OCD and Addiction

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What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder, or OCD, is a chronic anxiety disorder characterized by recurring, intrusive thoughts, ideas, or feelings that drive an individual to act in repetitive ways compulsively. The obsessive thoughts and behaviors associated with OCD trigger extremely distressing feelings and compulsive behaviors like constant checking or cleaning are the individual’s attempt to relieve those feelings. Some individuals find these feelings so distressing that they start to self-medicate with drugs or alcohol. In this way, OCD is often co-occurring with substance use disorders.

What are the Signs and Symptoms of OCD?

Common obsessions that people with OCD suffer include:

  • Fear or anxiety regarding contamination, i.e., from germs, dirt, the environment, etc.
  • Sexual thoughts, often with perverse or forbidden imagery
  • Fear or anxiety regarding losing control and behaving in an impulsive, inappropriate, or violent manner
  • Fears of responsibility, e.g., being afraid of being responsible for causing harm to others
  • Perfectionism, e.g., an irrational belief that there is one perfect way that things should or need to be done
  • Religious obsessions, i.e., the fear of offending God, or excessive concern with morality

Some people may experience obsessions that do not fall into these six categories, such as a preoccupation with superstitious beliefs, or the fear of developing cancer. Any concern that becomes excessive and leads to unwanted and intrusive thoughts and behaviors can qualify as an OCD obsession.

Common OCD Compulsions:

  • Excessive washing or cleaning, from brushing teeth so often and so forcefully that the gums are damaged, to scrubbing household surfaces repeatedly, even when they are already clean
  • Ordering, arranging, and rearranging things until the organization feels exactly “right.”
  • Checking things over and over, like whether the door is locked, or the oven is off
  • Compulsive counting of objects, actions, etc.
  • Feeling the need to use “good” words
  • Repetitive actions, movements or routines

Just like with obsessions, there are less common compulsions that are not included on this list. OCD compulsions are not the same as habits or rituals that anyone may have, such as needing to double check that the alarm is on before leaving on a trip. The distinction is that a person with OCD cannot control these behaviors, even when they are aware that they are extreme and are getting in the way of other aspects of life.

Individuals with OCD will often think about their compulsions even if they are not currently engaging in them, and will spend at least an hour or more a day engaged in compulsive behaviors. They will usually not experience pleasure after repeating these behaviors but, instead, a kind of relief from anxiety, or a brief respite from intrusive thoughts. OCD can be extremely disruptive in daily life, and can even be debilitating, preventing an individual from fulfilling personal and professional obligations, and causing a range of problems in daily life.

How Does OCD Interact with Addiction?

OCD often runs in families, and it is thought that brain circuits may not work properly in those who suffer from this disorder. Also, it is common for someone with OCD to also suffer from a substance abuse disorder or addiction.

Many people with OCD who begin abusing drugs and alcohol do so as a way to cope with or minimize their extreme feelings of fear or anxiety or to silence intrusive thoughts. This is known as self-medicating. Initially, the misuse of substances may seem to help, however, using drugs or alcohol is a dangerous coping method and many individuals who self-medicate become addicted.

People with OCD do not ever get a day where everything feels “right,” with no anxiety and no urge to act in compulsive ways, so the temptation to self-medicate will be continually present. What’s even more problematic is that both issues cause a number of the same effects in those who suffer from them, so that each disorder worsens the symptoms of the other.

How are OCD and Addiction Treated?

When you have a dual diagnosis of OCD and substance use disorder, both disorders must be treated at the same time to ensure that one does not derail the progress of the other. A patient should receive talk therapy in rehab that will help them understand why they began using drugs or experiencing the symptoms of OCD in the first place, allowing the patient to recognize and address the root causes of these issues.

Cognitive behavioral therapy is particularly useful for both OCD and substance use disorder. This form of treatment can help patients:

  • Cope with stress and triggers for both substance use and compulsive behaviors
  • Learn to recognize damaging and untrue thoughts that lead to compulsions
  • Start to reverse problematic habits and thought patterns, and replace them with safer, more beneficial ones
  • Set goals, make plans, and learn better life skills to practice in the future

Sometimes, medications to reduce anxiety may be necessary, particularly early in the recovery process. There are many pharmacological options for the treatment of OCD and specific drug addiction syndromes. Seeking treatment at a dual-diagnosis treatment facility with a medical staff will ensure that patients get safe, appropriate, and effective treatments for both OCD and addiction.