Many parents wonder, is OCD a form of anxiety, or something completely different? The stress of obsessive thoughts and pressure to do compulsive actions to try to calm down might only appear as anxiety. Many people with OCD may think they just have high anxiety until they get a diagnosis. It’s also very common for people with OCD to also have a co-occurring anxiety disorder.
Mental health experts have also juggled whether OCD is anxiety, if OCD is a form of anxiety, or if anxiety is considered an anxiety disorder. In fact, until the most recent version of the Diagnostic and Statistical Manual (what experts use to diagnose mental health conditions), obsessive-compulsive disorder was considered an anxiety disorder. Now, it’s in a distinct category of “obsessive and compulsive disorders.”
What to expect in this article:
- What OCD Is
- Is OCD an Anxiety Disorder? How OCD Is Classified
- Key Differences: OCD vs. Anxiety in Teens
- How Does OCD Affect Teens?
- How Family First Addresses Teen OCD and Anxiety
What OCD Is
Obsessive-compulsive disorder is a distinct, diagnosable mental health condition that has real effects on daily life. Your teen might deal with OCD related to a specific thought pattern, belief, or fear, such as contamination, symmetry, or identity. These obsessive, intrusive thoughts cause intense stress, often to the point that they might perform compulsive actions to try to feel some relief. This might look like:
- Thoughts about contamination causing them to excessively wash their hands or clean certain objects
- An intense focus on symmetry, leading to repetitive behaviors like arranging items in a specific order multiple times
- Constantly questioning their identity or beliefs and needing reassurance from others
- Thoughts about taboo subjects, like sex or violence, which cause intense shame and guilt
- An overwhelming fear of harm coming to themselves or others, leading to constant checking behaviors
There are many different types of OCD, but one thing is common across all of them: obsessions and compulsions can be all-consuming, making it difficult for your teen to focus on anything else.
Is OCD an Anxiety Disorder? How OCD Is Classified
OCD is often mistaken for an anxiety disorder—and for good reason. Anxiety caused by intrusive thoughts is one of the defining symptoms of OCD. However, OCD is no longer classified as an anxiety disorder.
In 2013, the American Psychiatric Association updated the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and moved OCD into a separate category called Obsessive-Compulsive and Related Disorders. This category includes conditions such as body dysmorphic disorder, hoarding disorder, and trichotillomania (compulsive hair-pulling).
Why the change? While anxiety is a core feature of OCD, it follows a distinct pattern involving intrusive thoughts and compulsive behaviors that differs from anxiety disorders like generalized anxiety disorder (GAD) or social anxiety disorder. The distinction allows for more effective treatment and symptom management.
Does OCD Cause Anxiety?
In short, yes—but maybe not how you’re thinking. Obsessive thoughts caused by OCD do cause intense stress and anxiety. Then, compulsive actions, even checking behaviors (which can include more thoughts “checking” on things), can make stress even worse. If someone doesn’t learn better coping mechanisms, their anxiety the next time they have an intrusive thought can be even higher. This can make symptoms normally associated with anxiety, like sleep problems, restlessness, stomachaches, and headaches, more frequent.
But OCD can co-occur with anxiety disorders, too. In fact, it’s the most common co-occurring diagnosis, as nearly 76% of people with OCD also have an anxiety disorder. Depression, ADHD, and compulsive internet and substance use also commonly co-occur with OCD.
Key Differences: OCD vs. Anxiety in Teens
Although OCD and anxiety disorders can look similar on the surface—both often involve fear, distress, and heightened worry—the underlying patterns are different. Understanding these differences can help parents recognize what their teen may be experiencing and why the right diagnosis matters.
How OCD Typically Shows Up in Teens
- Intrusive thoughts or mental images that feel unwanted and hard to control
- Thoughts that are often irrational, exaggerated, or unlikely, but feel very real to the teen
- A strong urge to perform compulsions or mental rituals (such as checking, counting, washing, or seeking reassurance)
- Temporary relief after performing a compulsion, followed by anxiety returning
- Feeling trapped in a repeating obsession–compulsion cycle
- Shame, guilt, or fear about their thoughts, even when they know the thoughts don’t reflect who they are
How Anxiety Disorders Typically Show Up in Teens
- Persistent worry or fear about school, friendships, family, health, or safety
- Concerns that are often realistic but exaggerated in intensity or frequency
- Physical symptoms such as stomachaches, headaches, restlessness, or trouble sleeping
- Avoidance behaviors (avoiding school, social situations, or stressful environments)
- Overthinking and reassurance-seeking without repetitive rituals
- Anxiety that feels constant rather than tied to specific intrusive thoughts
How Does OCD Affect Teens?
If they’re diagnosed, your teen’s mental health will be affected by OCD and anxiety, potentially for the rest of their life. Even if they haven’t been diagnosed, it doesn’t mean your teen is not living with OCD and anxiety. These conditions can affect every aspect of their life, including:
- Academic performance: The constant distraction and stress caused by OCD can make it difficult for your teen to focus on schoolwork, leading to a decline in academic performance. Compulsive rituals can also take up the time they would otherwise be able to use to study. They may also skip or avoid school out of embarrassment or because they slip behind, making it a struggle to catch back up.
- Social life: Teens with OCD may struggle to maintain friendships or engage in social activities due to shameful or guilty feelings (because they feel “weird”), the overwhelming need to perform compulsive behaviors, or avoiding triggers related to their obsessions. They might isolate themselves instead or only engage online, where they might feel safer or less judged.
- Family relationships: Obsessive thoughts and compulsions can be exhausting for both the teen and their family members. This can lead to strain in relationships as well as feelings of isolation and guilt. Parents can also feel burned out trying to accommodate compulsive rituals.
How Family First Addresses Teen OCD and Anxiety
We use evidence-based therapies at our Florida locations to help teens manage their OCD, including exposure and response prevention (ERP). ERP is a form of cognitive-behavioral therapy and is considered the gold standard in OCD treatment. It helps people gradually face their obsessive thoughts and learn how to manage the stress they feel without turning to compulsive rituals.
Our team also uses:
- Cognitive-behavioral therapy (CBT) for thought patterns, especially helpful for teens with co-occurring anxiety or depression
- Family therapy sessions to build better ways to cope instead of accommodating compulsive rituals
- Experiential therapies, like art, sandtray, or exercise, to help regulate the nervous system and build more stable emotional responses
- Somatic therapy to ease physical responses to stress and anxiety
- Medication management, when appropriate, to manage any severe co-occurring symptoms
Without treatment, anxiety and OCD can get worse—and the risk of co-occurring disorders rises. Older teens with OCD are more likely to deal with depression, which can cause suicidal thoughts and self-harming behaviors. And, as many as half of adults with OCD face severe impairment in their daily lives. Getting help for your teen now can help them manage their symptoms and feel more in control of their lives.
Get Help for Your Teen Today
If you’re ready to explore treatment options for your teen, reach out to Family First Adolescent Services. Our dedicated team is here to guide you through every step of the process, ensuring your child receives the compassionate care they deserve. We offer OCD and anxiety treatment in our residential program for boys and co-ed partial hospitalization program here at Family First.
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