Written by:

Danny Smith

Medically Reviewed by:

Dr Sharad Haridas – MRCPsych

Last Updated:

December 2nd, 2024

OCD and Addiction

Over 1 million people in the UK will experience OCD during their lives. Whilst we may use the words ‘obsession’ and ‘compulsion’ lightly, living with OCD is more than just having a particular fixation or dealing with impulsivity – OCD can ‘come to dominate your life.’  It is common for individuals with OCD to experience comorbid conditions like anxiety and depression. What is perhaps less discussed is that people with OCD are also at an increased risk of developing a substance use disorder. As addictions are known to deepen psychological distress, the relationship between OCD and addictions can be particularly problematic. But what are the signs of OCD? And why is it so often entangled with additional diagnoses across the mental health and addiction spectrum?

OCD and addiction

What is OCD?

OCD is an acronym for obsessive-compulsive disorder.

The International OCD Foundation define the condition as:

‘a mental health disorder that affects people of all ages and all walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions.’

OCD, then, is a condition characterised by cyclical cognitive patterns that can fit into categories of obsessions and compulsions.

Obsessions

Obsessions are related to the ways we think and feel. They occur when we have intrusive recurring thoughts, ‘urges, or mental images’. This means that obsessions are thoughts that return to us—and they are often quite upsetting. One of the key elements of obsessive thoughts is that they are often quite uncomfortable.

There are various types of obsessions, such as:

• Contamination,
• Violent,
• Responsibility obsessions
• Perfectionism,
• Sexual,
• Religious or moral
• And identity obsessions

Compulsions

Whilst obsessions are linked to our thoughts, compulsions are more of a behavioural symptom. Compulsions are types of behaviours that are repeatedly engaged in. These behaviours are often completed with a sense of urgency and impulse, and are often linked to an attempt to manage, reduce or resolve the thoughts or images experienced in obsessive thinking. This means that for many people, OCD compulsions ‘or rituals’ may not seem ‘logical.’ Compulsions are very personal and can change over time.

Compulsions can often fit into the following categories:

• Washing or cleaning
• Checking
• Repeating
• Ordering
• Mental compulsions

OCD symptoms

Two of the key elements of OCD are obsessions and compulsions. But how do these experiences manifest as concrete signs of OCD?

• Anxiety
• Panic attacks
• Social withdrawal
• Difficulty visiting new places
• Fear of infection
• Uneasiness with change
• Fear of harming yourself or others
• Repetitive, distressing images
• Hand washing
• Checking behaviours
• Asking for reassurance
• Repeating words or phrases
• Avoidance of potential anxiety triggers
• Thinking, saying or doing things to ‘neutralise’ thoughts
• Self-soothing behaviours

To learn more about living with OCD, you can contact a mental health service or a specialist OCD charity, such as OCD UK.

What is addiction?

An addiction occurs when a dependency on a substance or behavioural stimulus is developed. Addictions can be chemical (this happens when someone becomes addicted to a drug or substance) or behavioural (when an individual becomes reliant on engaging in a certain action). Research highlights that there are biochemical bases for both substance and behavioural addictions. This is because the neurotransmitters in our brains can be affected by specific actions, meaning that even behavioural actions can alter our neurochemistry.

Signs of an addiction

• Increased engagement with addictive stimulus
• Difficulty reducing engagement despite negative consequences
• Deterioration in physical health
• Anxiety
• Depression
• Social isolation
• Reduced performance at work or school
• Tiredness
• Withdrawal symptoms
• Unexplained aches or pains
• Appearing distant
• Being defensive or deceitful

How are OCD and addiction connected?

OCD and addiction both share a common thread – compulsivity. However, this does not mean that addiction and OCD are the same thing. However, some researchers have hypothesised that the link between the two conditions could lie in the neurobiological mechanisms for ‘increased impulsivity, impaired decision-making and reward system dysfunction.’

On an emotional level, addictions can develop as a way of managing difficult thoughts or feelings associated with OCD. This can begin as a type of self-soothing but can quickly tip over into dependency. OCD has been particularly linked with specific behavioural and substance addictions, such as porn, sex, and alcohol addiction. This does not mean that individuals with OCD only deal with these addictions, but that the data indicates that the prevalence of these dependencies is particularly high across the population of people with an OCD diagnosis.

OCD and porn addiction

Some individuals with OCD experience sexual obsessions. This means having cyclical thoughts, urges or images associated with sexual activity. This is often experienced by individuals with OCD who have a history of child sexual abuse. Due to the nature of these thoughts and obsessions, there is a link between OCD and porn addiction, as well as OCD and sex addiction.

OCD and alcohol addiction

According to a 2022 study, ‘Alcohol use occurs among individuals with obsessive-compulsive symptoms at a rate significantly greater than the general population.’ This indicates that comorbid alcohol addiction and OCD can progress to the extent that they ‘may be dependent on the other.’

OCD and addiction treatment

If you are dealing with OCD and addiction, the best mode of action is to access formal support. This can include contacting a charity, a primary health clinician or a specialist rehab service.

OCD Treatment

OCD treatment often blends medications and therapies. The therapies found to be the most effective in the treatment of OCD are:

• Cognitive behavioural therapy
• Exposure and response prevention
• Trauma therapy

Medications prescribed for OCD will vary on the situation but may include:

• SSRIs
• Tricyclic antidepressants
• Sedative medications

Addiction rehab

Addiction rehab focuses on targeting cravings and physical dependency to alleviate short-term discomfort and short-circuit the cycle of addiction. It then tackles deeper psychological difficulties linked to addiction and mental distress.

This works in four key stages:

1. Admission
2. Detox
3. Therapy (psychological and pharmaceutical0
4. Aftercare

Seek support

Here at Banbury Lodge, we can help you to take the steps towards an addiction-free future.  Contact us today for a free, confidential consultation with a member of our team. We are here to lend a listening, non-judgmental ear and guide you through potential options for specialist, holistic addiction and mental health support. We are available to talk you through the bespoke rehab packages we offer to help identify the most appropriate treatment for your needs.

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