Telling the Difference Between Anxiety and OCD
Written by Helena Lorenz, LMSW
In the world of psychological diagnoses, generalized anxiety disorder (GAD) and obsessive-compulsive disorder (OCD) are cousins of sorts. They have a lot in common and are sometimes hard to distinguish from one another. In fact, I know many people who have started therapy thinking that they are coming in to learn how to cope with what feels like extreme anxiety, only to learn that they have, in fact, been dealing with OCD.
With that in mind, I wanted to take a moment to walk through their distinctions because treating OCD and treating GAD are entirely different. In fact, some treatment methods that work for anxiety (such as positive affirmations or relaxing rituals) can actually be detrimental for those with OCD, as those coping tools can quickly turn into repetitive compulsions.
So, let’s walk through these different disorders and see if we can clear up any confusion!
So, let’s walk through these different disorders and see if we can clear up any confusion!
The Nature of the Worry
GAD: Characterized by persistent and excessive worry about various aspects of life, such as work, health, family, or social situations. The worries are often unrealistic or exaggerated and can feel difficult to control.
OCD: Characterized by intrusive, unwanted thoughts, images, or urges (obsessions) that then cause intense worry and discomfort. These obsessions then lead to repetitive behaviors or mental acts (compulsions) that the person feels driven to perform to reduce the anxiety caused by the obsessions.
Obsessions and Compulsions
GAD: Can experience intrusive thoughts that can sometimes feel like obsessions, but these thoughts are typically more vague/generalized (i.e., the intrusive thought of “I am bad at parties”, as opposed to the intrusive OCD thought of “The person I am talking to right now thinks I am liar”). People with GAD also do not typically engage in ritualistic compulsive behaviors that are the hallmark of OCD.
OCD: Obsessions can vary extremely widely but often revolve around themes such as contamination, symmetry, orderliness, or forbidden thoughts. Compulsions are repetitive behaviors or mental acts performed in response to obsessions and are aimed at reducing distress or preventing a feared event.
Impact on Functioning
GAD: Can definitely impair daily functioning due to excessive worry and occasional panic attacks, but does not lead to specific ritualistic behaviors that significantly interfere with daily life.
OCD: Can also significantly impair daily functioning, and the impact often comes from the time-consuming nature of performing rituals and the emotional distress caused by the nature of the obsessions.
Therapy Approach
GAD: Therapeutic treatments such as cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), acceptance and commitment therapy (ACT), and narrative therapy are all shown to be highly effective at managing symptoms.
OCD: While methods like CBT, DBT, and narrative therapy can be helpful in certain arenas, the gold standard of OCD treatment is Exposure Response and Prevention (ERP), which helps clients specifically address the negative impact of their compulsions on their daily living.
If you feel like you are struggling with either of these disorders, please reach out to one of our wonderful counselors and we will find the proper treatment fit for you!