The earlier you seek treatment for
obsessive-compulsive disorder (OCD), the better. Early
treatment of OCD can reduce symptoms and reduce the disruption the illness can
create in your life. Unfortunately, research shows that most people see an
average of 3 to 4 health professionals and spend more than 9 years seeking
treatment for OCD before they are correctly diagnosed.4 Their diagnoses are complicated by their being embarrassed or
secretive about their symptoms and by other conditions they may have along with
OCD, such as depression.
Treatment includes a combination of
professional counseling and medicines.
Depending on the severity of
your symptoms, your doctor may prescribe only counseling or counseling and an
antidepressant, such as fluoxetine (for example,
Prozac), fluvoxamine (Luvox), or sertraline (Zoloft). For severely ill people
who cannot function in a job or in social situations because of their symptoms,
it is recommended that medicines be tried first before counseling.4
- Obsessive-Compulsive Disorder: Should I Take Medicine for OCD?
A type of
cognitive-behavioral therapy called
exposure and response prevention is considered the
most effective type of counseling for
OCD.4 With exposure and
response prevention therapy, you repeatedly expose yourself to an obsession,
such as something you fear is contaminated, and deny yourself the ritual
compulsive act, which in this case would be washing your hands. This therapy is
done with a therapist or on your own with direction from your therapist.
In the beginning of exposure and response prevention therapy, your
therapist may ask you to write a list of your obsessions, rituals
(compulsions), and things that you avoid and then have you rank the amount of
anxiety each of the obsessions causes from highest to lowest. You might begin
exposing yourself to an obsession that causes a moderate amount of anxiety and
then work your way up the list to the obsession that causes the most
Therapists often combine exposure and response prevention
therapy with cognitive-behavioral therapy to help overcome the faulty beliefs
(such as fear of contamination) that lead to OCD behaviors.
Your doctor may first prescribe an antidepressant called
a selective serotonin reuptake inhibitor (SSRI), such as fluoxetine (for
example, Prozac), or a tricyclic antidepressant, such as clomipramine. You may
start to feel better within 1 to 3 weeks of taking an SSRI. But it can take as
many as 12 weeks to see more improvement. If you have questions or concerns
about your medicines, or if you do not notice any improvement by 3 weeks, talk
to your doctor. Your doctor may increase the dosage of your medicine or change
to another SSRI if the first medicine prescribed doesn't help.
Ongoing treatment for
OCD includes monitoring the dosage and effectiveness
of your medicines. Your doctor may want you to stay on one medicine for at
least 10 to 12 weeks before trying a different antidepressant. Although
antidepressants are considered the most effective medicine for OCD, researchers
are studying whether other medicines can be
combined with antidepressants for better results.