The term “OCD” is frequently heard these days. Due to its widespread use and portrayal in the media, it has come to be understood as “being particular,” having a strong desire for things to be neat or organized, or being what some might call a “germaphobe.”
While some of these characteristics may be related to some of the concerns that people with certain types of OCD may have, it is an oversimplification. Thus it’s an inaccurate portrayal of a much more complex and, at times, debilitating disorder.
Many people suffer from co-occurring disorders such as OCD and addiction. However, there appears to be a misunderstanding about the relationship between these disorders. So, what exactly is OCD?
Regarding mental health and substance abuse, it is advised to seek treatment at a behavioral health treatment center such as 449 Recovery in Mission Viejo, California. We provide access to comprehensive care for people suffering from OCD and addiction while helping equip them with the resources and skills needed to manage and live with their conditions effectively.
Obsessive-compulsive disorder (OCD) is a common mental illness in which a person experiences uncontrollable, recurring thoughts (obsessions) and compulsive behavior (compulsions) that they feel compelled to repeat. This can include repeatedly turning on and off the light switch whenever they enter a room. OCD symptoms vary and may include a wide range of possibilities for how these obsessions or compulsions can manifest.
OCD frequently focuses on specific themes, such as a fear of germs or the need to arrange objects in a specific way. Symptoms usually appear gradually and change over time. However, as we can see, this disorder is far more complicated.
Obsessions are anxious thoughts, urges, or mental images that occur repeatedly. They can include common symptoms such as aggressive thoughts towards others or self, unwanted taboos sexually, religiously, or harmfully, or needing to have objects symmetrical/in order. These compulsive behaviors can have negative consequences. Combining mental illnesses, such as anxiety disorders, with drug abuse can also be problematic.
These tasks do not bring pleasure to someone suffering from OCD. However, there may be some temporary relief from the anxiety caused by obsessive thinking. The majority of people with OCD are diagnosed by the age of 18, and approximately 1.8% of adults were diagnosed in the previous year. There are also an estimated 2.2 million people who suffer from OCD, and their symptoms vary from person to person.
According to the International OCD Foundation (IOCDF), OCD involves communication problems between the front part of the brain and deeper brain structures. These brain structures rely on serotonin, a neurotransmitter (basically, a chemical messenger).
The exact cause of OCD is unknown to experts. It is thought that genetics, brain abnormalities, and the environment all play a role.
- Biology: OCD may be a result of changes in your body’s natural chemistry or brain functions.
- Genetics: OCD may have a genetic component, but specific genes have yet to be identified.
- Learning: Obsessive fears and compulsive behaviors can be learned from watching family members or gradually learned over time.
In other words, it’s said that OCD may also be caused in part by communication barriers in the brain, and genetics may play a role in its development. Neuroimaging studies have revealed that OCD is caused by communication problems between the structures at the front of the brain and its deeper structures.
These areas include the prefrontal striatal cortex, a critical brain region responsible for the release of the neurotransmitter serotonin, which aids in the regulation of emotions or feelings, as well as executive functioning. As a result, a malfunction in this area of the brain could result in OCD.
Images of the brain at work also show that, in some people, medications that affect serotonin levels (serotonin reuptake inhibitors, or SRIs) or cognitive-behavioral therapy (CBT) have proven to improve the brain circuits involved in OCD.
The development of this mental condition usually begins in adolescence or early adulthood. However, it can also begin in childhood. Some experts believe that the signs, symptoms, and causes of OCD in children differ from the signs, symptoms, and causes of the disorder in adults. Twin studies, for example, have recently revealed that genes play a larger role when OCD begins in childhood (45-65%) than when it begins in adulthood (27-47%).
It is critical to understand that Obsessive-Compulsive Disorder is defined by obsessions and compulsions that cause distress and impair functioning. OCD can manifest itself in a variety of ways, or “symptom subtypes.” This means that even if two people have the same diagnosis, their symptoms can be very different.
As previously stated, when most people hear the term “OCD,” what comes to mind is being overly concerned with cleanliness or organization, as this is what is commonly told to people or presented in the media.
While extreme cleanliness, symmetry, and organization are common signs of OCD, it doesn’t mean that everyone who exhibits these behaviors will have a diagnosis of OCD. The following are characteristics to accurately diagnose someone with this mental condition as defined by the Diagnostic and Statistical Manual (DSM-5-TR):
- Doubting and having difficulty tolerating uncertainty
- Needing things orderly and symmetrical
- Aggressive or distressing thoughts about losing control and harming yourself or others
- Unwanted thoughts
- Spending too much time completing things (Getting dressed, playing with toys, completing tasks, etc.
- Resisting change
- Redoing tasks repeatedly
- Compulsive behavior
- Ritualistic behaviors (Cleaning, reorganizing, etc.)
- Compulsive hoarding
- Persistent repetition of words or actions
- Repetitive movements
- Social isolation
- Mood swings
- Fear of contamination
- Food aversion
- Going over repetitive thoughts
People suffering from OCD have persistent, rigid thought patterns that can be overwhelming. These behaviors and thoughts become all-consuming. To effectively manage this condition, professional help is required.
As we discussed previously, a few signs of this particular dual diagnosis include:
- Severe withdrawal symptoms
- Exacerbation of OCD symptoms
- Even more heightened paranoia and anxiety
- Obsessive thoughts and behaviors
If your loved one exhibits any of the above symptoms, it may be time to intervene and assist.
You may be aware of the distinction between thoughts and behaviors. Still, it’s important to distinguish the two, especially for people with mental health conditions like OCD, because they influence each other in a variety of ways.
Obsessions and compulsions are the two main characteristics of OCD that must be present for an accurate diagnosis. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) defines obsessions as persistent thoughts, urges, or images that are intrusive, unwanted, and cause significant anxiety or distress. Compulsions or rituals are the second characteristics. These compulsions or rituals are defined as repetitive or mental behaviors performed to relieve anxiety caused by obsessions.
Unwanted images or ideas preoccupy the minds of those suffering from OCD, essentially preventing the mind from functioning properly. The distress caused by these obsessions and compulsions can range from feeling overwhelmed by anxiety to potential harm, apologizing for losing control, and so on.
It is critical to understand the distinction between obsessions and compulsions, as well as examples of the two, to recognize the signs and symptoms of this mental disorder.
Obsessions are defined as thoughts, images, or impulses that occur repeatedly in a person’s mind and are uncontrollable. Individuals suffering from OCD experience these unwanted and disturbing obsessions, which can result in stigma or feelings of fear, embarrassment, doubt, and so on. This impedes aspects of daily life as well as important activities. Examples of obsessions include the following:
- Fear of acting impulsively to harm oneself or others
- Contamination/washing hands
- Unacceptable/taboo thoughts (Sexual, religious, etc.)
Compulsions are the second component of obsessive-compulsive disorder. Routines, religious practices, and learning a new skill, for example, all involve repeating an activity but are usually a positive and functional part of daily life.
These acts are extremely compulsive for people with OCD, to the point where they interfere with their ability to focus and function day and night. Individuals engage in repetitive behaviors to neutralize, counteract, or eliminate their obsessions. These behaviors are also known as rituals, such as repeatedly checking if a door is locked, repeatedly washing your hands, and so on.
Compulsive behavior is used to avoid or reduce anxiety or obsessions. People with OCD are aware that this is only a temporary solution, but in the absence of a better option, they rely on compulsion, which includes avoiding situations that trigger these feelings. However, they are time-consuming and interfere with important daily activities, exacerbating the situation.
In the case of someone who does not have OCD, “compulsive” refers to a personality trait or aspect of yourself that you prefer or enjoy. Individuals with OCD are motivated to engage in compulsive behavior but would prefer not to do these time-consuming and often disruptive acts. Examples of compulsions include the following:
- Checking, counting, washing, and repeating things.
- Hand-washing until your skin becomes raw.
- Checking doors repeatedly to make sure they’re locked.
- Checking the stove repeatedly to make sure it’s off.
- Counting in certain patterns.
- Silently repeating a prayer, word, or phrase.
It’s important to understand that not all repetitive behaviors or “rituals” are compulsions or obsessions. You must consider the function and context of the behavior. Behaviors are context-dependent.
Actively “ignoring” symptoms of OCD can produce an additional sense of denial (and thus more anxiety). It can quickly devolve into an unsustainable habit of “white-knuckling” through life.
A co-occurring disorder, also known as a dual diagnosis, occurs when two diseases, such as OCD and addiction, coexist. A co-occurring disorder makes coping with and managing addiction and mental disorders even more difficult.
Not only do these two illnesses intertwine, but they can also depend on one another. This not only affects how we cope (self-diagnosing), it affects how we recover. That’s why our team at 449 Recovery in Southern California believes in treating the “whole” person and getting to the root cause of disease. Holistic care is an incredible way to combat co-occurring disorders such as OCD and addiction.
Those suffering from obsessive-compulsive disorder and addiction have a close relationship. Approximately 25% of people with Obsessive-compulsive disorder also struggle with addiction. As a result, a co-occurring disorder is formed. OCD symptoms can often be debilitating for many people. Individuals suffering from this disorder are plagued by anxious thoughts and compulsions.
Professionals are unsure whether addiction causes mental illness or vice versa in a dual diagnosis case. However, self-medication, isolation, and anxiety are all addiction triggers. The link between obsessive-compulsive disorder and addiction is undeniable.
To provide a temporary escape from these debilitating symptoms, people with OCD commonly cope by turning to drinking alcohol or doing drugs. Over time, this turns into dependency and addiction, affecting all aspects of life.
OCD is also characterized by secrecy and isolation. Many people who suffer from this disorder feel as if they can’t be around other people because of their thoughts and compulsions. However, this is yet another addiction trigger.
The DSM-5 defines OCD as having recurring and persistent thoughts, urges, or images that are intrusive, unwanted, and cause anxiety or distress.
OCD presents diagnostic difficulties. This means that diagnosing this condition can be difficult at times because its symptoms can be similar to those of personality disorders, anxiety disorders, depression, schizophrenia, or other mental health disorders. It is also possible to have OCD in addition to other mental health disorders. OCD can only be diagnosed by trained therapists. Therapists will also look for three characteristics:
- Obsessions plague the individual.
- He or she exhibits compulsive behaviors.
- Obsessions and compulsions interfere with important daily activities such as working, going to school, or spending time with friends.
It is critical to collaborate with your doctor at an OCD treatment center to receive the proper diagnosis and treatment.
The good news is that there is assistance available for people whose lives have been impacted by behavioral health disorders. If you believe you or a loved one may be suffering from OCD, it is critical to seek professional help to evaluate and assess the situation.
During your evaluation, you and your doctor will discuss your thoughts, feelings, symptoms, and behavior patterns to determine if you have obsessions or compulsive behaviors that interfere with your quality of life. With your permission, this may also include talking to your family or friends.
There are no one-size-fits-all treatments for mental health. Some types of OCD and anxiety manifest more severely than others. As a result, because everyone is unique, symptoms will manifest differently. As a result, treatments and their duration may differ. The following are the current gold-standard treatment methods for OCD and addiction:
Anxiety-based disorders such as OCD and addiction can result in significant impairment and a lower quality of life. As a result, for people suffering from OCD, an outpatient rehab program may be the best option for monitoring and treating symptoms associated with this condition.
Our dual diagnosis treatment program at 449 Recovery consists of comprehensive treatment that assists our individuals in reducing their impulsive thoughts, behaviors, and anxiety symptoms by teaching them how to cope with the triggers that make daily functioning impossible. Our outpatient programs provide the following services:
- Partial Hospitalization (PHP)
- Prevention of Exposure and Reaction (ERP)
- Family Therapy
- Trauma Therapy
- Individual Therapy
- Group Therapy
For many people with OCD, Cognitive Behavioral Therapy (CBT) is an effective form of treatment. Furthermore, research has established Exposure and Response Prevention Therapy (ERP) as a well-established first-line treatment.
ERP Sessions involve gradually exposing you to your fears while teaching you how to resist the urge to obsess and engage in ritualistic behaviors. Psychotherapy helps people manage their obsessions and compulsions by providing context for their behaviors and thoughts. As a result, once someone learns how to regain control, it can help improve their quality of life.
Since OCD focuses on thoughts and compulsions, cognitive behavioral therapy is one of the most effective treatments. This therapy focuses on changing thoughts to change actions. It sounds very similar to OCD but in reverse. You focus on your habits and coping mechanisms for harmful thought processes in cognitive-behavioral therapy. However, you learn how to rewire your brain to cope in healthy ways rather than unhealthy ways.
This is a must-have treatment option for anyone suffering from obsessive-compulsive disorder or addiction. CBT is commonly used in the treatment of both mental illness and addiction. Unhealthy coping mechanisms are one way for people to develop a dual diagnosis. As a result, changing cognitive processes is a natural solution.
Certain medications can aid in the control of OCD obsessions and compulsions. Antidepressants and anxiety medications are frequently tried first. It is critical to note that medications that work for one person may not work for you.
The goal is usually to effectively control symptoms at the lowest possible dosage. It is not uncommon to try several medications before finding one that works well. To effectively manage your symptoms, your doctor may recommend more than one medication. It can take weeks or months to notice an improvement in symptoms after starting a medication. That is why, for those suffering from OCD, consulting with a professional and closely monitoring your treatment is the best option.
It’s important to note that while most people experience obsessive thoughts or compulsive behaviors at some point in their lives, not everyone is diagnosed with OCD. Obsessions and compulsions must be so severe that they consume all aspects of a person’s life for them to be properly diagnosed with this mental illness. Going to an OCD rehab center is therefore prudent, as treating mental illness necessitates professional assistance.
Through our treatment programs and services, our clients can reduce compulsive behaviors and improve their development skills. These programs typically last several weeks, or for as long as our mental health professional determines.
If you’re considering one of these treatment options, it’s critical to consult with your doctor to ensure you understand all of the benefits and drawbacks, as well as any potential health risks.
People in recovery should never feel isolated. Those on the path to a new life should collaborate, offering one another support and accountability. Creating a community of loved ones who care about you and have been through this journey with you can be extremely beneficial.
Substance abuse and mental health treatment typically entail the assistance of support groups and the community. The more open you can be with others, the more you can help each other, and the better your recovery journey will be.
You are not alone in this battle. OCD and addiction affect millions of people around the world. That being said, mental health and addiction treatment require patience and support, which we will provide throughout your journey.
If you are looking for treatment for yourself or a loved one, please contact our rehab center to learn more about the services we offer. We have the tools and resources to assist individuals in regaining control of their lives.
Dr. Warren Taff MD, graduated from the University of Birmingham, England School of Medicine, with a BA from Rutgers University. He then went on to UCLA School of Public Health in Los Angeles Health and Human Services and received an MPH. He also attended an internship in internal medicine, with the Veterans Administration. Dr. Taff’s residency includes General Psychiatry at USC, with elective residencies at the Royal Prince Alfred Hospital in Sydney, Australia, and Royal College of Psychiatry. Board certifications include American Board of Psychiatry and Neurology. Dr. Taff has extensive experience in both psychiatry and addiction medicine, extending from 1979 to present. He has held professional titles that include Chief of Staff and Medical Directorship in both hospitals and private sectors.