OCD and Alcohol: Does Drinking Actually Make OCD Symptoms Worse?

For many people who suffer from obsessive-compulsive disorder (OCD), the feeling of calm and elevated mood they experience when drinking alcohol is a welcome reprieve from the nagging fear of the intrusive thoughts or compulsive behaviors that burden them. However, that momentary relief can sometimes culminate in more severe problems—addiction. 

Does that mean that if you struggle with OCD and want to enjoy a drink from time to time, alcohol is strictly off-limits? Certainly not, but if you find yourself using alcohol to manage your obsessions and compulsion, or you are taking medications and alcohol is contraindicated, then maybe drinking alcohol is not the wisest choice in this situation. 

This article will explore the connection between OCD and alcohol so you can feel empowered with the decisions you make. 

How Alcohol Can Worsen OCD Symptoms

If you suffer from OCD and drink regularly, you’re not alone. Sometimes simply knowing that fact can help with guilt around drinking. Clinically significant alcohol or drug use has been found in 24-40 percent of people with OCD, with alcohol being the most commonly abused substance. Unfortunately, however, drinking presents unique risks for people with OCD and can make OCD symptoms worse.

Some people may get rebound symptoms after the alcohol wears off and then feel that the OCD is worse than it was before due to the surge with which it returns. Others may start to worry about what they did while using alcohol, therefore developing obsessions or compulsions related to the time when they were tipsy or drunk. 

OCD and Alcohol: Why You Feel Worse When The Buzz Wears Off 

Alcohol might have symptom-relieving qualities when it acts on the brain of people with OCD because it produces an increase of serotonin activity in the brain. This effect of alcohol on the levels of serotonin in the brain can occur after just one drinking session, but they are short-lived (meaning OCD symptoms return, often feeling worse once effects of alcohol wear off).

While alcohol has been found to increase the activity of serotonin transporters in the brain, it also depletes existing serotonin in brain cells. Translation: drinking alcohol gives a rush of good feelings, then a period of bad feelings. Coupled with the potential that those who suffer with OCD may have poor serotonin regulation, it makes sense that people with OCD often complain of worsening symptoms!

Are there Ways to Responsibly Drink If You Have OCD? 

It bears repeating: Many people with OCD do, in fact, experience increased symptom severity due to the effect of alcohol on the unique structure and function of the OCD brain, though this will not be the case for all. The decision to consume alcohol as a person with OCD must be made with the awareness that alcohol acts differently on the brain of those with OCD and that those with OCD are prone to developing an addiction to alcohol or other substances. Ultimately, the answer to the question about whether you can continue drinking if you have OCD is a very personal response that you, together with a medical professional, can make.

That said, if you’re concerned about your drinking and what to keep tabs on your consumption, here are some helpful tips:

• Know what abnormal drinking levels are. There is a common misconception regarding alcohol consumption and what “normal” levels of consumption are. An important first step is becoming more aware of what normal drinking habits are and examining whether you or someone you love, might have a drinking problem.  For information on moderate, binge, and heavy drinking definitions and descriptions visit the National Institute on Alcohol and Alcoholism. 
• Know when to get help for your drinking. Have you found it difficult to stop drinking, once you start? Have others told you that you drink more than you should, or that you drink too much? If the answer to any of these questions is yes, you might benefit from reaching out to your mental health provider, medical doctor, or another qualified medical professional for help. Contact the SAMHSA National Helpline (1800-622-HELP) which is available 24 hours a day, seven days a week for free and confidential assistance if you think you might have a problem with drinking. SAMHSA is not a counseling or treatment service; however, SAMSHA can connect you with services in your community.

Access therapy that’s designed for OCD

If you’d like to seek help with managing your OCD in healthy ways, you can access effective treatment. Here at NOCD, our licensed therapists are specialty-trained in treating OCD with exposure and response prevention (ERP) therapy, the gold standard for OCD treatment, and can assist you in handling spikes in OCD symptoms or relapses due to alcohol intake. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP. At NOCD, all therapists specialize in OCD and receive ERP-specific training.