Obsessive compulsive disorder (OCD) - Treatment

Treatment-Obsessive compulsive disorder (OCD)




Obsessive compulsive disorder (OCD) is a treatable condition. The treatment recommended will depend on how much it's affecting your life.
The 2 main treatments are:
  • psychological therapy – usually a type of therapy that helps you face your fears and obsessive thoughts without "putting them right" with compulsions
  • medicine – usually a type of antidepressant medicine that can help by altering the balance of chemicals in your brain
A short course of therapy is usually recommended for relatively mild OCD. More severe OCD may require a longer course of therapy and/or medication.
These treatments can be very effective, but it's important to be aware that it can take several months before you notice the benefit.
You can get treatment on the NHS through your GP or by referring yourself directly to a psychological therapies service.

Psychological therapy

Therapy for OCD is usually a type called cognitive behavioural therapy (CBT) with exposure and response prevention (ERP).
This involves:
  • working with your therapist to break down your problems into their separate parts, such as your thoughts, physical feelings and actions
  • encouraging you to face your fear and let the obsessive thoughts occur without neutralising them with compulsive behaviours – you start with situations that cause you the least anxiety first, before moving on to more difficult thoughts
The treatment is difficult and may sound frightening, but many people find that when they confront their obsessions, the anxiety does eventually improve or go away.
People with fairly mild OCD usually need about 10 hours of therapist treatment, combined with exercises done at home between sessions. A longer course may be necessary in more severe cases.

Medication

You may need medication if psychological therapy does not help treat your OCD, or if your OCD is fairly severe.
The main medications prescribed are selective serotonin reuptake inhibitors (SSRIs). These can help improve OCD symptoms by increasing the levels of a chemical called serotonin in your brain.
You may need to take the medication for 12 weeks before you notice any effect.
Most people require treatment for at least a year. You may be able to stop if you have few or no troublesome symptoms after this time, although some people need to take medication for many years. Your symptoms may continue to improve for up to 2 years of treatment.
Do not stop taking SSRIs without speaking to your doctor first, as this can cause unpleasant side effects. When treatment is stopped, it will be done gradually to reduce the chance of this happening. Your dose may need to be increased again if your symptoms return.

Side effects

Possible side effects of SSRIs include:
There's also a very small chance that SSRIs could cause you to have suicidal thoughts or want to self-harm. Contact your GP or go to your nearest accident and emergency (A&E) department if this happens.
Most side effects improve after a few weeks as your body gets used to the medicine, although some can persist.

Further treatment

Further treatment by a specialist team may sometimes be necessary if you've tried the treatments above and your OCD is still not under control.
Some people with severe, long-term and difficult-to-treat OCD may be referred to a national specialist OCD service.
These services offer assessment and treatment to people with OCD who have not responded to treatments available from their local and regional OCD services.
The national OCD services in England are:

OCD support groups

Many people with OCD find support groups helpful, as they can:
  • provide reassurance and coping advice
  • reduce feelings of isolation 
  • offer a chance to socialise with others
  • provide information and advice for family members and friends
The national charities OCD Action, OCD-UK and TOP UK can provide information about support groups in your area:
You may want to visit the HealthUnlocked OCD forum, where you can discuss all aspects of the condition with others who have OCD.
You can also find mental health apps and tools in the NHS apps library.

Psychological therapies for stress, anxiety and depression
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