Do I have GAD or OCD? (or both) How to Tell the Difference | Ep. 426

Not sure if you’re struggling with Generalized Anxiety Disorder (GAD) or Obsessive Compulsive Disorder (OCD)? In this episode, Kimberley shares her personal journey with both and breaks down how to tell the difference—so you can get the right support and start healing.

In this episode, you’ll learn:

• The key emotional and behavioral differences between GAD and OCD
• What it actually feels like to live with each diagnosis
• Why OCD can feel more urgent and harder to manage
• The most effective treatments for both conditions (and where they overlap!)
• Practical questions to help you identify what you’re experiencing
• How to move forward if you think you might have one—or both—of these disorders

GAD vs. OCD: How to Tell the Difference and What to Do Next

One of the most frequently asked questions in the mental health space is: What’s the difference between Generalized Anxiety Disorder (GAD) and Obsessive Compulsive Disorder (OCD)? In this episode of Your Anxiety Toolkit, Kimberley Quinlan opens up about her personal experience with both, and provides a detailed, compassionate breakdown of how to differentiate the two—and most importantly, how to treat them.

Let’s walk through the key differences, symptoms, and tools for managing GAD and OCD, so you can better understand your experience and feel empowered to get the support you need.

Kimberley’s Personal Experience: GAD vs. OCD

Kimberley shares that she lived with GAD for much of her life before being diagnosed with OCD in her forties—a diagnosis that came as a surprise, even to her as a clinician.

• GAD felt like a low-level hum of worry: It shifted depending on life stressors but was generally about real-life situations like work or health.
• OCD felt much more intense and intrusive: The thoughts were louder, more catastrophic, and brought a strong urgency to do something—like a compulsion—to make the fear go away.

While both caused distress, OCD’s impact was more aggressive and harder to manage without medication.

What Is Generalized Anxiety Disorder (GAD)?

To meet the criteria for GAD, a person must experience:

1. Excessive anxiety and worry about everyday issues (work, school, money, relationships).
2. Worry occurring most days for at least six months.
3. Difficulty controlling the worry.
4. Worry not better explained by another disorder (like social anxiety or specific phobias).
5. Significant distress or impairment in functioning.
6. Symptoms not due to a medical condition or substance use.
7. Physical symptoms, including:
   • Restlessness
   • Fatigue
   • Difficulty concentrating or “blank mind”
   • Irritability
   • Muscle tension
   • Sleep disturbances

Key Feature of GAD: Worry tends to revolve around real-life situations and is more generalized, not always specific or irrational.

What Is Obsessive Compulsive Disorder (OCD)?

OCD is defined by:

• Obsessions: Intrusive, unwanted, and repetitive thoughts, urges, or images.
• Compulsions: Behaviors or mental acts aimed at reducing the distress caused by obsessions.

Common compulsions include:

• Avoidance
• Mental rituals
• Reassurance seeking (from others or online)
• Physical actions (like checking or washing)
• Self-punishment

For a diagnosis, these symptoms must:

• Be time-consuming (more than 1 hour/day) or significantly impair functioning.
• Not be caused by medical issues or substances.
• Not be better explained by another mental health disorder.

Key Feature of OCD: Obsessions are often irrational and lead to compulsions. There’s usually a powerful urge to “fix” or neutralize the distress.

GAD vs. OCD: What’s the Difference?

While both GAD and OCD include anxiety, worry, and even compulsions like rumination and reassurance-seeking, the differences are important:

GAD	OCD
Worry is often about real-life situations	Obsessions are typically irrational or intrusive
Anxiety is more general and shifts across areas	Anxiety is focused and intense around one fear at a time
Worry feels more like problem-solving	Thoughts feel uncontrollable and urgent
Less intense compulsions	Compulsions are frequent, urgent, and often feel necessary

How to Tell the Difference in Your Own Life

Ask yourself:

• Are my thoughts realistic worries or irrational fears?
• Are my fears related to daily stressors or intrusive and repetitive?
• Do I feel in control of my thoughts, or do they feel like they control me?
• Is there a family history of OCD or GAD?

Pro Tip: If you’re unsure, a mental health professional can provide a proper diagnosis using structured assessments.

Can You Have Both OCD and GAD?

Yes! Many people have overlapping symptoms of both. The good news? The treatments for GAD and OCD are similar and highly effective.

Evidence-Based Treatments for GAD and OCD

Both disorders respond well to:

• Cognitive Behavioral Therapy (CBT): Helps you reframe anxious thoughts.
• Exposure and Response Prevention (ERP): Especially helpful for OCD, this helps you face fears without engaging in compulsions.
• Mindfulness and Acceptance: Building skills to tolerate discomfort and uncertainty.
• Medication: Can be especially helpful for OCD, though not always necessary for GAD.

Kimberley also emphasizes self-compassion as a crucial tool for healing. Being kind to yourself as you learn to sit with discomfort is a game changer.

GAD, OCD, or Just Anxiety?

Remember: everyone experiences anxiety. It’s when that anxiety disrupts your life, consumes your time, or limits your ability to function that it may be a disorder.

If you’re noticing that your worry or intrusive thoughts are taking over, it’s time to seek help. There are tools, therapies, and support systems that work.

Free + Paid Resources to Support You

Kimberley offers a variety of tools to help:

• Your Anxiety Toolkit Podcast – Over 350 episodes of compassionate, evidence-based support.
•  Courses at CBTschool.com, including:
  • Your Anxiety and Panic Toolkit
  • ERP School for OCD
  • Time Management for Optimum Mental Health

If you’re listening in March 2025, anyone who joins the new GAD course also gets free access to the Time Management course as a bonus!

Final Thoughts

You’re not alone in this. Whether you’re navigating GAD, OCD, or a mix of both, there are clear paths forward. With the right support, skills, and mindset, you can take your life back from anxiety.

Be kind to yourself. Be willing to sit with discomfort. Trust that change is possible.

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Transcription: Do I have GAD or OCD? (or both) How to tell the difference.

One of the most common questions I get is how to know the difference between generalized anxiety disorder and OCD. And today in this episode of your Anxiety toolkit, we are going to tackle this big topic together. Now, the reason that I’ve actually discussed this before, but the reason I want to come back and address it again is number one, when I asked you guys what questions you had, this was the number one question over and over again. But number two, since I recorded that last episode, I myself have had experience with both. And so I would first like to discuss with you and share with you personally my experience of having generalized anxiety my entire life, and then later on having a shift where I was diagnosed with OCD and I wanted to share with you my experience between the two and what the difference was. Then we’re going to move over and have the whole episode where we deep dive into the differences so that you feel very confident in knowing the difference and knowing what to do if you feel the one resonates with you compared to the other. So let’s go.

Welcome back to your anxiety toolkit, everybody. This podcast is about bringing you a giant virtual hug and providing you science-based compassionate skills that will help you take your life back from anxiety and truly just be happy. That’s my goal, to reduce the suffering if we can just reduce the suffering that we experience. Just imagine the change and the impact we could have. Imagine what we could get done. Imagine how much love we could give if anxiety wasn’t getting in the way. Today we’re talking about the difference between generalized anxiety and OCD. As many of you know, I was recently diagnosed with OCD myself in my forties. It was a very big shock to me, and the reason that it was a shock is because I was not prepared. I had had generalized anxiety for the majority of my life, generalized anxiety, and I were old friends.

I knew every experience of having generalized anxiety. I knew what it felt like for me. I knew what to do with it. I knew how it showed up in my life. I’d done a lot of therapy about it, but then when I was hit with OCD, it was a completely different experience. Now, what I’m going to share with you is not going to be true for everybody. This is just my experience and I’m going to share it, but then I’m going to get into the real absolute nitty gritty of the differences scientifically. But for me, when I have generalized anxiety, it’s just this general feeling like really bad things are about to happen. It’s very general. It’s not specific to one thing. However, it can shift. Let’s say one month it might be focusing on work or it might be focused on my child, or it might be focused on health depending on what stresses were showing up, but it just felt very general.

It was all day every day, this low level anxiety and stress, it sort of seeped into everything I was doing, but wasn’t at the forefront of everything I was doing all the time sometimes, but not all the time, and it was just very sort of nagging. It’s this nagging annoying, bad things might happen, bad things might happen, the sky might fall. However, when I started to show symptoms of OCD, the experience felt much different. The content wasn’t that much different in that it would focus on one thing and get very strong, but the difference was when I experienced that obsession, that thought, that fear, it was very intrusive. It just took my attention. I couldn’t focus on anything else. It just kept nagging. It kept coming, it kept coming, it kept coming. It wouldn’t stop, and it would twist and turn and make it sound even more worse and more scary and more catastrophic.

Now, I’m not saying that one caused more suffering than the other because they’re just different degrees of suffering, but the experience was more aggressive. When I had OCD, the voice was louder. It was meaner, it was more terrifying. It had more imagery to it, and I felt this immediate urgency that I had to try and get rid of it. Whereas with generalized anxiety, it was there and I would sort of just live my day ruminating with it. If I wasn’t being mindful, I could just sort of exist. Doing my daily thing while having the fear and trying to avoid the fear and ruminate about the fear so much. With OCD, there was this massive urgency to get rid of the fear to make it go away, to do compulsions, and that urgency felt so strong. I wanted to get rid of that urgency so much, and so I would engage.

I actually had a harder time using my tools when I was getting treated for OCD than when I had generalized anxiety, and I was managing that one both. I used CBT for, I used some ERP for both as well. I did find that I genuinely don’t think I would’ve recovered from OCD without medication, whereas with the generalized anxiety, there were periods of my life where I wasn’t on medication and that I could function really well and handle it and manage it really well. But again, this is just my, and so the real difference was that urgency piece and that uncertainty piece. Both had obsessions, both had compulsions, both caused distress, both incorporated a mean voice to them, but the loudness and the frequency was different, and that was my experience. Now, the reason I share this with you is I think for people who have one or the other or both, it’s important to know in our body how it shows up for us individually because it will be different for everybody so that we can come up with personalized strategies on how to handle it.

With OCD, it’s going to be very much more an emphasis on exposures and response prevention. That’s going to be the main piece with that mindfulness, and we talk about that in all of our courses. For OCD with generalized anxiety. I personally tend to do a little more cognitive therapy and metacognitive therapy than I do with OCD. Because OCD work, I tend to be a little more behavioral in my approach. So the treatment is a little different. In your anxiety and panic toolkit, we talk about that and we talk about acknowledging where the triggers are and where they’re showing up in your life. What are the daily stresses and can we navigate those stresses in the most mindful and compassionate ways so that you have an easier time managing your anxiety? Whereas with OCD, usually the triggers aren’t daily stresses. They’re imagined through our brain and they’re created from intrusive thoughts.

And so we do have a little bit of a different approach there. Both are very nuanced in their differences, but both are very, very effective. The good news here is the treatment for OCD and general anxiety. It’s something you can recover from with the right help and the right mindset and the right amount of time, and if you’re willing to just make some changes, you can recover from both. So what I’m going to do now, thank you for listening and holding space for me as I share my own personal experience. Now, I’m going to talk all about the specifics in regards to the differences. This is actually an episode I released last year, so I will be re-releasing it and talking about all of those differences, and so I hope that you find it helpful.

In order to get a GA diagnosis, you do have to have a specific set of symptoms, and we’re going to go through them. So number one, if you have GAD, the first symptom you need to have is anxiety and worry, and that’s usually focused on everyday events like work, school, relationships, money and so on. Now, the frequency of GAD needs to occur more days than not for at least six months. The person needs to find it difficult to control this worry and anxiety, and it focuses on areas that are not consistent with other mental health struggles. And what we mean by that is, let’s say if the focus was on being judged by other people, well that’s better understood as social anxiety or if the focus of your worry was on your health, then we would actually be better diagnosing you or understanding your symptoms as health anxiety.

If it was focused on a specific thing like planes or needles or vomit, we would better understand that as a specific phobia. And so in order to have the diagnosis of GAD, it needs to not be under the umbrella of a different diagnosis. Other things that we would rule out when we’re thinking about GAD is things like panic disorder, body image, or even a previous trauma. Now, the fifth symptom is it needs to cause distress and impairment. That’s very, very important here because again, we’re talking about a disorder. What that means is a lack of order, no order, and so what we want to see here is that it’s highly impacting their daily life, highly impacting their ability to function. And then the six criteria is it has to be ruled out that these symptoms could be from a medical condition or substance abuse. An example of that might be even me with pots, I have postural orthostatic tachycardic syndrome.

A lot of the symptoms of POTS can actually look a little bit like generalized anxiety. The seventh criteria are the specific symptoms, and this is important to recognize because this might be true of a lot of different situations, symptoms, diagnoses, medical and mental. You need to have symptoms such as restlessness or being on edge. You need to be either easily fatigued, difficulty concentrating, or having what we call a blank mind. You might have irritability, you might have muscle tension, and you could also have sleep disturbances. So that is the breakdown for GAD. As I said, it’s very easy to mix it up with other mental health disorders such as OCD because they can look very, very similar. So let’s talk about OCD. Now, what is OCD? Now, in order to understand what is OCD, we need to again address the specific criteria to get a diagnosis of OCD.

So symptoms of OCD include the presence of obsessions and compulsions or one. So sometimes, again, you might have obsessions without the compulsions, but usually at the onset of the disorder, you will have both. You’ll also have intrusive, unwanted, repetitive thoughts, feelings, sensations, urges or images. And these cause a very high degree of distress and anxiety. As we mentioned with GAD, the individual with OCD will often attempt to avoid or suppress these thoughts, feeling sensations or urges, and they will try to neutralize them using what we call compulsions. Now, there are five different types of compulsion. A lot of you who followed your anxiety toolkit will know about these compulsions. We’ve talked about them. We actually go over them extensively in our online course for OCD called ERP school. If you’re interested to learn more about that, you can go to CBT school.com. We have a whole array of courses there to help you work through this and get help if you don’t have access to treatment of your own.

So we do have five different types of compulsions. The first one is avoidance, the second one is mental compulsions. The third one is reassurance seeking, whether it be from Google or a loved one. The fourth one is physical compulsions, like checking or jumping over cracks or washing your hands just to give a few examples. And the last one is self punishment, right? So there are five types of compulsions. Now, these compulsions are not connected in a realistic way to what in the way that they’re designed to neutralize or prevent. They’re usually clearly excessive behaviors done repetitively and done usually from a place of not wanting to do them, but more that the person with OCD feels like they have to do them to reduce or remove their obsessions. Now, the obsessions or compulsions are time consuming, and so the frequency here is that they need to take up more than one hour per day or cause a significant degree of distress and impairment on their social, occupational or other areas of functioning in their lives.

The next criteria is that the obsessive compulsive symptoms are not attributable to physiological symptoms or substance abuse or a medical similar to GAD. Again, we want to always check for medical and substance abuse issues before we go ahead and get a diagnosis of either GAD or OCD. And then last of all that the disturbance is not better explained by another mental health condition. Again, if the worry or the obsession is around needles like we talked about before, or being judged by somebody else or health conditions, well, if that were the case, we would give them a different diagnosis. Okay? Now, this is also true for trauma. Again, I want to make sure we understand that often this same cycle will play out in different anxiety disorders, PTSD, bfr bs, phobias, health, anxiety, B, D, D, body dysmorphic disorder. So once we have ruled those out, we can then move forward and acknowledge that this might be OCD or it might be GAD.

So now that we’ve gone through all that, we can actually slow down a little and really take a look and talk about OCD versus GAD and how to tell the difference. So let’s break it down. Both GAD and OCD have intrusive thoughts or what we call an obsession, a repetitive thought. Now, both have the presence of rumination, compulsions, and reassurance seeking compulsions, right? That is true for both conditions. OCD tends to be more on irrational topics and subjects, whereas GAD tends to be more focused on daily stresses and rational actual events in the person’s life, but not always. Again, sometimes the person with GAD may engage in a lot of catastrophic thinking or irrational thinking that can actually make this disproportionate to their daily life stresses, right? Questions that you might want to ask yourself when you’re considering how to tell the difference between GAD and OCD are questions like, are your worries related to a daily stressor or are your fears intrusive and repetitive?

People with OCD tend to identify that their thoughts are very intrusive, that they can’t stop them, they’re relentless, they repeat themselves over and over, whereas people with GAD tend to find that these are more preoccupations with problems in their life and they’re trying to solve them. Another question to ask is, are my fears realistic, invalid, or are they irrational and distorted? That question too can help us differentiate whether your symptoms are more related to OCD or GAD. Another question to ask is, does anyone in your family have GAD or OCD? We know that these conditions are very, very genetic, so if you’ve got someone with OCD in your family, it might actually help us to determine, is this something that’s going on for you? Are you better understood as having symptoms of OCD than you are GAD? Another question or thing you might want to do is you can take a GAD or an OCD test, so we have specific diagnostic tests that can help determine these, and I strongly encourage, if you’re still having a hard time differentiating after you’ve listened to this episode, please do go and speak to a mental health professional who can help you determine and do those tests so that you can really be clear on what you’ve got and help you get the correct treatment.

Let’s sort of answer some questions about this topic that commonly come up, which hopefully will help you get even more clarity on this topic. So one of the most common questions we get asked in this area is, can you have OCD and GAD? Often, some of you are looking at these criteria going like, yes, yes, yes, yes, yes, yes, yes. And the truth here is yes, commonly people do have OCD and GAD. There is a very strong G-A-D-O-C-D overlap here, so it could be that you have both. The good news here if that is the case, is that the treatment for GAD and the treatment for OCD are very, very similar. In fact, again, like I said, it’s very controversial. Some clinicians say it doesn’t even matter. We don’t have to differentiate between OCD and GAD because the treatment is going to be so, so similar.

We’re going to use a combination of cognitive behavioral therapy and exposure and response prevention. We call cognitive behavioral therapy, CBT, and we call exposure and response prevention ERP for short, and those treatments are focused on reducing those safety behaviors or compulsions, such as rumination avoidance, reassurance, seeking physical compulsions and self punishment, and also encourages you to identify your fears and learn to face them as much as you can. Learn to navigate those fears by experiencing them, tolerating them, being kind to yourself as you ride the wave of and practice mastering your ability to be uncomfortable. That’s a huge piece of this. Also, master your ability to be uncertain, because in both conditions, they often require you to spend a lot of time trying to seek certainty to get clarity, to solve the fear, prevent the fear, and we actually instead work at reducing that by increasing our willingness to be uncertain.

What about other anxiety disorders versus OCD? Well, what we’ve talked about already, hopefully we’ll clear that up, is the real way to determine what your specific problem or struggle is. What is the focus of your intrusive, repetitive thoughts? Again, if it’s on your body and your body image, we would look at an anxiety disorder or an eating disorder, or maybe even BDD, if the focus is on your health, we’re going to look towards health anxiety or hypochondria. If your fear is around being judged, we’re going to look towards social anxiety. If your fear is in response to an actual trauma you’ve been through, we’re going to look to PTSD and other trauma symptoms that you might be having. So it’s important to identify the core fear, and that can actually help determine what specific struggle and diagnosis you have, right? Another important question that people ask is, can GAD lead to OCD?

We don’t actually have a lot of research on this, so it’s important that we recognize that yes, they can overlap that yes, GAD, you can have GAD, and then you can proceed into having OCD, but I wouldn’t actually say that GAD leads to it or causes it usually. Again, OCD, we don’t really have a lot of clarity on what causes OCD, but we do know that there is a genetic component and an environmental component that is contributing to having OCD. Lastly, what’s the difference between having OCD and general anxiety or just anxiety in and of itself? And often, again, we’re going to look at that core fear right now, the thing to remember here is everybody has anxiety. Everybody experiences anxiety. It is a normal part of being a human, but if that anxiety is starting to impact the functioning and quality of your life, if it’s starting to take up a lot of time, if it’s starting to stop you from being able to do the things you want to do, that’s usually when anxiety becomes what we call an anxiety disorder, and when that happens, I’m going to urge you to seek help.

There are treatments, there are solutions, there are practices that can help you overcome this anxiety and get you back to living the life you want to live. We don’t have to live a life where we just accept anxiety at this rapid rate without getting help and skills and tools to help you move forward. The whole reason I created your anxiety toolkit is because there are tools that can help you navigate anxiety in the most effective, wise and kind way. And so my hope here is that today, as we’ve learned to differentiate the difference between GAD and OCD and even other anxiety disorders, you can then go to get resources to help you overcome those specific struggles and challenges. Again, if you’re interested, please go to cbt school.com. We are also here on your anxiety toolkit where we have over 350 free episodes to help you also navigate these conditions. It is a honor and pleasure to help you with these struggles in your life, and I’m so grateful to be able to do that, and so I hope that’s been helpful. Have a wonderful, wonderful day, and I’ll talk to you soon.

Now, before you leave, couple quick and announcements. As you know, we do have a new version of our course on generalized anxiety and panic. It is called your Anxiety and Panic Toolkit. You can head over to cbt score.com/overcoming anxiety to learn all about that. We have some incredible bonuses for you. If you are listening to this in the month of March of 2025, please note for everyone who registers for the new launch of this course, you will get free access to our other complimentary course, which is called Time Management for Optimum Mental Health. Not only will you have a full step-by-step plan on how to manage generalized anxiety and panic, you will also get access to our time management course, specifically implementing the tools that I have had to implement to overcome some gnarly conditions and disorders. So that’s there for you. Again, CBT school.com/overcoming anxiety.

Before you leave, let’s do two things. Number one, let’s do, I did a hard thing segment and we also have a podcast review, so here we go. This I did. A hard thing is from Rachel in Scotland and Rachel in Scotland said, I have been struggling with a relapse of strong anxiety for a few months, which has made so much worse. When my dear brother passed away unexpectedly a couple of weeks ago after his death, my partner and my daughter and I were due to go to a classical musical concert. I did not know if I could handle going emotionally. I predicted intense anxiety, but we went anyway, and sure enough, for the first half an hour that we sat, I had a wave of panic and it felt like it would overwhelm me. I stayed with it and let the music begin, and about after a half an hour, the feeling in my chest and my throat subsided, and I saw the most beautiful musical performance with my family.

It reminded me of all the cool and enjoyable things I have done with anxiety along for the Ride. Your podcast has helped me over the years. Thank you so much, Rachel. In Scotland, you are doing the work. I couldn’t put it better in terms of you just sitting and feeling the feelings and waiting it out and being present with the music and experience. This is so cool, so thank you, thank you. Thank you for sharing that with me. What an honor that I’m on this journey with you. So thank you to Rachel, and last of all, the review of the week. This one is from Nutra, A 3, 4, 8. It said, excellent podcast. I don’t often leave reviews, but I felt obligated to say how great this podcast is, especially with my not so great experiences with anxiety and educational podcasts in the past, which may have sounded good at first, but then the more you listened, I would notice things pop up that were not evidence-based, someone talking about themselves for half the episode and other unhelpful things. This has been the first anxiety podcast I have found that has been consistently good, reliable, evidence-based, comforting, and motivating. It’s been a great supplement to therapy. Kimberley is so kind, knowledgeable, and real, so thank you, Nutra A 3, 4, 8. It is a pleasure. Thank you so much everybody, and I’ll see you for next week.

Please note that this podcast or any other resources from CBT school.com should not replace professional mental health care. If you feel you would benefit, please reach out to a provider in your area. Have a wonderful day, and thank you for supporting Ccbt School.