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Obsessive-Compulsive Disorder (Part 2)

How is obsessive-compulsive disorder (OCD) treated?

The first step is to talk with your doctor or health care provider about your symptoms. Asking questions and providing information to your health care provider can improve your care.

Your health care provider will perform a physical exam, and ask you about your health history to make sure that your symptoms are not caused by other illnesses or conditions. Your health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, social worker, or counselor, for further evaluation or treatment.

Treatment for OCD typically includes specific types of psychotherapy, such as cognitive behavioral therapy (CBT), medication, or a combination of the two. A mental health professional can talk about the benefits and risks associated with different treatment options and help identify the best treatment for you. Sometimes people with OCD also have other mental illnesses, such as anxiety, depression, and body dysmorphic disorder, a disorder in which someone mistakenly believes that a part of their body is abnormal. It is important to consider these other disorders when making decisions about treatment.

It is important to follow your treatment plan because both psychotherapy and medication can take some time to work. Although there is no cure for OCD, current treatments help many people with the disorder manage their symptoms, engage in day-to-day activities, and lead full, active lives.

Psychotherapy

Psychotherapy can be an effective treatment for adults and children with OCD. Research shows that certain types of psychotherapy, including CBT and other related therapies (such as habit-reversal training), can be as effective as medication for many people. For others, psychotherapy may be most effective when used in combination with medication.

Research shows that a specific type of CBT called exposure and response prevention (ERP) is effective for reducing compulsive behaviors, even for people who did not respond well to medication. With ERP, people spend time in a situation that triggers their compulsion (such as touching dirty objects) and they are prevented from engaging in their typical compulsion (such as handwashing). Although this approach may cause feelings of anxiety at first, compulsions decrease for most people as they continue treatment.

Children with OCD may need additional help from family members and health care providers when it comes to recognizing and managing their OCD symptoms. Mental health professionals can work with young patients to identify strategies for managing stress and increasing support so that the children are able to manage their OCD symptoms at school and at home.

Medication

Your health care provider may prescribe medication to help treat OCD. Serotonin reuptake inhibitors (SRIs) are the most common type of medication prescribed for the treatment of OCD.

SRIs, including selective serotonin reuptake inhibitors (SSRIs), are often used to treat depression, and they also are helpful for treating symptoms of OCD. With SRI treatment, it may take up to 8 to 12 weeks before symptoms begin to improve, and treatment for OCD may require higher SRI doses than are typically used in treating depression. For some people, these medications may cause side effects, such as headaches, nausea, or difficulty sleeping.

People respond to medication in different ways, but most people with OCD find that medication, often in combination with psychotherapy, can help them manage their symptoms.

Your health care provider can adjust medication doses over time to minimize any side effects or withdrawal symptoms. Do not stop taking your medication without talking to your health care provider first. Your health care provider will work with you to monitor your health and can adjust the treatment plan in a safe and effective way.

The most up-to-date information on medications, side effects, and warnings is available on the U.S. Food and Drug Administration (FDA) website: Link opens in a new windowhttps://www.accessdata.fda.gov/scripts/cder/daf/index.cfm.

Other Treatments

In 2018, the FDA approved the use of transcranial magnetic stimulation (TMS), most commonly used in treating depression, as an add-on treatment for adults with OCD. You can learn more about brain stimulation therapies, including TMS, on the National Institute of Mental Health (NIMH) website: Link opens in a new windowhttps://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml.

Beyond Treatment: Things You Can Do

There are several important things you can do to manage stress and anxiety associated with OCD:

• Create a consistent sleep schedule.
• Make regular exercise a part of your routine.
• Eat a healthy, balanced diet.
• Seek support from trusted family and friends.

Where can I go for help?

If you're not sure where to get help, your health care provider is a good place to start. Your health care provider can refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating OCD and can evaluate your symptoms.

In addition to your employee support program, you can learn more about getting help and finding a health care provider on the NIMH's Help for Mental Illnesses webpage: Link opens in a new windowhttps://www.nimh.nih.gov/health/find-help/index.shtml.

I know someone who is in crisis. What do I do?

If you or someone you know is having thoughts about wanting to die or is thinking about hurting themselves or someone else, get help quickly:

• Do not leave a person who is in crisis alone.
• Call 911 or go to the nearest hospital emergency room.
• Call the toll-free 988 Suicide & Crisis Lifeline at 988 or 800-273-TALK (800-273-8255), or visit Link opens in a new windowhttps://988lifeline.org. You also can text the Crisis Text Line (text HELLO to 741741) or go to the website (Link opens in a new windowhttps://www.crisistextline.org). These services are confidential, free, and available 24/7.