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OCD and alcohol
January 27, 2022

OCD and Alcohol Addiction

Over 17 million Americans with diagnosable mental illnesses also have substance use disorders. This article looks at one such “dual diagnosis” combination: obsessive-compulsive disorder (OCD) and alcohol addiction.

What Is OCD?

The primary symptom of OCD is struggling with at least one worry (obsession) or impulse (compulsion) that keeps recurring with painful intensity, despite every effort to ignore, suppress, or appease it. Most OCD-related thoughts are exaggerated or absurd: some common manifestations include:

  • Fear of illness, often combined with excessive hand-washing and/or sanitizing in attempts to remove every possible germ from the environment
  • Habitually going back, often multiple times, to make sure the door is locked or the stove turned off
  • Uncontrollable fantasies about committing acts of violence
  • Adopting extremely precise “coping rituals” and fearing that some terrible consequence will follow if a mistake is made

Though OCD sufferers may be intellectually conscious of behaving irrationally, they are unable to shake the anxiety that haunts them, and are often terrified of completely losing control if they do anything “wrong.”

OCD and Alcohol Use

It goes without saying that OCD is a miserable condition to live with. And since alcohol suppresses emotions and numbs pain, a few drinks can seem like an easy solution. The assault of obsessive-compulsive thoughts loses its intensity. The frustration with others’ failure to understand and empathize—the discomfort with being considered “weird”—is forgotten. Everything feels better—until the alcohol wears off and the harsh reality comes back, often combined with a hangover or other new problems.

Yet even if the alcohol use brought negative consequences, it did temporarily banish OCD-related worries—and it now has established a foothold as the simplest and easiest means of relief. For many people, the next step is to use it again until drinking becomes a regular habit—and, all too often, an addiction.  

Double Danger: OCD and Alcohol Addiction

It should be noted that the issue of co-occurring mental illness/substance addiction is often a chicken-or-egg question: Did the mental illness make the person vulnerable to temptation? Did the drug use cause brain injury that triggered the mental illness? Was there another underlying factor responsible for both conditions? That said, when it comes specifically to co-occurring OCD and alcohol addiction, the majority of sufferers experience symptoms of the mental illness long before they begin drinking.

Regardless of what causes what, around 30 percent of people with obsessive-compulsive disorder develop addiction to alcohol or another drug—nearly twice as often as people with no mental illness. And besides the health issues associated with alcohol addiction and the painful struggles of OCD, people with both conditions are at high risk of suicide.

Recovering from OCD and Alcohol Addiction

Unfortunately, relatively few people who suffer from OCD and alcohol addiction get treatment for both conditions: unless doctors are aware of preexisting obsessive-compulsive symptoms, the drinking problem may receive all the attention while the OCD goes undiagnosed. Treating the alcohol addiction with medical detox is an important first step, but unless the mental illness also receives attention, it’s unlikely the patient will be able to cope with the inevitable relapse temptations that trouble long-term addiction recovery.

Treatment for OCD involves therapy—usually looking realistically at obsessive thoughts and being conditioned to live without compulsive rituals—and sometimes medication. It’s important that the therapist and prescriber be aware of the alcohol problem, as there may be concerns about relapse triggers and/or developing new drug dependencies.

People recovering from OCD/alcoholism—or any form of drug addiction and/or mental illness—also need a support network, healthy physical habits, and purposeful (non-addiction-related) goals to stay strong and resilient. The journey is never easy, especially in the beginning, but with help and determination it is possible to find freedom and live a fulfilling life.

Holistic Treatment for Dual Diagnosis

Because so many people with substance use disorders also have some form of diagnosable mental illness, Beach House offers dual diagnosis programs to address all facets of OCD and alcohol addiction (or any other mental illness/addiction combination) for maximum effectiveness in recovery. Contact us to learn more.

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