Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 3/26/2022
Mental health can be confusing. So many disorders and illnesses have overlapping symptoms, treatments can be wildly similar, etc. Two of the most commonly confused conditions that people have? Anxiety and OCD — two conditions many of us just refer to as, “nervous.”
Without a professional diagnosis, most people will never really be certain which condition they have — or if they have both, simultaneously.
If you’re wondering which category you fit into (or whether you fit into both), there are some things you need to understand about OCD and anxiety.
The difference between anxiety and Obsessive Compulsive Disorder (OCD) can be difficult to distinguish.
There’s a good reason for this: they are similar — so similar that even the all-important mental health guidebook the DSM-5 once categorized OCD as anxiety. In fact, it’s only recently that the two have been given separate chapters.
This is all part of an ongoing discussion in the mental health space, but for now, the important thing is that both experts and normal people alike notice plenty of overlap between anxiety and OCD.
OCD and anxiety have several symptoms in common.
For instance, anxiety is often characterized as an unease created by intrusive thoughts or patterns of thought leading to the following symptoms:
Difficulty controlling worry
Distress and Impairment in social situations
Meanwhile, OCD is often described as compulsions as a result of intrusive and uncontrollable thoughts that cause distress and impact daily life — symptoms where people have recurring thoughts or behaviors that they feel they must repeat over and over and over again.
In other words, both individuals may appear anxious and in distress, and be dealing with patterns of thought that may cause distress in patterns that affect their quality of life.
Oh, and there’s a common comorbidity between the two conditions, as well — as many as 30 percent of people with OCD may also experience generalized anxiety disorder or another form of anxiety disorder in their lifetime.
It can be confusing.
The difference, then, is about nuance — specifically, where anxieties come from and how they’re dealt with.
In anxiety, the intrusive thoughts and fears are often overwhelming and debilitating. They’re also often a result of a once-realistic fear that has either been avoided to the point of discomfort or has begun to affect someone’s quality of life.
In OCD however, the fear is obsessive l from the beginning and people engage in unhealthy behaviors (compulsions) to deal with it.
A good example of OCD in practice might be someone who is afraid of home invasion, and therefore checks that their front door is locked dozens of times a day when they have no reason to believe anything has changed with their door lock.
An anxious person, meanwhile, would likely respond differently, either by avoiding being home alone or by installing extra security.
Interestingly, it’s not uncommon for someone to have both anxiety and OCD. As we mentioned before, research shows that as many as 30 percent of people with OCD have anxiety at some point in their lives.
The same research suggests that, when someone does have both, the appropriate treatment response is to address the OCD first as the primary source of distress.
This makes sense for several reasons, but the most important is that OCD represents a more illogical and irrational view of the world, and those extremes can cause more distress if not treated effectively.
OCD is a long-lasting disorder characterized by obsessions and compulsions — uncontrollable repetitive behaviors and uncontrollable thoughts.
Anxiety generally is an overreaction to something, but because OCD is an overreaction (and an illogical reaction) to nothing, it’s cause for more concern.
In short, if you have both, OCD is first up on the treatment service board.
And speaking of treatment, the good news for people dealing with both anxiety and OCD is that, for the most part, your treatments will likely be very similar.
While no two treatments for anxiety or OCD will look exactly the same, your healthcare provider will typically select from certain proven effective treatments to create your own tailored treatment approach.
Anxiety responds well to medications like antidepressants, therapy and lifestyle changes, and that’s all true of OCD, too.
There are some subtle differences, though, so let’s look at them briefly:
When coping with anxiety, you will generally see treatment take the form of Cognitive Behavioral Therapy (CBT), which is a form of therapy geared toward re-training your brain to learn a new way of addressing topics and thoughts that make you anxious.
CBT is about learning to see the anxious thoughts, reject their irrationality, contextualize the distress and ultimately learn to control the triggers for anxiety before things get out of hand.
When it comes to medications for OCD and anxiety, antidepressants like selective serotonin reuptake inhibitors (or SSRIs) are effective in helping the brain rebalance its supply of certain neurotransmitters, in turn helping your brain better regulate your mood.
All of the same is true for OCD that we’ve said of anxiety disorders, but additional tools are available for OCD sufferers. For instance, someone with OCD may benefit from exposure therapy and additional forms of psychotherapy.
Research shows that the use of SSRIs in the treatment of OCD is effective, but might generally require higher doses to bring benefits.
Whether you’re convinced that you have OCD, anxiety, both or another mental health disorder, if your fears and uncertainties are negatively impacting your life, it’s time to seek help.
OCD and anxiety are manageable conditions, but left unaddressed, they can have long-term consequences for your happiness, your mental health and even your physical health, too.
Not sure where to start? We recommend consulting a healthcare professional or mental health professional at first — if you need more questions answered, consider consulting our online mental health services for questions on how to get what you need.