OCD and Drinking: Does alcohol make OCD worse?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive thoughts, obsessions, and compulsions that can significantly impact a person’s daily life. 

For individuals struggling with OCD, finding ways to manage their symptoms and maintain a sense of control feels crucial. 

However, some individuals may turn to alcohol as a means of coping with their OCD, which raises an important question: Does alcohol make OCD worse?

OCD and Drinking: Seeking Relief

Obsessive-Compulsive Disorder (OCD) is a common and complex mental health condition that affects millions of people worldwide. 

For individuals suffering from OCD, it is not uncommon for them to develop coping mechanisms or turn to substances as a way to manage their symptoms. One such substance is alcohol, which is often used as a form of self-medication.

For the person with OCD, daily life can be incredibly painful. They suffer greatly, battling with tormenting obsessions and uncontrollable compulsions that interrupt their lives.

People with OCD can lose hours of their day to these obsessions and compulsions. They may lose friends and family, the ability to do their job and function. OCD can feel truly life-destroying, and so it is understandable that someone who struggles with this condition may seek relief from substances such as alcohol.

If this is you, please do not judge yourself for wanting to alleviate that pain.

Just know that there are resources, skills, and qualified mental health professionals available who can help you manage and overcome OCD using healthy coping mechanisms.

Understanding OCD: A Brief Overview

Before delving into the intricate connection between OCD and alcohol, it is important to have a clear understanding of what OCD entails. 

OCD is a chronic condition characterized by intrusive thoughts, feelings, images, urges, feelings, and sensations, known as obsessions. Followed by repetitive behaviors and rituals, referred to as compulsions. 

These obsessions and compulsions can significantly interfere with an individual’s daily life, causing distress and impairing their ability to function.

OCD affects approximately 2.3% of the global population, making it one of the most common mental health disorders worldwide. It can develop at any age, but it often begins during childhood or adolescence. 

The exact cause of OCD is still uncertain, but researchers believe that a combination of genetic, neurological, and environmental factors may contribute to its development.

The Relationship Between OCD and Substance Abuse

There is a strong correlation between mental health disorders and substance abuse. 

Many individuals with mental health conditions turn to substances as a means of self-medication, attempting to find temporary relief from their symptoms. This cycle of self-medication can be particularly prevalent for individuals with OCD, as they strive to alleviate the anxiety and distress caused by their obsessions and compulsions.

Alcohol use in individuals with OCD is far greater than in individuals within the general population. Alcohol, above all, is the most commonly used substance, with up to 24% of OCD sufferers also living with alcohol use disorder (AUD).

Among the uncontrollable pain of OCD, substances such as alcohol offer a welcome reprieve and a temporary moment of calm.

Alcohol, in effect, ‘dulls the mind’ and offers a momentary lift in mood and a slight sense of euphoria.

However, as the alcohol leaves our system and we begin to sober up, many report feeling much worse and can return to the substance in a bid to avoid feeling this way.

Alcohol can become the coping mechanism of choice due to its dulling effects, but unfortunately, it does not assist in long-term OCD management or recovery. 

For a long-term solution, science-backed methodologies like Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP) have proven to yield incredible results in long-lasting OCD recovery. 

Much like those compulsive behaviors, alcohol is only ever a very short-term fix.

Does drinking alcohol make OCD symptoms worse?

Alcohol, a widely consumed substance, has various effects on the brain and body. When consumed, it acts as a central nervous system depressant, slowing down brain activity and altering neurotransmitter levels. This can lead to changes in mood, judgment, and impulse control. 

Because of this, alcohol can exacerbate existing OCD symptoms. 

Research has shown that there are several neurotransmitters that could be involved in both OCD and SUD (substance use disorder) including serotonin, glutamate, and dopamine.

These neurotransmitters allow the brain to execute important cognitive and behavioral functions and alcohol inhibits those functions. This is why, when we drink, we can begin to feel slow and the world appears a little foggy. We’ve limited our brain’s ability to think and respond effectively.

For those with OCD and SUD, abnormal levels of glutamine have been identified, although research cannot verify whether this contributes to symptoms.

Alongside this, there are particular regions of the brain that may play a part in those with OCD and SUD. The prefrontal cortex is one such region.

Responsible for decision-making as well as cognitive and behavioral control, changes to the prefrontal cortex may impact an individual’s ability to resist engaging in compulsive behaviors.

Our judgment, resilience, and ability to develop purposeful responses are compromised. And when it comes to managing OCD, we need to be aware of and choose our responses.

Managing OCD takes a great deal of courage and willingness to do the hard thing and face our fears. When alcohol is brought into the mix, we have a lower tolerance for anxiety and uncertainty because our executive functions have been impeded. Brain fog, as a result of drinking, also makes it harder to stop engaging in compulsive behaviors as we have less resilience.

Does drinking trigger OCD?

Drinking alcohol has not been found to trigger OCD.

There has yet to be any research proving that alcohol consumption can cause the onset of OCD but evidence has shown that drinking alcohol can exacerbate the symptoms of OCD.

The wider impact of alcohol on our mental health

It’s important to understand that excessive drinking has a broader impact on our lives beyond only OCD. The Mental Health Foundation explains how alcohol can affect our everyday lives.

Here we will look at the important factors mentioned…

How alcohol affects your brain

Alcohol disrupts the neurotransmitters in the brain which affect your feelings, thoughts, and behaviors.

Although you may feel more relaxed and confident after drinking, the effects of alcohol quickly wear off and those chemical changes result in increased negative feelings.

You may notice after drinking that you experience low moods, heightened anxiety, and feelings of depression without understanding exactly why.

The alcohol has slowed down your ability to process information and this directly impacts how you feel and how you’re able to respond to those feelings.

How alcohol affects your body

In the short term, drinking too much could impact your sleep, and cause stomach cramps, bloating, and frequent migraines.

Many years of excessive drinking, however, could result in serious health conditions such as heart disease, high blood pressure, strokes, or liver disease.

There’s nothing to say that you can’t or shouldn’t enjoy a drink with friends or a glass of wine with dinner, but reliance on alcohol over a long period of time can result in irreversible damage in severe cases.

Alcohol and mental health

Alcohol and mental health problems are frequently linked. Those with mental health illnesses are more likely to turn to alcohol as a form of self-medication to manage their symptoms.

Unfortunately, the impact alcohol has on the brain and body means that it begins to impact wider areas of life. Relationships can become strained, an inability to work may lead to unemployment, and unemployment leads to financial struggles.

This all adds layers upon layers of pain and hardship which negatively impacts our mental health.

Conditions such as depression and anxiety are made more difficult to manage when alcohol comes into the mix, even though alcohol is initially used as a way to numb symptoms. Increased isolation, lack of motivation, and dependence on alcohol only contribute to a perpetuating cycle of pain.

Alcohol, suicide, and self-harm

Alcohol and suicide have a tragically close relationship.

Those with suicidal ideation often turn to alcohol for relief, but in turn, this only increases the frequency and intensity of those thoughts.

With suicide being of such a ‘taboo’ nature, those who struggle with thoughts of self-harm and suicide often resist seeking medical support for fear of judgment. However, in opting for alcohol as a solution, they do not receive the care they need and can quickly see suicide as the only option.

If you suffer from suicidal thoughts, please seek urgent medical assistance.

Why might OCD cause you to be dependent on alcohol?

Those living with OCD find themselves in a perpetual state of anxiety, stress, and uncertainty. Mentally and physically, it feels like they can never find a moment of peace from the fear and compulsive behaviors they feel compelled to perform.

Intrusive thoughts can make them feel as though they are a ‘bad person’ or in fear that they’re ‘going crazy.’ Each and every day can feel like a turbulent ride through the OCD cycle, over and over again.

It can be truly excruciating.

For example, someone with Harm OCD who fears they will hurt their child in some way. They may avoid their child in order to ‘make sure’ that this never happens. Now, not only are they confronted by these terrifying fears each day, but they no longer spend intimate time with their son or daughter, whom they love very much.

All they want is to make it stop.

This chronic distress can lead to the development of maladaptive coping mechanisms, such as self-medicating with alcohol. Alcohol provides temporary relief, numbing distressing thoughts and providing a sense of calm.

But this only lasts for a short while until the effects of the alcohol wear off.

The Science Behind OCD and Alcohol Dependence

The link between OCD and alcohol dependence extends beyond the surface-level symptoms and impacts. Research has shed light on the neurological factors and genetic links that contribute to the co-occurrence of these conditions.

Neurological Factors and Genetic Links

Studies have shown that individuals with OCD are stuck in a ‘loop of wrongness’, specifically in the areas responsible for reward and impulse control. These same regions are also implicated in alcohol dependence. Additionally, genetic factors play a role in both OCD and alcohol use disorder, further reinforcing the connection between the two. It is, however, important to note that the presence of a family member with OCD (or SUD) may not be enough in and of itself for either condition to develop.

Psychological Theories 

Psychological theories suggest that individuals with OCD may have an increased vulnerability to developing substance abuse issues due to underlying traits such as impulsivity or a propensity for seeking relief from distress. 

It is important that you remember that having alcohol dependence is not your fault, and there are resources and treatments that can help you. These topics require care and compassion, so please be gentle with yourself if you struggle in these areas.

Medication and Therapy Options

Medication can be an essential component of treatment for individuals with co-occurring OCD and alcohol use disorder. Selective serotonin reuptake inhibitors (SSRIs), often prescribed for OCD, may help manage symptoms and reduce the urge to self-medicate with alcohol.

Additionally, therapy options such as cognitive-behavioral therapy (CBT), exposure and response prevention, acceptance and commitment therapy, and mindfulness can equip individuals with coping mechanisms and help them develop healthier responses to anxiety and distress.

The Impact of Drinking on OCD Treatment

When OCD and alcohol use disorders co-occur, the effectiveness of OCD treatment can be compromised. 

Alcohol slows down the brain’s processes. This makes it more difficult to identify how you feel and the possible consequences of your actions.

In the long-term, excessive drinking will reduce the number of neurotransmitters in our brain, but some are needed to help us manage and prevent anxiety and depression.

In order for OCD therapy to be effective, the client must be engaged. They must be able to interact and implement the treatment, and alcohol can prevent them from being able to participate effectively.

In many cases, an OCD clinician will encourage the person with OCD to address their drinking before they begin therapy.

Without doing so, a patient who has difficulty with OCD and drinking approaches treatment without the ability to make sound judgment (which, in this case, is to engage in therapy).

If we are using alcohol to manage our anxiety, uncertainty, and other mental health struggles, drinking becomes a compulsion (to avoid or reduce anxiety or uncertainty).

In addition, it limits our ability to use ERP effectively and experience the benefits of ERP because alcohol is what takes the discomfort away rather than learning that you can tolerate the discomfort, uncertainty, and anxiety without engaging in any compulsion (including alcohol).

If you are in therapy, please raise this with your therapist so that they are aware, in case drinking is impeding your treatment.

Alcohol can also interfere with medications commonly prescribed for OCD, rendering them less effective. Additionally, alcohol impairs decision-making abilities and may diminish the motivation to engage in therapy or adhere to treatment plans, hindering overall progress.

When you work together with a qualified clinician, it is important that both OCD and alcohol consumption are addressed so you can get the best results out of your treatment.

OCD and Drinking (Not the best combo!)

Many people with OCD do experience an increase in the severity of OCD symptoms due to the intake of alcohol.

If you have concerns about your alcohol intake and would like to take precautionary steps around your drinking, consider the following:

1. Know what ‘normal’ drinking amounts are for you.

Everyone has varying levels of tolerance for alcohol. So, it’s important to begin by understanding what would be considered ‘normal’ levels for you.

2. Keep a record of your drinking habits.

You can use an app or a journal to keep track of what you drink and how often. Apps can help raise your awareness as to how many cans, bottles, glasses, or even units you intake.

3. Recognize whether or not your tolerance is increasing.

If you begin to notice that the usual two glasses of wine aren’t quite ‘cutting it’ and that more is required for you to experience the buzz we often seek from alcohol, this is something to be aware of. An increase in tolerance can be a sign that you need to decrease your alcohol intake.

4. Recognize if you find it hard to choose to drink less or nothing at all.

It is not always easy to admit this to yourself. However, if you notice that it is becoming harder to stop drinking once you start or that going for a prolonged period of time without a drink is proving difficult, this may be the time to reach out for help.

5. Seek professional support.

A qualified mental health professional will meet you without judgment. A prominent feeling in those with OCD is shame. When you add alcohol dependence on top of this, it can feel unbearable. But a mental health professional will not judge you. You will be met with compassion and kindness; they only want to help you get better.

6. Seeking Saftey

While this book is not specific to OCD and substance abuse, it is an incredibly insightful and effective manual for managing difficult co-occurring diagnoses. The focus of Seeking Safety is on comorbid PTSD and substance abuse. However as mentioned, there are many tools and techniques that can be applied to those with OCD. Alongside highly practical tools, it also restores ideals that may have been lost such as respect, care, protection, and healing.

If you would like help to manage your OCD using healthy, science-backed coping mechanisms, our team would love to support you.

If you’re based in California, we have an elite group of highly qualified OCD specialists who can support you in your OCD recovery.

We use the most effective treatment modalities, and our clients see incredible results; many say that they feel as though they have their life back!

To learn more about working with us in a private setting, please submit an initial intake form here to have a conversation with one of our compassionate professionals.