What Helps Obsessive Compulsive Disorder?

Although obsessive compulsive disorder (OCD) is highly distressing and disruptive to your life, there are several effective treatments for OCD. First line treatment is cognitive behavioral therapy (CBT). CBT aims to address the maladaptive thinking (obsessions) that induce the anxiety. In addition CBT addresses the behaviors (compulsions) that are focused on reducing the anxiety associated with the anxiety. The problem with OCD is that the anxiety induced by the obsessive thoughts compels you to act to reduce the anxiety…hence the appearance of the compulsive behaviors. And the compulsions serve to reduce the anxiety from the obsessive thoughts. However, the reduction in anxiety is only short-lived, as the intrusive thoughts will come back, and compels you to continue with the obsession-anxiety-compulsion cycle…a never-ending loop of obsessive compulsive anxiety.

For OCD, there is a specific form of CBT that addresses these obsessions and compulsions. It is called exposure and response prevention (ERP). Basically, you are exposed to your feared stimulus (the fear in the obsessions), and prevented from engaging in your escape response (the compulsive behaviors). So if your obsession is a germ contamination fear, and your compulsion is to wash your hands repeatedly, then in ERP, you are exposed to having dirty hands, and prevented from washing them.

If CBT and ERP are not effective for OCD, or if you have severe OCD symptoms, then prescription medications may be considered. SSRIs (selective serotonin reuptake inhibitors) are the mainstay of pharmacotherapy for OCD. Generally, the dosing of SSRIs for OCD is higher than the dosing of SSRIs for depression. For severe OCD, the combination of CBT and SSRIs are effective. However, if you depend entirely on prescription medications to reduce your anxiety symptoms without the skill-building and learning of coping skills in psychotherapy, then your OCD symptoms will most likely return when you discontinue your medications. Learn to eradicate your OCD by engaging in CBT treatment.