What is Obsessive Compulsive Disorder? 

OCD occurs when someone becomes trapped in a repetitive cycle of obsessions and compulsions. 

While many people experience obsessive thoughts or engage in compulsive behaviors at some point, this does not mean everyone has "a bit of OCD." For a diagnosis of OCD to be made, these cycles of obsessions and compulsions must be severe enough to consume significant time—more than an hour a day—cause considerable distress, or interfere with important aspects of the person’s life. 

Obsessions 

Obsessions are repetitive thoughts, images, or impulses that occur uncontrollably and feel beyond the person’s ability to manage. Individuals with OCD do not wish to experience these thoughts and often find them distressing.  

Compulsions 

Compulsions are repetitive actions or thoughts a person performs in response to their obsessions, aiming to reduce or neutralize them.  

Therapy for OCD 

Exposure and Response Prevention (ERP), a specific type of Cognitive Behavioral Therapy (CBT), is the first-line treatment for OCD.  

In therapy, patients are gradually exposed to situations or images related to their obsessions that they typically avoid or fear (exposure), while refraining from performing their compulsive rituals (ritual prevention). By staying in feared situations without performing their rituals and experiencing no negative outcomes, patients learn that their fearful thoughts are just thoughts, and the dreaded consequences do not happen even without the rituals. Over time, they gain confidence in their ability to manage their thoughts without relying on compulsive behaviors, resulting in reduced anxiety. 

Acceptance and Commitment Therapy (ACT) helps people with OCD to change their relationship with their OCD symptoms and move towards a more values-driven life. ACT views thoughts and behaviors as adaptable and fluid. In contrast to CBT and ERP, it focuses less on reducing the uncomfortable inner experiences that obsessions can create, and more on altering how they are experienced in the moment.  

Dialectical behavioral therapy (DBT) is a form of psychological treatment with the goal of helping people learn how to respond effectively to difficult feelings, relationships, and life situations. DBT can be used as a supplement to ERP because it involves learning a range of different skills to respond effectively more when urges to engage in compulsions arise. 

Mindfulness-based therapy (MBT) can help people with OCD learn mindfulness — the acceptance and awareness of present emotions and thoughts. MBT has been found to be an effective adjunct to ERP. It works by helping people with OCD shift away from the reactive fear, distress, anxiety, and/or disgust that arises from symptoms, and toward a mindset of acceptance and detachment. 

Medication for OCD 

Selective serotonin reuptake inhibitors (SSRIs) are another first-line treatment for OCD. Numerous studies have demonstrated that SSRIs are typically effective in treating OCD, often outperforming other types of medications. 

OCD typically requires a combined approach of both therapy and an SSRI/SRI for the best outcomes.  

Lifestyle Changes for Success with OCD 

• Avoid doom scrolling and social media: Social media use reinforces compulsive behavior. Posting and checking is a compulsive behavior in itself. 

• Get enough sleep: Aim for at least seven hours per night. Avoid looking at blue light (computer and phone screens) before bed. If you frequently wake in the middle of the night, get tested for sleep apnea. 

• Exercise: 45 minutes a day of gentle exercise, like biking or walking, gives you the full anti-anxiety benefits. 

• Proper nutrition: The brain needs nutrients to function. Be sure you are eating enough protein, whole grains, vegetables, and fruits. Consider taking a multivitamin as well.  

• Practice mindfulness: Meditation and other mindfulness techniques reinforce the work you do in therapy.