4 Types of Obsessive-Compulsive Disorder: Symptoms and Treatment

Obsessive-compulsive disorder (OCD) occurs when obsessions (persistent, unwanted thoughts) trigger anxiety, causing you to repeatedly engage in compulsions (specific behaviors) to find relief. These cycles can consume your day and detract from your quality of life.

OCD has four main subtypes, though you may experience symptoms from multiple types or have symptoms that don’t match any type perfectly.

Understanding the different types of OCD can help you recognize your symptoms and find the right treatment.

Contamination OCD is one of the most common types of obsessive-compulsive disorder, affecting nearly half of people with OCD.

This type involves intense fears about being contaminated by germs, dirt, chemicals, or other substances. With contamination OCD, touching a doorknob or shaking hands with someone can feel like a serious health threat. These fears can lead to excessive cleaning, handwashing, or avoidance of certain places, people, or objects.

People with contamination OCD may also experience intense feelings of disgust when touching certain things. They may find it difficult to stop focusing on that feeling.

Symptoms

Symptoms of contamination OCD can vary by person, but common symptoms may include:

• Intense fear of germs, dirt, or bodily fluids
• Avoidance of public spaces, bathrooms, or physical contact with others
• Repeated handwashing, showering, or cleaning rituals, sometimes for hours
• Feelings of being unclean
• Worry that objects or surfaces are contaminated, even if they appear clean
• Skin irritation, dryness, and possible bleeding from excessive washing
• Designation of strict “clean” and “dirty” zones in your home

This type of obsessive-compulsive disorder involves strong urges to make things feel “just right” or to ensure they are perfectly aligned. You might feel the compulsion to arrange objects in specific ways, make things look symmetrical (even on both sides), or repeat actions until they feel perfect.

These symptoms are more severe than a preference for keeping things orderly. With this type of OCD, you often feel uncomfortable, anxious, or worried that something bad will happen if things aren’t organized how you think they should be. Some people spend hours arranging things until they feel it is right.

Symmetry and ordering OCD often occurs alongside conditions such as tic disorders, attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder, and depression.

Symptoms

Symmetry and ordering OCD may cause symptoms such as:

• Urges to ensure objects are perfectly lined up, even, or balanced
• Anxiety or discomfort when things are out of order
• Repeating actions (like walking through a doorway or tapping) until they feel right
• Urges to arrange items by size, color, or shape in a specific way
• Trouble completing tasks due to repeating or adjusting your actions

Sometimes called “checking OCD,” this common type of obsessive-compulsive disorder centers around persistent doubts or fears about causing harm or being responsible for something terrible happening. To cope, you may perform repetitive checking behaviors that you think will prevent the bad outcome. 

You might worry you accidentally hurt someone, left the stove on, left a door unlocked, or made some other dangerous error. These fears can lead you to check locks, appliances, or past actions over and over again.

The doubts can persist even after checking multiple times, and the checking behaviors can become excessive and time-consuming.

Symptoms

Common symptoms of harm and checking OCD include:

• Intrusive worries about having hurt someone accidentally
• Repeated thoughts like, “What if I hit someone while driving and didn’t notice?”
• Fear of making a mistake that could lead to harm, like forgetting to turn off the stove or to lock the door
• Repeated behaviors like checking appliances, doors, or driving routes
• Mental reviewing of past events to check for mistakes

Also known as taboo thoughts OCD, this type involves disturbing thoughts that pop into your mind against your will. They might be unwanted sexual or religious ideas that feel wrong, or thoughts about hurting someone.

Most people have occasional strange thoughts, but people with this type of OCD feel extreme guilt, shame, or fear about having those thoughts.

Unlike other types of OCD, where you might see outward behaviors like handwashing or checking, the compulsions with this type of OCD often happen inside your mind. To relieve the anxiety, you might count silently, repeat phrases in your head, or avoid situations that trigger the intrusive thoughts.

Symptoms

Intrusive thoughts OCD may cause symptoms that include:

• Disturbing thoughts about harming yourself or others
• Unwanted sexual thoughts, including those that are taboo or socially inappropriate
• Religious obsessions, such as fears of sinning or offending a higher power
• Events that replay repeatedly in your mind
• A focus on “good” thoughts to try to cancel out “bad” thoughts
• Excessive guilt, shame, or worry about what your intrusive thoughts mean
• Avoidance of certain situations out of fear that the intrusive thoughts might come back

Identifying which type of obsessive-compulsive disorder you may have usually starts with an evaluation by a licensed mental health professional, such as a therapist, psychologist, or psychiatrist.

Your healthcare provider will likely ask you about your thoughts and how you cope with them. They’ll want to know how these thoughts make you feel and how much they interfere with your daily activities. Based on the themes of your symptoms, your provider can help determine the type of OCD you likely have.

Many people wait years before seeking help because they feel ashamed or don’t recognize their symptoms as part of OCD. If you think you’re experiencing symptoms of OCD, or if any of your thoughts or behaviors are getting in the way of your daily life, it’s important to speak with a healthcare provider or a mental health provider.

Most people with OCD can improve their symptoms with therapy, medication, or a combination of both. A type of cognitive behavioral therapy (CBT) called exposure and response prevention (ERP) is very effective for OCD.

Healthcare providers may also prescribe a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) to help reduce symptoms.

People with OCD may have a higher risk of suicidal thoughts and attempts. If you’re experiencing thoughts of suicide or harming yourself, seek emergency medical treatment or call the National Suicide Prevention Lifeline at 988.

There’s no known way to prevent obsessive-compulsive disorder from developing. OCD involves a mix of genetic factors, brain chemistry, and life experiences that experts don’t fully understand yet.

Early diagnosis and treatment may help you manage OCD symptoms. If OCD runs in your family, recognizing early signs and promptly seeking help can help reduce its impact on your life.

Stressful situations can trigger OCD symptoms, so managing stress through healthy habits like exercise, meditation, or support group attendance may help reduce triggers.

Obsessive-compulsive disorder (OCD) can be grouped into four main types: contamination and cleaning, symmetry and ordering, doubt about harm and checking, and intrusive thoughts. 

These types often overlap, and symptoms can look different for every person. A mental health professional can help you understand which type of OCD you may have. Support is available.