A patient with obsessive-compulsive disorder (OCD) can feel controlled by the disorder. Characterized by intrusive thoughts and behaviors, the patient is driven to repetitively perform certain behaviors. When she tries to stop them on her own, she can become overwhelmed by anxiety. Treatment for OCD attempts to get these thoughts and behaviors under control through different therapies and medication.
Exposure and Response Therapy
A subtype of cognitive behavioral therapy (CBT), exposure and response therapy exposes the patient to his trigger. Then the therapist teaches the patient not to respond to the trigger with his normal compulsive behaviors. For example, if the patient's compulsive behavior is hoarding, in which he cannot throw things away (even if they are not necessary), the therapist will work with the patient to identify which objects are needed and which ones are garbage. Exposure and response therapy can also decrease the patient's anxiety.
Psychotherapy
The patient may also undergo psychotherapy, which the National Institutes of Health (NIH) states can help reduce stress effectively and reduce anxiety. Psychotherapy can uncover the cause of the OCD and resolve those inner conflicts. This type of therapy can also reduce the compulsive behavior and obsessive thoughts by helping the patient develop healthy coping strategies. The therapy can be done one-on-one or in a group therapy setting with other OCD patients. In severe OCD cases, the Mayo Clinic recommends residential treatment or psychiatric hospitalization, where the patient is monitored by a psychiatrist or hospital staff and can receive treatment multiple times a day.
Medications
Medication may be added to the treatment regimen to decrease the severity of thoughts and behaviors in OCD patients. The Mayo Clinic notes that the doctor will give the patient the lowest dose possible to help with her symptoms. The patient may need to try multiple medications before finding the one or combination of sevearl that work the best for her. The NIH states that selective serotonin reuptake inhibitors (SSRIs) are used first, such as citalopram, paroxetine, fluoxetine, sertraline or fluovoxamine. Clomipramine, an older tricyclic antidepressant, is a secondary option. Although it is more effective for OCD, clomipramine has side effects, such as a drop in blood pressure when standing up. Clomipramine can be combined with an SSRI. The patient may also be given a benzodiazepine, an anti-anxiety medication, but only on a short-term basis.
