Alcohol Use Disorder and Obsessive Compulsive Personality Disorder

The defining characteristics of obsessive compulsive personality disorder can make alcohol use problematic very quickly because there is a direct link between AUD and OCPD symptoms.

What You’ll Learn:

• The common traits and behaviors associated with obsessive compulsion personality disorder and how they are related to alcohol use.

• What the research says about the strong connection between drinking and OCPD.

• Why perfectionism is likely the biggest catalyst for drinking among people with OCPD.

• How feelings of isolation and exhaustion add to the problem and prompt drinking.

• What people with OCPD can do to curb alcohol use and start feeling better.

Obsessive compulsive personality disorder, often referred to as OCPD, is the most common type of personality disorder. It’s estimated that 2-7.8% of the population are affected by the condition.

Alcohol use disorder is more common across every personality disorder, not just this one. Our guide to alcohol use disorder and personality disorders breaks down the risk and the research for each one.

OCPD shouldn’t be mistaken for OCD (obsessive compulsion disorder), but it is worth noting that 30% of people with OCD also have OCPD.

Obsessive compulsive personality disorder is marked by ego-syntonic personality patterns while OCD involves intrusive, distressing obsessions.

Those personality patterns are centered around rigidity, control, order and perfectionism. These patterns are continued even when it negatively impacts efficiency and creates anxiety.

The rigid self-control that’s associated with OCPD might seem counterintuitive to alcohol dependence, but the research has found something else altogether.

What OCPD Traits Influence Alcohol Use?

When doctors are diagnosing OCPD they do so by identifying eight specific traits and behaviors. The traits include:

• Preoccupation with details and order

• Perfectionism that gets in the way of finishing tasks

• Excessive devotion to work at the expense of leisure and relationships

• Rigid inflexibility about morals and ethics

• Inability to discard worthless objects

• Reluctance to delegate

• Miserliness toward self and others

• General rigidity/stubbornness

Having OCPD traits isn't an automatic diagnosis for the disorder. Many people have one or two OCPD traits, such as being extremely orderly and having a specific place for everything, but they don’t have obsessive compulsive personality disorder.

When someone exhibits at least four of these traits that’s when it’s considered OCPD.

The Significantly Higher Risk of AUD With OCPD

A higher rate of alcohol use disorder is associated with personality disorders across the board, but it’s particularly notable with OCPD. Obsessive compulsive personality disorder is a Cluster C type of personality disorder.

In this cluster it’s common for people to use alcohol to ease the sense of social disconnect that can lead to feelings of isolation and self-doubt.

NESARC studies collect some of the most extensive data on alcohol use and different subgroups. The research on OCPD is clear. For people with OCP, the AUD rate is 31.85%. That’s more than three times the national rate.

There are also studies that have found 20.8% of people with AUD have OCPD.

These rates mean that OCPD has one of the highest AUD rates among all of the personality disorders. In some studies, it was found to be the most common personality disorder among people with AUD.

The Perfection/Addiction Connection: Why Would a "Controlled" Personality Drink Problematically?

Researchers have zeroed in on what it is that makes people with OCPD so prone to problematic drinking. It’s perfectionism. That was the conclusion of a 2022 study that examined the effect of perfectionism on alcoholism.

Heightened Anxiety Due to High Expectations

Often people with OCPD feel as if they are constantly being judged and nothing less than perfection is acceptable.

This characteristic trait of obsessive compulsive personality disorder triggers a lot of negative emotions that can be difficult to manage.

It’s common for people with OCPD to self-medicate with alcohol to calm their social and general anxiety as well as feeling inadequate because they can't achieve unachievable perfection.

The Isolation That Comes With Perfection

That pursuit of perfection can also lead someone down a lonely path. It’s common for people with OCPD to feel more isolated. Isolation is known to increase alcohol use.

And the thing for people with OCPD is they can feel isolated even when they are physically around people. It’s more to do with not feeling connected and similar to others that's the true problem.

Imperfect Impulse Control

Interestingly, there’s also a surprising connection between perfectionism and impulse control. When someone is focused on perfectionism they are actually more likely to act impulsively. It’s behavior that can be reinforced by alcohol.

The Exhaustion of Doing Everything Perfectly

For some people alcohol use is a response to the exhausting effort that’s put into doing everything perfectly all the time. It’s seen as their way to escape the perfection pursuit for a little while and ease up a little bit.

The More Effective Strategy For Handling OCPD Without Alcohol

For people with OCPD there’s a real barrier to getting meaningful support for alcohol use disorder. They appear to be perfect or at least very put together to most people.

Their productivity, organization and work ethic, makes things appear to be running smoothly on the surface. There may not be signs of alcohol abuse until the condition becomes more severe.

As common as self-medicating with alcohol is, it’s never a real solution. It’s a bandaid that works in the moment and then things are only worse once the effects wear off.

For someone with OCPD, drinking excessively goes completely against the aspiration of perfection. Hangxiety is high and someone with OCPD can be really hard on themselves about their alcohol use.

What’s needed is a two-pronged dual-diagnosis treatment plan.

The top priority would be addressing the obsessive compulsive personality disorder if you aren’t already seeing a specialist who can help with finding healthy ways to cope with the symptoms of the disorder.

If you’ve been drinking chronically and have developed alcohol dependence, using healthy coping mechanisms alone may not be enough. In those cases, FDA-approved naltrexone medication is clinically proven to help curb alcohol cravings and reduce use.

People taking naltrexone have fewer drinking days and drink less when they do. It can really help you gain control over alcohol so that everything is easier to manage.

See if naltrexone medication is an option by taking the Alcohol Use Assessment. It’s a simple, confidential and quick test that uses Audit-C scoring to assess drinking behaviors and make recommendations for your situation.