Treatment options
A combination of targeted therapy and medication is considered the most effective treatment approach for OCD.
Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) is a kind of psychotherapy that aims to change unhelpful thinking patterns or unhelpful behaviour. It is used to treat a wide range of mental health issues, and there are different types of Cognitive Behavioural Therapies. Exposure and Response Prevention (ERP) has shown to be the most effective form of CBT when treating OCD, but we have also included some information about Acceptance and Commitment Therapy (ACT), which is also used to treat OCD.
Exposure and Response Prevention Therapy (ERP)
ERP is found to be the most effective form of Cognitive Behaviour Therapy (CBT) for treating OCD.
ERP involves purposefully exposing yourself to your fears. It has two components; exposing yourself to the thoughts, situations, images or objects that start your obsessions (exposure) and then stopping the compulsion carried out to make you feel ‘safe’ or less anxious (response prevention). The idea of ERP can sound VERY SCARY, however it is always carried out under the guidance of a therapist (at least to begin with). By resisting compulsions when triggered, over time you become habituated to your fear and anxiety levels drop.
In other words, it can be bloody hard to begin with, but it gets easier!
Acceptance and Commitment Therapy (ACT)
ACT involves recognising and emphasising your values, while learning to accept thoughts, feelings and emotions as they are. There is less emphasis on reducing the inner experience (the obsessions) and more of a focus on changing the way they are experienced. ACT doesn’t necessarily seek to alter or decrease obsessions, but to change the way you respond to them. Mindfulness Based CBT takes a similar approach. Russ Harris is highly regarded in ACT and has helpful resources to explore.
Does a traditional counselling approach work for OCD?
Generally speaking, OCD will respond best to pretty specific forms of therapy, as outlined above. This isn’t to say that more traditional forms of counselling won’t be beneficial for some, but because the thoughts and obsessions aren’t logical most of the time, trying to merely ‘talk through’ the fears might only fuel the patient’s need for reassurance and encourage them to further engage in the behaviour that is causing them so much distress.
Medication
Medication can be an effective treatment for OCD symptoms. Selective Serotonin Reuptake Inhibitors (SSRIs), which are traditionally used to treat depression and anxiety, have been found to be effective at addressing OCD symptoms. 40-60% of patients will respond to an SSRI medication, however, it’s hard to predict which variety of SSRI an individual will respond best to. It should be pointed out that not all antidepressant medications will be effective for the treatment of OCD.
It is important to note that there are many different SSRI’s that can be used to treat OCD. You can find a great list of these medications, as well as useful information about dosage and usage, here.
Consult an expert
It is extremely important to consult your psychiatrist or doctor before starting or adjusting your medication. It can be dangerous to stop taking any medication suddenly and can lead to dizziness, vertigo, electric shock sensations in the head (‘brain zaps’), flu-like symptoms, a relapse of your OCD or anxiety, and even suicidal thoughts. It is advisable to make a plan with an expert and come off, or increase the medication slowly so your brain can adjust to the change.
OCD symptoms can be so serious and distressing that they can lead to suicide. If you are considering suicide please call Lifeline on 13 11 14 or if you are not in Australia contact the emergency services number relevant to your country.
Before you see a professional, we recommend getting a mental health plan. This will give you access to a number of Medicare-rebated sessions with a psychologist.