Obsessive-compulsive disorder, or OCD, is an anxiety disorder in which an individual experiences recurring thoughts that cause irrational fears and anxiety. Individuals with OCD engage in repeated, compulsive rituals, such as counting items, hand washing and organizing. Executing these rituals provides temporary relief while they are being performed, but the anxiety returns soon after they stop. OCD is a highly destructive disorder that can overtake the life of an individual and keep him from enjoying many life’s most rewarding activities.
The Journal of Anxiety Disorders estimates that over 25 percent of those who seek treatment for OCD also meet the criteria for 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, often as a way to cope with overwhelming anxiety and fear. Treating an addictive disorder without addressing the emotional symptoms of OCD is unlikely to be effective.
Facts About Obsessive-Compulsive Disorder
OCD is frequently the subject of humor, fascination, or horror in movies and on television. We laugh at TV characters who observe complicated cleaning rituals or insist on controlling every aspect of their environment. We watch frightening movies about criminals who are obsessed with murderous acts or sexual behaviors. But in reality, those who live with OCD experience intense anxiety and internal torment over their uncontrollable thoughts. These intrusive thoughts can interfere with relationships, school, employment and social development. At times, it may seem that intoxication with drugs or alcohol is the only way to escape these persistent, unreasonable thoughts.
What is OCD, and how does it increase the risk of substance abuse? Here are a few facts about this debilitating mental health disorder:
- OCD affects about 2.2 million men and women in the United States, according to the Wexner Medical Center at Ohio State University.
- The disorder appears to have a genetic component, occurring more frequently in family members.
- Individuals with OCD are aware that their fears are unreasonable, but they still can’t control their need to perform compulsive rituals to relieve those fears.
- Ritualized behaviors, such as hand washing, checking locks or cleaning one’s living environment, can consume so much time that they interfere with other daily activities.
- Substance abuse, depression and other anxiety disorders often co-occur with OCD.
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The fears and rituals associated with OCD vary from one individual to another; however, certain patterns and similarities appear in this population. The Nemours Foundation notes that some of the most common fears among adults or children with OCD are:
- A fear of being exposed to bacteria or viruses
- An obsession with specific numbers that are considered “good” or “bad”
- A preoccupation with religious topics
- A fear of getting sick or of losing a loved one to illness or injury
- Intrusive images of sexual acts
- Intrusive thoughts of harming others or oneself
Rituals that involve grooming, cleaning, counting and organizing are among the most common behaviors seen in people with OCD. Some of these individuals worry that if they don’t carry out their ritualistic behaviors, they or someone close to them will be harmed. Others worry that if they don’t complete these rituals, they will hurt someone else.
Anxiety and Substance Abuse
OCD is one of several psychiatric conditions that is categorized as an anxiety disorder. According to the Anxiety and Depression Association of America (ADAA) approximately 20 percent of the people who have an anxiety disorder also have a substance use disorder. Unfortunately, these substances often make symptoms worse and ultimately increase the problems associated with OCD. The ADAA reports that over 26 percent of emergency room visits in the US are related to anxiety disorders.
Addiction itself is a compulsive condition, causing the repetitive pursuit of a destructive substance or behavior in spite of the negative consequences.
Obstacles and Opportunities in Treatment
Treating OCD as a co-occurring disorder presents a lot of challenges, but it also offers valuable, life-changing opportunities. Entering a treatment facility may be frightening, because it presents all the unknown factors of an uncontrollable environment. Intrusive thoughts and time-consuming rituals make it difficult to focus on individual therapy sessions or group meetings. A specialized Dual Diagnosis treatment program can accommodate the needs and symptoms of OCD, making it easier for these clients to complete their rehabilitation program.
According to the University of Michigan Depression Center, medication and behavioral modification therapy are the most common tools used to treat anxiety disorders like OCD. Cognitive Behavioral Therapy, or CBT, is a therapeutic modality that focuses on teaching the client how to identify and change negative behaviors. In the case of OCD, therapy sessions may encourage the client to expose himself to the object of fear without performing anxiety-reducing rituals. The ultimate goal is to eliminate the irrational anxiety associated with specific situations or items.
Antidepressants and OCD
Antidepressant drugs have been used successfully to minimize the symptoms of OCD. A class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) has proven to be especially effective at treating this complex disorder. Many clients who begin pharmacological treatment for OCD find that they are able to concentrate more fully on their recovery if they are also taking medication and undergoing behavioral modification therapy.
Getting Help for OCD and Addiction
Secrecy is often a hallmark sign of OCD, and one that makes for additional complications in treating the disorder. People with OCD are experts in keeping their disorder hidden; therefore, it remains out of the reach of loved ones to identify the problem and assist in seeking out help. Too often, by the time the individual does seek out professional help, the illness is in a much more advanced state, and the habits associated with it are more deeply ingrained.
When an individual with OCD becomes addicted to drugs or alcohol, they often keep their substance abuse a secret as well. Therefore, by the time friends and family realize what is going on, the process will likely be in a very advanced state.
Here are a few red flags that may alert you to substance abuse in someone you love:
- Losing interest in activities, hobbies or friends
- Spending more time than usual alone behind locked doors
- Responding to questions about their behavior in a defensive, hostile manner
- Behaving in an irritable, agitated way
- Staying out late at night and sleeping late in the morning
- Stealing money or prescription medications
- Hiding drug paraphernalia in drawers, closets or backpacks
A Dual Diagnosis applies to any individual who meets the criteria for a substance use disorder and a mental health condition. Dual Diagnosis patients must receive specialized care administered by professionals who understand how these afflictions overlap and interact with one another. The longer the problem goes untreated, the more serious the situation becomes.
But those who suffer from OCD and drug addiction are unlikely to seek out help for themselves. This makes the involvement of friends and family so important. Intervention in the situation is often required to help the individual in question get the help they need.
Seeking out help for OCD and addiction means finding a program that specializes in Dual Diagnoses, such as what is offered at Foundations Recovery Network’s facilities: Michael’s House, Black Bear Lodge, Skywood Recovery and Talbott Recovery. The addiction specialists on call at these residential rehab centers are experts in the important issues and treatments surrounding Dual Diagnosis patients.
Further Reading About Obsessive Compulsive Disorder and Addiction
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.