Obsessive-compulsive disorder (OCD) is a mental condition defined by anxiety-inducing obsessive thoughts and beliefs, and the behaviors that are compulsively performed to ease the obsessions. Since this behavior ends up adding to the individual’s anxiety instead of soothing it, both the obsessive thoughts and compulsive actions that define OCD end up amplifying one another, necessitating treatment that can offer the individual suffering from OCD symptom relief. There are currently several established OCD treatment options, each offering its own level of efficacy and possible side effects. It is recommended you consult with your doctor to find the treatment best suited to your symptoms and needs.
Deep TMS: Deep Transcranial Magnetic Stimulation (Deep TMS™) is a unique treatment course that uses magnetic fields to safely, effectively, and non-invasively reach brain structures associated with mental health conditions.
Deep TMS has been FDA-cleared to treat OCD since 2018, due to its ability to offer substantial relief to those battling this condition. This finding was confirmed by a 2019 multicenter, sham-controlled clinical study published in the American Journal of Psychiatry, which determined Deep TMS to effectively and safely alleviate symptoms of OCD, even among those patients who had not sufficiently improved from medication or therapy.
As a non-invasive form of therapy, Deep TMS does not require anesthesia, can be incorporated into the individuals’ daily routine and does not cause any long-lasting or significant side effects.
Cognitive Behavioral Therapy: CBT is a form of talk therapy that is considered a first-line treatment for OCD. Under the guidance of a trained mental health professional, CBT focuses on the thoughts, feelings, behaviors and physical reactions involved in OCD. This is done in an effort to familiarize the patient with the condition’s different facets and gradually help alleviate its symptoms. In treating OCD, cognitive therapy aims to assist individuals in recognizing and understanding the erroneous messages sent by their brains. Through guidance from a therapist, you’ll develop the ability to identify these messages and adopt new strategies to manage your obsessions and compulsions effectively. This therapy emphasizes examining the interpretations we assign to specific experiences that may be distorted or misunderstood. In cognitive therapy for OCD, the main focus is on how individuals deal with negative thoughts. While many people can easily brush off such thoughts with a dismissive attitude like “that’s just a silly thought,” some individuals hold onto the belief that all thoughts carry significant meaning. As a result, instead of being able to simply let go of these negative thoughts, their beliefs compel them to react differently.
Over the years, several different types of therapy have branched out of CBT to offer patients with OCD greater symptom relief. Most notably among them is acceptance and commitment therapy (ACT): ACT promotes openness and flexibility when reacting to OCD symptoms, as the therapist helps the patient define and follow through with a commitment to their own well-being.
Exposure and response therapy (ERP) is an additional form of therapy found to effectively treat OCD. ERP helps the patient overcome their OCD by gradually exposing them to stimuli they associate with OCD-inducing anxiety. The patient is encouraged to refrain from reacting to the stimuli in a compulsory manner, and over time they become accustomed to managing OCD-related, anxiety-raising behavior. Exposure and response prevention (ERP) is the primary psychotherapeutic approach for treating OCD, falling under the umbrella of cognitive-behavioral therapy (CBT). The pace of exposure is tailored to each individual, ensuring that they are never pressured into confronting anything they’re not ready for.
Initially, you’ll work with your therapist to identify and rank your obsessions and compulsions from least to most distressing. Then, you’ll begin facing these fears, starting with the least anxiety-provoking ones. For instance, you have a fear of driving on highways due to a traumatic experience. Your therapist might suggest exposure therapy by gradually exposing you to driving situations, starting with less intimidating routes such as quiet residential streets. Initially, you might only drive for a short distance, gradually increasing the duration and complexity of your trips. Throughout this process, you’d refrain from your usual coping mechanism, such as avoiding highways or pulling over frequently. By gradually confronting your fear and resisting the urge to avoid it, you can reclaim your confidence and ability to drive on highways without excessive anxiety.
Learn more about ERP for OCD and read examples of its application at choosingtherapy.com
Psychopharmacology: Medication is another form of therapy often considered a first-line treatment course for OCD.
The FDA has approved several selective serotonin reuptake inhibitors (SSRIs), such as the branded medications Prozac and Zoloft, as well as one tricyclic antidepressant (TCA) to treat the condition, with SSRIs being the most commonly prescribed class of medication.
Though many patients battling OCD symptoms attest to the relief psychopharmacology has provided them, many also experience a number of side effects, and may decide to discontinue this form of treatment due to their severity.
Psychodynamic Therapy: Another form of therapy found to offer some relief to patients with OCD is psychodynamics. This treatment explores the relationships and events found, among other features of their life, to be fundamental to the patient’s sense of self, view of the world and personal narrative. These elements are then examined in relation to the adverse OCD symptoms they are experiencing, in an effort to understand the deeper reasons behind the ways they respond to the anxiety their condition produces within them. Over time, the patient is hopefully able to move away from automatically responding to their induced anxiety, as more flexible, pacifying and beneficial reactions take their place.
Despite the above-mentioned options available for those battling OCD, some patients do not experience relief from first-line or non-invasive OCD treatment options. As a result, treatment-resistant patients may be offered neurosurgical options by the healthcare professionals treating them.
Recent studies relying on different neurological lesion methods have shown some level of efficacy in alleviating OCD symptoms among treatment-resistant patients. These methods include gamma knife coagulative lesions, implanting radioactive seeds that cause local ablations, and standard craniotomy. Ablative, neurosurgical options always focus on the cortico-striato-thalamo-cortical circuit of the brain, which is believed to become hyperactive in patients facing OCD.
In addition to the invasiveness and necessary recovery period following such procedures, it should be stated that studies examining these techniques are normally based on open trials involving a limited number of patients. As a result, their efficacy among the general OCD population has yet to be established, and requires that larger, blinded studies determine how effective they are in alleviating OCD symptoms.
