OCD or Anxiety? It's Not a Black and White Question | Dr Celin Gelgec & Dr Tori Miller

The question has been coming up in supervision a lot lately. Is this OCD — or is it GAD? Specific phobia? Health anxiety? Social phobia?

It sounds like a simple diagnostic question. It isn't.

In this episode of Breaking the Rules, Dr Celin Gelgec and Dr Tori Miller dig into one of the most common and most confusing clinical challenges in the OCD space — differentiating OCD from anxiety disorders that present in similar ways. They explore why OCD and anxiety so frequently co-occur, how anxiety disorders can morph into OCD over time, and why we're increasingly seeing subclinical OCD presentations in the clinic — and why that's actually a good thing.

They also talk about what to do when you genuinely can't tell. Why the DSM is a guide, not a definitive answer. And why the most important thing you can do is take your client along with you through the process — because a diagnosis that happens to someone, rather than with them, rarely lands the way it needs to.

Celin also shares a story about a client who'd worked through most of her trigger list — and then asked if she had to do the rest. What Celin said, and why, is one of the most honest things we've put in an episode about what it actually means to be done.

In this episode, you'll learn:

  • Why OCD was only separated from the anxiety disorders in DSM-5 (2013) — and what that tells us about how much they overlap
  • The anxiety disorders most commonly confused with OCD: GAD, health anxiety, specific phobia, and social phobia
  • Why untreated or poorly treated anxiety disorders can morph into OCD over time — and what to watch for
  • Why subclinical OCD is showing up more often — and why that's worth treating early
  • The key diagnostic features that separate OCD from GAD in practice
  • How scrupulosity OCD gets missed as social phobia — and why it matters
  • Why you don't need to know the answer straight away — and how to take your client through the process
  • What discharge from OCD treatment actually looks like — and who gets to decide

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