“What I Live With” is an ongoing series in which we deep dive into a variety of health conditions that disproportionally affect women. Here, a spotlight on three different OCD subtypes that present very differently than the more typical—and sometimes cliche—symptoms we so often see associated with the condition.
For as long as Lisa had been alive, she’d thought about death. The 38-year-old Connecticut mom of three recalls one of her earliest childhood memories: sitting in the nurse’s office, convinced the distant sirens outside her classroom meant something terrible had happened to her mother. “I think it was a weekly occurrence,” she tells Glamour. “I don’t even think they’d use the word anxious back then. They just said, ‘Yeah, she keeps coming back here — we don’t know why. Is everything okay at home?’”
The thing is, everything was okay at home. Lisa was surrounded by a tight-knit family, a solid friend group. But none of that mattered because their lives were in her hands. And if she “messed up,” they’d die. Or at least that’s what her brain had been telling her.
As it turns out, Lisa had Obsessive-Compulsive Disorder (OCD). For those with OCD, obsessions—repetitive and unwanted intrusive thoughts and images—are time-consuming and impede on their day-to-day life. And despite it affecting between 1% and 3% of the population, it’s still severely misunderstood and misrepresented. Plus, with women at a greater risk of developing the disorder, that should (unfortunately) come as no surprise.
TL;DR: people still get what it’s like to live with Obsessive Compulsive Disorder—and OCD subtypes—wrong.
“It takes an average of 14 to 17 years for an adult to find effective treatment,” Angela Henry, LCSW, tells Glamour, “And typically, this is due to misdiagnosis or clinicians not having the appropriate training to treat OCD effectively.”
Social media hasn’t helped either. Popular platforms frequently misuse “OCD” as a casual descriptor, distorting public perception of what it means to be someone living with the disorder. And research has shown that this kind of misrepresentation on places like TikTok affects how we view those struggling with real, distressing symptoms. (If you’ve ever heard of the phrase “I let my intrusive thoughts win” on the internet, you know what we mean.)
And here’s the trickiest thing about OCD: it doesn’t always look the same.
“OCD is creative,” says DC-based Licensed Professional Counselor Stephanie Woodrow. “There are common themes or subtypes, but OCD puts its own spin on it for everyone. It’s just a really sneaky disorder.”
What Are The Lesser-Known OCD Subtypes?
“Oh, I love this question,” Alegra Kastens, an LA-based LMFT specializing in OCD, says. “Because there’s a misconception that OCD is all about cleanliness and organization, which keeps people from being properly diagnosed.”
OCD catergories fall into broad categories like harm, contamination, sex, and morality, and the “subtypes” or “themes” have names. Each of these fall under the same diagnosis of Obsessive-Compulsive Disorder. Some OCD subtypes are Pure O (obsessions without observable compulsions), Relationship OCD (unfounded doubts about relationships), and Perinatal OCD (obsessions about harming a baby). So know that when Kim Kardashain exclaims that organzing makes her horny, that’s not what the condition is. Below, three lesser-known OCD subtypes and the women living with them.
Lisa: Postpartum OCD
The anxiety Lisa—the Connecticut mom mentioned earlier—had always had a way of rebranding itself since elementary school, morphing from one hyper-fixation to another. After the birth of her first child, her death-obsessed type of OCD swiftly transferred itself to her new baby.
She’d jolt awake at night and peer into the crib to make sure her sleeping baby was still breathing. The fear of Sudden Infant Death Syndrome—SIDS—wasn’t just a passing worry; it had become all-consuming. And sure, while bags might’ve been underneath her eyes, and the need to sleep might’ve been inside her, the obsession with watching her baby breathe was stronger.
But she wasn’t just awake—she was wired. Her fixation was taking over her life. She remembers her chest running like an engine, which she actually mistook for generalized anxiety before becoming properly diagnosed with Postpartum OCD a few years later. “I’m not a runner at all, but I swear I could’ve gone for miles on those nights.”
Kastens explains that for mothers with postpartum OCD, this kind of nighttime ritual is a textbook compulsion. OCD operates in two parts: Obsessions—unwanted thoughts or images that cause distress—and compulsions, the behaviors a person performs to try to neutralize that distress. “For some mothers, it might mean obsessively googling something like SIDS,” Kastens says, pointing to Lisa’s case. “For others, it might be avoiding changing a baby’s diaper because they’re terrified they might be secretly be a pedophile.”
Lisa was also having intrusive thoughts, like seeing her child smothered under a blanket, him being ripped from her husband’s arms. And then, when her second pregnancy came, the fear rebranded itself again in a CVS parking lot of all places. Lisa had gone in to pick up her birth control prescription, but as she did, a wave of panic hit. OCD had convinced her she had potentially “killed a baby” by taking the pill, even though she knew that wasn’t possible. Desperate for reassurance, she turned to the internet, posting anonymous questions like, Can birth control cause abortions?—even though she already knew the answer. The backlash, of course, came quickly. Birth control is a lifesaving medication, people snapped. What kind of pro-life misinformation is this?
The strangest part, says Lisa, “I’m 1000% for abortion rights, for birth control, for anyone making whatever choice during pregnancy—no guilt, no shame, no second-guessing.”
Alegra says this is actually a common symptom of postpartum OCD—and what differentiates it from postpartum psychosis. “You know what’s happening, but the need to act on the compulsion is much stronger,” says Kastens, which tosses all logic out the window.
Keagan: ‘Scrupulousity’ OCD
Logically, she knew the IRS wasn’t going to come after her. But with scattered papers and checks across her kitchen counter, 29-year-old Virginia resident Keagan was rereading the questions on her forms—what was your income last year? Did you make any charitable donations? All to prove that she wasn’t doing something inherently “bad.”
Keagan wasn’t obsessed with being a good mother like Lisa. She’s obsessed with being a good person. She has “scrupulosity OCD,” a subtype that preys on morality, ethics, or religious and spiritual beliefs. In Keagan’s case, it was debilitating, the hours spent rechecking her bank statements and trying to convince herself that she wasn’t breaking the law. “I think I taught myself federal tax code at one point,” Keagan says. “Seriously, it was absurd.”
But it didn’t feel absurd when she was in her OCD flare. She would ask her partner for reassurance. She would check and recheck her filing. She would read for hours about how to report her income correctly. Before this, there was another obsession— one just like it, she says. She was convinced that she may have burned a house down with a cigarette, something, again, that would make her a “bad” person or citizen. “I would check and recheck candles, stoves, you name it.”
At the core, you might think Keagan and Lisa’s guilt for something that wasn’t happening sounds similar: That’s because it is. “At the end of the day, it’s all OCD,” says Kastens. “And your themes can always change. If you have Pure O, that doesn’t mean you’ll never have rOCD.”
Or, in Danielle’s case, you might have both at the same time.
Danielle: ‘Pure O’ OCD and ‘Relationship’ OCD
When Danielle, 33, starts a new relationship, her anxiety spikes in a way that goes beyond what most people experience (… think: asking your friends for outfit advice, overthinking how to act on a first date).
She has relationship OCD (rOCD), a subtype that latches onto romance, poking and prodding at her feelings until she’s forced herself into a thought-spiral. Did she say the wrong thing? Why did her partner take five extra minutes to text back? Does she even love them? Do they love her? The questions cycle in an “endless, exhausting loop,” she tells Glamour. “When you have relationship anxiety, you might convince yourself that you’re not attracted to your partner, so you avoid sex with them,” says Kastens. “You might have retroactive jealousy and distressing images of their sexual past, despite having one of your own.” You might also be convinced they’re not in love with you, despite them being all-in. This was Danielle’s case, which ultimately caused her to seek internal and external reassurance.
But sitting with that uncertainty is better than seeking reassurance, according to Kastens. Mental compulsions, like reassurance seeking (whether from others, the internet, or yourself), can worsen anxiety in the long term, especially when it involves others, Kastens tells Glamour.
Danielle also simultaneously suffers from Pure O, where intrusive thoughts plague her. She will have extreme memories of things she did ten years ago or more that are distressing and embarrassing. They are constant and painful; sometimes, she wishes her brain would just “shut up.”
She wants people with OCD to know that sometimes, thoughts are just that: thoughts. “You’ll see all these social media posts like, ‘Your thoughts are your reality!’ ‘Your thoughts manifest your destiny.’” For someone with OCD, Danielle says, that’s simply not the case: Don’t listen to that, she says.
Instead, she hopes that people will continue to educate themselves about OCD and OCD subtypes so that they recognize it — whether that’s within themselves or maybe someone they love.
“Listen, I’m the opposite of what most people think when they hear ‘OCD,’” she tells Glamour. “My house is a mess. I’m not super tidy. I’m not particularly concerned about germs.”
But just like Lisa and Keagen, that doesn’t make her experience any less real. If anything, it proves how OCD works the same ruthless way, no matter how wild or silly the obsession might seem to someone who isn’t fighting against it.
The post OCD Subtypes: 3 Women on Living With Lesser-Known Variations on the Condition appeared first on Glamour.
