Although obsessive-compulsive disorder (OCD) can involve high anxiety levels, doctors no longer classify it as an anxiety disorder.
Obsessive-compulsive disorder (OCD) is a highly misunderstood condition. One of the many myths about OCD is that it’s an anxiety disorder.
While anxiety can be a feature of OCD, the most recent versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) or the International Statistical Classification of Diseases and Related Health Problems (ICD-10) do not classify it as an anxiety disorder.
It’s possible, however, to have OCD as well as an anxiety disorder.
Anxiety disorders include:
- generalized anxiety disorder
- panic disorder
- specific phobia
- social anxiety disorder
- separation anxiety disorder
- selective mutism
It’s possible to have multiple anxiety disorders at the same time. It’s also possible to have OCD as well as one or more anxiety disorders.
Clinicians in the United States use the DSM to diagnose mental health conditions like OCD. The manual also categorizes and describes other conditions.
The manual is periodically updated. The latest edition — the fifth edition text revision — is called the DSM-5-TR.
OCD was first included in the third edition of the DSM, published in the 1980s. In the DSM-III, OCD was classified as an anxiety disorder.
The DSM-IV also classified OCD as an anxiety disorder.
In the DSM-5, OCD was moved to the new category of Obsessive-Compulsive and Related Disorders.
The diagnostic criteria for OCD also
Mental health conditions in the obsessive-compulsive and related disorders category include:
- body dysmorphic disorder (BDD)
- excoriation (skin picking) disorder
- hoarding disorder
- obsessive-compulsive disorder (OCD)
- obsessive-compulsive and related disorder due to another medical condition
- other specified obsessive-compulsive and related disorder
- substance/medication-induced obsessive-compulsive and related disorder
- unspecified obsessive-compulsive and related disorder
Anxiety is a feeling of intense worry. While anxiety disorders are mental health conditions, feeling anxious from time to time is not the same as having an anxiety disorder.
Still, people may colloquially refer to their anxiety disorder as “anxiety.”
People with OCD, on the other hand, experience persistent, unwanted, intrusive thoughts (i.e., obsession). They may then engage in repetitive behaviors to try to reduce the thought or the anxiety associated with the thought (i.e., compulsion).
Someone with OCD might realize that these repetitive actions are not necessarily helpful but find it difficult to stop carrying out these compulsions — like scratching an itch.
You can have OCD and an anxiety disorder at the same time.
OCD involves two main components: obsessions and compulsions.
Obsessions are unwanted and intrusive thoughts that are difficult to suppress. These thoughts might keep returning again and again.
Anything can be a focus of your obsessions — examples range widely. But some common themes include:
- fears of harming yourself or someone else (harm OCD)
- fear that you’re not actually the sexual orientation you identify with (sometimes called homosexual OCD)
- fears of saying something offensive, rude, or obscene
- thoughts or images that are violent
- thoughts or images that are sexually explicit
- fear about throwing things away
- fear about getting ill
- intrusive images, words, or sounds
- questioning your relationships or feelings about someone (relationship OCD)
- thoughts you believe to be blasphemous or immoral (scrupulosity)
- mentally replaying past events (real events OCD)
Compulsions are repetitive rituals, behaviors, or actions that you engage in to either get rid of the thought or reduce the anxiety around the thought. These compulsions may be physical (like washing your hands or counting your steps) or mental (like thinking positive thoughts or praying).
Common compulsions include:
- avoiding or hiding knives, scissors, and other potentially dangerous objects
- checking and re-checking whether you’ve locked doors, turned off the gas, and more
- collecting certain items
- counting objects, steps, or actions
- mentally replaying your actions to check if you’ve hurt anyone
- organizing or arranging objects in a specific way
- repeating specific phrases
- seeking reassurance from others or through research
- washing your hands, objects, or body excessively
Anyone may experience intrusive thoughts from time to time. Experiencing intrusive thoughts doesn’t necessarily mean you have OCD. Likewise, many people have habits or rituals without having OCD.
But if you have highly distressing intrusive thoughts and have the compulsion to engage in certain rituals to get rid of them, you might want to seek treatment. Speaking with a therapist may help you find some relief.
OCD isn’t classified as an anxiety disorder. However, OCD is often accompanied by high anxiety levels.
If you suspect you have OCD or an anxiety disorder, it’s a good idea to speak with a mental health professional. Therapy can help you cope with your distress and feel better. Learn more about finding the right therapist and accessing additional mental health help.
Here’s a full list of Mental Health Resources to help you find care.