Recognizing OCD and Addiction and What To Expect From Treatment

What Is OCD?

Obsessive-compulsive disorder (OCD) is a chronic mental health disorder characterized by two core components: obsessions, or intrusive, unwanted thoughts, images, or urges, and compulsions, or repetitive behaviors or mental acts performed to reduce the distress caused by those obsessions.[1] 

OCD is not a personality trait, a preference for orderliness, or an endearing quirk. It’s a real, often painful disorder that can consume hours of every day, drains energy, and shapes life in ways that other people don’t always see.

Obsessions are generally experienced as intrusive — they enter the mind without being wanted, and the person experiencing them recognizes that they are irrational or excessive but cannot stop them. Common examples include fears of contamination, fear of hurting others, doubts about safety, intrusive sexual or religious thoughts, and a need for symmetry or exactness. 

Compulsions are the behaviors that develop from the obsessions, such as hand washing, checking, counting, mental rituals, and ordering. These are all repetitive actions taken to neutralize the obsession or “prevent” some feared outcome. While they do provide initial relief from the anxiety caused by the obsession, that relief is only temporary, which is part of what makes the cycle so consuming.

According to the National Institute of Mental Health, approximately 2 to 3 percent of adults in the U.S. suffer from OCD in their lives.[2] It is highly treatable, but many people do not get diagnosed for years because they feel ashamed of their symptoms or do not recognize their own patterns as OCD.

What Are the 4 Types of OCD?

Although OCD can look different from person to person, therapists frequently categorize its symptoms into four general types:

• Contamination OCD — Fears of germs, dirt, illnesses, combined with extreme measures taken to protect oneself against contamination, such as excessive handwashing, cleaning, and avoidance of perceived contaminated objects or situations
• Checking OCD — Constant doubts and repeated checking behavior related to safety, harm, or making mistakes, such as constantly checking locks on doors, turning off appliances, and repeatedly checking work assignments before submitting them.
• Symmetry and Ordering OCD — Needing to arrange objects or perform tasks according to precise rules, resulting in severe discomfort if those rules are violated.
• Intrusive Thoughts OCD — Experiencing recurring, disturbing images or thoughts related to sex, violence, religion, or other taboo topics, often accompanied by intense mental compulsions, avoidance, or reassurance-seeking

Many people exhibit symptoms from multiple categories. While all forms respond similarly to evidence-based treatments, some specific therapeutic methods may differ depending on the type of symptoms being treated.

What Causes OCD?

There is no single cause for OCD, though researchers believe that there are several variables that contribute to its development. The most common are listed below:

• Genetics — OCD appears to run in families. Twin studies suggest that genetic factors may contribute to the development of the disorder.[3]
• Brain chemistry and structure— Research has identified differences in brain circuits involved in behavior, emotional regulation, and response control in people with OCD. Studies also suggest serotonin signaling may play a role, though the exact causes of OCD are not fully understood.[4]
• Trauma and Stress — Severe trauma or long-term stress can contribute to developing or worsening OCD symptoms in susceptible people.[5]
• Streptococcal infections (in some pediatric cases) — A small percentage of children diagnosed with OCD have developed the condition after contracting a strep infection that caused an autoimmune reaction.[6]
• Other risk factors  — Including certain temperamental traits and a family history of related anxiety disorders.[7]

OCD is a legitimate medical condition resulting from chemical composition and biological processes in the brain. It does not reflect poor judgment or lack of responsibility.

OCD Symptoms

OCD symptoms vary widely, but typically include:

• Obsessive thoughts: Persistent and involuntary intrusive thoughts, images, or urges that cause significant distress.
• Compulsive behaviors: Repetitive actions or mental acts intended to counteract the distress associated with the obsessive thoughts. Examples include excessive hand washing, compulsive checking, counting behaviors, mental rituals, and compulsively organizing items.
• Avoidance: Avoiding places, activities, or objects that trigger obsessive thoughts.
• Reassurance-seeking: Common among people struggling with OCD. This can include frequently asking family members, friends, or coworkers to verify or reassure them regarding concerns that cause emotional discomfort, or repeatedly searching for answers online to alleviate anxiety.
• Time consumption: OCD compulsions can often take up more than an hour or more each day, often interfering with daily activities.
• Significant distress or impairment: OCD symptoms result in a meaningful degree of distress and functional impairment, including problems with employment, interpersonal relationships, sleep disturbances, and overall quality of life.

If you find yourself caught in one of these patterns, it would be beneficial to get a professional assessment.

 

 

OCD and Addiction

Studies indicate that there is a high rate of co-occurrence between OCD and substance use disorders. 

Approximately 25% of people diagnosed with OCD will develop a substance use disorder.[8] There are several reasons why these two conditions tend to occur together. One is self-medication — alcohol and benzodiazepines may temporarily reduce feelings of anxiety related to obsessive thinking and intrusive thoughts. Another reason is the neurobiological basis for both disorders. Both OCD and substance use disorder affect areas of the brain responsible for habits, reward, and cycles of compulsion that contribute to both conditions.

This connects to another common question: when it comes to compulsive behavior and addiction, are they the same? Both involve repetitive behaviors that the person feels they have to perform, and both the compulsions and the substances produce temporary relief from anxiety. 

The difference is that OCD compulsions are typically performed to alleviate or neutralize a specific obsession or prevent a feared outcome, while addictive behaviors are driven by reward, craving, and dependence. Many patients have both, and the patterns reinforce each other. Treating only one rarely produces lasting recovery.

When to Get Help With OCD

You should seek professional help if you or someone you know is experiencing any of the following:

• Unwanted intrusive thoughts, images, or urges that cause significant levels of distress
• Performing repetitive behaviors or mental tasks that require extensive amounts of time and energy
• Avoiding certain situations because of the fear of triggering obsessive thoughts
• Using substances as a means of reducing obsessive symptoms
• Symptoms are interfering with your job, personal relationships, and daily routines
• Feelings of shame, social withdrawal, and hopelessness due to the patterns

Fortunately, OCD is highly responsive to treatment, and early intervention nearly always leads to improved results.