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Updated on November 4, 2022

The Link Between Alcoholism & Obsessive Compulsive Disorder

Are Alcoholism and OCD Related?

Obsessive-compulsive disorder (OCD) is a chronic mental health disorder that often occurs alongside an alcohol use disorder (AUD). Having either OCD or AUD increases your likelihood of developing the other.

Some people with OCD may turn to alcohol to tame their symptoms, though they’re more likely to worsen them.

What is OCD?

Around 2.3% of adults in the U.S. will experience OCD at some point in their lifetime.1

OCD causes intrusive, reoccurring thoughts known as obsessions. It also causes the urge to repeat certain behaviors, called compulsions, repeatedly. 

People with OCD struggle to control these obsessions or compulsions, such as washing their hands for fear of germs. In some cases, OCD symptoms can interfere with a person’s daily life or ability to maintain relationships or a job.

Some people with OCD may believe alcohol lessens their obsessions and the desire to perform repetitive behaviors. Research shows that 24% of adults with OCD meet the criteria for an AUD.2

Symptoms of OCD

To be diagnosed with OCD, a person has to meet the following criteria:3

  • The presence of obsessions, which the individual tries to suppress or alleviate
  • The performance of compulsions designed to prevent or reduce some kind of anxiety
  • The obsessions or compulsions are time-consuming (one hour or more a day)
  • Another disorder can’t explain their OCD symptoms

The most common types of obsessions seen with OCD include:

  • Fear of contamination or germs
  • Fear of forgetting things, such as turning off the oven or locking the door
  • Unwanted thoughts about sex, religion, or violence
  • Hostile thoughts to self or others

The most common types of compulsions seen with OCD include:

  • Excessive cleaning, hand washing, or bathing
  • Compulsive counting
  • Checking behaviors, such as unplugging an iron
  • An extreme need for tidiness or order

OCD can manifest very differently depending on the individual. Regardless of how their obsessions and compulsions present, people with OCD are more likely to turn to alcohol or another drug as a coping mechanism.

Does Alcohol Cause Intrusive Thoughts?

Intrusive thoughts, or obsessions, are a primary symptom of OCD. While alcohol doesn’t necessarily cause intrusive thoughts, how it impacts the brain can make people with OCD more likely to experience obsessions.

Does Alcohol Make OCD Symptoms Worse?

Yes, alcohol can make OCD symptoms worse. 

Alcohol temporarily increases the brain’s amount of serotonin, a neurotransmitter that promotes a happy mood and positive feelings.4 

Someone with OCD might feel a temporary reduction in their obsessions and compulsions. Therefore, they’ll associate alcohol with a reduction in symptoms. When the effects of the alcohol wear off, serotonin levels may drop, sometimes below where they were before.

This drop in serotonin can lead to a low mood and increase the obsessions and compulsions associated with OCD. The urge to perform compulsions might feel even more potent after the alcohol’s effects have worn off. 

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Risks of Using Alcohol to Cope with OCD

While alcohol can be a dangerous coping mechanism for anyone, it’s precarious for someone with OCD. The risks of using alcohol to cope with OCD include:

  • Increased intensity or frequency of obsessions and compulsions
  • Lowered ability to cope without alcohol
  • Higher risk of anxiety and depression
  • High blood pressure
  • Liver disease
  • Problems with relationships or work
  • Financial issues
  • Risk of alcohol dependency or overdose

People with OCD are especially vulnerable to substance use disorders because it may become another compulsion for them. Even though it may feel like alcohol consumption eases OCD symptoms, it only opens the door to negative consequences. 

Treating Co-Occurring OCD and Alcoholism

Co-occurring conditions can pose an additional challenge in treating an alcohol use disorder, but recovery is possible. A combination of treatments can address OCD and AUD at the same time.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy (CBT) is the most highly recommended treatment for OCD. It addresses unhealthy thinking and behavior patterns and seeks to replace them with healthier habits.

The specific type of CBT most effective for OCD is exposure and ritual prevention (ERP).5 ERP involves exposing a person to the triggers or stimuli that tend to elicit obsessions or compulsions. The therapist will help the client work through techniques to take control of these situations.

Medication Therapy

Certain medications can be effective treatments for OCD. Medications typically work best when accompanied by another type of therapy, such as CBT.

Research shows selective serotonin reuptake inhibitors (SSRIs) are the best medication for OCD.6 Commonly prescribed SSRIs include clomipramine, fluoxetine, sertraline, citalopram, and more.

Detoxing and Rehab

While detox and rehabilitation programs aren’t aimed at treating OCD, they’re an excellent intervention for AUD or any other kind of substance use disorder. Treating AUD can empower a person with OCD to move on to healthier coping mechanisms and seek further treatment.

There are many types of rehabilitation programs. For example, inpatient programs allow participants to live on-site at a treatment facility while receiving treatment. Outpatient programs allow them to live at home and continue life while receiving treatment at designated times.

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Summary

Obsessive-compulsive disorder is a mental health disorder that co-occurs with alcohol use disorder. People with OCD often believe that consuming alcohol will ease their symptoms. However, it actually worsens them. 

Treatment options for OCD and alcoholism include cognitive-behavioral therapy, medication, and rehabilitation programs.

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Resources

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  1. Obsessive-Compulsive Disorder (OCD).” National Institute of Mental Health, U.S. Department of Health and Human Services, 2022 
  2. Mancebo, M. et al. “Substance Use Disorders in an Obsessive Compulsive Disorder Clinical Sample.” Journal of Anxiety Disorders, National Library of Medicine, 2008.
  3. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health [Internet].” Substance Abuse and Mental Health Services Administration, National Library of Medicine, 2016.
  4. Lovinger, D. “Serotonin’s Role in Alcohol’s Effects on the Brain.” Alcohol Health and Research World, National Library of Medicine, 1997.
  5. Obsessive-Compulsive Disorder and Substance Use Disorders.” Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, 2016.
  6. Medications for OCD.” Department of Psychiatry, University of Florida Health, 2022.

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