Understanding Obsessive Compulsive Disorder
To understand substance abuse and OCD, you must first understand OCD as a type of anxiety condition. Obsessive Compulsive Disorder, also known as OCD, is a psychiatric disorder that affects millions of Americans and people around the world. The National Institute on Health defines OCD as “a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.” Those who live with OCD say the illness feels like being imprisoned by one’s own mind. The brain manufactures obsessions and compulsions and the person with the illness feels as if they must carry them out or engage them in some way. Whether someone with OCD has repeated and relentless thoughts about fear of germs, or they compulsively arrange things in their environment, OCD is a complex illness that requires medication, and behavior modification, and abstinence from drugs and alcohol.
Symptoms of OCD
OCD is characterized by symptoms of obsessions, or compulsions, or both. Obsessions are defined as repeated, unwanted thoughts. These may come in the form of urges, mental images, thoughts, or sounds that cause extreme stress and anxiety. Here are some common obsessions associated with OCD:
- An irrational and extreme fear of germs
- Fear that food is contaminated, bad, rotten, or spoiled
- Constant thoughts about rearranging objects to make things “perfect”
- Extreme need for neatness and over-organization
- Panicked thoughts about death
- Crippling fear about unforeseen events like car crashes
Compulsions are defined as repeated and recurring behaviors, which take place as the result of obsessive thoughts. Obsessions are thoughts. Compulsions are actions. Here are some common compulsions associated with OCD:
- Excessive handwashing
- Cleaning and re-cleaning surfaces with bleach
- Constant arranging and rearranging of objects to achieve “perfect” neatness
- Repeatedly checking and re-checking on things, like making sure the iron is off
- Compulsive counting, either aloud or silently
- Obsessive grooming, such as the brushing of hair or teeth
Although we have all been known to check the door more than once to make sure we’ve locked it, or counted the tiles on our bathroom floor; this is nothing compared to the reality of OCD. A person with Obsessive Compulsive Disorder feels as if he or she cannot control his or her thoughts and actions. It is as if they must think a thought again and again just because it comes into their head or they must take an action because their mind told them to – even if that means checking and rechecking the door lock twenty-seven times in a row. When left untreated, OCD can negatively impact all aspects of daily living. Someone with OCD can become debilitated to the point that their illness interferes with work, family relationships, and life at home. Some people with OCD are afraid to leave the house, operate a car, or get a job.
Dual-Diagnosis and Obsessive Compulsive Disorders
Many people who have OCD also have a problem with substance abuse. When this happens, a person is considered to have a dual-diagnosis. This means the person has a mental health diagnosis and a substance abuse problem, also referred to as “co-occurring disorders.” To receive a dual-diagnosis, someone must have both an addiction and one or more psychiatric disorders. This is not an uncommon diagnosis for people with OCD. Here are some interesting statistics you might like to know about OCD and substance abuse:
- Most people are diagnosed with OCD by age 19.
- Continued research suggests genetic factors are behind OCD
- About 20 percent of those with a substance abuse problem also have an anxiety or mood disorder
The Compulsive and Addictive Use of Drugs
It is important to make the distinction that a compulsion is different from an addiction. Although addiction involves the compulsive use of drugs, someone can have a compulsion and not have an addiction. Quite often, people use the words “addiction” and “compulsion” interchangeably, but this is a mistake. Someone with OCD can have a compulsion to wash his or her hands, but not be addicted to hand-washing. In order for an addiction to be present, there has to be a physical and physiological component involving the abuse of mood or mind-altering chemicals. Hand-washing in and of itself does not contain addictive properties. Opiates, on the other hand, are addictive substances with addictive qualities all by themselves. What makes OCD and substance abuse such a complicated situation is that someone with OCD already has difficulties with obsession and compulsion. The abuse of drugs or alcohol is therefore magnified for someone with OCD. He or she has already demonstrated a predisposition to be vulnerable to this particular type of mental cycle. When substances with addictive properties are introduced into a brain already prone to compulsion, the addictive cycle kicks into overdrive.
Treatments and Therapies for Obsessive Compulsive Disorder
Medication + Therapy + Abstinence from Drugs & Alcohol = OCD Treatment OCD is treatable, although there is currently no known cure for Obsessive Compulsive Disorder. OCD is generally treated with a combination of medication and psychotherapy, although there are more extreme treatments available. Most people with OCD greatly benefit from working with a psychiatrist to take medication that readjusts brain chemistry while also working with a psychologist to learn behavior modification. Of course, psychiatry and psychology won’t work properly unless a person with OCD stays away from drugs and alcohol. Serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed medications used to treat OCD. An older class of tricyclic antidepressants called clomipramine has been prescribed for many years and has been recognized for its positive impact on those with OCD. In more recent years, however; doctors have been prescribing newer SSRIS like fluoxetine, fluvoxamine, and sertraline to treat the symptoms of Obsessive Compulsive Disorder. It is important to remember that medication alone is only part of the story when it comes to treating OCD. Although an antidepressant may relieve some of the mental and physical symptoms of OCD, behavior modification is an important aspect of OCD treatment. Therapy is an important part of the healing process and therapy really works. Here are three popular OCD treatment methodologies: Cognitive Behavioral Therapy: This is a type of “talk therapy” that requires the facilitation of a mental health care professional who specializes in CBT. CBT involves learning new skills that retrain the brain to think in different, less obsessive and compulsive thought patterns. Electroconvulsive Therapy (ECT): Also known as electroshock therapy, ECT if often used to treat OCD and has actually proven to be quite effective for treating the illness. With ECT, a medical professional uses a machine that delivers mild electrical shocks to the brain. This small amount of electricity triggers a seizure that activates changes to the levels of certain chemicals. Psycho Surgery: It may seem strange, but there are actually four different types of therapeutic surgeries performed on the brain to correct OCD for people who do not respond to medication, behavioral modification, or ECT. Research indicates that most people with OCD respond positively to ongoing, specialized treatment when keeping the formula for OCD treatment in mind: Medication + Therapy + Abstinence from Drugs & Alcohol = OCD Treatment For those who have a substance abuse problem and OCD, get help. Drugs and alcohol have been proven to exacerbate the symptoms of OCD. If you have OCD, but you also have an addiction to drugs or alcohol, you need to arrest the cycle of addiction before you can find relief for your Obsessive Compulsive Disorder. Depending on what types of drugs you have been taking, or how much alcohol you have been drinking, you may need to go to a detox program followed by inpatient treatment.
Jennifer’s Story of OCD and Addiction
To put things into perspective, Jennifer M. from Aberdeen, Idaho has bravely agreed to share her story about OCD and substance abuse. Jennifer is what is known as a “poly-substance abuser.” Some people latch on to a certain type of drug and just become addicted to that particular drug. Heroin addicts abuse heroin just like alcoholics abuse alcohol. A poly-substance abuser is someone who is addicted to drugs but doesn’t place any emphasis on what those drugs might be. He or she will develop an addiction to meth, heroin, cocaine, prescription medications, or use a combination of drugs. Jennifer struggled with OCD and addiction for years. Here is her story: Hi, my name is Jennifer and I am recovering from OCD and drug addiction. I have three years and two months clean. I gotta tell ya, it hasn’t been an easy road. In fact, it’s just been downright difficult. But, I will say this – it has definitely been worth it! I was diagnosed with Obsessive Compulsive Disorder when I was 19. It started showing up when I was much younger, but when I joined the military, the disorder basically just exploded in my life. I was desperately afraid of the germs that surely accompanied one hundred women living together in tight quarters. We never got a real, hot, ten-minute shower in boot camp. We had to hurry up and get in and out. I would freak out that I wasn’t clean and the drill sergeants would yell at me. I got sent home from boot camp with a general discharge for medical reasons.Not only was I afraid of germs, I had panicked thoughts about any and everything. Plus, I had my strange rituals. I would have to lock and unlock the door four times to make sure it was really locked. Things like that. I guess you could say I am like textbook OCD – the kind of character you see in the movies. I really relate to Jack Nicholson in the movie “As Good as it Gets.” I knew I had OCD because I had been diagnosed in the military, but I didn’t do anything about it. I went home and started drinking and using drugs. I enrolled in a community college and lived at home. I partied a lot because I had finally found something that would ease the crippling anxiety I always felt because of my OCD.Drinking numbed me to the obsessive thoughts about dying in a plane crash….. thoughts that were unrelenting, even though I never flew anywhere on an airplane! Popping pills solved my eating problem. I would be afraid to eat anything because I was convinced my food was contaminated. I was so sick from all the pills I was taking, I never even thought about food. Meth zoned me out so I could find relief from my obsessions.When I was 25-years-old, my family did an intervention on me. I was a shell of a person, weighing in at like a hundred pounds. I was malnourished. I was hooked on meth and mollys and anything else I could get my hands on. I needed help.I went into a detox program and then inpatient treatment. The treatment center I went to specialized in treating people with a dual-diagnosis. I had a dual diagnosis because I was addicted and I had OCD. I started taking medication prescribed by my psychiatrist and I got sober. Now, my OCD is way under control. Although I still struggle some days with doing random things like having to turn the lights on and off ten times, for the most part, my life is manageable.I would tell anyone who has OCD and is struggling with addiction to get help right away. I never thought my life would be as okay is it is today. For so many years…. all I wanted was to just be okay! I wanted freedom from my obsessive thinking and my compulsive behavior. Now, I feel like I have achieved that in so many ways. One of the most important things I learned to do was to find fun things to do sober. For that, I am grateful. Do you have a problem with drugs or alcohol? Learn the telltale signs of addiction. Can you relate to Jennifer’s story? What is your experience with OCD and substance abuse?