Affecting 2.2 million adults in the United States, obsessive-compulsive disorder (OCD) is a type of anxiety disorder where the patient has invasive thoughts and compulsive behaviors, according to the National Institute of Mental Health (NIMH). The treatment for OCD is similar to other anxiety disorders, such as using medication and psychotherapy to manage symptoms and find the cause of the anxiety. However, because of the compulsive behavior, OCD treatment also incorporates exposure therapy.
Psychotherapy
An important component of anxiety treatment, psychotherapy helps the patient manage his disorder. Cognitive behavioral therapy, a type of psychotherapy, targets the cause of the anxiety and teaches the patient how to effectively cope with the anxiety. Therapy also helps the patient reduce his level of stress, which can trigger anxiety.
For OCD, cognitive behavioral therapy also includes exposure and response prevention. This type of therapy exposes the patient to the compulsive behavior trigger, but does not allow the patient to react. For example, if the patient compulsively washes his hands due to a fear of germs, the therapist will put some dirt in front of him. Exposure and response prevention decreases the patient's urge to react to the compulsive behavior trigger.
Hospitalization
The Mayo Clinic notes that a patient with severe OCD may require hospitalization or residential treatment. During hospitalization, the patient is in a safe environment where she receives psychiatric therapy. The patient is also closely monitored for behavioral changes. This type of treatment can be helpful for a patient who has problems following her treatment plan, such as not taking her medication or going to therapy sessions. Hospitalization may also work for a patient who does not respond to the psychotherapy she is receiving.
Medication
The severity of the obsessions and compulsions can be managed with medication. The first choice is a selective serotonin reuptake inhibitor (SSRI), which targets the neurotransmitter serotonin. The Mayo Clinic states that fluoxetine, fluvoxamine, paroxetine and sertraline are approved by the Food and Drug Administration (FDA) for OCD treatment. If a patient does not respond to a SSRI, then clomipramine, a tricyclic antidepressant, is prescribed. The National Institutes of Health (NIH) notes that clomipramine is very effective with OCD, but has more side effects than an SSRI, such as a drop in blood pressure when the patient stands up. Clomipramine may also be combined with an SSRI. Another group of anxiety medications, benzodiazepines, may be combined with another treatment method. However, if benzodiazepines are used, it is short term due to a risk of addiction.
