Obsessive-Compulsive Disorder or OCD is often the subject of humor and fascination on television, movies and the media. We may laugh at characters who follow complex cleaning rituals or who insist on controlling ever detail of their environment. We watch crime series about criminals obsessed with murder or deviant sexual behaviors. The truth is, OCD is nothing to laugh at and is, instead, a painful reality for millions of people every day. Individuals who live with OCD experience intense anxiety and torment over their uncontrollable thoughts. These thoughts often disrupt their daily relationships and interfere with jobs, school and social interactions which can lead to the dual diagnosis of OCD and addiction.
According to the Journal of Anxiety Disorders, over 25% of those who seek treatment for OCD also struggle with a substance abuse disorder. OCD often appears during adolescence, sometimes earlier, and young adults experiencing OCD symptoms during this time are more likely to turn to drugs or alcohol to cope with overwhelming anxiety. For many people suffering from OCD, the temporary relief offered by drug and alcohol may seem like a good way to escape the persistence of their unreasonable thoughts and behaviors. Let’s take a closer look at the relationship between OCD and addiction, as well as the treatments available today for this difficult dual diagnosis.
What is OCD?
Obsessive-Compulsive Disorder is an anxiety disorder in which a person experiences recurring thoughts that provoke irrational fears and intense anxiety. Those with OCD engage in compulsive and repeated rituals — for example, hand washing, organizing or cleaning one’s living environment. Although these rituals provide temporary relief while being performed, anxiety returns soon after they stop. OCD can be a highly disruptive and destructive disorder which overtakes the life of the person. Most often, it keeps him or her from enjoying normal daily activities or interpersonal relationships.
According to the Wexner Medical Center at Ohio State University, OCD affects about 2.2 million men and women in the United States. Research shows that the disorder also has a genetic component, occurring much more frequently in family members. Although those with OCD are aware that their fears and anxieties are unreasonable, they aren’t able to control their need to perform compulsive rituals to relieve their fears. Regardless of whether their fears are real or imagined, they consume an incredible amount of both physical and mental energy. In many cases, OCD causes anxiety, depression and even suicidal thoughts if left untreated. As with many other anxiety disorders and associated depression, alcohol and drug addiction commonly co-occur with OCD.
Obsessive-Compulsive Disorder often appears in someone’s late teen years or early twenties, although some cases begin as early as the preteen years. OCD is marked by having “obsessions” and/or “compulsions.” OCD often emerges in someone’s late teens and early twenties, but it can also start in the early teens. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), both obsessions and compulsions are time-consuming, taking up more than an hour a day. They also cause substantial disruption to the sufferer’s daily routines.
For example, someone with OCD might spend thirty minutes washing their hands after having an intrusive thought. He or she might complete this ritual despite being an hour late to work. The stress of OCD obsessions and compulsions on daily life can cause co-occurring drug addiction to take root. The rituals and fears common to OCD vary between individuals. However, certain similarities and behavioral patterns appear within the demographic.
Other rituals common to OCD may involve organizing, grooming and cleaning. Most people worry that if they don’t complete their patterns of ritualistic behaviors, they or someone they care about will come to harm. Sometimes, these individuals fear they will hurt someone else if they don’t complete these rituals.
Obsessions are commonly occurring and powerful images, thoughts or urges that cause great suffering and distress to the individual. A person may try to ignore these obsessions or get rid of them by carrying out another thought or action. This is called “performing a compulsion.” The distress caused by these obsessions can compromise the sufferer’s relationships with friends and family, causing them to withdraw. Forming new relationships can be especially difficult. Both situations may lead to depression and subsequent addictions to drug and/or alcohol. The Nemours Foundations reports that some of the most common fears among children or adults with OCD include:
- An obsession with certain/specific numbers being “good” or “bad”
- A fear of getting sick or of losing family members or loved ones to illness
- Intrusive thoughts of harming others or oneself
- A fear of exposure to bacteria or viruses
- An obsession with religion or religious topics
- Intrusive images of sexual acts or behaviors
Compulsions are classified as repeated behaviors or mental rituals which those suffering from OCD believe will deter other unwanted thoughts or urges. Typically, these rituals have no tangible connection to the OCD obsessions they are meant to get rid of. Those with OCD feel “compelled” to carry out these rituals no matter how illogical they are.
Common OCD compulsions include:
- Excessive “double-checking” things like appliances, locks or light switches
- Counting, repeating words or tapping
- Excessive praying due to religious fears
- Hoarding useless items or garbage
- Repeatedly “checking in” on a loved ones’ safety or well-being
- Excessive washing or cleaning
What Causes OCD?
Although extensive research has been done, the exact causes of OCD have not yet been determined. OCD is thought to have a neurological basis, as studies show the brain functions differently in people with OCD. An abnormality, or an imbalance in neurotransmitters, is thought to be primarily involved in the disorder. Research finds that OCD is equally common among adult men and women, although earlier onset on symptoms tends to be more common for boys in childhood than in girls.
Other conditions which weigh in on OCD include genetic, behavioral, cognitive and environmental factors. OCD tends to run in families. Individuals with close relatives suffering from OCD are more likely to develop OCD themselves. Recent research has also linked rapid-onset cases of OCD with streptococcal infections, as well as to bacteria responsible for Lyme disease and the H1N1 flu virus. Behavioral theory also suggests that people who associate certain objects with fear may develop rituals to cope with and reduce that fear. Over time, that avoidance ritual may develop into an obsessive behavior. Other environmental causes may include traumatic brain injuries during childhood and extremely stressful or traumatic life events.
OCD and Addiction
Research shows that approximately one quarter of individuals seeking treatment for OCD also suffer from a substance abuse disorder. Unfortunately, drugs and alcohol often make symptoms worse and ultimately exacerbate the symptoms of OCD. Because individuals living with OCD experience a high level of fear in their daily lives, the combination of drugs and alcohol addictions can be especially dangerous. Many turn to drugs or alcohol as a means of escape, but those with OCD are much more likely to see their drug or alcohol use turn into dependence and addiction.
Individuals with OCD often find themselves in social isolation because of the difficulty of their symptoms. They understand their obsessions and compulsions don’t follow a logical path and may feel shame for thinking and acting the way they do. The shame, loneliness and isolation associated with OCD can easily lead to substance abuse. Addiction is a compulsive condition in itself, causing the repetitive use of a destructive substance or behavior despite the negative consequences. Unfortunately, many people who seek treatment for their substance abuse issues are not simultaneously treated for their OCD. Treating one disorder without addressing the other often leads to failed treatment and relapse.
OCD Treatment Options
Treating OCD can be difficult in itself, but when combined with a substance abuse disorder may present exceptional challenges. The key to effectively treating the co-occurring disorders of OCD and addiction is to treat each issue at the same time. Many individuals with OCD are resistant to seeking treatment, as entering a treatment facility may present a host of unknown factors in an uncontrollable environment. Intrusive thoughts and time-consuming rituals may cause difficulties in focusing on individual or group therapy sessions. Seeking treatment in a specialized Dual Diagnosis treatment program can accommodate the needs associated with symptoms of OCD. This makes it much easier for these clients to complete a rehabilitation program and to prevent relapse.
Cognitive Behavioral Therapy is often an effective treatment for drug addiction and OCD. This form of mental health counseling teaches those with OCD and a substance abuse disorder to cope with unwanted thoughts and feelings that can lead to drug abuse. Antidepressant medications can also be effective in treating OCD symptoms.
Common medicines for treating OCD symptoms include Fluvoxamine (Luvox CR), Paroxetine (Paxil, Pexeva), Fluoxetine (Prozac), Sertraline (Zoloft) and Clomipramine (Anafranil). It’s important to remember that addiction is a chronic illness. OCD’s symptoms can be treated with medication, but overcoming addiction requires constant attention to avoid relapse.
Blu By the Sea
Seeking help for OCD and addiction means finding a specialized Dual Diagnosis program. At Blu By the Sea in Destin, our addiction specialists are experts on the important issues and problems facing patients with a Dual Diagnosis. Both obsessive-compulsive disorder and addiction can leave you feeling helpless and isolated. But it doesn’t have to stay that way. Our medical professionals are here to help you overcome OCD and addiction and to learn to live a normal, healthy and balanced life. Contact us today for more information regarding our Dual Diagnosis treatment program.