.

My Ongoing Battle With OCD

I gave you a glimpse of my past experiences with OCD, which surfaced as early as third grade. For many years, between those early compulsions and my eating disorder, my mind felt relatively free from major mental health struggles. But once I overcame my eating disorder, OCD reemerged—this time in the form of Pure O OCD and Relationship OCD, both of which remain significant battles in my life.

Pure O OCD and Relationship OCD has put my mind through relentless strain, to the point where, at times, I’ve even missed my old struggles. As painful as they were, they came with tangible compulsions—actions I could complete to gain temporary relief. But with Pure O OCD, there’s no visible ritual, no action to provide even fleeting reassurance.

I’ve spent entire days trapped in mental loops, doing nothing but sitting on the couch or lying in bed, endlessly replaying scenarios and analyzing thoughts to exhaustion. No TV, no phone—just me and the mental spiral that refuses to relent. 

My experiences with Relationship OCD are one in the same as Pure O OCD, but its focus is solely on my relationships. Personally, I use them interchangeably, as the compulsion I often give into is excessive rumination. When I can't handle the rumination, I finally seek reassurance, which brings my only form of temporary relief with ROCD.

Since I began struggling with ROCD, I found solace in being single, because it removed one of the biggest triggers for my OCD. While I do experience non-romantic OCD as well, it isn't nearly as severe. The fear of commitment became overwhelming once I understood what I was experiencing, and for years, my solution was avoidance. It was easier to stay single than to endure the distress that relationships triggered.

But while staying single may feel like an easy way out, I’ve learned that avoidance only strengthens OCD’s grip. The only way to break free is to face it head-on, and that’s exactly what I’ve been trying to do.

I won’t pretend to have all the answers, but I do know this—while OCD may always be a part of my life, I can learn how to manage it. And that’s exactly what I’m working toward.

In my next blog, I’ll be sharing the strategies I’m using to work through OCD—so stay tuned if you’re looking for ways to navigate this disorder yourself. You’re not alone in this, and I hope that by continuing to share my journey, I can help make yours feel a little less isolating.

In the meantime, if you're struggling with OCD, or if you think you may have it, I highly recommend checking out NOCD—a platform dedicated to helping individuals with obsessive compulsive disorder. There's a large supportive online community and self-help resources, as well as online therapy options. Understanding what you're going through is the first step toward recovery.