Have you ever wondered what are the four types of OCD? Turns out, it’s a myth that there are only four types of OCD, and mental health professionals recognize up to 15 different subtypes grouped around common OCD themes. When we say OCD themes, we mean the subject around which the person’s anxieties or intrusive thoughts revolve. For example, the first subtype of OCD we will talk about is harm OCD. Someone with harm OCD may have constant anxiety and intrusive thoughts about harming themselves or others. Are you or a loved one struggling with obsessive-compulsive-like tendencies? If so, this guide can help you understand the OCD triggers and symptoms.
The Most Common OCD Themes
Psychiatrists have been subtyping OCD since at least the early 2000s. They wanted a better understanding of the unique symptoms individuals with OCD experience. The subtypes are grouped into the most common OCD themes according to these symptoms.
The 15 OCD subtypes are:
- Harm OCD
- Pedophile OCD
- Sexual orientation OCD
- Relationship OCD
- Responsibility OCD
- Suicidal OCD
- Just right OCD
- Health anxiety OCD
- Moral scrupulosity or religious OCD
- Sensorimotor or hyperawareness OCD
- Contamination OCD
- Metaphysical contamination OCD
- Existential OCD
- Order and symmetry OCD
- Post-partum OCD
Some people qualify for two or more of these subtypes; however, it is even more common for one subtype to resolve only for another to emerge. Some subtypes are more likely to co-occur than others.
There is good news, though. OCD treatment can help people of all subtypes better manage their symptoms.
Harm OCD
Harm OCD (HOCD) is a subtype featuring intense fear about doing or causing harm. These thoughts occur frequently and can interfere with daily life.
What Triggers Harm OCD?
Fear of intentional or unintentional violence triggers HOCD. These triggers can come about due to emotions or physical reminders.
The main emotion that may trigger HOCD is anger. People with this condition may fear that they may lash out violently if they get too angry.
Physical reminders of violence (e.g., weapons) can also trigger HOCD symptoms. Someone with HOCD may not keep knives in their kitchen for fear of hurting someone they love.
People with HOCD may also fear unintentional violence. For example, they may have extreme anxiety about accidentally leaving the oven on or the car in neutral.
Harm OCD Symptoms
HOCD symptoms revolve around fears of harming the self or others. Here are some questions that can help identify symptoms of this disorder:
- Does the person fear “snapping” and becoming violent?
- Does the person believe that they are or could be capable of violence?
- Does the person constantly make sure others are unhurt?
In some cases, fear of becoming violent may be a symptom of another disorder. Yet, if the person’s fear is not aligned with reality, it is more likely a sign of HOCD.
Pedophile OCD
Pedophile or pedophilia OCD (POCD) features intense fear that one is or is becoming a pedophile. People with this disorder may believe their everyday intrusive sexual thoughts have special meaning.
What Triggers Paedophile OCD?
Intrusive sexual thoughts trigger POCD. It is not uncommon for people to have intrusive thoughts about children.
For example, someone may note that a young girl is beautiful. For most people, this type of thought is fleeting and harmless. People with POCD may take thoughts such as this one as a sign that something is wrong with them.
They may also imagine paedophilic acts. The goal is not to get aroused, that way, they can “validate” that they are not a pedophile despite their intrusive thoughts.
Unfortunately, POCD can be confusing because some may become sexually aroused when triggered. They may then try to avoid the trigger altogether. This coping mechanism can be devastating for people with children.
Paedophile OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person avoid children or places with children?
- Does the person obsessively search for reassurance online that they are not a pedophile?
- Does the person check to ensure they are not aroused when with children?
As with HOCD, these thoughts could be a sign of another disorder. However, when the person displays no signs of pedophilia other than intrusive thoughts, it’s more likely that they suffer from POCD.
Sexual Orientation OCD
Sexual orientation OCD (SO-OCD) features intense fear about one’s sexuality. Though this subtype is common in cis-gendered heterosexual people, it can happen to people of all genders and sexual orientations.
What Triggers Sexual Orientation OCD?
There are two main triggers of SO-OCD:
- Sexual thoughts that don’t align with the person’s sexual orientation
- Fear that the person has been lying to themself about their sexual orientation
In the first trigger, the person may have an intrusive thought about engaging in a sexual act that does not align with their sexual orientation. For example, a man who identifies as gay imagines sleeping with a woman.
These types of intrusive thoughts are common. Most people dismiss them when they arise. However, people with SO-OCD can’t move on so easily.
That is when the second trigger may kick in. The person may begin to doubt their sexual identity because of these intrusive thoughts.
Sexual Orientation OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person doubt their sexual identity?
- Does the person mentally rehearse facts that prove their true sexual orientation?
- Does the person avoid others who are open about their sexual identities?
- Does the person check themself for arousal when having an intrusive thought about an experience that does not align with their identity?
It is not uncommon to question one’s own sexual identity. However, these types of thoughts become all-consuming for people with SO-OCD.
Relationship OCD
Relationship OCD (ROCD) features intense fear about one’s own relationship. This subtype can be particularly frustrating because it is hard to distinguish intrusive thoughts from normal questions about a relationship.
What Triggers Relationship OCD?
Conflict, separation, and intimacy can trigger ROCD. It is also common for people to experience symptoms after seeing or meeting someone they find attractive.
Anxieties in people with ROCD tend to centre around two common themes. The first theme is relationship worries, in general. The second theme is specific concerns about the person’s romantic partner.
General relationship fears could revolve around how to choose the right romantic partner or identify ‘real love.’
More specific anxieties in ROCD may feature uncertainties about if someone’s partner is ‘the one.’ People with ROCD who worry about their partner may also fear that they will cheat.
Relationship OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person constantly compare their partner to other people?
- Does the person avoid romance novels and media because they trigger relationship doubts?
- Does the person struggle to maintain romantic relationships due to excessive worry?
These questions are not just hard on the person who has ROCD. They can also be confusing and devastating for that person’s partner.
Responsibility OCD
Responsibility OCD is closely tied to HOCD (harm OCD). It features obsessive concerns about whether someone has fulfilled their responsibility to keep others safe.
What Triggers Responsibility OCD?
Beliefs that someone has acted irresponsibly trigger responsibility OCD. Another trigger of this subtype is if someone believes their action (or inaction) will result in harm to a person or pet they are responsible for.
Responsibility OCD has important distinctions from HOCD. In HOCD, the worries revolve around intentionally or accidentally hurting someone directly.
With this subtype, the fear is not about hurting someone directly. Instead, it revolves around the fear of being irresponsible, which causes harm to a loved one or pet.
In some cases, people with responsibility OCD may also worry about indirectly harming people they are not responsible for (i.e., strangers).
Responsibility OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person repeatedly check that the appliances are off before leaving the house?
- Does the person clean obsessively to prevent accidental falls or health hazards?
- Does the person often retrace their steps to ensure their actions haven’t caused harm to others?
Another symptom of responsibility OCD is extreme guilt. These individuals may feel guilty, even when they have no reason to.
Suicidal OCD
Suicidal OCD features intense and intrusive thoughts about hurting oneself. However, unlike true suicidal ideation, the person suffering from this subtype does not want to end their life.
What Triggers Suicidal OCD?
Intrusive thoughts about self-harm or suicide trigger suicidal OCD. These types of thoughts are not to be taken lightly. However, the desire to protect the self drives obsessions in people with this subtype.
Similar to HOCD, people with suicidal OCD may have an intense fear of ending their own life. For this reason, many professionals call it Harm OCD with suicidal obsessions.
People with and without OCD commonly have intrusive thoughts about self-harm and suicide. People with suicidal OCD take these thoughts seriously.
Fears in this subtype revolve around the desire not to harm oneself. People with suicidal OCD take their intrusive thoughts as proof that they may one day act on them.
Suicidal OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person avoid emotions like sadness for fear of becoming suicidal?
- Does the person avoid weapons for fear of using them to commit suicide?
- Does the person anxiously compare their experiences to those of people who have committed suicide?
If you or someone you know is seriously considering self-harm or suicide, the Talk Suicide Canada hotline is here for you. Text 988 or go to talksuicide.ca to connect with a crisis responder.
Just Right OCD
Just right OCD is unique from other subtypes. It does not feature particular anxieties or fears about doing or not doing something. Instead, people with this subtype can only move on once things feel ‘just right.’
What Triggers Just Right OCD?
A feeling that something is incomplete or ‘off’ triggers just right OCD. This feeling may come about due to sights, sounds, or touch.
Surroundings must be in the right order or position. If not, the person must correct the problem before moving on to a new task. Some professionals also refer to this subtype as perfectionism OCD.
What happens if the person does not correct the perceived issue? They may feel a sense of unease until they can. In severe cases, people with this subtype may become completely dysfunctional.
Just Right OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person repeat an action over and over again with no apparent cause?
- Does the person obsessively make sure everything is balanced and in order?
- Does the person repeat an action until they get it perfect?
This subtype can co-occur with many of the others on this list. For example, someone may wash their hands obsessively until they are perfectly clean. This person could have Just Right and health anxiety, which we discuss next.
Health Anxiety OCD
Health anxiety OCD features an intense fear of being physically or mentally ill. We all struggle with health anxieties at times. With health anxiety OCD, though, the fears never go away.
What Triggers Health Anxiety OCD?
Perceived symptoms of physical or mental illnesses trigger health Anxiety OCD. Someone may experience a strange bodily sensation, find a concerning mark on their skin, or have an abnormal emotional reaction.
The person may then look up their symptom online. They may self-diagnose themselves and then look for more evidence of their suspicion.
Looking for more evidence could mean constantly reflecting on their bodily sensations. They may also visit a healthcare professional for reassurance.
However, even if the doctor alleviates their concerns, the person will continue to worry that something is wrong.
Health Anxiety OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person monitor their symptoms obsessively?
- Does the person spend hours online looking up their symptoms?
- Does the person believe doctors have missed something when they do not agree with the person’s self-diagnosis?
Studies show that health anxiety OCD may be the same thing as hypochondriasis. We need more research to know for sure.
Moral Scrupulosity or Religious OCD
Moral scrupulosity or religious OCD features obsessions about faith and morality. In the former, people obsess about being ‘good.’ In the latter, people fear they are not living a life that is pleasing to their god(s).
What Triggers Moral Scrupulosity or Religious OCD?
Bad actions or behaviours often trigger moral scrupulosity or religious OCD. These actions convince the person that they are morally bad or religiously impure.
Moral scrupulosity OCD often centres around a single event. The person obsesses over the shame and guilt of what they did. They believe their decisions prove that they are a bad person.
People with religious OCD may feel the same. However, they believe they are bad for breaking religious rules or guidelines.
Often, people with this subtype fear death. They believe they will receive punishment in the afterlife for their ‘bad’ actions.
Moral Scrupulosity or Religious OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person repeatedly apologize or seek forgiveness for seemingly minor wrongs?
- Does the person practice toxic positivity to avoid intrusive ‘bad’ thoughts and feelings?
- Does the person obsess over being a ‘good’ person?
In some cases, this subtype may involve self-harm. Individuals may force themselves to ‘pay penance’ for their perceived bad deeds. No matter how they justify it, this is a form of self-harm and should not be ignored.
Sensorimotor OCD
Sensorimotor OCD is also known as hyperawareness or somatically-focused OCD. It occurs when people obsessively attend to their bodily functions. It often overlaps with health anxiety OCD.
What Triggers Sensorimotor OCD?
Bodily functions such as breathing and blinking trigger sensorimotor OCD. People become hyper-focused on these sensations and can’t think of anything else.
Like just right OCD, this subtype does not necessarily feature fear and anxiety. Instead, the person can’t move on from thinking about the bodily sensation.
When it occurs with health anxiety OCD, this subtype can cause fear and anxiety. People will start worrying that their bodily functions are dysfunctional.
They may obsess over changes in these bodily processes as proof that something is wrong with their health.
Sensorimotor OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person obsess over bodily functions like blinking, breathing, swallowing, or their heartbeat?
- Does the person monitor these bodily functions obsessively?
- Does the person try to stop thinking about their bodily functions?
- Does the person often see health care providers to alleviate fears about their bodily functions?
People with this subtype often have co-occurring depressive disorders. They may feel stuck since they can’t stop thinking about their bodily functions.
Contamination OCD
Contamination OCD features intense anxieties about germs. They may constantly fear that they may become sick if they aren’t hygienic enough.
What Triggers Contamination OCD?
A fear of germs typically triggers contamination OCD. This fear may manifest in excessive hand washing or showering and home cleaning.
People with this subtype may suffer from co-occurring anxiety disorders like agoraphobia (fear of leaving home) and social anxiety (fear of people and crowds).
Contamination OCD has some features in common with Just Right OCD. People with this subtype don’t know if their selves or homes are contaminated. Instead, it is a feeling.
This subtype can also share commonalities with HOCD (harm OCD). Some people fear they may contaminate others.
Contamination OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person obsessively decontaminate themself, their home, and those who enter their home?
- Does the person avoid places or situations where they believe they could be contaminated?
- Does the person avoid high-contact areas like doorknobs or handshakes?
People with this subtype may experience panic attacks if they can’t control the situation. Even the thought of contamination can cause them deep distress.
Metaphysical Contamination OCD
Metaphysical contamination OCD features intense fear about contaminated spiritual energy. It is virtually identical to traditional contamination OCD but with a focus on essences and auras instead of physical spaces.
What Triggers Metaphysical Contamination OCD?
Fear of negative energies triggers metaphysical contamination OCD. This fear manifests similarly to regular contamination OCD.
People with this subtype take part in obsessive spiritual cleansing rituals. They may have intense anxiety about bad thoughts, negative places, and people with certain ‘auras.’
Metaphysical Contamination OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person avoid things, places, and people with ‘bad vibes?’
- Does the person have rituals they perform to cleanse bad energy?
- Does the person obsessively search for people, places, and things that could contaminate their energy?
As with traditional contamination OCD, this subtype often features panic attacks, agoraphobia, and social anxiety.
Existential OCD
Existential OCD features intrusive thoughts about philosophical questions about existence. People who experience this subtype crave answers to these often unanswerable questions.
What Triggers Existential OCD?
Anxiety about existentialism and existence triggers existential OCD. Existentialism incorporates theories about free will, life’s meaning, and what it is to be human.
As with sensorimotor OCD, these thoughts can become all-consuming. People with this subtype may be unable to live life as usual.
Existential OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person obsessively question the purpose of life, the nature of human existence, or what is real?
- Does the person miss out on work, school, or social events due to rumination on these thoughts?
- Does the person require a clear answer to these questions despite being told they are impossible to answer?
It is common to question our existence occasionally. Yet, when these symptoms start interfering with one’s life or health, these questions can lead to a disorder like OCD.
Order and Symmetry OCD
Order and symmetry OCD features intense anxiety when things are out of place. Studies show that it may or may not be the same subtype as Just Right OCD.
What Triggers Order and Symmetry OCD?
Disorder and disorganization trigger order and symmetry OCD. Unlike just right OCD, this subtype features intense anxiety about things being out of order.
Often, people with order and symmetry OCD believe something bad will happen to them or someone else if they don’t maintain balance and order. In this way, this subtype can resemble HOCD (harm OCD).
Order and Symmetry OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person obsess over everything being in its place?
- Does the person believe something bad will happen if they don’t keep everything in its place?
- Does the person suspect their fears are irrational but continue to keep things orderly just in case something terrible happens?
Interestingly, symmetry OCD commonly co-occurs with Tourette’s and other conditions featuring tics.
Post-Partum OCD
Post-partum OCD features intense anxiety about one’s baby after giving birth. Mothers are more likely to suffer from this disorder. However, new fathers can also develop post-partum OCD.
What Triggers Post-Partum OCD?
Fears of hurting their baby trigger post-partum OCD in new parents. This subtype has much in common with HOCD (harm OCD). It can also feature symptoms of:
- Health anxiety OCD
- Paedophilia OCD
- Responsibility OCD
- Contamination OCD
Parents may fear they will hurt, sexually abuse, or emotionally damage their baby. Sadly, these symptoms can result in avoidance and a failure to bond with their newborn.
Post-Partum OCD Symptoms
Here are some questions to help identify symptoms of this disorder:
- Does the person obsess over fears of hurting their newborn?
- Does the person avoid their newborn for fear of hurting them?
- Does the person obsessively check that their newborn is still breathing, baby bottles are properly sterilized, or the bath water isn’t too hot?
New moms are five times more likely to suffer from this subtype than others. Up to 70% of people with post-partum depression also have post-partum OCD.
Treatment Can Help Alleviate OCD Subtype Symptoms
OCD is a serious mental health condition featuring intrusive thoughts and obsessive behaviours. These fifteen subtypes group symptoms people experience by common OCD themes.
Are you tired of dealing with the symptoms of OCD? Simcoe Addiction and Mental Health offers safe and effective treatments for these OCD subtypes. We can also help treat co-occurring conditions you may be suffering from.
Contact Simcoe today to learn more about how our programs can help you.
