It is not at all uncommon for people with narcissistic personality disorder (NPD) to have multiple mental illnesses. If you’ve experienced someone with narcissism, any obsessive-compulsive tendencies might be low on the list of what you noticed about them. It is also harder to notice OCD symptoms in narcissists because they look different than they do in someone who is not narcissistic. 

Narcissists can develop OCD, but it is not as common in people with NPD as other comorbidities (co-occurring mental illnesses) are. What’s more, the expression of OCD in the narcissist is quite different than in someone without narcissism. 

Read on to learn more about OCD and the frequency and nature of its co-occurrence with NPD. It’s also important to be able to recognize the difference between these two disorders since they have overlapping symptoms.  

What is Obsessive-Compulsive Disorder? 

OCD is characterized by repeated, unwanted thoughts and/or sensations that cause a person to feel as though they need to do a certain behavior or think certain thoughts over and over. These are the compulsive behaviors for which the mental illness is named. 

There are two aspects to OCD. The first is the obsessive thoughts that a sufferer experiences. This might be something like believing that certain numbers or colors are good or bad. The second aspect of this condition is that the individual feels a compulsion to engage in habitual behavior. The compulsion is so strong that the person will feel as though they are powerless to resist or stop. 

How is OCD Different from Normal Habits? 

Of course, everyone has some repeated thoughts or habits, but there are several characteristics that distinguish OCD behaviors from normal habits. The first is that the person doesn’t feel like they can control the behavior. 

You might be in the habit of brushing your teeth after every time you eat, but if you believe that you have to brush each tooth exactly seven times clockwise and seven times counterclockwise, that might be OCD. 

Another trait that separates OCD from normal habits is that compulsive behavior typically takes up at least an hour out of your day. Moreover, these aren’t habits you enjoy doing, and they can quickly begin to interfere with your professional or personal life. 

What are the Categories of OCD?

Typically, OCD behaviors are categorized as either checking behavior, such as compulsively checking that a door is locked repeatedly, or contamination behavior, which is associated with the fear that things can become dirty and you, therefore, feel a compulsion to clean even if they aren’t really dirty. 

OCD categories also include symmetry and ordering which results in a compulsion to have things ordered in a particular way, and ruminations which are obsessive thoughts that can sometimes become violent. 

How is OCD Different in the Narcissist?

One of the reasons it can be so difficult to recognize OCD in a narcissist is that many of the traits overlap between the two disorders. For example, both mental illnesses often involve feeling the need to be perfect.

The narcissist is hypervigilant about every detail in their life given their need for external validation, but that can look very similar to the OCD trait of needing everything to be just so because of obsessive thoughts and compulsive behaviors. 

OCD and NPD also share the characteristic of believing that other people will be incapable of doing things correctly. But people with OCD tend to be preoccupied with being incapable themselves, whereas this is not a trait associated with NPD. Narcissists often already believe they are perfect and that it is the other people in their lives who are flawed. 

People with OCD also typically realize that their habits are annoying and they know it’s an indication that they have a problem. But when OCD is combined with narcissism, one major difference is that the narcissist doesn’t see that anything they do is problematic. 

Instead, a narcissist will believe that everyone around them should be doing things to make them more comfortable instead of further complicating their life. So, if they have an OCD compulsion to clean, they want everyone to make sure their environment stays pristine.

If the compulsion is centered around a particular behavior, the narcissist may insist that anyone in the house engage in that same behavior as well. 

How Frequent is OCD in Narcissists? 

Because narcissists don’t often seek help and NPD shares many traits with OCD, it’s likely that the frequency of comorbidity with these two mental illnesses is underreported. But one study in Brazil found that, of the several comorbidities with OCD, narcissism was only reported in 7.5 percent of the cases. 

The study involved 40 psychiatric patients and 40 non-psychiatric patients, and it found that people with avoidant and dependent personality disorders tended to manifest OCD symptoms more frequently than narcissism. 

A more recent study from 2008, however, found that there was a consistent association between obsessive-compulsive personality disorders and narcissism, particularly in men. In women, NPD was more frequently associated with specific phobias, bipolar II disorder, and generalized anxiety disorder. 

Final Thoughts

When a person has one mental illness, it’s not uncommon for them to develop more, and many mental conditions are associated. Given that many narcissists don’t believe they have a problem and never seek help, it’s likely that our understanding of the co-occurrence of other mental conditions is far from complete. 

There is, however, evidence that narcissism and OCD co-occur, particularly in men. From the perspective of someone who is subjected to narcissistic abuse, these distinctions may make little difference.

Still, it helps to better understand the way a narcissist thinks and the reasons behind their obsessive behavior. It’s also important to recognize these possibilities should someone with narcissism decide to seek help. 

If you suspect that someone in your life has NPD, OCD, or a combination of the two, you might take careful note of the behaviors they display. That can help a psychologist or psychiatrist to tease apart the possible comorbidities.

For your part, be sure to take good care of your own mental health since both problems can have a significant effect on your life as well. 

Now that you know a little bit about the co-occurrence of NPD and OCD, you might be interested in this article about how narcissism is categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).