What Is the Difference Between OCD and GAD?

Anxiety is a common part of many mental health concerns. Conditions such as Obsessive Compulsive Disorder (OCD) and Generalised Anxiety Disorder (GAD) are often characterised by symptoms of anxiety as well. Feeling restless, keyed up, or preoccupied can be a major symptom of both disorders. Considering this similarity in emotional experiences, many people find it difficult to distinguish between the symptoms of OCD and GAD. 

If you too have been wondering how to tell these two conditions apart - read on. This blog will help outline some of the differences between OCD and GAD.

Let’s start with the basics - what are OCD and GAD?

Obsessive Compulsive Disorder (OCD) is a disorder that is characterised by unwanted, intrusive thoughts (called ‘obsessions’) and repetitive behaviours that are geared towards reducing the discomfort caused by the thoughts (referred to as ‘compulsions’).

Generalised Anxiety Disorder (GAD) is an anxiety disorder that is characterised by excessive worrying across many different dimensions (work, social life, family). The anxious thoughts tend to take up a large portion of one’s day.

Although these conditions share some similarities - feeling anxious being one of them - there are some hallmark features which can help tell them apart. Let’s dive in.

The Presence of Compulsions - yes or no?

A major differentiating factor between OCD and GAD is the presence of compulsions. Compulsions - repetitive behaviours which help reduce stress such as checking, counting, or cleaning - are a defining aspect of OCD. Compulsions can look different for different people, but they all stem from the belief that engaging with them can prevent a negative outcome from occurring. For example, a person diagnosed with OCD might believe that the only way to prevent an accident is to count to 7 before crossing any road. If your symptoms include the presence of compulsions, it is more likely to be a case of OCD. However, please note that a formal diagnosis for your concerns can only be provided by a trained psychiatrist after a thorough evaluation and assessment. 

Alternatively, those coping with GAD might try to manage their symptoms by avoiding stressful situations, asking for reassurance from loved ones, or by preparing for worst case scenarios. These strategies provide short-term relief by helping you feel more in control of your anxious thoughts. However, over time, they can start to take a toll on your quality of life. A trained therapist can help you find more sustainable ways of managing your symptoms. 

Thought Content - what are we thinking about?

Both OCD and GAD are accompanied by a host of anxious thoughts. Observing what these thoughts are saying can be an important way of distinguishing between the two conditions. 

In OCD, our thoughts are typically improbable or unrealistic. I need to unlock my car door thrice to prevent an accident; I must arrange my desk in a particular manner to pass my test. People suffering from OCD might be able to recognise the slightly magical nature of these beliefs, but the thoughts themselves feel very real and cause a lot of distress. 

On the other hand, thoughts in GAD tend to focus on more probable concerns. What if I lose my job; How will I adjust to my big move? While these worries are grounded in reality, the anxiety associated with them is extreme, persistent, and often disproportionate to the thought.  

The Number of ‘Worries’ - one or many?

The number of anxious thoughts one experiences also differs between OCD and GAD. With OCD, one tends to zoom into a specific thought or stressor. That one thought keeps swirling around, taking up brain space and causing anxiety. 

Conversely, with GAD, there are a host of different thoughts and stressors. One’s mind might flit from one worry to the next, such that they are left with a general sense of being constantly overwhelmed.

Treatment Methods - ERP and CBT

Ultimately, distinguishing between OCD and GAD is important because the way in which they are treated differ. Evidence suggests that the best type of therapy for OCD is Exposure and Response Prevention (ERP).  ERP is based on the idea that repeated practice or exposure in a gradual manner can help reduce distress. In ERP therapy, your therapist will guide you to engage in activities which might initially be anxiety inducing with the goal of reducing distress over time.

Alternatively, GAD responds best to Cognitive Behavioural Therapy (CBT). CBT is a form of therapy that is based on the idea that how one thinks influences the way they feel and behave. A CBT therapist will help you identify negative thought patterns and work with you to develop a more balanced way of viewing the world. CBT also uses specific relaxation and coping strategies to help one manage their anxiety. 

The important thing to remember is that although OCD and GAD are two distinct, distressing conditions, they both respond well to the right treatment. If you or someone you know is experiencing symptoms similar to either of these conditions, seeking professional support can help. A qualified mental health professional can help you make an accurate diagnosis and can help you create an intervention plan that is tailored to meet your unique needs.