OCD vs anxiety: What's the difference?

‍Obsessive compulsive disorder (OCD) is a mental health condition that involves unwanted and distressing thoughts, sometimes followed by rituals to try and get rid of them. The distressing nature of the obsessive thoughts and behaviors can cause intense feelings of anxiety. At the same time, people with anxiety disorder may also experience obsessive thoughts—but that doesn't necessarily mean they have OCD.

Because of the similarities in symptoms, it's not uncommon for people experiencing them to have questions. If you think you might have OCD, anxiety disorder, or both it’s incredibly important to talk to a trained professional, like a psychiatrist, who’s trained to understand the differences and help. If you’re not ready to see a psychiatrist, or just want a little more information, we’ll discuss the differences between OCD and anxiety more clearly and also address whether you can have both an anxiety disorder and OCD (spoiler alert: you can).  

How are OCD and anxiety different?

OCD and generalized anxiety disorder (GAD) and related disorders, may have overlapping symptoms, but they’re distinct conditions with very different treatments. While OCD is not itself a type of anxiety disorder, many people with OCD will feel intense anxiety related to obsessive thoughts and some are driven to perform compulsive behaviors (like handwashing) as a way to cope with or relieve their anxiety in the short term. Put another way, the anxiety that people with OCD experience results specifically from their obsessive thoughts.  

People with generalized anxiety disorder, on the other hand, will experience intense, uncontrolled anxiety in their daily lives for various reasons, and sometimes without a specific trigger. They recognize their worries are irrational, but can’t help but worry anyway, But, they won’t try to manage this anxiety through compulsive behaviors.  

In certain types of anxiety disorders, anxiety can be triggered by something specific, like social situations. But still, in these conditions, anxiety itself is the main symptom, whereas in OCD it’s the result of a symptom, namely obsessive thoughts and from the frustrating and time-consuming nature of compulsions (if they perform them).  

People with OCD typically:

• Have difficulty controlling their obsessions or compulsions even when aware that they’re abnormal  
• Spend a significant amount of time daily on their obsessions or compulsions, generally more than 1 hour
• May derive temporary relief from their anxiety via compulsions but don’t get pleasure from them
• Face problems in their life or work due to their obsessions and/or compulsions  

People with anxiety:

• Find it challenging to control their worries, even when they recognize that their anxiety is excessive
• Experience persistent and excessive worry or fear about various aspects of life, such as relationships, health, work, or everyday situation
• Often have physical symptoms related to anxiety, like nausea, muscle tension, and sweating
• Have a heightened sensitivity to potential threats or dangers
• Tend to avoid anxiety-provoking situations or triggers— which can significantly impact their daily life and functioning.
• May experience panic attacks, characterized by sudden and intense surges of fear or discomfort, along with physical symptoms like rapid heartbeat, shortness of breath, chest pain

There are plenty of other, clearer key differences that set OCD apart from anxiety disorders. For instance, like we’ve discussed, symptoms of OCD include repetitive, uncontrollable thoughts.  Often these thoughts revolve around specific topics, like the fear of losing control or losing a specific object, the violation of cultural or sexual taboos, and the urge to bring perfect order to objects to your surroundings.

Obsessive thoughts are not a symptom of anxiety disorders, on the other hand. People with generalized anxiety disorder can excessively ruminate, and these thought patterns look like repeated worries over the same topic. This is what makes distinguishing GAD from OCD sometimes more challenging. Anxiety symptoms can vary from person to person  depending on the particular type of disorder, but usually they will experience additional symptoms  like restlessness, insomnia, headaches and other aches, and feelings of worry that won’t go away.  

See the chart below for more features of both conditions and how they compare:

Can anxiety be misdiagnosed as OCD?

There are a few reasons OCD may be mistaken for an anxiety disorder. For one, if you have OCD your unwanted thoughts can cause you to feel a great deal of anxiety (which you may then seek to manage using compulsive behaviors). But if OCD effectively causes anxiety, you might wonder why it isn’t an anxiety disorder.

OCD is not considered an anxiety disorder in part because it’s the obsessive thoughts that elicit anxiety. That may seem paradoxical, but on closer inspection, it’s not. Generalized anxiety disorder is characterized by anxiety that has no particular cause (or occurs due to external stress) and may last for months or years. You might also think of it this way: in GAD, anxiety is the condition, whereas in OCD anxiety is a secondary effect that emerges from the condition.  

Related article: OCD and depression: Are they related?

How do you know if you have OCD or anxiety?

Ultimately, the only way to know whether you have OCD or anxiety is to consult a mental health professional qualified to make such a diagnosis, like a psychiatrist. Self-diagnosis doesn’t always lead to appropriate treatment—many conditions have similar or related symptoms, and the brain and human behavior are incredibly complex. To get better, it’s best to see a psychiatrist who is in an expert in the field.  

If you think you might have an anxiety disorder, OCD, or another mental health disorder, learning more about the symptoms you are experiencing can be a good start to getting an accurate diagnosis. If you regularly experience what seem like panic attacks, you might reasonably wonder if you have panic disorder, a type of anxiety disorder, for example. For generalized anxiety disorder, meanwhile, prolonged feelings of worry, fatigue, difficulty concentrating, insomnia, and restlessness are among the most common symptoms. If something specific triggers your anxiety, then you might have a phobia.  

If you believe you have experienced some of those symptoms, then you should contact a professional who can work with you to determine the appropriate diagnosis. One option is to take Talkiatry’s quick online assessment. From there we will connect you to a Talkiatry psychiatrist that fits your needs and takes your insurance.

Can you have both anxiety and OCD?

The short answer is yes, you can have both OCD and an anxiety disorder. In fact, the two coincide regularly. According to one study, about 75% of people with OCD will also have an anxiety disorder.  

If you do have both conditions, you may experience more intense anxiety. You may also exhibit more frequent avoidance behaviors—meaning you’ll take action to avoid a source of anxiety instead of dealing with it—according to some studies. Other studies have proposed that OCD and anxiety disorders may arise from shared brain mechanisms and genetic roots, although some brain mapping of OCD patients show that OCD impacts different parts of the brain compared to anxiety disorders alone.

Since anxiety disorders and OCD occur at the same time in some people, and both conditions involve anxiety, determining whether you have one, the other, or both could be confusing and frustrating. Thankfully there are professionals trained to help you navigate the process and help decide which treatment options are right for you. 

OCD and anxiety treatment

There are a number of effective treatments for OCD and anxiety. Conveniently, psychiatrists prescribe some of the same medications, like SSRIs (selective serotonin reuptake inhibitors), to treat both. Doctors do, however, tend to prescribe higher doses of SSRIs when treating OCD compared to depression or anxiety. The treatment plan will depend on your specific condition and needs which is why it’s so important to see a qualified health professional if you think you may be experiencing a mental health condition.  

Here’s a look at other distinct treatments that are approved for OCD and anxiety disorders.  

OCD treatments include

• Medications, like antipsychotics are sometimes used in conjunction with SSRIs, while still other medications are currently being evaluated for their potential to supplement or offer alternatives to traditional treatments.  
• Exposure and response prevention therapy (ERP): Exposure therapy involves exposing individuals to their obsessions or triggers in a gradual and controlled manner.  People face their fears little by little and stop themselves from doing their usual rituals at the same time.
• Deep brain stimulation (DBS), a surgical treatment involving the direct stimulation of areas of the brain with electricity, is an experimental therapy used in rare cases to treat OCD.

Anxiety treatments include  

• Anti-anxiety medications like antidepressants, benzodiazepines or propranolol can help reduce physical symptoms of anxiety like shakiness.
• Cognitive behavioral therapy (CBT), where you learn to talk about and recognize your feelings with a licensed therapist, can help you to alter negative thought paths.
• Acceptance and commitment therapy, which involves mindfulness and goal-setting, is approved for treating anxiety disorders.
• Relaxation techniques and practices, like deep breathing exercises, progressive muscle relaxation, and meditation can help reduce anxiety and promote a sense of calm

If you believe you have a mental health condition, your first step should be to contact a professional qualified to make a qualified anxiety or OCD diagnosis. This is true of most any health condition, but it’s especially important when dealing with conditions that share symptoms, regularly occur together, and may be difficult to distinguish for the untrained eye.  

One way to take that “first step” is by completing Talkiatry’s quick assessment. We’re a national psychiatry practice that provides in-network virtual care. We’ll use your answers to make sure we’re the right fit for you before matching you with a Talkiatry psychiatrist suited to your needs.

FAQs

Here are more answers to your questions about the differences between anxiety and OCD.

What is OCD?

Obsessive-compulsive disorder (OCD) is a long-term disorder in which a person has recurring thoughts they cannot control (obsessions), repeats the same behaviors compulsively, or both. People with OCD may lose a significant amount of time to their symptoms, which can be detrimental to work, relationships, and overall quality of life.  

What is an anxiety disorder?

Broadly speaking, people with anxiety disorders experience persistent (as opposed to temporary) anxiety, either generally or when confronted with specific types of situations. These disorders may affect job performance, relationships, and other aspects of life. A number of different anxiety disorders exist, including generalized anxiety disorder, panic disorder, social anxiety disorder, and disorders related to phobias.

Is anxiety part of OCD?  

While OCD is not categorized as an anxiety disorder, the intrusive thoughts associated with the disorder are often anxiety-inducing. People with OCD may in turn initiate compulsive behaviors partly as a means of temporarily alleviating or managing the anxiety produced by their obsessive thoughts. Additionally, OCD and anxiety disorders are significantly comorbid, meaning that people with OCD are more likely than the general population to have an anxiety disorder and vice versa.  

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.