You may have landed here because you did a quick Google search on “How is OCD treated?” If you or someone you know lives with obsessive-compulsive disorder (OCD), you might be curious about what you can do to manage this condition.
OCD is a highly treatable mental health disorder in which a person has distressing intrusive thoughts, urges, or images called obsessions—and to cope, they perform repetitive physical or mental actions known as compulsions. This leads to a cycle of obsessions and compulsions that can be broken through evidence-based treatment.
According to Tracie Zinman-Ibrahim, LMFT, CST, a therapist at NOCD, OCD treatment for children and adults is pretty much the same—aside from possible changes in language. “Instead of saying ‘OCD,’ we might talk to children about the ‘worry monster’ or the ‘worry bug,’” she explains. Other than that, there’s not a significant difference in how OCD treatment is administered to children and adults.
Keep reading to find out how OCD is treated in children and adults, plus lifestyle changes you can adopt to support recovery.
Therapy for OCD
There are a few different forms of therapy that can help treat OCD symptoms—although one in particular is backed by the most evidence proving its effectiveness in treating OCD.
Exposure and Response Prevention Therapy for OCD
Exposure and Response Prevention (ERP) therapy is the best treatment for OCD—it’s backed by decades of research demonstrating its effectiveness. This specialized therapy works to break the OCD cycle of obsessions and compulsions by exposing you to what triggers your intrusive thoughts, images, or urges. The second and perhaps most crucial part of ERP focuses on response prevention techniques that teach you how to resist engaging in the compulsions that make OCD worse over time.
A therapist specializing in this gold-standard treatment will guide you through various exercises that will help you stop doing compulsions and learn to accept the uncertainty and doubt that obsessions can bring. “Over time, your brain learns that the irrational fear of obsessions coming from OCD are not actual threats and that you can go live your best life and co-exist with them,” says Zinman-Ibrahim.
On average, it can take about two months of ERP treatment to see a change in your symptoms. But, according to Zinman-Ibrahim, some people may take a bit longer to see results. “Recovery is always dependent on how committed you are to treatment. I’ve had people start feeling better after a few short weeks, and then I’ve had people that are still doing compulsions a lot, and it takes just a little bit longer.”
Learning to manage OCD with ERP therapy can actually be even more efficient through virtual therapy. Research reveals that just 11 hours of virtual ERP led to significant improvements in OCD symptoms. This is less than half the time, on average, it takes for standard therapy to deliver results.
Acceptance and Commitment Therapy (ACT) for OCD
While ERP is typically the first-line treatment, it may sometimes be paired with other types of treatment. Acceptance and Commitment Therapy (ACT) may be recommended when ERP is less successful, or as a way to help people gain ERP skills.
Evidence suggests that ACT is a great supplemental therapy for managing symptoms. Zinman-Ibrahim notes that ACT may be used in conjunction with ERP therapy to increase motivation to continue treatment. “We often put two treatment modalities together for OCD,” she says.
ACT is a type of psychotherapy—or talk therapy—that involves changing your relationship with your obsessions rather than directly confronting your distressing thoughts. “With ACT, you learn to co-exist with intrusive thoughts, images, urges, and feelings without judging them,” says Zinman-Ibrahim. “We don’t want to give meaning to them, but we also don’t want to engage with them. Instead, we move into more non-engaging responses to the intrusions and decide how to respond based on our personal values.”
Unlike ERP, there aren’t many studies that support ACT’s effectiveness in treating OCD alone. “ACT can be helpful, but it doesn’t tend to be a standalone treatment for OCD,” says Zinman-Ibrahim.
Medication for OCD
A number of prescription medications can also increase the effectiveness of ERP therapy for OCD, and have been found effective in decades of research. Medication may be necessary depending on the severity of symptoms, a person’s psychology and neurobiology, or other co-occurring mental health conditions that are also impacting them, such as major depressive disorder.
In these cases, a healthcare professional will develop a treatment plan that combines therapy and medication to increase the chances of long-term recovery.
Common medications used to treat OCD include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and atypical antipsychotics.
If you’re having difficulty progressing through ERP, these medications can help reduce your distress or anxiety to more manageable levels so that you can fully engage in ERP exercises. It can take between 8 to 12 weeks for SSRIs to work—so if this medication is part of your treatment plan, be sure to take it as directed even if you don’t see a quick change in your OCD symptoms.
However, according to Zinman-Ibrahim, taking medication alone for OCD treatment may not be as beneficial. “Multiple studies that have been done that looked at therapy alone, medication alone, and combinations together,” she says. “The least effective was medication by itself and nothing else.”
Different types of medications used for OCD
There are several medications a healthcare professional may prescribe to manage OCD symptoms. Here are specific SSRIs that have been approved by the FDA to treat OCD:
- Sertraline (Zoloft)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Fluvoxamine (Luvox)
- Citalopram (Celexa)
- Escitalopram (Lexapro)
Clomipramine (Anafranil) is the only TCA prescribed for OCD. Atypical antipsychotics, such as aripiprazole (Abilify), risperidone (Risperdal), and haloperidol (Haldol), may be combined with SSRIs and TCAs as part of a person’s treatment plan.
What about side effects?
Like any medication you take, there’s a chance that you may experience some unpleasant side effects while taking SSRIs, TCAs, or atypical antipsychotics.
If you have concerns about the risks of taking medications, Zinman-Ibrahim recommends speaking with an OCD prescriber. “There are specific SSRIs and other medications that are given at a very specific dose range for OCD, so going to someone who is a prescriber who understands that is important,” she says.
Other treatments for OCD beyond therapy and medication
Although OCD therapies and medication are typically the first-line treatments, there are some instances where additional or alternative treatment is necessary to manage symptoms.
Here are some other treatments a healthcare provider may recommend for OCD:
- Transcranial magnetic stimulation (TMS). When traditional therapies like ERP and ACT aren’t effective in treating OCD, medical interventions like TMS may be necessary. TMS is a newer treatment involving short magnetic pulses that stimulate the brain’s neurons (nerve cells). It was initially permitted by the U.S. Food and Drug Administration (FDA) for depression, but research revealed that it could also relieve symptoms of OCD–leading to the FDA’s approval in 2018. “TMS highlights a very specific part of your brain, and it regulates the neural activity of the brain structures associated with OCD,” says Zinman-Ibrahim. She adds that deep TMS, a subtype of TMS, can be very effective for treatment-resistant OCD, possibly leading to a 30% or more decrease in symptoms.
- Deep brain stimulation (DBS). A surgical procedure that uses electrical stimulation to encourage changes in brain activity. Electrodes are implanted in the brain to create electrical impulses strong enough to restore normal brain activity. DBS may be helpful for chronic, severe, or treatment-resistant OCD.
- Intensive outpatient programs (IOPs). If you have severe OCD symptoms, have difficulties completing out-of-session therapy practices, or aren’t progressing in treatment, you may need an intensive outpatient program. These programs typically require 8 to 15 hours of therapy delivered over several weeks.
- Gamma knife radiosurgery (GKRS). GKRS is a safe and non-invasive treatment for refractory or treatment-resistant OCD. During this procedure, several radiation beams target nerve fibers in the front of the brain that may be causing OCD.
In the words of Jamie Feusner, MD, “There is always hope—even if other treatments haven’t worked, it’s still possible to find a plan that allows you to conquer OCD.” If typical research-backed forms of treatment haven’t worked for you in the past, you can still get help from a licensed professional who specializes in OCD and try other methods.
Lifestyle habits that can make a difference for OCD symptoms
As you navigate OCD treatment, make sure you’re taking care of other aspects of your life, too. “You can do all the therapy and medications you want, but you can still have lifestyle issues that increase your symptoms and slow down your results,” says Zinman-Ibrahim. Here are some lifestyle habits you can implement to support OCD treatment:
- Get enough sleep. Living with OCD may impact your sleep–and vice versa. Research reveals that people with OCD are more likely to have insomnia—a common sleep disorder. “With less sleep, you have less time to process and rejuvenate to do what you need to do. Practicing good sleep hygiene, such as sleeping and waking up at the same time every day, can support OCD treatment.
- Exercise. Physical activity can also benefit OCD. A study involving 15 participants found that a 12-week aerobic exercise (e.g., walking, running, bicycling, swimming) program significantly reduced OCD symptoms months after the study commenced.
- Take nutritional supplements. Certain vitamins, herbs, and minerals are natural remedies that may help with OCD. Selenium, vitamin B12, n-acetyl cysteine (NAC), and adaptogens are a few evidence-based supplements that have been shown to reduce symptoms of this mental health disorder.
- Avoid or limit caffeine consumption. While coffee and energy drinks are quick energy boosters, they may worsen your OCD symptoms. Caffeine doses of at least 400 milligrams (mg) may trigger anxiety and potentially OCD symptoms. “People with anxiety and OCD often feel an increase in their symptoms when they do things like drink coffee,” says Zinman-Ibrahim.
- Have self-compassion. Don’t be hard on yourself when you face challenges during OCD treatment.“Be kind to yourself and realize it’s hard to deal with OCD and that we don’t make up these intrusive thoughts ourselves,” says Zinman-Ibrahim. “Nobody does anything perfectly.”
- Practice mindfulness. Mindfulness is being fully present and aware of your feelings, thoughts, and surroundings. Mindfulness practices help you process intrusive thoughts and resist doing a compulsion to get rid of them. A few ways to practice mindfulness include taking purposeful breaks throughout the day and doing seated or moving meditations.
- Find a community. You don’t have to go through recovery by yourself. “A lot of people with OCD will isolate themselves away from others because of fear, embarrassment, or shame,” says Zinman-Ibrahim. “This can often make symptoms worse.” She recommends finding in-person or online communities, such as a support group, that can be there to support you during recovery.
While these lifestyle changes can be great for your OCD and overall well-being, Zinman-Ibrahim emphasizes they are not a replacement for therapy or medication. “These tips aren’t necessarily treatments,” she says. “They have more to do with looking at the holistic picture and putting yourself in a position where professional treatment will be as helpful as possible.”