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OCD Treatment

Specialized treatment for obsessive-compulsive disorder including ERP therapy

Understanding OCD

OCD isn't just being particular or liking things organized—it's a relentless cycle of intrusive thoughts and repetitive behaviors that can consume hours of your day. Maybe you have disturbing thoughts that feel completely unlike you, and you perform rituals to make them go away, but the relief only lasts a moment. Perhaps you check the stove ten times before leaving the house, wash your hands until they're raw, or replay conversations endlessly to make sure you didn't say something wrong.

You might feel ashamed of your thoughts or worry that having them makes you a bad person. But OCD thoughts are not a reflection of who you are—they're symptoms of a neurological condition. The thoughts feel urgent and real, but they're false alarms from your brain. With proper treatment, including specialized therapy and sometimes medication, people with OCD can break free from this exhausting cycle and reclaim their lives.

You might be experiencing:

Intrusive, unwanted thoughts that feel disturbing or terrifying
Compulsive rituals (checking, washing, counting, arranging) to reduce anxiety
Spending hours each day on obsessions and compulsions
Fear of contamination or germs leading to excessive cleaning
Needing things to be symmetrical, in perfect order, or "just right"
Intrusive thoughts about harming yourself or others (that you don't want to act on)
Excessive doubt and need for reassurance from others
Mental rituals (counting, praying, repeating phrases silently)
Avoiding situations that trigger obsessions (places, people, objects)
Difficulty functioning at work, school, or in relationships due to OCD

Important: Having disturbing intrusive thoughts does NOT mean you're a dangerous person. These thoughts are the opposite of your values, which is exactly why they're so distressing. This is a hallmark of OCD.

Our Medication Approach

Medication can significantly reduce the intensity and frequency of obsessions and compulsions, making it easier to engage in therapy (especially ERP). While medication alone is less effective than ERP therapy, the combination of both is often the most powerful approach for moderate to severe OCD.

SSRIs (First-Line Treatment)

SSRIs are the primary medication for OCD. They work by increasing serotonin levels, which helps reduce obsessive thoughts and compulsive urges. OCD typically requires higher doses than depression and takes longer to respond.

  • Common choices: Fluoxetine (Prozac), Sertraline (Zoloft), Fluvoxamine (Luvox), Paroxetine (Paxil), Escitalopram (Lexapro)
  • Typically requires higher doses than for depression or anxiety
  • Takes 8-12 weeks to see significant improvement (longer than other conditions)
  • If one SSRI doesn't work, trying another often helps

Clomipramine (Anafranil)

An older tricyclic antidepressant that's actually the most effective medication for OCD. Reserved for cases where SSRIs haven't worked due to more side effects.

  • About 70% of people respond to clomipramine
  • Requires careful monitoring but can be life-changing for severe OCD

Augmentation Strategies

If an SSRI alone isn't enough, we may add another medication to enhance its effectiveness.

  • Atypical antipsychotics (low dose): Aripiprazole (Abilify), Risperidone (Risperdal), Quetiapine (Seroquel)—especially helpful if you have tics
  • Another SSRI or clomipramine added to current SSRI
  • Memantine or other medications for treatment-resistant cases

Our Prescribing Philosophy

  • Start with an SSRI, gradually increasing to therapeutic dose for OCD
  • Give adequate time (at least 8-12 weeks at target dose) before switching
  • Monitor for side effects and adjust as needed
  • Medication is most effective when combined with ERP therapy
  • Long-term treatment is often needed; we work together on duration

What to Expect

Most people see a 40-60% reduction in OCD symptoms with medication. You likely won't be completely symptom-free from medication alone, but it should make symptoms much more manageable and allow you to engage in therapy effectively.

Therapy & Lifestyle Changes

Exposure and Response Prevention (ERP) is the gold-standard treatment for OCD and the most important component of recovery. While medication can help, ERP teaches your brain that the feared consequences of not doing rituals won't actually happen. It's challenging but highly effective—most people who complete ERP see significant, lasting improvement.

Therapy Approaches We Recommend

Exposure and Response Prevention (ERP) - The Gold Standard

ERP involves gradually facing your feared situations or thoughts (exposure) while resisting the urge to do compulsions (response prevention). This teaches your brain that anxiety naturally decreases without rituals and that feared consequences don't happen.

  • You create a hierarchy from least to most anxiety-provoking situations
  • Work gradually from easier to harder exposures at your own pace
  • Practice between sessions is crucial for success
  • Most people see significant improvement within 12-20 sessions

Cognitive Therapy for OCD

Addresses the beliefs that maintain OCD, like overestimating danger, feeling excessively responsible for preventing harm, or believing thoughts are dangerous. Helps you develop a healthier relationship with intrusive thoughts.

Acceptance and Commitment Therapy (ACT)

Teaches you to observe thoughts without believing or fighting them. Instead of trying to eliminate intrusive thoughts, you learn to accept their presence while focusing on valued actions. Can complement ERP nicely.

Intensive Outpatient Programs

For severe OCD that interferes significantly with daily life, intensive programs offering daily ERP sessions (several hours per day) can provide faster results. We can refer you if appropriate.

Lifestyle Changes That Make a Real Difference

Resist Reassurance-Seeking (Critical)

Asking others "Did I do that right?" or "Is this okay?" is a compulsion, even though it doesn't seem like one. It temporarily reduces anxiety but strengthens OCD long-term.

  • Work with family/friends to stop providing reassurance
  • Practice sitting with uncertainty instead

Delay Compulsions

If you can't resist a compulsion entirely, practice delaying it. Wait 5 minutes, then 10, then longer. Often the urge will pass, and you'll prove to yourself you can tolerate the discomfort.

Stress Management

Stress makes OCD symptoms worse. While you can't eliminate stress, you can develop better coping strategies.

  • Regular exercise reduces overall anxiety and OCD symptoms
  • Mindfulness meditation (observing thoughts without engaging)
  • Adequate sleep—sleep deprivation worsens OCD

Limit Alcohol and Stimulants

Alcohol might temporarily ease OCD anxiety but worsens symptoms overall and can interfere with medications. Excessive caffeine can increase anxiety and obsessive thinking.

Family Involvement

OCD affects the whole family. Family members often get pulled into accommodating rituals. Family therapy can help everyone learn how to support you without reinforcing OCD behaviors.

Track Progress

OCD recovery isn't linear. Keeping a log of your symptoms and exposures helps you see progress even when it doesn't feel like you're improving. Celebrate small wins.

Support Groups

Connecting with others who have OCD reduces isolation and shame. The International OCD Foundation (IOCDF) offers support groups and resources.

You Can Get Your Life Back from OCD

OCD is one of the most treatable anxiety disorders. With evidence-based treatment—especially ERP therapy—people dramatically reduce their symptoms and reclaim time and energy that OCD has stolen. You don't have to live this way. Our team has specialized training in treating OCD and we're here to help.