Many people experience intrusive thoughts, worries, or urges they cannot seem to turn off. You might find yourself asking, “Is this just anxiety… or could it be OCD?”
This is a very common question. Anxiety and obsessive-compulsive disorder (OCD) can look similar on the surface, especially when thoughts feel repetitive, distressing, or hard to ignore. Understanding the difference can help you make sense of what you are experiencing and decide what kind of support might be most helpful.
At Tiny Therapy Collective, we often work with adults across Ontario who feel stuck in cycles of worry, mental checking, reassurance-seeking, or rumination and are unsure how to label what they are going through.
What Is Anxiety?
Anxiety is a natural response to perceived threat or uncertainty. It is your nervous system’s way of trying to keep you safe. Anxiety often shows up as excessive worry about real-life concerns, such as work, health, relationships, or the future.
Common experiences associated with anxiety include:
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Persistent worry or overthinking
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Feeling on edge or tense
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Difficulty relaxing
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Physical symptoms such as a racing heart, tight chest, or stomach discomfort
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Avoidance of situations that feel overwhelming
In anxiety, worries usually feel connected to realistic concerns, even if they are exaggerated or hard to manage. Anxiety often responds well to therapy that focuses on understanding thought patterns, building emotional regulation skills, and supporting the nervous system.
What Is OCD?
Obsessive-compulsive disorder is not simply about being organized or liking things a certain way. OCD is driven by obsessions and compulsions, which work together in a cycle.
Obsessions are intrusive, unwanted thoughts, images, or urges that cause distress.
Compulsions are behaviours or mental acts done to reduce that distress or prevent something bad from happening.
Examples include:
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Repeated intrusive thoughts that feel disturbing or “out of character”
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Fear of causing harm, making a mistake, or being responsible for something terrible
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Mental rituals such as reviewing events, replaying conversations, or seeking certainty
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Reassurance-seeking from others or from yourself
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Checking, avoiding, or repeating behaviours to feel “safe enough”
Unlike general anxiety, OCD thoughts often feel ego-dystonic, meaning they go against your values or sense of self. This can create intense shame or confusion, especially when the thoughts do not match who you believe yourself to be.
Key Differences Between Anxiety and OCD
Although anxiety and OCD overlap, there are some important distinctions.
The Nature of the Thoughts
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Anxiety tends to focus on realistic future concerns, such as “What if I fail?” or “What if something goes wrong?”
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OCD focuses on intrusive, repetitive thoughts that feel irrational, disturbing, or impossible to resolve.
The Role of Compulsions
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Anxiety may lead to avoidance or reassurance-seeking, but these behaviours are not always rigid.
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OCD involves compulsions, either physical or mental, that feel necessary to relieve distress, even if only temporarily.
Relief Is Short-Lived in OCD
With OCD, compulsions reduce anxiety briefly, but the distress returns quickly, often stronger than before. This reinforces the cycle.
Control and Certainty
OCD is driven by a strong need for certainty. Many people with OCD feel stuck trying to get “just enough reassurance” to finally feel calm, which never fully arrives.
What About Intrusive Thoughts?
Intrusive thoughts are a key feature of OCD, but they can also occur with anxiety, trauma, or depression. The difference lies in how the thoughts are interpreted and responded to.
With OCD, intrusive thoughts often lead to:
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Intense fear or guilt
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Repeated mental checking or reassurance
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Attempts to neutralize or undo the thought
Therapy that addresses intrusive thoughts, obsessive-compulsive patterns, and stress and burnout can help interrupt this cycle in a supportive, structured way.
How Therapy Can Help
Whether you are experiencing anxiety, OCD, or a mix of both, therapy can help you understand what is driving your symptoms and learn skills to respond differently.
At Tiny Therapy Collective, we take a compassionate, evidence-based approach:
Cognitive Behavioural Therapy (CBT)
CBT helps identify patterns of thinking that keep anxiety or OCD going. It supports learning how to respond to thoughts without getting pulled into cycles of fear or reassurance.
Dialectical Behaviour Therapy (DBT)
DBT offers practical tools for distress tolerance and emotion regulation, which are especially helpful when thoughts feel overwhelming or urgent.
Mindfulness-Based Approaches
Mindfulness helps create space between you and your thoughts, allowing them to pass without needing to analyze, fix, or eliminate them.
Trauma-Informed and Strengths-Based Care
Many people with OCD or anxiety are highly conscientious, empathetic, and self-aware. Therapy honours these strengths while helping reduce self-blame and shame.
For some clients, symptoms overlap with depression, low self-esteem, or patterns related to substance use and coping, all of which can be addressed collaboratively in therapy.
Everyday Supports You Can Try
While therapy is often key, there are small steps you can take now:
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Notice reassurance-seeking: Ask yourself whether seeking reassurance brings lasting relief or keeps the cycle going.
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Label the pattern: Gently naming “this feels like an intrusive thought” can reduce its power.
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Practice allowing uncertainty: Anxiety and OCD both thrive on certainty. Practicing small moments of uncertainty can build tolerance over time.
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Ground your body: Slow breathing, movement, or sensory grounding can help calm the nervous system when thoughts feel intense.
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Reduce self-judgment: Having intrusive thoughts does not say anything about your character or values.
When to Consider Professional Support
It may be helpful to connect with a therapist if:
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Thoughts feel repetitive and distressing
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You spend a lot of time managing or neutralizing thoughts
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Anxiety or compulsions interfere with work, relationships, or rest
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You feel stuck in mental loops you cannot break on your own
Taking the Next Step
You do not need to figure out whether it is “anxiety or OCD” on your own. Many people experience a combination of both, and support can be tailored to your unique experience.
At Tiny Therapy Collective, our therapists work with adults across Ontario using CBT, DBT, mindfulness, and trauma-informed care to help reduce distress, build confidence, and create lasting change. We offer services both online and in-person at select locations.
If you are wondering whether therapy could help, we invite you to book a free 15-minute consultation to explore next steps and find support that feels right for you.
