Treating OCD and Addiction: Obsessive versus Compulsive Behavior

Obsessions are intrusive, recurring, and unwanted thoughts and urges. When someone has obsessive thoughts they often have accompanying behaviors that they are unable to control and bring no real relief. These are called compulsions. These thoughts and behaviors can have a severe impact on day-to-day life.

Our guide will explain the difference between obsessions and compulsions, the conditions they are associated with, and how to get help for co-occurring disorders.

Behaviors: Obsessive & Compulsive 

obsessive compulsive disorder

While obsessive and compulsive behaviors are most commonly associated with obsessive compulsive disorder (OCD), there are other mental health issues that can lead to either obsessive or compulsive behaviors, or both. Some of these include:

  • Body dysmorphic disorder.
  • Hoarding disorder.
  • Trichotillomania (obsessive hair pulling).
  • Excoriation (skin picking disorder).
  • Asperger’s syndrome and autism.
  • Gambling disorder.
  • Love addiction or obsessive relationship jealousy.
  • Post-traumatic stress disorder.
  • Underlying medical conditions, such as Huntington’s disease.
  • Substance-induced OCD (e.g., illicit drugs, alcohol, or prescription medication).

These disorders, including OCD, can lead to behaviors that are classified as either obsessions or compulsions. 


Obsessive behaviors stem from intrusive thought patterns, urges, and mental images that cause an unwanted emotional pull, distress, anxiety, and disturbances to a person’s daily routine. They can include:

  • Thoughts about harming oneself or someone else.
  • Worry about not performing an action, such as turning off the stove or locking the door.
  • Unpleasant or disturbing mental images that may be graphic or sexual in nature.
  • Fear that another person is performing harmful actions against the individual.
  • Intrusive thoughts about breaking social, religious, or cultural mores.
  • A need to have items or personal effects symmetrical or in a specific order
  • Fear of contamination or being dirty.

Compulsive Behaviors:

Obsessive thoughts and behaviors can often turn into compulsive behaviors. These behaviors often manifest as a way to manage or get rid of obsessive thoughts. Compulsions can also come in other forms of repetitive behaviors, such as seeking out sexual encounters, or using drugs or alcohol, in order to find relief from obsessive thoughts, without being related specifically to OCD. Compulsive behaviors can include:

  • Constantly checking doors, locks, stoves, etc. to ensure safety.
  • Avoiding triggering situations, such as shaking hands or hugging.
  • Counting objects over and over.
  • Washing and cleaning hands, body, or personal effects.
  • Enforcing a specific order for events or objects.
  • Following a very strict routine or forcing someone else to follow a strict routine.
  • Demanding reassurance constantly, especially about perceived flaws.

Some compulsive behaviors are motor or verbal tics that are unconscious or uncontrolled. These include:

  • Repeating words or phrases.
  • Sniffing or clearing the throat.
  • Rapid blinking.
  • Scratching or twitching.

Compulsions can also come in the form of compulsive thoughts. These include repeatedly going over tasks performed or tasks that will be performed. They can also include silently praying to avoid spiritual harm.

Signs of Co-Occurring Addiction & OCD

Addiction, clinically referred to as substance use disorder, is a chronic but treatable condition that causes a person to compulsively use drugs or alcohol, despite negative consequences to their physical or mental health, and their quality of life. Substance use disorders are the result of a complex interaction between genetics, life experiences, and a person’s environment.

The Diagnostic and Statistical Manual of Mental Disorders (5th ed.) lists specific criteria that are used by healthcare providers and addiction specialists in the diagnosing of substance use disorders. These include:

  • Using substances more often or in greater quantities than intended.
  • Expressing a desire to cut down or stop using drugs or alcohol but being unable to do so.
  • Spending a lot of time getting, using, and recovering from the use of drugs or alcohol.
  • Being unable to meet work, home, or school obligations because of substance use.
  • Using drugs or alcohol despite negative social or interpersonal problems.
  • Giving up activities they once enjoyed so they can use drugs or alcohol.
  • Using drugs or alcohol in situations where it is dangerous to do so (e.g., while driving).
  • Using substances despite a physical or mental health condition that is caused by or made worse by continued use.
  • Needing to use more drugs or alcohol to achieve the same effects (tolerance).
  • Having an intense desire to use the substance (cravings).
  • Developing unpleasant side effects when use of a substance is stopped suddenly or cut back (withdrawal).

What Is a Co-Occurring Disorder?

Sometimes referred to as a dual diagnosis, co-occurring disorders occur when someone has more than one disorder at the same time. Approximately 17 million people in the United States have a co-occurring substance use and mental health disorder. Virtually any mental health and substance use disorder can co-occur; some of the more common co-occurring disorders include:

People who struggle with obsessive thoughts, compulsive behaviors, or any of the related disorders, such as obsessive-compulsive disorder, PTSD, or anxiety disorders,  may develop a substance use problem in order to manage the severity of the symptoms. This could involve the use of an intoxicating substance like alcohol or heroin, or it could be a prescription medication, such as a benzodiazepine, which can be very addictive.

In some cases, OCD, obsessive thoughts, or compulsive behaviors are triggered by brain changes from a substance use disorder and may center around acquiring a steady supply of the addictive substance.

How to Treat OCD and Substance Use Disorders

While substance use does not necessarily lead to a mental health disorder — or vice versa — because of the complex interplay of mental health disorders and substance misuse, integrated treatment that addresses both simultaneously is generally recommended.

Integrated treatment approaches for co-occurring disorders often involve a combination of evidence-based therapeutics including medication, counseling, and behavioral therapies. Your team of addiction specialists will work with you to develop a plan that is customized to your specific mental health diagnosis, as well as the substance or substances of use.

Finding Dual Diagnosis Treatment for OCD and Addiction

People who struggle with mental health problems are at a greater risk of developing substance use problems, and vice versa. When both disorders co-occur, appropriate treatment is needed that can effectively address both issues. Many rehabilitation programs offer treatment for co-occurring disorders that can help clients achieve recovery from obsessive thoughts, compulsive behaviors, and substance abuse.

If you or someone you love struggles with OCD and addiction, it is important to find the right co-occurring disorder treatment in New Jersey. Some things to look for when deciding on treatment for you or a loved one includes:

Paying for OCD and Addiction Treatment

One concern that many people have is how to cover the cost of treatment. At our inpatient rehab facility in New Jersey we work with you to get you the help you need and deserve. Contact our helpful and knowledgable admissions navigators at to learn more about using your insurance coverage for rehab, what to expect in inpatient rehab, or how to start treatment.

You can find out if your insurance will cover some or all of your treatment by using our to check your coverage.

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