October is Obsessive Compulsive Disorder (OCD) Awareness Month, and there are a lot of people right now who don’t even know they have it. A reason why? Instead, they think they suffer from anxiety.
It’s not such a surprise; the two mental health diagnoses overlap to some extent. For example, OCD is partly accompanied by feelings of anxiety, Simone Leavell-Bruce, PsyDa psychotherapist specializing in OCD, previously said Women’s health. If you ask him: “OCD is like anxiety on steroids. »
Meet the experts: Simone Leavell-Bruce, PsyD, is a North Carolina-based psychotherapist specializing in OCD. Levi Riven, PhDis a clinical psychologist and founder of Riven Psychology.
There’s just one important thing: OCD requires an entirely different treatment than anxiety, and traditional anxiety therapy might actually make OCD worse. So it is certainly It’s worth knowing the difference between the two. About one in 40 adults in the United States has OCD, with signs appearing most often between ages 7 and 12 and in early adulthood, around age 20, the study found. International OCD Foundation. Women also seem more susceptible to this disease; an exam completed that women may be 1.6 times more likely to suffer from OCD than men.
Here are the main signs therapists look for when diagnosing OCD and how they distinguish it from anxiety.
The main differences between OCD and anxiety
Your concerns are unusual for others.
While generalized anxiety disorder tends to focus on everyday fears, the worries—or obsessions—related to OCD are more novel, especially for those who don’t suffer from it.
Let’s take this as an example: the night before a big presentation at work, an anxious person might stay up all night with racing thoughts about all the ways it could go wrong the next day. What if I fail? Have I practiced enough? I hope I can achieve this. For a person with OCD, worries are less rooted in daily reality. Instead of being entertained by thoughts about preparation or worrying about whether people will enjoy their presentation, they might have intrusive thoughts such as impulsive swearing or racial slurs during the presentation. What if I offend people? Have I ever done anything like this before? Am I a bad person?
Obsessions can also often be wacky, surprising and taboo. Some common themes of OCD revolve around worries that you are secretly a pedophile, intrusive thoughts that you have harmed others – or that you have the capacity to do so – and confusing, all-consuming doubts around your sexuality.
This brings us to a central element of OCD: obsessions are usually ego-dystonic, meaning they contradict a person’s value system, morals, and self-perception. Levi Riven, PhDan Ottawa-based psychologist, said. (As in: This person who fears being a pedophile is not.) The things that people with OCD worry about – like hurting someone – are actually the things they would least like to do. “That’s what makes OCD so scary: It hits you with something that you just don’t recognize in yourself,” Leavell-Bruce said.
Common obsessions include:
Contamination, or the extreme fear of encountering germs, diseases, or dirt that could infect you
Fear of hurting someone, or of having already done so, but you don’t know or remember.
Excessive worry about your healthsuch as having an undiagnosed illness or that you will develop one
Overwhelming worry about things being equal, orderly, or feeling “perfect”
You follow each obsession with a compulsion.
Every case of OCD will include compulsions, Leavell-Bruce said; they may just not be what you think. When most people think of OCD, they probably think of compulsive hand washing, cleaning, or other physical rituals, but many compulsions can occur entirely in your own head.
Instead of a physical check or seeking external reassurance, many people with OCD will go through an internal check or rumination process to feel better, Riven said, and it can look a lot like what someone does when they’re anxious.
Common constraints include:
Avoidance of a stressful stimulus or thought
Constantly ask others for reassurance
Check that you have or have not done something
Excessively cleaning a space or yourself
Ruminating excessively on an obsession
Make sure everything is okay
A recent study published in Psychological assessment who surveyed 641 OCD patients found 62 unique compulsion rituals among the patients. Among this wide range of physical and mental rituals, avoidance, reassurance, control, and cleansing/handwashing were the most common. Of these, avoidance, seeking reassurance, and checking can all make it seem like a person is simply anxious about something, instead of carrying out a compulsion.
Compulsions are also central to OCD treatment (more on this later). But essentially, performing – or not performing – these rituals can mean the difference between reducing OCD symptoms or making them worse.
Your rumination – or deep thinking process – is different.
Since rumination can also occur in generalized anxiety disorder, it may be difficult to identify it as an OCD-related compulsion. Rumination is when someone thinks deeply about a particular concern for an extended period of time in hopes of understanding it better.
A person with generalized anxiety disorder will use rumination as a way to “anticipate possible disasters and find ways to prevent them,” Riven said. They may weigh future choices against each other (such as how much preparation to prepare for a presentation) and insist on making the wrong decision.
During this time, a person suffering from OCD-related rumination compulsions will be trapped in rumination cycles where they may review and analyze memories of past actions, check their own interests and desires, or even try to override “bad thoughts” with “good thoughts.” While classic anxiety rumination focuses on catastrophic events and possibilities about the future, OCD rumination often focuses on world catastrophes. self: reassure yourself whether something happened or not, or check your memories and emotions to make sure some intrusive thoughts aren’t true.
Let’s say a person with rumination OCD fears saying an insult during their work presentation. The night before, they might stay up examining their emotions about the insults to be sure they don’t actually mean to use them and examine their memories to gather “evidence” that this behavior has never happened before. OCD rumination involves finding evidence that something happened or didn’t happen, or that something about you is true or false.
Traditional therapy doesn’t help you feel better.
In typical cognitive behavioral therapy (CBT)A therapist will analyze a patient’s anxiety to help them understand where it’s coming from and reframe threats, Riven said. CBT talk therapy is widely considered the best therapy for the treatment of generalized anxiety disorders, according to the National Institute of Mental Health. But for someone with OCD, trying to understand an absurd obsession only makes things worse. If someone has the intrusive thought that they might hurt someone (a common OCD obsession), for example, there is little benefit in trying to understand where that thought comes from in their personal history, because it simply isn’t based on much of anything. (Again, OCD-related thoughts tend to run counter to what a person actually believes and/or wants.)
“If it’s not clear that a person has OCD and they are simply expressing anxiety, a supportive and well-meaning therapist might work to reassure them, which actually maintains the cycle of doubt,” Riven said. Think of it like this: Performing a compulsion like seeking and getting comfort is almost like rewarding a dog with a treat every time it barks, Leavell-Bruce said. This reinforces the fact that whatever your obsession is, it poses a real threat to you and deserves your attention, which makes it stronger. Getting specialist support from a therapist trained in OCD care – which may not just give you peace of mind – can make all the difference.
Ultimately, only a credentialed professional can tell you if you have OCD or anxiety.
So if you think you might be one or the other, it’s always a good idea to ask for help. Another thing OCD and anxiety have in common: they are highly treatable. Don’t hesitate to ask for help!
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