Is It GAD Generalized Anxiety Disorder or OCD?

Do you have GAD Generalized Anxiety Disorder or OCD Obsessive Compulsive Disorder? Have you wondered about the difference between GAD and OCD?

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People with GAD and OCD have worries and anxiety and rumination and catastrophize and run through what-if scenarios.

And they also are over-thinkers and have difficulty tolerating doubt and uncertainty.

There is an overlap in symptoms between people with GAD and people with OCD, but I want to point out some key differences so that you know the difference as that affects your treatment.

1. First, people with OCD have what we call “sticky thoughts”. The thoughts, images or sensations can get stuck and become obsessive.

People with GAD have worries that jump around from one topic to the next. And although the worries may be excessive, they are not the same worry, repeatedly.

2. That brings us to the content of thoughts. People with OCD experience obsessive thoughts that are the opposite of their character and opposite of who they are and what they value. We call this ego dystonic.

People with GAD typically have worries surrounding what they are doing or going to do.

3. And the third difference concerns rituals and compulsions.

People with OCD may do physical compulsions and rituals like washing, blinking, checking door handles, tapping, re-doing things to get a just-right feeling, etc.

They may also have mental compulsions like ruminating, analyzing, replaying things, repeating things, counting, neutralizing bad thoughts with good thoughts.

The purpose of the compulsions is to self soothe, and lower their anxiety and discomfort, although the behaviors actually feed the OCD cycle.

For people with GAD, they typically do no perform rituals and compulsions like in people with OCD, but they can have some of those behaviors. And they often do have avoidance behaviors and ruminate and do other behaviors that may maintain their anxiety cycle as well.

It is important to know whether you are experience GAD or OCD, because this ultimately affects your treatment. A trained therapist is going to interview you to review your symptoms and history and include assessments like Yale-Brown obsessive compulsive scale and the DASS and other measures before giving a diagnosis.

And, to make things a little more complicated, it is possible to have both conditions.

As far as treatment goes, the gold-standard treatment for OCD is ERP, Exposure and Response Prevention as a first line of treatment. There are other therapies like ACT and mindfulness, and medications that may be added to the treatment as well.

For GAD, ERP can also be effective for some, and other therapies focused more on thoughts like CBT’s cognitive restructuring or ACT therapy using cognitive defusion along with acceptance and mindfulness-based therapies.

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Paige

Intro: An Ocean Full of Characters by Trevor Kowalski
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(Although Paige Pradko is a licensed psychotherapist, the views expressed on this video and this YouTube channel including comments or any related content should not be taken for medical, psychological, or psychiatric advice. Always contact your physician and mental health provider before making any decisions related to your physical or mental health.)

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[joshuaandrews]

I feel like I experience both of these. My worries generally tend more toward the everyday kinds of things (though not exclusively) but it isn’t frantic and all over the place. My response to the worries feels more like OCD as I tend to ruminate over a single fear and get caught in thought loops over that fear for long periods of time.

[wonderland]

Perfect timing seeing this video. For all my life, I was diagnosed with GAD up until recently. I was told I have OCD. makes total sense!

[laura-janeluff]

Hello from the UK. Thank you ever so much for this explanation. My counsellor brought you and your videos to my attention. I have watched a few and we believe I have OCD (Pure O) intrusive thoughts but now I feel I also have GAD. I'm gradually putting pieces of the puzzle together and learning more to try to help me. Thank you again 😊

[RhiannonlivesforRamen]

Thank you for this video. I've recently got a new therapist who within half an hour of speaking to me said he thinks I have GAD and not OCD which I was diagnosed with 8 years ago. I was starting to think he might be right but I've done a lot of research on OCD and it's always sounded more like those symptoms, however when the OCD isn't ruling my life it feels a bit like GAD. Now I feel like i can explain my thought patterns better to him so I really appreciate the explanation ❤

[biengfunny]

Wow awesome doc.. this is exactly what I feel.. because I'm a perfectionist i over thinking what I fell in my body, I worry alot.. and i beginning to feel anxious that's how my health anxiety.. but time after time I learned to handle the situation.. I don't think that much anymore of my worries.. and I'm ok.. and I'm very thankful for all the technique and advice doc I learned a lot.. every videos you made.

[kimberleefarr]

Diagnosed with GAD in 2009. After hundreds and hundreds of appointments, finally diagnosed with pure O.

[BeingBetter]

Paige, I wanted to write you this personal note to tell you about my progress. I know it's not a doctor-patient relationship, . but I want you to know. Partially with some of the things you've taught me and many other tools in my toolbox, a trip that was 7 hours on the road including highways! I'm choking back tears, my voice is wavering while I'm trying to talk to my voice dictate on my phone, and hope it understands me. My life is so beautiful and rich now, I just didn't believe it, I didn't believe in myself. You were one of those people who believed in me, and I'm so grateful for that. I don't care if this comment is embarrassing or it makes me feel awkward later, I want you to know how much I appreciate your guidance in these videos.

Paige, sometimes the anxiety would manifest as a fear of bridges and elevators, but I've got IN an elevator with my husband, I grabbed his arm and 4 of us were in an elevator. The doors opened, and I walked out alive! We crossed the Norman Wood Bridge in Pennsylvania, took at least 30 seconds to cross and I felt so much panic I knew I was going to die that moment I was going to face the eternity in the end of all things. I tried Claire Week's relaxation tips, and shut my eyes. We made it across, as soon as we were on the other side not caring how crazy I looked, I shouted and screamed with joy.

This is good, noble work that you do.

[arjunmrao]

GAD & OCD .... The difference b/n these explained very very well in this video....only a sufferer can understand the subtle difference b/n these 2 .... I am largely healed so therefore with a calm mind I can understand and relate to what you have explained here (YOU HAVE EXPLAINED IT VERY WELL HERE) .... People neck deep in trouble with OCD etc may not be able to understand clearly what you are saying here, Most people live with their problems rather than seeking help, Your Explanation is awesome, in myself the alarm system overall doesn't go off Soo Often like it used to in the past, my mind is pretty well organized & compartmentalized overall rather than getting clouded muddled and jumbled at the drop of a hat (Thanks to you Paige Madam) .... Even under stress my mind stays grounded largely, The Logical Mind takes over after a moment or two of worry .... But your above video is incomplete, my friend is not seen sitting on the sofa behind you .... Also You have lost weight I Feel (Good Development)

[DrPatrickKingsep]

Hi Paige - GAD and OCD - helping people to understand the differences between these two conditions. Interesting video and I think will help many people struggling with symptoms and unsure what the reason is for it.

[paromitadesarkar]

got my answer to the question i asked in another video of yours . thank you. Very grateful for you.

[angeloserenuela]

keep working maam! OCD sufferers need you

[ranc]

It is possible to have both GAD and OCD :(
Where there is pull back push forward and you stay stuck. OCD means to accept worry thoughts, whereas GAD means actively stopping worries. And if you fight thoughts you will fight GAD, and in the same time you will nourish OCD. If you accept thoughts and shift focus, you starve OCD, yet GAD stays in the background as hovering hard-to-spot hypervigilance.

CBT cognitive restructure would make you tolerate toxic people and toxic environment, labelling narcissists as someone who has no influence over your emotions, while in the same time is it fact that long term exposure to narcissistic abuse causes brain injury. CBT will instruct you to interact and expose yourself - which means going along with abuse and mocking and responding and reacting to drama and you get sucked in into fantasy world of narcissist - because you have no boundaries to set - since CBT will explain that your panic symptoms and red flags are pathological and hallucination.

[boniefunelas]

Filipino subscriber here. I really appreciate all your videos about anxiety and panic attacks. It really helps me a lot specially the CALM and MEWS method. Looking forward to more helpful contents.

[meneerdegraaf]

I feel like what I have is OCD, although I rarely do any physical compulsions. The thoughts I'm having are mostly 'magical' and I feel like I'm afraid it's something I taught myself. I used to go into very intensive therapy for OCD/GAD (not really sure what it was) but mostly for constant rumination and anxiety. I could constantly ruminate on things like 'did I tell someone something about another someone I wasn't supposed to that will now be bad for that other someone' or 'do I have something on my hands that can make someone else sick if they touch me or something I touched'. While in therapy, which was partly group based, I heard the thoughts that others had, like sexual intrusive thoughts with children, or being afraid you hit something with your car, or thinking you may have heard someone call for help, which caused an 'oh no, I could think these thoughts as well' coupled with the anxiety I was feeling. I somehow managed to overcome a lot of it, also with help of medication (fluoxetine) and have had some moments in the past 7 years where my head started 'acting up' again. But for a few months now, I feel like I'm having a major relapse. I quickly contacted my general practitioner and have restarted my fluoxetine (which I have tried to slowly stop using, which seemed to go ok for a long time), while also applying for specialized mental health support, which will take 30+ more weeks before there is space for me. Based on my history, they want to offer me a GIT-PD treatment, which simply put is meant to treat personality disorders. Although I do feel like there are certainly aspects in my personality that may hinder me, I am currently dealing with this intense fear again that I could have and ruminate on any thought. I feel like I have the craziest thoughts, like 'did I somenow get a small piece of glass on my hand that hurt someone else in some way' or 'does this (it can literally be anything) make me horny/aroused' or 'did I accidentally damage someones car while brushing by it, even if I made no contact at all', etc. I feel like the core fear comes down to that I somehow did or thought something that is bad or caused someone harm. But I rarely do a compulsion physically, but I ruminate a lot at moments. I can also jump from thought to thought. There are also moments where I feel happier again and realise that all these thoughts are utter nonsense or are vert exaggerated, especially when I don't experience physical anxiety, but it doesn't last. I also feel like my mental health problems are usually triggered by new situations that would cause some anxiety for most people, but for me a much exaggerated amount of it. For example, this relapse started a few weeks before the birth of my son. That's why I also feel like I might have something called an adjustment disorder (and perhaps that is why I am now signed up for GIT-PD). When reading this, what do you think a possible diagnosis can be? I am not necessarily looking for a label, but perhaps more so for evidence-based methods that can help me overcome my problems. I want to take up sporting and mindfulness again and generally live more healthily. I am already taking supplements that are good for brain health (like magnesium l-threonate and magnesium bisglycinate, omega-3 fish oil, curcumin). Thanks in advance!

[karlomoonblade]

I have experience both, first GAD then now I have OCD ( Existential/Philosophical OCD in my case), I'll take GAD at any moment, OCD is a different level of anxiety because you are against your own thoughts which is INESCAPABLE

[ronaldlawler]

thank you very much for this excellent video, you gave me advice on this last year and it helped me immensely, all the best 👍🙂

[itsukuitsuku]

Paige, it was helpful. Glad you posted.

[antonisl]

For many years I was sure I had both. When I was younger (38 now) I had many rituals and compulsions. Recently my therarist whom I visit since I was 24 told me that I dont have OCD, I dont match the criteria and I have excessive anxiety. I am so confused now because I am sure I have OCD as well.

[amywatson]

Hi Paige
Can you please make a video about the types of OCD. As i am trying ti engage my young person with your videos, i really want the video urgently