OCD and Addiction: Understanding Obsessive-Compulsive Disorder Treatment

What Is OCD?

Living with obsessive-compulsive disorder can be challenging and debilitating. If left untreated, it can lead to anxiety, depression, and even suicidal thoughts.

For some, this condition can be the start of a vicious cycle of chemical dependency that causes depression, triggering anxiety and worsening symptoms.

Integrated treatment is the best way to treat OCD and addiction. This approach combines mental health care with a substance abuse treatment program. OCD, which stands for obsessive-compulsive disorder, is a severe mental illness that has two aspects:

• Obsessions: intrusive thoughts, images, or impulses
• Compulsions: the urge to do something over and over again

Actions, such as excessive hand-washing or checking things repeatedly, are often associated with this condition. However, although these actions may be examples of tendencies, the actual disorder is much more severe.

How OCD Affects Life

People living with this condition have little control over their obsessive thoughts and compulsive behaviors. The time-consuming nature can negatively affect work, school, or social life.

Medical professionals still do not entirely understand the neurological roots of the disorder. A recent study published in the journal Biological Psychiatry found that people with this condition displayed more activity in the brain regions associated with recognizing an error but had less activity in areas of the brain that could stop an action.

Some other studies have reported an association between this disorder and childhood trauma. However, more research is needed to confirm the findings.

How Common Is OCD?

According to the Anxiety and Depression Association of America (ADAA), 2.2 million adults, or 1.0% of the US population, has this condition. It is equally common in men and women, and the average onset age is 19.

It’s estimated that on a worldwide level, around 2% of people have obsessive-compulsive disorder.

How Is It Diagnosed?

A simple blood or genetic test can not detect this condition. A doctor may do a physical exam and blood test only to rule out other medical conditions.

Generally, diagnosis occurs through an interview with a skilled clinician to discuss thoughts, feelings, symptoms, and behavior patterns to see if the person has obsessions and compulsions that affect their quality of life.

How Are OCD and Addiction Connected?

The relationship between these two conditions is complex. Many people with this disorder resort to substance use to subdue feelings of anxiety and stress.

One study published in the Journal of Anxiety Disorders found that:

• 27% of adults with this condition met the criteria for a substance use disorder
• 12% met the criteria for an alcohol use disorder
• 11% met the criteria for alcohol and a drug use disorder, and 3% met the criteria for a drug use disorder

People who started experiencing symptoms in childhood or early adolescence have also been found to have increased rates of abusing substances.

Is Social Isolation a Factor in Addiction?

People with obsessive-compulsive disorder understand the severity of their condition and the irrationality of their actions. They understand the relationship between their obsessions and compulsions, although they have no control over it.

Not being able to break free from these thoughts and actions can be very distressing. As a result, some people retreat into their homes and distance themselves from their friends and family.

A possible side effect of this social isolation is depression, making the person even more susceptible to substance use.

Understanding Obsessions

Common Types of Obsessions

Obsessions can take many different forms, including:

• Fear of contamination by dirt or germs
• Worries about harming others
• Preoccupations about numbers, patterns, or sexual identity
• Concern with orderliness and symmetry
• Fear of losing control over one’s behavior

Effects of Obsessions

Some examples of effects caused by obsessions include:

• Not touching objects that other people have touched
• Doubts that you have locked the door or turned off the stove
• Thoughts of driving your car into a crowd of people
• Troublesome sexual images
• Thoughts about acting inappropriately in public
• Avoiding situations that can trigger obsessions

Addiction vs. Obsession

Although somewhat similar, there are some crucial distinctions between these two conditions.

When there is an addiction, there is little control over doing, taking, or using something to the point where it can be harmful. However, biological processes at work have been manipulated by substances over time, making it difficult to experience pleasure or euphoria unless the substance is present. Addictions are also frequently rooted in escaping from the real world to a desirable place.

On the other hand, an obsession is a ritualistic routine that becomes part of a person’s everyday life. It’s possible to be obsessed with a story, a thought, an idea, an activity, or another person.

For example, an obsession may include repeated hand washing after touching someone or rechecking all the doors at night several times even though they’ve already been locked.

All of these obsessions are rooted in fear. Fear that if you do not lock the doors, a burglar will come into the house. Fear that if you do not wash your hands several times, you will catch some terrible disease.

Understanding Compulsions

Common Types of Compulsions

Compulsions can take many different forms, including:

• Excessive cleaning or washing
• Meticulously arranging objects
• Walking in predetermined patterns
• Compulsive counting
• Following a strict routine
• Demanding reassurance

Effects of Compulsions

Some examples of compulsive behavior include:

• Washing your hands until your skin becomes raw
• Checking the stove multiple times to ensure it is off
• Checking the door locks repeatedly to ensure they are locked
• Arranging kitchen items to face the same way
• Silently repeating a word, phrase, or prayer
• Counting steps

Addiction vs. Compulsion

One significant difference between addiction and compulsion is that addiction has to do with pleasure, and compulsion does not. Using a substance like heroin or other addictive behaviors like gambling typically results in some sort of pleasurable experience, at least at first. In contrast, a person cleaning excessively or checking the door locks repeatedly does not get pleasure from the act.

The second significant difference is that people with compulsive behavior are very aware of their compulsion’s negative effects on their quality of life. Addiction may not be as easy to identify.

Professional Treatment Options

Effective care requires specialized approaches that address both the obsessions and compulsions characteristic of this disorder. When these conditions co-occur with substance use, integrated approaches that address both simultaneously produce the best outcomes. Professional help enables individuals to understand their patterns, develop coping strategies, and reduce the distress caused by obsessive thoughts and compulsive behaviors.

Treating a Dual Diagnosis

A co-occurring psychiatric condition or dual diagnosis is when there are a substance abuse disorder diagnosis and one or more mental health disorders.

Integrated care for dual diagnosis is more effective compared to treating individual disorders with separate plans.

Integrated approaches include the use of multiple modalities such as the combination of psychotherapy and pharmacotherapy.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) can help explore thoughts and beliefs surrounding substance use and ultimately change negative thinking patterns. CBT is one of the most effective forms of OCD therapy, particularly a specific type called Exposure and Response Prevention (ERP). This specialized approach helps individuals gradually face their fears and resist engaging in compulsions, breaking the cycle that maintains the disorder.

Medication for Treatment

Medications such as selective serotonin reuptake inhibitors (SSRIs) can help people control their obsessions and compulsions. As this condition is associated with low serotonin levels, SSRIs can increase the brain’s serotonin levels by limiting its reabsorption by brain cells. Common SSRIs include citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline.

Comprehensive Support Services

Integrated programs may also include additional support services to help obtain long-term recoveries, such as housing, employment, and socialization.

Support groups such as Dual Recovery Anonymous can give emotional and social support. During these meetings, anyone can share their personal experiences regarding how they have learned to cope with their symptoms.

Integrated care is available as part of inpatient and outpatient programs.

Why Integrated Care Matters

The relationship between OCD and addiction is cyclical and self-perpetuating without professional intervention. Many individuals use substances to temporarily escape from intrusive thoughts and the anxiety caused by their compulsions. However, substance use ultimately worsens obsessive-compulsive disorder symptoms and creates additional problems that compound distress. Effective OCD treatment must address both the substance use and the underlying mental health condition simultaneously.

At Compass Recovery in Orange County, we provide comprehensive OCD therapy alongside substance use care through our integrated dual diagnosis program. Our experienced team understands the unique challenges of treating these co-occurring conditions and utilizes evidence-based approaches including specialized CBT for obsessive-compulsive disorder, exposure and response prevention, medication management, and holistic healing methods. We address both the compulsions and obsessions while treating substance use in a supportive residential environment.

Get Help Today

This information should not replace a visit to a doctor or treatment center. If you are concerned that you or a loved one might be struggling with co-occurring disorders, ask for professional help today.

Don’t let OCD and addiction control your life any longer. Professional care can help you break free from the cycle of obsessions, compulsions, and substance use. Our admissions team at Compass Recovery is available 24/7 at (949) 444-9047 to answer questions, verify insurance coverage, and help you begin your journey toward freedom. Contact us today and discover that recovery is possible with expert, integrated care.

If you are experiencing a mental health crisis or need immediate support, please visit SAMHSA’s National Helpline or call 988 for the Suicide and Crisis Lifeline.