Generalized Anxiety Disorder (GAD) and Obsessive Compulsive Disorder (OCD)

When people are experiencing anxious thoughts throughout the day, they may look to the books or the internet to figure out the possible causes. Sometimes, they find themselves wondering if their thoughts are more consistent with anxiety-related problems or obsessive compulsive-related problems.

GAD is a type of anxiety disorder that is characterized by excessive and uncontrollable worry. Someone with GAD tends to worry about a lot of different things in their life: work, school, family, relationships, health – and so on and so on.

In recent years, OCD has moved from being in the anxiety disorder section in DSM-IV to its own section as part of the obsessive compulsive and related disorders. OCD is a disorder that leads to unwanted, distressing, or intrusive thoughts (obsessions) and urges to do something over and over again to reduce these anxious thoughts or as rules (compulsions).

Types of worries in GAD vs OCD

In general, worries in GAD tend to be about daily life, such as relationships, finances, work, health, and potentially missing the occasional appointment. These are usually mundane but important parts of our lives.

On the other hand, thoughts in OCD tend to be more ‘magical’ in nature and be based on unusual domains. Examples might include contamination thoughts, such as the house being dirty despite haven cleaned it multiple times; thoughts or urges to harm a loved one; or urges to have a certain symmetry to life (having everything in a certain order).

Partners worrying about finances
Worrying about finances can be a common theme in GAD-related worries

Sticky-ness of thoughts in GAD vs OCD

People with GAD tend to have many worries throughout their day. Although they can be difficult to ‘unstick’ in the moment, their worries tend to change from hour-to-hour or day-to-day. For example, the morning might be about missing their appointment, the afternoon may be focused on finances, and the evenings are for worrying about the next day.

On the other hand, OCD thoughts tend to be much stickier, in that a person is very pre-occupied with the thought all the time. For example, a person with obsessive thoughts about contamination may constantly think about whether something is dirty throughout their day.

Response to worries in GAD vs OCD

Obsessive thoughts can often lead to compulsions – behaviours that are done in response to these thoughts in order to reduce anxiety and feel better (at least in the short-term). In keeping with the contamination thoughts, a person may feel compelled to wash their hands repeatedly to feel clean. These behaviours are usually well above what is necessary – for example, this person may wash their hands for hours a day until their hands are raw.

On the other hand, GAD thoughts may not necessarily lead to compulsions. For some people, they are so stricken with anxiety that it leads to them not being able to do anything because their anxiety paralyzes them. For others, it may be that the worrying itself keeps them feeling safe (“if I am worrying about it, then I will be prepared if something bad happens”).

Worries in OCD tend to be somewhat ‘magical’ in nature – such as a knob still feeling dirty despite disinfecting it multiple times a day

Ego-syntonic and ego-dystonic worries

Perhaps the most important distinction is whether the thoughts are ego-syntonic or ego-dystonic. Ego-syntonic thoughts are those that are consistent with how we see ourselves as people; ego-dystonic thoughts are those that are inconsistent with how we see ourselves.

GAD-related thoughts are typically ego-syntonic. They worry about the topics that are relevant to their values and who they see themselves as. For example, someone who cares about family will worry about their relationships with them and their families’ health. Somebody who cares about finances will worry excessively over potentially losing their job or whether their current finances will support them.

On the other hand, OCD-related thoughts are typically ego-dystonic. Somebody with obsessive thoughts about hurting another person are usually so distressed because they would never consider doing this to somebody. It is this dissonance in what these thoughts are saying and who they view themselves as that creates such strong distress. Another example might be somebody with thoughts about symmetry – they may never thought of themselves as caring whether something was in even or odd pairs, which again creates distress because of these unusual thoughts.

Summary

  • Generalized anxiety disorder and obsessive-compulsive disorder can lead to anxious thoughts that consume a person’s day
  • OCD thoughts tend to be more ‘magical’ in thinking, sticker, and ego-dystonic (inconsistent with how a person views themselves)
  • GAD worries tend to be about daily life, varied on a daily basis, and ego-syntonic (consistent with how they view themselves)
  • Check this post out for more information on common anxiety disorders.

If you found this post helpful, please consider subscribing to the mailing list for more evidence-based information on mental health!

Best wishes,

P