Have you ever experienced a time when you were overly concerned or worried about something? Symptoms of psychiatric disorders such as Obsessive-Compulsive Disorder (OCD) and Phobia are similar which can confuse individuals trying to differentiate disorders and are often misunderstood or even mistaken for each other.
Both disorders result in intense anxiety particular to a fear or phobia and avoidance behaviors, but they originate, function, and are treated very differently. In this blog, we are going to outline what OCD and phobias are, how they are different from each other, how they happen, what the symptoms are, interventions, and why understanding the difference is important?
Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder (OCD) is a chronic mental health disorder characterized by the presence of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, or images that lead to significant anxiety and distress.
People react to their obsessions through compulsions, repetitive behaviors or mental acts done in response to the obsession with the hope that it will reduce anxiety or prevent a feared event, almost always according to rigid rules.
For example, a person with OCD may have a persistent, intrusive worry about germs (obsession), and cope by washing his or her hands a number of times per day (compulsion). Core symptoms of OCD include intrusive thoughts that generate considerable distress, time-intensive and ritualistic behavior given to alleviating that distress, and some awareness that the thoughts and behaviors are excessive or irrational.
Other patterns of OCD include chronic time-consuming rituals that last for more than an hour each day and can cause significant distress and impairment of functioning in social, occupational, and personal life.
Phobia
A phobia is an intense and irrational fear of a specific object, situation, or activity that is disproportionate to the actual danger it poses. People with phobias experience very severe anxiety when encountering the thing that they fear and will often go to great lengths to avoid it. For example, someone with a phobia of spiders (arachnophobia) may go into a panic when seeing even a small spider and may even refuse to enter rooms where they think spiders may be encountered.
Some major characteristics of phobias are that they must have a specific trigger, such as heights, animals, and confined spaces, to which the person responds with immediate anxiety when near the trigger or even just thinking of it and or they show strong avoidance.
The adult individuals who recognize their fear is excessive or unreasonable. The fear will also be consistent and persistent for at least 6 months or more as changing in behavior due to the fear not severely affecting daily living.
What Causes OCD and Phobia?
OCD
- Obsessive-Compulsive Disorder (OCD) can develop due to a combination of several factors. Genetics make a substantial contribution; studies consistently show that a family history of OCD increases the risk of developing the disorder.
- Furthermore, the structure and functioning of the brain has been implicated, since abnormalities in serotonin transmission and brain regions, such as the orbitofrontal cortex and caudate nucleus, have been associated with the disorder.
- Environmental factors, like traumatic experiences in childhood or infections like Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), can also elicit a child exhibiting symptoms.
- People who are excessively detailed, perfectionistic, or who have a strong need for control are generally more vulnerable to OCD.
Phobia
- Phobias can emerge as a result of psychological, environmental, and/or biological factors. A traumatic experience may be a common cause; if an individual was bitten by a dog, they may have a fear of dogs that persists indefinitely.
- Another common origin of phobias is through observational learning; for example, if a parent or caregiver displays fear towards an object or situation, such as snakes, or weather, such as thunderstorms, then the child may internalize that fear.
- Evolutionary factors can contribute; people still have, or are likely to develop, fears based on their historical relevance to survival. For example, people may be more likely to develop a fear of heights, or fear of dangerous animals.
Finally, genetics may play a role in development of phobias; people with a family history of anxiety disorders may be more likely to develop phobias.
Symptoms of OCD and Phobia
Symptoms of OCD usually involve repeated and unwanted thoughts or images (e.g., fears of contamination, doubt). People with OCD will often engage in repetitive behaviors (e.g., handwashing, checking, or counting) as a way to alleviate their anxiety brought on by the obsessions they experience. This relief tends to be temporary, and the anxiety will generally return once the compulsions have been completed.
Symptoms of phobias involve an immediate anxious response when a person sees the fear object or situation. Symptoms are often manifested as sweating, shaking, and an elevated heart rate, often accompanied by fear, panic, or dread. Avoidance behavior occurs as well. In some cases, people will go to extreme lengths to avoid a phobia trigger. Symptoms can increase to panic attacks at their worst.
Treatment of OCD and Phobia
The most effective method of treating OCD usually involves the use of multiple treatment modalities.
- One of the primary treatment modalities involves a specialized form of therapy called (ERP) Exposure and Response Prevention, where the individual is gradually exposed to the trigger while being prevented from performing their compulsive actions, allowing the anxiety to calm naturally.
- Patients may also be prescribed medication, commonly taking the form of SSRIs (Selective Serotonin Reuptake Inhibitor), to help manage symptoms.
- Cognitive therapy is also helpful for patients with OCD, as it helps the patient to challenge their irrational beliefs that fuel their obsessions. If patients are seeking OCD treatment in NYC, it is important to find providers who specialize in ERP or OCD-focused Cognitive Behavioral Therapy (CBT).
- Acceptance and Commitment Therapy (ACT) manage OCD symptoms by helping individuals to accept their intrusive thoughts without judgment and reduce avoidance behaviors.
Phobias are generally treated through a modality called Exposure Therapy, which involves patients exposing themselves to their feared object or situation in a controlled manner and gradually until the anxiety disappears. CBT is also used frequently in conjunction with exposure therapy to help patients challenge and reshape their irrational fears as well.
Finally, patients should consider using some form of relaxation technique such as breathing techniques, and mindfulness or progressive muscle relaxation; which are all helpful in managing symptoms. Patients come to find that medications are rarely used for phobias unless the anxiety is extreme.
When OCD and Phobia Overlap?
It is fascinating that OCD and phobias can co-occur or mirror each other in certain aspects.
- For example, a person with OCD may develop strong fears around contamination, which may lead others to view them as having a contamination phobia; but, again, it is the compulsive behavior of cleaning a certain way, repeatedly, that does not exist with a phobia.
- Similarly, a person with severe agoraphobia (or fear of going out into open or crowded spaces) might develop checking compulsions to make sure they have everything they need to keep them from a panic attack.
- Given the overlap and the influence of their symptoms on one another, consideration by a professional is necessary to differentiate between the two and come up with the best treatment plan.
Conclusion
Although OCD and phobia are both classified as anxiety disorders, there are essential differences in what causes them, what they look like, and how they are treated.
- OCD involves unwanted and intrusive thoughts and compulsive behaviors that attempt to manage them.
- whereas phobia is more focused on a recognizable and identifiable external object/situation that leads to irrational fear and avoidance of that object/situation.
Understanding the difference matters—both in terms of clinical treatment and in order to better understand oneself better and help others. Whether you are searching for OCD therapy in NYC, or you are just trying to get help from someone, step one towards getting help can be scary. It is also step one towards reclaiming your life. You deserve to be free from fear. You deserve to have peace. You deserve to be exist beyond OCD and phobias.
References
- Audet, S. (2019). OCD is Not a Phobia: An Alternative Conceptualization of OCD. Clinical Neuropsychiatry, 16(1), 39. https://pmc.ncbi.nlm.nih.gov/articles/PMC8650207/
- “Phobias.” Johns Hopkins Medicine, https://www.hopkinsmedicine.org/health/conditions-and-diseases/phobias#:~:text=A%20phobia%20is%20an%20uncontrollable,the%20source%20of%20this%20fear.
- “Obsessive-compulsive disorder (OCD) – Diagnosis and treatment.” Mayo Clinic, 21 December 2023, https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438
- “Specific phobias – Diagnosis and treatment.” Mayo Clinic, 9 June 2023, https://www.mayoclinic.org/diseases-conditions/specific-phobias/diagnosis-treatment/drc-20355162
- “Symptoms – Obsessive compulsive disorder (OCD).” NHS, https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/symptoms/
