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Addictions & Compulsive Disorders

    Even though science has come a long way to help us understand the medical underpinnings of addiction, there is still a "stigma" attached to being diagnosed with an addictive disorder, that somehow, you "lack moral character" and it is your "fault." Even though no one would blame you for heart disease or high blood pressure, the same does not usually hold true for a diagnosis of addiction. Instead, the person who uses various chemicals (drugs and alcohol) or behaviors (compulsive gambling, sexual activity, binge eating or anorexia) to cope with and quell uncomfortable feeling states, and is labeled a "bad person" rather than someone who is suffering from a treatable illness.

    Research has also shown a link between addiction and Compulsive disorders. Compulsive disorders, more commonly known as obsessive compulsive disorder (OCD) are usually comprised of behaviors that employ a set of rigid rules and rituals that are used to avoid intense fear and anxiety. They may include excessive hand washing or grooming, repeatedly cleaning the same room or object over and over, shopping for unnecessary things, hoarding or saving things because you are afraid to throw anything away, or continuous "checking" to make sure and object (door or drawer) is shut or lights (or appliances) are turned off. These repetitive behaviors can become overwhelming and paralyze everyday life. CHANGE is possible and appropriate treatment can offer relief and freedom from the merry-go-round of these incontrollable habitual behaviors.

   OCD is considered to be a chronic condition that can be therapeutically controlled but never really cured. Research has demonstrated that the longer the condition has been left untreated, the more the behaviors become entrenched and therefore harder to change. For example, an adult who has always washed his hands 20 times before eating or retiring for the evening will likely find it hard to reverse a deeply engrained habit without intensive therapy. If caught early however, (i.e., in children and teens), prognosis is usually much better because they can usually remember a life without these rituals.

    However, if an addiction masks an OCD diagnosis, a person might miss a vital window of treatment opportunity. And, while OCD doesn’t typically transform into other mental health issues, individuals who do not receive proper treatment can develop other mental health issues such as Depression, Generalized anxiety disorder, PTSD, or Agoraphobia.

    The first course of medical intervention usually includes prescribing an SSRI antidepressant, since they have been found to be effective and do not have severe side effects. SSRIs (selective serotonin reuptake inhibitors) treat OCD by increasing the serotonin available in the brain. This class of drugs include Fluvoxamine (Luvox), Fluoxetine (Prozac), Sertraline (Zoloft), and Paroxetine (Paxil). If SSRI antidepressants are ineffective, Clomipramine, a Tricyclic antidepressant, may be prescribed. Clomipramine has been shown to be more effective than SSRI antidepressants but it has more numerous and unpleasant side effects (including sedation, urinary retention, orthostatic hypotension, and dry mouth) and therefore patients are less likely to remain compliant with the treatment regimen.

    Behavioral therapy interventions can also include exposure therapy (repeated exposure to a situation that triggers anxiety symptoms, and learns to resist the urge to perform the compulsion) and Thought stopping (learning to stop unwanted thoughts and focus attention on relieving anxiety). Psychoanalytically-oriented psychotherapy can be implemented in both short-term and long-term therapy depending on the treatment goal. Both frameworks focus on exploring unconscious drives and unresolved childhood conflicts that seem to continually resurface in adult life and prevent healthy attachment and intimacy with others.

This mode of therapy is a process and therefore, there may be times of great frustration along the way. But keep in mind that it took many years for the problems to develop and it will take time to understand and go through the healing process.

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