OCD Treatment From a Psychiatrist

Obsessive-compulsive disorder, or OCD, is a chronic, debilitating mental disorder. Although it is common, it often leaves people feeling isolated. Fortunately, OCD treatment from a psychiatrist can provide much-needed relief from the endless cycle of unwanted thoughts, anxiety, and repetitive behaviors.

Understanding OCD

OCD is classified by the obsessive-compulsive cycle, in which obsessions fuel compulsions. Obsessions are unwanted thoughts that cause anxiety (intrusive thoughts). To get rid of that anxiety, the person will complete compulsions, which are repetitive actions meant to eliminate or neutralize the thought. The internal thought process here is that if they do not do the compulsion, then the intrusive thought will come true. However, compulsions only provide temporary relief. Without treatment, the obsessive-compulsive cycle will continue.

The most common example of this is a fear of germs. With this subtype of OCD, the intrusive thought may be that the individual will get sick if they do not wash their hands properly. The compulsion may be that they need to wash their hands four times to ensure cleanliness. The more a person gives into this compulsion, the worse their symptoms become. For example, they may soon find themselves washing their hands eight times every time they use the bathroom.

OCD classifications

Intrusive thoughts prey on what a person values the most. This is part of what makes OCD so distressing. It is also why there are many classifications of OCD, such as:

• Contamination OCD: Overwhelming fear of germs or getting sick.
• Harm OCD: Overwhelming fear of causing harm to oneself or others, either on accident or on purpose.
• Perfectionism OCD (“just right” OCD): An all-consuming need to have things be “just right,” such as needing belongings to be lined up symmetrically.
• Relationship OCD (ROCD): Intense fear of being in the wrong relationship, accidentally cheating on one’s partner, or that one’s partner does not love them. 
• Scrupulosity OCD (religious or morality OCD): Overwhelming fear of acting immorally or out of line with one’s religious beliefs.
• Sexual OCD: Distressing fear of being sexually attracted to family, children, and others.
• Sexuality orientation and gender identity OCD: Intense anxiety over whether one is lying to themself about their sexuality or gender identity.

OCD treatment

Although there are many OCD subtypes, treatment for each type will use the same approach. Identifying the subtype allows the psychiatrist to customize treatment for the patient. This also ensures lesser-known manifestations of OCD (such as harm OCD) do not go untreated. For instance, it is common for individuals with OCD to deal with contamination obsessions in addition to harm or perfectionism obsessions. Any untreated OCD subtype tends to get worse with time.

After diagnosing OCD, a psychiatrist will likely recommend OCD treatment through medication or therapy. These methods are typically combined to make treatment possible. Many patients struggle to go through therapy without medication because their obsessions are too distressing. This poses a problem as therapy is often necessary to provide lasting relief for OCD.

OCD therapy

Part of the gold-standard treatment for OCD is a type of cognitive behavioral therapy (CBT) known as exposure and response prevention (ERP). With ERP, the patient gradually exposes themselves to their fears (exposures), then works to prevent compulsions (response prevention). The goal is to take the power away from the obsession by learning to sit with the uncertainty and anxiety it causes.

For a patient with contamination OCD, exposure may look like touching an object they deem dirty (such as a doorknob). The response prevention would be choosing not to do the compulsion (excessive washing) despite the intrusive thought that they will get sick. With time, the patient can easily face the obsession without having to do the related compulsion. The patient would then move on to harder exposures.

Medication

Since the very nature of ERP is to face one’s fears to overcome them, many people get stuck during OCD treatment. Often, this is because their anxiety levels are simply too high to allow them to do exposures at all. Medication can help reduce anxiety, allowing the patient to complete exposures successfully. Some patients with OCD find medication helpful for the long term, while others choose to taper off it as they progress through treatment.

According to the International OCD Foundation, prescription medication can reduce OCD symptoms by up to 60%. These medications are usually selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, or antipsychotic medications. Here are some of the most common medications that psychiatrists prescribe for OCD: 

• Fluoxetine
• Sertraline
• Paroxetine
• Escitalopram
• Citalopram
• Clomipramine

A high dose of these medications is needed to effectively manage OCD. A psychiatrist will work to find the right medication and dosage for each patient.

Consult a psychiatrist

Living with OCD is hardly a walk in the park. Many feel like they cannot open up to others, which is part of what makes OCD such an isolating disorder. This is why it is important to consult a psychiatrist for diagnosis and treatment. To learn more about OCD and for help managing it, call our New York psychiatrist.

Request an appointment here: https://nycpsychiatricassociates.com or call NYC Psychiatric Associates at (917) 391-0076 for an appointment in our New York office.

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