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Compulsivity and Addiction: How Compulsive Behavior and Substance Abuse Are Related

Characters with compulsive tendencies have been depicted often throughout the years in television, film and theater. Modern examples include the character Adrian Monk of the television series “Monk” and Robert McCall of “The Equalizer” film franchise. A more classic example would be Felix Unger of “The Odd Couple,” as seen on Broadway and on the small and silver screens.

Although none of these three characters have problems with drug use or alcoholism, people with compulsive tendencies are generally at greater risk of substance abuse than the rest of the population.

People can also fall prey to compulsive exercising, gambling, shopping, dieting and eating, but in this article, we would like to focus on when compulsivity collides with drug or alcohol use. Why? The combination could unravel one’s life and even turn deadly.

If you know someone who compulsively drinks or uses drugs, find out why you need to act quickly to get this person help before their physical and mental health goes significantly downhill.

What Causes Compulsive Behaviors? 

Compulsive behaviors are borne out of a desire to manage anxieties. For instance, someone who develops a heightened awareness or fear of germs may become a compulsive hand washer – or they may refuse to touch certain everyday items at all. The behavior gives them a sense of control over, and relief from, their anxiety.

This is why obsessive-compulsive disorder (OCD) is classified under anxiety disorders. Although you may notice a lot of people with unique quirks and compulsive tendencies, the symptoms of OCD must be severe and persistent. Thus, OCD diagnoses are actually quite rare.

In fact, the National Alliance on Mental Illness estimates that only 2 percent of the U.S. population will be diagnosed with OCD in their lifetime. At any given time, roughly 2 million Americans are actively suffering from OCD.

The Symptoms of Obsessive-Compulsive Disorder (OCD)

For someone with full-blown OCD, they will have persistent symptoms in two areas: obsessions and compulsions. Yes, the compulsions are usually borne out of the obsessive thoughts.

Someone with OCD will show signs of obsession, such as:

  • Aversions to germs or dirt
  • Repeated unwanted ideas
  • Aggressive impulses
  • Fixation on symmetry and order
  • Persistent sexual thoughts
  • Thoughts of being harmed, or harming loved ones

And the OCD sufferer will show signs of compulsion, such as:

  • Constant checking – such as to make sure doors are locked or appliances are in working order
  • Counting and recounting everyday objects
  • Repeated hand washing
  • Stubbornly sticking to a routine or ritual
  • Constant cleaning of various items
  • Arranging items to face a certain way
  • Organizing collections in alphabetical or other type of order
  • Hoarding items already used or of little to no value

OCD sometimes emerges as a way of managing another type of mental illness. In fact, the risk factors of obsessive-compulsive disorder include:

  • Genetics – a family history of the disorder
  • Extreme anxiety – especially borne out of living through traumatic or highly stressful events
  • Existing mental disorder – such as a mood disorder, other form of anxiety disorder, or a substance use disorder

The Compulsive ‘Reward’

Compulsive behaviors all relate back to dopamine and the reward system of the brain. Going on an invigorating run, for example, can give the person a “runner’s high,” in which a large amount of dopamine is released in the brain, eliciting a state of euphoria.

The person may then begin to repeat the same action in hopes of re-experiencing that original high. Sometimes they will achieve it; but, in most cases, they won’t. Nonetheless, the person keeps doing the same action to the point where it’s almost involuntary and ritualistic. This is compulsive behavior.

According to Graham C.L. Davey, Ph.D., a prolific author and a psychology professor at the University of Sussex (England), the brain registers all pleasures in basically the same way – with a release of dopamine in the nucleus accumbens, located in the basal forebrain. This pleasure can be brought on by eating a slice of cake, taking a drug, exercising, a sexual activity, winning a jackpot, beating a level in a video game – you name it.

Compulsivity and Substance Abuse: When Compulsions Turn Harmful

Some compulsions are largely innocuous and even healthy, such as exercising or counting calories (although these can be taken too far). One can even have the recurrent compulsion to thoroughly clean up after oneself after cooking and/or eating, and it’s hard to find much wrong with that. These can be considered “positive compulsions,” although it’s important to be mindful of moderation in these.

But when a compulsive person turns their attention to drugs or alcohol, red flags should be popping up left and right. Getting high on a new drug or getting inebriated to a certain point can result in a rush of dopamine in the brain and a state of euphoria, as we spoke of a moment ago. If it’s a positive and memorable experience for the user or drinker, a compulsive person will be hard-pressed to resist chasing that high again.

That high can never be exactly replicated, but a compulsive person will keep trying to relive or achieve it again. Before long, tolerance to alcohol or drugs increases, and then the person becomes used to having a certain level of that substance in their system each day. If they were to suddenly stop at this point, painful withdrawal symptoms will ensue.

OCD and Substance Abuse

For people with full-blown OCD, co-occurring substance usually has the following role: The person begins using drugs or alcohol as a means of self-medicating the OCD symptoms. Thus, you can conclude that having OCD is a risk factor for drug or alcohol addiction.

Getting Help for Compulsivity and Addiction

Do you have a family member or close friend with compulsive tendencies (such as gambling, shopping or eating) and who has taken an affection to drinking or a specific drug? Seek help on this individual’s behalf soon. Their quality of life can quickly deteriorate.

You may need to start with an intervention to get them to go into treatment. Compulsive people are usually not aware that their behaviors are unhealthy or abnormal; and even if they are, their compulsions usually override their willpower to stop. An intervention can help break through their current tailspin.

It’s also important that they enter a dual diagnosis treatment program, one that can address their mental health symptoms. Reflections Recovery Center in Prescott, AZ can help your son, husband, brother, male cousin, etc. learn to manage his compulsive inclinations in healthy ways as he recovers from alcohol or drug abuse.

Dual Diagnosis Treatment for OCD and Compulsivity