OCD Vs. Anxiety: What Is the Difference?

What Is OCD?

Obsessive compulsive disorder (OCD) is a mental health condition characterized by obsessions and compulsions. Anxious or intrusive thoughts (obsessions) lead people to act on their urges, resulting in these compulsive or repetitive behaviors. The goal of doing so is to reduce the stress and anxiety that accompany these thoughts.

Common symptoms of OCD include:

• Strict rituals or behaviors to calm anxious thoughts
• Excessive cleaning
• Repetition
• Persistent or intrusive thoughts
• Preventative actions to reduce thought triggers

What Is Anxiety?

Anxiety involves feelings of worry, tension, and uncertainty that can be triggered by stress or can be generalized with seemingly no external cause.

Some common symptoms of anxiety include:

• Racing mind
• Nervousness
• Difficulty focusing or concentrating
• Feelings of dread or panic
• Irritability
• Feeling disconnected
• Hypervigilance
• Feeling restless, jumpy, or on-edge
• Exhaustion or fatigue
• Insomnia or feeling unrested after sleep

How Common Are Anxiety Disorders and OCD?

Approximately 2% of the adult population in the U.S. will be affected by OCD at some point in their lives.¹ Furthermore, approximately 76% of adults diagnosed with OCD in the U.S. have a lifetime diagnosis of an anxiety disorder (generalized anxiety disorder, social anxiety disorder, panic disorder, or a specific phobia).²

Moreover, a 2021 study with 867 participants revealed that roughly 34% of them were diagnosed with generalized anxiety disorder (GAD) as well as OCD.³

OCD Vs. Anxiety: Key Differences

People with OCD engage in very different behaviors than those with anxiety. Those with OCD experience repetitive thoughts and engage in certain behaviors to soothe these anxieties. People with anxiety tend to experience intrusive thoughts as well, but don’t engage in the same compulsions.⁴

Here are four major differences between OCD and anxiety:

1. The Presence of Compulsions

Compulsions are a key element of OCD. They are the result of needing or wanting to alleviate an obsessive or intrusive thought. Compulsions like constant checking, counting, or cleaning, make OCD difficult to manage, as engaging in these behaviors is not always possible or advisable, and they take up a significant amount of someone’s time, disrupting their ability to function normally.

2. Causes & Focus of the Anxiety

People with OCD often ruminate on very specific fears—often ones that are not realistic or are seemingly insignificant. On the other hand, someone with generalized anxiety disorder (GAD) may experience more situational or life-related anxieties. Someone with anxiety may also deal with social anxiety, panic disorder, or specific phobias.

3. The Duration of the Anxiety

Someone with an anxiety disorder may have anxiety that only persists until they are able to work through or alleviate the cause of their anxiety. Those with OCD may be able to lessen symptoms of anxiety after completing a ritual, but the very same anxiety will eventually return, causing an OCD cycle of worry that will persist, often until they seek professional help.

4. The Types of Thoughts & Behaviors

People with anxiety may act on their anxious thoughts, but their responses to anxieties are not compulsions. Instead, they frequently behave in certain ways in response to how they’re feeling in the moment, like avoiding going out if they’re feeling socially anxious. Behaviors of those with OCD need to be acted upon immediately, as a person believes not doing so will lead to negative repercussions or consequences.⁶

Is OCD an Anxiety Disorder?

OCD was originally recognized as a type of anxiety disorder, as the manifestation of OCD overlaps heavily with the same mental neural pathways associated with anxiety. However, research into OCD shows that there are more differences between anxiety and OCD—which is why we consider the two related, but not at all interchangeable.⁵

Do I Have OCD Or Anxiety?

OCD and anxiety seem to share certain symptoms, like repetitive thoughts and avoidant behaviors, and can also co-occur—which can make distinguishing the two conditions difficult. Nonetheless, the recurrent thoughts that are present in anxiety are generally linked to valid, real-life issues. OCD, on the other hand, doesn’t typically involve real-life concerns and may include content that’s odd, illogical, or seemingly magical in nature. Moreover, the key characteristic that distinguishes OCD from anxiety is the presence of compulsions.²

In order to know what truly may be at play, it is important to consult with a mental health expert who can provide a thorough evaluation and establish an accurate diagnosis. If you suspect you’re dealing with anxiety or OCD, it’s important to seek professional help.

Can Someone Have Both OCD and Anxiety?

Although many people living with OCD might experience anxiety, that doesn’t necessarily mean that they have a coexisting anxiety disorder. However, anxiety conditions are highly comorbid among OCD sufferers.² A recent study revealed a significant correlation between OCD and generalized anxiety disorder (GAD).³

What Other Condition Could It Be?

OCD and anxiety can have overlapping symptoms and can co-occur with other related disorders, such as body dysmorphic disorder, trichotillomania, and hoarding disorder, as well as a variety of other psychological conditions which can often lead to a misdiagnosis.

The most common conditions that must be differentiated from OCD include:²

• Major depressive disorder (MDD)
• Impulsive/compulsive-like behaviors like substance misuse or gambling addiction
• Psychotic disorders like schizophrenia
• Tic disorders
• Obsessive-compulsive personality disorder (OCPD)

How Are OCD and Anxiety Diagnosed?

OCD and anxiety can only be diagnosed by licensed professionals, including psychologists, psychiatrists, and medical doctors. The diagnosis process for both OCD and anxiety will be similar, as each will entail identifying a person’s thoughts, behaviors, and triggers. What will differentiate a diagnosis lies in how a person chooses to cope with these factors. A person with OCD may do so by engaging in compulsions, whereas someone with anxiety may dwell or fixate on a thought, as well as any possible scenarios and outcomes.⁵

How Are Anxiety and OCD Treated?

Treatment for OCD and anxiety will generally include a multifaceted approach that includes both psychotherapy and medication. While certain techniques may vary, a person should expect some similarities between treatment approaches. To determine if you may benefit from anxiety treatment, OCD treatment, or both, exploring your options is the first step towards recovery.⁵

Therapy for Anxiety and OCD

Therapy is a great way to learn about your thoughts and how they impact your behavior in order to manage them. It can also better your understanding of what causes your intrusive thoughts or cognitive distortions, as well as identify what may be triggering them. Many behavior-based therapies are found to be effective for both OCD and anxiety. To find the right therapist or psychiatrist, you can start by using an online therapist directory.

Therapy options for anxiety and OCD may include:

• Exposure and response prevention (ERP): ERP for OCD is the gold standard treatment option. Controlled exposure teaches those with OCD to form new perceptions of their thoughts, thus allowing these thoughts to exist without controlling one’s actions or behaviors. It also helps to desensitize a person to these thoughts.
• Cognitive behavioral therapy (CBT): CBT for anxiety is one of the most popular treatment options. It teaches people about the relationship between their thoughts, feelings, and behaviors, and how changing one can improve other parts of life as well.^5,7
• Acceptance and commitment therapy (ACT): ACT can help those with OCD, as it encourages clients to form new relationships with their intrusive thoughts or compulsions. It helps people separate their thoughts from behaviors, so they are not urged to act upon them. ACT can also help someone with anxiety accept their anxious thoughts and be able to move on from them.

Medication for OCD and Anxiety

Sometimes, especially in chronic cases, medication—in combination with therapy—may be necessary. There aren’t any specific medications for OCD, but since it usually co-occurs with other mental conditions like anxiety, anxiety medication may be appropriate. Talk with your doctor or psychiatrist to better understand what being on anxiety medication might feel like for you. It’s important to also discuss the risks associated with any medication.⁷

How to Cope With Anxiety and OCD

There are ways a person can learn to cope with symptoms of anxiety and OCD. You can make healthy lifestyle changes and engage in mindfulness and wellness-based practices to keep you grounded. Learning appropriate OCD coping skills, along with therapy, can be paramount to coping with your symptoms.

Here are some ways to cope with comorbid anxiety and OCD:

• Practice meditation: Meditation for OCD can be a great coping method, as it allows you time to relax and reset. Implementing this practice into your daily routine can help reduce symptoms by bringing balance, self-awareness, and new ways to manage your stress.
• Practice journaling: Journaling with mental health in mind is a great way to deal with anxiety and OCD. Writing out your thoughts and feelings can help you process symptoms. By doing this, you can learn more about your behaviors and understand where they may come from.
• Practice grounding techniques: Grounding techniques can include cognitive, somatic, and behavioral exercises. These techniques can shift negative perceptions into more realistic or positive ones. Furthermore, they can support you in reframing difficult situations, as they encourage you to focus on your present feelings.
• Practice mindfulness: Practicing mindfulness for anxiety can help you stay grounded in the moment. By taking a step back and remembering to think before you react, you may reduce any autopilot impulsive responses.
• Practice self-compassion: A big part of working through perfectionism is accepting yourself the way you are. Give yourself the self-compassion and self-love you deserve, regardless of your performance. You are worthy just as you are.