Addiction and obsessive-compulsive disorder (OCD) tend to go hand in hand. OCD can flood a person’s mind with catastrophic thoughts. For a person with this type of mental disorder, a small moment can offer the potential for trouble, however unlikely in real life.
Sarah Maraniss Vander Schaaff wrote in the Washington Post what someone with OCD must contend with daily:
“…I could find the possibility of disaster in much smaller moments: Was a fever a sign of meningitis? Did the pharmacist give me the wrong medication? Did I hit someone while daydreaming as I drove home and somehow not even notice?”
Or as Vander Schaaf contends, OCD can compel someone to engage in repeated, unnecessary actions, like going to multiple doctors because an initial exam or diagnosis had seemed inaccurate or repeatedly washing one’s hands. The belief is that if they do not engage in these actions, something bad may happen.
So it should come as no surprise that people with OCD often seek refuge in drugs or alcohol to mute those invasive thoughts. In fact, a study published in the Journal of Anxiety Disorders revealed that out of 323 adults with OCD, 27 percent met the lifetime criteria for a substance abuse disorder.
The quest to quiet those unwanted thoughts can lead to addiction. The only way to combat co-occurring substance abuse and mental health disorders is through dual-diagnosis treatment.
Read on to find out more about the prevalence and nature of co-occurring mental health and substance abuse disorders and dual-diagnosis treatment options.
What is OCD?
The National Institute of Mental Health (NIMH) defines OCD as “a long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions), and behaviors (compulsions) that he or she feels the urge to repeat over and over.”
The obsessions component of the disorder appears as repeated thoughts, urges, or mental images that promote anxiety. The symptoms often include:
- Having things in perfect or symmetrical order
- Fearing germs or contamination
- Having aggressive thoughts toward others or the self
- Having unwanted forbidden or taboo thoughts involving sex, religion, and harm
The compulsions aspect of OCD declares itself as repetitive behaviors that are performed in response to an obsessive thought. Those compulsions can include:
- Engaging in excessive hand washing and/or cleaning
- Repeatedly checking on things (like seeing if the oven is off or the door is locked)
- Counting compulsively
- Having to order or arrange things in a particular and/or precise way
Other behaviors that are indicative of OCD include someone:
- Displaying the inability to control his or her behaviors or thoughts, even when they are recognized as excessive
- Spending at least one hour a day on these thoughts or behaviors
- Unable to derive pleasure when performing certain behaviors or rituals, but instead may feel some relief from the anxiety those thoughts cause
- Experiencing significant problems in their daily life due to these behaviors or thoughts
Someone with OCD may also display certain tics or sudden, brief, repetitive bodily movements. Those can be head jerking, eye blinking, facial grimacing, or shoulder shrugging. They can be vocal tics where he or she may engage in frequent sniffing, grunting, or throat clearing.
What Does OCD Have To Do With Mental Illness?
Mental illness does not discriminate whatsoever. It impacts people from every ethnic, socioeconomic, educational, and spiritual stratum. Symptoms of mental illness can crop up at any age, but three-fourths of all mental health disorders begin at 24 years of age, states the American Psychiatric Association.
What’s more, mental illness can impact people at varying degrees. There are conditions that people have that hardly ever interfere with their daily lives, and others that are so debilitating they require hospitalization.
Symptoms that are common to all mental illnesses include:
- Mood swings
- Excessive tension or worrying
- Appetite or weight changes
- Sharp increases in energy
- Sleep disorders, such as insomnia
- Racing thoughts or rapid speech
- Inability to experience pleasure
- Strong feelings of guilt or worthlessness
- Loss of interest in activities
- Feelings of helplessness
- Trouble concentrating
- Impaired judgment or impulsivity
People with OCD tend to have excessive tension and worry. The intrusion this mental disorder inflicts on the mind can come in the form of racing thoughts. It can cause someone to have an inability to experience pleasure. There are other behavioral criteria on the aforementioned list that people with OCD experience.
Other common mental disorders that people have along with some sort of substance addiction include:
- Bipolar disorder
- Borderline personality disorder
- Generalized anxiety disorder
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Eating disorders (anorexia, bulimia, binge eating)
- Personality disorders
- Post-traumatic stress disorder (PTSD)
The Causes of OCD and Mental Illness
There is no specific cause of mental illness. However, a combination of factors can predispose someone to develop a mental health disorder. Those aspects can be genetic, biological, psychological, environmental, or a combination of any of these factors.
OCD can often be the result of genetics. It can run in families and begin in adolescence or young adulthood. Researchers have also found that parts of the brain and biological processes play a role in the development of obsessive thoughts and compulsive behaviors. Also, individuals who have experienced physical or sexual trauma are at an increased risk for OCD.
Substance Abuse and OCD
There is a significant correlation between substance addiction and mental health disorder. A 2014 survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that almost 44 million Americans, age 18 and up, experienced some form of mental illness and more than 20 million had a substance use disorder. Of those, almost 8 million had co-occurring mental and substance use disorders.
People with OCD who become addicted to drugs and/or alcohol abuse those substances to drown out those intrusive thoughts that come.
Psychologist Jan Weiner said in an interview that people with OCD are particularly prone to addiction because the mental health condition itself is considered a “negative state.” This means that people with OCD are “very anxious and will obsess about certain themes or topics and then will do their compulsion to remove that negative state or to try to decrease the anxiety associated with it,” she said.
People with OCD will turn to substances like alcohol or benzodiazepines to remove that “state.”
“Alcohol and benzodiazepines work very quickly to reduce anxiety, which leads to a more positive state. However, the drugs wear off very quickly and the negative state returns,” Weiner, an OCD expert, said.
In fact, alcohol and drug use can worsen OCD symptoms. A substance addiction will bring out self-destructive tendencies in somebody with OCD.
If you suspect that you or a loved one has a substance use disorder with a co-occurring OCD condition, then there are particular signs of addiction you should be aware of.
Signs of Addiction
The hallmark of any substance abuse addiction is compulsively seeking out drugs or alcohol above practically all obligations. That person can also have extreme mood changes, confused thinking, and thoughts of suicide. Another clear warning sign of addiction is the tendency to seek isolation over the company of family and friends.
According to the National Alliance on Mental Illness (NAMI), other signs of addiction include:
- Loss of control over the use of alcohol or drugs
- Feeling like you need a drug to be able to function
- Developing a high tolerance and withdrawal symptoms
- Sudden changes in behavior
- Using substances under dangerous conditions
- Engaging in risky behaviors
When addiction sets in, the risk of incurring health complications, legal troubles, and even death compound. The most effective solution in treating co-occurring disorders is dual-diagnosis treatment, which is available at a reputable professional treatment center.
Treating OCD and a Substance Use Disorder
Dual-diagnosis treatment is specifically designed for people who have co-occurring disorders, such as OCD and alcohol addiction. Dual diagnosis treatment differs from standard rehabilitation. An array of therapy methods and techniques are used to ensure that dual disorders are effectively treated.
In professional treatment, the substance is safely removed from the body via medical detoxification, and the patient is stabilized. Once this occurs, clinicians are assigned to treat the OCD and the psychological root of the substance addiction.
That work can be administered through a residential treatment, partial hospitalization, or an intensive outpatient program where a client can receive ongoing care and comprehensive therapy. Patients can also receive effective, evidence-based treatment in the form of cognitive behavioral therapy (CBT), a modality that has been proven to be effective in helping people with OCD.
What’s more, patients can receive CBT and treatment involving the use of antidepressant drugs known as selective serotonin reuptake inhibitors (SSRIs) (Zoloft, Prozac, Lexapro) have been shown to effectively treat people with OCD and a co-occurring substance disorder.