Patient Education ►
Cannabis and OCD Obsessive Compulsive Disorder by Peter Kershaw , contributing writer
In any given year , around 2.5 million Americans have Obsessive Compulsive Disorder ( OCD ). In all likelihood , the figures are much higher as many who suffer from OCD are too embarrassed to seek diagnosis and treatment . More than three times as many women have the condition than men . People with OCD often suffer in silence , afraid they ’ ll be stigmatized as “ crazy ” if they tell anyone .
Gratefully the stigma is fading , all the more so since several famous and successful people have come out , including the comedian and talk show host Howie Mandel . Mandel ’ s 2009 book Here ’ s The Deal : Don ’ t Touch Me chronicles his life-long struggle with OCD . As we ’ ve learned more about OCD , we can now look back over history and recognize that many brilliant and gifted people struggled with OCD , such as Howard Hughes . OCD is nothing to hide in shame over .
OCD sufferers experience unwanted intrusive and sometimes disturbing thoughts , images , or urges that can trigger intensely distressing feelings . Though they recognize their thoughts are illogical , they ’ re also overwhelmed with anxiety because of their inability to stop them . To establish some sense of control over obsessive thought patterns , they may embrace specific coping mechanisms . This is the “ compulsive ” element of OCD — ritualistic repetitive behaviors to distract them from disturbing thought patterns . For example , insisting that clothing and household items be arranged in specific orders and patterns , obsessing over germs and cleanliness , obsessively checking and rechecking locks , appliances , etc . Intrusive thoughts and images coalesce around specific themes such as safety , harm ( self or others ), religious scrupulosity , relationships , social performance , etc .
OCD patients often demand perfection of themselves , which of course , they can never obtain , and so they tend to emotionally beat themselves up over their perceived “ failures .” These behaviors can prove challenging for loved ones to cope with , but it ’ s important for us to recognize OCDs need these coping mechanisms . The worst thing we can do is criticize the behaviors of OCD patients . Judging them with “ It ’ s all in your head ” will only worsen things .
Pure-O
Another form of OCD is Pure-O ( Purely Obsessional OCD ), in which they experience obsessive thought patterns without compulsive behaviors . Pure-Os often struggle as much as regular OCDs , and in some ways , perhaps more so . Pure-Os may , for example , “ freeze up ” and shut down for hours , unable to complete simple tasks . Because the outward symptoms of Pure-Os are usually less apparent , they may go undiagnosed more readily than regular OCDs . Again , it ’ s
very important to support rather than criticize them . A long and tender hug can go a long way for a Pure-O ( something about that oxytocin ).
The medical establishment offers various pharmaceuticals for OCD with varying degrees of effectiveness . However , they all come with potentially risky and unpleasant side effects . According to the International OCD Foundation , “ About half of OCD patients stop taking their medication due to side effects or for other reasons .” 1 Of even greater efficacy for treating OCD is Exposure and Response Prevention ( ERP ), a form of psychiatric therapy administered by a trained therapist . ERP “ retrains the brain ” over time to stop obsessive thought patterns . The patient can even learn how to use ERP themselves to stop obsessive thoughts .
Cannabis and OCD
OCD is an anxiety disorder . To gain further appreciation for the efficacy of cannabis in treating anxiety in general , see this author ’ s October 2020 article , “ Anxiety and Cannabis .” Please bear in mind that OCD is just one among five specific anxiety disorders , including General Anxiety Disorder , PTSD , Panic Disorder , and Social Anxiety Disorder . Though sharing some similarities , OCD also has attributes that differ from the others . As such , it ’ s not reasonable to assume cannabis is always as effective in treating OCD as other forms of anxiety . Complicating matters is the fact that , to date , control group cannabis studies are scant concerning OCD ( at least in the U . S .) compared to other anxiety disorders . One 2020 study did show promise , but it included only one patient . 2
A 2016 Mexican study noted , “ The use of and dependence on cannabis was found to be greater in the Mexican population among individuals with obsessive-compulsive symptomatology ….” 3 Here , we ’ ll emphasize “ dependence .” There seems little question of an increased risk for triggering OCD from heavy daily cannabis use . Whether heavy use causes OCD or merely triggers a predisposition is debatable . What isn ’ t debatable is that OCD patients who are heavy daily cannabis users should cut way back , if not quit entirely ( at least a couple of weeks ). Too much of a good thing can go bad .
Many OCD patients have reported moderate cannabis use to be of considerable benefit . However , OCD patients should stay clear of high-THC strains ( bred to produce the highest THC at the expense of other cannabinoids ). Stick with more moderate THC strains ( 1:1 THC to CBD strains are ideal ). It should also be noted that depression is common among OCD patients . Again , cannabis has often proven remarkably effective ( see this author ’ s August 2020 article , “ Depression and Cannabis ”).