Understanding Obsessive-Compulsive Disorder

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Understanding Obsessive-Compulsive Disorder’s Role in Addiction

When you or a loved one experiences a particular mental health condition, it can be worrisome trying to figure out the next steps. You might have questions and want to know about the condition. These are all natural anxieties. You deserve to know more about your condition and the options that are available to you for treatment.

This guide will cover all that you need to know when it comes to co-occurring obsessive-compulsive disorder and addiction. It will help you understand if you’re showing signs of either condition, as well as why they occur in the brain and how they affect each other.

Finally, it will discuss some of the options you have for treatment. Always seek the help of a professional to get an official diagnosis and treatment plan, and don’t be afraid to lean on loved ones for support throughout your journey.

Overview of Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by a pattern of unwanted thoughts (obsessions) that lead to repetitive actions (compulsions).

  • Obsessions are defined as intense repetitive thoughts, images, and/or urges that cause distress.
  • Compulsions are repetitive thoughts or actions someone feels he or she must perform.

Someone with this condition has a need to perform compulsive acts based on their thinking and rationale. To avoid or resist these compulsive actions causes anxiety that can interfere with daily life.

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OCD affects 2.2 million adults and symptoms may start in the late teens or early ’20s. One-third of those with this condition experience their first symptoms in childhood. About half of all cases begin by adulthood, but about a quarter occur before the mid-teens.

It is often a lifelong battle for those diagnosed, although there are forms of therapy to keep symptoms manageable.

Most of us can relate to taking the same commute route out of habit, having intrusive thoughts, or performing some kind of ritual or repetitive behavior once in a while. But for people with OCD, these kinds of thoughts and actions are so overwhelming, that those with severe forms, may ritualize on and off all day. Often, these obsessions can cause problems at work, school, and home.

You’ll need to consult a professional to receive a formal diagnosis, but some signs and symptoms of obsessive-compulsive disorder to look out for include:

  • Unwanted, forbidden thoughts involving religion, sex, and/or harm
  • Uncontrollable thoughts or behaviors (even when consciously recognized as extreme)
  • Mental images that cause anxiety
  • Irrational fears of contamination
  • Aggressive thoughts toward self and others
  • Excessive cleaning or washing
  • Compulsive counting
  • Fixation on making things symmetrical and precise
  • Repeatedly checking and re-checking things

Obsessive-Compulsive DisorderThough symptoms may worsen or ease over time, it’s important to note that these behaviors and thoughts must take up at least an hour each day to be considered OCD. If they cause significant problems in your daily life, you have genuine cause for concern.

While many of us may feel satisfied or content while performing some of our small compulsions, those with OCD don’t derive any pleasure from the action. Although, they may feel temporary relief from the persistent thoughts subsiding, they are still suffering.

Tendencies of Obsessive-Compulsive Disorder

Obsessions are persistent and repetitive unwanted thoughts or impulses that cause distress and tend to have a theme. For example, someone with a constant need to wash their hands may obsess about germs and keeping healthy.

Those who have OCD often exhibit a tendency towards particular obsessions or themes.

OCD-Related ConditionsSome of the more common obsessions include:

  • Fear of dirt or contamination
  • Difficulty tolerating the unknown
  • The need to keep things symmetrical or in a specific order
  • Thoughts of harming oneself or others
  • Unwanted thoughts about sex, religion, or aggression

Examples of an obsession might include imagining recurring, unpleasant images or the need to arrange things so they are symmetrical or in a specific numerical order.

Symptoms of compulsions include:

  • Repeated washing or excessive cleaning
  • Counting
  • The need for a strict routine
  • The need for constant reassurance

Some examples of compulsions include showering several times a day or counting things in patterns. Although there are some common symptoms of OCD, it’s a very individualized condition that people experience in different ways.

If you believe your obsessions are different from the above listed themes, it’s entirely possible that you may have the condition. Whether a condition is physical or mental, people can be affected differently. It’s best to consult with a healthcare professional to get an official diagnosis and work out a way to best help ease your compulsions.

Causes And Risk Factors

Currently, OCD research is still being conducted and the condition itself is still being fully understood. Because everything about this condition is not quite understood yet, the exact cause of the condition is unknown.

There are some theories, however, including:

  • Changes in brain chemistry or functioning
  • Family history, indicating a genetic cause
  • A learned process, like something children pick up from watching adults
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Stress also tends to trigger intrusive thoughts that may lead to obsessions and compulsions. A person who experiences trauma might become obsessed with personal safety. They may imagine getting attacked or visualize harm done to them, responding in an irrational way.

OCD may also work in concert with other mental health conditions such as anxiety disorders or substance misuse.

How Is Obsessive-Compulsive Disorder Diagnosed?

Mental Health DisordersThere is no blood test you can take that says you have obsessive-compulsive disorder. Instead, mental health professionals will likely evaluate your behavior to determine if you experience both obsessions and compulsions that disrupt your life for at least one hour a day.

A mental health professional will talk to you about your feelings and thoughts and may ask for permission to speak with your family and friends. They may consider whether your symptoms actually indicate the existence of another condition such as an anxiety disorder or schizophrenia.

There may also be a physical exam. This will allow your care team to rule out another cause that may mimic the symptoms of OCD. They will also want to know if you have any complications related to the illness. All of these questions and evaluations are intended to help identify the particular conditions that you might struggle with so that your healthcare team can be more effective in helping you live a healthier life.

OCD-Related Conditions

Some individuals who exhibit some symptoms of OCD may instead be struggling with a different kind of mental disorder. A variety of mental disorders can overlap in certain symptoms, especially in obsessions or the need to have things a particular way. This is why it is especially important to seek assistance from a healthcare professional. It’s always best to ensure that you get treated for the correct condition!

Some conditions that are similar to obsessive-compulsive disorder, include:

  • Body dysmorphic disorder–an obsession about physical appearances, such as weight or body size
  • Hoarding disorder–an obsession with collecting or ordering things
  • Trichotillomania–the urge to pull out and eat your hair
  • Excoriation–the need to pick at your skin
  • Hypochondriasis–being obsessed about diseases and physical health
  • Olfactory reference syndrome–an obsession about body odor

Co-Occurring Mental Health Disorders

People with obsessive-compulsive disorder often attempt to hide their condition or compulsions from others. They may avoid stressful situations that could trigger them, perform ritual behavior behind closed doors, or prevent people from coming into their home. Some will even turn to substances to cope. nfortunately, though these substances may initially have a calming effect, this only leads to bigger problems.

In fact, about 20% of Americans with a mood or anxiety disorder have an alcohol or substance use disorder. The problem comes from the fact that these kinds of co-occurring disorders tend to affect each other. Symptoms of one condition can make the symptoms of the other worse and vice versa. In this instance, OCD and the stress it brings may cause someone to use substances as a way to relax, facilitate smoother social interactions, or even just numb their anxiety. In turn, the substance use can actually make compulsions and obsessions associated with OCD even more severe.

The Relationship Between OCD And Addiction

Cognitive behavioral therapyAddiction has one major factor in common with OCD: it’s largely impacted by impulse. Addicted individuals often find themselves unable to control their desire to use, even if there are negative, life-impacting consequences. In fact, one of the major factors of addiction is to continue the use of a substance despite the negative consequences to physical or mental health.

As a result, many addicted individuals end up experiencing a very strong, almost overwhelming compulsion to use even if they’re trying to stop. They may not be able to fight the urge. Combatting this urge is part of what makes turning away from addiction and maintaining sobriety so challenging.

Further, OCD and addiction appear to affect the same area of the brain. Repeated substance use leads to changes in the prefrontal cortex, which carries out executive processes like self-regulation and decision-making. These brain alterations can decrease or weaken a person’s ability to resist strong urges.

Similarly, researchers have compared the brain images of people with OCD to those without and found that there are differences in the prefrontal cortex. It makes sense that when both conditions are present, they can have dramatic effects on each other.

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If you’ve been diagnosed with obsessive-compulsive disorder and think you may also be grappling with an addiction, here are some critical symptoms to look out for:

  • Having intense cravings for the drug
  • Feeling like you must use the drug regularly
  • Building up a tolerance to the drug so your body requires more of it to get the same effect
  • Trouble at work, school, at home, or socially
  • Spending money you don’t have to keep up your habit
  • Participating in risky behavior while under the influence
  • Finding yourself unable to quit using and feeling withdrawal when you cut back

If you believe you’ve developed a co-occurring condition, talk to a health or mental care professional as soon as possible.

Treatment Options

Relationship Between OCD And AddictionWhile there may be no cure for obsessive-compulsive disorder or addiction, that doesn’t mean there isn’t help!

First, make it a priority to treat both of your conditions. It may take some time to figure out dosages of medications and the proper course of therapy, but it’s crucial that you don’t address one without the other. OCD by itself is treated in a number of ways: medication, cognitive behavior therapy (CBT), or a combination of both. The healthcare team may decide if you need one alone or a combination of the two to feel better.

Treatment may also involve addressing any co-occurring mental health issues, such as depression, body dysmorphic disorder, or anxiety. To improve treatment outcomes, it’s necessary to address all co-occurring issues at the same time.

Although many don’t think of obsessive-compulsive disorder (OCD) as common, it affects on average 2.2 million adults in the U.S. Complex on its own, OCD is further complicated when it co-occurs with another condition or disease. A dual diagnosis of OCD and a substance use disorder is the beginning to a rocky path, but one you can navigate through with the right help.

Medication-Assisted Treatment

Medications can include serotonin reuptake inhibitors (SRIs) to reduce the symptoms of OCD. It can take up to 8 to 12 weeks to feel the effects of the medication.

Though traditionally used to treat depression, serotonin reuptake inhibitors (SRIs) tend to be the most effective medication-assisted treatment for OCD, though some doctors opt for selective serotonin reuptake inhibitors (SSRIs) that sometimes have less intense side effects. The significant downside to SRIs, of course, is the long time frame of 8 to 12 weeks that it takes to start working, though for some it doesn’t take as long. There have been studies on using antipsychotic medication to treat OCD, but it tends to be riskier and come with mixed results.

This year alone has brought important developments to the treatment of obsessive-compulsive disorder. A recent Duke University study’s findings suggested that OCD is likely highly treatable using a class of drugs already undergoing testing in clinical trials. Researchers found that by altering the brains of mice to replicate behaviors similar to OCD, the symptoms could be treated with this kind of medication.

Addiction treatment often includes several components, ranging from inpatient rehabilitation to medication to individual counseling. Many find it helpful to join a 12-step program, but there are countless styles of programs across the country so it’s important you find what will work for you.

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) may be used to treat both OCD and addiction. For OCD, it’s typically directed to the area of exposure and response prevention.

  • “Exposure” creates direct or imagined exposure to situations or things that trigger obsessions and/or compulsions. The goal is to lessen the anxiety caused by the trigger over time with repeated controlled exposure.
  • “Response” deals with the ritual side of things and aims to help patients learn to resist the compulsion and eventually drop the behavior altogether.

When it comes to addiction, CBT aims to help patients learn to stop negative patterns of thinking and behavior and redirect focus to healthy living.

Currently, there is no official therapy to treat both obsessive-compulsive disorder and addiction at the same time. It’s important for you to work one-on-one with a doctor, psychiatrist, or mental health professional to create your own plan of action to tackle your dual diagnosis. The good news is that you have different options for each, and can combine therapies as your doctor sees fit.

With some time, patience, and the right treatment, you can take back control of your life from both OCD and addiction.

Frequently Asked Questions:

What are the four types of OCD?

  1. Contamination
    • Excessive cleaning and washing
  2. Perfection
    • A need to order things in a particular fashion
  3. Doubt and Harm
    • Checking and rechecking things like light switches, door locks, and the stove
  4. Forbidden Thoughts
    • Intrusive thoughts, usually of a violent, religious, or sexual nature that often are in contradiction with a person’s morals and beliefs

Is obsessive compulsive disorder a mental illness?

Yes, obsessive compulsive disorder is categorized as a mental illness. However, there is treatment available that can help manage OCD.

What causes obsessive compulsive disorder?

OCD is a condition that healthcare professionals are continuing to learn about. However, there are some theories that propose the following as potential causes of OCD:

  • Changes in brain chemistry or functioning
  • Family history, indicating a genetic cause
  • A learned process, like something children pick up from watching adults

What are the signs of OCD in adults?

OCD is usually characterized by two things: unwanted thoughts, also called obsessions, and the actions that the thoughts provoke, also called compulsions.

Individuals with OCD may exhibit the following symptoms:

  • Unwanted, forbidden thoughts involving religion, sex, and/or harm
  • Uncontrollable thoughts or behaviors (even when consciously recognized as extreme)
  • Mental images that cause anxiety
  • Irrational fears of contamination
  • Aggressive thoughts toward self and others
  • Excessive cleaning or washing
  • Compulsive counting
  • Fixation on making things symmetrical and precise
  • Repeatedly checking and re-checking things

This list is not a complete list of OCD symptoms and behaviors. It’s highly recommended to seek a professional medical diagnosis for OCD.