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Addiction: Disease or Mental Illness?

​There are many who would say that addiction is not a disease or a mental illness. I would like to draw a parallel between two mental disorders to prove that addiction is a disease. Addiction is very similar to obsessive-compulsive disorder. When we think of OCD we tend to think of someone who is really organized. But that is not an accurate description of OCD. OCD is characterized by an irrational obsession that leads to extremely high levels of anxiety. Once anxiety is present a compulsion is acted upon in an effort to relieve anxiety. While compulsion is being actuated anxiety is lessened, but as soon as the compulsion is stopped the anxiety comes back worse because it is reinforced by the obsession. The obsession is driving the anxiety and the compulsion gives credibility to the obsession thus people who suffer from OCD get stuck in a cycle.


Cycle of OCD

Obsession -> Anxiety -> Compulsion -> Anxiety reinforced by Obsession



Let me illustrate what I just explained. Lets say someone has OCD and their obsession is that they will contract some viral disease that will kill them. Being exposed to any type of germs creates high levels of anxiety. The compulsion to try to lessen the anxiety is to wash their hands. While washing their hands the anxiety melts away because they feel they are clean from the germs. The second they grab a towel to dry their hands their obsessions kicks in and says, “there’s germs on the towel”. So the person will wash their hands again, and again only to have the same outcome. Then they get stuck in a cycle of OCD. And you may see someone who suffers from OCD wash their hands 300 times in a day until their hands are cracked and bleeding. This obviously creates a problem for people and it’s easy to see how OCD is a mental disorder.



How does OCD relate to addiction? Addicts suffer the same cycle as someone with OCD. For drug addicts the obsession is the results of the drug. For example with methamphetamines the obsession is the high, escape, numbing, or all of the above. When a drug addict is without their drug (obsession) they get high levels of anxiety manifested through a craving. These levels of anxiety are comparable to OCD, they are very intense and are intrusive in the lives of the individual. Make no mistake extreme anxiety is truly suffering. The addict’s compulsion is to use the drug. While high the anxiety is relieved, but as soon as the high wears off the anxiety comes right back stronger than before. At this point the addict reverts back to their compulsion reinforced by the obsession. And they get stuck in the same cycle.


Cycle of Addiction with Substance Use

Obsession (Effects of Drug) -> Anxiety (Craving) -> Compulsion (Use Drug) -> Anxiety reinforced by Obsession (Guilt, shame, embarrassment, craving)


The parallels between OCD and Addiction are obvious. I make this observation in an effort to help those who would argue that addiction is simply a choice and not a disease or mental disorder. Addiction to drugs may have been a choice initially but once someone is addicted it has become a disease and a mental disorder.


Tycen Sigler, CSW, Treats Addictions and Compulsive Behaviors

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