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Most people are not cured of obsessive compulsive disorder (OCD) in the sense that they never have any intrusive thoughts or engage in any compulsions ever again. However, it is possible to successfully manage and alleviate symptoms through a combination of behavioral therapy and medication.
There is no cure for intrusive thoughts because it is part of the human experience to have unpleasant or intrusive thoughts. When people feel “cured” it is not because they never an intrusive thought again; rather, it is because they know how to manage their intrusive thoughts using the skills they learned, and they're able to feel better over time.
A type of Cognitive Behavioral Therapy (CBT) called Exposure and Response Prevention (ERP) is the gold standard treatment for individuals with OCD. Dr. Eric Storch, head of psychology at Baylor College, explains, “CBT with ERP has been shown to be helpful in 75–85% of individuals and is generally well-tolerated by individuals.”
Once clients learn skills to address OCD through therapy, they have greater ability to reduce the grip that OCD has on their lives.
Dr. Eric Storch, PhD of Baylor College, says a combination of exposure and response prevention and medications is "recommended among those most severely impacted by OCD."
Exposure and Response Prevention
With the guidance of a trained therapist, Exposure and Response Prevention involves directly confronting obsessive thoughts. The goal is to slowly accustom the person to the obsession, to the point where he or she no longer feels threatened by it or tempted to engage in compulsions.
This radical approach empowers individuals by gradually teaching them just how much control they have over their own brain patterns.
Medications for OCD
Medication management with selective serotonin reuptake inhibitors (SSRIs) has also been shown to be an effective treatment for OCD.
“[SSRIs] have been shown to help as many as 60% of individuals and are widely available and generally well-tolerated,” says Dr. Storch, “Their combination is recommended among those most severely impacted by OCD.”
Although typically used as an antidepressant, using higher doses of SSRIs than what is normal for depression can be successful in reducing symptoms of OCD. Combined therapy with ERP and an SSRI may benefit those who have inadequate responses to ERP as well as those with severe OCD.
Novel treatments for OCD
Promising research suggests novel treatments may be available in the near future, including new medications being investigated in clinical trials, the use of smart phone apps, and new types of cognitive behavioral therapy (CBT) like Acceptance and Commitment Therapy.
Co-founder and Director of the Bio Behavioral Institute Dr. Fugen Neziroglu shares that at her institute, “[We] are now looking at the effect of adding Acceptance and Commitment Therapy or Dialectical Behavioral Therapy to ERP," explains Dr. Fugen Neziroglu, Co-founder and Director of the Bio Behavioral Institute, "We are also investigating the role of treating some of the predictor variables, especially overvalued ideation and trauma, in increasing treatment response.”
While there is no cure for OCD, there are effective treatments available with novel treatments on the horizon. While the treatment may not work for every person, most people can find significant relief using a combination of ERP and/or medication. As frustrating as it may be, living with anxiety is a necessary part of life. Rather than trying to completely eliminate it, it is better to adopt a new mindset and develop the coping skills necessary to live with it.
Sources
- The most effective behavioral treatment for OCD is exposure and response prevention.
- Harvard Health Publishing. (2009). Treating obsessive-compulsive disorder.
- We do know that each of these medications affect a chemical in the brain called serotonin. Serotonin is used by the brain as a messenger.
- International OCD Foundation. (2018). Medications for OCD.
- CBT alone, consisting of ERP, is recommended as initial treatment for a patient who is not too depressed, anxious, or severely ill to cooperate with this treatment modality, or who prefers not to take medications.
- Koran LM, et al. (2007). Practice Guideline for the Treatment of Patients with Obsessive-Compulsive Disorder. American Journal of Psychiatry, 164(7), 5–53.
- Combined treatment should be considered for patients with an unsatisfactory response to monotherapy.
- Koran LM, et al. (2007). Practice Guideline for the Treatment of Patients with Obsessive-Compulsive Disorder. American Journal of Psychiatry, 164(7), 5–53.
- Several lines of neurochemical and genetic evidence suggests that glutamate dysregulation may contribute to OCD although much remains unclear.
- Pittenger, C. (2015). Glutamate modulators in the treatment of obsessive-compulsive disorder. Psychiatric Annals, 45(6), 308–315.
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