Treatments for Obsessive Compulsive Disorder

You have Obsessive Compulsive Disorder and you are searching for treatments that work. You are in a great deal of pain. And you wonder if you are crazy. (You are not!)

Obsessive Compulsive Disorder (OCD) is a bear of a disorder. Not one of those cute, little, pudgy brown bears that eat your hot dogs while you are camping out in the middle of a RV site in New Hampshire. No, it’s a mean, crazed, nearly-starved grizzly bear that discovers you, all alone, when you are the only food to be found for hundreds of miles. Sorry to tell you, friend, but without a really great exit strategy, the grizzly will get you. So, too, is it with OCD.

Like all people with psychiatric disorders, those with Obsessive Compulsive Disorder want an easy fix. Unfortunately, there is none. Treatments that help get rid of OCD take work. A lot of it. But the good news is that treatments can work. People with OCD can learn to manage their symptoms. With enough work, many experience a great deal of relief. Some almost forget they ever had symptoms. Let’s look at what works.

As a therapist with a specialty in OCD, I’m pretty familiar with techniques and treatments that work. So I’ll give you my shpeel. In case you don’t know, shpeel is my ‘big talk.’

OCD can be as nasty as the grizzly you just met. So planning a combat strategy takes some serious thought. One of my first suggestions to clients with moderate to severe OCD is that they consider medication. The reason for this is simple. OCD is a neurological disorder. While you may be super smart (and most people with OCD are,) your brain’s circuitry and danger alert system don’t always work properly. Medication is often necessary to make them function more effectively. At the very least, medication can help take the edge off, while learning strategies for handling the disorder. Working through OCD is hard. If there is a way to make the work a little easier, why not pursue it? Although the reasons for why they work is unclear, SSRIs such as Prozac, Zoloft, Paxil, Celexa, Luvox help. These drugs do not make all obsessions go away, but they make the victim of these obsessions care about them a whole lot less. If you want to consider medications, it is wise to work with a psychiatrist familiar with OCD.

As to therapy, some approaches work well and others not at all.Although OCD is often triggered by a catalyst found in life’s experience, reviewing your early childhood usually does not get you far. The techniques that work are Exposure, Response Prevention and Cognitive Restructuring.

Those with OCD get stuck in horrific thoughts. These thoughts violate everything in which the person believes. A gentle soul imagines slitting the throats of innocent kids. A devoutly religious person imagines screaming obscenities in church. Because the person with OCD is tortured by ‘what if,’ as in what if I actually do these things, tremendous, nauseating anxiety accompanies these thoughts. In an attempt to get rid of the thoughts, people engage in rituals (compulsions) that make no sense to others. These rituals provide relief, although very temporary, from the anxiety.

The goal of Exposure and Response Prevention is to help people learn to tolerate the anxiety brought on by obsessional thoughts. Exposure and Response Prevention works like this. Working with a therapist(or on your own) you will make a list of your obsessions, rating the distress level caused by each. Then, starting with those obsessions which cause the least distress, you will expose yourself to situations which bring on these obsessions. But rather than engaging in a compulsion to lessen your anxiety, you will tolerate the anxiety by deep breathing or another relaxation technique. You will continue to expose yourself to obsessional situations (and refrain from engaging in compulsions) until you feel that that obsession is manageable. At this point, you will move on to tackle a higher level obsession. I promise you this. Over time, you will find yourself less and less bothered by your thoughts. Think of the hungry grizzly. If you don’t feed him and don’t offer yourself as food, eventually he will get annoyed and go away.