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Obsessive-Compulsive Disorder (OCD) & Addiction | Dual Diagnosis Prevalence, Symptoms, Risk Factors, & Treatment

Published on April 26, 2021
Obsessive-Compulsive Disorder (OCD) & Addiction | Dual Diagnosis

Obsessive-Compulsive Disorder (OCD) affects 2 to 3 million adults and about 500,000 children in the United States. That’s 1 in 100 adults and 1 in 200 children who suffer from OCD, a mental disorder marked by obsessive thoughts and uncontrollable actions.

Even more widespread, more than 23 million Americans (10 percent) suffer from alcohol or drug addiction at some time in their lives. 

Some individuals have the misfortune of dealing with both OCD and addiction. OCD can contribute to addiction and interfere with a successful recovery. A person who struggles with these co-occurring disorders needs treatment that addresses both issues.

Prevalence Of OCD & Addiction Dual Diagnosis 

Studies show that about 25 percent of people with obsessive-compulsive disorder (OCD) have also struggled with substance abuse. 

Many turn to drugs or alcohol to self-medicate. Substance abuse may temporarily alleviate some of the symptoms of OCD, as well as the stress it can cause.

The International OCD Foundation notes that this estimate of dual diagnosis prevalence could be skewed by several factors:

  • not everyone who enters addiction treatment is screened for OCD
  • some OCD programs send people to addiction treatment first
  • people with co-occurring disorders may hide their symptoms so they’ll be accepted into a treatment program for either addiction or OCD

Symptoms Of Obsessive-Compulsive Disorder (OCD)

People with obsessive-compulsive disorder (OCD) have symptoms that affect their thoughts and behavior. Obsessions are intrusive thoughts that pop up often and cause intense anxiety. Compulsions are repetitive behaviors that are burdensome and interfere with daily activities.

Some of the obsessions that plague people with OCD are:

  • Sex: forbidden images, aggressive behavior
  • Contamination: body fluids, germs, household chemicals
  • Loss of control: fear of harming oneself or others, fear of blurting obscenities
  • Perfectionism: needing things to be perfectly even, fear of losing things
  • Religion: obsession about right vs. wrong, fear of going against God
  • Illness: fear of getting a disease or becoming physically sick
  • Numbers or colors: seen as “good” or “bad” 

Common compulsions seen in OCD individuals are:

  • Washing: hand washing, excessive cleaning, bathing excessively
  • Checking: parts of your body, ensuring that you didn’t make a mistake, making sure you didn’t harm yourself or others
  • Repeating: doing the same tasks several times unnecessarily, repeating simple actions (opening and closing something multiple times), repeated body movements (tapping or touching)
  • Mental compulsions: counting while doing things to reach a “good” number, canceling out a “bad” word with a “good” word
  • Arranging: straightening or ordering things until it feels “right”
  • Avoidance: staying away from situations that make obsessions flare up

“Compulsive behavior is done with the intention of trying to escape or reduce anxiety or the presence of obsessions,” says the International OCD Foundation. But it only gives temporary relief. The stress always comes back, so the compulsions must be repeated over and over. 

Symptoms Of Addiction

A person with a drug or alcohol addiction faces a similar struggle. They also engage in behaviors (substance abuse) to temporarily relieve unpleasant feelings, yet the anxiety returns—sometimes even more intensely. 

As with OCD symptoms, substance abuse can disconnect you from others and affect your ability to live a normal life. Your need for drugs and alcohol can become crippling and all-consuming.

Symptoms of alcohol or drug addiction include:

  • loss of control over drug or alcohol use
  • strained relationships with friends and family members
  • poor school or work performance, possibly resulting in job loss
  • money problems from buying drugs or alcohol
  • borrowing or stealing money from loved ones
  • health problems from alcohol or drug use

Risk Factors For OCD & Addiction

There’s not a clear cause of obsessive-compulsive disorder (OCD), but there are some theories. It may be caused by changes in your biology. It could be genetic. Or it could be learned by watching family members who struggle with OCD symptoms.

Several risk factors that can contribute to the development of OCD and/or addiction are:

  • Family history: If your parents or siblings have OCD or suffer from addiction, you’re more likely to go through the same struggle with your mental health.
  • Stressful life events: Trauma or extreme stress can trigger OCD and may lead to substance abuse.
  • Mental health disorders: Other mental issues, like anxiety or depression, can lead to OCD or substance addiction.

Brain Function

Brain function may also play a role in the development of OCD. Research shows that people with OCD have an abnormal brain structure. Part of this abnormality is in the prefrontal cortex, which is responsible for decision-making and behavioral control. 

Studies have also found that neurotransmitters (chemical messengers) connected to the brain’s reward system—such as glutamate, serotonin, and dopamine—play a role in OCD and addiction. 

Dopamine is a brain chemical that affects motivation and the ability to control behavior. Loss of behavioral control is a hallmark in both OCD and addiction, and dopamine is well known as a reinforcer of substance abuse.

Dual Diagnosis Treatment For OCD & Addiction

Though addiction often goes hand-in-hand with other mental disorders, it can be difficult to find a dual diagnosis treatment program

Rather than staffing mental health professionals who are trained in multiple disorders, many treatment centers expect people to recover from one issue before addressing another. 

OCD symptoms can interfere with addiction treatment and cause some people to resume substance abuse for relief. Addiction can make it harder to break OCD habits.

But this is exactly why dual diagnosis treatment is necessary. Relapse rates for both disorders are much higher if they aren’t addressed at the same time. 

Dual diagnosis treatment programs recognize how co-occurring disorders exacerbate each other and give you tools to overcome both issues.

Medication & Behavioral Therapy

Typical treatment options for OCD are medication and behavioral therapy. Selective serotonin reuptake inhibitors (SSRIs) can be effective at reducing OCD symptoms. Some people benefit more from exposure and response prevention (ERP) and cognitive-behavioral therapy (CBT).

ERP repeatedly puts a person in a situation that triggers their OCD symptoms so they can learn to respond differently. CBT works through issues that cause OCD and teaches prevention techniques.

CBT is a cornerstone of substance abuse treatment, as well. Behavioral therapy may be combined with a broad range of treatment methods, such as exercise, art therapy, and meditation. 

Dual diagnosis treatment through a whole-person approach nurtures you back to physical and mental health.

For more information about dual diagnosis treatment for OCD and addiction, speak with an Ark Behavioral Health specialist today.

Written by Ark Behavioral Health Editorial Team
This page does not provide medical advice.

International OCD Foundation - Co-Occurring OCD and Substance Use Disorder: What the Research Tells Us
International OCD Foundation - What Is OCD?
Mayo Clinic - Obsessive-Compulsive Disorder (OCD)
National Institute of Mental Health - Obsessive-Compulsive Disorder

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