Compulsive behaviors and addiction are often linked. Throughout the years in television, film, and theater, we have been shown characters with compulsive tendencies or “addictions” to certain things. While none of these characters have had issues with substance abuse specifically, people with compulsive tendencies or a compulsive disorder diagnosis are typically at a higher risk of developing a substance use disorder than the rest of the population.
Compulsions related to exercising, gambling, shopping, dieting, and eating are well known and rather common among the population. However, there are others who struggle with compulsions that collide with drug or alcohol use. These particular individuals are at an even higher risk for life-altering or even life-threatening events.
If you or someone you know drinks compulsively or uses drugs, it may be time to consider treatment to address their addiction. At The Hills in Los Angeles, California, we offer individualized treatment plans designed to address the issues of addiction and co-occurring mental health disorders.
Understanding Compulsive Disorders
Compulsive behaviors typically arise out of the desire to manage anxieties. For example, someone who develops a heightened fear of germs or illness may become a compulsive hand-washer or compulsive cleaner. Also, they may refuse to touch everyday items such as door handles, or gas pump handles without gloves on or without an extensive cleaning of their hands after. This behavior gives them a sense of control over and provides a small amount of relief from their anxiety.
Obsessive-compulsive disorder or OCD is classified under anxiety disorders. Although many people have unique quirks and compulsive tendencies (such as checking their door a couple of times before they can feel confident it is indeed locked before leaving for the day), it does not mean they have an obsessive disorder. For an obsessive disorder to be formally diagnosed, the symptoms must be severe and persistent. Consequently, diagnoses of obsessive-compulsive disorder are rarer than one might think. Despite the frequency with which people refer to compulsive disorders, the National Alliance on Mental Illnesses (NAMI) estimates that only two percent of the population in the United States will be diagnosed with obsessive-compulsive disorder in their lifetime. At any given time, approximately two million Americans are actively living with obsessive-compulsive disorder.
The Symptoms of Obsessive-Compulsive Disorder
Those diagnosed with obsessive-compulsive disorder will experience persistent symptoms that fall into two categories: obsessions and compulsions. The compulsions are typically born out of obsessive thoughts. Someone with a compulsive disorder will show signs of obsession that may include actions such as:
- Repeated unwanted thoughts or ideas
- Aggressive impulses
- Aversion to germs or dirt
- Fixation on symmetry and order
- Thoughts of being harmed or harming loved ones
Also, they will show signs of compulsion, such as:
- Constant checking – such as whether they turned the oven off or locked the door
- Counting and then recounting everyday objects
- Repeated hand washing
- Rituals and routines
- Constant cleaning
- Arranging items to face a certain way
- Hoarding items already used or which contain little to no value
For some, obsessive disorders will present as a means of managing another type of mental illness. There are many different risk factors for obsessive disorders, which include genetics and family mental health history. For example, if a family member has a history of a compulsive disorder, or if the individual has a history of an existing mental health disorder (anxiety or a mood disorder), there is an increased risk for developing a compulsive disorder. Also, if the individual struggles with extreme anxiety or has experienced a highly stressful event, compulsive disorders can arise as a means of managing the symptoms of stress and anxiety.
Compulsivity and Substance Abuse
Some compulsions such as exercise or calorie counting can be considered healthy provided; they are not taken to the extreme. These are considered “positive compulsions,” although caution must be used as these behaviors can become dangerous when not kept in check.
However, when a compulsive person turns their attention (or compulsions) to drugs or alcohol, it is cause for concern. Getting high on a new drug or highly intoxicated can result in a rush of dopamine in the brain, and a state of euphoria similar to that caused when someone with an obsessive disorder partakes in a task, they take pleasure in. The experience becomes a positive and memorable experience for the user or drinker. Unfortunately, a compulsive person will struggle to resist chasing that high again. Since that high and the feelings associated with it can never be exactly replicated, the compulsive person will keep trying to relive or achieve it again to the point of harm. Before long, their tolerance to alcohol or drugs increases to the point where they must have a certain substance level in their system each day. If they were to stop suddenly, painful withdrawal symptoms would occur.
People with obsessive disorders typically begin using drugs or alcohol to self-medicate the symptoms they are experiencing associated with their mental illness. Thus, substance abuse and obsessive disorders are linked, although one does not always cause the other.
How Compulsion and Addiction are Related
To understand how compulsion and addiction are related, it is helpful to review the definitions of each. Addiction is a broad term used to describe the process by which people become dependent on a substance or behavior in order to cope with life. This dependence becomes so essential to the person that they will persist in using the substance or engaging in the behavior when it becomes harmful to themselves, their family, or other vital areas of their life.
In contrast, a compulsion is a narrower term used to describe an intense urge to do something that can sometimes lead to a behavior but not always. Compulsions are a small but important part of the addictive process and are also a significant element of obsessive-compulsive disorder.
Critical Differences Between Addiction and Compulsion
There are two main differences between addiction and compulsion. They include pleasure and reality.
Pleasure
At least as experienced with diagnosed obsessive-compulsive disorder, a compulsion does not include the experience of pleasure, whereas addiction does. While those with addictions use for a variety of different reasons or discomforts, the desire to use a substance is based on the expectation that it will be pleasurable or “dull” a specific discomfort.
In contrast, someone who experiences a compulsion as part of an obsessive-compulsive disorder may not get any pleasure from the behaviors he or she carries out. Although these behaviors tend to produce a similar dopamine response as seen with substance use, they do not necessarily result in pleasurable outcomes. Often, these compulsions are a way of dealing with the disorder’s obsessive part, resulting in a feeling of relief.
This can appear confusing as there typically comes a time for people with addictions where they no longer enjoy the addictive behavior. They continue their addiction as a means to seek relief from the urge to use. This continual use is only compounded by the experience of withdrawal symptoms should they stop using the substance. Although this can mirror an obsessive disorder’s appearance because the pleasure is gone, the original motivation to engage in substance use was to feel good as opposed to satisfying a particular anxiety or emotion.
Reality
Another significant distinction between addiction and compulsion relates to the individual’s awareness of reality. When someone has an obsessive disorder, they are usually aware their obsession does not have roots in reality. They are often disturbed by the feeling they need to carry out a behavior that defies logic, yet they do it to relieve feelings of anxiety.
On the other hand, those with addictions are often detached from the nature of their actions. This is often called denial because the addicted person denies that their behavior is a problem. Usually, it is not until a significant adverse event occurs (such as losing a spouse, getting fired, or legal issues) that they are faced with the reality of their addiction.
The relationship between addiction and compulsion is often confused. Addiction and compulsion are both terms that have become a standard part of our everyday language, and they are often misused or misunderstood. This can become confusing for everyone, especially those suffering from addictions and compulsions. Usually, people begin to use these terms interchangeably without regard for the distinctions and differences between them.
Seeking Help for Compulsivity and Addiction
If you or a loved one struggle with compulsive behaviors that have turned to drinking or drug abuse, it is time to seek treatment. The sooner the individual enters a treatment program such as here at The Hills in the Los Angeles area, the more likely they are to experience success in treatment and recovery.
Those who struggle with addiction and compulsivity suffer from something called a dual diagnosis. This means they have both a mental health condition (anxiety and related obsessive-compulsive disorders) in conjunction with a substance abuse disorder. It is essential for these individuals to enter a program where treatment for their dual diagnosis is possible. If the program they choose is not capable of addressing their mental health symptoms, treatment is unlikely to be successful as the root cause of behaviors is not addressed. At The Hills in Los Angeles, CA, our programs can help you or your loved one learn to manage their compulsive symptoms in healthy ways through evidence-based treatment modalities. These treatments are carried out in conjunction with you or your loved one’s recovery from (or withdrawal from) alcohol or substance abuse. The success of treatment and recovery depends on your loved one successfully completing the program’s entire duration. This means a program designed explicitly for their disorder and needs is best suited to ensure their success. If you or your loved one are ready to seek treatment, contact The Hills today!
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