OCD & Addiction Treatment at Banyan

Common Symptoms of OCD and Addiction

Symptoms vary widely based on the nature of the obsessions, type of compulsions, substance, and co-existing mental health issues. Some may be more concerned about the fear and rituals, and others may focus more on the use of alcohol or other drugs.

Common symptoms may include:

• Repeated thoughts, fears, or images that cannot be stopped, resisted, or dismissed
• Severe anxiety if rituals cannot be performed
• Repeated checking, cleaning, counting, organizing, or reassurance-seeking behaviors
• Repetitive thinking, such as repetition of words, phrases, or events
• Avoidance of people, places, and things that trigger obsessive thoughts
• Concealment or shame associated with rituals or substance use
• Alcohol or drug use to relieve feelings of stress
• Growing amounts and frequency of alcohol or drug use
• Intense urges to use drugs and alcohol
• Inability to stop using drugs and alcohol despite a strong desire to do so
• Severe reactions, such as withdrawal when not using alcohol or drugs
• Trouble keeping up with work, school, home responsibilities, or social, family, and friends
• Conflicted feelings about doing rituals versus getting high or drunk

Assessment is thorough and comprehensive.

How OCD and Addiction Are Diagnosed

Usually, licensed mental health and substance use professionals diagnose OCD and addiction. Assessments may include questions about obsessions, compulsions, substance use, physical health history, traumatic events, history of treatment, current medications, and current life difficulties that the symptoms are causing. It's also important to find out whether the symptoms of anxiety and mood are related to substance use, as well as their timing and function. 

They may also ask if alcohol or drugs are currently being used to manage distress related to OCD symptoms, and they will likely inquire about how symptoms fluctuate during periods of sobriety. Getting a diagnosis right is crucial, since OCD is often misunderstood or goes unnoticed; additionally, substance use can make a clinical picture difficult to interpret. A thorough evaluation is key for clinicians when formulating a treatment plan that effectively addresses the compulsions at the core of OCD while also addressing the risks inherent in addiction.

Treatment for OCD and Addiction

Ideally, treatment for co-occurring mental illness and addiction will approach both disorders as intertwined, rather than separate issues. If left unchecked, obsessions and rituals associated with OCD can fuel an individual’s need to self-medicate. Conversely, if addiction is not simultaneously addressed, substance use can erode mental health gains and increase overall instability. 

Treatment may look like:

• Individual therapy that focuses on obsessions and compulsions, avoidance, and triggers for substance use
• Cognitive behavioral and other evidence-based interventions to help patients respond to intrusive thoughts differently
• Exposure work, if clinically indicated and appropriately managed
• Group therapy for support, structure, and accountability
• Planning for relapse prevention including an understanding of OCD triggers and training in distress tolerance
• Mental health care and medication management, if clinically indicated
• Skill building for managing emotions, learning how to tolerate uncertainty, and improving day-to-day functioning
• Treatment that includes family members if loved ones are impacted by rituals, reassurance seeking, or addiction

A successful treatment program will work to reduce symptom severity, improve coping skills, and help people return to a more active and flexible daily life.

Banyan’s Approach to Treating OCD and Addiction

At Banyan Treatment Centers, clinicians first gather a comprehensive picture of OCD symptoms and substance use. We carefully consider what an individual is experiencing related to intrusive thoughts, compulsions, avoidance, substance cravings, and relapse risk. We then incorporate safety concerns, prior treatment, psychiatric history, and present-day functioning to develop an individualized treatment plan. 

Our care model is grounded in evidence-based treatment and holistic support, and we strive to create an environment where patients can focus on their recovery in a non-judgmental setting.

Levels of Care for OCD and Addiction Treatment

The most suitable level of care for OCD and addiction recovery will depend on the person’s symptoms, the degree of disruption to functioning that OCD symptoms are causing, the person’s substance use and related needs, and the availability of supports. Some patients are better served by starting in a highly intensive level of care, while others may do fine with a lower level of treatment from the start.

For adults whose OCD and addiction are so severe that they are significantly impacting their ability to function or stay safe, residential treatment may be best. This highly structured live-in care is a great way to provide a stable setting where consistent and intensive care can be delivered. Partial hospitalization is a day treatment program that offers intensive treatment and support during the day, with the option to go home or to supportive housing at night. It may be a good fit for those who need substantial support but do not need overnight care. Outpatient treatment can offer ongoing treatment and support with added flexibility. It may be a good option for those who have a stable living situation, manageable risk, and adequate supports that allow them to be successful in non-daytime hours. 

For some adults requiring a more structured level of care, virtual Intensive Outpatient Programs via telehealth may be an alternative option. The appropriate level of clinical care must be determined according to an individual's clinical presentation, functioning, and treatment needs.

OCD & Addiction Treatment: What to Expect

Patients are usually assessed thoroughly at the start of treatment and then engage in a discussion about their most distressing symptoms. Following this, the clinical team will determine what treatment is best for the patient, create a treatment plan based on that recommendation, and then continue to modify the plan as the patient progresses through treatment.

In the course of treatment, patients engage in individual counseling, group therapy, mental health visits, coping skills training, and work to overcome their avoidance behavior. Through these modalities of treatment, patients learn how their OCD symptoms contribute to their risk of relapse and how OCD symptoms contribute to cravings, disrupt their daily schedule, and increase their risk of relapse. Treatment aims to help patients reduce the frequency with which they experience distressing intrusive thoughts and the frequency with which they rely on substances to alleviate that distress.