Obsessive-Compulsive Disorder and Addiction

Obsessive-compulsive disorder and addiction commonly co-occur, as many turn to drugs and alcohol in effort to suppress their symptoms.

The Relationship Between Obsessive-Compulsive Disorder and Addiction

Like many other anxiety disorders, alcohol and drug addiction often co-occur with obsessive-compulsive disorder (OCD). According to the Anxiety and Depression Association of America (ADAA), approximately 25 percent of the people who have obsessive-compulsive disorder also have a substance use disorder. Individuals who experience OCD symptoms for the first time in childhood or adolescence are more likely to develop a drug or alcohol problem later on in life, often as a way to cope with the overwhelming anxiety and fear. Many sufferers resort to substance abuse in an attempt to drown out the thoughts and emotional distress that their obsessions cause in their daily lives. Alcohol and/or drugs may provide the user a temporary sense of relief; however, these substances often make symptoms worse and ultimately increase the problems associated with OCD. Once the effects wear off, their intrusive thoughts and anxiety are stronger and more persistent than ever.

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What Is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder is a psychological condition that occurs when an individual suffers from constant anxious thoughts that lead to the performance of compulsive actions in an effort to calm those thoughts. People who develop OCD often exhibit persistent behaviors that include repeating actions, repeating words, counting, moving objects, and/or checking and rechecking items in a specific manner. Despite the fact that those suffering from OCD engage in these rituals in an attempt to reduce their anxiety, it never provides permanent relief. The compulsive behaviors are unrelenting and often increase in both severity and frequency during the natural course of the disorder.

One of the main symptoms of OCD is persistent doubt. Although people that are suffering from the disorder know that their obsessions are irrational and probably won’t ever happen, there is always a tiny possibility that the individual may experience one of the awful consequences they fear will happen if they don’t perform their compulsions, such as disease or injury. They also doubt their perception, feelings, and memories. People with OCD tendencies have lost “the experience of conviction,” which can lead to compulsions such as recurrent checking. The less an individual trusts their memory, the more he or she checks. Doors, windows, locks, and other things must be checked repeatedly because of the fear that something has been overlooked despite repeated efforts. Both the obsessive thoughts and compulsions can take up an inordinate amount of time, making it extremely hard to meet the demands of a normal life.

People suffering from OCD often describe feeling as if a hijacker has taken over their brain. Individuals with the disorder know that their fears are unreasonable, but still can’t control their need to perform compulsive rituals to relieve those fears. For instance, those with OCD who feel compelled to wash their hands know that their hands are not actually dirty. They know that their thoughts and actions are not rational, but they cannot stop themselves from behaving as if they were true. This knowledge that they are acting on irrational fears and situations can cause an individual considerable emotional pain because they cannot stop what they know is absurd. Very often, they attempt to keep these rituals secret due to embarrassment and fear of being humiliated or judged by others.

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Obsessions vs. Compulsions

Obsessions are recurrent and persistent thoughts, impulses, or images that cause individuals suffering from the disorder distressing emotions such as anxiety or disgust. Many people with OCD recognize that these thoughts, impulses, or images are simply a product of their mind and are unreasonable; however, they are unable to ignore or disregard them.

Common OCD obsessions include:

  • Fear of germs, viruses, bacteria, or “getting sick”
  • Obsessions over “good” or “bad” numbers
  • Intrusive thoughts of harm toward others or self-harm
  • Obsessions with religious topics or “blasphemous” thoughts
  • Intrusive images of sexual acts
  • Fear of losing a loved one to injury or illness

Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession. Those with OCD feel “compelled” to perform these behaviors or rituals regardless of the logic in doing so, as they provide relief from the discomfort caused by their feared situation.

Common OCD compulsions include:

  • Excessive washing and cleaning
  • Excessively “double-checking” things like light switches, appliances, and locks
  • Counting, repeating words, or tapping, to soothe anxiety
  • Excessive praying out of religious fear
  • Repeatedly “checking in” on loved ones’ safety
  • Hoarding useless items or trash

In some instances, a person may suffer from only obsessions or only compulsions. OCD symptoms often take up a lot of time (sometimes more than an hour a day) and significantly interferes with the person’s work, social life, and relationships. The emotional distress that these symptoms cause is the reason that many people suffering from the disorder will engage in substance abuse.

Obsessive-Compulsive Disorder and Addiction Treatment

The key to effectively treating co-occurring obsessive-compulsive disorder and substance use disorder is a multi-disciplinary approach that simultaneously addresses both disorders at the same time. Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP) are considered to be the most promising treatment regimens for the disorders. CBT is particularly effective as it teaches addicted individuals with OCD how to cope with the unwanted thoughts and feelings that can lead to drug or alcohol use. There are also many cases in which medication is combined with therapy to reduce and help end the OCD, which primarily consists of either anti-anxiety drugs or antidepressants.

Obsessive-compulsive disorder and addiction can leave you feeling helpless and alone; but know that it doesn’t have to be that way. A dual diagnosis treatment program staffed by a team of medical professionals that understand the complex nature of both OCD and addiction can help you beat substance abuse. Contact a dedicated treatment specialist today to learn about your treatment options.

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