What is OCD?
What Causes OCD?
Doctors don’t know exactly what causes OCD. A theory is the disorder is the result of abnormal brain functioning that impacts the brain’s circuits. According to BeyondOCD, an OCD advocacy organization, a study of the brains of people with OCD found that those with OCD have 32 percent more inflammation in brain tissue than those who don’t. However, they have identified a few risk factors that make a person more likely to experience OCD. These include:
• Family History of OCD
• History of Physical or Sexual Trauma
• Being an Adolescent or Young Adult
Doctors have also identified a greater number of young people experience OCD symptoms after experiencing a streptococcal infection. They call this condition Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections, or PANDAS for short.
In addition to OCD in the young population, doctors have identified another OCD syndrome known as postpartum OCD. An estimated two to three percent of new mothers experience this condition. Some of the symptoms doctors associate with postpartum OCD include:
• Excessively or frequently washing a baby’s clothing, bottles, or other items
• Isolating the baby and keeping family members away for fear they will harm or contaminate the baby
• Experiencing frequent thoughts or fears of harming the baby
Both postpartum OCD and postpartum depression can occur in a woman. These require treatments to help a person free themselves from obsessive thoughts and compulsive behaviors.
Signs of OCD
True to its name, doctors divide OCD and its symptoms into two separate categories: obsession and compulsion. Obsessions are usually thoughts or fears that a person cannot escape, even when they know they may be irrational. The symptoms are usually distressing to the person and can impair their abilities to function at work and school.
• Fear of germs or that their food, water, or medication is poisonous
• Fear of losing an item or putting it in the wrong place
• Need to have objects in a symmetrical or particular order
• Having unwanted and repetitive thoughts of unpleasant things, such as death, violence, or sex
Compulsions are behaviors a person routinely engages in, even when they know the behaviors are harmful to them.
• Cleaning one’s hands or other body parts over and over
• Hoarding behaviors, where a person refuses to throw away any belongings
• Frequently arranging and re-arranging particular items and becoming upset should those items get out of order
• Counting items over and over
Checking items repeatedly, such as constantly checking to ensure a door is locked
• Constantly requiring reassurance regarding behaviors or choices
OCD and Addiction: A Dual Diagnosis
Rates of OCD and SUDs
A study of 323 participants published in the Journal of Anxiety Disorders found that 27 percent of patients with OCD also struggled with a substance use disorder (SUD). Of those who struggled with a substance abuse disorder and addiction, an estimated 70 percent reported they struggled with OCD for at least one year before struggling with addiction. The younger a person is diagnosed with OCD, the more likely they are to develop an alcohol use disorder.
The journal article also found 25 percent of those who seek medical treatment for OCD suffer from a substance abuse disorder. The most commonly abused substances among those with OCD were alcohol, cannabis, and cocaine.
Researchers also found that having OCD significantly impaired the abilities of a person to function in daily life. For example, those with OCD and a substance abuse disorder were more likely to receive disability benefits compared to those who did not have both disorders. Also, those who had both conditions were more likely to be house-bound, experience psychiatric hospitalizations, and report suicide attempts than a person who had one condition or the other.
Connection between OCD and SUDs
Doctors don’t know exactly why OCD and substance abuse disorders commonly occur together, but there are a few theories. The first is that a person with OCD may turn to substance abuse as a means to escape from their everyday struggles with OCD. For example, a person may drink alcohol in excess to escape their thoughts or to help them sleep so they can avoid the urge to engage in repetitive behaviors. Doctors may call these theories as self-medication or tension-reduction models. Doctors also know that people with OCD and substance abuse often have many emotions in common. These include fear, isolation, and shame.
A study published in the Journal of Anxiety Disorders also found that most people with OCD experienced their OCD symptoms before their substance abuse disorder. However, it is possible that a person with SUD may start to develop OCD following the development of their substance abuse problem.
Misconceptions About OCD
Study Results on OCD and Addiction
Dual-Diagnosis Treatment Approaches
Unfortunately, medication treatments alone aren’t usually enough to help a person treat their OCD. According to Beyond OCD, an estimated one in three people with OCD won’t respond to medication treatments alone.
The FDA has also approved some medications as deterrents to return to substance abuse. For example, a person can take medications if they struggle with alcohol that will make them feel very ill if they drink again.
Doctors may also prescribe supportive medications to treat withdrawal symptoms. Examples can include medications to control nausea or to reduce the risks that a person would experience seizures.
Doctors may use a specific CBT type called exposure and response prevention (EX/RP). This therapy involves exposing a person to their anxiety or fear in small doses and teaching a person how to better deal with the emotions they feel. This approach should only be employed by a medical professional.
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