Addiction and Obsessive-Compulsive Disorder (OCD) are two mental health conditions that can very much affect a person’s life, often leading to feelings of confusion, shame, and frustration.

Both involve an overwhelming sense of needing to repeat certain actions or thoughts, but the reasons for these behaviours and the impact they have on the individual can differ.

But is there a connection between addiction and OCD? And if there is, how are they related, exactly? In this article, we’ll explore the link between addiction and OCD, whether these conditions can overlap, how one might influence the other, and how they can be managed.

Although they may seem like separate conditions, there are similarities in how they manifest, and understanding these connections is essential for finding the right treatment and support.

What Is Addiction?

Addiction, at its very core, is a progressive, chronic and relapsing disorder characterised by compulsive alcohol and/or drug-seeking behaviour and the inability to stop using substances despite negative consequences.

It’s often associated with substances like alcohol, drugs, or nicotine, but behavioural addictions also exist in the same capacity. So, this condition can also take the form of behaviours, such as gambling, gaming, or even shopping.

There are several stages of addiction, starting with experimentation and occasional use, but over time, the brain becomes increasingly dependent on the substance or behaviour to feel “normal.”

This dependency can affect the brain’s reward system, making it more difficult, if not impossible, to function as the person would have previously without the addictive substance or behaviour.

What Is Obsessive Compulsive Disorder?

Obsessive-compulsive disorder (OCD) is a mental health condition where a person experiences persistent, unwanted thoughts (obsessions) and feels like they have no choice but to perform certain rituals or behaviours (compulsions) in an attempt to ease the anxiety caused by those thoughts.

For example, someone with OCD might feel the need to wash their hands repeatedly, check if the door is locked multiple times, or arrange objects in a very specific way. The compulsive actions are often performed to relieve the anxiety caused by the obsessions, but these actions are typically excessive or irrational.

OCD can be incredibly time-consuming, and the thoughts and actions can interfere with daily life, relationships, and work. The key difference between OCD and normal behaviours is the level of distress and disruption these thoughts and actions cause in the person’s life.

Common Types of OCD

There are different themes and patterns of OCD that an individual can struggle with. However, these are not distinct subtypes of this condition. They represent the different ways OCD can show up in someone’s life.

Some of the most common include:

Contamination OCD

  • Obsessions: Fear of dirt, germs, illness, or something being “contaminated.”
  • Compulsions: Repeated hand-washing, cleaning, avoiding certain places or things, or using sanitising products excessively.

Checking OCD

  • Obsessions: Worrying that you’ve left something dangerous or unsafe (e.g., an appliance on, a door unlocked, or leaving the house in an unsafe condition).
  • Compulsions: Constantly checking things over and over, like switching off the stove, checking locks, taking pictures of sockets before you leave the house or rereading texts to ensure there’s no mistake.

Symmetry and Ordering OCD

  • Obsessions: The need for things to be in a particular order, symmetry, or perfection.
  • Compulsions: Arranging things until they feel right or performing tasks in a specific order to relieve anxiety.

Hoarding OCD

  • Obsessions: A deep fear of throwing things away or an overwhelming attachment to possessions.
  • Compulsions: Humanising objects and collecting and keeping items (even ones that seem useless) due to fear of needing them in the future or fear of regret if they’re discarded.

Intrusive Thoughts OCD (Pure O)

  • Obsessions: Unwanted, disturbing, or irrational thoughts that can be violent or sexual, causing significant distress.
  • Compulsions: Mental rituals to neutralise or “counteract” the thoughts (e.g., repeating certain words in the mind or seeking reassurance). Sometimes, people may perform physical rituals, too, but (typically speaking) the compulsions are mental rather than outwardly visible.

Fear of Harm OCD

  • Obsessions: Fear of harming others or themselves, even though they have no intention or desire to do so.
  • Compulsions: Avoidance of situations where harm could occur or reassurance-seeking from others to make sure nothing terrible happened.

How Are Addiction and OCD Similar?

After reading the above, addiction and OCD may seem completely different. However, they share a number of similarities, especially in how they manifest in the brain and affect the individual’s behaviour.

Compulsive Behaviours

Both addiction and OCD involve compulsive behaviours that a person feels driven to repeat.

For someone with addiction, these behaviours might include using substances or engaging in certain activities. For someone with OCD, the compulsions might be related to cleaning, checking, or organising.

However, in both cases, the individual feels a strong urge to perform the behaviour, often to relieve anxiety or discomfort.

Loss of Control

A common trait in both addiction and OCD is a sense of losing control over the behaviour.

People also often try to stop using a substance or engaging in a particular activity but struggle to do so, even when they know it’s harmful. Those with OCD may also feel this sense of being powerless to stop performing compulsive behaviours, even though they realise these actions are excessive or irrational.

Relief from Anxiety

Both addiction and OCD are often linked to attempts to reduce anxiety or emotional distress.

With active addiction, people may turn to substances or behaviours to numb emotional pain or escape from stress. In OCD, compulsions are performed in an attempt to ease the anxiety caused by intrusive thoughts or obsessions.

Although the relief is always temporary, it reinforces the cycle, making it difficult to stop.

Brain Chemistry

Both addiction and OCD have been linked to imbalances in brain chemistry. Especially in the areas of the brain that deal with reward, motivation, and anxiety.

Those in active addiction experience their brain’s reward system hijacked by the substance or behaviour, making it more difficult to stop. In OCD, there is an overactive connection between specific brain circuits, leading to obsessions and compulsions.

Can Addiction and OCD Overlap?

Yes, they can. If this is the case, a dual diagnosis would be required.

Although addiction and OCD are separate conditions, there are instances where they can overlap, leading to a complex situation for individuals who struggle with both. In fact, it’s not uncommon for someone with OCD to develop an addiction or vice versa.

Recent research shows there is a link between obsessive-compulsive disorder (OCD) and addiction, but it’s still a very complicated link to fully understand.

A big study in Sweden looked at over 6 million people and found that those with OCD were nearly four times more likely to struggle with substance misuse, like alcohol, drugs, or tobacco. This might be partly because some of the same genes could be involved in both OCD and addiction.

In another study of over 38,000 veterans with OCD, nearly 37% also had problems with substance use. The most common substances they used were tobacco (26.5%), alcohol (17.1%), and cannabis (5.5%).

There’s also evidence to suggest a higher chance of developing behavioural addictions as well. In fact, 70% of people with OCD reported having symptoms of behavioural addiction, compared to 58% of people without OCD. The problem was particularly significant when it came to internet addiction in this particular study, with nearly 30% of people with OCD affected, compared to just 3% of those without.

As we’ve touched on earlier in this article, both OCD and addiction involve problems with the brain’s reward system. This means that people with OCD may be more likely to act on their urges, which can lead to addictive behaviour. In fact, people with both OCD and addiction tend to be more impulsive, meaning they struggle more than others to control their actions.

How Are Addiction and OCD Treated?

The treatment for addiction and OCD varies, but both conditions can benefit from a combination of therapy, medication, and support.

However, when addiction and OCD are present together, treatment becomes more complex and may need to be tailored to address both issues simultaneously. This is something called a dual diagnosis treatment programme.

Dual diagnosis treatment is when two conditions have been identified, and a programme is created to treat both at the same time. These types of programmes are often personalised to the needs of the person, so specific treatment routes will vary. However, some core approaches include:

  • Cognitive-behavioural therapy: One of the most effective treatments for both addiction and OCD is cognitive behavioural therapy. It focuses on identifying and changing negative thought patterns and behaviours.
  • Exposure therapy: A specific form of CBT called exposure therapy is often used to treat OCD. It involves exposing the person to situations that trigger their obsessions and then preventing them from engaging in compulsive behaviour to reduce anxiety around those triggers.
  • Medication: For addiction, there are medications that can help reduce cravings and withdrawal symptoms whilst in early treatment. For OCD, SSRIs (a type of antidepressant) are often prescribed to help regulate serotonin levels in the brain.
  • Support Groups: Support groups can also be a valuable resource for individuals struggling with both addiction and OCD.

Addiction and OCD: The Key Takeaways

Understanding the link between addiction and OCD can be important. Especially for those who struggle with these conditions, as it can help guide treatment and recovery efforts.

If you or someone you know is living with both active addiction and OCD, it’s important to seek professional support. With the right treatment and therapy, it is possible to manage both conditions and life that is enjoyable once again.

If you are experiencing addiction or OCD, don’t hesitate to reach out for help. Call us on 01253 847 553 today.

John Gillen - Director at Ocean Recovery

John Gillen - Author - Last updated: November 28, 2024

John is one UK’s leading professionals in the addiction recovery industry. Pioneering new treatment techniques such as NAD+ and ongoing research into new therapy techniques such as systematic laser therapy, John is committed to providing the very best treatment for people throughout the UK and Europe. During his extremely busy schedule, John likes to regularly update our blog section with the latest news and trends in the industry to keep visitors to our site as well informed as possible on everything related to addiction treatment.