Understanding OCD and Substance Abuse

Understanding the link between OCD and addictionThe human mind is designed for agility. Thoughts can wander in and wander out again with amazing speed, and if a person thinks hard enough, unwanted images and messages could be absent from the mind altogether. This complex machine, build for speed, is easy for the average person to operate with precision.


But what happens when thoughts that come in just will not go out again? And what happens when the person loses control over the ability to block unpleasant thoughts or images? The result could be obsessive-compulsive disorder (OCD). It is a common, and very serious, mental health disorder that could come with consequences — unless people get the help they need in a treatment program.

OCD Signs and Symptoms

People who have OCD have two very different mental health symptoms that intermingle and cause distress.

The first issue involves obsessions. These are repeated thoughts or images that intrude the person’s mind on a regular basis. They might involve safety, aggression, contamination, religion, sex, or violence. The person with OCD does not want to have these thoughts. And the person with OCD may not need to see any trigger in order to experience these thoughts. They come unbidden, on a regular basis.

The second issue involves compulsions. These are repetitive behaviors the person does in response to OCD obsessions. Compulsions might involve counting, cleaning, checking, or arranging. The person with OCD may know, on an intellectual level, that the behaviors are outside of the norm and unlikely to help with the obsessive thought. But the person might also feel compelled to do these acts, despite how strange they might seem.

The National Institute of Mental Health acknowledges that everyone has obsessions and compulsions from time to time. Some people worry about foodborne illness, for example, so they keep a clean kitchen. Others fear loss of paperwork, so they keep office files in order. These are all natural, healthy responses. People with OCD are a little different. These people:

  • Cannot control their behaviors or thoughts, even when they know that they are unusual
  • Spend at least an hour per day on the thoughts or behaviors
  • Do not find pleasure in the behaviors
  • Experience significant problems due to the thoughts or the behaviors

While this set of symptoms might seem rare and/or unusual, OCD is remarkably common. According to the Anxiety and Depression Association of America, 2.2 million Americans have OCD. Men and women are impacted at equal rates.

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OCD Complications

People with OCD may have vivid memories of what life was like when their brain cells worked in a predictable and manageable way. They may be desperate to gain that control once more. On first glance, substances of abuse may look like a good solution.

Drugs like alcohol or benzodiazepines have a sedating effect, and that might help people to avoid their thoughts or deflect their compulsions. Drugs like heroin and cocaine could boost happy chemicals in the brain, and that might help people with OCD to feel as though their disease is somehow tolerable. To people like this, the drugs seem useful or helpful.

Unfortunately, these drugs can also be terribly addictive. A brain exposed to drugs is changed with every exposure, and in time, that brain can become dependent on the substance of abuse. The brain might not work at an ideal level without that punch of drugs. In severe cases, the brain might work worse if no drugs are available.

People with OCD are at increased risk for drug addiction due to the way their minds work. A craving for drugs, to them, can become a new obsession that they cannot control. The use of drugs can be a compulsion that makes the obsession go away. Some people with OCD develop obsessive mannerisms about how they take drugs, too. They might line up materials in a row, take a certain number of pills, or count out the doses they have left. It could become part of the spectrum of illness they face.

In the Journal of Anxiety Disorders, researchers suggest that substance abuse issues impact more than a quarter of all people who seek out OCD treatments. It is clear that these two illnesses are closely related.

Even if people with OCD do not develop addictions, they can face other problems in time. As the organization Beyond OCD points out, the symptoms associated with this mental illness tend to get stronger with time. People with the disorder tend to spend more and more time on their compulsions, and their obsessions tend to grow stronger. Some people with OCD become so distraught that they are unable to leave the house. Others face an increased risk of suicide.

Help Is Possible

There is good news, when it comes to OCD. The most effective treatments for the disorder, per the International OCD Foundation, involve a combination of therapy and medication.

The therapy could take many forms, but one form called exposure and response prevention could be particularly helpful. Here, people with OCD work with a counselor and learn to tolerate the thoughts, images, and situations that are the targets of the obsession. They do not need to learn to like these intrusions. But they do need to learn to accept that they appear and that nothing needs be done with them. That could stop the need to deal with them through compulsive behavior, and it could allow for a more healthy way of life.

Medications can be used to balance brain chemistry signals gone awry through drug use, compulsions, or both. The medications might be used only during the early part of the recovery process, or the person with OCD might need to stay with medications for the rest of life in order to see real relief. Either is possible.

Heading into therapy for OCD is not a sign of weakness. It is a form of self-healing and self-control. Choosing to get better could be the best thing anyone could do in order to bring about long-term health, wealth, and healing — even with OCD.

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