Obsessive Compulsive Disorder (OCD) Treatment
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One of the psychotherapies best known for treating obsessive compulsive disorder, or OCD, is Cognitive Behavior Therapy (CBT). In CBT, a therapist will help you to look at your thinking patterns, and how these are connected to your emotions and behaviors; then, by helping you change one of these you'll learn that you can effect the other two. In other words, by changing your behavior, you can change your thoughts and emotions; by changing your thoughts, you can change your behaviors and emotions; and by changing your emotions, you can change your behavior and thoughts. While CBT is one of the most effective psychotherapies for OCD, it's still not a cure and isn't as effective as we would like it to be.
More recently, we've begun using a skill called mindfulness in the treatment of OCD. Mindfulness is about staying in the present moment, and bringing acceptance to whatever you experience in the present moment. Researchers have found this very useful in the treatment of OCD, because it helps people to detach from their thoughts and see that their thoughts are just thoughts, not facts.
An excellent book that focuses on the use of mindfulness with OCD is Brain Lock by Jeffrey Schwartz. He has done a lot of research on OCD and on the efficacy of using mindfulness and some additional skills to treat this anxiety disorder.
Medications are often used to treat this disorder as well, but again are not a cure and often don't provide the results we would like. Most often, it's a combination of medication and psychotherapy that is the most effective treatment for OCD, but this depends on the severity of the illness.
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Some people with obsessive compulsive disorder (OCD) will take a type of medicine called a selective serotonin reuptake inhibitor, SSRI for short. This is a tablet taken once or twice every day for as long as needed. The medicine can help people feel less anxious. Some people with OCD do cognitive behavioral therapy (CBT), some take medication and some do both.
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Obsessive-compulsive disorder (OCD) is usually treated with a combination of psychotherapy and medication management. In this video, psychiatrist Sue Varma, MD, discusses how cognitive behavioral therapy and SSRI medications can work to treat OCD.
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Obsessive-compulsive disorder is a type of anxiety disorder, and anxiety disorders in general are treated with either psychotherapy, medication, or a combination of both. If you are a veteran with obsessive-compulsive disorder, the most recommended therapy is CBT (cognitive-behavioral therapy). The cognitive part of CBT focuses on the patterns of thinking behind your fears, and the behavioral part works on changing how you react to the situations or triggers that create anxiety for you.
The type of medication most often prescribed for obsessive-compulsive disorder are the SSRIs, or serotonin reuptake inhibitors. Brand names of SSRIs include Prozac, Zoloft, Paxil, Celexa, and Lexapro. SSRIs relieve anxiety symptoms by blocking the reabsorption (reuptake) of serotonin in the brain. This makes more serotonin available in the brain, which improves your mood. The SSRIs drugs for OCD are sometimes prescribed in higher doses than for other anxiety disorders, which raises the risk of side effects. Some OCD patients can recover to a substantial degree without medication.
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In most cases, obsessive compulsive-disorder (OCD) is a lifelong disorder. A 40-year follow-up study of patients with OCD admitted to hospitals, and published, found that more than 80% improved but only 20% made a complete recovery. Most of the improvement occurred early in the course of the illness, and about 50% continued to have OCD for more than 30 years, although they often learned to cope with the symptoms.
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Obsessive compulsive disorder (OCD) plus bipolar disorder is, in my view, the psychopharmacologist's Mount Everest. When we have to use medications for OCD, the only ones that work very well are serotonin antidepressants (selective serotonin reuptake inhibitors [SSRIs] or Anafranil). Sometimes the atypical antipsychotics also can play a role. In order to avoid inducing manias, mixed states, and rapid cycling, we try to make as much progress as possible with a cognitive behavioral therapy called graded exposure and response prevention. In this therapy, one intentionally exposes oneself to stimuli that would ordinarily induce the desire to engage in a compulsion. Then one uses relaxation techniques to resist the urge to do the compulsion. Most patients find that if they do this, with lots of practice, they can ride out the urge to enact the compulsion and it passes. Similarly, a technique called thought stopping can be used to deal with obsessions.
However, there are lots of patients with bipolar disorder and OCD who also require medications. My personal approach is to be sure I have a rock stable mood by using mood stabilizers optimally, and then introducing Anafranil. One can also use other SSRIs, but my experience with them is that they are typically highly destabilizing for bipolar patients.
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Deep brain stimulation is surgery used in treatment of Parkinson's disease. In this video, Wayne Goodman, MD, chairman of the Department of Psychiatry at the Mount Sinai School of Medicine, discusses whether the treatment works for OCD.
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Unlike drug therapy for OCD, behavior therapy has no side effects. In this video, Wayne Goodman, MD, chairman of the Department of Psychiatry at the Mount Sinai School of Medicine, describes the advantages of behavior therapy for OCD.
