OCD vs Anxiety: How to Finally Tell the Difference

You might find yourself double checking things, constantly replaying conversations in your head, or seeking reassurance about something that doesn’t feel quite right. Is it OCD? Anxiety or maybe just perfectionism. These experiences can overlap and feel confusing, but there are important differences. In this episode, I’m breaking down what OCD actually is.

Beyond the stereotypes, how it shows up differently than anxiety and perfectionism. What intrusive thoughts really mean? The treatment that’s most effective for creating long-term relief and change. If you’ve ever felt stuck in your own thoughts or behaviors, this episode will help you better understand what’s going on and what you can do about it.

Welcome to Calmly Coping. I’m Tati Garcia, a licensed therapist and speaker here to help high achievers stop overthinking and finally feel calm and confident from within. If that resonates, then hit subscribe. Let’s dive into the episode. OCD. Obsessive Compulsive Disorder is one of those mental health terms that’s thrown around a lot, and honestly, it’s often misunderstood.

It’s not about being overly clean or organized. It’s not about color coded calendars or straighten up desks. OCD is a mental health disorder that can become debilitating and like any mental health issue, it exists. On a spectrum, meaning that it can make functioning somewhat difficult to extremely difficult, and at its core, OCD includes obsessions and compulsions.

Obsessions are persistent, unwanted, and intrusive thoughts, images, or urges that cause significant distress or anxiety. And compulsions are the behaviors or mental actions a person feels driven to do in response to an obsession. Usually to try and ease the anxiety or prevent something bad from happening.

So maybe you have an obsession. What if somebody breaks into my house? Or what if I get a severe illness? And the compulsions that could show up in response to these obsessions can be more obvious, like repeatedly checking a lock if you’re anxious about somebody breaking in, washing your hands over and over.

However, the connection does not always need to be rational. It could be completely irrational. It could be something bad is gonna happen to my family if I don’t check my lock three times or anything else that can be seemingly unrelated. But here’s the thing, compulsions can also be more subtle. It can look like repeatedly checking your bank statement over and over again after getting anxious about your finances.

Or asking your partner for reassurance multiple times about a medical concern you have, or maybe it’s mentally rehashing a conversation you had yesterday just to make sure you didn’t embarrass yourself, so you’re mentally checking it over and over again, or even mentally repeating a phrase or prayer or counting to try and prevent something bad from happening.

And these covert compulsions are just as real and just as powerful as the more obvious ones, but they’re oftentimes not recognized. As being OCD, and it’s important to note that some people have OCD traits or behaviors, meaning you might have some compulsive checking or reassurance seeking behaviors, especially when you are anxious.

However, this doesn’t necessarily mean that you meet the criteria for an OCD diagnosis. A diagnosis is more likely when the obsessions and compulsions cause significant distress take up a lot of time. For example, over an hour a day. Or interfere with your work relationships or daily life. So if you’re caught checking to see if the door is locked so long that it makes you late for work, then this could be an example of that.

And if that sounds like something you’re dealing with, it’s important to talk to a licensed mental health professional and preferably one trained in OCD specific treatment. That’s because self-diagnosis can be confusing and misleading. And getting the right help makes a big difference. An OCD is also highly biological, meaning that if you have an OCD diagnosis, it’s highly possible that somebody in your immediate or extended family, this can look like an aunt, uncle, or grandparent, could have OCD as well, even if they were never diagnosed.

And in previous generations, it can be highly likely that people were never diagnosed unless it severely impacted their life. Now, let’s talk about the difference between OCD and perfectionism. One of the biggest overlaps between OCD and perfectionism is this. A low tolerance for uncertainty in OCD. The brain, neurologically speaking struggles to reach a sense of completion or certainty.

That’s why someone might check something again and again. Even when they know it’s probably fine, their brain doesn’t feel like it’s okay. It doesn’t have that sense of certainty. So they keep on going and going, but never fully reach that feeling that they’ve done it enough. And this is why compulsions happen.

They’re an attempt to reduce the anxiety caused by feelings of uncertainty. But the problem is that the compulsions don’t provide true reassurance. So they might calm the anxiety briefly, but ultimately they just reinforce the obsession and compulsion loop because you are teaching your brain that. Once I have this obsession or worry, then I need to engage in this compulsion to reduce the anxiety.

And you’re reinforcing the idea that this is something that you need to do in order to get some feeling of relief, but it’s really never long lasting. And perfectionism often stems from a similar root, a strong need to avoid making mistakes or doing something wrong. And when OCD is in the picture, that drive for perfection can become compulsive.

Needing something to be just right, to feel safe or in control, or to feel like it’s done. There is a strong correlation between OCD and perfectionism. Now, let’s talk about the difference between OCD and anxiety. So, OCD used to be considered in the category of anxiety disorders, but now it’s in its own separate category in the DSM five, which is the Diagnostic and Statistical Manual for Mental Health Disorders.

Anxiety is still a big part of OCD, but it’s not the whole picture. And some people with OCD experience more of a general sense of discomfort or distress rather than obvious anxiety. So it could be just a strong feeling of. Being uncomfortable or not at ease, and here’s where it gets tricky. So not all therapists or clinicians are trained in recognizing OCD, and because it can present similarly to generalized anxiety, people are often misdiagnosed or given the wrong treatment approach.

This is something that I’ve experienced in many clients that I’ve met with. Maybe they’ve been in therapy before and have been treated for anxiety disorders, however, that didn’t fully address or resolve the symptoms they were feeling. Then when I met with them, since I am trained in OCD and more aware of the symptoms, I was able to recognize this is actually OCD and this is the treatment approach that we need to use, which is different than that for anxiety and.

Some of the differences are that traditional anxiety treatment might involve thought challenging or challenging anxious thoughts. But in OCD, this can actually make things worse because it can feed the compulsion to mentally check or analyze the thought, thus kind of getting you deeper into this obsession and compulsion loop.

So that’s why understanding the difference and getting the proper treatment is. Very important. The most effective treatment for OCD is called Exposure and response Prevention or ERP. There are also, of course, medications for OCD, however, that is something that I won’t be going into in this episode. ERP has two main parts, so there is the exposure part, so that is intentionally facing the fear or obsession, for example, touching something that is contaminated.

So this can look like if you’re afraid of germs, maybe touching something dirty and just sitting with and being with that discomfort. The response prevention piece is then not engaging in the compulsion that usually follows. So staying with that stuff on your hands and not washing your hands as much as that urge is going to come up, and you may really feel compelled to do it.

You’re going to stop engaging in the compulsion. This teaches your brain that you can sit with discomfort, fear, or uncertainty, and you’ll be okay. At first, your anxiety will spike, but over time it’s going to decrease because you’re no longer reinforcing that fear by engaging in the compulsion. So let’s go back to those earlier examples that I had shared.

So maybe instead of checking your bank app five times, you check it once. And then you sit with the discomfort. When you have obsessions about your financial situation, if you typically rehash a conversation mentally, you let the thought be there without analyzing it again and again. And having a mindfulness practice can be really powerful if you are somebody who experiences these mental compulsions, this mental checking.

Another name for that is pure O or pure obsessive OCD. There are still compulsions that are present, but it can be harder to recognize because those compulsions are actually mental and oftentimes mental checking or rehearsing. And if you usually ask for reassurance when you start to feel anxious or distressed, or.

About something, you might resist that urge, even though it feels uncomfortable. This process helps you to build real confidence in your ability to handle and tolerate uncertainty, which is, like I mentioned, the real crux of OCD. I’ve worked with so many clients who experience OCD as a therapist, and it doesn’t always look the same, but in every case, there is hope.

Treatment is possible. And here’s something that’s really important to remember. Intrusive thoughts are a part of being human. Everyone has them. Even people without OCD, myself included, I experience intrusive thoughts as well as some OCD like traits. So what matters isn’t whether you have these thoughts, it’s how you respond to them.

You don’t have to analyze them, fight them, or try to control them, because the more you try to control a thought, the more power you give it and the more it sticks around. May seem counterintuitive, but the more you try to stop a thought, the more you keep it there. With the right tools and support, you can learn to let go and feel more free.

If this episode resonated with you, consider sharing it with someone you care about, especially if they’ve ever questioned whether their thoughts or behaviors might be something more. Remember, you are not your thoughts and you are not your compulsions. You are capable of learning, healing, and changing your relationship with fear and uncertainty, and you don’t have to go through it alone.

While you wait for next week’s episode, I have other episodes about calming your mind, improving work-life balance, and feeling more confident from within. So be sure to check out these episodes here. Thank you so much for tuning in today, and until next time, be calm.