OCD and Addiction

Most people today are familiar with the concept of addiction as a mental health condition.  The stigma of addiction has dimmed with time and acceptance, and more people are comfortable talking about addiction as a disease and how their families may have been impacted.  Obsessive-compulsive disorder (OCD) is another mental health condition that is familiar to many but is often misunderstood. People may joke that their very clean mother has OCD, or they may have seen a character on TV struggle with OCD in a comical fashion.  In reality, obsessive-compulsive disorder is a burdensome mental illness that takes an exhaustive mental, and even a physical toll on its sufferers. It shares some similarities with addiction, including engaging in compulsive negative behaviors. The strain it causes can drive some people to substance abuse in an effort to gain relief from OCD symptoms.  When a person suffers from two distinct mental health conditions, such as OCD and addiction, this is known as a dual diagnosis. In order to recover from both conditions, it is critical to seek treatment from a treatment team that has experience in working with people who have a dual diagnosis.

What Is OCD?

Obsessive-compulsive disorder is a form of anxiety.  Like other forms of clinical anxiety, OCD has its foundation in fears or worries that have no rational basis.  People with OCD experience these fears or worries as obsessive thoughts that, try as they might, they cannot ignore.  People with OCD then feel compelled to perform rituals or repetitive behaviors that temporarily relieve these fears. For example, someone might check all the locks in the house in a specific order every night before going to bed,  check all the household appliances to make sure they are turned off before leaving the house or wash their hands repetitively. While these behaviors may seem relatively harmless, or maybe a little annoying to the people around them, they are actually very challenging to the person experiencing them.  The thoughts and behaviors are compulsive, meaning that the individual cannot help but go through with them. These rituals can seriously impact someone’s life, preventing them from enjoying day-to-day activities and even interfering with their health, social life, and job performance. For example, someone might wash their hands so much that their skin becomes chapped and bleeding, but they still cannot stop washing them for fear of germs.  The person who obsessively checks the locks might not be able to sleep because they have to keep getting out of bed to check and recheck the locks. These are a just a few examples of behaviors associated with OCD. OCD symptoms include:

  • Repeated, persistent, and unwanted thoughts
  • Intrusive urges or mental images
  • Repetitive behaviors meant to relieve anxiety or prevent bad things from happening

Some examples of obsessive thoughts are:

  • Fear of germs or uncleanliness
  • Need for organization or symmetry
  • Unwanted thoughts about harming yourself or others
  • Unwanted thoughts about aggression, sexual acts, or religion

Some examples of compulsive behaviors include:

  • Ritual hand-washing or another excessive cleaning to prevent germs from spreading
  • Need to organize objects in a very specific way, such as arranging all cans with labels facing forward
  • Ritual checking of locks in a home
  • Ritual checking of appliances
  • Counting in a certain sequence or repeating specific phrases as a form of protection

What Is The Link Between OCD and Addiction?

There is a clear link between OCD and addiction, with as many as 25% of people seeking treatment for OCD also receiving a diagnosis of a substance abuse disorder.  For many of these people, the symptoms of OCD began before the substance abuse. This sequence indicates that they began abusing drugs or alcohol as a way to temporarily relieve OCD symptoms.  Unfortunately, while substance abuse may provide short-term relief from obsessive thoughts and compulsive behaviors, in the long run substance abuse increases anxiety and therefore exacerbates OCD symptoms.

Treatment for OCD and Addiction

For people with a dual diagnosis of OCD and addiction, it is important to treat both conditions in order to truly recover from both.  If left untreated, the intrusion of OCD can make it difficult to focus on recovery. Also, if OCD symptoms persist, the individual may continue to feel the urge to abuse drugs or alcohol in an effort to relieve those symptoms.

One possible cause of OCD is a low level of serotonin, so medications that increase serotonin levels in the brain can be used to treat OCD.  Serotonin is a neurotransmitter that helps regulate mood and feelings of happiness. Low levels of serotonin are also linked to depression and anxiety.  Selective serotonin reuptake inhibitors (SSRIs) are a type of medication used to treat depression, anxiety, and OCD. Typically, the brain reabsorbs and recycles serotonin. SSRIs prevent the brain from reabsorbing, or re-uptaking, serotonin, forcing it to pump out new serotonin while leaving the old serotonin behind.  This increases the overall amount of serotonin in the brain. This can reduce overall anxiety and OCD symptoms, allowing people who suffer from OCD and addiction to focus on addiction treatment without the distraction of obsessive thoughts and compulsions.

Another approach to treating OCD that is also used to treat addiction is cognitive behavioral therapy.  Cognitive behavioral therapy is a practical approach to changing behaviors, whether they are addictive or obsessive.  By working with a therapist, the client will learn to identify negative behaviors and triggers for those behaviors, then practice strategies to avoid triggers or cope with them.  This practice can be applied to OCD and addiction. For example, someone could identify that shaking hands with another person triggers their OCD-based fear of germs, leading them to ritual hand washing.  The therapist could work with the person to practice actually shaking hands without following through on the hand washing. The goal would be that, over time, the individual becomes desensitized and learns to shake hands without triggering any OCD symptoms.  An example of how cognitive behavioral therapy can be used to treat addiction would be that a person could recognize that going to their local pub triggers them to drink. A cognitive behavioral therapist could work with them to avoid the pub by coming up with alternative social interactions that are sober.  Other techniques include learning coping mechanisms, such as breathing techniques, to handle triggers that cannot be avoided.

Treatment for addiction to drugs or alcohol typically requires more than just cognitive behavioral therapy.  A holistic approach looks at the individual as a whole, addressing mental, physical, and emotional needs. In-patient rehab provides the best setting for holistic addiction treatment.  Removing oneself from the routine stresses of work and family presents an opportunity to focus solely on recovery. First, people addicted to drugs or alcohol must go through detox and withdrawal.  Because this process presents potential health risks it is important to go through detox under the supervision of a trained medical staff. Medical support can also ease the discomfort associated with detox.  Many people with addiction have neglected their overall health, and inpatient rehab centers often provide services such as nutritional counseling to help with overall healing. Trained counselors can help with mental and emotional healing through cognitive behavioral therapy as well as other forms of individual counseling, plus family and group therapy.  

The team at Blu By The Sea is ready to help individuals with a dual diagnosis of OCD and addiction.  Our team specializes in holistic treatment and has experience applying that approach to a variety of dual diagnoses.  We aim to treat the whole person: body, mind, and soul. Our counselors offer individual therapy, including cognitive behavioral therapy, as well as family and group therapy.  Our medical staff can provide supervised detox and withdrawal and prescribe any necessary psychiatric medications, including SSRIs. In addition, we offer nutritional meals prepared on site, complementary therapies such as yoga, art and spa therapy, and a gym membership.  Our idyllic location on the beach allows you to soothe your soul during recovery. If you or someone you love struggles with OCD and addiction, call Blu By The Sea today.