According to the National Survey on Drug Abuse and Health, 9.2 million adults in the United States struggled with substance use disorder and another mental illness (such as an anxiety or mood disorder) in 2018. These statistics show that substance use disorder and other forms of mental illness tend to coincide; however, it isn’t clear which comes first.

One mental illness in specific is endured by many individuals with substance use disorder: obsessive-compulsive disorder (OCD). According to the Anxiety and Depression Association of America (ADAA), OCD affects 2.2 million US adults. And an estimated 30% of these individuals have had substance use disorder at some point in their lives—nearly double the rate of the general population. This begs the question, how are the two connected? And how can one properly recover from both disorders?

liquor bottles on shelves

What Is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder, otherwise known as OCD, is a form of an anxiety disorder that causes people to have uncontrollable reoccurring thoughts (obsessions) and behaviors (compulsions) that they feel the need to repeat.

There are four different types of OCD that each includes different forms of obsessions and compulsions that patients may suffer from:

  • Contamination and Washing: Worries about germs, feelings of disgust, compulsive washing and cleaning of the body or items. People suffering from this form of OCD will go to great lengths to avoid areas, items, or even people that they fear may be contaminated. When they can’t avoid these people or situations, they resort to compulsively washing themselves and their personal items.
  • Symmetry, Counting, and Arranging: Worries about making sure everything is in an even number, making sure that everything is perfectly arranged and symmetrical. Patients with this form of OCD may have specific “rituals” that they take part in such as mental counting and arranging, as well as counting and tapping behaviors. They may also suffer from “magical thinking,” for example, if their desk at work isn’t perfectly aligned they may believe that something bad may happen as a result.
  • Doubt and Harm: Worries about accidental harm followed by repeatedly checking for safety. For example, someone suffering from this form of OCD may repeatedly check the stove to make sure it was turned off in fear that something will happen to them or their loved ones. They always suffer from excessive feelings of doubt, dread, or uncertainty and a heightened feeling of responsibility.
  • Intrusive Thoughts: People with intrusive thoughts typically suffer from uncontrollable, scary thoughts such as thinking about behaving violently or doing something that goes against their own morals. When people with intrusive thought OCD have these thoughts, they do not want them to become reality. They obsess over getting rid of the thought and compulsively avoid whatever triggered the thought. Some may even compulsively visit a priest for confessions or compulsively seek reassurance of some form.

Common Symptoms of Substance Use Disorder

When someone is addicted to any substance, they typically will display an array of symptoms. Each substance entails different physical and mental symptoms. Common symptoms include:

  • Not being able to control the intake of a substance
  • Developing a tolerance to the substance and having to repeatedly take more of the drug or alcohol to achieve the desired effect
  • Spending a lot of time obtaining or searching for the substance
  • Feeling an intense need to use the substance
  • Not being able to function without the substance

How Does OCD Affect People with Substance Use Disorder?

People suffering from substance use disorder and another mental illness are typically attempting to self-medicate the symptoms of their secondary mental illness. People with OCD, specifically the intrusive thoughts type, often attempt to numb their thoughts and feelings by using an illicit substance. In the early stages of their substance use, their symptoms of OCD may appear to subside. Nonetheless, once their substance use progresses, the intrusive thoughts will begin to come back—most likely all at once. This causes their OCD to worsen and reappear seemingly out of nowhere.

In addition, both disorders cause people to isolate themselves from their friends and loved ones. This occurs because of the anxiety associated with OCD and the desire to hide their addiction from the people closest to them. When people suffering from OCD and addiction isolate themselves, their conditions tend to worsen due to the loneliness, guilt, shame, and desperation for a solution that they begin to feel. If left untreated, both conditions can lead to severe mental distress and even hospitalization.

How to Get Help for OCD and Substance Use Disorder

When you are suffering from both substance use disorder and obsessive-compulsive disorder, treatment can become increasingly difficult unless both conditions are treated simultaneously. Thankfully, with the influx of information on dual-diagnosis patients, addiction treatment centers have begun implementing co-occurring and dual-diagnosis treatment plans. Both OCD and substance use disorder can require extensive medical treatment and specialized therapy. When you enter a treatment center that utilizes dual-diagnosis treatment plans, they will customize your treatment plan to specifically cater to your needs.

Treatment plans and the length of time a person will be in treatment can vary. Some patients may require a 30-day treatment plan, while others may need up to 6 months of treatment. Completing treatment to its full extent is vital in order to effectively manage the symptoms of OCD and to achieve long-term sobriety. While treatment may seem like a daunting task, recovery is possible and attainable. You can build a happy and fulfilling life if you are open, honest, and willing to do what it takes in order to recover.

*Kailey Fitzgerald is a young writer in the recovery community. She has learned how to manage her own co-occurring disorders and has found passion in helping others to do the same.