Abbreviated as OCD, obsessive-compulsive disorder is a type of anxiety disorder where the sufferer goes through bouts of thoughts that cause irrational anxieties and fears. Those with OCD participate in compulsive, repetitive behaviors known as “rituals.” Examples of rituals are behaviors such as ceaseless hand-washing, counting items over and over again in cycles, and highly specific organizing. Performing these rituals allows the sufferer to feel temporary relief from their crippling panic while the ritual is underway. However, the anxiety is soon to return once the ritual is completed to the OCD sufferer’s specifications. It’s a highly taxing disorder that can easily consume the life of the individual by preventing them from enjoying activities they would otherwise find far more rewarding.
It’s estimated, per the Journal of Anxiety Disorders, that more than 25% of people who look for treatment for their OCD also meet the criteria for a substance use disorder. Those who have their first bouts of OCD symptoms in their childhoods or teen years are at much greater risks for developing an alcohol or a drug problem, even before adulthood. This destructive behavior is usually a means to cope with overwhelming fear and anxiety in their minds.
It is much more likely that a person will be successful in overcoming a substance use disorder if the underlying emotional issues brought on by OCD are also properly addressed at the same time. A dual-diagnosis treatment regimen, with the aid of properly trained medical and mental health professionals, is best when looking to completely recover from both disorders at once. It’s also important to understand as much as you can about the complex nature of OCD.
The Societal Cost of Obsessive-Compulsive Disorder
Although it is often used as a subject of fascination or humor in popular culture, OCD is anything but a laughing matter. Society chuckles at fictional portrayals of characters obsessing over complex, arbitrary cleaning or organizing rituals. We label them “control freaks” for seeking to maintain their environmental or mental bubble.
Yet in real life, people who have to live with their OCD experience extreme internal strife and anxiety over their overwhelming thoughts. These meddlesome ideas can cause a break in relationships, at work, at school, and with social skills. It may even seem that to live a life of intoxication with alcohol or drugs is the only way to keep the monsters at bay by seeking escapism at the bottom of a bottle of mind-altering pills or alcohol.
The Statistics and Facts About OCD
How does being diagnosed with OCD cause an increase in substance abuse risk, and what are some of the problems that come with it? Here are some facts and figures relating to this potentially crippling mental health issue:
• Anxiety, depression, and substance abuse issues often occur in parallel with OCD.
• Behaviors such as obsessive cleaning, repetitive hand-washing, and checking locked doors can take up so much time in one’s day that they interfere with normal daily routines.
• Those with OCD are cognizant that their concerns and anxieties are unreasonable, but still they cannot get a grip on their fears and thus rely on completing their obsessive rituals.
• There is a genetic component to OCD that is inherited; it appears far more frequently in members of the same family.
• Approximately 2.3 million men and women in the United States are affected by OCD.
Common Rituals and Fears in OCD Sufferers
The rituals and fears affiliated with obsessive-compulsive disorder can be highly different from person to person. However, it’s important to remember that there are some similar veins of anxiety and behavior that appear in the general OCD population. According to the Nemours Foundation, the most typical fears and concerns found in children and adults with OCD are as follows:
• Intrusive thoughts about harming oneself or others
• Frequent thoughts or fantasies about sexual acts
• Anxiety over getting sick or losing a loved family member to an accident or an illness
• An obsession with religious subjects
• A fixation over numbers that can be labeled as “evil” or “good”
• A fear over being infected by virulent viruses or strains of bacteria
Rituals that entail cleaning, grooming, organizing, and counting are typically seen as the most common obsessions in those with obsessive-compulsive disorder. Many of these people fear that if they fail to complete their ritual behaviors or tasks in a highly specific way or time frame, someone they love will come to some form of drastic harm. Other sufferers fret that unless their ritual is completed successfully, they will uncontrollably harm someone else. It does not matter to the person with OCD if these fears hold a legitimate basis in reality; they require a massive amount of physical and mental energy to accomplish and even more so if left unfulfilled.
Substance Abuse, OCD, and Anxiety
Obsessive-compulsive disorder is only one of several psychiatric illnesses that are considered anxiety disorders. Roughly 20% of those who are suffering from a psychiatric disorder relating to anxiety are also victims of a concurrent substance use disorder according to the Anxiety and Depression Association of America. However, mind-altering substances often make symptoms more severe and wind up increasing the number of problems typically associated with OCD. Over 26% of ER encounters are due to anxiety disorders according to the ADAA.
Having an addiction is in and of itself a compulsive state; it inspires a ceaseless chase for a harmful substance or pattern of behavior despite all of the negative outcomes and consequences. Therefore, obsessive-compulsive disorder and substance addiction are a dangerous mix. People who are victims of OCD suffer from high levels of anxiety and fear every day of their lives. Often, drugs and alcohol are used as a means of escape in a time when all else feels hopeless. This is the situation at its most complex; someone in such a feedback loop has a very difficult time overcoming their chemical addiction and dependencies without significant assistance. This is why professional treatment is highly recommended to help a person start a new life through therapy.
Opportunities and Obstacles in OCD Treatment
Treatment for obsessive-compulsive disorder in parallel with a substance abuse problem comes with a lot of challenges, but it ultimately results in a radically changed life for betterment of the sufferer. Deciding to finally enter a rehab facility might cause a spike in anxiety, but this is primarily because doing so highlights all of the “unknowables” in someone’s life in a way that they cannot directly control. The rituals that formed the backbone of their life prior can no longer be practiced. Time is instead focused on attending group meetings and individual therapy sessions. Intrusive thoughts and actions might still take their toll, which is why a supportive environment is so crucial.
A dual-diagnosis treatment program that has been specialized for the individual is what will be the most effective, providing it can allot for all the needs for a sufferer of OCD. Such a program will greatly increase the odds that the person is able to successfully maintain control over their conditions. The University of Michigan Department of Psychiatry says that behavioral modification therapies combined with the proper medications are the most effective regimens for tackling anxiety disorders such as OCD.
One of the most potent behavioral modification therapies is CBT, or cognitive behavioral therapy. CBT focuses on educating the client about how to notice and change negative behaviors. The idea is that all things begin as an idea; changing how you react to the idea and crafting a rational response to it in your head help reverse the downward spiral that OCD can cause in one’s thinking. The first step is to notice when you are having a cognitive distortion. This is usually done first with the help of a trained medical professional, especially in the case of a dual diagnosis. Often, it helps to write the negative thoughts down. Then, after noting the type of negative cognitive distortion you’ve had, you are then tasked with coming up with a rational response to them.
An example of this would be thinking, “If I don’t perform a ritual, my loved one would die.” This is jumping to conclusions in the form of “fortune telling.” A person may write down a rational response, such as “There is no reason to believe that performing a ritual will do anything to help or hinder my loved one; there is no evidence that any OCD rituals could help in a problem, and it only makes me more nervous.” The idea is that when given enough time and proper education, the sufferer will be able to notice different kinds of cognitive distortions on their own. Eventually, they won’t even need to write them down to have enough time to think of a rational response because they will have been so acclimated to catching themselves in the act beforehand and coming up with a rational response for their anxiety.
When it comes to OCD, therapy sessions that focus on teaching the person how to change negative thoughts and expose themselves to their anxieties and fears without needing to rely on arbitrary rituals will be the most important tool for recovery. The final objective is to completely get rid of irrational anxieties associated with certain items, thoughts, or situations.
Antidepressant drugs can also play a role for some sufferers of obsessive-compulsive disorder; they are generally used to minimize the symptoms. SSRIs have been proven to be especially helpful when treating OCD. Many people who begin a regimen of pharmaceuticals discover that they are concentrating better and can focus on their therapy more, especially if undergoing cognitive behavioral therapy.
Building a Support Network With OCD
A robust support network is critical for people who suffer from OCD and substance abuse issues. Each condition has the potential to cause the sufferer to isolate from loved ones and family. Their job can also be at risk. This withdrawal serves to make the anxiety disorder’s symptoms more intense. An integrated dual-diagnosis rehabilitation regimen allows clients to have the ability to communicate with one another in regard to shared successes and difficulties to ensure that they don’t feel alone. Members talk about battling the same symptoms and share strategies for how to overcome their plights. These structured support groups not only highlight the spectrum of OCD experiences, but group therapy also gives a beacon of hope for recovery while allowing socialization in a healthy environment.
Teaching loved ones is also a critical component of recovery from a dual diagnosis. Often frustrated and confused, friends and family can feel hopeless as to what they could do to help or understand OCD. This bafflement typically focuses on the ritualistic behaviors of the sufferer and the seemingly nonsensical nature of each impulse. Educational courses combined with counseling sessions aid loved ones in understanding the gravity of the disorder and its uncontrollable nature. The more you and your support network understand about the compulsive, disabling conditions of OCD, the better equipped you’ll be for the road to recovery.
Getting Aid for Addiction and OCD
Shame and secrecy are quite common in obsessive-compulsive disorder and often add another layer of complexity. Long-time sufferers are masters at keeping their disorder hidden away, and they keep themselves out of reach for help. Far too often, once the sufferer seeks help or is noticed to have a problem, the dual issues of OCD and addiction have become far more severe. The habits associated with ritualistic behaviors are far more ingrained in the mind.
This can manifest in a person losing interest in friends and hobbies and being overly defensive with their “quirks.” They may also be particularly avoidant of social situations and begin to self-medicate with drugs and alcohol. Those who suffer are unlikely to get help on their own, and intervention is frequently required to finally get them the help they need. Addiction specialists are experienced in helping those from all walks of life recover, so they can step in to make sure a sufferer gets professional help.