This or That? Anxiety vs OCD.
Is It OCD or Anxiety? How to Tell the Difference Between OCD, GAD, and Overthinking
Ever find yourself Googling, “How do I know if I have OCD?” and then immediately wondering if Googling that was also part of the problem?
Or maybe your brain just will. not. shut. off!
Now you are replaying conversations from three days ago, or maybe you are imagining every possible outcome before making a decision. You wonder, “What if I’m wrong?” or “What if something bad happens?” You think through a situation from approximately 47 (yes) different angles, just to make sure you’re prepared.
And now, on top of all of that, you start to wonder: Is this anxiety? Is it overthinking? Or could it be OCD?
Anxiety, generalized anxiety disorder (GAD), and OCD can overlap in ways that make it hard to tell them apart. All can involve worry, intrusive thoughts, uncertainty, and that deeply annoying feeling of needing to figure something out before you can relax. There are some important differences though. Let’s break it down.
First: Is Overthinking a Mental Health Diagnosis?
Nope.
“Overthinking” is not an official mental health diagnosis. It’s more of a catch-all term people use when they spend a lot of time analyzing, worrying, replaying, predicting, or trying to figure things out. Overthinking can show up with anxiety, OCD, depression, perfectionism, ADHD, or simply during a particularly stressful season of life.
The tricky part is that overthinking can feel super productive.
Your brain may tell you:
“I’m not spiraling. I’m just being prepared.”
“I’m not obsessing. I’m just trying to understand what happened.”
“I’m not stuck. I just need a little more information.”
I’ve been there! A lot. But sometimes, all of that thinking becomes a way to avoid uncertainty, discomfort, or the possibility of being wrong. It might feel productive or even protective, but unfortunately, your brain is kind of like a toddler in this regard: the more attention you give it, the more it learns that it should keep asking for attention (sorry to all the toddlers reading this).
What Does Generalized Anxiety Disorder (GAD) Look Like?
People with generalized anxiety disorder often experience excessive worry across multiple areas of life.
That might include:
School or work
Relationships
Health
Money
Family
The future
Making the “right” decision
Things that have already happened
Things that could potentially maybe possibly happen someday
The worries may shift around, too. Maybe you finally solve one problem, only for your brain to immediately say, “Great. Anyway, what about this other thing?”
Someone with GAD might worry:
“What if I get sick?”
“What if I make a mistake at work?”
“What if my partner is mad at me?”
“What if I made the wrong decision?”
“What if something happens to someone I love?”
The goal behind the worrying is often to feel more prepared or prevent something bad from happening.
The problem is that your brain never quite feels prepared enough. The goal post is always moving.
People with GAD may also experience physical symptoms like restlessness, difficulty concentrating, muscle tension, irritability, fatigue, or trouble sleeping. Basically, your nervous system can start acting like there is a bear chasing you when you are, in fact, sitting on your couch trying to watch a tv show.
What Does OCD Look Like?
OCD also involves anxiety, but it is more than “being super organized” or liking things a certain way. OCD involves obsessions and compulsions.
Obsessions are unwanted thoughts, images, urges, sensations, or doubts.
These thoughts can feel disturbing, confusing, or completely opposite to who you are.
Examples might include:
“What if I hurt someone?”
“What if I’m secretly a bad person?”
“What if I contaminated myself or someone else?”
“What if I accidentally cheated?”
“What if I’m not actually attracted to my partner?”
“What if I made a terrible mistake and don’t remember?”
“What if I can’t be 100% sure?”
The key thing to understand is that having an intrusive thought does not mean you want to act on it! In fact, OCD often latches onto the things you care about most. It attacks your values, which is obviously super distressing.
Compulsions are things you do to try to get relief or certainty.
Some compulsions are easy to recognize. You may repeatedly wash your hands, check the stove, arrange things until they feel “right,” or ask other people for reassurance.
But compulsions can also happen internally. This is where people with OCD often think, “But I don’t do any rituals. I just think about it a lot.”
Mental compulsions can include:
Replaying memories
Reviewing conversations
Trying to “figure out” what a thought means or “making meaning” out of an intrusive image.
Mentally checking your feelings
Comparing yourself to others
Googling for answers
Asking for reassurance
Trying to prove a fear is not true
Analyzing every possible scenario
Checking your memory
So yes, sometimes overthinking is actually a compulsion. The thought itself may not be the problem. The issue is the repetitive cycle of trying to get rid of uncertainty through analyzing, checking, or seeking reassurance.
So, Is It OCD or Anxiety?
Here is one helpful way to think about it.
With generalized anxiety, your brain tends to worry about many real-life possibilities:
“What if I fail this exam?”
“What if I lose my job?”
“What if something happens to my family?”
With OCD, there is often an obsession followed by an attempt to gain certainty or reduce distress:
“What if I secretly did something terrible?”
“I need to replay what happened until I know for sure.”
“What if this intrusive thought means something about me?”
“I need to Google this and make sure.”
But there can absolutely be overlap. Someone can have both OCD and generalized anxiety disorder. You also do not need to perfectly diagnose yourself before reaching out for therapy.
Seriously. You are not expected to show up to your first session with a PowerPoint presentation titled, “Here Is My Differential Diagnosis Justitication.”
Part of therapy is figuring out what is happening and finding the right approach!
Why Reassurance Can Keep the Cycle Going
One of the biggest things I see in OCD and anxiety therapy is the search for certainty.
You might tell yourself:
“If I could just know for sure, I could finally relax.”
And for a minute, you might! I get it.
You ask someone, “Do you think I’m a bad person?”
They say no.
Relief. Yay!
But then your brain says:
“Okay, but what if they’re wrong?” or “What if they are lying to me because they don’t want to hurt my feelings?”
And suddenly, you need reassurance again.
This is why reassurance, checking, Googling, analyzing, and mentally reviewing can become so exhausting. They work temporarily, but they teach your brain that uncertainty is dangerous and that you need to perform a certain action before you can feel okay. This is where OCD treatment and anxiety therapy can help you learn a different response.
What Is ERP Therapy?
For OCD, one of the most effective treatments is Exposure and Response Prevention (ERP). ERP therapy helps you gradually face situations, thoughts, or feelings that trigger anxiety or uncertainty while learning to reduce compulsions and other responses that keep the OCD cycle going. For example, if someone repeatedly checks whether they locked the door, ERP might involve practicing leaving after checking once and allowing uncertainty to be there.
And no, it’s not because therapists just love making clients uncomfortable. We don’t! The goal of ERP is to teach your brain:
“I can handle feeling uncertain without doing a ritual to make the feeling go away.”
That is a very different message from:
“I need to feel 100% certain before I can move on with my life.”
In therapy, I also incorporate approaches like Acceptance and Commitment Therapy (ACT), which can help you learn how to make room for uncomfortable thoughts and feelings while still taking action toward the life you actually want. Instead of OCD attacking your values, I help you learn how to actually live them out loud.
The goal is not to never have another anxious or intrusive thought. Sorry, I wish that was possible but it’s not. I wish I could hand you that service, for free, forever. Unfortunately, brains are going to brain. Instead, the goal is to become less controlled by those thoughts. I want YOU back in the driver’s seat of your own life.
You Don’t Have to Figure This Out Alone
Whether you are dealing with OCD, generalized anxiety, constant overthinking, or a combination of all three, you deserve support. You also do not need to wait until your symptoms are “bad enough.” If your brain feels constantly busy, you spend hours stuck in mental loops, or anxiety is getting in the way of your relationships, school, work, or ability to live according to your values, therapy can help.
I provide OCD therapy and anxiety therapy for teens and young adults in Chicago, including specialized treatment for intrusive thoughts, compulsions, excessive worry, perfectionism, reassurance-seeking, and feeling stuck in your own head.
For teens and young adults, life can already come with approximately 8,410 things demanding your attention. You do not need your brain adding a full-time job of trying to solve every possible uncertainty, too.
You may not be able to stop every anxious thought from showing up, but you can learn that you do not have to answer every thought, solve every doubt, or wait until you feel completely certain before living your life.
Your brain deserves a break. You deserve to live a life worth living.
If you’re looking for a therapist in Chicago who specializes in OCD and anxiety therapy for teens and young adults, I’d love to help.
