Although OCD was once thought of as difficult to treat, in reality, more than two-thirds of people respond well to treatment for OCD, which includes medication, cognitive-behavioral therapy, surgery and self-help strategies. Let's learn more about the different types of treatment for OCD.
Medication is an Effective Treatment for OCD
Medical treatment for OCD has focused on drugs called serotonin reuptake inhibitors (SSRIs). Well-known SSRIs include Prozac (Fluoxetine), Zoloft (Sertraline), and Paxil (Paroxetine). Anafranil (Clomipramine), a tricyclic antidepressant, also may be used as a treatment for OCD.
Although these medications are often called antidepressants, they are effective in treating anxiety disorders such as OCD, too. These drugs are thought to work by increasing the amount of serotonin that is available within the brain. Problems with serotonin may be an important cause of OCD
SSRIs may take up to 12 weeks at high doses to most fully reduce your symptoms, so it is important that you consistently take your medication. If one type of SSRI does not prove beneficial, your physician may try another SSRI or augment it with other types of medications. Common side effects reported by people taking SSRIs are problems with sleep and sex drive. However, most people are able to tolerate this kind of treatment for OCD without major difficulty.
In cases where a single medication does not work, some patients may benefit from the addition of an antipsychotic medication.
Cognitive-Behavioral Therapy is a Proven Treatment for OCD
Cognitive-behavioral techniques (CBT) also have proven highly effective in treating symptoms of OCD, as well as preventing relapse. CBT aims to fix the harmful patterns of thinking and behavior that often accompany OCD. Exposure and response prevention (ERP) therapy, a form of CBT, is also effective for OCD. In ERP therapy, you are gradually exposed to the specific obsessions or situations that provoke your anxiety. At the same time, you are taught ways to avoid using the ritual or compulsion that is normally used to reduce your anxiety.
Although exposure therapy is effective, it can be stressful, as it requires that you face what you fear most. Unfortunately, about one-quarter of people with OCD do not want to take part in behavioral therapy, and an additional 20% drop out of treatment once they have started. CBT also requires commitment and hard work. The structure can vary, but CBT may involve weekly sessions over a period of a few months with a therapist, and often involves homework.
CBT works as well as medication and the effects may be longer-lasting, although a combination of CBT and medication may be the best treatment choice for some people. The decision to take a drug or to begin psychotherapy (or a combination of both) is a decision that can only be made by you, with the guidance of health professionals.
Treatment for OCD can Include Self-Help
Self-help options can be used alone or in combination with these other treatments. Numerous self-help books have been written on coping with OCD, and many of the books have been written from a cognitive behavioral perspective and may suggest homework assignments that are designed to help you manage your symptoms.
Additional self-help strategies include deep breathing or mindfulness meditation, regular exercise, keeping a daily journal, participation in activities or hobbies that provide a distraction.
Surgery may be a last resort for the small number of people whose symptoms don't improve after trying all currently available medical and/or cognitive-behavioral techniques. A very small minority of individuals with OCD have symptoms severe enough to consider brain surgery. Surgical procedures for OCD involve inactivating certain brain regions that are responsible for the symptoms associated with OCD. In most cases, approximately 50% to 70% of people who have these procedures see a significant improvement in symptoms.
Deep-brain stimulation -- a new and exciting technique that has been effective in treating severe depression and Parkinson's disease -- could hold promise for treating OCD. Deep-brain stimulation involves implanting an electrode in the brain that can turn different regions on and off. It is important to note that while there have been some promising case reports for psychiatric illnesses, deep-brain stimulation is not yet an established treatment for any of mental illness including OCD.
Larson, Paul. "Deep brain stimulation for psychiatric disorders". Neurotherapeutics January 2008 5: 50-58. 01 September 2008.
Schruers, K., Koning, K., Luermans, J., Haack, M. J., & Griez, E. "Obsessive-compulsive disorder: a critical review of therapeutic perspectives". Acta psychiatrica Scandinavica 15 February 2005 111:261-271. 01 September 2008.