Re: GAD vs OCD and differential diagnosis

[Guest guest]

Kathy:

Thanks very much for responding with your informative and helpful post regarding

GAD vs. OCD.

Warmly,

in Missouri (Luke's mom)

Re: GAD vs OCD and differential diagnosis

HiI :

I was lucky enough to attend an excellent seminar at the OCF

Conference in 2000 by Dr. Lee Fitzgibbons and Dr. Rausch. It

was entitled " Generalized Anxiety Disorder: OCD in Disguise! "

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[Guest guest]

HiI :

I was lucky enough to attend an excellent seminar at the OCF

Conference in 2000 by Dr. Lee Fitzgibbons and Dr. Rausch. It

was entitled " Generalized Anxiety Disorder: OCD in Disguise! "

They compared the DSM-IV diagnostic criteria of OCD and GAD. My

summary (just a lay person after all) is that OCD has obsessions and

compulsions (both physical or mental) which are tied together in a

vicious cycle. GAD has worries and often observable neutralizing

behaviors. These neutralizing behaviors are not required by the

DSM-IV criteria for GAD but are frequently observed, e.g.

reassurance seeking, checking, mental reviewing (what I used to think

was wise planning ahead!), over preparation, medical consultation.

Also the GAD dx does not require insight into the excessiveness of the

concerns compared to OCD which does (except in children).

Although the worries of GAD are not described fully in the DSM-IV

criteria, GAD worries tend to be about real life concerns, e.g. job

responsibilities, finances, health of self/others, wellbeing of family

members, household responsibilities, being late, etc. Dr.

Fitzgibbons described GAD as having a whole smorgasbord of worries

that are more fluid and realistic than OCD obsessions. According to

the DSM-IV criteria OCD obsessions are not excessive worries about

real life problems but recurrent thoughts, images, impulses causing

distress or anxiety which the suffer attemps to supress or neutralize.

Avoidance in GAD tends to be more subtle than in OCD, for example when

I get GADing because my dh is not home on time, I start to think he is

in a crash and in the ER. Then when he comes home in one piece,

instead of welcoming him warmly I used to upbraid him for not

keeping me better informed of his whereabouts and ETA. This is a

form of avoidance in that I am trying to stop his behavior which can

be a trigger for my GAD. Now I try to recognize it as a GAD moment and

that my anxiety is out of proportion to the situation and welcome him

home warmly like a regular wife would.

Apparently people with GAD are commonly diagnosed with comorbid

anxiety disorders, in particular Social Anxiety, Panic Disorder and

OCD. I have a friend with GAD and Panic Disorder. The DSM-IV criteria

for OCD do not require physical symptoms of anxiety distress, whereas

those for GAD require three or more of the following physical anxiety

distress symptoms: restless,on edge; easily fatigued; difficulty

concentrating; irritability; muscle tension; sleep disturbance.

In both GAD and OCD the avoidance and/or neutralizing behaviors

provide immediate relief which unfortunately only serves to strengthen

the worry and anxiety and reduce effective functioning in a vicious

cycle.

Another reference I have found useful in understanding differential

diagnoses and OCD is: " Obsessive-Compulsive Disorder Casebook " by Dr.

Greist and Dr. Jefferson.

I think anxiety is so common. Now I know more about what to look for

I am surprised where I find it. When I talk about it with people

often they are getting treatment for it or realize it is a problem but

did not know about getting help so they feel better.

Take care, aloha, kathy (h)

kathyh@...

In @y..., " msmichelle " <msmichelle@k...> wrote:

> Kathy:

>

> What are some of the differences between OCD and GAD? I've never

done any research on GAD and Luke's psych has never mentioned it as a

possible diagnosis.

>

> Thanks for your insight.

>

> Warmly,

>

> in Missouri (Luke's mom)

> Re: Any thoughts on what I should do?

(long)

>

>

> HI Tana:

>

> We also live in a small town, not quite as small as yours, and

> definitely found it essential to travel (500 mile round trip by

air)

> each week to find suitable treatment for our son, Steve.

>

>

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Stembridge, and Jackie Stout. Subscription issues or suggestions may

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louisharkins@h... .

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