OCD and Anxiety: How Are They Related
The following is a transcript of a video shot and produced by NOCD. The copy below has been only lightly edited for clarity purposes.
There’s definitely a relationship between obsessive-compulsive disorder or OCD and anxiety. Many people who experience an obsession, which is an intrusive thought or image or urge that pops into their head, get very anxious when that occurs, and as a way to almost ameliorate that anxiety, they do a compulsion — some kind of mental or behavioral act that will somehow neutralize the experience and allow them to feel better again.
Unfortunately, as OCD progresses, it takes longer and longer to do those compulsions, and that’s why people feel stuck for more and more in their life as OCD gets worse and worse. There are people who may have OCD without experiencing anxiety; instead, they may feel guilt or shame or disgust and really identify when the obsession occurs that those are the experiences or feelings that they’re having.
We can still do the same type of treatment for them, even though it’s not necessarily an anxiety-based [diagnosis] but more again, a basis in disgust or guilt or shame or some other kind of emotion that they find to be very uncomfortable or unwanted. It wouldn’t be enough just to manage the anxiety because we want to make sure that we’re targeting the obsessions and compulsions in OCD.
There are very good anxiety management skills that people can use, and there’s great therapy out there for a general anxiety disorder or something of that nature. But when we’re going for OCD, we specifically have to do something called exposure and response prevention therapy. And that is really going to target triggering people’s obsessions, purposely sitting with those uncomfortable thoughts or images or urges, but at the same point doing something we call response prevention, or the elimination of the typical compulsion or ritual that someone does once they experience the obsession. It is only by allowing people to realize that they don’t need to do the compulsion, and that they can still handle the discomfort that they’re feeling, that they learn that they can overcome their obsessive-compulsive disorder.
All anxiety disorders can be treated with exposure and response prevention therapy, as well as obsessive-compulsive disorder. However, the targets for what we’re going to do exposure and response prevention for are going to be different based on the disorders. So for example, if you have a panic disorder, I might expose you to uncomfortable physical sensations, and have you not run to the emergency room if that’s what you typically do. Instead, I will have you sit with those uncomfortable situations and let them pass on their own and learn that you can handle them.
Similar with OCD, I may expose you to an intrusive thought image or urge, and instead of doing your compulsion, which, for instance might be checking the locks to make sure they’re locked so that no one breaks in the house, I might have you purposely go to bed without checking the locks and learning that you can handle doing that.
We’ve definitely found that when we do ERP for individuals with OCD, it has great effects on other things going on in their life, too — many people report that they feel less depressed. They also report that they feel less anxious in general as well. Even if we’re not specifically targeting depression or anxiety. We just know that as people start to see less influence of OCD on their life, specifically through using exposure and response prevention therapy, that they start to feel better in general, overall.
To find an OCD specialist who is trained in ERP, you can use the NOCD network. You can visit our therapist directory online or download the NOCD app to find a therapist. Our care team will meet with you to discuss what’s going on and can set you up with a therapist who will help you manage OCD.
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."
- ERP Therapy
- Obsessive compulsive disorder (OCD)
- OCD Treatment
NOCD Therapists specialize in treating OCDView all therapists
Licensed Therapist, MA
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.
Licensed Therapist, LCMHC
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.
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.