It’s completely normal to occasionally worry about being judged or embarrassed. But when these fears are recurring, overwhelming, or interfere with your day-to-day life, they could be signs of a more complex mental health issue, like obsessive-compulsive disorder (OCD) or social anxiety disorder (SAD).
While OCD and SAD are separate conditions, they do share some overlapping characteristics, such as a fear of judgment, unwanted thoughts, and avoidance behaviors.
In this article, we’ll explore the similarities and unique characteristics of social anxiety disorder and OCD so you can better understand what you’re experiencing and get the right kind of support.
OCD vs social anxiety disorder
Before we look at how OCD and SAD overlap and where they’re distinct from one another, let’s define what these conditions are.
OCD is characterized by the cycle of intrusive thoughts, images, or urges, feelings, or sensations—known as obsessions—followed by compulsions, which are physical or mental actions done to relieve distress from obsessions or to stop something bad from happening. Common compulsions include avoidance, rumination, and seeking reassurance.
Social anxiety disorder (also known as social phobia) involves persistent and intense fear of social situations where you feel you might be judged or scrutinized by others. “It tends to make you isolate yourself and avoid social situations,” says Tracie Ibrahim, LMFT, CST, Chief Compliance Officer at NOCD.
Symptoms of social anxiety disorder can include:
- Sweating, blushing, shaking, or a racing heartbeat.
- Being so nervous about social situations to the point of feeling nauseous.
- Avoiding eye contact with others.
- Having a stiff posture when around others.
- Feeling self-conscious around other people.
- Feeling embarrassed or awkward in front of other people.
While both conditions are closely related in many ways (so much so that OCD is often misdiagnosed as an anxiety disorder), looking at their characteristics can shed light on several key differences.
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Understanding the nature of thoughts
Both OCD and SAD can involve fears of social rejection or being perceived negatively, which are sometimes followed by physical symptoms like a racing heart, blushing, or sweating. What sets the conditions apart is the nature of the thoughts that are driving the fear.
With SAD, the thoughts are usually tied to real-life situations and may sound like, “What if they think I’m awkward?” or “Am I being judged?” These thoughts reflect a fear of being negatively perceived.
When it comes to OCD, the thoughts tend to be more intrusive, less realistic, and ego-dystonic—meaning that they don’t align with your values. Someone with OCD might think, “What if I accidentally offended someone?” or “What if I came across as weird or creepy?” despite no real reason to believe that something bad happened. These thoughts tend to stick due to how distressing they are and the compulsions that follow them.
Responses to social triggers
The thoughts that show up in OCD and social anxiety disorder are very similar, as they both involve fears about being judged by others. The main difference lies in what triggers these thoughts and how you respond to them.
Someone with OCD may fixate and ruminate over past interactions to find certainty, despite no real evidence of having done anything wrong. In contrast, someone with SAD may also worry about how they came across to others, but their fear is more grounded in a general concern about being judged or embarrassed.
Most importantly, trying to respond to OCD-related fears with logic never really works. This is because the anxiety you’re experiencing isn’t about what’s likely to happen—its about the what-ifs. Your brain is trying to get absolute certainty, and logic can’t provide that.
With SAD, however, logic and reframing your thoughts can sometimes help reduce anxiety, as your fears are typically based on plausible concerns—such as being judged or saying the wrong thing. In these instances, it can be more effective to reframe the negative thoughts by asking yourself, “What’s the worst thing that could happen?” or “Would I think less of someone else for doing the same thing?”
Avoidance behaviors and their functions
Both conditions involve avoidance, but for different reasons. With OCD, avoidance functions as a compulsion—an attempt to relieve distress or prevent feared outcomes. In social anxiety disorder, it’s typically a safety behavior used to reduce anxiety in triggering social situations.
Despite these different motivations, the result is still the same: it only strengthens the cycle of anxiety and avoidance.
Compulsions specific to OCD
In addition to avoidance, OCD can involve other repetitive physical or mental compulsions. These compulsions are a key difference that separates OCD from SAD, which is less likely to involve repetitive behaviors.
Below are some examples of OCD-related compulsions tied to social situations:
- Seeking reassurance from others (“Was there anything offensive about what I said during that conversation?”).
- Mentally reviewing your behavior to reassure yourself.
- Overthinking or ruminating on social interactions.
- Assuming how others feel based on their body language or tone of voice.
- Imposing rules and restrictions on your social interactions.
Can you have OCD and social anxiety disorder at the same time?
Yes. In fact, social anxiety disorder commonly co-occurs with OCD. Despite the common occurrence, having one doesn’t guarantee that you’ll develop the other, notes Ibrahim.
How to treat OCD and social anxiety disorder together
Social anxiety disorder and OCD are treatable with exposure and response prevention (ERP) therapy. ERP is a form of cognitive behavioral therapy (CBT) that was specifically designed for OCD, but it is also effective for anxiety disorders.
With the guidance of a therapist, you’ll gradually face situations you fear while resisting the urge to engage in compulsions or safety behaviors.
“We’ll build a fear ladder or hierarchy and start small—like imagining you’re speaking up in class or writing a script about going to an event,” explains Ibrahim. “Then we build up from there, like going to an event or saying hi to somebody at the grocery store.” She says ERP is about facing your fears step by step, realizing that they aren’t as scary as they seem, and knowing that you can get through them.
ERP can feel challenging at first, but over time, it helps you build tolerance for discomfort, reduce anxiety, and break the cycle of avoidance and compulsions.
Bottom line
OCD and social anxiety disorder have many similarities, but they are distinct conditions. Both involve unwanted thoughts, intense anxiety, and avoidance, but OCD seeks absolute certainty on “what-if” fears and includes both mental and physical compulsions.
If you think you have OCD, SAD, or both, seeking the proper diagnosis is the first step toward effective treatment. ERP therapy can help you break the cycle and get long-lasting relief.
Key takeaways:
- OCD and social anxiety disorder can both involve unwanted thoughts and avoidance, but OCD includes compulsions and a need for certainty.
- Social anxiety thoughts are typically more plausible, while OCD thoughts tend to be intrusive, unrealistic, and ego-dystonic.
- Avoidance reinforces anxiety in both disorders, but the motivation behind it differs—safety-seeking in SAD, compulsion in OCD.
- Exposure and response prevention (ERP) therapy is an effective treatment for both OCD and social anxiety, helping people confront fears and break the cycle of anxiety.
