Treatment for Obsessive-Compulsive Disorder (OCD)

What Is OCD?

Obsessive-compulsive disorder manifests itself in individuals as thoughts, fears, and reservations that might seem less than reasonable to an outsider. These fears, reservations, and obsessions lead to compulsive behaviors.

In many cases, OCD manifests itself as fear of germs or the need to control certain environments, especially through the specific arrangement of objects.

Stress and worry are two major triggers when it comes to OCD. Self-care techniques like meditation, yoga and relaxation help alleviate inner tension while also boosting self-help skills that can be applied during any times of worry or crisis.

Therapies Related to OCD

Most effective treatments for OCD include a variation of cognitive behavioral therapy (CBT) known as exposure and response prevention (or ERP). 

Exposure With Response Prevention

It is human nature to avoid sources of anxiety, which might alleviate symptoms in the short term, but this can make fears and reservations far worse in the long term.

Exposure and response prevention entails exposing the individual to fears and misgivings in controlled and mild circumstances. The individual is provided with support until fears lessen or subside.

ERP is all about helping the individual manage obsessions and compulsions, giving them healthy tools they can take with them and utilize whenever necessary.

Web-Based CBT

Web-based CBT is another option that is gaining in popularity, especially following the onset of the COVID-19 pandemic. Web-based CBT gives individuals the ability to experience the benefits of therapy from the comfort of their own homes, which increases accessibility. 

Bergen 4-Day OCD Treatment

The Bergen 4-day concentrated exposure approach is a short-term therapy that has been shown to effectively address OCD in a concentrated manner. This approach involves more intensive exposure treatment spanning over four consecutive days.

Studies show that more than 90 percent of participants improve with this approach.

Habit Reversal Training

Habit reversal training is sometimes utilized to introduce competing responses to stimuli. Usually, the competing response is innocuous compared to the individual’s normal reaction, something that is less noticeable. This method includes positive reinforcement and enhanced relaxation techniques.

Medications for OCD

Medication can result in 40 to 60 percent decreases in OCD symptoms, according to the International OCD Foundation. Depending on the individual’s age, there are different forms of medication available.

Serotonin reuptake inhibitors (SSRIs) are the most effective in treating OCD and reducing symptoms. SSRIs are traditionally used as a form of antidepressant, but they also help with managing OCD symptoms effectively. These are the most common forms of medication prescribed to people with obsessive-compulsive disorder.

Popular OCD medications include the following:

• Citalopram (Celexa)
• Clomipramine (Anafranil)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac)
• Fluvoxamine 
• Paroxetine (Paxil and Pexeva)
• Sertraline (Zoloft) 
• Venlafaxine (Effexor)

OCD medications like SSRIs help to alleviate OCD symptoms and increase serotonin levels in the brain. It can often take a few weeks or even one or two months for these medications to take effect.

When combined with therapy, some OCD patients are able to taper off SSRIs successfully and maintain a high quality of life.

Conditions Related to OCD

Certain disorders and conditions share similarities and common characteristics with OCD. These are some of the disorders that commonly co-occur with OCD:

Hoarding Disorder

Hoarding disorder is related to OCD, as individuals with hoarding disorder spend a great deal of time and energy collecting and arranging items. However, individuals with hoarding disorder tend to want to keep the status quo and see nothing wrong with their condition, while a majority of those with OCD recognize their condition as problematic and seek treatment.

Body-Focused Repetitive Behaviors

Individuals who live with body-focused repetitive behaviors (BFRBs) share similarities with individuals with OCD. Both groups engage in repetitive behavior, but those with BFRBs generally perform actions like pulling out body hair or picking at their skin to reduce stress.

People with BFRBs respond well to habit reversal as well as certain forms of medication. 

Body Dysmorphic Disorder

Body dysmorphic disorder is classified as some sort of preoccupation with what an individual perceives to be physical flaws or defects. These “flaws” commonly seem blown out of proportion in the eyes of casual observers.

Body dysmorphic disorder involves repetitive behaviors, such as grooming, comparing oneself to others, or obsessively observing appearance.

Substance Abuse & OCD

Individuals with anxiety disorders such as OCD may be susceptible to co-occurring substance abuse problems.

Alcohol and controlled substances have a way of providing temporary stress relief. Those who use controlled substances in conjunction with having OCD might arrest their fears for fleeting moments, but drugs and alcohol only provide temporary solutions at best. They will often create more problems for the individual down the road.

With prolonged use, controlled substances can ultimately aggravate an individual’s OCD symptoms. Healthy coping mechanisms are far more effective.

The Connection Between OCD & Substance Abuse 

Depending on certain factors like family life, environment, and childhood experiences, individuals with OCD have anywhere from a 10 percent to 40 percent chance of also having a substance abuse issue, according to the Substance Abuse and Mental Health Services Administration.

Both OCD and substance use disorder involve high levels of compulsive behavior. In many cases, a substance use disorder develops secondarily to an anxiety disorder. Substances are generally used to make the individual feel more comfortable.

Treatment for Co-Occurring OCD & Substance Abuse

The right treatment approach for co-occurring OCD and a substance use disorder will vary from person to person.

Most often, treatment for substance abuse includes therapy and support group participation, which helps the individual get to the why behind their substance abuse problem. They’ll also learn to develop healthy coping tools to avoid substance abuse in the future.

Group therapy is often beneficial to those undergoing substance abuse treatment. However, not everyone with OCD will feel comfortable receiving treatment in a group setting. If this is the case for you, talk to your treatment team about the best approach.

Treatment approaches for co-occurring substance use disorder and obsessive-compulsive disorder will often incorporate both ERP and CBT.

Co-occurring disorders treatment is imperative. It helps to ensure that both conditions are addressed appropriately. Isolating each condition and treating it by itself poses the risk of the unaddressed condition getting worse. Full recovery is unlikely unless both conditions are effectively treated.

Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More