What’s the Difference Between Anxiety and OCD? – Mental Health in Focus
Does it ever feel like your brain is stuck in a never-ending loop? Or maybe it’s like you’re living on autopilot while never being truly present? Ever been referred to as an anxious person or even a worrywart?
Anxiety is a common emotion felt by all of us at some point throughout our lives. It’s the evolved result of the fight or flight response, designed to protect us from danger. While it’s just an emotion for some, anxiety can become more than just a fleeting feeling for others. But what’s the difference between anxiety and OCD?
In this blog post, I’m going to delve into the differences between Generalized Anxiety Disorder and Obsessive-Compulsive Disorder (OCD). Often confused as the same condition, it’s important to understand exactly what it is you’re experiencing so you can seek the right help.
Why Is It Important to Understand the Differences Between Anxiety and OCD?
While many people seek help for their anxiety by going to therapy, they’re often left disappointed by tips or techniques that didn’t work for them, or stopped working after a short time. It’s also common for OCD compulsions to remain unaddressed, worsened when the tools provided by therapists mutate into new compulsive behaviors. Ineffective therapy can often feel as though it’s working in the moment, but the results quickly dissipate following the session.
If your therapist isn’t using an evidence-based approach to treating OCD and is instead relying on anti-anxiety practices, it’s possible that your OCD can become louder than ever before. Some therapists will even advertise themselves as equipped to handle OCD using EMDR or basic CBT therapy, but some of these approaches are ineffective for OCD and likely only reinforce obsessions or ‘sticky’ thoughts.
It’s important for therapists and individuals to understand the difference between anxiety and OCD so they can find treatment that works in the short- and long-term for recovery.
What Is Obsessive-Compulsive Disorder (OCD)?
Obsessive-Compulsive Disorder is a chronic condition and is likely to persist if not treated effectively. Nearly 70% of people report a continuous course of symptoms, and 23% experience waxing and waning (AAFP Foundation). Because OCD is often misdiagnosed and treated with the nonevidence based practice treatment protocols, sufferers’ symptoms become worse in treatment. Misdiagnosis occurs due to a general misunderstanding of OCD. Obsession only thoughts with the presence of no compulsion. Therapists and clinicians may select generalized treatments that are very effective with anxiety, however OCD is not an anxiety disorder, it is a spectrum of symptoms that may include anxiety. This leads to mental health providers who are not fully trained in recognizing its various manifestations; it’s not uncommon for people struggling with OCD symptoms to wait as long as 10-17 years before getting appropriate treatment. The average time after meeting diagnostic criteria currently stands at a shocking 11 years.
How Treatment of OCD Differs to Anxiety
Although intense anxiety (along with a wide array of other emotions and actions) is often a result of the constant repetition of thoughts and seemingly irresistible compulsions, the treatment of Obsessive-Compulsive Disorder and Generalized Anxiety Disorder looks vastly different.
In fact, OCD treatment’s progress can be negatively affected when it is treated as Generalized Anxiety. While Generalized Anxiety Disorder and OCD can exist at the same time, it is extremely important to make sure that you are working with a clinician who is able to differentiate the two, is trained in using Exposure and Response Prevention therapy (or ERP, EX/RP) and is well versed in applying the appropriate ERP techniques to different presentations of OCD.
How Can I Tell the Difference Between OCD and Anxiety?
You may be asking yourself, “well, how do I know if I have Generalized Anxiety Disorder, and how do I know if I have OCD?” That question is an important one, and the answer can be found in the differentiating symptoms that sufferers experience.
People with generalized anxiety often report:
- Feeling like they’re constantly anxious or worrying about upcoming events like giving a presentation for school, taking a test, attending a job interview or social situations
- Difficulty sleeping, whether that be difficulty falling asleep, staying asleep, or waking up earlier than intended without being able to fall back asleep
- Difficulty with concentration
- Muscle tension
Additionally, people often report feeling like they can’t control these worries, coming up with as many contingency plans as possible in order to feel less anxious about the upcoming situation. For instance, making lists on top of lists prior to an upcoming vacation so that you don’t forget anything, or continuing to rehearse an upcoming speech even though you already have the entire thing very well memorized.
With Generalized Anxiety, if someone doesn’t do one of these previously discussed safety behaviors (that is, whatever helps to make that person feel as though they are “in control” and “adequately prepared”) for the anxiety-inducing event, there is no specific feared consequence.
OCD Can Require More Specific Control
In comparison, individuals with OCD often report experiencing an obligation to carry out specific activities (internal and external) to remain in control or prevent something from happening.
This could manifest itself as the need to:
- Kiss all of their stuffed animals before being able to sleep
- Putting a coin or other object in their sock or pocket
- Saying their prayers “perfectly” or a certain number of times
- Check the stove or locks multiple times despite the knowledge that it is locked
- Ask for reassurance from others that something is OK.
Keep in mind there are many themes for OCD called subtypes. We have only outlined a few examples. Many of these thoughts and activities are carried out with the thought that something bad may happen as a consequence of them avoiding it. For example, children may believe something bad will happen to their parents, or they’ll end up in the principal’s office. Adults may compulsively pray to avoid antagonizing God or another religious figure.
Something else people with OCD often report is excessively worrying about things that feel unrealistic/irrational, like getting pregnant from using a public bathroom, or other intrusive thoughts that completely go against their values or who they thought they were as a person.
And sometimes they do not go against values, making it hard for a person to know if it is a true will/intention versus the cycle of OCD.
Could You Be Suffering From OCD?
Do you find yourself constantly asking others to reassure you of your frightful thoughts? People with OCD often report having to consistently ask for reassurance from others to affirm that their “sticky” thoughts are not true, or that the worst-case “what if” will not become a reality. They also often report feeling as though they have to do some sort of behavior, or don’t have a choice about having to carry out that compulsion in order to alleviate their distressing feelings. These behaviors or compulsions can be internal or mental and/or external or more apparent.
Some symptoms that people often report include:
- Repetitively saying a mantra or phrase in their head
- Attempting to avoid intrusive thoughts/images/sensations
- Seeking reassurance to convince themselves that their thoughts go against their values, or by researching and Googling
- Excessive hand washing or washing/cleaning in general
- Repetitive behaviors such as going up and down the stairs multiple times
- Checking the locks numerous times
- Redoing (this could be anything.
As you can see, these two disorders have many commonalities, with some slight yet very important differences. These minut differences between Obsessive-Compulsive Disorder and Generalized Anxiety determine which treatment approach will effectively target the associated symptoms a person is experiencing.
Seek Treatment That Works for You
By now, you might be tired of seeing therapist after therapist to no real avail. You’ve given them your focus (and your money), but you’re still struggling just as much or even more than you were before. If that’s the case, it’s likely that you’ve been receiving ineffective treatment. The International OCD Foundation offers a wealth of details if you need to understand a little more than we have provided.
Some common struggles people face include:
- Not feeling comfortable enough to tell your therapist about certain symptoms because you feel judged by them or as if they don’t understand you
- Therapists who look horrified at the mention of thoughts regarding self-harm or the harm of others, even if you don’t actually intend to carry out these behaviors
- Fears that you will be committed or “locked up” if you talk about the thoughts you have been experiencing
If any of this sounds familiar to you, I encourage you to ask your current therapist for a Yale Brown Obsessive Compulsive Scale (YBOCS) assessment, an expert tool used to assess OCD. If you’d prefer to start afresh with someone new, find me at In Focus Counseling.
I can help you to discover the difference between Generalized Anxiety Disorder and OCD, assess you for both conditions and get a grip on your exact situation. Both are treatable when using the appropriate therapy, so going to someone who understands the differences is important. Only then can we create a treatment plan that works for you and find a way of moving forward together.
Get in touch and let’s start improving your mental health.