Obsessive-compulsive (OCD)

The most common type of psychological therapy recommended for people with OCD is cognitive behaviour therapy (also called CBT). Other treatment options that may be offered by a psychologist include family therapy, counselling and help with goal setting.

Cognitive behaviour therapy (also called CBT) is used by specialist mental health professionals to change a person’s thinking patterns and behaviour. Therapy includes gently exposing the person to situations that trigger their obsessions and compulsions and helping them to learn ways to resist the compulsive behaviour. These situations are practiced daily until anxiety eventually decreases.

A range of techniques can help a person with OCD to manage their obsessions and compulsions. These include meditation, slow breathing techniques and relaxation training. These techniques are most effective when they are used with a CBT program.

For some people with OCD, antidepressants may be suggested. These can help the brain to restore its chemical balance. Antidepressants can only be prescribed by a medical doctor (GP or psychiatrist). It can take a few weeks before antidepressants start to work and, in that time, they can cause side effects, which should eventually go away. If a person decides to stop taking antidepressants, they should talk to their doctor first, as the dose should be reduced slowly. If the person does not find antidepressants helpful, the doctor may suggest other psychiatric medications.

The doctor needs to know if the person is taking other medications, including prescription, over-the-counter, herbs or supplements, as antidepressants can make some other medications less effective and may cause reactions when combined.

For a person with severe, debilitating OCD who does not respond to the treatments listed above, a psychiatrist may recommend other types of treatment, including: deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS). These approaches are only offered to adults. DBS sends electrical impulses to the brain to help regulate the brain’s abnormal impulses. TMS involves placing an electromagnetic coil against the scalp. Magnetic fields send a pulse to the nerve cells in the brain.

As well as the treatment options discussed above, the person with OCD might find it helpful to try some of the following things:

• Delay the urge to do a compulsive behaviour by distracting yourself with something else (exercise, read, play a game).
• Keep a journal and write down thoughts or worries. Note how repetitive they are.
• Anticipate urges. If the person knows there are certain things they always compulsively check, pay extra attention to doing it the first time (for example, say out loud that it has been done). When the urge to check later comes up, re-label it as “just an obsessive thought” instead of checking again.
• Allocate a set time each day for worrying and leave the rest of the day free of obsessions and compulsions. When thoughts or urges come to mind, write them down and wait until the “worry time” to do them.

More ideas via Better Health Channel.

It may be helpful to learn more about OCD by reading websites like this one, information sheets from health professionals, and talking to professionals and other people who have OCD (or family members with OCD), either through support groups or online forums.