January 15th, 2024
It’s reported that in the UK alone, about 250,000 people live with OCD. The condition doesn’t discriminate, affecting young children and adults regardless of gender or background.
However, did you know that there are emerging reports suggesting that people with OCD may have a propensity for addiction?
What is OCD?
Obsessive-Compulsive Disorder (OCD) is a mental health condition characterised by persistent, unwanted thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) that an individual feels compelled to perform in response to the obsessions. These thoughts and behaviours can interfere significantly with daily activities, relationships, and overall quality of life.
People with OCD often experience distress due to the intrusive nature of their obsessive thoughts, which can be fear-inducing or anxiety-provoking. In an attempt to alleviate this distress or prevent a feared event, individuals engage in compulsive behaviours or mental rituals. Despite the temporary relief these behaviours may provide, they are typically not connected to the actual events they are meant to prevent and can become time-consuming and disruptive.
OCD can vary in severity, and its impact on daily functioning can range from mild to severe.
Why does OCD occur?
The exact cause of OCD is not fully understood, but it is likely to involve a combination of genetic, neurological, behavioural, cognitive, and environmental factors. Here are some key factors that may contribute to the development of OCD:
Genetics: There appears to be a genetic component to OCD, as individuals with a family history of the disorder are more likely to develop it themselves. Specific genes associated with serotonin regulation and other neurotransmitters have been implicated in OCD.
Brain Structure and Function: Research suggests that abnormalities in certain areas of the brain, particularly the basal ganglia and the orbitofrontal cortex, may play a role in the development of OCD. These areas are involved in regulating emotions, decision-making, and motor function.
Neurotransmitter Imbalance: Changes in the levels or functioning of neurotransmitters, particularly serotonin, may contribute to the development of OCD. Serotonin is thought to play a crucial role in mood regulation and anxiety, and studies have shown that a boost in serotonin decreases OCD symptoms.
Cognitive Factors: Distorted thought patterns and cognitive processes may contribute to the development of OCD symptoms. Individuals with OCD often have exaggerated fears or beliefs that certain actions will prevent a feared event from occurring.
Environmental Factors: Stressful life events, trauma, or a history of abuse may contribute to the onset of OCD in some individuals. Environmental factors alone are unlikely to cause OCD, but they may interact with genetic and neurological factors.
Learned behaviour: Some researchers believe that certain behaviours associated with OCD symptoms may be learned to avoid responses to anxiety or stress. For example, a person might develop compulsive rituals as a way of coping with overwhelming anxiety.
Are there different types of OCD?
While OCD variations could be infinite, conventionally, it is believed that an individual’s OCD tends to align with one of these five primary categories. Themes often intersect and overlap across these categories:
Individuals with checking-related OCD exhibit compulsive behaviours driven by the fear of harm or danger. They repeatedly verify things to alleviate anxiety.
Example signs of OCD: Constantly checking that doors are locked, appliances are turned off, or the stove is not left on.
This category involves an intense fear of contamination through physical contact or intrusive thoughts. The fear often leads to repetitive cleansing rituals.
Example signs of OCD: Washing hands excessively due to a fear of germs, avoiding contact with certain surfaces, or feeling contaminated by specific thoughts.
Symmetry and ordering
OCD related to symmetry and ordering revolves around the need for things to be arranged in a particular way or a fear of imbalance. Individuals may feel compelled to arrange items symmetrically to alleviate distress.
Example signs of OCD: Aligning objects perfectly, arranging items in a specific order, or feeling compelled to repeat actions until they are symmetrical.
This category involves persistent, distressing thoughts or mental images intruding on a person’s mind. These thoughts often lead to anxiety and compulsive behaviours to neutralise them.
Example signs of OCD: Fearful thoughts about harming oneself or others, intrusive and unwanted mental images, or obsessive doubts about personal actions.
Hoarding OCD involves an excessive attachment to possessions, leading to difficulty discarding items even if they have little or no value. The fear of losing something important drives the hoarding behaviour.
Example signs of OCD: Accumulating excessive amounts of newspapers, magazines, or items with sentimental value and difficulty parting with them, even when the clutter becomes overwhelming.
Is there a link between OCD and addiction?
There is some evidence suggesting a potential link between obsessive-compulsive disorder (OCD) and addiction, although the relationship is complex and not fully understood.
A study found that those with versus those without OCD, those with OCD had a significantly higher probability of misusing drugs and/or alcohol.
Here’s what was found:
4.5-fold increased risk of alcohol-related disorder
6.7-fold increased risk of any drug-related disorder
1.2-fold increased risk of substance use–related criminal conviction
5.2-fold increased risk of substance use–related death
Particularly heightened risk for sedative- and other drug–related disorders, with a 10.5-fold increase
In addition, the table below shows that by the age of 32, individuals with OCD showed a cumulative incidence of alcohol- and drug-related disorders at 23%, in contrast to the 5% incidence observed in the general population.
Source: NCBI- Association of Obsessive-Compulsive Disorder and Obsessive-Compulsive Symptoms With Substance Misuse in 2 Longitudinal Cohorts in Sweden
It’s important to note that not everyone with OCD develops an addiction, and vice versa. Additionally, the nature of the relationship between addiction and OCD can vary among individuals.
Why does OCD co-occur with addiction?
In this section, we take a look at some of the theories as to why addiction and OCD co-occur.
Shared impulsivities with OCD and addictions
Impulsivity in individuals with OCD can manifest in various ways, potentially leading to behaviours that share similarities with addiction. This impulsivity is often characterised by difficulty in resisting urges or impulses, and it plays a role in the intricate relationship between OCD and addictive behaviours.
Moreover, the link between impulsivity and addiction becomes more apparent when considering the shared neural pathways and underlying mechanisms. Both OCD and addiction involve dysregulation of the brain’s reward system, particularly in areas associated with impulse control. Neurotransmitters such as dopamine, which play a crucial role in reward processing, may contribute to the reinforcing nature of both compulsive rituals in OCD and addictive behaviours.
A way to deal with OCD and comorbidities
Comorbidities in OCD are common and can include other mental health conditions such as depression, ADHD, and Tourette’s Syndrome.
It’s feasible that some individuals with OCD may turn to substances like drugs or alcohol, or even activities like gambling or video games, as a way to cope with the ongoing challenges and distress associated with their condition. This can be a form of self-medication in an attempt to alleviate anxiety, depression, or other symptoms. However, substance use is not a recommended or effective long-term solution for managing OCD or its comorbidities. The more exposure to the drug or activity, the higher the chance of forming addictions.
There are also factors, such as shared genetics, that could contribute to OCD and addiction. Especially in the case of twins, there is a heightened likelihood of sharing OCD due to the presence of shared genetics. The connection between OCD and addiction is further complicated by shared risk factors, adding to the intricacies of their relationship. Genetics that elevate the probability of developing either condition may overlap, establishing a predisposition for the co-occurrence of OCD and addiction.
Treatment for OCD and addiction
Recovering from addiction is tough, but having a variety of tools and strategies at your disposal is essential for a successful journey. Dealing with both OCD and addiction as a dual diagnosis can improve overall success.
While UKAT doesn’t have a specific rehab treatment for OCD, many of our addiction treatment methods can also help with your OCD.
Individual and group counselling sessions are personalised to explore the reasons behind addiction and OCD, giving individuals a chance to express and deal with their emotions. We use Dialectical behavioural Therapy (DBT) to provide emotional regulation skills crucial for OCD treatment and addiction treatment.
Holistic therapies like yoga and meditation are included in treatment plans to promote overall well-being. These practices increase self-awareness, reduce stress, and contribute to emotional resilience, creating a good environment for OCD treatment alongside addiction.
Aftercare is important for ongoing support. Group therapy sessions allow shared experiences and reinforce coping strategies, helping individuals deal with OCD while staying on the path to recovery.
The combination of these therapeutic approaches not only addresses drug addiction but also provides a holistic foundation for effectively confronting and managing OCD.
What are the next steps?
If you’re facing the heavy burden of OCD and addiction, know that you’re not alone. At UKAT, we understand the profound impact these challenges can have. Reach out to us for compassionate support and effective OCD treatment and addiction treatment. Our team is here to guide you towards healing, offering a caring environment where you can reclaim hope and rebuild your life.
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