Therapy For OCD & Other Treatment Options

Obsessive-compulsive disorder is a common mental illness that can affect almost every aspect of your life, from your thoughts and feelings to your daily routines, social interactions and ability to develop and maintain relationships. 

Luckily, like other forms of mental illness, obsessive-compulsive disorder can be treated with a combination of self-care, medication and psychological therapy. 

Below, we’ve explained exactly what obsessive-compulsive disorder is, as well as the symptoms you may experience if you have OCD. 

We’ve also explained how different forms of therapy, either on their own or combined with good habits and the use of medication, can help you to gain control over your thoughts and behaviors and prevent OCD from affecting your quality of life.

Obsessive-compulsive disorder is a mental illness that can cause you to experience unwanted, uncontrollable thoughts that contribute to certain repetitive behaviors.

The thoughts, ideas and sensations caused by OCD are often referred to as obsessions, while the repetitive behaviors that stem from them are referred to as compulsions.

It’s common and perfectly normal to occasionally have irrational thoughts or repetitive, unusual habits. 

For example, you might double or triple-check that your door is locked before you go to sleep, or meticulously organize the contents of your desk. 

Doing these things doesn’t mean that you have OCD. However, if your thoughts are difficult or impossible to control and your compulsive behaviors are rigid, inflexible and disruptive to your daily life, it’s possible that you could have OCD.

Like many other forms of mental illness, OCD is relatively common. According to the National Comorbidity Survey Replication (NCS-R), 1.8 percent of adult women and 0.5 percent of men were affected by OCD in the previous 12 months.

OCD causes thoughts and urges which cause feelings of anxiety. These are typically referred to as obsessions. 

It also causes repetitive behaviors, referred to as obsessions, that can occur in response to these thoughts.

If you have OCD, you may experience one or several of the following obsessions:

• Fears of disease or contamination. You may experience obsessions related to germs, bodily fluids, chemicals, contaminants in the environment or substances such as dirt or mud.

• Worries about losing control of yourself. You may obsess over the risk of losing your self-control and acting impulsively, saying something inappropriate, or harming yourself or another person.

• Obsessive religious beliefs. If you’re religious, you may constantly feel anxious about sinning, blaspheming, or doing something immoral.

• Unwanted sexual obsessions. You may develop obsessive sexual thoughts, including thoughts that make you feel perverse or uncomfortable.

• Obsession with being perfect. You may feel that certain things need to be absolutely perfect. This can result in anxiety about forgetting things, losing certain items or letting your desk, home or other areas become cluttered, disorganized or asymmetrical.

These obsessions may cause one or several of the following compulsions:

• Cleaning obsessively. You may clean your home, bedroom and other spaces on a very frequent basis, even when they’re already clean. This habit may extend to your personal hygiene, causing you to wash your hands, hair or brush your teeth excessively.

• Organizing and arranging items. You may feel a need to organize and arrange certain items in a very precise way, such as books, clothing, or virtual items like files on your PC or mobile device.

• Counting or mentally arranging things. You may start to count in your head while you perform certain tasks to make sure you end on the right number, or mentally review your actions to “undo” things that you perceive as bad.

• Checking that everything is okay. You may constantly check that everything is alright, whether it’s a door that you worry is unlocked or a terrible potential event that you need to check didn’t happen.

• Repeating routine tasks. You may constantly redo certain activities, such as reading or writing information, touching, blinking or moving, or redoing tasks to make sure that you perform them correctly.

Some people with OCD also have motor or vocal tics. These may include repetitive movements such as shoulder shrugging, jerking of your head or shoulders, blinking or suddenly moving your eyes in certain directions.

Common vocal tics that may occur in people with OCD include grunting, sniffing and repeatedly clearing your throat.

OCD and Magical Thinking

A common symptom of obsessive-compulsive disorder is magical thinking — a belief that your thoughts, actions or wishes have a disproportionate impact on real-life events.

For example, if you have OCD, you might feel the urge to count to a specific number or tap on the steering wheel of your car a certain number of times in order to drive safer and lower your risk of being in an accident.

Or, you might have a specific personal routine that you need to go through before boarding a flight to make sure that your journey is safe.

Obviously, doing things like tapping on the steering wheel or packing your luggage in a certain way won’t have any impact on the safety of your journey. 

However, if you have OCD, you may feel a strong connection between your actions and a perceived real-life event. 

Therapy is one of the most effective ways to treat OCD. In fact, research shows that therapy is more effective as a treatment for OCD than medication alone.

Most mental healthcare providers treat obsessive-compulsive disorder either with therapy or by combining therapy with medication for OCD to help you better control your symptoms.

Several different types of psychotherapy are used to treat OCD. Of these, research shows that the most effective forms of therapy are cognitive behavioral therapy (CBT) and an approach to therapy called exposure and response prevention (ERP).

If you think you may have OCD and want to take part in therapy, it’s important to reach out to a mental health professional.

You can do this by talking to your primary care provider, who may provide you with a referral to a psychiatrist, psychologist or other mental health provider.

You can also connect with a licensed psychiatry provider from home using our anxiety treatment online service to take part in a confidential evaluation in a comfortable, private setting. 

Cognitive Behavioural Therapy (CBT)

Cognitive behavioral therapy, or CBT, is a form of therapy that involves identifying false beliefs and thought patterns, then adjusting them to change the effects they can have on your feelings and behavior.

Research shows that CBT is an effective treatment for a diverse range of mental health issues, including OCD, anxiety and depression.

As part of CBT, you’ll learn how to recognize how distorted or obsessive thinking can contribute to your problems, as well as how you can change these thought patterns.

You’ll also practice techniques to modify your behavior, such as learning how you can cope with challenging situations using problem-solving skills instead of compulsions.

Your mental health provider will customize the direction and content of your therapy to deal with your specific obsessions and compulsions. 

You may be given tasks to complete outside of your therapy, such as practicing certain skills or coping with triggering situations.

Over the long term, CBT can help you to gain greater control over your thoughts and behavior, letting you live without letting your OCD symptoms interfere with your quality of life. 

Exposure and Response Prevention (ERP)

One of the most effective forms of cognitive behavioral therapy for OCD is called exposure and response prevention, or ERP. 

ERP involves deliberately exposing yourself to the situations, objects or other things that cause you to develop obsessive thoughts. 

Through ERP, you’ll develop the skills required to resist the urge to engage in compulsive behaviors when you’re exposed to these triggering items.

The main objective of ERP is to stop you from panicking and feeling as if you’re in danger when you encounter something that triggers your obsessive thinking.

ERP can take time, and it’s often a challenging process. However, over time, you’ll start to gain a greater awareness that your obsessions are just thoughts and equip yourself with the mental skills required to contextualize and control them. 

To help you make steady progress, your therapy provider might start with low-anxiety situations before exposing you to more difficult scenarios. 

Intensive Forms of Therapy

Most of the time, OCD improved with regular outpatient therapy — a therapy session one or two times per week.

However, if you have severe OCD that doesn’t improve with regular outpatient therapy, you may need to take part in a more intensive form of therapy.

Mental health professionals offer several forms of focused, intensive therapy for OCD, including intensive treatment day programs, partial hospitalization programs and residential care, in which you’ll live voluntarily in a treatment center while you take part in therapy.

Although uncommon, people with OCD sometimes require inpatient care. This type of treatment is usually only used if a person has severe symptoms that prevent them from properly caring for themself, or if their symptoms make them a safety risk.

Inpatient treatment for OCD is used to stabilize a patient, allowing them to gradually transition to a less intensive form of therapy.

Therapy and Medication

Your healthcare provider may suggest therapy on its own, or prescribe medication for you to use while you’re taking part in therapy.

Several types of medication are used to treat OCD, including a class of antidepressants referred to as selective serotonin reuptake inhibitors, or SSRIs.

SSRIs work by adjusting the levels of certain neurotransmitters in your brain. They often help to control the symptoms of OCD. However, they may take between eight to 12 weeks to produce a noticeable improvement in your symptoms.

In some cases, your healthcare provider may prescribe an older type of antidepressant, such as a tricyclic antidepressant, to control your symptoms. 

Research shows that the following antidepressants are effective at treating OCD:

• Citalopram (sold as Celexa®)

• Clomipramine (Anafranil®)

• Escitalopram (Lexapro®)

• Fluoxetine (Prozac®)

• Fluvoxamine (Luvox®)

• Paroxetine (Paxil®)

• Sertraline (Zoloft®)

• Venlafaxine (Effexor®)

If you’re prescribed medication for OCD, make sure to take it at the correct dosage and closely follow the instructions provided by your healthcare provider. Inform your healthcare provider if you develop any side effects during treatment. 

Other Treatments for OCD

Most of the time, therapy on its own or in combination with medication is effective at controlling the symptoms of OCD.

In addition to these treatment methods, several other treatments are being studied as potential options for severe OCD. 

These include transcranial magnetic stimulation (TMS), brain surgery, deep brain stimulation (DBS) and gamma knife, a brain treatment that uses gamma rays. 

These treatments aren’t commonly used to treat OCD, although they may be used in situations where other treatments have failed to produce improvements. 

Self-Care Techniques for OCD

While therapy alone is often effective at treating OCD, it becomes much more effective when it’s combined with the right habits and self-care techniques. 

Try the following self-care techniques to improve your results and make progress towards taking control of your OCD:

• Remember that you’re not “going crazy.” Obsessive-compulsive disorder affects lots of people. It’s a common mental illness that can affect the lives of people of all ages and backgrounds. Instead of thinking of OCD as a personal weakness that defines you as a person, try to think of it as a solvable problem that you can and will overcome.

• Focus on making gradual improvements. Therapy for OCD works, but the results are rarely immediate. Focus on making steady, gradual improvements to how you think and behave over the course of several months, not overnight changes. This could mean doing something small like opening a door without washing your hands after. Over time, small changes can make a huge positive impact and help you to avoid falling back on your compulsive rituals when you feel stressed.

• Consider taking part in a support group. Group therapy is a great way to discuss your symptoms and make progress with others. Try visiting a local support group, or consider taking part in our online therapy groups to access expert help from home.

• Focus on your physical health too. Keeping yourself physically healthy is an important part of improving your mental health, as it ensures you’re in the best possible situation to complete the therapy program. Try to keep yourself physically healthy by exercising, eating a balanced diet, getting lots of fluids and ensuring you sleep for long enough to feel fully rested.

• Keep notes of your obsessions and compulsions. One way to track your progress is to keep a journal of your mental health journey. Try making a note whenever you feel an obsessive thought so that you can track changes in your thinking over time. 

Obsessive-compulsive disorder is a common mental health condition that can occur in people of all ages and backgrounds. 

If you’re affected by OCD, in person or online therapy can help you to gain control over your symptoms and enjoy a higher quality of life, either on its own or in combination with medication and self-care.

To get started with therapy for OCD, it’s best to talk to your primary care provider or schedule an appointment with a mental health professional to discuss your symptoms. 

You can also talk to a licensed psychiatrist or therapist with our online mental health services for an evaluation and personalized treatment plan that may include appropriate medication.