OCD and Addiction Treatment

There is no one single cause of OCD; instead, OCD is likely caused or triggered by a variety of factors.

Brain and/or Hormones

Brain development and hormones may be causes of OCD, but studies have not found enough evidence for researchers to say for certain that either one is more of a cause than anything else. However, it is true that parts of the brain that involve memories, emotions, and gut feelings look different in the brains of those with OCD than those without.

An imbalance of hormones like serotonin or other neurotransmitters like dopamine might also be a cause for OCD, as some OCD can be treated with serotonin reuptake inhibitors (SRI) medications, which are often used to treat anxiety disorders.

Genetics

Genetic predisposition also likely comes into play when we consider the cause of OCD. According to the International OCD Foundation, “10%-20% of children who have a parent with OCD will develop OCD themselves.”[2]

Environment

Environmental factors might also contribute to the development of OCD for some individuals, as some compulsions are learned behaviors that people might pick up from parents, caregivers, or friends. There is often a rise in certain OCD behaviors during specific, global events, like the COVID-19 pandemic. During 2020 and 2021, there was a rise in compulsions like hand washing and activities connected to fears about spreading or contracting the virus.

Anyone can develop OCD at any point, but it often manifests in children between 7-12 or in young adults around the age of 20 (IOCDF).[3] OCD is usually developed gradually, and it seems to equally affect men and women and people of different ethnicities or races.

Obsessive-compulsive disorder can manifest in many ways, but the main symptoms are pervasive and ongoing thought patterns that cause fear or doubt, and physical or mental rituals that are repeated as often as the thought patterns occur. Below are some common obsessions and compulsions to be aware of.

Common Obsessions

• Fear of contamination from things like dirt, germs, chemicals, bodily fluids, etc.
• Fixation on exactness, including the desire for symmetry, fear of making mistakes, the fear of losing or forgetting things, etc.
• Fascination with violence or sex (or fear of becoming violent, in sex or otherwise).
• Fear of thoughts that go against one’s religious beliefs.

Common Compulsions

• Washing and cleaning.
• Repeating body movements, doing things in sets or multiples, arranging items in a certain way.
• Checking and re-checking thoughts or actions (i.e., checking that nothing bad has happened since the last time you had that thought, which might only be seconds before).

OCD is, by definition, something that affects a person’s daily life. This means that the rituals or compulsions a person with OCD engages in might take up hours of the day, or they might interfere with relationships.

A person with OCD might also begin avoiding people, places, or thoughts that trigger the obsessive thought, which in turn triggers the compulsive behavior. This can make simple daily tasks, like leaving the house, impossible to complete.

OCD can also cause people to feel shame or guilt because they cannot control their obsessive thoughts or compulsive behavior. They may feel embarrassed and try to hide their condition from loved ones. Family members and friends might feel helpless, or they may even become angry at the person with OCD if they feel that they should be able to change their thoughts or behaviors.

Substance Abuse and Its Interaction With OCD

The relentless anxiety and distress caused by OCD symptoms often drive people toward alcohol or drugs as a way to temporarily escape obsessive thoughts and reduce the overwhelming urge to perform compulsions.[4] Substances may initially seem effective at quieting the mental chaos, allowing brief periods where intrusive thoughts feel less intense or the need to engage in rituals diminishes. However, the relief from the self-medication is short-lived. It creates a dangerous pattern where people begin relying on substances to cope with OCD symptoms, gradually developing tolerance and drug or alcohol dependence while the underlying obsessive-compulsive patterns continue to worsen. When co-occurring OCD and addiction occur, treatment requires specialized attention.

Because OCD is a mental disorder, the diagnosis is not linked to any medical test. Instead, a doctor or psychologist would ask a patient questions about their thoughts and behaviors. If a person engages in rituals that:

• Go on longer than one hour
• Cause distress
• Interfere with daily life
• And are not caused by other disorders or substances/medications

If the above are true, the provider would diagnose the patient with OCD and recommend treatment.

Treatment for OCD usually includes some kind of psychotherapy like Cognitive Behavior Therapy (CBT), Exposure and Response Prevention Therapy (ERP), or Acceptance and Commitment Therapy (ACT). Anxiety Management techniques can also help, and sometimes medication is prescribed. With all these treatment options, a strong support system is extremely helpful, whether that is found through group therapy, OCD support groups, or a strong family/friend network.

Cognitive Behavior Therapy (CBT)

The goal of CBT is to change one’s thought patterns to lessen the obsessive thoughts and compulsive behaviors. Often, a person is gradually introduced to triggering situations and, together with the therapist, learns behaviors to replace or prevent compulsive behavior.

Exposure and Response Prevention Therapy (ERP)

ERP is an evidence-based treatment during which a person with OCD is purposefully exposed to the trigger or fear that causes their obsessive thoughts and compulsive behaviors. The goal behind ERP is to help the client choose a response where they do not act in a compulsive way in response to the trigger. ERP is a type of Cognitive Behavior Therapy.

Acceptance and Commitment Therapy

ACT is a unique kind of therapy that teaches patients to accept thoughts as thoughts, which do not need to be acted on. This kind of therapy takes power away from the obsessive thought so that the person with OCD does not need to engage in the compulsive behavior.

Anxiety Management

Anxiety management involves things like slow breathing, meditation, and relaxation techniques to help a person combat their intrusive thoughts when they occur.

Medication

Medication is sometimes prescribed, as SRIs and other medications used to treat depression and anxiety can sometimes be helpful for those with OCD. However, this is not always the case, so a trained doctor or psychiatrist should prescribe the medication.