Is There A Connection Between Alcohol And OCD?
Yes, there is.
While a couple of beers, cocktails, or glasses of wine is a healthy way to ease stress and tension for many adults, even one alcoholic beverage can become problematic for some OCD-sufferers. Alcohol is appealing to people with OCD, primarily because it takes the “edge off” of their OCD symptoms. But this reprieve is only temporary with symptoms returning in full-force once the effects of the alcohol wear-off.
But to fully understand how alcohol affects people with obsessive-compulsive disorder (OCD), you must first understand how OCD works. OCD is an anxiety disorder that affects approximately 2.5% of Americans. This mental health condition involves constant, uncontrollable and intrusive thoughts, images, urges, and behaviors. In other words, OCD is relentless, annoying, and highly upsetting.
People with OCD are bombarded with distressing thoughts, urges, and images (obsessions) with relief from them only occurring once they have performed certain actions (ritualistic behaviors). These thoughts and behaviors are so powerful that they can impact your self-esteem, relationships, and quality of life. OCD can even cause you to lose your job due to frequent callouts and/or a poor work performance (i.e. distraction from insistent and meddlesome thoughts and ritualistic behaviors).
Did you know that contrary to popular belief, alcohol can actually worsen OCD symptoms? It’s true. Thus, it is extremely important that you and your loved ones understand the connection between OCD and alcoholism. It is the only way you can get your OCD symptoms under control, so you can have the life you deserve.
What is Alcoholism?
Disclaimer: For the purposes of this article the term “alcoholism” will encompass “alcohol misuse,” “alcohol abuse,” “alcohol use disorder,” and “alcohol addiction.”
Did you know that more Americans struggle with alcoholism than any other drug? Well, it is true. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that approximately 15 million Americans struggle with alcoholism, which is almost twice the number of those who are addicted to an illegal substance like cocaine, crack, heroine, meth, etc. (8 million).
So, what is alcoholism? An alcoholic is any person who has a hard time controlling or managing his or her alcohol consumption. For some, the condition is chronic. “Users” grapple with a persistent urge to drink alcohol daily. They believe that they are unable to function properly without alcohol in their systems.
Others binge drink. These individuals consume large amounts of alcohol in one setting, although this consumption may not be daily. Unfortunately, most alcoholics are completely dependent on alcohol. And, over time and with continued use, they require larger amounts of alcohol to get the desired effects. Why does this happen? Larger amounts of alcohol are required as the body develops a “tolerance” to the alcohol.
When an individual is unable to get the alcohol his or her body craves, he or she experiences withdrawal symptoms like:
- Emotional & Physical Pain
- Mental Confusion
- Hot Flashes
- Mood Swings
- Anger & Aggression
Note: It is possible to be an alcoholic without being totally dependent on alcohol. Alcoholism is largely defined by how much alcohol you consume on a daily or regular basis and/or how much alcohol you consume at one time.
What Causes a Person with OCD to Become Dependent on Alcohol?
Approximately 25% of OCD-sufferers also have a substance abuse disorder like alcoholism. Although the exact cause of alcohol dependence varies from person-to-person, several factors appear to play a role in its development, severity, and progression. For many, alcohol is a form of escapism. In other words, it is a way to block out upsetting, stressful, overwhelming, or depressing situations, thoughts, and/or behaviors. This makes alcohol extremely appealing to people with OCD because it allows them to “turn-off” the intrusive thoughts, images, and urges and stop the involuntary behaviors (rituals and routines) – at least temporarily.
Unfortunately, however, consuming large amounts of alcohol on a regular basis or in one sitting can lead to “hangovers” and an escalation in OCD symptoms afterwards. Understand that frequent alcohol consumption can reduce your tolerance levels, requiring more of the substance to receive the desired results. That is the main reason why people become addicted to alcohol and the main reason people with OCD should either limit how much alcohol they consume or refrain from it altogether.
Yes, it allows you to block out intrusive thoughts, images, and urges, but it can also create another group of issues. So, instead of having to “deal” with one problem (your OCD) now have to deal with two problems (alcoholism and OCD symptoms). This makes your path towards recovery even harder. Not impossible – just harder.
But the fact that alcohol can compound one problem with another problem or that it is only temporary and wrought with tons of risks typically does not faze an OCD-sufferer, who is desperate for a reprieve from his or her symptoms. What does this person do instead? Ignore the ill-effects of drinking alcohol so he or she can get a dose of temporary relief.
What Causes a Person to Turn to Alcohol to Cope with OCD Symptoms?
There are many reasons why a person may turn to alcohol to cope with OCD symptoms.
Researchers believe that genetics and biology may influence the development and progression of OCD, however, a variety of factors are thought to play a role in it as well. In fact, studies have found a *possible* genetic link to OCD. Researchers also suggest that cognitive function and chemical composition play an important role in the development of OCD.
Environmental factors also appear to factor into who develops OCD. These factors may include chronic and/or extremely high levels of stress, trauma, fluctuating emotions, and other mental health conditions, such as depression or addiction. All of these factors can cause someone with OCD to turn to alcohol as a form of “release.” In this case, alcohol use or abuse is a way to self-medicate or dull the effects of OCD.
The goal is to stop the unwanted thoughts and behaviors by becoming so intoxicated that you are unable to focus on your obsessive thoughts or engage repetitive behaviors. Conversely, alcoholism or heavy drinking can trigger or aggravate anxiety. And, increased anxiety can trigger or worsen OCD symptoms. Researchers suggest that the brain regions involved in alcoholism are the same ones involved in OCD, so it just makes sense that the two conditions are related.
Note: OCD-sufferers with a family history of alcoholism are particularly at risk of becoming alcoholics. Thus, alcoholism and OCD are heavily interconnected with one condition compounding the other one.
Is it Risky to Use Alcohol to Cope with OCD Symptoms? What are the Risks?
Yes, it is very risky to use alcohol to cope with OCD symptoms.
People who experience OCD symptoms during childhood have a higher risk of becoming alcoholics. Why? Because when a person with OCD is introduced to alcohol early in life it increases his or her risk of using or abusing it as a way to stop or reduce his or her symptoms.
It is important to understand that alcohol is an addictive substance that is commonly used to self-medicate in a variety of situations. After a person self-medicates for a long period of time, he or she becomes addicted or psychologically dependent on the substance, which in this case, is alcohol. Alcohol is so intoxicating because of its effect on the mind and body.
It boosts your serotonin production, causing you to feel happy, relaxed, confident, and “unbothered.” Chronically high serotonin levels can cause a chemical imbalance in the body, worsening OCD symptoms overall. When this occurs, your body turns to alcohol to re-balance itself, initiating a vicious cycle.
More specifically, your brain associates your consumption of alcohol with happy, calm, and positive feelings and lower levels of stress, anxiety, and depression. As a result, a mental connection forms causing the “user,” which in this case is the OCD-sufferer, to continue abusing alcohol to experience the same happy and positive feelings.
Thus, the more people drink, the more accustomed their bodies become to the alcohol. This causes them to drink larger amounts more often to attain the desired effects. The problem is high levels of alcohol can trigger high levels of stress and anxiety – common OCD triggers. Thus, if you use alcohol to help cope with your OCD symptoms, you should consider seeking help with a qualified therapist and/or addiction specialist.
How Does Alcohol Worsen OCD?
Alcohol interrupts the way your brain communicates with or transmits messages to various parts of your body. This interruption in your brain’s communication system can impact how your brain functions overall, leading to changes in your temper, thought processes, and/or behavior. So, consuming too much alcohol too frequently can exacerbate OCD symptoms.
But, although studies indicate that alcohol can worsen a person’s OCD symptoms, many OCD-sufferers still partake in it because they believe some relief (even if it’s temporary) is better than no relief. Study participants reported that alcohol temporarily decreased their stress and anxiety, thereby reducing or eliminating their OCD symptoms.
Keep in mind that alcohol is also a depressant that affects your central nervous system. In other words, it functions like a sedative and like a sedative it relaxes your mind and body, which is attractive to a person struggling with non-stop intrusive thoughts and repetitive behaviors.
So, to sum it up, OCD-sufferers turn to alcohol because it numbs them. In other words, it eases their anxiety, so they do not feel compelled to think about, worry, or fret over unpleasant or negative thoughts or perform repetitive actions to remove those thoughts.
For example, a person, who has been overindulging in alcohol may experience an OCD flare once he or she realizes how much money has been spent on alcohol throughout the day or night. This could jumpstart the obsessive thoughts and “force” him or her to engage in certain behaviors to ease the pressure and reduce the anxiety.
How Can Alcoholism Affect the Daily Life of an OCD-Sufferer?
However, it is important to understand that seeking treatment for these co-occurring conditions (alcoholism and OCD) is the only way to properly manage them. In fact, according to a 2020 study, approximately 70% of participants struggling with OCD were also struggling with some form of substance abuse or addiction (i.e. alcoholism).
Researchers also found that as many of 3 million people experience OCD symptoms each year. People with OCD often report using illicit drugs or misusing or abusing alcohol as a way to stop the distressing voices in their heads that tell them to perform certain actions.
However, once the calming effects wear-off, the stress and anxiety return with a vengeance, triggering or worsening OCD symptoms. So, although the alcohol is meant to “take the edge off” the OCD symptoms, most of the time it has the opposite effect. When alcohol is added to OCD, your personal, social, work, academic, and even financial lives can take a major hit.
If left unchecked, these two co-occurring conditions (OCD and alcoholism) can devastate your self-esteem and self-confidence, friendships, romantic and family relationships, and even your career ambitions.
Marla, a 40-year-old woman, is hiding something… What? Well, she has a habit of compulsively washing her hands. It has been going on for years because Marla is unable to stop the behavior. Marla started drinking alcohol to relieve her stress and block out her obsessive thoughts. Over time, she began drinking more and more alcohol to cope with her intrusive thoughts and ritualistic behaviors.
Marla was well-aware that her thoughts and behaviors were unhealthy, but she just couldn’t stop them. The mere thought of “bacteria,” “infection,” or “germs” was enough to trigger a lengthy episode of hand-washing. She would often repeatedly wash her hands until they dried out, cracked, became raw, and bled.
To Marla, it was almost impossible to sanitize her hands without performing the ritual of repetitive hand-washing. Sometimes, Marla would wash her hands up to 100 times a day, taking up much of her day with this behavior. As a result, she had little time to enjoy life, see friends, partake in hobbies, spend time with loved ones, pursue career opportunities, improve herself, or even develop a romantic relationship with someone.
Life was rough for Marla. Alcohol became her only friend. She spent most of her time in a self-imposed isolation – washing her hands and drinking. Eventually, Marla became fed-up with her OCD symptoms and sought treatment. The first thing the substance abuse therapist noticed was how many times Marla excused herself to go to the restroom.
After Marla returned to the counseling session, the therapist diagnosed Marla with OCD and explained what she could expect from the therapy sessions. He assured Marla that there are a variety of medications and therapies that could help her get a handle on her drinking and OCD symptoms. The therapist adopted a triage treatment approach that involved himself, a psychiatrist, and Marla’s loved ones.
Has COVID-19 Worsened Alcoholism in OCD-Sufferers?
Yes, it has.
There has been a noticeable uptick in alcoholism amongst OCD-sufferers since the inception of COVID-19. Studies suggest that people, who struggle with an anxiety condition, like OCD, are more likely to drink heavily during the pandemic.
But although the pandemic has caused many young adult OCD-sufferers to drink more, COVID-19 has significantly increased the risk for older adults with OCD. This boost in drinking amongst older OCD-sufferers appears to stem from a fear of contracting the virus and becoming “contaminated,” ill from it, or possibly dying from it.
In other words, the pandemic, the mask mandates, social isolation, layoffs at work, restricted travel, and lockdowns have worsened OCD symptoms for many adults. As a result, people with OCD have taken up drinking to ease their stress and reduce their anxiety.
Understand that people with existing mental health conditions like anxiety or depression are especially vulnerable to increased alcohol consumption during upsetting, traumatic, overwhelming, or distressing events – like a global pandemic. In fact, according to an online survey conducted on Facebook in 2020, COVID-19 have even caused people without mental health conditions to increase their alcohol consumption (29%).
However, it caused approximately 41% of people with anxiety to increase the amount of alcohol they ingest. Researchers also found that adults under the age of 40 were more likely to drink more during the pandemic (40% of adults 40 and younger) than those over this age.
About 30% of those between the ages of 40 and 59 were more likely to drink more due to the stress of the pandemic, while 20% of older adults (ages 60 and older) without anxiety increased their alcohol consumption during the pandemic. Researchers also found that those over the age of 40, who struggle with anxiety or depression were twice as likely to turn to alcohol to calm their nerves and ease their COVID-19 anxiety.
Is it Possible to Treat OCD and Alcoholism Simultaneously?
Yes, it is possible.
Researchers suggest that approximately 25% of OCD-sufferers, who seek treatment for OCD, also struggle with alcoholism. And because alcohol tends to be the most abused illicit substance, the odds that a person who has OCD will misuse or become addicted to alcohol is high.
When alcoholism and OCD are present, professional help is required to effectively manage the two conditions. And, although each condition is evaluated separately both conditions can be treated at the same time. This treatment approach is called a “dual diagnosis treatment approach.”
As mentioned above, the conditions are evaluated separately, however, considered interconnected. This is because each condition can trigger or aggravate the other one. The treatment approach or approaches depend on the symptoms and severity of the individual conditions. However, most treatment approaches involve a combination of therapy and medication.
The most common therapy approach is cognitive-behavioral therapy (CBT) and exposure therapy to ease OCD-related stress and anxiety. The goal of these treatment approaches is to change how the individual perceives or sees his or her other triggers – and how he or she responds to them. The aim is to reduce or eliminate the power these triggers (i.e. intrusive thoughts and ritualistic behaviors) have over an OCD-sufferer’s life.
The most common medications used for alcoholism and OCD are:
Note: Anti-anxiety medications for OCD can be highly addictive, so it is important that you consult a mental health professional before altering your treatment plan or taking any medication for OCD.
The truth is people with OCD have the highest rate of alcoholism and substance abuse. And, although, OCD can control your life and rob you of your happiness and freedom, it doesn’t have to. Thankfully, a variety of treatments are available to help you with your OCD symptoms so you don’t feel compelled to turn to alcohol to help you cope with them.
If you feel like your alcohol use is getting out-of-control, don’t fret. All hope is not loss. A qualified addiction therapist can help you get a grasp on your OCD symptoms and your alcohol abuse issues – at the same time! All you have to do is ask for help. With the right treatment you can stop drinking, put your OCD symptoms to bed, and reclaim your life.
- Center for Substance Abuse Treatment. (2005). Substance abuse treatment for persons with co-occurring disorders. Substance Abuse and Mental Health Services Administration (US): Treatment Improvement Protocol (TIP) Series, 42 [Table], Case Study: OCD and Alcohol. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK64203/table/A76291/
- New York University. (2021). Drinking during COVID-19 up among people with anxiety and depression: Differences by age group point to need for tailored public health messaging and substance use support. ScienceDaily. Retrieved from http://www.sciencedaily.com/releases/2021/01/210119113215.htm
- Ariadna Capasso, Abbey M. Jones, Shahmir H. Ali, Joshua Foreman, Yesim Tozan, Ralph J. DiClemente. Increased alcohol use during the COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S. Preventive Medicine, 2021; 106422 Retrieved from https://www.sciencedirect.com/science/article/pii/S0091743521000062?via%3Dihub
- Nestadt, G., Grados, M., & Samuels, J. F. (2010). Genetics of obsessive-compulsive disorder. The Psychiatric clinics of North America, 33(1), 141–158. https://doi.org/10.1016/j.psc.2009.11.001
- Kantra, D. S. (2011). Do you have OCD? Psych Digest. Retrieved from http://psychdigest.com/do-you-have-ocd-2/
- Mayo Clinic. (2021). Obsessive-compulsive disorder (OCD). Retrieved from https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432
- Capasso, A., Jones, A. M., Ali, S. H., Foreman, J., Tozan, Y., & DiClemente, R. J. (2021). Increased alcohol use during the COVID-19 pandemic: The effect of mental health and age in a cross-sectional sample of social media users in the U.S. Preventive Medicine, 106422. Retrieved from https://www.sciencedaily.com/releases/2021/01/210119113215.htm
- Ahrnsbrak, R., Bose, J., Hedden, S. L., Lipari, R. N., & Park-Lee, E. (2016). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm
- Drugs.com. (2020). Alcohol withdrawal. Retrieved from https://www.drugs.com/health-guide/alcohol-withdrawal.html
- Legg, T. J. (2018). Alcoholism. Healthline. Retrieved from https://www.healthline.com/health/alcoholism/basics
- Drink Responsibly. (2021). Curbing alcoholism. Retrieved from http://drinkresponsibly.in/?p=522
- Oscar–Berman, M. & Marinkovic, K. (2003). Alcoholism and the brain: An overview. Alcohol Research & Health, 27(2), 125-133. Retrieved from https://pubs.niaaa.nih.gov/publications/arh27-2/125-133.htm
- Health Guide Info. (2010). A review of environmental factors and OCD. Retrieved from https://www.healthguideinfo.com/ocd-causes/p98532/#:~:text=A%20Review%20of%20Environmental%20Factors%20and%20OCD%201,OCD%20is%20still%20ongoing.%20…%203%20References.%20
- Lovinger, D. M. (1997). Serotonin’s role in alcohol’s effects on the brain. Alcohol Health Res World, 21(2),114-20. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15704346/#:~:text=Serotonin%20is%20an%20important%20brain%20chemical%20that%20acts,effects%20on%20the%20brain%20and%20to%20alcohol%20abuse
- The Recovery Village. (2021). OCD and alcohol. Retrieved from https://www.therecoveryvillage.com/alcohol-abuse/faq/alcoholism-ocd-related/#:~:text=People%20who%20experience%20symptoms%20of%20OCD%20early%20in,substance%20to%20find%20temporary%20relief%20from%20their%20OCD
- Durrant, R. (2011). Anxiety, alcohol use, and aggression: Untangling the causal pathways. Legal & Criminological Psychology, 16(2), 372–378. https://doi.org/10.1111/j.2044-8333.2011.02023.x
- Lawrence, A. J., Luty, J., Bogdan, N. A., Sahakian, B. J., & Clark, L. (2009). Impulsivity and response inhibition in alcohol dependence and problem gambling. Psychopharmacology, 207(1), 163–172. https://doi.org/10.1007/s00213-009-1645-x
- Kiluk, B. D., Nich, C., & Carroll, K. M. (2010). Neurocognitive indicators predict results of an informed-consent quiz among substance-dependent treatment seekers entering a randomized clinical trial. Journal of Studies on Alcohol and Drugs, 71(5), 704–712. Retrieved from https://doi.org/10.15288/jsad.2010.71.704
- National Institute on Drug Abuse. (2010). Why do drug use disorders often co-occur with other mental illnesses? Retrieved from https://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental-illnesses/why-do-drug-use-disorders-often-co-occur-other-men
- Gluck, S. (2013). OCD statistics and facts. Healthy Place. Retrieved from https://www.healthyplace.com/ocd-related-disorders/ocd/ocd-statistics-and-facts
- Ellis, R., Wynter, R., & Light, R. (2020). Body and mind: Are we adequately prepared for the toll this pandemic will take on mental health? University of Huddersfield. Retrieved from https://pure.hud.ac.uk/en/publications/body-and-mind-are-we-adequately-prepared-for-the-toll-this-pandem
- Deupree, S. (2020). CBT for OCD: How it works, examples & effectiveness. Choosing Therapy. Retrieved from https://www.choosingtherapy.com/cbt-for-ocd/
- American Addiction Center. (2020). Treating OCD & heavy drinking. Retrieved from https://www.alcohol.org/co-occurring-disorder/ocd/
- SAMHSA. (2017). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHFFR2017/NSDUHFFR2017.pdf