OCD and Addiction: How to Understand & Treat Addiction With a Co-occurring Severe OCD

Overcoming OCD: Effective Therapies

Discover evidence-based treatments for managing obsessions and compulsions

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What is Obsessive-Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is a mental health issue that causes people to experience obsessive thoughts and compulsive behaviors. Generally speaking, it follows a pattern of unwanted thoughts and fears, the obsessions part, which leads you to engage with repetitive behaviours, which become your compulsions. 

Obsessions: Obsessions are persistent unwanted thoughts, impulses, and images that result in distress. While people suffering from OCD often see that it is their own mind creating these obsessions, they feel powerless to make them go away through logical reasoning alone. Instead, people typically try to ignore them or ease them with compulsions. 

Compulsions: These are the repetitive behaviours, or sometimes mental acts, that a person feels compelled to engage with in response to an obsession. While these behaviours may feel soothing in the short term, they are only reinforcing the obsession. It’s also important to note that while a compulsion may seem like a logical response to an obsession (for example, hand washing in response to the fear of germs), it may also be something that seems wildly unrelated to the obsession. 

OCD could centre around anything in theory, but it often focuses on specific themes for certain people. For example, one person may experience an excessive fear of germs, which would be the obsession part, which results in them compulsively washing their hands or cleaning their house, which would be the compulsion part. 

Experiences of OCD vary between people, some days you might find that your symptoms are manageable. However, it is often challenging to deal with and can have a negative impact on your life.  

ocd and addiction

People with OCD often understand that their fears or worries are excessive, yet they have little power to control them. This can lead to feelings of embarrassment and shame. As such, it’s common for people to simply try and ignore their obsessions, but sadly this only results in more anxiety and distress which will ultimately lead to further engagement with compulsions to soothe the stress. 

Unmanaged OCD can have a big impact on your quality of life, affecting all areas of it including: 

Daily activities: Performing compulsions can not only monopolise your time, but they might also cause you to avoid certain environments you know cause your OCD to flare up. This might interfere with daily activities such as work, socialising or even leaving your house. 

Relationships: OCD can have an impact on your relationships where you may feel compelled to hide your symptoms or even withdraw from certain relationships altogether. 

Quality of life: You may find that managing your obsessions by performing compulsions takes up a lot of time and energy, leaving you feeling exhausted and with little time for other activities that bring you joy. OCD can also cause you to feel ashamed, isolated, and anxious, all of which contribute negatively to your quality of life. 

Clearly, OCD can have a huge influence on a person’s ability to live a normal and fulfilling life. And with approximately 12 in every 1,000 people in the UK affected by the condition, learning to manage it is important. Fortunately, there are evidence-based treatment options that can help people learn to live a fulfilled life with OCD. 

What is The Correlation Between OCD and Substance Abuse?

As is the case with many mental health conditions, substance abuse can often co-occur with OCD; this is known as a dual diagnosis. It’s estimated that around 30% of people with OCD have had a substance abuse disorder at some point in their lives. Unfortunately dealing with both of these issues can result in quite serious health repercussions. 

There are many reasons why somebody dealing with OCD may turn to substance abuse. As mentioned previously, dealing with obsessions and compulsions can be mentally and physically exhausting and leave a person feeling drained. Self-medicating with substances can feel like a way to relax, as alcohol and drugs can suppress thoughts and feelings, however, it only provides short-term relief. In the long run, it can make symptoms worse, hinder treatment, and interfere with support networks. 

People suffering from OCD may also experience social isolation, along with feelings of anxiety and shame, which can also lead to substance abuse. In most cases, substance abuse in the face of OCD is a coping strategy, but unfortunately, it is not a very effective one and can lead to a negative cycle. 

If you are suffering from OCD and a substance abuse problem, you will ultimately need to find healthier coping strategies. This can initially cause symptoms such as anxiety to feel worse, but over the long term it will help provide you with a more robust toolkit for better managing your OCD symptoms.

What Are the Symptoms of OCD?

OCD has two main components, obsessions, and compulsions. While it’s common to experience both with OCD, it is possible to only experience one of them. 

Some examples of some common obsessions some people may experience with OCD:

  • Fears around germs, health, or dirt
  • Fears about injuring themselves or others 
  • Fears around the health or safety of your loved ones 
  • Fears of saying something inappropriate or offensive 
  • A desire for objects to be orderly 
  • Explicit sexual thoughts 
  • Violent thoughts 
  • Intrusive words, sounds, or images 

These obsessions are characterised as being unwanted, intrusive, and repetitive. As much as you might try to suppress them, they simply resurface. Unfortunately, this persistence can make the person suffering from them believe even more strongly that they might come true if they don’t intervene or react with a compulsion. 

Some examples of compulsions people with OCD may experience include:

  • Excessive washing of their hands or body 
  • Excessive cleaning 
  • Organising objects in a specific way 
  • Repeating certain phrases or counting 
  • Making contact with an object a set number of times
  • Seeking excessive reassurance from others 
  • Hiding objects you are fearful could be used to injure yourself or others 
  • Going over behaviour to convince yourself you haven’t harmed anyone

These compulsions are a reaction to the obsession and in many cases, they follow a set pattern. Experience the obsession, and soothe it with a compulsion. This can temporarily relieve the anxiety or distress it causes, but it doesn’t address the problem in the long term. 

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Is OCD a Disability?

According to the Equality Act 2010, a mental health condition is considered a disability if it has a long-term effect on your normal day-to-day activities. In this context, long-term means over 12 months, and day-to-day activities mean something you engage with regularly on a normal day, such as attending your job or socialising. 

Under this definition, OCD can be considered a disability in certain circumstances. If you are experiencing OCD which has lasted at least 12 months and is interfering with your day-to-day life, you may be considered disabled which means you can get more support at work from your employer.

OCD and Addiction

While addiction is common, it’s even more common among those suffering from severe mental health conditions including OCD. 

There are many reasons why this could be the case. For some, their addiction is a form of self-medication and an effective way to stop unwanted thoughts, even if it is only temporary. There are also some overlapping risk factors for both OCD and addiction, such as early stress and trauma and genetic differences which make some people vulnerable. 

Some people have also noted that compulsions and addictions are similar. However, it’s important to note that they are not the same thing. Compulsions are a behaviour or response someone feels compelled to act out as a way to soothe anxiety or avoid negative outcomes. In many cases, people feel like bad things will happen if they fail to act their compulsion out. These compulsions may be self-destructive (e.g. excessive hand washing that leads to cracked skin) or could be neutral such as counting or tapping. On the contrary, addiction involves substances or behaviours that are linked with a reward. This could be pleasure or escapism. While addiction might be harmful, at the moment it feels enjoyable. 

So while you might say that addiction is compulsive because it is difficult to stop, compulsions are not usually an addiction. 

How is OCD Treated?

Living with OCD doesn’t have to feel unmanageable, there are effective treatments that can help reduce the overall effect it has on your life. There are currently two main lines of treatment in the UK:

Talking therapy: Often cognitive behavioural therapy (CBT) is the chosen modality, as it helps people to reframe their obsessions without addressing them through compulsions. CBT usually works quite quickly. Another form of therapy specifically designed for OCD is exposure and response prevention (ERP). This enables you to face your obsessions, acknowledge them but resist the urge to engage with a compulsion. 

Medication: Sometimes selective serotonin reuptake inhibitors (SSRIs) are used to treat OCD. SSRIs do take a while to work, up to several months in many cases. 

The first step for getting help with your OCD is to visit your GP. They will ask you about your symptoms and talk you through the different approaches to treatment. In most cases, the specific treatment – or combination of treatment – will depend on the severity of your symptoms. 

Medication for OCD 

The most common medication for OCD in the UK is SSRIs. If SSRIs do not work, you may be offered clomipramine, a tricyclic antidepressant.

The Challenges and Opportunities in Treating OCD

One of the main challenges of treating OCD for many people is recognising and accepting that there is a problem in the first place. Despite being one of the most disabling mental health disorders in the world, it is highly misdiagnosed. Research has found that on average, it takes ten years or longer for a diagnosis. Even once a diagnosis has been made, shame and denial can get in the way of accessing proper care. 

The good news is there are plenty of opportunities to get better once you are aware of the problem and feel ready to address it. Whether you’d like to take a psychological approach with talk therapy or would consider medication, there are evidence-based treatment options for OCD. 

Treating OCD And Addiction

While OCD and addiction often coexist and can wreak havoc on a person’s life, the good news is both are treatable conditions. Treatment will be required for both and may include a combination of detoxification, talk therapy, symptom management, and support groups. 

You might think it sensible to treat one at a time, but this approach is actually not recommended. Instead, you will actually need to address both problems at the same time as both OCD and addiction can reinforce one another.

Castle Craig is a world-leading rehab clinic that has been helping people overcome addiction since 1988. Our experts have experience treating both OCD and addiction, as well as dual diagnosis, and our holistic, patient-centred treatment approach will set you up for the best chance of success. If you’d like to find out more, give our friendly team a call on 

0808 271 7500. 

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FAQs

Do people with OCD have addictions?

Addictions are more common amongst people dealing with OCD compared to the general population. For example, it’s reported some 30% of people with OCD have had a substance abuse disorder at some point. 

Is OCD a form of addiction?

While some people say ‘addiction’ and ‘compulsion’ interchangeably, research has shown they are not the same thing. To sum it up, engaging with addictive behaviours creates pleasure in the brain, whereas compulsions that are not addiction-driven lack the same sense of satiation.

Can OCD be a coping mechanism?

OCD can be a response to early stress or trauma, including abuse in childhood such as bullying or neglect. 

Can OCD make you an alcoholic?

While OCD doesn’t directly cause alcohol abuse problems, it can increase your risk of developing a substance abuse problem. Research has found that 24% of individuals with OCD meet lifetime criteria for alcohol use disorder (AUD).

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