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Obsessive compulsive disorder (OCD) and addiction sometimes co-occur which means that a person has both conditions. This page will explain the common symptoms of OCD, show how it can overlap with addiction and provide information on dual diagnosis treatment.
What is Obsessive Compulsive Disorder?
OCD is a disorder characterized by obsessions like recurring or uncontrollable thoughts and compulsions like excessive or repetitive behaviors that negatively impact one’s quality of life.
Symptoms of OCD
Obsessive compulsive disorder symptoms most often begin in late childhood to young adulthood. However symptoms can appear at any age. Some common symptoms of OCD include:
Obsessions
- Fear of contamination, germs or becoming ill
- Fear of self or others being harmed
- Fear of acting on impulse and harming self or others
- Needing things lined up or organized in a particular way
- Worry about losing or misplacing things
- Obsessive concern with violent images
- Unwanted thoughts about sex or religion
- Excessive concern with morality (right or wrong)
- Excessive concern with gender identity or sexuality
- Relationship related obsessions
- Obsession about death
- Perfectionism related obsessions
Compulsions
- Excessive cleaning, bathing or handwashing
- Arranging or re-ordering things in a certain way
- Compulsive counting
- Repetitive checking (For example if the stove is off or if the door is locked)
- Mentally reviewing events repeatedly
- Avoiding situations that might trigger obsessions
- Repeated body movements
- Repeated activities (going in and out of a door)
- Doing activities in multiple numbers (flicking the light switch 3x)
Obsessions and compulsions can cause significant distress for people with obsessive compulsive disorder. The symptoms of obsessive compulsive disorder impact their ability to function in daily life. The obsessions and compulsions people with OCD experience can be time consuming and may last more than one hour at a time.
Facts About OCD
According to the International OCD Foundation about 1 in 40 adults will be diagnosed with OCD in their lives. Around 1 in 100 children and teens will experience OCD at a young age. It can sometimes take more than two years of symptoms before they are assessed and diagnosed by a mental health professional.
Trauma can play a significant role in the development of OCD. One study found that 60% of research participants had experienced a traumatic event before their OCD symptoms began.
Symptoms can be debilitating and stressful and many people with OCD may turn to substances to find relief. Unfortunately substance use can worsen OCD symptoms and addiction may lead to more obsessive and compulsive behavior.
Co-occurring OCD and Addiction
Similar to OCD addiction also involves unwanted repetitive behaviors that may negatively impact a person’s relationships, social activities, education or career. In both OCD and addiction a person seeks to relieve unwanted mental, emotional or physical distress by engaging in behaviors that become consuming and undesirable over time.
Both disorders are characterized by obsessive thoughts and the desire to get relief. In each disorder the person receives temporary relief through their repetitive or addictive behaviors but ultimately ends up experiencing the same distress again and the cycle continues.
It is unclear exactly how many people struggle with both OCD and addiction. Studies of OCD have found that OCD and addiction co-occur at a lifetime rate of 25%. This means that approximately 25% of people with OCD will also struggle with addiction at some point in their lives.
When a person is diagnosed with both OCD and addiction then it is referred to as a dual diagnosis or a co-occurring disorder.
What Causes OCD and Addiction?
There are many factors that may contribute to a person developing OCD or addiction. A family history of either disorder will increase a person’s risk. This could be due to genetic, environmental or cultural factors. However just having a family member with one of these disorders isn’t necessarily enough on its own to cause the condition to develop.
Neuroscientists studying obsessive compulsive disorder and addiction have found that certain neurotransmitters including serotonin, dopamine and glutamate may be involved in both substance use disorders (SUDs) and OCD.
Research has also found that changes to the prefrontal cortex, which is the area of the brain responsible for cognition and decision making, may contribute to the development of OCD and SUD.
What Are the Treatment Options for OCD and Drug Addiction?
Fortunately both OCD and drug addiction can be treated. In fact neuroscience research has shown brain function changes and symptom improvements in individuals who received behavioral treatment.
Dual diagnosis treatment targets both OCD and addiction simultaneously. Research on dual diagnosis treatment has found that treating the conditions at the same time promotes longer engagement in treatment. It also has a higher reduction of OCD symptoms and higher abstinence rates at 12 months than traditional treatment.
Addiction often leads to physical dependence so the first phase of treatment is often detox. Many treatment centers provide medically assisted detox to help a person manage withdrawal symptoms and discomfort and detox safely.
After the detox phase is complete then patients will begin the treatment process. Addiction treatment is offered on both an inpatient and outpatient basis. Inpatient treatment is best suited for those with more severe cases of addiction and co-occurring mental health disorders like OCD.
Inpatient treatment typically lasts for at least 30 to 90 days but some programs may be six months to a year or longer. Patients reside in the facility around the clock until they complete treatment so this option is for those who can be away from home for an extended period.
Many different treatment modalities are offered during inpatient treatment. These include individual counseling, group therapy, 12 step programs and medication assisted treatment. Some facilities may offer holistic therapies and special amenities as well.
Outpatient rehab typically provides the same type of treatment modalities but patients continue to reside at home throughout treatment. Outpatient treatment is the best option for people who need to remain involved in work, school or family life while in rehab. Patients typically visit the outpatient treatment center several times a week or sometimes every day in intensive outpatient programs.
Aftercare is a crucial aspect of the treatment process that shouldn’t be forgotten. Many people recovering from addiction will relapse at some point in their recovery journey. Relapse rates are even higher in people who have co-occurring mental health disorders like OCD. For this reason it is important to continue to have support after completing rehab.
Aftercare programs may include ongoing individual counseling, group therapy, 12 step programs, job assistance programs and more.
Where Can I Find Information About Treatment?
If you or a loved one are struggling with OCD and addiction then there are many resources available where you can get information about treatment options and local support groups:
Substance Abuse and Mental Health Services Administration (SAMHSA): Provides a 24-7 national helpline in both English and Spanish. This helpline provides referrals and information for addiction treatment centers, support groups and community organizations. You can reach the helpline by calling 1-800-662-HELP (4357).
Rehabs.org: Offers an online directory of treatment centers around the United States.
Narcotics Anonymous (NA) is a 12 step support program for people in recovery from addiction. You can search for meetings in your local area on their website.
