OCD vs. GAD: The Similarities & Differences

You recently applied for your dream job. At first, you were excited about the prospect of finally fulfilling your dreams. You could not believe your good fortune. You got an interview – and it went well (in your opinion). But…now that the interview is over and the waiting period has begun, you have become anxious. What if you do not get the job? You were recently laid off due to COVID, so you really need a job. You are afraid that if you are not hired for the job, you will be unable to pay your bills, and will end up homeless.

You do not want to wind up on the streets. You try to push those negative thoughts out of your mind, but with each passing day, this becomes harder and harder. Now, a week later, all you can think about is whether or not you will get the job – and what could happen if you don’t. You try to ease your angst by developing a routine to busy yourself while you wait.

This routine involves waking up, getting dressed, going to the gym for an hour, going back home, taking a shower, fixing yourself breakfast, settling down at the computer and searching for “backup jobs” until lunch, fixing yourself lunch, watching television for about an hour, sitting back down in front of the computer and resuming your search for “backup jobs,” and continuing this behavior until 5 pm.

Then, you go for a run around the neighborhood, take another shower, fix dinner, eat dinner while watching Hulu, scrolling social media, and/or calling a friend or loved one, get ready for bed, listen to music, or watch more television, and going to sleep (if you can).

The thing is these activities only temporarily ease your angst, it pops back up when a new bill arrives, and at random times, such as while lying in bed or eating dinner. Once you start thinking about getting a job or going hungry or homeless, you break out in a cold sweat, get a headache, and become easily irritated. The fear and doubt are stressful, frightening, and overwhelming. You are prone to anxiety.

You have been reading up on your “symptoms,” and you are unsure if you have OCD or GAD. Because you are unsure, you have scheduled a consultation with a psychotherapist. You are tired of living like that – it has happened before – when you were younger and afraid you would not get into your chosen college. It was horrible, and you want it to stop for good. What is wrong with you?

The truth is obsessive-compulsive disorder (OCD) is often misunderstood. And, because it shares a lot of similarities with a generalized anxiety disorder (GAD), it is often misdiagnosed – and vice versa. This typically occurs because the differences between the two conditions are somewhat indistinct and both conditions involve anxiety. Moreover, researchers have not quite figured out all of the ways OCD can manifest.

This can make it challenging to determine if a person has OCD, GAD, or both! While this distinction may not seem like a big deal to some (OCD and GAD are both anxiety conditions), getting the right diagnosis is paramount to fully recovering from both conditions. Although OCD and GAD are treated similarly, it is important to know which condition(s) need to be addressed because there could be some differences in how each condition is treated.

If you are unsure if you are struggling with OCD and GAD, you have come to the right place. This article can help you better understand if you will OCD, GAD, or both, so you can address your concerns with your doctor, and receive the proper treatment for what ails you.

Could I Be Struggling With OCD?

Possibly.

Obsessive-compulsive disorder (OCD) is an anxiety condition that involves non-stop, involuntary obsessions or “fixations” (i.e., intrusive thoughts, beliefs, urges, doubts, fears, mental images, etc.) that may or may not lead to compulsions or rituals/routines (I.e., excessive hand-washing, cleaning, checking, organizing, avoiding people or things, needing reassurance, ruminating, repeating words or phrases, counting, etc.).

OCD is a real mental health condition that can alter one’s life, health, and well-being. It is also a solitary condition because many OCD sufferers hide their obsessions and compulsive behaviors from others. This can wreak havoc on relationships and friendships because these individuals tend to “emotionally detach” from others to avoid “detection.” Sometimes, it can be hard to distinguish OCD from other mental health conditions, especially other anxiety conditions, because the symptoms typically overlap.

Common OCD obsessions can include:

• Excessive fear of deliberately harming yourself or others, such as a partner, a family member, a pet, or even a child
• An extreme fear of missing something or making a mistake, such as forgetting to turn off the oven, lock the door, let the dog out for a potty break, or close the windows
• An irrational fear of dirt, germs, and contamination or contaminating others, such as being afraid that you will contract COVID if you leave your home, or expose someone else to the virus if you come in contact with him or her
• A constant need for symmetry or orderliness, such as a need to ensure that everything is organized, neat, and “perfect”

Common OCD compulsions can include:

• Cleaning and hand-washing (i.e., scrubbing your body, washing your hands until they crack, etc.)
• Checking (i.e., checking that the doors and windows are closed and locked, or the oven is turned off)
• Mental counting (i.e., adding and subtracting in your mind)
• Organizing and arranging (i.e., constantly organizing and re-organizing your spices, etc.)
• hoarding
• Asking for reassurance from others (i.e., continuously asking others if you are “likable,” “good enough,” “ok,” etc.)
• repeating words in their head
• Constantly trying to “block out” upsetting thoughts, urges, doubts, fears, and mental images by thinking of happier, more pleasant things
• Avoiding certain people, places, and situations that trigger obsessive thoughts

Note: Some OCD sufferers only experience obsessions or compulsions, while others experience both obsessions and compulsions.

Could I Be Struggling With GAD?

Possibly. 

Generalized anxiety disorder (GAD), like OCD, is an anxiety condition that can impact your life, health, and well-being in a variety of ways. Truthfully, most, if not all people experience anxiety from time to time. It is normal and even healthy to experience anxiety from time to time. Anxiety alerts us to possible danger, so it is a needed emotion – just not all of the time. 

How many of us have never worried about our health or the health of a loved one, our jobs, family dynamics, the state of our relationships, or other life situations? Occasional worry, concern, and anxiety are simply parts of life. However, our bodies are not meant to stay in constant “hyperdrive.” When we are unable to “relax,” it not only stresses our bodies but also our minds.

 The difference between normal angst and GAD is that people, who struggle with this condition, tend to worry, fret, and/or become nervous or anxious more often and more severely than someone without GAD – even when these emotions are warranted or rational. Thus, GAD involves constant worry, fear, doubt, anxiety, and dread that prevent you from living a happy and productive life. 

GAD interferes with your ability to have a life free of unrelenting anxiety. Understand, however, that GAD is not the same thing as occasional worry, nervousness, fear, doubt, angst, etc. GAD is more pronounced and can last for a longer period, such as months or years. Healthy anxiety typically lasts for a shorter period, such as a day, a few days, or a couple of weeks. 

Note: GAD gradually develops, sometimes presenting before the age of 30. However, it can also be present during childhood. Studies suggest that GAD is more common in females than in males. 

Common GAD symptoms can include:

• An unrelenting and unproportional worries, nervousness, fears, doubts, stress, and/or anxiety 
• Overthinking things causes you to revert to a “worst case scenario”
• Viewing people, situations, and events as “threatening,” even if they are not
• An inability to deal with uncertainty in a healthy way
• An unrelenting fear of making a mistake or the wrong decision
• An inability to “relax” or let go of your fears, doubts, etc. 
• Constantly being on “the edge”
• Inattention or difficulty concentrating
• Fatigue
• Sleep issues (i.e., insomnia)
• Muscle tension, cramps, or aches
• Trembling, feeling twitchy
• Extreme nervousness (i.e., being easily startled)
• Prouse sweating
• Gastrointestinal distress (i.e., nausea, diarrhea, abdominal pain, upset stomach, and/or irritable bowel syndrome (IBS))
• Irritability
• Excessive worry about everyday things
• An inability to control your worries, fears, doubts, and/or nervousness
• Restlessness
• Constant headaches, stomachaches, or unexplained aches and pains
• Difficulty swallowing
• Twitching
• Lightheadedness
• Breathing difficulties
• Frequent urination

How Are OCD and GAD Similar?

According to studies, OCD sufferers may eventually also develop GAD – in some cases. Research also suggests that people, who have OCD and GAD, also have an elevated risk of developing major depressive disorder (MDD) or another mood disorder, like bipolar disorder. OCD and GAD share some common characteristics, such as intrusive or upsetting thoughts, doubts, worries, fears, and avoidance of certain people, things, or situations. 

Both OCD and GAD can cause “emotional distress” that is so severe that it disrupts one’s life, health, and well-being. And, both OCD and GAD involve a “fixation,” which is hard to ignore, dismiss, or let go of. OCD sufferers and GAD sufferers know that these intrusive thoughts, fears, doubts, and/or worries are likely unrealistic, however, knowing that these emotions (and the perceived accompanying events) are unwarranted does not make them easier to cope with or manage. 

Moreover, both OCD and GAD are typically attached to specific triggers, which cause or escalate these thoughts, fears, doubts, worries, concerns, etc. For OCD sufferers and GAD sufferers, the mere thought of doing something can cause a continuous loop of upsetting, worrisome, or frightening thoughts, worries, concerns, nervousness, doubts, etc. 

According to researchers, both OCD and GAD involve repetitive thought disruptions, negative emotions, an inability to dismiss the disruption, and a loss of mental control. Lastly, both OCD and GAD are anxiety conditions, and both can be triggered by stress, trauma, or anxiety.

How Are OCD & GAD Different?

GAD sufferers tend to hyper-focus on real-life, everyday concerns. However, these are real-life everyday concerns, the worries, doubts, fears, and thoughts tend to be extreme or excessive. With GAD, worries, concerns, thoughts, fears, and doubts may revolve around health, relationships, work, school, finances, and/or minor everyday stresses – things that most people, shrug off or let it go after a while. 

Moreover, people with GAD tend to feel these negative emotions more intensely than people, who do not have the condition. For example, someone with GAD may experience extreme distress (worry, anxiety, and fear) if asked to do a presentation at work, recite a poem in front of the class, or host a function. He or she may also become extremely anxious if his or her daily routine is disrupted. Thus, GAD is not only unpredictable but also involves “catastrophizing” or imagining the worst-case scenario. 

On the flip side, OCD differs from GAD in that it tends to involve intrusive thoughts, doubts, fears, worries, urges, and nervousness that extend beyond everyday concerns and issues. OCD also involves long-term obsessions (far longer than most GAD episodes) and/or repetitive compulsions. And, although OCD can also involve real-life everyday concerns or worries, many times, the obsessions are more intense and irrational than GAD worries and concerns. 

People with OCD can “fixate on” just about anything. For instance, a person with OCD may become deathly afraid of catching COVID and lock himself or herself up in his or her home, never leaving it for fear that he or she will become “contaminated” by it. Or, he or she may take several showers, scrubbing his or her skin until it is red and raw after returning from the grocery store because he or she believes germs are floating around there. 

On the other hand, a person with GAD would not necessarily perform rituals or routines, like excessively showering or locking himself or herself in the house out of fear of contracting something. If a person with GAD does these things, it is usually temporary, unlike someone with OCD. 

Compulsions are uncommon with GAD. For instance, a person with GAD would likely profusely sweat, become jittery, lose track of thought, or experience stomachaches or headaches, because of excessive worry and nervousness, but would not resort to compulsions to ease his or her distress. So, ultimately, GAD concerns and worries tend to be connected to everyday concerns, while OCD worries and concerns tend to be more unlikely and irrational, prompted by the barest evidence.

Are OCD and GAD Treated the Same?

Yes, for the most part. 

Because OCD and GAD are both anxiety conditions, it makes sense that the treatment would be similar for both conditions. The go-to treatment for OCD and GAD is exposure and response prevention (ERP) therapy. ERP therapy is a subtype of cognitive-behavioral therapy (CBT). Other therapies used to treat both OCD and GAD are acceptance and commitment therapy (ACT), TMS “trauma” therapy, addiction therapy, couples or marriage counseling, group therapy, individual therapy, and/or family therapy. 

In some cases, these conditions are treated with SSRI antidepressants, like Zoloft, Paxil, and Prozac, SNRIs, atypical antidepressants, antipsychotics, MAOIs, etc. The main difference between how OCD is treated and how GAD is treated is that cognitive restructuring is primarily used for GAD. 

Cognitive restructuring involves teaching GAD sufferers how to identify the thoughts that are causing the anxiety, challenge or question those thoughts, and look at those thoughts in a different, healthier, and more positive way. Paxil, Lexapro, Cymbalta, and Effexor are FDA-approved for GAD, while Anafranil, Prozac, Luvox, Paxil, and Zoloft are FDA-approved for OCD. Although, all of these medications can be used “off-label” for either condition. 

Natural remedies or alternative treatments that can be used to treat OCD and GAD include mindfulness meditation, podcasts, forums, support groups, yoga, journaling, CBD, hypnotherapy/hypnosis, vitamins and minerals, healthy coping skills, and strategies, and self-help tools, like Impulse Therapy, an online OCD treatment program. Regardless of the condition, with the right treatment program, you can control your OCD symptoms and/or GAD symptoms so worry and anxiety no longer dominate your life.

References

• Langlois, F., Freeston, M. H., & Ladouceur, R. (2000). Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: Study 1. Behavior Research and Therapy, 38(2), 157–173. Retrieved from https://doi.org/10.1016/s0005-7967(99)00027-3
• Bahrami, F., & Yousefi, N. (2011). Females are more anxious than males: A metacognitive perspective. Iranian Journal of Psychiatry and Behavioral Sciences, 5(2), 83–90. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3939970/
• Goodwin G. M. (2015). The overlap between anxiety, depression, and obsessive-compulsive disorder. Dialogues in Clinical Neuroscience, 17(3), 249–260. Retrieved from https://doi.org/10.31887/DCNS.2015.17.3/ggoodwin
• Mayo Clinic. (n.d.). Generalized anxiety disorder (GAD). Retrieved from https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/symptoms-causes/syc-20360803
• National Institute of Mental Health. (n.d.). Generalized anxiety disorder: When worry gets out of control. Retrieved from https://www.nimh.nih.gov/health/publications/generalized-anxiety-disorder-gad
• OCD Center of Los Angeles. (2019). OCD vs. GAD and how to tell the difference. Retrieved from https://ocdla.com/ocd-vs-gad-7071
• Glasofer, D. R. (2022). How GAD and OCD compare. Verywellmind. Retrieved from https://www.verywellmind.com/what-is-the-difference-between-gad-and-ocd-1393010