Understanding Anxiety vs OCD
OCD BLOG SERIES: PART ONE
Experiencing occasional fears is a normal part of life. Children may worry about a monster in the closet, whether the house might burn down, or returning to school after a lockdown. These fears are part of the brain’s protective mechanism, reminding us of possible threats and signaling our nervous system to respond (fight, flight, freeze, or fawn). This alarm system is essential for safety—as long as it doesn’t become overactive.
When the brain’s threat response becomes overly sensitive, anxiety and even Obsessive-Compulsive Disorder (OCD) can develop. Parents often struggle to differentiate between anxiety and OCD, as they share similarities but also have distinct differences.
Similarities Between Anxiety and OCD
Overthinking and Worry: Both conditions involve repetitive worries, worst-case scenarios, and persistent “what-ifs.”
Physical Symptoms: Stomach aches, headaches, sweating, and racing hearts often accompany intrusive thoughts.
Impact on Daily Life: Anxiety and OCD can lead to school refusal, reduced social engagement, and disrupted routines.
Genetic and Developmental Factors: Some children are more predisposed to anxiety or OCD due to genetics or natural nervous system sensitivity.
Shame and Persistence: Children with either condition often feel shame, and their symptoms rarely improve with simple reassurance or avoidance.
Differences Between Anxiety and OCD
The key distinction lies in the child’s response to their worries:
Anxiety: Characterized by excessive worry and avoidance of feared situations.
OCD: Involves obsessions (intrusive thoughts) and compulsions (repetitive behaviors or mental acts to alleviate anxiety). Compulsions provide temporary relief but reinforce the OCD cycle, making it stronger over time.
For example:
A child with anxiety may fear getting sick and avoid crowded places.
A child with OCD may share the same fear but compulsively wash their hands multiple times a day.
A child with OCD might have intrusive thoughts like, "What if I accidentally hurt someone I love?" To counter this distressing thought, they might engage in a mental compulsion such as repeatedly reviewing their actions from the day to ensure they didn’t harm anyone.
Spotting OCD in Children
Some OCD behaviors are easily observed, like excessive hand washing or checking locks. Others, such as reassurance seeking (“I’m not a bad person, right?”) or mental compulsions (repeatedly reviewing actions in their mind), can be harder to identify. Parents might mistake these symptoms for anxiety when they’re actually signs of OCD.
Key Takeaway: Both anxiety and OCD are treatable, but understanding the differences is essential for effective support.
In part two of this blog series, we’ll dive deeper into common OCD themes, compulsions, and treatment strategies.
Helpful Resources for Children
Books:
Breaking Free of Child Anxiety and OCD by Eli R. Lebowitz
Talking Back to OCD by John S. March
What To Do When Your Brain Gets Stuck by Dawn Huebner
Podcasts:
Websites:
By understanding OCD and accessing the right tools, you can help your child overcome their struggles and thrive.