Signs and Symptoms of Anxiety Disorders

Many people experience anxiety at some point in their lives. In fact, anxiety is a very normal response to stressful life events like moving, changing jobs, or having financial troubles.

However, when anxiety symptoms become larger than the events that triggered them and begin to interfere with your life, they could be signs of an anxiety disorder.

Anxiety disorders can be debilitating, but people can manage them with proper help from a medical professional. Recognizing the symptoms is the first step.

In this article, we discuss common symptoms of an anxiety disorder, as well as how to reduce anxiety naturally and when to seek professional help.

How to Manage OCD: 6 Methods and Resources

OCD can create many dilemmas without offering a true resolution. When the dilemma arises, you feel compelled to constantly try and resolve the source of your anxiety. This pulls you into an endless loop of circular thoughts, or ruminations, that are hard to stop.

For instance, imagine you have an intrusive fear of hitting someone with your car, which is a common OCD anxiety. Let’s say you’re driving along one day, and you run over a pothole. The bump in the road triggers feelings of panic, and racing thoughts start to bubble up and overwhelm you.

The rational part of your brain knows that it was only a pothole. Regardless, your anxiety continues to increase, and you then misinterpret this anxiety as a signal that something terrible has happened.

To ease your anxiety, you feel compelled to drive back just to “check.” And even when you get home, the intrusive thoughts continue — your brain tells you that you didn’t look hard enough and that the police will be at your door any minute.

Why is your brain doing this?

Research tells us that when you have OCD, there’s too much brain activity in the area that detects errors — and too little activity in the areas that tell us to stop compulsive behaviors.

So the next time your OCD presents a dilemma that makes you anxious, see if you can try to resist the temptation to ruminate for too long or try to “solve” the problem by engaging in compulsions. The longer you sit with the feelings of uncertainty, the less power they will have over your behaviors. Your anxiety will reduce over time, a process known as habituation.

Obsessions and compulsions are difficult to overcome, and it takes practice. It can be very helpful to practice with the help of a trained mental health professional’s guidance.

It’s time to redefine obsessive-compulsive disorder | Opinion

I’m sure you’ve heard someone say to you, “I’m so OCD!” or “God, my OCD is so bad today!” when their pens aren’t in a straight line or their papers are out of order.

Obsessive-compulsive disorder is a term most people recognize but few fully understand. It’s usually something people casually refer to — an explanation as to why they’re organized.

But OCD is larger than that, and for many, including myself, it’s a real challenge dealt with daily.

In the United States, 2.2 million adults are affected by OCD, according to the Anxiety and Depression Association of America. This is about 1% of the U.S. adult population.

I’m convinced, however, that the numbers are greater than this in reality.

OCD is an anxiety disorder in which people have recurring, unwanted thoughts that make them feel driven to do something repetitively and cause distress or anxiety, according to the American Psychiatric Association.

There are two parts to OCD — obsessions and compulsions.

Obsessions can present themselves in the form of intrusive thoughts, which to put it simply, feels like a super annoying voice in your head, constantly telling you things you don’t want to hear and that mostly have no validity behind them.

Compulsions are a way for people with OCD to “avoid” the content of their obsessions.

For example, if you fear that an intruder will break into your house in the middle of the night, naturally, you will lock your door. But an OCD brain insists you check the lock again and again and again.

An OCD brain clings onto uncertainty and what-ifs and doesn’t recognize the fear is improbable. Validation and giving into compulsions only fuels the cycle, but it is possible to “cure” yourself — at least I know I have helped myself get out of a lot of my cycles.

For some people, commonly-acknowledged obsessions over germs or making sure everything is perfectly in order is a reality and a struggle.

However, it’s important to understand this is just the tip of the OCD iceberg and should not be the generalization for all those that have it. OCD makes it hard to distinguish between intuition and anxiety, making it feel like you can’t make a clear decision on much of anything without internal debate.

I always thought I was just an anxious, “Type A” person. As a kid, I worried about things other kids didn’t seem to be as worried about — “Will mom and dad get home from dinner safely? Will some unexpected tragedy happen?”

I worried about things past my years, and no decision was made without overthinking.

As I got older, those worries became easier to push aside as I gained a better grasp over my mind, and I subconsciously helped myself to beat some of my OCD.

But new concerns come about with age, and as we all know, the new responsibilities of young adulthood can be stressful.

Of course, the coronavirus pandemic didn’t help anything, and it was at this point when my worries about uncertainty and the future got out of hand.

I started seeing a counselor for what I thought was anxiety, but through my own research and the guidance of my counselor, I started to feel like there was something behind the anxiety. I stumbled across some OCD pages on Instagram and soon found I identified with every issue discussed.

Seven months later, at 19 years old, I had an official diagnosis and a medication plan that has actually proven effective.

The average onset of OCD, according to the ADAA, is 19 years old, which is crucial information for a college student to acknowledge, as many might be suffering without a diagnosis quite yet.

OCD can make you feel like you’re not doing badly enough to need help, or you’re really fine and you’re “making it up.”

This probably proves true for other mental disorders too, but it’s important to understand if you feel that you need help, get help.

Your problems are valid, even if someone else’s situations seem worse. Everyone has the right to better themselves, and although this can feel difficult at first, if you keep your eye on the end goal, it becomes easier to work through the hard times.

You are your own best advocate. Use this to change your life for the better.

A New, Innovative Therapy That Treats Depression and OCD

According to the International OCD Foundation, obsessions are thoughts or impulses that occur routinely and outside of a person’s control. Although patients don’t want to have these thoughts, obsessive compulsive disorder is tough to treat because patients often fear a loss of control by getting treated for their symptoms.

The Cincinnati Anxiety Center is a treatment facility that offers cutting-edge therapy including a new treatment called Transcranial Magnetic Stimulation (TMS). Clinical Director and Cincinnati Anxiety Center Owner Nathan Fite, PhD, says the new treatment is often used after exhausting other treatments such as medication therapy. However, it can also be a treatment you opt for first in your therapy plan. “It’s a very effective treatment of major depression, but recently was FDA approved for usage with a specific coil for obsessive compulsive disorder,” says Dr. Fite. “It’s an exciting new option for patients who haven’t responded to medication management and cognitive behavioral therapy. The beauty of the treatment is that it works and does not have any of the systemic side-effects of traditional medications.”

What is Transcranial Magnetic Stimulation (TMS)?

Neuromodulation therapies are often invasive and require surgery or inducing seizures. However TMS is a painless and noninvasive form that changes brain activity by using electromagnetic currents on the skull and directing them to specific brain regions. The outpatient treatment includes putting a magnetic coil up to the head of the patient at the specific regions of the brain that’s associated with depression or obsessive compulsive disorder.

How does TMS work?

The Cincinnati Anxiety Center offers two types of TMS. One is a standard, surface TMS that’s administered for a half hour once a day, five days a week, for about six weeks totaling 30 sessions. Depending on the patient there may be a three week taper. The second is a shorter three-minute session using Theta Burst. “The recent Three-Dee randomized non-inferiority study showed that it has comparable efficacy to traditional rTMS protocols for depression,” says Dr. Fite. “What’s traditionally given in 30 minutes, you can now get in three minutes.” The same number of sessions are necessary for both options. The treatment itself entails a machine that releases magnetic pulses into the dorsolateral prefrontal cortex, stimulating the brain cells to communicate through electrical pulses. Dr. Fite says most patients will begin experiencing results after 15–20 sessions.

How effective is TMS?

“A recent study that was conducted by Brainsway, [which makes TMS machines,] concluded that by using TMS in conjunction with elevating anxiety by presenting OCD fears while also stimulating the brain at an elevated anxious state, about 55 percent of patients have some level of response to the treatment,” Dr. Fite says. The clinically significant results are telling for the majority of patients, and now the treatment has FDA approval. As for traditional TMS for depression without additional intervention, Dr. Fite says results roughly follow the rule of two-thirds. One third of patients who haven’t responded to medication will remit from depression using TMS. Another third will have a clinically significant response. The other third won’t respond to it.

Seek medical advice to learn if this treatment is right for you

If you’ve exhausted all treatment options or would like to opt for less invasive options, the team at the Cincinnati Anxiety Center will evaluate and see if this treatment is right for you. Learn more about the treatments offered at the Cincinnati Anxiety Center.

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Living with OCD in a pandemic

Most people behave in one or more ways that others may consider peculiar, and I am no exception. I want my clothes to match, from shoes to eyeglasses and everything in between (including underwear — a challenge when packing for a trip). If visitors use my kitchen, they’re asked to put things back exactly where they were found. In arranging my furniture, countertops and wall-hangings, I strive for symmetry. And I label packaged foods with their expiration dates and place them in my pantry in date order.

I know I’m not the only one with quirks like these that others may consider “so OCD,” a reference to obsessive-compulsive disorder. But the clinical syndrome, in which people have unbidden recurring thoughts that lead to repetitive habits, is far more than a collection of quirky behaviours. Rather, it is a highly distressing and chronic neuropsychological condition that can trigger serious anxiety and make it difficult to function well in school, at work or at home.

For someone with OCD, certain circumstances or actions that most people would consider harmless, like touching a doorknob, are believed to have potentially dire consequences that require extreme corrective responses, if not total avoidance. A person may so fear germs, for example, that shaking someone’s hand can compel them to wash their own hand 10, 20 or even 30 times to be sure it’s clean.

For many, the COVID-19 pandemic only made things worse. Past research has found a potential correlation between traumatic experience and increased risk of developing OCD, as well as worsening symptoms. A person with OCD who already believes dangerous germs lurk everywhere would, understandably, have become paralysed with anxiety by the spread of the novel coronavirus. And indeed, a Danish study published in October found that the early months of the pandemic resulted in increased anxiety and other symptoms in both newly diagnosed and previously treated OCD patients ages 7-21.

How serious is OCD?

The disorder often runs in families, and different members can be affected to varying degrees. Symptoms of the condition often begin in childhood or adolescence, afflicting an estimated 1 per cent to 2 per cent of young people and rising to about 1 in 40 adults. About half are seriously impaired by the disorder, 35 per cent moderately affected and 15 per cent mildly affected.

It is not hard to see how the disorder can be so disruptive. A person with OCD who is concerned that they may fail to lock the door, for example, may feel compelled to unlock and relock it over and over. Or they may become unduly stressed and anticipate disaster if a strict routine, like switching a light on and off 10 times, is not followed before leaving a room. Some people with OCD are plagued by taboo thoughts about sex or religion or by a fear of harming themselves or others.

Comedian Howie Mandel, now 65, told MedPage Today in June that he has suffered from OCD since childhood, but wasn’t officially diagnosed until many years later after spending most of his life “living in a nightmare” and struggling with an obsession about germs. He has been working to help counter the stigma of mental illness and increase public understanding of OCD in hopes that greater awareness of the disorder will foster early recognition and treatment to avert its life-impairing effects.

How is OCD treated?

“Until the mid-1980s, OCD was considered untreatable,” said Caleb W. Lack, a professor of psychology at the University of Central Oklahoma. But now, he said, there are three evidence-based therapies that may be effective, even for the most severely afflicted: psychotherapy, pharmacology and a technique called transcranial magnetic stimulation, which sends magnetic pulses to specific areas of the brain.

Most patients are initially offered a form of cognitive behavioral therapy, called exposure and response prevention. Starting with something least likely to elicit anxiety — for example, showing a used tissue to people with an obsessive fear of contamination — patients are encouraged to resist a compulsive response, like repeated hand-washing. Patients are taught to engage in “self-talk,” exploring the often irrational thoughts that are going through their heads, until their anxiety level declines.

When they see that no illness has resulted from viewing the tissue, the therapy can progress to a more provocative exposure, like touching the tissue, and so forth, until they overcome their unrealistic fear of contamination. For especially fearful patients, this therapeutic approach is often combined with a medication that counters depression or anxiety.

One silver lining of the pandemic is that it may have allowed more people to get treated remotely through online health services. “With telemedicine, we’re able to do very effective treatment for patients, no matter where they may live in relation to the therapist,” Lack said. “Without ever leaving central Oklahoma, I can see patients in 20 states. Patients don’t have to be within a 30-mile radius of the therapist. Telemedicine is a real game-changer for people who won’t or can’t leave home.”

For highly impaired OCD patients for whom nothing else has worked, the latest option is transcranial magnetic stimulation, or TMS, a noninvasive technique that stimulates nerve cells in the brain and helps to redirect neural circuits that are involved in obsessive thoughts and compulsions.

“It’s as if the brain is stuck in a rut, and TMS helps the brain circuitry get on a different path,” Lack explained. As with exposure and response prevention, he said, TMS uses provocative exposures, but combines them with magnetic stimulation to help the brain more effectively resist the urge to respond.

In a study of 167 severely affected OCD patients at 22 clinical sites published in May, 58% remained significantly improved after an average of 20 sessions with TMS. The Food and Drug Administration has approved the technique for treating OCD, though many insurance companies are not yet offering coverage.

Where can I get help?

Bradley Riemann, a psychologist at Rogers Behavioral Health System in Oconomowoc, Wisconsin, said his organization, which has 20 locations in nine states, relies on treatment teams that include psychologists, psychiatrists, nurses and social workers to provide both outpatient and inpatient treatment for OCD patients as young as age 6. Too often, Riemann said, parents inadvertently reinforce the problem by clearing a path so that their child can avoid their obsessive fear and resulting compulsive response. For example, they might routinely open doors for a child fearful of contamination.

The nonprofit International OCD Foundation, based in Boston, can help patients and families find therapists and support groups for those struggling with the condition. A message can be left at 617-973-5801.

This article originally appeared in The New York Times.

COVID-19 Has Made It ‘Really Tough’ For People With Anxiety Disorders

Mental health professionals have reported surging demand from people seeking therapy since the start of the pandemic.

To learn more about how things have changed, WESA’s health and science reporter Sarah Boden is speaking with psychiatrists, therapists and social workers over the coming weeks about what they’re observing in their own practices.

In this first conversation, Boden spoke with Kristen Walker of the Counseling and Wellness Center of Pittsburgh. Walker is a cognitive behavioral therapist who focuses on treating anxiety disorders, which can cause people to fixate on worst case scenarios.

This conversation has been edited for length and clarity.

Sarah Boden: In many ways, COVID-19 and other recent events have confirmed our greatest fears. How do you help patients navigate this?

Kristen Walker: One of the things that can be really effective is helping people focus on what they can and can’t control: ‘Well, I have control over wearing a mask. I have control over whether I exercise. I have control over whether I eat a healthy meal.’ And all those things help manage some of that external anxiety.

Boden: I know that clinicians want to be careful to not over-pathologize a patient. But I do wonder, since March 2020, are more people developing anxiety disorders?

Walker: In my experience with folks I’ve been seeing, yes. I mean, in order to have that anxiety disorder, there are clinical markers that need to be met: feelings of being on edge, constant worry, difficulty sleeping, having a startle response, maybe avoidance of people in situations. All of those different kinds of things are hallmarks of what we would consider an anxiety disorder.

Boden: And are we just talking generalized [anxiety]? Or are you seeing all different types of anxiety disorders?

Walker: All different kinds. The social anxiety disorder has been tough for folks. One of the things we typically encourage folks with social anxiety disorder to do is to go out there, get in public, meet people, do things to do those exposures. And that’s been pretty limited with Covid.

Boden: Besides social anxiety disorder, I’m wondering how the pandemic has impacted other anxiety disorders like, for example agoraphobia, which is a fear of leaving your home, being in, I guess, unfamiliar places or places you can’t control the environment.

Walker: People with agoraphobia tend to not leave their home or I mean, if they do leave their home, they tend to stick close to a routine. Somewhere where they know that they can get out safely. So it’s harder for people to kind of rationalize for themselves. ‘Oh, even though this feels really uncomfortable, this is going to be a good thing for me to go,’ because now there’s this added layer of COVID-19.

Boden: Yeah, it’s so interesting. You’re talking about the sort of exposure therapy, I guess you could call it, [that] in some ways the exact opposite of what the public health guidance was at certain points earlier in 2020.

Walker: Yes, yes. That’s completely contraindicated for somebody with agoraphobia, or social anxiety.

Boden: I also want to ask about obsessive-compulsive disorder. I think in media, we might see this portrayed as somebody who’s constantly washing their hands, or always on the lookout for some sort of danger or calamity in the real world. How have people with this diagnosis been impacted by the pandemic?

Walker: The pandemic has been really tough. If somebody does have more of a fear of germs, for example, when they wash their hands they immediately feel better. And what that does is it brings down the anxiety for a temporary time period. Eventually it spikes back up and higher. Now, all of a sudden there’s the CDC guidelines coming out, especially early on in the pandemic where you were being told, wipe down your groceries, leave your deliveries outside for a couple of days, make sure you’re washing your hands. So that was really tough to navigate.

Boden: I suppose, really with any anxiety disorder, the behaviors are not always irrational. It’s just calibrating that sort of alertness or protective behaviors to the situation. But suddenly we’re in a situation where a lot of those behaviors are being reinforced.

Walker: Right. Right. Because it reinforces the need or the urge to isolate.

Boden: Looking towards the future, what do you think the long term effects will be of the pandemic on your clients?

Walker: It’s going to take time to reacclimate to being out there in the world again. So I think it’s going to require support, patience, care, gentleness for each other.

This story was produced as part of “Pittsburgh’s Missing Bridges,” a collaborative reporting project by the Pittsburgh Media Partnership. 

Osher Günsberg opens up about his anxiety and OCD to his old radio co-hosts

The Bachelor’s Osher Günsberg recalls how difficult it was hosting breakfast radio while on ‘heavy drugs’ as he speaks about his anxiety and obsessive compulsive disorder






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Osher Günsberg has talked openly about his mental health struggles and how he was a changed person when he was on ‘heavy drugs’.

The Bachelor host spoke about the difficult time with his old radio co-hosts, Matty Acton, Abby Coleman and Stav Davidson, as his SBS documentary on suicide in Australia, titled Osher Günsberg: A Matter of Life and Death, airs later this month.

The 47-year-old, who suffers from anxiety and obsessive compulsive disorder, said he found it really hard to form emotional relationships while he was heavily medicated. 

Struggles: The Bachelor's Osher Günsberg has recalled how difficult it was hosting breakfast radio while on 'heavy drugs' while speaking about his anxiety and obsessive compulsive disorder

Struggles: The Bachelor’s Osher Günsberg has recalled how difficult it was hosting breakfast radio while on ‘heavy drugs’ while speaking about his anxiety and obsessive compulsive disorder 

‘You guys knew me when I was on a whole lot of meds,’ Osher said during an interview on B105 FM’s Stav, Abby and Matt on Friday.

‘Remember when I told you that I had to come off the meds and I might be a bit weird for a week?’

‘It was so hard for you,’ replied Abby. ‘I found it hard when you were on medication. I found it really hard to connect with you. You were just so disconnected from your emotions.’

The reality TV host explained that he ‘needed to be on those heavy drugs’, but acknowledged there are ‘benefits and side effects’ when it comes to taking medication for mental health issues. 

Open: The Bachelor host spoke about the difficult time with his old radio co-hosts, Matty Acton, Abby Coleman (right) and Stav Davidson (left), as his SBS documentary on suicide in Australia, titled Osher Günsberg: A Matter of Life and Death, airs later this month.

Open: The Bachelor host spoke about the difficult time with his old radio co-hosts, Matty Acton, Abby Coleman (right) and Stav Davidson (left), as his SBS documentary on suicide in Australia, titled Osher Günsberg: A Matter of Life and Death, airs later this month.

‘It made it difficult for me to form emotional relationships. I know that Abby, I know that was hard,’ he continued, before reflecting on the times he went off his medication. 

‘The thing is guys – I couldn’t bear it. It was like running your motorbike in the red. I couldn’t be with that level of isolation of my head and, as I came back on my new meds, it was a lot better.’ 

Osher stated that ‘people have different brains’ and those who struggle with mental health need to be on and off different medication.

'I couldn't be with that level of isolation of my head': Osher reflected on the times he went off his medication. Pictured here with Australian Idol co-host James Mathieson

‘I couldn’t be with that level of isolation of my head’: Osher reflected on the times he went off his medication. Pictured here with Australian Idol co-host James Mathieson 

The TV star revealed this was the main reason he decided to do the documentary in the first place. 

‘This is just another thing that happens for people in our community and it’s no big deal,’ he added.

‘There’s solutions out there, and as long as we treat it like a problem to be solved it’s fine. ‘

Osher Günsberg: A Matter of Life and Death premieres at 8:30pm on Sunday the 19th September on SBS.

Coming soon: Osher Günsberg: A Matter of Life and Death premieres at 8:30pm on Sunday the 19th September on SBS

Coming soon: Osher Günsberg: A Matter of Life and Death premieres at 8:30pm on Sunday the 19th September on SBS

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What Is Trait Anxiety, and How Does It Compare to State Anxiety?

Everyone experiences some level of anxiety from time to time — it’s a natural response to feeling threatened or afraid.

Still, the anxiety that comes up for you will probably depend on different factors, including the specific circumstances of the situation as well as your own unique personality.

Here’s how to tell the difference between state and trait anxiety.

State anxiety

This form of anxiety tends to show up when you face a potential threat or other frightening situation. It usually involves a mix of mental and physical symptoms.

Mental symptoms might include:

  • feelings of worry
  • difficulty concentrating
  • irritability

In-the-moment physical symptoms might include:

  • trouble breathing
  • rapid heartbeat
  • upset stomach
  • muscle tension and pain

Of course, you can also experience state anxiety when there’s no actual physical threat. You just have to believe there’s one.

Say you’ve just received a terse email from your supervisor: “I need to see you in my office ASAP.”

No details, no explanation.

You know you’re not in any danger, and you can’t think of anything you’ve done that might require a reprimand. All the same, you walk down the hall to their office on slightly wobbly legs. You try to comb through your memories of the past few days to figure out what they might want, but your mind has gone completely blank.

Once you sit down in their office and they explain they just wanted to give you a heads-up about a potential software security issue, the wave of relief that crashes over you carries away those feelings of worry and fear.

Trait anxiety

Experts who distinguish between trait and state anxiety consider trait anxiety more of a fixed part of your personality — that’s to say, a personality trait.

A higher level of trait anxiety generally means you’re more likely to feel threatened by specific situations, or even the world in general, than someone with lower levels of trait anxiety.

You might tend to feel more anxious and stressed in everyday circumstances — even those that wouldn’t inspire fear or worry in others. For example:

  • Your partner seems a little distant? You start to worry they want to break up.
  • Still haven’t received any feedback on your thesis idea? Your professor must hate it. In fact, they’re probably trying to think of a way to explain you’re not cut out for a graduate degree, after all.
  • Never heard back from your friend after your last few texts? You must have done something to upset them.

Older research notes four dimensions of trait anxiety:

  • Threat of social evaluation. This might include criticism or conflict.
  • Threat of physical danger. This might include things like illness or car accidents.
  • Ambiguous threat. This might involve a more general sensation of doom or unexplainable worries.
  • Threat in daily routines or harmless situations. This might involve fears around meeting new people or making mistakes in your work.

To put it another way, you might consider trait anxiety something of a predisposition toward experiencing those feelings of worry and fear.

Chronic feelings of anxiety and worry can leave your nervous system on near-constant alert for potential threats. As a result, you might begin to notice longer-lasting anxiety symptoms, such as:

  • changes in your mood, like irritability and unease
  • trouble concentrating on tasks
  • tendency to avoid the source of your fear
  • insomnia and other sleep problems
  • appetite changes
  • fatigue
  • body aches and pains that have no clear cause

A Heightened Reactivity To Unlikely Threats Is A Key Sign Of Obsessive Compulsive Disorder, Shows New Research

A new paper published in the journal Clinical Psychological Science offers insight into why people with obsessive compulsive disorder engage in what psychologists refer to as “catastrophizing,” or the repeated mental simulation of unlikely catastrophic events. According to the researchers, it has to do with a flawed perception of the likelihood of low probability events.

“OCD-related obsessions are largely organized around fears of a specific harmful consequence that compulsions are enacted to prevent,” say the researchers led by Christopher Hunt of the University of Minnesota. “Virtually all common consequences associated with the major OCD subtypes possess two striking commonalities. First, most feared consequences in OCD are objectively catastrophic: the loss of one’s home, health, loved ones, or soul are among the costliest consequences imaginable. Second, the scenarios surrounding these catastrophic outcomes are often highly improbable.”

Examples of highly improbable catastrophic events that pervade the mind of someone with OCD fall into predictable categories, such as:

  • Contamination/washing (for example, “contracting a deadly infectious disease such as HIV from a public surface or becoming poisoned from contact with a household cleaner”)
  • Doubting/checking (e.g., “failing to prevent a fire, flood, or burglary after not checking stove tops, water taps, and locks or accidentally hitting and killing a pedestrian without knowing it”)
  • Aggressive OCD (e.g., “suddenly deciding to jump off a bridge or secretly and intentionally poisoning someone”)
  • Religious OCD (e.g., “being sent to hell for an immoral thought or trivial act or suddenly shouting obscenities in church”)
  • Sexual OCD (e.g., “acting on secret incestuous or homosexual desires”)
  • Somatic OCD (e.g., “failing to catch symptoms of a deadly disease, choking after not chewing food well enough, or going insane from continuously monitoring a bodily function”)

To test the idea that highly improbable events are viewed as more probable than they are by people with OCD, the researchers recruited 78 university students to participate in an in-person experiment. The researchers first measured participants’ levels of OCD using the 18-item OCI-R questionnaire. The OCI-R measures people’s overall levels of OCD as well as the OCD subtypes of washing, checking, ordering, obsessing, hoarding, and neutralizing.

The researchers then requested that participants play a video game in which they were a farmer with the objective of harvesting crops in an unpredictable environment. Participants made decisions in the game such as choosing to take a short, dangerous road versus a long, safe road to start planting their crops. Negative events, such as wild birds consuming one’s crops, were met with small electric shocks to the wrist. Participants’ expectations and reactions to negative outcomes in the game were measured by gauging their startle response (via an EMG electrode placed below the lower eyelid) as well as through self-reported anxiety and threat-probability ratings that were administered at different points during the game.

The researchers found that participants with OCD symptoms were more avoidant of low probability negative outcomes in the game. They state, “OCD did not confer a general tendency to avoid threat but, rather, a specific proclivity to avoid experimental analogues of improbable catastrophes.”

They also found that participants with OCD symptoms showed an increased startle response, as measured by eye-flinching, to low probability negative events. Such results, according to the researchers, offer initial experimental support for the observation that “a variety of common OCD presentations involve concerns with improbable catastrophic consequences and further implicate a more general sensitivity toward improbable threat as a candidate deficit driving this phenomenon.”

“The current study represents the first lab-based test of whether OCD is associated with an underlying sensitivity toward improbable catastrophic threats,” conclude the researchers. “Results show that individuals with higher OCD symptoms were more avoidant of potential threats that were both improbable and highly aversive and were also more expectant of and more physiologically reactive to improbable threats more generally.”

A full interview with Dr. Christopher Hunt discussing his research on obsessive compulsive disorder can be found here: Why people with OCD fear things they shouldn’t

What OCD really means and how to seek support

We all experience things like worrying we’ve left an appliance on, or avoiding walking under scaffolding, but for most people, these random stresses and superstitions are short-lived.

Obsessive-compulsive disorder (also known as OCD), however, is a serious anxiety disorder, where worries and urges can have a debilitating effect on a person’s day-to-day, impacting both their mental health and relationships with others.

Misunderstanding and stigma about OCD can make it difficult to reach out – but support is available, and it can make a significant difference for those affected.

What is OCD?
“Obsessive-compulsive disorder is an anxiety disorder that causes people to experience a variety of symptoms that typically fall into one of two categories: ‘obsessions’ and ‘compulsions’,” explains Priory consultant psychiatrist, Dr Paul McLaren.

“Obsessions are characterised by persistent and irrational thoughts or urges, and compulsions refer to physical or mental acts that people feel compelled to perform.”

McLaren explains that some people with OCD only experience one type of symptom, whilst others experience both. “These irrational thoughts and behaviours can become extremely time-consuming,” adds McLaren, and the defining factor is that they feel impossible to stop or control.

OCD is ranked by the World Health Organisation as one of the top 10 causes of mental illness-related disability, but misconceptions around the term mean people often don’t treat it with the seriousness it deserves.

It’s often commonly implied that OCD simply means that you like to wash your hands a lot, and it’s not uncommon to hear someone describe themselves as a ‘little bit OCD’ if they like to be very tidy or organised.

Handwashing is a common compulsion if someone has an intrusive thought of being contaminated by germs, but as McLaren explains: “This is not the only form of OCD. Common presentations not only include contamination worries but also double-checking and hoarding behaviour, as well as ruminations and intrusive thoughts and images.

“These obsessions and compulsions can be overwhelming to someone living with OCD, despite their best efforts to avoid thinking and acting in a certain way.”

Why does it happen?
No one’s sure yet what causes OCD – but there are lots of different theories, and it’s likely that a number of factors are involved in its development.

“OCD can run in families,” says Glenys Jackson, clinical lead for mental health at Bupa Insurance ( “If one of your parents or a brother or sister has OCD, it’s possible you may develop it too. Traumatic life events, social isolation or bullying could trigger OCD or make it worse, and it can also develop during pregnancy.

“The pandemic has put a huge strain on everyone’s mental wellbeing. Factors such as reduced social contact, feelings of isolation and fear associated with contracting or spreading Covid-19 all have strong links to poor wellbeing. These stressors are making OCD symptoms worse in some cases.”

How is OCD diagnosed?
If you think you may have OCD and it’s affecting your life, see your GP. Jackson says: “They’ll ask you a series of questions related to OCD to help make a diagnosis. These include how your OCD affects you personally and how it affects your life.

“You may feel embarrassed about your symptoms and it can be hard to talk about them. However, it’s important to be open and honest with your GP or therapist about any obsessions and compulsions you have.

“This will help them make the right diagnosis and recommend the best type of treatment for you.” Your GP may then refer you to a healthcare professional who specialises in mental health for further assessment or treatment.

What kinds of treatment can help?
According to Jackson, most people with OCD “spend years struggling with their symptoms” before they seek help.

This is often because of stigma around having a diagnosed mental health condition, they are embarrassed to seek support, or they leave the symptoms to manifest in the hope that they will go away. But as Jackson stresses: “It’s so important to speak up and find a way to treat and manage your OCD.”

When you’re facing obsessive thoughts or compulsions, it can be hard to see them for what they are. “With practice and help, it can become easier to identify when your thinking is affected by the symptoms within OCD and you can build techniques to reduce the impact and bring the symptoms under control,” assures Jackson.
“This might include actively exploring and confronting your compulsions or thoughts, maybe through exposure and response prevention where a therapist works with you to challenge the OCD.
“It might sound difficult, but it can help you to acknowledge that thoughts and compulsions don’t have power over you. It is important to talk to a professional to determine what pathway is most appropriate for your presenting symptoms.”

Cognitive Behavioural Therapy (CBT) can also help manage symptoms. This form of talking therapy helps you examine in detail how you think about certain situations in your life, how you behave in response to those thoughts, and how your thoughts and behaviours make you feel. “CBT aims to give you the understanding and tools to carry on working towards recovery by yourself,” Jackson says. Your doctor may also prescribe medication if you have severe OCD, or if your symptoms don’t improve with therapy.

Self-care interventions are really important too, and it’s always good to remember that you’re not alone. “OCD is a common anxiety disorder. In fact, a large part of the population may have had some OCD traits at some point in their lives,” says McClaren. “Don’t let it prevent you from talking to people and getting the help you will need. There are online forums and support groups that take place regularly.

“There is a lot of information available online regarding OCD, including testimonies from people with OCD and how they have dealt with it. This can help you put your difficulties into perspective, offer context, and give you more understanding in what may be helpful for you.”


OCD vs. OCPD: Symptoms, Causes, and Treatment

Obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) are mental health disorders that share similar names, so distinguishing between the two can be challenging. However, the clinical definitions of these disorders are different.

People with OCD have obsessive, intrusive, repetitive thoughts, known as obsessions. They may feel compelled to repeat behaviors, which are known as compulsions. With OCPD, a person may be excessively focused on order and perfection.

Understanding the differences between OCD and OCPD can help determine what treatment is needed.


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Symptoms of OCD vs. OCPD

OCD and OCPD may overlap in terms of similar thought patterns and behaviors. They may also share similarities involving order, perfectionism, and organization. However, only OCD is characterized by true obsessions and compulsions.

Traits of OCD

OCD is mainly characterized by obsessions and compulsions that are time-consuming and cause distress to the person with OCD.

Obsessions present as repeating thoughts, worries, or even mental images that are intrusive, unwanted, and unrelenting.

Compulsions present as repeating behaviors that a person feels driven or urged to perform. This repetition is often done to avoid anxiety or a perceived risk, such as excessive handwashing to avoid the risk or fear of germs.

People with OCD are typically aware that they have a disorder, though people with OCPD may not be.

Traits of OCPD

OCPD is characterized differently than OCD. People with OCPD are strongly focused, almost obsessively so, toward a goal of perfection for themselves and others and toward maintaining rules and order in their environment.

People with OCPD may exhibit the following traits:

  • High-achieving, conscientious, and function well at work
  • Face challenges understanding others’ points of view
  • Have difficulty hearing constructive criticism
  • Look for patterns of control and order
  • Desire perfectionism to the point that this strong urge interferes with actually completing tasks
  • May have tendencies toward being unable to discard old or valueless objects

Consistency of Symptoms

OCD is a disorder based on fear, anxiety, and efforts to control uncertainty. The obsessions and compulsions may ebb and flow based on the person’s current level of anxiety or fear. OCPD, however, is a personality disorder, so the behaviors don’t tend to fluctuate. Rather, they occur more consistently over time.

Causes of OCD and OCPD

While the exact causes of both OCD and OCPD are not yet fully understood, there are several possible factors.

OCD Risk Factors

  • Neurological factors: OCD may result from disruptions in communication between certain regions of the brain. Other studies suggest that abnormalities in neurotransmitters such as serotonin may be a significant factor in OCD.
  • Genetics: Studies have shown a genetic factor to OCD, in that individuals with a family history of OCD are more likely to have the condition.
  • Stress and environment: Incidents like brain injury, infection, trauma, and stressful events can contribute to the development of OCD. Stress can both prompt and exacerbate the symptoms of OCD.
  • PANDAS: A reaction to streptococcal infection (the same type of bacteria that causes strep throat) during childhood can sometimes cause inflammation in the brain which can lead to the development of OCD. These types of cases are called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections).

OCPD Risk Factors

  • Genetics: OCPD appears to have a genetic component. Studies have found that OCPD is more likely in individuals who have a family history of the condition.
  • Early attachment: One study indicates OCPD may start in childhood from disruptions to attachment bonds. For example, if a child is unable to form a bond with a primary caregiver during childhood, it can impact later relationships and create attachment difficulties. Personality disorders form to help the person cope with the attachment injury.


Mental health experts diagnose OCD and OCPD using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association’s official handbook, to diagnose mental health conditions.

Diagnosing OCD

To diagnose OCD, a clinician will use the DSM-5 to determine the following:

  • If obsessions or compulsions (or both) are present
  • If the obsessions and/or compulsions are occurring because the person is trying to prevent anxiety, distress, or a potential situation
  • If the obsessions and/or compulsions are excessive, and these thoughts and/or behaviors are taking up considerable time in the person’s life (more than one hour a day) or causing distress
  • If the obsessions and/or compulsions impair the individual’s ability to function socially or at work

Diagnosing OCPD

To diagnose OCPD, a clinician will use the DSM-5 to examine the following traits:

  • A constant pattern of order and control that can come at the expense of flexibility, efficiency, and openness
  • Perfectionism that may interfere with being able to complete a task, especially when the person’s standards are not being met
  • A preoccupation with details, rules, order, organization, and schedules to an extreme degree
  • An excessive devotion to work outside of a financial need, even forsaking personal relationships in favor of work
  • Significant difficulty with flexibility when it comes to their own ideas and their plan for how to complete tasks


OCD and OCPD are often treated in similar ways. In both cases, medication and talk therapy (or a combination of both) will help treat OCD and OCPD.

OCD Treatment

People with OCD may be prescribed selective serotonin reuptake inhibitors (SSRIs), which have been shown to help treat OCD. SSRIs are often the first-line treatment for OCD.

Psychotherapy can also be used to treat OCD, including:

  • Cognitive behavioral therapy (CBT): CBT helps people understand how their thoughts (particularly negative ones) influence their behavior and how to react differently.
  • Exposure and response prevention (ERP): ERP exposes someone to the triggers causing their obsessions and assists them in overcoming the need for their compulsions.

OCPD Treatment

Treatment for OCPD has not been well-researched, with only a few small studies to date.

At this time there are no specific medications for OCPD, although the same medications that help treat OCD (SSRIs) can also help with OCPD.

Small research studies suggest that CBT is also effective in treating people with OCPD, because it can help them examine their thoughts and the actions that follow.


When biological factors, such as genetics, are at play, it may not be possible to prevent OCD or OCPD. However, there may be some interventions that can mitigate the environmental contributions to these conditions.

Early intervention may also be the key in reducing the severity of the conditions. Education and improving access to effective treatments can help.


People with OCD are frequently distressed by the excessive and repeating thoughts and behaviors they experience. It can be time-consuming to repeat behaviors and can impact a person’s social functioning. These behaviors can affect those around them as well.

There are support groups available for people with OCD and their loved ones. Connecting with people who have similar experiences can help.

Many people with OCPD are not aware that they have a disorder or the effect it has on the people around them. This can make it especially difficult to seek help. If you notice symptoms of OCPD, speak with a mental health professional about a screening.

Seek Help

If you or a loved one is struggling with OCD or OCPD or both, you can contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline online or call 800-662-4357 for more information on how to find support and treatment options specific to your geographic area.

For more mental health resources, including a helpful list of links and hotline numbers, see our National Helpline Database.

A Word From Verywell

OCD and OCPD are separate conditions, but both are treatable through similar methods. It’s important to seek help from a mental health professional or healthcare provider when noticing symptoms to achieve an accurate diagnosis of OCD or OCPD.

Frequently Asked Questions

  • The most significant difference between OCD and OCPD is that OCD is classified as an anxiety disorder and OCPD is classified as a personality disorder.

  • People with OCD tendencies may experience anxiety. OCD is classified as an anxiety disorder.

  • A person can be diagnosed with both OCD and OCPD. OCPD occurs in people with OCD 15%–28% of the time.

Anxiety for yoga: Benefits and poses

Many people use yoga to help with their anxiety. There is some evidence to suggest that it is useful, particularly in people living with obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD).

Anxiety is the body’s response to stress and is part of the natural fight, flight, or freeze reflex.

Anxiety might resemble a feeling of distress, unease, or dread. Its intention is to keep a person alert or aware during times of threat.

Sometimes, anxiety can get in the way of everyday life. This is particularly true for people who live with health conditions that can cause excessive anxiety, such as OCD or GAD. Doctors believe that exercise, including yoga, can help people to manage the symptoms of anxiety.

This article looks at why yoga is beneficial for anxiety, which yoga poses may help with anxiety, how to perform them, and the research to support these ideas.