OCD is usually treated with a combination of behavior therapies and prescription
medications.
Cognitive behavioral therapies (CBT):
These treatments aim to examine and evaluate a person's fears and to develop
appropriate methods of coping with stress and anxiety. People react differently
to CBT, and although it is not associated with many side effects, people will
experience some anxiety during treatment. Common therapies include the following:
- Exposure and response prevention (ERP) - With this therapy, a person
with OCD is exposed to situations that provoke obsessive thoughts, but is
prevented from performing the usual compulsive ritual. For example, the person
may be asked to touch a dirty cup and then wait for a predetermined length
of time before washing their hands.
- Habit reversal - In this therapy, the person is asked to substitute
a different response (such as deep breathing) for the usual compulsive ritual.
- Thought stopping - This therapy involves thought stopping and distraction
whenever an obsessive thought appears. However, this is usually less effective
than other types of CBT.
- Saturation - This approach asks the patient to concentrate intensely
on the obsessive thought until the thought loses its impact and becomes meaningless.
As with thought stopping, this technique is usually less effective than other
types of CBT.
Prescription medications:
Most medications used to treat OCD affect levels of serotonin, a chemical messenger
in the brain. The most effective medications for OCD are antidepressants such
as fluoxetine, paroxetine, fluvoxamine, and sertraline. These medications belong
to a class of medications called selective serotonin reuptake inhibitors (SSRIs).
SSRIs work by increasing levels of serotonin in certain areas of the brain.
Clomipramine, a nonselective serotonin reuptake inhibitor, is also commonly
used. Clomipramine and the SSRIs are used in their normal antidepressant dosage
ranges to treat OCD. Note that it may take six to eight weeks to produce a noticeable
change in OCD symptoms and that a minimum six-week trial at full dosages is
required to fully evaluate the medication's effectiveness. People with OCD must
work closely with their doctor and pharmacist to find the most effective medication
with tolerable side effects.
What the family can do to help:
OCD affects the entire family of a person with this disorder. Family members
may have difficulty accepting that the person with OCD cannot stop the disruptive
behavior. They may feel angry and resentful. But families can learn ways to
encourage and support the person with OCD to seek help and follow through with
treatment. Some families find that family therapists trained in OCD can help
them deal with their loved one's disorder.
For more information, contact the National Mental Health Association or the National Institute of Mental Health.