Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Is OCD a Form of Anxiety? An OCD therapist explains

6 min read
Dr. Keara Valentine

If you’re familiar with obsessive-compulsive disorder (OCD), and know the anxious feelings that accompany the condition, you might be wondering: What’s the difference between anxiety vs OCD? And could OCD just be a form of anxiety? Is OCD a Form of Anxiety? An OCD therapist explains

As a therapist who treats OCD, I’ve encountered this question from patients many times. The fact is, while OCD and anxiety definitely share some commonalities—worry is a part of both mental health conditions—they are not the same. One distinction is that people with OCD don’t just feel anxious; they engage in compulsive behaviors to try to tamp down the anxiety they feel. People who have anxiety but don’t have an OCD diagnosis may also feel like they want to escape their distress, but they don’t partake in compulsive rituals as a result. 

In this article, we’ll discuss the key distinctions between OCD and anxiety disorders, why they are separate diagnoses, and in what ways they overlap. We’ll also talk about why OCD is treated differently from anxiety.

How OCD and anxiety are different

To start, it’s helpful to define these two diagnoses. 

Anxiety is an umbrella term for multiple anxiety-related disorders. Anxiety affects 18% of the United States population, making it the most commonly diagnosed mental health condition in the country. A common diagnosis within the anxiety umbrella is generalized anxiety disorder, or GAD, which is characterized by “persistent and excessive worry” about multiple issues, which lasts for over six months and is accompanied by at least three physical symptoms, according to the Anxiety & Depression Association of America. Symptoms may include feeling nervous, irritable, or on edge; breathing rapidly, hyperventilating or trembling; gastrointestinal problems; and increased heart rate, just to name a few.

OCD, on the other hand, is a condition where a person experiences unwanted thoughts, urges or impulses that are obsessive and lead them to compulsive actions in an attempt to reduce the distress that comes with these thoughts. For example, someone with OCD might have obsessive thoughts about getting sick if they come into contact with other humans. This thought makes them very anxious. To cope, they wear gloves everywhere they go and obsessively take showers after being out in public.

For comparison’s sake, while someone with anxiety might be irrationally worried about getting sick when they leave the house, they typically don’t engage in compulsions like avoiding people or repetitive showering. While the feeling of anxiousness might be similar, only in OCD does the anxiety lead to repetitive behaviors (compulsions).

Why OCD is no longer considered an anxiety disorder 

You might be interested to know that, historically, both GAD and OCD were indeed considered anxiety disorders. But as of the 2013 publication of the fifth edition of the DSM (The Diagnostic and Statistical Manual of Mental Disorders), a diagnostic reference guide used by clinicians, that’s no longer the case. Now, GAD is considered an anxiety disorder, while OCD falls under its own category: Obsessive-Compulsive and Related Conditions. These related conditions include body dysmorphic disorder, hoarding disorder, and trichotillomania (aka hair-pulling), to name a few.

OCD was historically conceptualized as an anxiety disorder because of the intense anxiety or fear associated with persistent and unwanted thoughts, images and urges. However, the American Psychiatric Association reclassified OCD as a separate diagnosis because there are significant differences in brain chemistry and function for each of these disorders. 

How to Know if You Have OCD or Anxiety

As previously mentioned, someone with anxiety experiences excessive worry, but doesn’t perform compulsive acts to reduce their distress. In addition to the presence of compulsions in OCD, the nature of OCD thoughts and anxiety thoughts can be a distinction between the two diagnoses. People with anxiety may worry about things that technically can happen—like the loss of a job, financial hardship, and any number of other stressors in everyday life. The intrusive thoughts suffered by people with OCD tend to be more irrational, focused on outcomes that are not likely to happen.

Additionally, GAD is generally characterized by physical symptoms of anxiety, such as hyperventilation, while physical symptoms are not a requirement for an OCD diagnosis, according to therapist Davida Vaughn, M.S., Ed.S., LPC.

Do these symptoms sound familiar? Learn how you can overcome them.

The best way to figure out if you have anxiety, OCD, or both is to talk to a mental healthcare professional who specializes in these conditions and can help you begin your recovery journey.

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Can you have both OCD and Anxiety or GAD?

It is possible to have both generalized anxiety and OCD, but one does not require the other—and it’s also important to mention that anxiety is not a necessary part of OCD. Dr. Patrick McGrath, Head of Clinical Services at NOCD, points out in a recent video that sometimes compulsions are motivated by other equally intense and uncomfortable emotions, like disgust, shame, or guilt, rather than anxiety. 

How OCD and anxiety are treated

Getting the right diagnosis from a trusted profession is the first step to finding the right help. The good news is that both OCD and anxiety are treatable—even at the same time. 

For OCD, traditional talk therapy is unlikely to be effective. So what does help? Exposure and response prevention (ERP), which is the gold standard treatment for OCD, backed by rigorous clinical research. In ERP, you work with a therapist who has received specific training in this form of treatment. It’s not about finding the root cause of your worries and fears but about allowing these thoughts to exist without engaging in compulsive behaviors.

ERP is also a highly effective form of treatment for anxiety disorders such as GAD, but these conditions can also be treated with other types of therapy, such as cognitive behavioral therapy (CBT), or with medication management.

Let’s take a specific example to see why the appropriate therapy is key. For some people with OCD, reassurance seeking can be a compulsion that’s used in an attempt to soothe oneself from the discomfort of obsessive thoughts. In other words, if you’re obsessively worried about something, you might repeatedly ask the people around you to tell you that you’re okay and that nothing bad will happen. This is the type of behavior you’d work to stop engaging in in ERP therapy. In ERP treatment, the goal would be to avoid this reassurance and manage the discomfort.

Access therapy that’s designed for OCD

I’ve personally used ERP to help many people who struggled with OCD regain their lives. I encourage you to learn about accessing ERP therapy with NOCD.

Learn about ERP with NOCD

Where exactly to find help 

Living with OCD, an anxiety disorder, or both conditions can be incredibly difficult, but effective treatment for both conditions is available. You can work with a qualified professional and start feeling better.

NOCD Therapists receive specialized training in treating both OCD and anxiety disorders with evidence-based ERP therapy. If you think you may be struggling with OCD or anxiety, I strongly encourage you to learn about NOCD’s treatment for both conditions.

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Dr. Keara Valentine

Dr. Keara Valentine specializes in cognitive behavioral therapy and other evidence-based treatments for anxiety disorders, obsessive-compulsive disorder (OCD), social anxiety, panic, and depression. She is also a Clinical Assistant Professor within the Department of Psychiatry and Behavioral Sciences at Stanford University, providing psychotherapy in the mood, anxiety, and OCD clinics and participating in research on novel OCD and Hoarding Disorder treatments.

Patrick McGrath, PhD

Dr. McGrath is a Licensed Clinical Psychologist and the Chief Clinical Officer at NOCD. He is a member of the Scientific and Clinical Advisory Boards of the International OCD Foundation, a Fellow of the Association for Cognitive and Behavioral Therapies, and the author of "The OCD Answer Book" and "Don't Try Harder, Try Different."

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NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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