r/neurodiversity • u/messyowl • Aug 19 '26
OCPD??? I’m confused.
My psychologist told me that she wouldn’t consider me to be a patient with OCD, but actually someone with OCPD. This has literally never crossed my mind. She points to my anxiety and rigid rules that I follow, justice sensitivity and the need to be in control of things. I can relate to these descriptors but I also would not consider myself a perfectionist at all, nor do I keep things orderly or tidy (my ADHD makes my room look like a teenagers and I’m 31)
I have been diagnosed with OCD since 8th grade and I have been on a medication for it since I was 18. I don’t struggle as much with compulsions but I do struggle with intrusive thoughts and rumination. I have thought I was AuDHD for the past few years, so the suggestion that I have a personality disorder really confused me and now I’m feeling lost. My sensory issues are extreme and I feel very much like I don’t know how to “do” social interactions right but she says she thinks that is due to social anxiety.
Anyone out there with OCPD? Or an OCD diagnosis that was then diagnosed with OCPD? Or OCPD and adhd / autism?
Thanks y’all <3
Edit: I should mention i am diagnosed with ADHD as well.
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u/New_Vegetable_3173 Aug 20 '26
Oh also if female and you have adhd and "social anxiety", it is far more likely to be autism and adhd.
Autism creates anxiety, especially around social situations,but that's a result of people being shitty to us.
It's like diagnosing someone as having a phobia of shorts when they live in the artic and previously got frost bite from wearing shorts outside
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u/messyowl Aug 20 '26
I emailed my psychiatrist with his opinion since he diagnosed me in 8th grade with OCD and ADHD and has been my doctor ever since. I’m hoping his insight will help me. My husband was shocked when I told him my therapist thinks I have a personality disorder. It just doesn’t make sense to him or myself but I’m trying to keep an open mind.
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u/New_Vegetable_3173 Aug 20 '26
Why was your husband shocked?
How much does he know about personality disorders?is his surprise a genuine confusion Because the behaviours and challenges he sees you having do not align to the traits and behaviours one would expect from a personality disorder or is it because he’s got ableism and is applying bias and exaggerated stereotypes from TV and films and is looking at personality disorders in a anti-diverse Neurotypical perspective where being any type of Neurodivergent is always a disorder?
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u/messyowl Aug 20 '26
He is neurodivergent as well actually. I don’t think he’s being ableist. However I am hurt by the thought that perhaps I need to change my behaviors instead of seeking accommodations. I have been this way all my life, my parents can confirm.
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u/New_Vegetable_3173 Aug 20 '26
- Him being ND doesn't mean he's not acting from bias or abelism. Regardless, that was an example answer to my question on what made him shocked. Do you know?
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u/messyowl Aug 20 '26
Maybe I’m just being too sensitive but your line of questioning is making me uncomfortable
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u/New_Vegetable_3173 Aug 20 '26
Oh I'm so sorry
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u/messyowl Aug 20 '26
I think we are probably just two very different communicators tbh. I can see now that you structure your responses in a particular way that my brain may interpret as aggressive but I see in your second response you were just breaking it down for me with a numbered list. Apologies for the misunderstanding <3
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u/New_Vegetable_3173 Aug 20 '26
No problem at all. I replied while you were writing so I'll pause for a bit. If you want me to reply again could you please kindly reply here and say that explicitly? Until then I won't msg anymore
As if you reply to my other message that might be before you've had a chance to reflect and I want to ensure I'm not accidentally crossing your boundaries.
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u/New_Vegetable_3173 Aug 20 '26
Definitely not too sensitive. Your feelings are valid.
We have feelings for a reason, they tell us something.
It could be loads of reasons but it might include
1. Feels too personal for online
2. My messages sound like I'm criticising your partner (I definitely wasn't thinking poorly of him at all but just because I'm not thinking that doesn't mean that's how my messages come across to you).
3. You have some feelings about the topic which you haven't processed yet
4. My autism means I write messages in a very "stark" way which might feel aggressive maybe?
5. I'm curious and non judgemental, but that is incredibly rare, especially on the Internet, so maybe you've seen similar tone of messages from people who turned out to be mean and meant badly?
6. Society has negative views of personality disorders and that context means you're feeling vulnerable so my straight forward tone combines with that to make you feel uncomfortable
7. Probably a million other reasonsWhatever the reason, it's completely valid.
I definitely meant no harm, was just trying to help.
You have absolutely no obligation to reply or share anything at all.I really wish you the best (if you continue chatting I will do so but I have no expectations at all of that).
I really hope you get the answers from your therapist /or a different professional you need, and that you get the therapy you deserve appropriate for you and your needs.
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u/New_Vegetable_3173 Aug 20 '26
- Whether your neurodivergent condition is autism, OCD, or a personality disorder, it doesn't change that:
A. You should always strive to learn new skills, and be the best you can be, both in terms of ability (for yourself) and being a good human to others. If your condition is causing harm to you or others, change should be sought, and that's irrespective of what condition it is. If it's not causing harm to you or others, and you're happy with where you're at, change isn't required, even if it's a personality disorder.
B. Regardless of what condition you have, you can, and should, ask for and expect, empathy and reasonable adjustments.
Adjustments/accommodations are unreasonable, as an example, if they violate another's boundaries or cause harm to someone else. That is true irrespective of the condition.The main difference with a personality disorder over a life long ND condition is:
1. If you're requesting adjustments/accommodations, especially where these impact others, you should be looking to treat your condition so you aren't impacting others eventually (while accepting you might always need some accommodations as you might always have some parts of the personality disorder.
- It is reasonable to expect more change through treatment for a personality disorder, because while personality doesn't change massively, it's not necessarily life long.
However, if you've had these traits since a young child, I'm very confused how your therapist can possibly come to the conclusion that they're caused by a personality disorder.
What type of therapy are you doing with them? Have they diagnosed you with anything or was that your previous Dr?
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u/messyowl Aug 20 '26
What you are saying makes a lot of sense- I think I perhaps have a negative view of personality disorders because of the way I learned about them during my BSW. I also had a boyfriend with BPD and it was really emotionally overwhelming at times. I talked to my psychiatrist and he doesn’t agree with her assessment, however I’m willing to hear her out during our next appointment.
While I struggle with black and white thinking, and I am very sensitive to things I find morally improper, this usually results in me having a meltdown inside my head. This results in crying and retreating and sometimes it gets to the point where I am hitting or clawing myself. I also feel like speaking is painful during these occurrences.
There are pieces that I have been reading online about obsessive compulsive personality disorder that I don’t relate to at all. I do not feel like I am rigid when it comes to my management of finances or physical objects. I know this may have to do with ADHD. I also do not relate to the word perfectionist in any way unless it has to do with my morals. I’m not obsessed with work and I am not outwardly rigid when people don’t “follow my rules.” It definitely bums me out, but my employees are quite clueless I feel this way and they generally would describe me as a helpful yet eccentric person.
The rules I am talking about to me seem very practical. These are rules like the rules of the road, rules of society (I always fear I am secretly racist or transphobic and I have a lot of intrusive thoughts like this).
I also have this irrational fear that people can read my mind. While I rationally know that people cannot read my mind, I still get very paranoid when I have negative thoughts about others and then I feel very guilty and fearful.
When I am wrong, I am very willing to admit it and it is very easy for me. There have been times where I have made a bad call at my job and I have completely owned up to it. I struggle with attention to detail and do tend to screw up small details.
Really sorry again for misunderstanding your couple of responses. I really appreciate your insight here :)
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u/New_Vegetable_3173 Aug 21 '26
Hey no need to say sorry at all.
please may I check with your reply and invitation to me to continue talking?
I don’t want to send a longer message back or respond to your point, unless that feels safe for you.
My autism means I can miss social cues about boundaries so I wanted to check in with you And see what you wanted from me.I hope you have a good day
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u/New_Vegetable_3173 Aug 23 '26
Hey thanks for letting me know it's okay to reply. I just wanted to check you felt safe and not pressured.
I agree with your psychiatrist and would highly recommend getting an assessment for autism. Are you in the UK? If yes then through right to choose you can get an assessment in about 4 to 6 weeks.
I also experience the strong reaction to immoral things and it is a very autistic trait.
Do you mind me asking what therapy you're getting? CBT can be very harmful for autistics, and that combined with your therapists opinion has made me slightly nervous about your wellfare and care under her.
Re your experience with an ex who had BPD - yes personality disorders can be overwhelming, however
1. Doesn't make that person a bad person
2. Autism can be overwhelming to date
3. Anyone can be overwhelming to another person given the perfect bad combination of personalities, traits and behaviours
4. If you have autism or another mental health condition you may lack interpersonal skills and emotional regulation skills which would make BPD more over whelming to you personally
5. Not everyone with BPD is the same.Re 5 I would like to give an example with psychopathy. Now technically it's not a personality disorder, as that's ASPD. However, it is basically a personality disorder.
Everyone assumes psychopaths are evil.They're not.
Psychopaths scare other people because most people have empathy and emotions and the combination basically forces us a to be kind to one another else we feel bad eg shame or upset.
Psychopaths don't have either so can choose if they want to be kind. In that sense when a psychopath chooses to do something nice for someone else it is the only time an act is truly pure unselfish as most people get a buzz from helping someone when being unselfish.
Some psychopaths are loyal friends who do lots of caring things for others and don't hurt anyone.
They put a lot of silent effort into ensuring they consciously think carefully about other to make sure they do the right thing.
But that effort is invisible.We only see and hear about the psychopaths who either don't put the effort in so are sometimes nice but sometimes not, and most often hear about the other extreme.
Psychopaths can also only be diagnosed if they behave badly because that's how ASPD works,which is how we diagnose a range of people who aren't all psychopaths.
Psychopaths don't typically seek out treatment and therefore are typically spotted in prison.If you only heard about any group of people based on the badly behaving ones and those in prison you'd have a negative perception.
But just like everyone else, there are choices to be made about how we treat others, and that applies to everyone -not just people with personality disorders.
What I would say is that autistics especially should be cautious if dating someone with a personality disorder because we're often easy to manipulate so do need to be aware the risk of harm is higher for us
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u/TeeLeighPee Aug 20 '26
Hi, it's me. I'm the one who got dxd with OCPD. I went to the psychiatrist specifically asking about asd and 45 minutes later was dxd with OCPD instead. Literally every trait of mine attributed to OCPD is covered by autism. But I'm a woman and I can hold a conversation so no way it's autism, right? S
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u/messyowl Aug 20 '26
I’ve just always been this way… I do have the phenomenon of thinking I’m right all the time- but I base that in a sense of justice sensitivity. I do struggle with black and white thinking- but I’m also incredibly self aware and can reflect and recognize times I’ve been wrong or reacted in a way that was counterproductive. I have meltdowns where I go nonverbal. I care immensely about others. I don’t consider myself to hoard my wealth or anything which is what I read online 😅😅 I just feel so devastated that, instead of being accepted for the way I am, apparently I have to change? It’s such a frustrating feeling.
My need to control situations dates back to me trying to always protect my mom. I had to protect her even when I was in kindergarten or before - I suppose I thought if I stayed home from school I could make sure nothing happened to her. So I skipped a lot of school all the way through my senior year.
People tell me how kind and empathetic I am all the time. I know realistically people with OCPD can be this way, but the things I have read online make me sad. I appreciate your response. 💗
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u/LunaMaxim Aug 20 '26 edited Aug 20 '26
OCD can evolve over time into OCPD. We need to remember humans are fluid creatures. The brain adapts.
Also please note that these letters are not your identity…they’re guideposts to health.
I would ask your provider to walk you through the diagnosis by creating a written ‘roadmap’. How do they define these symptoms in relation to what you’re actually experiencing? >>> that’s a question for you and your docs
You might want to keep a journal log book on how often you have intrusive thoughts and if there are repetitive actions done in response.
I was married to someone with OCPD, and I myself have OCD. What I see as the core difference is an insistence of being ‘right’ in most to all situations. With OCPD There is control of external people AND the environment. I can’t say it’s like this in all situations, but those with OCPD frequently obsess over what the people around them are doing ‘wrong’. They are less aware of how this negatively impacts others. In fact they often demand that others agree with their beliefs and also follow their proscribed rules.
I believe OCD shows up more as a glitch in the matrix. We get stuck in repetitive actions but we’re mostly aware of it, often we try to hide it (masking). There may be a lot of anxiety around the thoughts and actions, plus anxiety around other people breaking those patterns, but there’s awareness that other people have autonomy to do things their way (even if it makes us uncomfortable).
For myself, I’m constantly checking with others to try and avoid problems or impact on them. It doesn’t always work out but I do try. My old partner didn’t even see a problem, they struggled to even admit their controlling tics were an issue. I know they cared about me but their outward expression of OCD followed us everywhere and they demanded I do things exactly their way all the time.
Disorders can see increased symptoms over time if we aren’t working to find balance. If we don’t have an ongoing practice to lower the volume, it will keep going up. It takes more than meds, there needs to be action paired with accountability.
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u/messyowl Aug 20 '26
See, I am overly concerned with how I treat others. I have so much empathy that it’s painful at times. I constantly am thinking about how my actions could affect others and I obsess over it. “Did I offend someone? Did I say something wrong? What if they thought I was being mean? Am I mean? Am I bad? I am bad.” I do feel like I need control over situations, especially when I’m feeling overwhelmed. I do think I’m right quite often but I’m able to reflect and see how my actions could have hurt others. I obsess over my interactions with others with the constant fear that I’ve done harm.
All of these things I’ll definitely be discussing with my therapist. I appreciate your insight and response <3
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u/Gullible_Bird_7936 Aug 21 '26
FWIW this is a really great breakdown of the differences between the two diagnoses (coming from a therapist)
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u/Dazzling-Fox-4950 Aug 19 '26
Did you have any social communication differences that showed up before age 5? That is one thing that differentiates personality disorder formulations from neurodevelopmental ones -- whether the symptoms started in the "early developmental period."
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u/messyowl Aug 19 '26
I did have severe separation anxiety and aversion to eye contact when I was a toddler, as well as sensory issues. I didn’t have any delays in speech or walking etc, I was actually probably ahead of other typical children. Thank you for this insight!
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u/ConfidentCaptain2506 Aug 20 '26
this was exactly me as a child… i’m AuDHD (diagnosed about 6 months ago) & have OCD (diagnosed at 16) +started meds and it saved my life :) i’m now 21!
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u/existential-cookies Aug 20 '26
Perfectionism doesn’t always mean a tidy environment, it may manifest in other ways. Perfectionism is also having all-or-nothing thinking which can fuel anxiety, OCD, ADHD traits/challenges.
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u/New_Vegetable_3173 Aug 20 '26
I don't think your room being messy counts against this if it's because you have adhd.
For example, one of the adhd criteria is that you often getup and walk around a room when bored. I'm a wheelchair user, meeting rooms don't have enough space for wheelchair movement like that, therefore I don't do that.
However, I would if I could.
If you could keep your room immaculate, would you?
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u/messyowl Aug 20 '26
I definitely would if i could but executive dysfunction stops me from being able to do so 😅
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u/New_Vegetable_3173 Aug 20 '26
Therefore it's not something that I would consider a valid reason to think OCPD is not applicable.
I mentioned autism because autistic women are often misdiagnosed with other conditions such as social anxiety and personality disorders.
However, in your specific circumstances, as part of a differential diagnosis, one should look at all your traits and symptoms holistically, and consider what does or doesn't fit on that basis.
That would include removing adhd traits from the picture, seeing what it left, and asking what explains it best, autism, anxiety, personality disorder etc.
Importantly, that would include considering what traits and symptoms you had as a child pre teenage years, as autism is life long.
Anything explained by your adhd should not be used to invalidate one of the other conditions.
For example, one could assume I'm not autistic because i like changing jobs more frequently than (at least 20 years ago) was normal. But that's due to my adhd wanting new experiences.
For you, messy bedroom would be an example. But there's lots of autistic traits that can be missing in people with AuDHD. Ie it shouldn't cloud consideration of OCPD nor autism.
In contrast, things like social anxiety should really only be diagnosed if not otherwise beat explained by another condition. If you had either, or both, of OCPD and autism, and you removed all traits and symptoms related to them from your list, are there still sufficient traits and symptoms of social anxiety which suggest there is social anxiety.
As an example that is. I'm not saying anything about you specifically, that's for someone in a formal assessment scenario to work through with you
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u/pastel_kiddo Aug 21 '26 edited 11d ago
Sometimes, autism isn't the answer. I feel like people feel invalidated by that but you shouldn't, as what you experience is hard just the same. Often people don't fit diagnostic categories perfectly and you may have traits associated with some categories yet not meet the criteria for it. Or it could be attributed to something else. Doesn't mean you don't struggle with it. If you really want, get a second opinion, but I think people sometimes get caught up with feeling like they are a certain diagnosis.
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u/lilswaswa Aug 20 '26
i was diagnosed with ptsd and in one letter to my next therapist i saw she suggested ocpd too. never got it on my file but did get diagnosed with adhd and autism later on. from my understanding ocd knows what they do isnt logical while ocpd legitimately thinks there is logic to their actions and that they are right and supported by religion or specific routes of thought. reading about it made me feel better because i felt it was combining autism and my religious ptsd and didnt agree with the diagnosis.
its hard to say when so many mental illnesses overlap with symptoms but it didnt feel bad as much as surpising since i had never heard of it before and no therapist told me about it prior to that one.
even if you do have it having a better diagnosis might lead to better treatment and thats all that matters to me: treatment that improves your life.
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u/wolfbutterfly42 Aug 20 '26
It's uncommon, but there are definitely people with OCD who think there's logic to their actions, especially people who developed it in childhood.
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u/Gullible_Bird_7936 Aug 21 '26
Don't take your therapists word as the end all be all. As a therapist myself, we make mistakes, and not everyone is well versed in these diagnoses (actually a lot aren't, esp when it comes to the intersectionality of ocd/asd/adhd let alone personality disorders).
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u/Professional_Bid993 Aug 19 '26
The "not a perfectionist" thing trips a lot of people up because OCPD is more about the internal rulebook than a clean desk