OCD and Alcohol Abuse: What Is the Connection?

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There are a few different mental health diagnoses that are more common for people who struggle with alcohol abuse. One of those conditions is OCD, or obsessive compulsive disorder. OCD and alcohol abuse can go hand in hand, and can even exacerbate one another, with increased drinking leading to increased OCD symptoms, and vice versa.

Fortunately, there is hope for people who experience both OCD and alcohol abuse. If you want to learn more about the link between these two conditions, including steps you can take if you have a dual diagnosis of both OCD and alcohol use disorder, read on below.

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Is There a Link Between OCD and Alcohol Use Disorder?

Many researchers have examined the link between OCD and alcohol use disorder (AUD). On average, researchers find that roughly 30 percent of people with OCD also experience AUD.1 Similarly, about 18 percent of people with alcohol use disorder also qualify for a diagnosis of OCD.

Researchers have speculated a few different reasons why OCD and drinking are linked. Both OCD and addiction have a common symptom of compulsive behavior, but those compulsions can look very different. The most likely link between OCD and addiction lies in the brain. Researchers have theorized that OCD and addiction have common neurological underpinnings that are rooted in the areas of the brain linked to impulse control and compulsion,2 and that these similar neurobiological processes are at the root of the connection between OCD and alcohol abuse.

letters arranged on table spelling ocd

What Is OCD?

Many people have a stereotypical image in their mind of what OCD looks like, picturing someone who is oddly obsessed with cleaning or organization. The reality of OCD can be quite different and much more debilitating. OCD is a type of anxiety disorder where a person has repeated obsessive thoughts and/or behaviors that they feel compelled to enact and repeat.3 These obsessions and compulsions are often intrusive, unwanted, and very distressing for the person with OCD. 

Compulsions and obsessions are also sometimes somewhat illogical. For example, someone with OCD might have a recurrent thought that they need to perform actions like washing their hands or locking their door in a certain way or else something terrible will happen to one of their loved ones. Someone with OCD might experience an extreme sense of anxiety if they don’t enact these compulsive behaviors.

What Is the Link Between OCD and Addictive Behavior Overall?

Why do OCD and addiction tend to go hand in hand? Both OCD and addiction have common symptoms, with both leading a person to experience a strong urge to enact a behavior, even when they do not want to. These compulsions might lead someone to enact the behavior, whether washing their hands repeatedly or consuming alcohol, to the point of discomfort.

While OCD is linked to many other kinds of addictions, like cocaine or opioid addiction, alcohol is the most common substance linked to OCD.4 Some people with OCD might also use substances like alcohol as a way to self-medicate their symptoms. Self-medication is common for people with all different kinds of mental health conditions, particularly for anxiety disorders like OCD.5

Unfortunately, because it can be challenging to access quality mental health care, and because seeking help is still somewhat stigmatized, this can lead people to self-medicate with what’s most readily available to them. Because alcohol is a legal and socially accepted substance to consume, this might partially explain why OCD and alcohol use go hand in hand.

Can AUD Make OCD Worse?

Researchers have established a link between OCD and alcohol use, but can alcohol consumption actually make OCD symptoms worse? Unfortunately, the answer appears to be yes.

OCD is an anxiety disorder and researchers have long studied the link between alcohol and anxiety. Alcohol consumption can reduce anxiety symptoms in the short term, which is what leads many people to self-medicate with alcohol as a means to reduce those symptoms. However, in the long term, alcohol consumption will just make symptoms worse.6

Can Having OCD Make it Harder To Quit Drinking?

Having OCD doesn’t mean that it’s impossible to quit drinking, but there might be a few extra considerations to keep in mind. Because OCD and alcohol abuse are linked, treating just one of these conditions isn’t going to be as effective as treating both conditions together. Treating both OCD and drinking together will have the most positive impact.

OCD might also make it a bit harder to quit drinking, but it’s still possible with proper support. Some people might benefit from entering an inpatient treatment center. Others might find that a combination of individual therapy and coaching support is a more helpful approach. Even if you have both OCD and AUD, you are still an individual, and the most effective treatment plan will be one that’s tailored to your specific needs.

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What To Do If You Have a Dual Diagnosis of AUD and OCD

If you have OCD and alcohol use disorder, there are some important things that you should keep in mind.

Pay attention to how drinking makes you feel

When you drink, how does it impact your OCD symptoms? How do you feel in the moment, and how do you feel hours later? Does your anxiety increase? Paying closer attention to how drinking impacts your symptoms can be a first step in cutting back.

Track how much you are drinking

Many people develop a tolerance for drinking over time and need to consume more alcohol to maintain the same “buzz.” Pay attention to how much alcohol you consume, and even consider tracking the amounts in a journal or diary.

Learn how alcohol might impact OCD medications

If you take medication for your OCD, alcohol may negatively impact the effectiveness of your medication and subsequently increase symptoms. Ask your doctor for additional information.

Ask for help when you need it

There’s no shame in asking for help. None of us can get through life’s journey on our own. Whether reaching out to a trusted friend, medical provider, therapist, or someone else, don’t be afraid to ask for help when you need it.

Getting Help for AUD and OCD

If you have OCD and want to cut back on your drinking, you don’t have to tackle this challenge on your own. There is help available to you. Ria Health’s online program can help you gain control of OCD-related drinking, helping you find supportive connections and building new coping skills. Reach out today to get started.

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About the Author

Dr. Chelsea Hetherington (she/her) is a developmental psychologist, writer, coach, and consultant. She helps therapists, coaches, and other businesses in the mental health space connect with their audiences and attract their dream clients through educational content writing. Her writing bridges the gap between research and practice by making complex mental health and personal development topics more accessible and easy to understand. You can find more of her writing at www.mindfultype.co


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