Anxiety disorders are the most common mental health conditions in the world. They include generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, and more.
OCD, which stands for “obsessive-compulsive disorder”, was also once classified as a type of anxiety disorder. In 2013, it was moved into its own separate category in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), called “Obsessive-Compulsive and Related Disorders.”[1]
The two conditions, however, still share many similarities. And OCD and anxiety disorders can also co-occur in the same person at the same time. If you suspect that you or someone you love has OCD or anxiety, or both, a mental health professional can offer much-needed insight and guidance.
This page can also help you better understand OCD and anxiety, as it explores:
According to the American Psychiatric Association (APA), anxiety disorders are the most common type of psychiatric disorder. Over 40 million people experience an anxiety disorder in any given year.[2]
All of these disorders share features of excessive fear and anxiety and related behavioral disturbances. But they have been divided into the following types:[3]
Of all anxiety disorders, GAD is the most common.
OCD is the most misunderstood mental health diagnosis. You must have heard someone joke, “I’m so OCD about my desk being clean,” but real OCD is far more distressing than a preference for tidiness.
It consists of:
The obsessions or compulsions must be time-consuming (taking more than one hour per day). For this reason, they cause clinically significant distress in social, occupational, or other areas of functioning. For diagnosis, the obsessive-compulsive symptoms must also not be attributable to the physiological effects of a substance (such as a drug of abuse or a medication) or another medical condition.
OCD has a lifetime prevalence of 1 to 3% and is very disabling. That said, milder OCD symptoms that don’t meet the full diagnostic threshold are estimated to occur in over 25% of adults.[4]
AMFM is here to help you or your loved one take the next steps towards an improved mental well-being.
OCD and anxiety disorders share a lot of similarities. The proportion of OCD patients who also have at least one other psychiatric condition can reach as high as 62%, and anxiety disorders are among the most frequent ones.[5]
Every three in four people with OCD may have a co-occurring anxiety disorder. In fact, in a study of 867 people with OCD, about one in three also had GAD.[6]
According to the National Institute of Mental Health (NIMH), both OCD and anxiety disorders share increased activity in the brain areas called the “amygdala” and the “prefrontal cortex”.[7]
Genetics also plays a significant role in both disorders, as they tend to run in families. Neuroticism is the broad personality trait associated with anxious worrying. It is about 40% heritable and has been shown to independently predict the onset of anxiety disorders and OCD. At the genetic level, OCD and anxiety disorders share roughly 55% of their genetic risks.[8]
People with either condition typically feel a constant fear that something bad will happen, even when there is no clear danger. Their fear is hard to control and interferes with daily life.
The physical symptoms shared between the two conditions include increased heart rate, excessive sweating, shortness of breath, gastrointestinal distress, muscular tension, and fatigue.
Plus, when it comes to mild symptoms, OCD and anxiety disorder presentations can look so similar that they are hard to tell apart. It is only as severity increases that the two begin to differentiate into their distinct patterns.
Despite their many similarities, OCD and anxiety disorders are distinct diagnoses.
In anxiety disorders, worry is grounded in real-life concerns like health, finances, politics, relationships, performance, and so on. All of these are typically rational, logical thoughts about your daily life and the future, and people tend to feel ego-syntonic about them. In other words, the anxiety is connected to someone’s actual fears about their actual life.
In OCD, by contrast, compulsive behaviors are ego-dystonic and may be bizarre. Ego-dystonic means that people with OCD feel that their thoughts are intrusive, unwanted, and inconsistent with who they are as a person.
Anxiety disorders produce excessive worry, but they do not involve the specific, ritualistic behaviors that define OCD. Compulsions are present in OCD but not in anxiety disorders. The compulsive behavior loop is unique to OCD, and this looks like:
An obsession triggering distress → a compulsion temporarily relieving the distress → the obsession returning, strengthened
At the level of brain structure, OCD is due to the dysfunction in the cortico-striato-thalamo-cortical (CSTC) loop.[9] Anxiety disorders also affect the prefrontal and amygdala circuits, but orbitofronto-striatal hyperactivity is specific to OCD.
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. OCD support is a phone call away – call 866-478-4383 to learn about our current treatment options.
See our residences in Southern California’s Orange County & San Diego County.
Take a look at our homes on the east side of the Metro area in Washington County.
View our facilities in Fairfax County, VA within the DC metro area.
The diagnosis of OCD and anxiety disorders requires a detailed clinical interview where you describe your experience to the clinician in your own words. You will be encouraged to talk about:
Your doctor will then map your reported symptoms onto criteria defined in the DSM-5.
Alongside the diagnostic interview, your providers will use validated severity measures to quantify how severe the symptoms are. For OCD, the gold standard severity scale is the Yale-Brown Obsessive-Compulsive Scale.[10] The Generalized Anxiety Disorder 7-item scale (GAD-7) is widely used to screen for and measure the severity of generalized anxiety disorder.
You will likely also undergo some medical workup consisting of laboratory tests and imaging studies to rule out medical conditions that could explain your symptoms, such as thyroid disorders, neurological conditions, or medication side effects. A Brain MRI may be particularly relevant if OCD has a sudden late-life onset.
Yes, a person can absolutely have both OCD and an anxiety disorder at the same time.
A systematic review and meta-analysis drawing on a pooled sample of more than 15,000 people with OCD found a comorbidity rate of 69%.[11] Anxiety disorders were among the most common co-occurring conditions.
Lifetime comorbidity rates for OCD have been reported at 30% for generalized anxiety disorder, 22% for specific phobia, 18% for social anxiety disorder, and 12% for panic disorder.[12]
In the National Comorbidity Survey-Replication, 90% of respondents with lifetime OCD met the diagnostic criteria for another lifetime disorder, out of which anxiety disorders were most common. In 79.2% of cases, OCD began after the comorbid anxiety disorders.[13]
In another study of 867 participants with OCD, GAD was comorbid in 33.56% of cases. Comorbid GAD was uniquely associated with an increased number of avoidant behaviors.[6]
Further, research unfortunately indicates that people with a dual diagnosis of OCD and anxiety disorders exhibit more severe obsessions and compulsions.
While individual treatment for mental health conditions can vary slightly depending on someone’s unique symptoms and background, OCD and anxiety are typically treated in the following ways:
CBT is the first-line psychological treatment for anxiety disorders. It works by targeting the relationship between how a person thinks and how they behave, essentially breaking the self-reinforcing loops.
A systematic review and meta-analysis of CBT for OCD delivered in real-world clinical settings found remission rates of 59.2% after treatment and 57.0% at follow-up.[14]
It has also been shown to produce changes in the brain circuits in the orbitofrontal cortex that are disturbed in OCD and anxiety. In other words, CBT physically rewires the brain circuits that cause OCD and anxiety in the first place.
Exposure and response prevention (ERP) was developed to disrupt the obsession-compulsion cycle.
Every time a person performs a ritual to reduce the distress triggered by an obsessive thought, they teach their brain that the ritual was necessary.
ERP interrupts this cycle as it exposes the person to the triggers of their obsessions. Over time, the person learns that the feared outcome does not happen, and they can tolerate the distress of not acting upon their compulsions.
OCD was once thought to be untreatable, but research on ERP therapy shows great results in reducing symptoms with ERP. So, it is now considered the first-line psychological treatment for the disorder.[15]
For example, a meta-analysis of 30 studies found that ERP produced significant reductions in OCD symptoms and also reduced comorbid depression and anxiety symptoms in OCD patients. Plus, longer ERP sessions were associated with better treatment outcomes.[16]
The medications used to treat both OCD and anxiety disorders belong primarily to a class of drugs called” selective serotonin reuptake inhibitors”, or “SSRIs”. These are antidepressants with strong anti-anxiety and anti-obsessive effects.
The FDA-approved SSRIs for OCD include fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and paroxetine (Paxil).
All SSRIs appear to be roughly equal in their effectiveness, so the choice between them is based on which side effects you can tolerate best.
On average, doses of SSRIs up to two to three times higher than what’s used for depression produce the greatest benefit for OCD. A study of 2,268 patients found that higher doses of SSRIs were associated with better outcomes in OCD compared to low or medium doses.[17]
Clomipramine was the first ever drug found to be effective for OCD. However, compared to SSRIs, clomipramine has a more difficult side effect profile, so it is reserved for people who have not responded to multiple SSRIs.
Some people have such severe OCD symptoms that they do not respond to trials of multiple medications and intensive psychological therapy.
Therefore, they may be admitted to residential programs or intensive outpatient programs that deliver CBT with ERP at a rate of multiple hours of treatment per day.
Transcranial magnetic stimulation (TMS) is also an FDA-cleared treatment option for severe OCD.[18] It uses magnetic pulses delivered through a device placed against the scalp to directly stimulate specific brain regions. It is a non-invasive procedure performed in outpatient settings.
If you or someone you love has been living with the weight of anxiety, OCD, or both, professional support can be very helpful.
A Mission for Michael (AMFM) offers evidence-based, holistic mental health treatment in our treatment centres located in California, Minnesota, and Virginia. We also provide remote psychotherapy services for those who find it more comfortable attending sessions from home.
We are in-network with many major insurance providers, including HMOs, PPOs, and employee assistance programs (EAPs).
Reach out to us for a confidential conversation today.
Complete the form to receive a prompt call back from a member of our experienced and compassionate admissions staff. All communication is 100% confidential.
"*" indicates required fields
At AMFM, we strive to provide the most up-to-date and accurate medical information based on current best practices, evolving information, and our team’s approach to care. Our aim is that our readers can make informed decisions about their healthcare.
Our reviewers are credentialed medical providers specializing and practicing behavioral healthcare. We follow strict guidelines when fact-checking information and only use credible sources when citing statistics and medical information. Look for the medically reviewed badge on our articles for the most up-to-date and accurate information.
If you feel that any of our content is inaccurate or out of date, please let us know at info@amfmhealthcare.com
