Obsessive-Compulsive Disorder (OCD) and Addiction: Treatment, Signs, and Symptoms

What Is Obsessive-Compulsive Disorder (OCD)?

OCD is a mental health condition that causes obsessions, or repetitive unwanted thoughts, and compulsions, or irrational, uncontrollable urges to fulfill the obsessions. Obsessions may include upsetting thoughts or images or a preoccupation with something, such as whether you left the oven on or locked a door.[1]

Compulsions are repetitive actions that you feel you have to do, either to suppress obsessions or to follow a self-imposed rule.[2] This is often done to reduce anxiety or prevent an unwanted situation, even if the action isn’t linked to the unwanted situation. A compulsion may be excessive hand-washing or repeated mental acts like counting.

For people with OCD, obsessions and compulsions can be time-consuming and distressing, often taking an exorbitant amount of time and disrupting day-to-day life. Though the specific obsessions and compulsions can vary, the signs of OCD may include:[3]

• Fear of losing something or forgetting something
• Fear of germs
• Repetitive thoughts of aggression or violence toward oneself or others
• A strong desire to have objects in a specific order or symmetrical
• Excessive hand-washing or cleaning
• Excessive checking, such as whether the door is locked or the oven is off
• Obsessive counting
• Repetition of words

The Link Between OCD and Addiction

OCD and addiction have similar mechanisms that can cause them to co-occur. Though the research findings vary on how often OCD co-occurs with substance use disorder, they share some commonalities. Both OCD and addiction involve dysregulation of the brain’s reward system and neurotransmitter pathways, especially involving dopamine, serotonin, and glutamate.[4]

With OCD, people may experience intrusive thoughts of obsessions that can lead to repetitive behaviors or compulsions intended to reduce stress or prevent unwanted situations. Drug addiction also involves compulsive drug seeking and use despite negative consequences, fueled by cravings and an inability to control use.

Some research indicates that people with OCD may be more vulnerable to addiction and may rely on substances to self-medicate anxiety or distress caused by obsessive thoughts.[5] This is counterproductive, however, as substance use can worsen OCD symptoms or trigger compulsive behaviors.

The complex relationship between OCD and addiction requires specialized treatment that addresses both the mental health disorder and the substance use simultaneously, as well as addressing how these two conditions influence one another.

Factors That Link OCD and Addiction

There are many possible reasons why OCD and addiction may co-occur, including:

• Genetics: OCD and addiction share some common traits that someone may have inherited, such as an increased risk for OCD and addiction due to first-degree relatives who have an addiction.[6]
• Trauma: According to one study, about 60% of participants experienced a traumatic life event before their OCD symptoms started.[7] Trauma is also a potential factor in addiction.
• Impulsivity: According to one study, people with OCD were more impulsive than those without OCD, which is also a factor in substance abuse.[8]

Treatment for OCD and Addiction

If you’re struggling with both OCD and substance abuse or OCD and alcohol abuse, simultaneous treatment is necessary to improve treatment outcomes. It’s important to have addiction and OCD interventions that are tailored to your symptoms and treatment goals.

In addition to traditional therapies like support groups and family therapy, some of the possible evidence-based interventions for OCD and addiction include:

• Cognitive behavioral therapy (CBT): CBT focuses on identifying unhealthy thoughts and feelings and changing the processes that lead to actions. This helps you understand how and why you think and act as you do to consciously change your patterns.
• Holistic therapies: Holistic therapies offer an integrative approach to individualized treatment of OCD and addiction, encompassing the mind, body, emotions, and spirit to promote healing and wellness.
• Medication-assisted treatment (MAT): MAT therapy uses medications to help with reducing cravings, alleviating withdrawal symptoms, and promoting comfort in recovery, ensuring you can focus completely on your OCD treatment and the mental aspects of addiction recovery.
• Psychodrama: Blending interaction with psychotherapy guided by a mental health professional, psychodrama helps you gain an understanding of yourself and how you developed certain behaviors to consciously change them.
• Eye movement desensitization and reprocessing (EMDR): EMDR is a trauma-focused psychotherapy that uses specific techniques to help you process traumatic experiences and reduce the emotional impact and distress associated with them.

Seek Help for OCD and Addiction

OCD and addiction can co-occur for several reasons, including the desire to self-medicate the compulsions and obsessions and relieve distress. If you or a loved one is struggling with OCD and addiction, dual-diagnosis treatment options offer help through integrative care that addresses both conditions.