OCD doesn’t go away on its own, and it has no cure. You can’t ignore it or think your way out of the repetitive thoughts and behaviors that control your life. What you can control is your decision to get treatment.
The first step is to see your doctor. An exam will show if your symptoms are the result of a physical issue. If they’re not, your doctor can recommend a mental illness specialist, like a psychologist, therapist, or social worker, who can create a plan for you. If you are considering medication, they may refer you to a psychiatrist as well.
For many people, combining talk therapy and medication works best.
Cognitive behavioral therapy (CBT). OCD has a cycle: obsessions, anxiety, compulsions, and relief. CBT, a type of psychotherapy, gives you tools to think, act, and react to your unhealthy thoughts and habits. The goal is to replace negative thoughts with productive ones.
Exposure and response prevention (ERP). This is a specific form of CBT. As the name suggests, you’ll be exposed to the things that trigger your anxiety, a little at a time. You'll learn new ways to respond to them in place of your repetitive rituals. ERP is a process you may do one-on-one with your mental health professional or in group therapy, either by yourself or with your family there.
Medication. Antidepressants are often the first medications prescribed for OCD. It doesn’t necessarily mean that you are depressed, it’s just that antidepressant also treats OCD. Your doctor may have you try clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), sertraline (Zoloft), or another antidepressant, depending on your age, health, and symptoms.
Buspirone (BuSpar) is an anti-anxiety drug that is sometimes used to treat chronic anxiety and is helpful for panic, as well as OCD. You’ll need to take it for a few weeks before seeing full relief of symptoms.
Some anticonvulsant drugs (such as gabapentin [Neurontin] or pregabalin [Lyrica]), some blood pressure medications (such as propranolol), and some atypical antipsychotics (such as aripiprazole or quetiapine or Seroquel) are also occasionally used "off label" to treat anxiety symptoms or disorders.
It can take a couple of months for OCD drugs to start to work. They also can give you side effects, like dry mouth, nausea, and thoughts of suicide. Call your doctor or 911 right away if you have thoughts about killing yourself.
Take your medication regularly and on schedule. If you don’t like the side effects or if you feel better and want to stop taking your medicine, ask your doctor how to taper off safely. If you miss a few doses or stop cold turkey, you could have side effects or a relapse.
Other treatments. Sometimes OCD doesn’t respond well to medication or therapy. Experimental treatments for severe cases of OCD include:
- Clinical trials. You could join research trials to test unproven therapies.
- Deep brain stimulation, where you get electrodes surgically implanted in your brain
- Electroconvulsive therapy. Electrodes attached to your head give you electric shocks to start seizures, which make your brain release hormones like serotonin.
Your treatment goals for OCD are to retrain your brain and to control your symptoms with the least amount of medication possible. Set yourself up for success physically by eating healthy food, exercising, and getting enough sleep. Emotional support matters, too: Surround yourself with encouraging family, friends, and people who understand OCD.