Addiction and Obsessive Compulsive Disorder

Addiction can make you feel like you’re not in control of your life. It can feel like you are being controlled by cravings and obsessive thoughts that don’t allow you to carry on normally with your daily activities. It is expected for you to engage in compulsive behaviour if you’re addicted to a substance. If you have an addiction, you will likely continue to seek and use drugs, even if you’re fully aware of the negative effects of your behaviour.

Repetitive actions and compulsive thoughts are also among the most recognisable symptoms of obsessive compulsive disorder (OCD). It’s for this reason that it may not be easy to tell the difference between the symptoms of addiction and those of OCD if you have both disorders. While this can prove to be a challenge, there are successful approaches to treating both conditions.

What is obsessive compulsive disorder?

Every now and then, people may wash their hands more often than necessary or return home to double-check the locks. This is only a minor part of what it’s like to have OCD. If you have this condition, these compulsive behaviours and anxieties become overwhelming and uncontrollable; so much so, they can make it impossible (or at least very difficult) to live a healthy and stable life.

The condition causes you to use repetitive, ritualistic actions to get some form of relief from the stress of your addiction. You may believe that if you don’t keep checking your locks or washing your hands several times a day, something bad could happen to you or your loved ones.

Scientists still don’t know the exact cause of OCD, though it has been found to be related to reduced or inadequate production of serotonin, which is a neurotransmitter that affects your mood and mental stability. This condition is a chronic disorder that can remain with you as long as you live, but it can be managed with antidepressant medications and psychotherapy.

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Spotting addiction and obsessive compulsive disorder

One of the most serious risks associated with both addiction and OCD is the tendency for social isolation. If you have OCD, you may make the effort to hide from what you believe are the dangers of a certain social situation. Alternatively, you might want to mask your fears and drink alcohol in order to achieve this.

Having both disorders can be dangerous, as the symptoms of one disorder can exacerbate those of the other. For example, your anxiety may get worse over time as your abuse of alcohol morphs into addiction. As your anxiety worsens, you may end up drinking more and that can make your addiction even more severe.

If you’re concerned that you or a loved one may have both conditions, there are a few signs to look out for. Some of these include increased anxiety when the effects of the alcohol wear off, social isolation, impulsive behaviour, agitation, panic attacks, nightmares, guilt and depression. Strong indicators of OCD may include excessive cleaning, compulsive counting, fearing that you or your loved ones will get sick and hoarding collectible items.

Statistics and facts about obsessive compulsive disorder

  • The condition is believed to have a genetic component, since it occurs more frequently in members of the same family
  • People who have the disorder know that their fears are not reasonable, but yet are unable to control their need to engage in compulsive actions as a form of relief from those fears
  • Repetitive, ritualised behaviours like always cleaning the home, changing locks, or washing hands can take up so much time that they get in the way of other day-to-day activities
  • Conditions like depression, substance abuse and other anxiety disorder often tend to co-occur with OCD

Origins of obsessive compulsive disorder and who is most at risk

There are no known causes of the disorder, but experts have linked it with neurotransmitter imbalances in the brain. These imbalances lead to a blockage of communication between certain regions of the brain. In particular, serotonin and vasopressin have been associated with the thought processes and behaviours of OCD. The latter is involved in cellular function and fluid regulation, while serotonin affects sleeping patterns, metabolism, moods and emotional regulation.

Scientists have also found that people with OCD may have structural abnormalities in the basal ganglia and frontal lobes of the brain. These parts of the brain are associated with movement and cognition. In some cases of OCD, symptoms similar to those seen in disorders like Tourette’s Syndrome may be exhibited. Such symptoms may include compulsive body motions like repetitive blinking or tapping.

You may be at risk of having the condition if you have a family member who is affected by it. The disorder has been found to run in families, much like other forms of mental illness. It doesn’t have to be a parent who has it for you to be at risk. Rather, it could be a sister, brother, or any other close blood relative. There are other theories regarding the possible causes, including exposure to environmental toxins and childhood illness.

Symptoms of obsessive compulsive disorder

OCD used to be classified as an anxiety disorder, but it was placed in a separate category with others involving obsessive fears of repetitive behaviours. Regardless of classification, anxiety and fear remain central in your thought process if you have OCD.

There are a number of thoughts, images or fears seen in cases of OCD. Obsessive compulsive behaviours can include repeatedly checking electrical appliances or locks, rituals involving repetitive grooming or cleaning, rituals involving counting, preoccupation with certain symbols or numbers, fear that your loved ones will get hurt, fear that you’ll get injured or sick, fear of parasites and germs, a compulsive need for cleanliness and order and hoarding trash, containers, or collectible items.

Others may include an obsession with sexual words or images, an obsession with counting things, being obsessed with symmetrical placement of objects, the fear of offending a religious deity, fear of losing possessions or forgetting things, fear of harming yourself or others, fear of unclean environments or substances and the obsessive fear of doing bad things or being an evil person.

Obsessive compulsive disorder and addiction: Understanding the relationship

Experts see many cases of OCD co-occurring with addiction. If this is what you’re dealing with, then it is possible that you began to self-medicate with drugs or alcohol in order to manage your symptoms. Tranquilisers or alcohol can help with your anxiety if you are consistently anxious or afraid, providing temporary relief from your obsessive thoughts. Sadly, these thoughts return after the effects of the substance wear off.

Not only will the symptoms you attempt to self-medicate return, but alcohol and illicit drugs can actually make them worse, which in turn gives OCD more power over your life. Evidence shows that people who had compulsive behaviours and obsessive thoughts in early adolescence and childhood are more likely to abuse alcohol or drugs when they get older.

Experiencing obsessive compulsive disorder at a young age can cause significant psychological distress and make you isolated from your peers. If your all-consuming fears cause you to remain housebound, the isolation can raise your risk of depression and make you vulnerable to substance abuse. This only leads to a vicious cycle in which substance dependency increases depression and isolation, which can then trigger anxiety and worsen OCD symptoms.

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Why so many people with obsessive compulsive disorder are addicted to substances

Often, you are at risk of having OCD if a close relative has it, because the condition has a genetic component to it. Addiction is similar in the sense that you are also at risk of developing an addiction if it runs in your family. While you may not necessarily develop either (or both) of these disorders because a close relative has them, there are other factors that could contribute to the fact that many people suffer from both conditions.

One of the most obvious reasons that individuals with OCD become addicted to substances is that alcohol and other addictive substances are often used to self-medicate the symptoms of obsessive compulsive disorder. In order to get relief from your symptoms of anxiety or fear, you may consume alcohol or drugs. However, the problem is that your symptoms will return after the effects of the substance wear off and before you know it, you’re returning to the same substances to manage the same symptoms.

Over time, as you continue to self-medicate with drugs or alcohol, you can become dependent and then addicted. Soon, you may be locked in a vicious cycle that makes your OCD symptoms – as well as your addiction – worse.

The effects of substance abuse on obsessive compulsive disorder

OCD is a psychological disorder that tends to have high co-morbidities with various other psychological disorders. Among the disorders often seen co-occurring with it are ADHD, personality disorders, bipolar disorders, anxiety disorders and depression. Having a disorder like this puts you at higher risk of suffering from a substance use disorder, which can significantly worsen OCD.

Often, OCD symptoms precede substance abuse. The reason for this that you may use alcohol and other drugs to provide relief from obsessive fear and anxiety. While you may get temporary relief during the period in which the substances work, once they wear off, the symptoms return and leave you right back where you started.

Substance abuse can make obsessive compulsive disorder worse, because many substances can actually cause anxiety issues. Alcohol in particular can result in effects that mimic those of OCD. This can prove problematic in treatment, especially when both disorders are advanced. However, it is possible to treat both successfully. Please seek help as soon as possible if you believe you or a loved one have OCD, as well as problems with drugs or alcohol.

Living with obsessive compulsive disorder and addiction

Living with these serious conditions can be very difficult, as each one on its own can rule your life. OCD can cause a number of painful or annoying complications, which may include issues like suicidal thoughts and frequent embarrassment. The despair, hopelessness and distress caused by the disorder can be frustrating and it gets worse if you have to deal with an addiction as well. However, it is important that you don’t lose hope, because help is available.

You may experience problems holding down a job, as there are a number of ways your co-occurring disorders can cause serious problems at work. For instance, it may lead to reduced productivity, because it can be very time-consuming. It doesn’t help either if you have to drink or use drugs at work in order to cope with your symptoms.

There are other problems you might face, including relationship issues and poor academic performance, because you’re unable to pay attention in class. Another serious problem you may have to deal with is shame. You don’t have to continue to feel this way or suffer the effects of these co-occurring conditions. Seek treatment, as it can go a long way to help improve your quality of life.

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Ten things you should know about obsessive compulsive disorder and addiction

  1. OCD and addiction are chronic disorders. That means there is no cure, but they can be managed with proper treatment. During treatment, particularly cognitive/behavioural therapy, you will learn how to use certain tools to cope with these conditions. Failure to apply them and exert some control can cause you to relapse.
  2. OCD was called the ‘doubting disease’ in the 19th century for a reason. Doubt and guilt are regarded as hallmarks of the disorder. These qualities are behind much of what manifests as symptoms.
  3. It is possible to resist acting on a compulsion, but impossible to refuse to have an obsessive thought, as such thoughts are biomechanically generated events of a mental nature that are not your real thoughts, but seem to be so.
  4. Psychotherapy is a highly effective form of treatment for both OCD and addiction. Cognitive Behavioural Therapy (CBT) in particular is believed to be the best form of treatment for obsessive compulsive disorder.
  5. Medication can help, but is not a complete treatment for addiction and obsessive compulsive disorder.
  6. Getting well depends mostly on you. You should not depend on the help of anyone to maintain abstinence and manage anxiety. Others may support you, but you carry the weight.
  7. Treatment is intended to provide you with the tools needed for recovery. In other words, it teaches you to become your own therapist.
  8. Addiction and OCD are best treated together and at the same time, rather than separately or by ignoring one entirely.
  9. Recovery takes time and can be a lifelong process.
  10. The risk of relapse is always there, so you must always be on guard.

Risks associated with long-term addiction and obsessive compulsive disorder

One of the problems that may surface after dealing with OCD for a long time is increased risk of suicide. Suicidal thoughts and behaviours may become more frequent over time, especially if the symptoms keep getting worse.

You may also risk serious damage to your psyche and mental health. Some of the same areas of the brain are affected by both disorders and so much strain can cause damage. While OCD may not necessarily cause any direct physical harm, dangerous substances can cause liver problems if used for a prolonged period of time.

Obsessive compulsive disorder and alcohol addiction

If you have OCD, you may be able to vividly remember what it was like to have your brain cells work in a manageable and predictable way. This can cause desperation to have control once again and the easiest way to do so might seem to be using alcohol or drugs. Drugs like cocaine and heroin can help make your symptoms more tolerable by boosting happy chemicals in the brain.

Drugs like benzodiazepines or alcohol can help you deflect your compulsions or avoid your thoughts due to their sedating effects. Before you know it, you can become addicted with repeated use of these drugs. Having OCD puts you at greater risk of being addicted because of the way your brain works. Cravings for drugs can turn into a new obsession that you’re unable to control and using drugs can be a compulsion that caused the obsession to go away.

You may even develop obsessive mannerisms about how you take drugs by counting out the doses you have left, taking a particular number of pills or lining up materials in a row. Addiction and OCD are a dangerous combination, as the substance of abuse can make your symptoms worse, which in turn can push you deeper into addiction as you continue to use the substance to find some level of relief.

Can alcohol worsen obsessive compulsive disorder?

Yes. Alcohol can cause OCD to become worse. As much as it may seem to provide some level of relief from symptoms of the disorder, these satisfactory effects are only short-lived. Anxiety is actually one of the effects of excessive, long-term use of alcohol; when that is added to the mix, the anxiety resulting from this condition can only get worse.

The worse your symptoms become over time – and the longer you use alcohol to self-medicate – the more likely you are to develop an addiction, which can lead to a host of other problems that can make life even more difficult.

Alcohol might seem like a reasonable means to self-medicate for anxiety and could appear to be helpful for handling social situations. It might also help you sleep better, feel more relaxed and normal. However, these are not good enough reasons to go down the path of alcohol abuse. If you believe you or a loved one has OCD and are abusing alcohol, please seek help as soon as possible.

Treating obsessive compulsive disorder and alcohol addiction

Co-occurring conditions should be treated simultaneously rather than favouring one over the other. Early intervention and treatment for alcohol addiction and OCD is recommended. It is best to receive treatment in a residential rehab facility, where you’ll be better able to avoid self-medicating with alcohol, since all access to it will be cut off.

It can be a challenge to find the right kind of treatment if you have a dual diagnosis. A good number of mainstream rehabilitation centres (to which you may have access) are not equipped to handle dual diagnosis. With OCD, you require special considerations, as well as medication therapy and counselling.

It is best to work with specialists who have experience dealing with such co-occurring conditions. Comprehensive treatment is required for both disorders if there is to be any chance of successful recovery. A dual diagnosis treatment advisor will be able to point you in the right direction, while taking your specific needs into consideration.

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Integrated treatment for a dual diagnosis of obsessive compulsive disorder and substance abuse

Integrated treatment is an ideal way of dealing with co-occurring conditions like these, because it addresses both adequately. It can be problematic to ignore one disorder and treat the other, because the links between these two conditions are often not entirely clear. Even though it is not easy to pinpoint the precise link between substance abuse and OCD, experts are aware that they are connected to similar regions of the brain.

Using the available knowledge of how these conditions affect one another, treatment specialists are able to come up with effective methods of treatment that integrate care for both of these disorders. A joint approach to treatment is believed to be the most desirable and most likely to lead to a favourable outcome. Among the treatment methods that have been found to work are motivational interviewing, 12-step facilitation, trauma-informed therapy and mindfulness.

Motivational Interviewing helps to address the intense internal conflict you can face when deciding to change your addictive behaviours. This approach involves a therapist helping you to explore your life goals and core values in order to determine whether abusing substances aligns with your perception of a healthy and positive life.

Choosing the best dual diagnosis treatment centres for obsessive compulsive disorder and addiction

Today, OCD is no longer the complex and mystifying disorder it once was. There are effective treatment options available that can help you to manage your symptoms and achieve successful recovery from your addiction. You don’t have to allow yourself or your loved one to live with OCD and addiction any longer, because you can receive professional help. The best dual diagnosis treatment is one that takes an integrated approach to helping you recover. There are a number of considerations that should be factored into your choice of treatment centre.

An ideal treatment centre ought to have a team of medical personnel, therapists and other addiction specialists who have experience dealing with addictions co-occurring with OCD. The centre should offer options that provide an integrated approach to treatment.

If you or your loved one have also had to deal with trauma, a useful form of treatment could be trauma-informed therapy. This type of treatment can help you regain a sense of control by emphasising emotional, psychological and physical safety. Other useful therapy approaches include dialectal behaviour therapy, cognitive behavioural therapy, group therapy and individual therapy – all of which can be tailored to suit your needs.


FAQs

What is obsessive compulsive disorder?

Also called OCD, obsessive compulsive disorder is a condition in which you have unwanted recurring sensations, obsessions, ideas and thoughts that make you feel like you must do something repetitively. It may lead to repetitive behaviours like repeatedly cleaning, checking on things, counting, or washing your hands. These repetitive behaviours can be so problematic that they actually get in the way of fulfilling your daily activities and social interactions.

How is OCD diagnosed?

In order to arrive at a diagnosis of OCD, there has to be a presence of compulsions and/or obsessions that are time-consuming; that is, taking up more than an hour a day. These compulsions and obsessions must also impair any important functions such as work and social interactions, in addition to causing major distress. The disorder is a chronic one, so it has no cure. However, it can be managed with the appropriate treatment approach.

What are the signs and symptoms of obsessive compulsive disorder?

OCD causes a range of physical and emotional side effects. If you suspect that a close friend or relative may have this disorder, it may be easier to spot the physical symptoms before the emotional ones. The physical signs may include constantly counting, always washing hands, repeatedly checking locks or electrical appliances and repeatedly cleaning items, amongst others. Beyond these, there are no other physical symptoms that accompany this disorder.

While there are no physical signs besides the compulsive and obsessive behaviours like the ones mentioned above, it is possible to develop physical problems linked to these behaviours. For instance, if you are obsessed with germs and parasites, you may wash your hands so much that your skin becomes raw, red and painful. The major emotional sign is anxiety and while you may not be able to feel it yourself if it is a loved one who has OCD, you may notice its manifestations.

It is also possible for you or your loved one to display a number of emotional symptoms, which may be regarded as non-OCD symptoms. These may include constantly feeling that nothing is ever right, extreme tension, excessive worry and signs of depression. Other signs that you may have OCD include having thoughts that you might be harmed or may harm others, persistent sexual thoughts, aggressive impulses, fear of contamination and repeated unwanted ideas.

What are the causes and risk factors of obsessive compulsive disorder?

There are a number of risk factors that can contribute to your having OCD, the first of which is genetics. You are especially at risk if a close family member such as a parent or sibling has the disorder. Genetics alone cannot cause OCD, as there are other factors at play, such as life events, your age, gender, personality, brain structure, employment status and drug use, amongst others.

Some of these risk factors interact with one another in different ways. For example, gender as a risk factor varies with age. If you are male, you are at greater risk for developing the disorder in childhood. By the onset of puberty, the risk for both females and males is largely the same. Depending on your personality type, you may be more susceptible to developing the disorder. For instance, you may be at greater risk if you score high on measures of neuroticism.

You may be at the greatest risk for developing the condition in your late adolescent years, but the risk starts dropping once you reach early adulthood. The connection is still not entirely clear, but there appears to be a relationship between certain irregularities in the brain and symptoms of OCD. In terms of socioeconomic status, you may be at greater risk if you are of lower socioeconomic status. Traumatic or incredibly stressful life events are another possible risk factor.

What is the treatment for obsessive compulsive disorder?

OCD is a chronic disorder, so treatment is not intended to bring about a cure. Rather, the goal is to help bring your symptoms down to a controlled level, so they don’t cause distress in your daily life. It is possible that you may need to continue treatment for as long as you live. The treatments available are effective, so you’ll have little to worry about. The two major forms of treatment available are medications and psychotherapy, which are often combined to create an effective treatment plan.

Psychotherapy has been found to be useful for treating the condition, particularly cognitive behavioural therapy (CBT). One type of CBT that may be used during your treatment is exposure and response prevention (ERP), in which you may be gradually exposed to an obsession or an object which you fear. The goal is not to torture you of course, but to help you learn healthy ways to cope with your anxiety. It takes some effort, but the result is always worth it.

Medications are typically used in combination with therapy in order to create the most effective treatment programme possible. The compulsions and obsessions of the disorder can be controlled using certain psychiatric medications – antidepressants in particular. Some of the most commonly used antidepressants include sertraline or Zoloft, paroxetine or Paxil/Pexeva, fluvoxamine, fluoxetine or Prozac and clomipramine or Anafranil.

Can addiction affect obsessive compulsive disorder?

Yes. Addiction can affect OCD, which may surface before you ever have any problems with alcohol or drugs. The symptoms of OCD mainly include fear and anxiety; these feelings can be so intense that you will want a fast way out, even if that involves alcohol or illicit drugs. Addictive substances can provide some level of relief from these symptoms. This makes it all too easy to get into the habit of using them to self-medicate. Unfortunately, this almost always ends badly.

Abusing drugs or alcohol is a dangerous coping method and can lead to addiction if you persist. Addiction can make OCD behaviours worse or make treatment more difficult. Many of the effects seen in addiction cases are the same or similar to those seen in OCD. This can cause some of your symptoms to worsen or become amplified. During treatment, the lines between both conditions can become blurry, making the dual diagnosis a challenge to treat.

In turn, OCD can also make addiction worse, because the more you feel the need to find some way to cope with your symptoms, the more you drink or consume an addictive substance to get some level of relief. Eventually, you may find yourself entangled in a vicious cycle.

What should I do if I have an addiction and obsessive compulsive disorder?

If you suspect that you have OCD and addiction, see a physician immediately. It is only a medical professional who can give you a proper diagnosis and suggest the most appropriate course of treatment. Don’t try to detox on your own, because doing so may cause dangerous withdrawal symptoms, depending on how dependent you are and the exact substance you have been abusing.

Also, don’t try to self-medicate any further by trying a new drug because you feel it may help. If the only thing keeping you away from seeking treatment is funding, explore different ways to raise money. For instance, you can combine any personal savings you may have with donations or loans from family and friends.

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