If you’ve ever wondered whether what you’re experiencing is Anxiety or Obsessive-Compulsive Disorder (OCD), you’re not alone. Many people picture OCD the way it’s shown on TV or in movies, such as someone washing their hands until they are raw. While that can be true for some, OCD has many different subtypes that can look completely different. To make things even more confusing, almost everyone with OCD experiences anxiety, either as a symptom, a co-occurring condition, or both. Even doctors can find it hard to tell the difference. Research shows that up to half of OCD cases are first misdiagnosed, and on average, it takes 7 to 10 years from the onset of symptoms to receive the correct diagnosis.
Furthermore, anxiety itself can appear in many different forms, including social anxiety, panic disorder, and phobias. For the purpose of this article and to keep things simple, when I refer to Anxiety, I will be focusing on Generalized Anxiety Disorder (GAD) and closely related subtypes.
The hopeful truth is that both Anxiety and OCD are highly treatable. With the right approaches, including Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Exposure and Response Prevention (ERP), many people find significant relief and get back to living more fully.
Why Does Knowing the Different Matter?
As a psychotherapist in Ontario, I am able to provide therapy as treatment, but I am not able to offer a formal diagnosis. If you are seeking a diagnosis, that can be provided by a professional trained to do so, such as your family doctor, a psychologist, or a psychiatrist. Regardless of whether you pursue a formal diagnosis, it is valuable to understand the key differences between anxiety and OCD. With this knowledge and a clearer picture of your symptoms, you will be better prepared to speak with a professional and reduce the risk of misdiagnosis. While not required in order to access care, a diagnosis can help guide treatment options and support the best possible outcome.
Anxiety vs. OCD: A Quick Comparison
Anxiety usually shows up as excessive worry about everyday stressors, restlessness, or difficulty sleeping. Someone might replay conversations at night or feel on edge about upcoming deadlines.
OCD involves a specific cycle:
- Obsessions: intrusive, unwanted thoughts, images, or urges (such as “What if I left the stove on?” or “What if I hurt someone I love?”).
- Compulsions: repetitive behaviors or mental rituals meant to reduce the distress from those thoughts (like checking the stove repeatedly, constantly asking for reassurance, or repeating a phrase in your head).
Something that can make OCD harder to spot is that compulsions are not always visible. They can also take place entirely in the mind, such as silently reviewing memories, counting, or “neutralizing” a thought with a mental phrase.
Where They Overlap
OCD shares many features with general anxiety, including tension, fear, and distress. What makes OCD stand out is the repetitive nature of the obsessions and compulsions.
For example, someone with anxiety often worries about changing day to day issues, while someone with OCD might be consumed by one thought, such as “What if I left my door unlocked and my house burns down?” and then feel to go back and check several times in a row, often in a ritualized way, until they feel reassured that they can safely go to work.
Thoughts Are Not Actions
A major source of shame in OCD is the nature of intrusive thoughts. They often target the things you care about most, which can make you feel like a bad person. It is important to remember that thoughts are not actions. Having a disturbing thought does not mean you will act on it, nor does it reflect your character. The fact that these thoughts cause distress is proof they go against who you are and the values that are most important to you.
The Hope: ERP Therapy Works
OCD has one of the most effective treatments available. Exposure and Response Prevention (ERP) helps people face fears without performing compulsions. Over time, the brain learns that the feared outcome does not happen and the anxiety fades.
Research shows that around 65 to 70 percent of people with OCD experience significant improvement with ERP and/or medication when they stick with treatment. Many notice changes within a few months. In Ontario, more than 350,000 people live with OCD, and many find real recovery through therapy.
Final Thoughts
Whether you are struggling with anxiety, OCD, or both, there is hope. With the right tools and support, you can break free from the cycle of worry and rituals and feel more present in your daily life.
At ANEW Counselling & Therapy in Barrie, I work with individuals and couples using compassionate evidence-based approaches like ERP. If you are curious about whether OCD therapy is right for you, I would be happy to talk.