OCD vs Anxiety: What’s the difference?

Obsessive-compulsive disorder (OCD) and anxiety disorders share similarities, most pertinently overwhelming feelings of anxiety. However, they are distinct conditions and sufferers contend with different symptoms dependent on which disorder they have.

A key difference between OCD and anxiety disorders are the compulsive actions sufferers of OCD feel forced to perform to provide relief from their symptoms.

People with GAD often worry excessively about a host of issues; however, they will not feel the need to repeatedly perform a compulsion to combat feelings of anxiety brought on by their worry. ^[1]

For both OCD and an anxiety disorder, getting a medical diagnosis is the first step towards getting the right treatment for your symptoms.

What is OCD?

Obsessive-compulsive disorder is a mental health condition with two main components: obsessions and compulsions. ^[2]

• Obsessions are intrusive and recurring thoughts, images, or urges that are distressing and cause anxiety.
• Compulsions are repetitive behaviors or mental acts that individuals with OCD feel compelled to perform in response to their obsessions. These actions are intended to reduce anxiety or prevent perceived harm from occurring.

Beset by unwanted obsessions, people with OCD rely on their compulsive rituals to provide them with relief. They may engage in various cycles of obsessions and compulsions per day which can feel immensely disruptive, time-consuming, and stressful.

They may recognize these thoughts are irrational and not rooted in reality, but this fact alone does not make them any easier to contend with.

What is anxiety?

There are many different types of anxiety disorders including generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder. They are all marked by excessive anxiety and/or fear in different situations.

Your specific symptoms fluctuate depending on the type of anxiety disorder you have. For example, someone with panic disorder has a fear of the physical symptoms of anxiety, panic, and fear, whereas someone with social anxiety disorder may fear being judged by other people. ^[1]

Is OCD an anxiety disorder?

No, OCD is technically not an anxiety disorder. As per the Diagnostic and Statistical Manual of Mental Disorders (DSM)’s latest edition, OCD is defined within a section called ‘Obsessive-compulsive and related conditions’.

Historically, OCD was considered an anxiety disorder by the DSM, but the fifth edition published in May 2013 separated them. The change was made due to research that had found that OCD and related disorders had specific tenets – obsessions and compulsions – that differentiated them from anxiety disorders. ^[4]

How common are anxiety disorders and OCD?

OCD affects roughly 2% of the population with the age of onset primarily occurring across two age groups: pre-teen children and young adults. ^[1]

Anxiety disorders are more prevalent, with over a third of the population suffering from one in their lifetime. ^[1]

OCD vs Anxiety: Symptoms

OCD symptoms

To receive a diagnosis of OCD, a person with OCD must: ^[3]

• Have demonstrated obsessions and compulsions or both.
• Prove the obsessions and compulsions are causing significant distress.
• Prove the obsessions and compulsions are not attributable to the physiological effects of other medications, substance abuse, or a separate medical condition.
• Prove the obsessions and compulsions are not better understood as symptoms of a separate mental health disorder.

Typically, the obsessions and compulsions are irrational in nature, with sufferers experiencing multiple, different obsession-compulsion cycles a day. ^[1]

Anxiety symptoms

Anxiety disorders encompass a range of conditions characterized by excessive and persistent anxiety or fear. While specific symptoms may vary depending on the type of anxiety disorder, some common symptoms include:

• Excessive worry
• Restlessness
• Physical symptoms (e.g.: trembling, sweating, dry mouth, fatigue, or shortness of breath)
• Avoidant behaviors
• Panic attacks

As noted earlier, a core difference between OCD and anxiety disorders are the compulsions performed by suffers of OCD in response to intrusive thoughts. While people with anxiety disorders may ruminate excessively, they do not engage in compulsive behaviors to reduce their anxiety. ^[1]

Another noteworthy difference is that people with anxiety disorders typically worry about real-life concerns. On the other hand, people with OCD can obsess over unrealistic matters, often accompanied by irrational compulsions. ^[1]

OCD vs Anxiety: Causes

While the exact causes of OCD and anxiety disorders are not fully understood, there are some factors that may contribute to their development:

Causes of OCD

Genetic Factors: There is evidence that OCD can run in families, suggesting a genetic predisposition. Certain genes and variations in neurotransmitter systems may contribute to the development of OCD. ^[2]

Neurobiological Factors: Imbalances in certain neurotransmitters, such as serotonin, have been implicated in OCD. Dysfunction in specific brain regions, such as the orbitofrontal cortex and the basal ganglia, may also play a role.

Environmental Factors: Traumatic events, such as physical or sexual abuse, can increase the risk of developing OCD. Other environmental factors, including significant life stressors, childhood adversity with one’s parents, may also contribute. ^[2]

Causes of Anxiety Disorders

Genetic Factors: Like OCD, anxiety disorders may have a hereditary component. Having a family history of anxiety disorders or related conditions appears to increase the risk of developing an anxiety disorder. ^[5]

Environmental Factors: Traumatic experiences, such as physical or emotional abuse, neglect, being bullied, or significant life stressors, can contribute to the development of anxiety disorders. ^[5] Chronic exposure to stressful situations, such as work-related stress or chronic illness, may also play a role.

Physical or mental health problems: Living with a serious physical or mental health condition, especially depression, can trigger anxiety disorders in people. ^[5]

OCD vs Anxiety: Treatment

There is an overlap in treatment approach for OCD and anxiety disorders, however the details of each treatment plan vary dependent on the disorder and the individual. They usually include one or a mix of the following options:

Cognitive behavior therapy (CBT) – CBT is the most well-known treatment for both OCD and anxiety disorders. It is a form of talk therapy that encourages patients to recognize and modify harmful thought patterns. CBT with exposure response prevention (ERP) can work well for both OCD and anxiety disorders. ^[6]

Medication – Doctors can prescribe medications to help alleviate symptoms of both diseases. Typically, selective serotonin reuptake inhibitors (SSRIs) are prescribed for OCD, to help balance neurotransmitter activity in the brain. ^[1] A larger range of antidepressants and beta-blockers can be prescribed to treat anxiety.

When treating OCD with medication, there are two notable differences. First, OCD typically requires high doses of SSRIs not usually required for anxiety disorders. Second, people with OCD may take longer to respond to medication than those with anxiety disorders. ^[1]

Self-care and stress management – Incorporating healthy lifestyle habits, such as regular exercise, sufficient sleep, and a balanced diet can help manage symptoms of anxiety disorders. Combining these with relaxation techniques, such as deep breathing exercises, yoga and mindfulness meditation can be beneficial to sufferers of both OCD and anxiety.

Can you have OCD and anxiety at the same time?

It is possible to have both OCD and an anxiety disorder concurrently. In a 2021 study, 33.56% of participants with OCD also had GAD. ^[7]

Another study found that anxiety disorders exist comorbidly with OCD in just over 75% of cases worldwide. ^[8]