Signs of OCD & narcissism together & treatment options

Key Takeaways

Obsessive-compulsive disorder (OCD) and narcissistic personality disorder (NPD) are different conditions that share some similar traits. They can both cause a strong desire for control, perfectionism, and relationship challenges.
There’s evidence that narcissistic traits could predict the onset of OCD. But it’s unclear whether NPD causes OCD, or vice versa.
To successfully manage co-occurring OCD and NPD, both conditions must be addressed in treatment. Therapies like cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) are effective for treating symptoms of OCD, while dialectical behavioral therapy (DBT) techniques are generally recommended for managing NPD.

Narcissistic personality disorder (NPD) is a mental health condition characterized by an extreme sense of superiority and a lack of empathy. As a result, it may lead people to exploit others and constantly seek adoration and approval.

Obsessive-compulsive disorder (OCD), on the other hand, causes people to experience uncontrolled, upsetting, and intrusive thoughts called obsessions. In response, people with OCD engage in ritualistic behaviors, called compulsions, which they perform in an attempt to alleviate their distress.

Although NPD and OCD are distinct conditions with unique diagnostic criteria, they share some similar symptoms, like a desire for control and perfectionism. While other personality disorders besides NPD may be more likely to be diagnosed in people with OCD, it’s possible for NPD and OCD to co-occur.

How are OCD and narcissism related?

The relationship between NPD and OCD is complex, and there’s limited research on how they interact. However, according to a recent study, the presence of narcissistic traits may predict the onset of OCD. The study also uncovered that, as narcissistic traits increase, OCD symptoms seem to worsen.

This interaction underscores the importance of seeking a professional evaluation if you think you might be living with OCD and/or NPD. Receiving an accurate diagnosis can help ensure that you receive the integrated care you need to manage both conditions.

While research shows a connection between OCD and NPD, this relationship isn’t yet fully understood. However, it may be tied to some shared symptoms, like:

Unstable self-image: OCD and NPD can both affect how a person sees themselves. OCD might cause someone to view themselves as incompetent or unworthy, while NPD may cause a person to view themselves as highly superior.
Desire for control: People with OCD may desire control as a way to relieve anxiety. NPD may cause a desire to control or manipulate others for power or admiration.
Social challenges: Some presentations of OCD can make it difficult to maintain relationships due to partner-centered symptoms. And a lack of empathy and a tendency to exploit others due to NPD can make it difficult to create connections.
Perfectionism: A person with OCD may have perfectionist tendencies due to deep-seated worries about uncertainty or what could happen if things aren’t “just right.” Similarly, the sense of grandiosity brought on by NPD may demand perfection from oneself and others.

These overlapping experiences can make it more difficult to identify whether someone is living with OCD, NPD, or both. So if you’re concerned that you might have one or both of these conditions, don’t hesitate to seek help. A mental health professional can provide an evaluation and accurate diagnosis so you can get the right care for your needs.

Signs you may have co-occurring OCD and NPD

While it can’t replace professional help, learning some signs of co-occurring OCD and NPD might help you better understand yourself and your experiences. So let’s review some examples of the ways that these conditions might present.

Let’s imagine a person with OCD without NPD who has obsessive thoughts about someone else. They constantly worry about this person’s safety. So they engage in daily compulsive behaviors to “prevent” anything bad from happening to this person. At the same time, they’re aware that they can’t actually control the other person or guarantee their safety. They know their obsessions and compulsions are difficult to manage, and they don’t want them to negatively affect anyone else.

Now let’s imagine a person who has OCD and NPD. This person has obsessive thoughts about cleanliness. They become intensely anxious if the surfaces in their home aren’t sanitized to their standards. But instead of engaging in compulsive cleaning rituals themselves, they demand that others in the household do the cleaning for them. They think they’re entitled to have other people meet their demands, and they’re unable to see the problem with treating their housemates this way.

As you can see, having OCD and NPD can affect a person’s awareness of their symptoms. So if it’s difficult for you to identify ways that your OCD negatively impacts yourself or others, you might be living with both OCD and NPD.

OCD fear of narcissism vs. NPD

The obsessions caused by OCD can take many different forms. For example, some people with OCD obsess about germs, symmetry, or social rejection. But it’s also possible for a person with OCD to obsess about having NPD or another mental health condition.

Worrying that you have NPD doesn’t mean that you’re living with it. But it’s always best to talk to a mental health professional if you have these concerns.

Can one condition cause the other?

We don’t know whether having OCD could lead you to develop NPD, or vice versa. But there’s some evidence to suggest that the presence of narcissistic traits could predict OCD. These conditions may also have some shared risk factors, including experiencing trauma. So being exposed to trauma at a young age may contribute to the onset of OCD, NPD, or both.

Treating OCD and narcissistic personality disorder together

To successfully treat OCD and NPD together, both concerns must be addressed at the same time. Research shows that approaches like cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) can help people effectively manage OCD. These therapies can address the unhelpful thoughts and beliefs associated with these conditions.

For NPD, dialectical behavioral therapy (DBT) techniques are often recommended to help people improve their emotional regulation and interpersonal skills. A therapist can integrate these approaches by tailoring interventions that address both the compulsive behaviors of OCD and the interpersonal challenges of NPD in a way that enhances overall treatment progress.

In addition to therapy, medication is sometimes used to treat OCD. While there are no medications approved for treating NPD, if you have co-occurring OCD, you can talk to your provider about whether medication is right for you.

Find care with Rula

OCD and NPD are two different mental health conditions characterized by some similar symptoms. For example, they can both cause an unstable self-image, perfectionism, and a desire for control. Living with co-occurring conditions can be confusing, especially if you don’t understand which condition is causing your symptoms. But rest assured that, with the right care, you can learn to manage your OCD, NPD, or any other mental health concern you’re facing.

At Rula, we believe that everyone deserves access to convenient, affordable mental healthcare. So we built our therapist-matching program to help people quickly and easily find in-network providers they can meet with via convenient virtual appointments. In just a few clicks, you can explore our extensive network and find the right therapist or psychiatric provider for you. And with over 10,000 mental health professionals to choose from, you won’t wait weeks or months for an appointment. With Rula, you can access the care you deserve as soon as tomorrow.