The misuse of addiction vs. compulsion causes confusion for everyone, especially those experiencing these conditions. However, it also creates confusion for professionals trying to help people progress through treatment.
Addiction vs. Compulsion
In order to understand the meaning of the two terms, it is essential to look at the common features that they share as well as their key differences. Addiction is a broad term used to describe the process by which someone becomes dependent on a particular substance or behavior. In contrast, compulsion is a narrow term used to describe the intense urge to do something, which can sometimes lead to a behavior. Compulsions are also a symptom of obsessive-compulsive disorder (OCD). Someone with OCD may have a compulsion to engage in a behavior like washing their hands, tying their shoes, or checking the stove as a way of trying to alleviate anxiety. Compulsions in OCD are often directly related to obsessions, which are repeated thoughts that generate distress.
Pleasure vs. Relief
A major distinction between addiction and compulsion is the way they are perceived. People with OCD may feel a sense of relief when taking part in compulsive behavior, but they don’t feel pleasure; someone with an addiction, however, does experience pleasure through their behavior, at least at the onset. For someone with OCD, compulsions develop as a way to mitigate the anxiety or fear that their obsessions are causing. Someone with an obsession with contamination, for example, may develop compulsions that involve excessive washing and cleaning. In the case of addiction, the desire to use the substance or engage in the behavior involves an expectation that it will be pleasurable. This expectation of pleasure is so strong that someone with an addiction will continue their behavior even in spite of the negative consequences it can cause, like:
Financial problems Health issues and physical discomfort Social disapproval Legal consequences Decreased self-esteem
For people with addictions, there often comes a point where they don’t really enjoy the addictive behavior. Instead, they are just seeking relief from the urge to engage in it. This is compounded by the experience of withdrawal that often happens when they stop taking the substance or engaging in the behavior. Although this can resemble the way someone with OCD engages in compulsions because the pleasure is gone, the original motivation to engage in the behavior was to feel good.
Denial vs. Reality
Another major distinction between an addiction and a compulsion has to do with awareness and acceptance of reality. Someone with OCD may often be aware that their obsessions are not realistic or that their compulsions are excessive or illogical. They may even feel disturbed by their thoughts and their need to carry out a compulsive behavior, yet they do it anyway to relieve their distress. In contrast, people with addictions often have memory and cognitive impairment and lack this same level of insight. They may not recognize the negative consequences their addiction is causing. This is known as denial, and it’s a core component of the addictive process in the brain.
Treatment
Addiction and OCD can both cause major disruptions in your life. However, both conditions are treatable, and it’s important to seek professional help.
Treatment for Compulsions
Treatment for OCD may involve a combination of medication and therapy:
Medications can include antidepressants like selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), and your doctor may augment these with an antipsychotic. Therapy for OCD is generally a form of cognitive behavioral therapy (CBT), which involves learning to recognize and change your thought patterns. Exposure therapy is often helpful for people with OCD, as it helps you learn how to tolerate anxiety-inducing objects or thoughts without performing a compulsion.
Treatment for Addiction
Treatment for addiction can vary based on what you are addicted to. If your addiction involves a substance, your doctor may prescribe medication to help you detox safely and deal with symptoms of withdrawal. Your doctor may also prescribe medication to address the neurochemistry associated with pleasure in the brain. For example, naltrexone is a medication that blocks the sense of pleasure induced by opiates. Your doctor may prescribe this medication to block compulsions related to cravings for alcohol and opiates, as well as for behavioral addictions. Therapy is also an important component of addiction treatment. This may include individual or group counseling, as well as a stay in a residential treatment facility.
A Word From Verywell
While addition and compulsion share some commonalities, they mean different things. Compulsions do play a part in addiction, but these are different than the compulsive behaviors that people engage in as part of OCD. If you are experiencing compulsions or an addiction, talking to your doctor or mental health professional is an important first step. By getting an accurate diagnosis, a health professional can recommend appropriate treatments that can help. For more mental health resources, see our National Helpline Database.
