Obsessive-compulsive disorder and drug addiction go hand-in-hand like many other co-occurring disorders. Treatment for each disorder depends on the other. Therefore, it’s imperative that rehabilitation centers focus on resolving both through proper management and therapy.
What is a Co-Occurring Disorder and What Does It Have to Do with Addiction?
According to the National Alliance on Mental Illness (NAMI), “Either substance abuse or mental illness can develop first. A person experiencing a mental health condition may turn to drugs and alcohol as a form of self-medication to improve the troubling mental health symptoms they experience. Research shows though that drugs and alcohol only make the symptoms of mental health conditions worse. Abusing substances can also lead to mental health problems because of the effects drugs have on a person’s moods, thoughts, brain chemistry, and behavior.”
Obsessive-compulsive disorder is another one of these co-occurring disorders that complicate drug and alcohol addiction.
Other common dual diagnoses with drug addiction:
- Bipolar Disorder
- Eating disorders (anorexia, bulimia, binge eating disorder)
- Post-traumatic Stress Disorder (PTSD)
The Symptoms of Obsessive Compulsive Disorder
The obsessive-compulsive disorder does require a doctor’s diagnosis. According to Mayo Clinic, “Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it’s also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social or work functioning.”
As more studies are conducted on OCD, it’s beginning to take on a different definition and approached in a new way. According to Psychology Today, “Obsessive-compulsive disorder (OCD) is defined by the presence of repetitive and distressing obsession and compulsion, which tend to increase in severity during the natural course of the disorder. In the new diagnostic classification system (DSM-5), OCD is no longer considered an anxiety disorder. In May 2013, The APA (American Psychiatric Association) classified OCD as an impulse disorder, like behavioral addiction. The emphasis is on the compulsive aspect, which means the continued repetition of a behavior despite adverse consequences. The compulsions (or behaviors) are fueled by the obsessions (e.g., intrusive thoughts of contaminations).”
OCD Obsessions and Compulsions – What’s the Difference?
According to the National Institute of Mental Health: “Obsessions are repeated thoughts, urges, or mental images that cause anxiety. Common symptoms include:
- Fear of germs or contamination
- Unwanted forbidden or taboo thoughts involving sex, religion, and harm
- Aggressive thoughts towards others or self
- Having things symmetrical or in a perfect order
Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:
- Excessive cleaning and/or handwashing
- Ordering and arranging things in a precise way
- Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off
- Compulsive counting”
Common misconceptions are like those about addiction. First, people believe those participating in OCD enjoy it or get pleasure from it. Second, people believe if the OCD sufferer wasn’t so “weak,” that they would overcome it. Lastly, they feel as though they can continue on and live their daily lives while struggling with their disorders.
Symptoms may worsen or get better over time. People with OCD and in treatment may try to help themselves by avoiding situations that trigger them (this may lead them to become isolated), or they may use alcohol or drugs to ease their symptoms. Although most adults with OCD recognize that what they are doing seem unreasonable, many adults and children do not realize their behavior is strange to others. Those familiar with symptoms like parents or teachers typically recognize OCD symptoms in children.
OCD and Addiction Are Treatable Together
Due to the mental and emotional (and sometimes physical) distress caused by the obsessive-compulsive disorder, those with a diagnosis can turn to drugs or alcohol to cope. It can be extremely draining to deal with the symptoms of OCD. Although some medications do exist for symptoms, they are not always easy to obtain or they suffer some from some side effects.
These medications include (according to NIMH) “serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are used to help reduce OCD symptoms. Examples of medications that have been proven effective in both adults and children with OCD include clomipramine, which is a member of an older class of “tricyclic” antidepressants, and several newer “selective serotonin reuptake inhibitors” (SSRIs), including: fluoxetine, fluvoxamine, and sertraline.”
The rehabilitation center you choose should focus on dual treatment of your addiction and OCD. That means not just depending on a medication to reduce the obsessive-compulsive symptoms. There are other ways to treat these co-occurring disorders, and the goal is to find a treatment center that addresses the complexity of your diseases.
The National Institute on Drug Abuse says this about effective treatment for addiction: “Based on scientific research since the mid-1970s, the following key principles should form the basis of any effective treatment program:
- Addiction is a complex but treatable disease that affects brain function and behavior.
- No single treatment is right for everyone.
- People need to have quick access to treatment.
- Effective treatment addresses all of the patient’s needs, not just his or her drug use.
- Staying in treatment long enough is critical.
- Counseling and other behavioral therapies are the most commonly used forms of treatment.
- Medications are often an important part of treatment, especially when combined with behavioral therapies.
- Treatment plans must be reviewed often and modified to fit the patient’s changing needs.
- Treatment should address other possible mental disorders.
- Medically assisted detoxification is only the first stage of treatment.
- Treatment doesn’t need to be voluntary to be effective.
- Drug use during treatment must be monitored continuously.
- Treatment programs should test patients for HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as teach them about steps they can take to reduce their risk of these illnesses.”
Therapies for Addiction and Obsessive Compulsive Disorder That Work
There are so many effective ways to approach addiction therapy when you have a co-occurring disorder. Whether it’s OCD or ADHD, therapeutic models exist to address all types of disorders.
Cognitive Behavioral Therapy (CBT) – NIDA says, “A central element of CBT is anticipating likely problems and enhancing patients’ self-control by helping them develop effective coping strategies. Specific techniques include exploring the positive and negative consequences of continued drug use, self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations.”
Contingency Management Interventions/Motivational Incentives – For opioid (specifically heroin use), this type of therapy is used to increase treatment retention and promote abstinence from drug use. In a voucher system, a patient receives a voucher for every urine sample collected that has no trace of drugs. These can often be exchanged for food items or other goods. Prize incentives work similarly. Cash prizes are given instead of vouchers. So far, these types of motivational therapies do not seem to encourage gambling behaviors.
12 Step Facilitation – This is a widespread support therapy that encourages active engagement. The most common 12-step programs include Al-Anon and Narconon. Three ideas govern 12 step programs: acceptance (of the addiction and the disease), surrender (giving yourself over to a higher power), and active involvement (coming to meetings and other activities).
Family Behavior Therapy – NIDA says, “Which has demonstrated positive results in both adults and adolescents, is aimed at addressing not only substance use problems but other co-occurring problems as well, like conduct disorders, child mistreatment, depression, family conflict, and unemployment. FBT combines behavioral contracting with contingency management. FBT involves the patient along with at least one significant other like a cohabiting partner or a parent (in the case of adolescents). Therapists seek to engage families in applying the behavioral strategies taught in sessions and in acquiring new skills to improve the home environment.”
How Obstacles Transform into Opportunities
“There is good in everything if only we look for it.”— Laura Ingalls Wilder
Dealing with drug addiction and OCD is one of the hardest things a person will go through in their lives. These two diseases work together to create a situation that many people find themselves stuck in. It affects their family, their work, their school, and their health. At The Evergreen, we prefer to view these obstacles as opportunities to become better, happier members of society. Besides typical detox and therapies that help transform negative drug habits, here are some other ways we help patients learn and adopt habits that increase their sense of well-being:
- Eating right – Diet is an important aspect. If you were doing drugs or suffering from anxiety, it may the case that you used food in a way that was unhealthy – be it eating too much or too little. We serve food in our facility that helps you get back into shape, and we have resources that help you make good food choices once you return home.
- Exercising – Enjoying all the things your body can do for you begins immediately. Under medical supervision, you will participate in exercises that get you moving and feeling amazing. When you return home, we will continue to encourage you managing your health through regular exercise.
- Learning to have fun without drugs or alcohol – There are a lot of things to do that don’t involve drug or alcohol use. We work with you to identify situations that don’t trigger your addiction or OCD so as to find fun activities you can do without worry of relapse.
- Socializing – Socializing can be a trigger for both substance abuse and OCD. Through group support, we help you learn that social interactions don’t need to rely on drug use or obsessive behaviors.
Learn more about what The Evergreen can do to get you sober and healthy again.
NAMI.org. (2017). Dual Diagnoses. Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis
Nimh.nih.gov. (2017). Obsessive Compulsive Disorder.