Treating OCD During Addiction Treatment

For an individual with obsessive compulsive disorder (OCD), daily routines can become difficult. For someone suffering from a substance use disorder, it can be even more cumbersome. Treating OCD and the dual diagnosis is discussed here.

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What is OCD?

Obsessive compulsive disorder is often comorbid with substance abuse issues. When the two issues require treatment at the same time, special caution may be needed. Keep reading to learn more about treating OCD and addiction at the same time.

Obsessive compulsive disorder, commonly abbreviated as OCD, is a personality disorder that is characterized by several different signs. The most common signs of OCD are unreasonable thoughts and fears that are obsessive, leading to compulsive behaviors. The disorder often centers around the fear of germs or arrangement.1  

How Is OCD Diagnosed?

There are several different ways that OCD is diagnosed. These steps are outlined below.2

  • Psychological Evaluation: Psychological evaluation of an individual who may have OCD is done through discussing thoughts, feelings, and behaviors.
  • Diagnostic Criteria: Medical professionals will compare the psychological evaluation and physical symptoms of OCD to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
  • Physical Evaluation: A physical evaluation may be performed to rule out any other possible issues an individual may be suffering from. 

Triggers of OCD

There are several different possible triggers for obsessive compulsive disorder. Some of them are listed below:

  • Family History: Obsessive compulsive disorder is often genetic in nature, and individuals with family members suffering from OCD may develop it as well.
  • Stressful Life Events: Traumatic or stressful events can cause OCD symptoms to appear or worsen.
  • Other Mental Health Disorders: Other mental health disorders may cause OCD to appear in individuals at risk for the disorder, as well.

Signs and Symptoms of OCD

In individuals suffering from OCD, some may see more obsessions than they do compulsions. The two are categorized individually and differ from one another. 


Obsession symptoms tend to be themed in nature. They are overwhelming thoughts that are focused on a central theme. Many people who suffer from OCD have fears or obsessions with the following:3

  • Fear of dirt, germs, or contamination of any kind
  • Doubt related to any uncertainty
  • Obsessions with order and arrangement
  • Thoughts about losing control and harming others or themselves
  • Unwanted thoughts of any kind that are invasive

In most cases, an obsession that causes psychological stress or trauma leads individuals to seek the use of substances to escape the symptom. This is how the substance abuse problem normally begins. 


As with obsessions, compulsions typically have themes. The themes of compulsions tend to be related to the obsessions that an individual may be suffering from. If obsessions are described as thoughts, then compulsions can be described as actions.3

  • Washing surfaces or hands incessantly
  • Checking for specific orders
  • Counting
  • Strict adherence to a routine
  • Asking for or demanding reassurance

Eventually, the relation between an unwanted obsession and the use of a substance to escape it can lead to compulsion. The compulsion may not have been substance use, to begin with, but they need to stop the obsession can turn it into one. 

Do I Have Generalized Anxiety Disorder or OCD?

Generalized anxiety disorder, often abbreviated as GAD, differs from OCD. GAD is more common than OCD is, affecting up to one in six adults. Generally, GAD is a constant uneasiness or apprehension related to something specific.4

This factor makes it similar to the obsession portion of OCD, but it lacks the compulsions. Individuals who suffer from GAD do not feel compelled to take any actions based on the worrying thoughts that they’re having. 

Treating a Dual Diagnosis of OCD and Addiction

Treating OCD

Individuals who suffer from OCD may also be diagnosed with an addiction disorder, meaning that they are being dual diagnosed, or diagnosed with two separate issues. When treating a dual diagnosis of OCD and addiction, the addiction must be managed while the compulsions are being treated at the same time. This issue can make treatment difficult, as some patients with OCD have extreme difficulty controlling their actions associated with obsessions.

How Are OCD and Addiction Connected?

Of adults that suffer from OCD, at least one in four also fit the criteria for a substance abuse disorder diagnosis. Many report that the need for substance use came following the obsessions in their lives. OCD symptoms led them to seek a way of stopping the obsessions that they were facing. 

Is OCD Social Isolation a Factor in Addiction?

Social isolation is often a common side effect of OCD. Many individuals who suffer from the disorder end up homebound due to the fears that they may be facing. Isolation often leads to depression, which can increase the risk of seeking substance use, and addiction as a result. 

Treatment for OCD

There are several treatments available for OCD. Four of the most common treatments available are listed below in detail. 


There are numerous medications available for those suffering from OCD. The most common are selective serotonin reuptake inhibitors (SSRIs), anxiolytics, and antidepressants. The medication that is prescribed depends on the symptoms the individual is suffering from. 


Psychotherapy is often referred to as talk therapy. It consists of using psychological methods to help improve happiness, overcome challenges, and change behaviors. Psychotherapy is often required for those suffering from OCD. 

Self-Help Strategies

Self-help strategies are tools taught to those suffering from OCD. They are a form of behavioral therapy meant to be employed when an individual realizes they are being triggered or becoming symptomatic. 

Brain Mapping

Brain mapping is a medical way of determining what parts of the brain OCD stem from. It can help in altering the brain composition of individuals who have OCD, rerouting certain responses, and lessening the symptoms being experienced by the individual.

True OCD is a fairly rare personality disorder when compared to its most similar disorder, GAD. Often, individuals who suffer from OCD have issues with substance abuse as well. The two are related and tend to be dually diagnosed. Treating both is possible, but it requires commitment and professional guidance. 


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