OCD vs. Phobia and Fear

I’ve struggled with anxiety issues for my entire life. Over time it has been bad enough to have been hospitalized, and it has subsided enough to give me a chance to step back and reflect on my phobias and fears. As well it goes without saying I also have OCD.

These two things are indeed interconnected. I often don’t know which is an offshoot of which. Does my anxiety stem from my OCD, or is my OCD a reaction to a base of anxiety?

While those questions will remain unanswered for now, I felt it would be good to explore the differences between OCD and phobia and fear. Because “anxiety” is such an amorphous concept, I am narrowing this down to the concept of “phobia” and “fear” to be most pointed.

The purpose of this article is not to downplay one or the other or to compare which is worse or… well, of course, I’m not going to say: better. Neither is better, they are just different, and it is worth exploring. Because exploration is how I learn about myself. Oh, I am often wrong, but I can only speak from my own experience. An experience I have a lot of.

I battle with OCD taking over my mind. I also battle with fears and phobias taking over my mind.

So let’s dig into the details of each and see how they differ. We’re going to stick with the term “fear” for the sake of brevity, but it is to include the concepts of phobia and anxiety and everything in that area of mental illness.

When it comes to fear, we’re often talking about a mechanism of the singular. That is to say, the brain is focused on one thing potentially doing one thing. If I have a fear of heights, it is pretty much focused on… heights. Being, well, way up there untethered. The fear, often irrational (we’ll get to that in a bit) is that I will fall. And the brain can extrapolate the falling all the way to the result of death.

With OCD, a much more multi-faceted universe is concocted which is equally irrational. However, the key here is the “universe.” OCD comes with a narrative that ends in fear and avoidance of said fear. To expand, when I am in an OCD episode, I do not just fear one thing resulting in one horrible conclusion. Rather, I have built (I hesitate to use the phrase “made up” because of the somewhat offensive connotations but it can work here) a set of circumstances that have caused things to not be right, and I need to act on this not-rightness.

For example, I’ve built up the idea that leftovers — which my rational brain knows to a 90% surety are not spoiled — are indeed spoiled food. I’ve built up a scenario around this. The seal on the container must not have been tight enough (I have no evidence of this, yet I think there’s at least enough of a chance.) There is air trapped in the container, which is akin to leaving it unsealed anyway (this isn’t how things work, at least not fully.)

This is OCD. It is irrational in a slightly different way. I’ve built a narrative from the past, and that narrative is driven by things that could be true to a rather minuscule percentage. In this example, there is probably a 1% chance the food is spoiled. Probably less. Damn near 0%. Yet, the thought is there for reasons I’ve come up with. I cannot stop these reasons. I know they are wrong, but I cannot stop them. Thus from that, I cannot be swayed in my fear. And I must take the action (compulsion) of throwing out what is most likely good food but is absolutely contaminated to me.

“Absolutely” is a strong word for something I know is irrational. But it is absolute. My brain has been convinced by my OCD telling it a story.

Now is fear more rational? It may or may not be. For one, if one is to climb 13 feet (or 50 feet!) into the air on a ladder, they very much so have increased their chances of falling. Now what the likelihood is of that happening can’t really be measured here. But there is no real narrative of the completely wrong that precedes such fear. It is just fear because the percentages of failure (falling) are not known fully, but rationally are certainly not bordering on 0%. People fall off ladders all the time. They do. You probably won’t, but if there are enough people reading this… one of you probably will.

If all of you had the same food in your fridge that I just threw out (sorry!)… my rational brain is certain that zero of you would get sick because of contamination and spoilage. But my OCD tells me the food is spoiled for… reasons.

OCD also involves magical thinking, where pure fear does not.

My brain, when my OCD is high, believes in omens. If you talk about a car accident while driving, I believe you have literally increased the chances of it happening. I will often (yes, rudely) shush you. Ok, I’ll try to be nice about it, but this is beyond fear. It is a way of thinking that is very near 100% irrational. Now, I’ve actually thought about this a lot and it all becomes murky. Is there a chance that one increases their potential for an accident just by thinking about accidents while driving? I haven’t looked up the science, but again — we’re probably not at 0% but damn close.

This one is very close to me in terms of comparison and contrast of OCD vs. fear and phobia.

The OCD in me does not want any talk of accidents while driving — not because the discussion is abhorrent to me — but because I truly believe (with part of my brain) that this increases the chances. On the other hand, I do have an extreme phobia for driving. To the point where I will not, and have not in years. The fear part is much more rooted in reality. I don’t have magical thinking when driving, I just don’t want to risk an accident and all the problems that will cause. Accidents are common. They’re not so tremendously common that the media is calling for all of us to stop driving. But we anecdotally know from seeing accidents that have happened every few months or weeks (depending on where you live!)

This is my experience with OCD vs. fear and phobia. They’re alike in many respects. I’m not even positive how they interact fully, but I do know they are separate entities in many respects, enough to detail them as such here.

Neither is better or worse. I don’t want my OCD as much as I don’t want my anxiety issues. I just happen to tackle them differently. Because they are different.