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Whats the difference between GAD and OCD?

If you worry and cannot stop you may have Generalized Anxiety Disorder (GAD). If you have unwanted intrusive thoughts that you try get rid of via magical means you may have Obsessive Compulsive Disorder (OCD). But what is the difference between GAD and OCD and how would treatment be different if you had either or both?

In my practice I differentiate OCD from GAD by the presence of "magical thinking". Obsessions will likely be completely unwanted and not in line with your personal values and often quite ludicrous. Someone with OCD may love their family and be very happy in their life and still think "What if I go crazy and murder my family?" They may then have complicated rituals to keep their family safe, but they do not dare to stop them for fear of harm coming to their family. This contains many examples of "magic"; thoughts about harm are dangerous, and a ritual somehow makes them less dangerous!

Meanwhile, another person may worry obsessively about losing their job. The worry is not out of the blue, their company is not doing particularly well. And while they have reassurances from their superiors that they are doing well, the "what if...?" of worry tricks them constantly. Although this may look like OCD, this would be more typical of GAD; a worry about a more "realistic" outcome that does not have an overt compulsion to fix it.

How would treatment look different for these disorders? OCD treatment should challenge the OCD; an exposure to see what really happens if a ritual is dropped may provide some leverage to take life back from the OCD. Treatment for GAD meanwhile may spend time identifying the "worry traps" that catch a person, seeing them in advance, and staying out of them while moving on with their lives. There are more nuances and difference among the two, but this may provide you some insight to use as you challenge yourself continue your life and not the life that OCD or GAD wants for you.

As always talk with your therapist or reach out to find the relief that you deserve from OCD, GAD or both!

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