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

As a therapist who treats obsessive-compulsive disorder (OCD), I’ve had so many patients who ask the exact question you want answers for: What’s the difference between anxiety and OCD? Are they related to each other? 

OCD and anxiety definitely share commonalities. Both are mental health conditions that revolve around worry, but a distinction with OCD is that you don’t just feel anxious, you engage in compulsive behaviors to try to tamp down the anxiety that you feel about your obsessions. On the other hand, if you have anxiety, but not OCD, you may desperately want to escape your distress, but you don’t partake in compulsive rituals as a result. 

Read on to learn more about both conditions.

How OCD and anxiety are different

Anxiety is an umbrella term for a number of different disorders, and it’s very prevalent. In fact, according to the National Institute of Mental Health anxiety affects more than 19% of the United States population every year, making it the most commonly diagnosed mental health condition in the country. 

One subtype of the condition is generalized anxiety disorder, or GAD, which is characterized by persistent and excessive worry that lasts for more than six months, and is accompanied by at least three physical symptoms—such as nervousness, irritability, feeling on edge, breathing rapidly, hyperventilating or trembling, having gastrointestinal problems, or noticing an increased heart rate. With OCD, on the other hand, you experience obsessions like unwanted thoughts, urges or impulses that lead to compulsions that are done in an attempt to reduce the distress from your obsessive feelings. For example, if you have OCD you may have obsessive thoughts about getting sick when you come into contact with others. To cope with your anxiety, you may wear protective gloves everywhere you go, and obsessively take showers or wash your hands after being in public.

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Why OCD is no longer considered an anxiety disorder 

Here’s an interesting fact: Both GAD and OCD were once considered to be anxiety disorders. But the Diagnostic and Statistical Manual of Mental Disorders—the medical reference guide used by clinicians—now delineates the two. GAD is considered an anxiety disorder, while OCD falls under its own category of obsessive-compulsive and related conditions. These OCD issues can include body dysmorphic disorder, hoarding disorder, and trichotillomania (or hair-pulling).

So why was OCD once thought to be an anxiety disorder? Well, because the intense distress or fear associated with persistent and unwanted thoughts, images and urges can feel similar to anxiety. However, OCD is a separate diagnosis because research has found that there may be significant differences in brain chemistry and function. 

How to know if you have OCD or anxiety

It’s worth repeating that if you have excessive worry, but don’t perform compulsive acts to reduce your distress, you may be experiencing anxiety, rather than OCD. If you have anxiety, you may worry about things that could possibly happen—like losing your job, facing financial hardship, or having other stressors in your everyday life. With OCD, you may recognize that your fears aren’t based on a true threat, but feel distressed about them anyway.

Can you have both OCD and Anxiety?

The short answer is yes. It’s possible to have both generalized anxiety and OCD. There’s some evidence that upwards of 69% of people with OCD experience other mental health issues such as anxiety in their lifetime. But one does not require the other—and it’s also important to know that anxiety isn’t a necessary part of OCD. Patrick McGrath, PhD, Head of Clinical Services at NOCD, points out 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

Both OCD and anxiety are absolutely treatable—even at the same time. So don’t hesitate to seek a diagnosis from a trusted professional, and take that first step to getting the help you need.  

The most successful treatment for OCD is a form of behavioral therapy called exposure and response prevention (ERP). Unlike traditional talk therapy, which can actually make OCD worse, ERP was developed specifically to treat OCD, and is clinically proven to be highly effective in the majority of people.

Here’s how it works: A trained therapist who specializes in OCD will take the time to understand your symptoms and create a custom ERP therapy plan specifically for you. Then, you’ll work together to rank your fears or triggers based on how stressful they seem. To begin with, your therapist may ask you to face a fear that brings on only a mild amount of distress. You may feel a mild amount of distress, as a result, but instead of responding with a compulsion, you’ll learn tools to help you tolerate the discomfort. By making this conscious choice and seeing that nothing bad occurs, or realizing that you handled the discomfort better than you thought you could, your brain learns that there was nothing to fear in the first place.

As your therapy progresses, you’ll tackle triggers that elicit a bit more distress, to conquer bigger fears. With an ERP therapist guiding you, you’ll practice confronting your fears in your everyday life, too, instead of just the controlled setting of therapy. 

Often something amazing happens as a result of this therapy: You won’t be riddled with distress from intrusive thoughts, images, or urges. Your need to engage in compulsions goes away. And the things that matter the most to you won’t feel like they’re at risk of slipping away. For instance, when you spend time with a loved one, you’ll be able to focus on the connection between the two of you—rather than on whether the salt and pepper shakers on the table are in a perfectly straight line. In essence, you’ll get to live a life that’s free from the grip of OCD.

Working with an OCD specialist to address the thoughts and situations that cause you distress is more accessible than ever thanks to virtual ERP therapy. In fact, peer reviewed research shows live teletherapy sessions of ERP can be more effective, delivering results in less time than traditional outpatient ERP therapy, often in as little as 12 weeks. 

NOCD Therapists specialize in treating OCD

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Ilyas Patanam

Ilyas Patanam

MBA

I’m a licensed therapist with specialized training in treating OCD using Exposure and Response Prevention (ERP) therapy, the gold standard of treatments. ERP treats all types of intrusive thoughts, including violent and taboo, so that you can overcome OCD.

Ilyas+1 Patnam

Ilyas+1 Patnam

LCSW, LCSW-2

I’m a licensed therapist with specialized training in treating OCD using Exposure and Response Prevention (ERP) therapy, the gold standard of treatments. ERP treats all types of intrusive thoughts, including violent and taboo, so that you can overcome OCD.

Ray Li

Ray Li

LCSW, LCSW-2

I’m a licensed therapist with specialized training in treating OCD using Exposure and Response Prevention (ERP) therapy, the gold standard of treatments. ERP treats all types of intrusive thoughts, including violent and taboo, so that you can overcome OCD.

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