Is OCD Actually An Anxiety Disorder?

Anxiety is often a significant symptom in those affected by obsessive-compulsive disorder (OCD), but is it an anxiety disorder? According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), obsessive-compulsive disorder is not usually categorized as an anxiety disorder, although some organizations may still view it as such. In general, OCD consists of intrusive mental obsessions and resulting compulsions that may temporarily relieve anxiety. It may also involve various tics. Like anxiety disorders and other mental health conditions, OCD can be treated with a combination of therapy and medication. You can start your OCD treatment journey by connecting with a licensed therapist online.

What is obsessive-compulsive disorder?

When people think of obsessive-compulsive disorder (OCD), the thought of someone aggressively cleaning or being extremely hygienic usually comes to mind. However, obsessive-compulsive disorder is usually much more complicated than that. Obsessive-compulsive disorder is a mental health condition characterized by unwanted thoughts and repetitive behaviors. The obsessions and compulsions of this mental illness can lead to elevated anxiety levels, and some symptoms of OCD mimic those of anxiety disorders. 

While the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) no longer classifies OCD under anxiety disorders (instead listing it under obsessive-compulsive and related disorders), it includes specific criteria required for OCD diagnosis, including the following.

Obsessive behaviors

• Recurrent and persistent thoughts, impulses, or images that are intrusive and cause marked anxiety or distress, in contrast to worrying about a real-life issue.
• A purposeful attempt to ignore these thoughts, impulses, or images by thinking about other things.
• A knowledge that the obsessions are a product of their mind, as opposed to being delusional.

Compulsive behaviors

• Repetitive actions (physical or mental) that the person feels compelled to perform in response to an obsession.
• The behaviors or mental actions usually prevent or reduce distress toward a particular setting.
• Actions might not always be affiliated with the content of the obsessive theme.
• The symptoms are not typically caused by something else, such as a concurrent psychiatric condition or a substance.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

According to the Diagnostic and Statistical Manual of Mental Disorders, for an individual to be diagnosed with OCD, obsessions and compulsions must take up at least one hour each day or lead to significant impairment or distress.

Manifestations

OCD can present early in life, most commonly appearing during adolescence and adulthood. No matter the age, OCD can take many forms and vary between individuals. People with this condition can have compulsions, obsessions, or both, and they can be so severe that they interfere with daily life. Symptoms of OCD can improve or worsen over time.

Signs and symptoms of OCD can include the following.

Common obsessive behaviors

• Fear of contamination or germs
• Aggressive thoughts toward self or others
• Unwanted taboo or forbidden thoughts involving harm, religion, or sex
• Needing things to be symmetrical or in order

Common compulsive behaviors

• Excessive hand washing or cleaning
• Repeatedly checking things, like making sure the stove is off or the door is locked
• Counting
• Arranging things in a precise way

Sometimes, people may do these things as a habit; not every ritual is necessarily a compulsion. But someone with OCD normally won’t be able to control these thoughts, even if they recognize that they are excessive. They do not typically get pleasure from them, but they may experience relief from anxiety after performing them. People with OCD usually spend at least one hour on these rituals every day, and they can lead to significant problems in their daily life.

Tics

While Tourette syndrome may be the best-known tic disorder, some people with OCD experience motor or vocal tics. Motor tics can be defined as brief, sudden, repetitive movements, like shrugging the shoulders or jerking the head. Vocal tics can include sniffing, grunting, or repetitive throat clearing. Tics can intensify when individuals are faced with stressful events.

OCD versus anxiety disorders: What's the difference?

OCD and anxiety disorders used to be closely linked, but the Diagnostic and Statistical Manual of Mental Disorders no longer classifies OCD as an anxiety disorder.

That said, some organizations, like the Department of Health and Human Services, may still consider OCD an anxiety disorder.

Treatment options

Treatments for OCD and anxiety may be available. If you believe you’re experiencing symptoms, one of the first steps you could take is to get a diagnosis from a licensed professional. This diagnosis may allow you to get treatment for OCD and anxiety, usually in the form of therapy, medication, or a combination of the two.

A form of psychotherapy known as cognitive behavioral therapy (also known as cognitive behavior therapy or CBT) has often been particularly successful for those diagnosed with OCD. It usually requires the individual to confront the sources of their fears and anxiety. 

The confrontation strategy is normally a specific type of CBT known as exposure and response prevention (ERP). ERP is a type of therapy that typically results in modifying thoughts, perceptions, and emotions in problem areas. In a sense, you can train your brain to react differently (or not respond at all) to something that was once dreadful.

Psychiatric medication can also be one option for those with OCD, but you should always speak to your doctor or psychiatrist regarding medication options. OCD is known to affect people differently; the best treatment is one that is tailored for you by a team of healthcare professionals.

Navigating OCD with therapy

If you’re living with OCD, online therapy can be a vital part of your treatment plan. 

Online therapy often has many benefits. You don’t usually have to worry about making phone calls to find a nearby therapist with open appointment slots or commuting to their office. With online therapy, the process can be simple. After you sign up, you can be matched with an available therapist to start treatment from the comfort of your home. You can usually reach out to your counselor outside of sessions as well; if you’re overwhelmed, you can send in-app messages, and your therapist will typically get back to you as soon as they can.

Online therapy for symptom management

Research suggests that online therapy for obsessive-compulsive disorder can be one effective form of treatment. A 2012 Cambridge study found that internet-based cognitive behavioral therapy is effective in decreasing symptoms related to OCD, saying, “[Internet-based cognitive behavioral therapy] is superior to the control condition in improving OCD symptoms, depressive symptoms, and general functioning.”