Obsessive-compulsive disorder (OCD) treatment is not a cure for the disorder, but it can help someone with OCD manage their symptoms. The first step to treating an OCD patient is getting their symptoms under control. While some people may see improvements earlier in treatment, other people may require treatment for the rest of their lives.
Therapies for OCD
Psychotherapy is the primary treatment suggestion for individuals living with compulsions and obsessive behavior. Many different therapies have been successful for OCD patients. Depending on the patient’s needs, their mental health professional will choose the best type of therapy for their disorder.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) for OCD helps the patient understand that their brain is sending false messages, causing their irrational behavior. Through CBT the patient can learn to recognize these messages and respond to them in new ways, rather than with compulsive behavior. Cognitive behavioral therapy can help a patient learn to control obsessions and compulsions. This type of therapy may help the individual step back and examine their thoughts. For example, instead of thinking that a friend is ignoring the patient, they should try to understand that maybe their friend had something else on their mind and didn’t notice the patient.
Aversion therapy is a behavior modification therapy, and this type of therapy can be successful with compulsive disorders. Some therapists suggest managing compulsive behavior such as nail biting, skin picking, hair pulling and other behaviors through aversion therapy. The behavior modification may be as simple as snapping a rubber band on the wrist or as extreme as receiving an electric shock.
Common aversion therapy consists of patients thinking about the unwanted experience that they enjoy, then the negative aversion is given. For example, a violent person may see images of violent crime or an alcoholic might have to drink while he or she smells an unbearable smell, takes drugs that cause sickness or receive electric shocks. The patient may soon associate the behavior with the horrible memory or sickness.
The purpose of psychoeducation is to help individuals understand their mental health condition. This is commonly the first step in any therapy program. People who have a full understanding of the challenges they face as well as the resources available, often complete treatment with a better result than people who are resistant. Psychoeducation allows individuals with OCD to address their challenges and feels more in control of the condition.
Rational Emotive Behavior Therapy
The very first step in rational emotive behavior therapy (REBT) is to identify the unreasonable thoughts, feelings and beliefs that lead to stress. When an individual possesses an unyielding expectation of themselves, almost every situation may lead to disappointment, regret and anxiety.
Even when the patient has identified the problem that is responsible for causing these thoughts, the process of actually changing the thoughts can be very challenging. Rational emotive behavior therapy uses cognitive strategies to help individuals respond rationally to such situations.
Exposure and Response Prevention
Exposure and response prevention (ERP) is a specific style of cognitive-behavioral therapy. As the name advocates, the therapist may gradually expose the patient to items that may activate their anxiety. After responding with their natural reactions, the patients can learn new ways to respond to these triggers. A mental health professional can administer ERP one-on-one or in group therapy with other people struggling from OCD or the families of the patients.
Systematic desensitization is a procedure that includes the gradual exposure of stimuli that the patient would most usually avoid. For patients with OCD, the therapist may expose their clients to an unclean environment or something small like a messy junk drawer. This process is only for patients who have a predisposition to either clean or organize.
The goal of the systematic desensitization treatment is to expose the client to increasing levels of anxiety-inducing events and eventually reduce the amount of anxiety experienced toward the end of treatment.
There are three phases to this type of treatment. First, the patient is taught a deep muscle relaxation technique and breathing exercises because fears involve tension and tension is incompatible with relaxation. Second, the patient creates a fear ladder list, with stimuli that creates the least anxiety at the bottom and the stimuli that creates the most fear at the top. The patient works through each step of their fear ladder starting at the bottom. When they feel comfortable with one step, they move on to the next step in the ladder.
Group therapy for OCD is an effective treatment because of the social support system it provides. Much of the patient’s struggles associated with OCD is a result of feeling isolated because of their disorder. Group therapy allows the patient to recognize that they are not alone and that other people understand their challenges. They may gain new ideas for dealing with their disorder from other people in the group.
By attending therapy in a group setting, the patient can receive encouragement and motivation from other group members.
Medications Used for Treating OCD
There are medications which may help control the obsessions and compulsions of OCD. Most commonly, antidepressants are tried first before a physician prescribes another type of medication.
Medications known as selective serotonin reuptake inhibitors (SSRIs) have been used to treat OCD patients. These medications offer a different chemical structure than more potent antidepressants. The primary job of SSRIs is to help the brain maintain enough supply of the neurotransmitter serotonin. Serotonin deficiency links depression and OCD.
It’s important to remember that SSRI medications for OCD do not work immediately. A patient may start seeing improvement after a few weeks, though it could take 10 to 12 weeks to see the full benefits of a medication.
An anxiolytic is a medication which obstructs anxiety. Therapists usually prescribe these to individuals who have tried SSRI medications and failed to see improvements. Anxiolytic medications are strong medications, and they are dangerous and addicting substances.
While OCD is very different from depression, some medications that were originally used to treat depression may also be effective for anxiety disorders like OCD. Anti-depressant medications are usually taken for several weeks before symptoms start to dissipate. Patients may get discouraged and stop taking these medications when they do not see relief of their symptoms within a few days. It is important to give the medication a chance to work.
Antidepressants are often the first medications prescribed for OCD. The patient’s doctor may prescribe Prozac for OCD to allow the individual to calm their uncontrollable behavior. Zoloft is another antidepressant prescribed often, depending on the patient’s age, health and symptoms.
Treating OCD and Co-Occurring Substance Abuse
If someone tries to seek treatment for OCD while continuing to use drugs or alcohol, they may continue to experience severe obsessive behaviors and symptoms. Therapy after detox is the ideal component of treatment for a co-occurring OCD and addiction, which may occur in an outpatient setting or residential facility. Behavioral therapies are often the most useful to the patient for helping them to understand how their current behaviors are hindering their treatment and exacerbating symptoms.
Treatment usually involves developing strategies to avoid drug use. Some of these strategies include making positive lifestyle changes, finding new hobbies, relying on the support of loved ones and developing action plans in the case of a setback.
Treatment can help patients set and achieve goals and learn to use healthy coping and relaxation techniques. Patients learn to recognize their negative behaviors and how to make positive direction changes.
If you are or a loved are struggling with a substance use and co-occurring disorder like OCD, The Recovery Village can help. A staff of professionals offers a continuum of care for substance use and co-occurring disorder treatment. Call and speak with a representative to learn more about which program could work for you.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.