Treatment of Obsessive-Compulsive Disorder (OCD)

Written by Angela Lacalamita, MA, LCPC

What is Obsessive-Compulsive Disorder (OCD)? OCD is an anxiety disorder that results in obsessive thoughts and/or compulsive behaviors. Obsessions are defined as recurrent, uncontrollable, intrusive thoughts or mental pictures that produce anxiety, fear or worry. Compulsions are repeated actions aimed to reduce the anxiety, fear or worry. People that suffer from OCD will try to control their obsessive thoughts by checking things over repeatedly or perform rituals. Some common obsessions may include: fear of getting a disease/ contamination or unreasonable fear or worry that if things are not perfect, something terrible will occur. Common compulsions may include repeated hand washing or showering, repeatedly checking the stove, door locks, electrical outlets, the need to perform a task a certain number of times or saving things/ hoarding items that may not have value.

OCD can progress to a point where it can significantly interfere with one’s ability to function productively in social, family, work and academic settings.  Dependent on the severity of the symptoms, it could potentially result in one becoming homebound.

What causes OCD? Researchers have not confirmed the exact cause of OCD. However, biological and environmental factors play a significant role. Biological factors point to the neurotransmitters serotonin and dopamine. Experts believe that there are insufficient levels of the neurotransmitter serotonin and over activity of dopamine. More recent studies that have used brain imaging have discovered over activity in certain parts of the brain. Another contributing factor is having a genetic predisposition to OCD due to a family member having OCD or another anxiety disorder. Environmental factors such as stress and/or life transitions can potentially trigger OCD in those who may be psychologically prone.

What are the treatment approaches for OCD?  The American Psychological Association recommends that that use of SSRI medication (selective serotonin reuptake inhibitors) and/ or cognitive behavioral therapy be used in treating OCD. Experts maintain that the use of SSRI’s is an effective approach in manipulating the serotonin level in the body, thus allowing it to be available for other nerve cells. Another approach to treating OCD is through the use of the different treatment approaches within Cognitive Behavioral Therapy (CBT). One effective approach in treating OCD is using Exposure and Response Prevention. This approach is aimed at reducing the intrusive thoughts, images or impulses through repeated exposure to the obsession. The exposure is used to learn more effective thinking patterns and develop adaptive coping skills to manage the anxiety. The response prevention refers to making the decision to resist the compulsion. With gradual and repeated exposure, the individual becomes less anxious resulting in reducing and refraining from engaging in compulsive behavior.

Cognitive behavioral therapy in conjunction with a SSRI medication seems to offer the best long results. Treatment results vary by individual; however most individuals can significantly reduce their symptoms and regain control of their lives.