In our last post, we talked a little bit about Dual Diagnosis, which is what professionals call it when someone has both a substance use disorder and a mental illness. As we discovered in that article, one mental illness that is commonly linked with substance use disorders is Obsessive Compulsive Disorder (OCD). We’ll dive into that today.
You’ve probably heard of OCD before, and chances are you’ve seen it portrayed in movies and television. As Good as it Gets (TriStar Pictures, 1997) Monk (USA Network, 2002-2009), and One Hour Photo (Catch 22 Entertainment, 2002) are some popular examples. Characters with OCD are portrayed as comedic or horrific, their behaviors funny or scary, or both. Here’s the truth:
- OCD is a potentially debilitating mental illness that impacts over 2 million Americans, according to The WexlerMedical Center at Ohio State University,
- OCD seems to have a genetic component and commonly runs in families,
- OCD is characterized by often unreasonable, obsessive fears and a compulsive need to engage in ritualized behavior,
- and people who suffer from OCD engage in compulsive behaviors like hand washing, lock checking, counting, and cleaning (among others), and these behaviors can disrupt daily life.
Feelings of anxiety and internal tension are common for folks with OCD. Substance use can seem like a solution. In a study published in the Journal of Anxiety Disorders in 2009, 27% of study participants who had been diagnosed with OCD had co-occurring addiction issues. Participants reporting childhood onset of OCD were more likely to report substance use issues, so while substance abuse and addiction can cause OCD-like symptoms, OCD seems to precede addiction most of the time.
OCD and Substance abuse is a dangerous mix. First, consider that substance use can increase feelings of anxiety and depression – the feelings that a person with OCD is trying to quell. Also, according to Dualdiagnosis.org, secrecy is a distinguishing trait of OCD, and that can get in the way of finding help. Sufferers learn to keep their rituals a secret, and by the time they reach out, their compulsive habits can be deeply ingrained making them difficult to alter. Compulsive substance use becomes another secret. By the time friends or family members become aware there is a problem, the process of addiction can be quite advanced. Here are some warning signs:
- Losing interest in activities, hobbies or friends;
- Spending more time than usual alone behind locked doors;
- Responding to questions about their behavior in a defensive, hostile manner;
- Behaving in an irritable, agitated way;
- Staying out late at night and sleeping late in the morning;
- Stealing money or prescription medications;
- or Hiding drug paraphernalia in drawers, closets or backpacks (from org)
Getting professional help is critical, and the right kind of help can make all the difference. OCD is a complicated disorder on its own. When substances are added to the mix, things can become more challenging. Once again, as we learned in the last post, looking for treatment centers and professionals that are trained in the treatment of Dual Diagnosis is of the utmost importance. According to the Anxiety and Depression Association of America, the most effective treatment for OCD is Exposure and Response Prevention, a form of Cognitive Behavioral Therapy (CBT). Medication is also often recommended. When looking for a treatment program, be on the lookout for:
- Professionals with experience working specifically with OCD and addiction;
- Programs that utilize CBT;
- A combination of psychiatric and addiction professionals with postgraduate degrees and ongoing training in the treatment of co-occurring disorders (depending on the level of care, these professionals may be on staff or contracted by the facility);
- and collaborative treatment planning and discharge planning that includes referrals to appropriate professionals for ongoing care.
If you or someone you love is struggling with OCD and substance use, please reach out. It can be intimidating to get started, but the help is there if you know where to look. We are here to help, and you can also reach out to the Substance Abuse Mental Health Services Association at 1-800-HELP (4357) or visit https://www.findtreatment.gov/. If you are looking for an individual therapist, consider visiting Psychology Today. You can search by zip code and then look for therapists with specialized experience in OCD and substance use disorders.