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Obsessive-compulsive disorder (OCD)

by Psychologytherapy
Obsessive-compulsive disorder (OCD)

What is obsessive-compulsive disorder?

OCD is an anxiety disorder characterised by obsessions and compulsions. The obsessions are intrusive, repetitive and unwanted thoughts, very hard to stop, that generate anxiety. The compulsions are the unproductive actions that the person repeats in order to get rid of the anxiety, as they reduce it temporarily. The problem with the compulsions is that they reinforce the brain’s beliefs that the obsessions are bad and dangerous and that the only way to feel relief and avoid the negative consequences of the thoughts is by performing the compulsions. But this increases the anxiety, and leads to a circle of obsessions-compulsions.


The causes of obsessive-compulsive disorder are unknown, however, the success of selective serotonin reuptake inhibitors (SSRIs) to treat OCD suggests that a serotonin alteration might be involved.


The main symptoms of obsessive-compulsive disorder are anxiety and a circle of obsessions and compulsions. The content of the obsessions and intrusive thoughts can be about anything. OCD tends to focus on whatever is important for the person, and some of the most common types of OCD involve fear of germs, hurting someone, organization, or sexual thoughts,

The compulsions can also take any form, and they can include visible behaviours such as cleaning repeatedly, checking, or taping, or mental compulsions like counting, praying, seeking reassurance, etc.


The main two treatments for OCD are psychotherapy and medication. They can be used together, but also have been found to help on their own.


When it comes to medication, the drugs recommended for OCD are selective serotonin reuptake inhibitors (SSRIs). There are different types of SSRI, but for each person is different, and what works well for someone might not be the best option for another. Hence, you might need to try more than one if the first one you try isn’t right for you. The first step to get the appropriate medication would be talking to your GP. Medication is prescribed exclusively to adults and it might be offered to children below 16 years old in very particular cases if OCD is severe and after having had therapy the condition hasn’t improved.

In any case, taking tablets is a personal choice, and some people decide not to take them. Medication is helpful to reduce the symptoms of OCD and can help to engage better in therapy.

Psychotherapy (CBT with ERP)

Medication and psychotherapy are not exclusive and they often complement each other. Psychotherapy has been proven that helps with OCD symptoms for most people who try it. The type of therapy effective for this condition is Cognitive Behavioural Therapy (CBT) with Exposure Response Prevention (ERP).

CBT is a talking therapy based on the idea that the way the person feels is influenced by their thoughts, so the goal is to challenge the unhelpful and intrusive patterns and changing them for other, more realistic, and productive ones. ERP is used as a part of CBT. The idea behind ERP is that by staying with the anxiety and not performing the compulsions, that anxiety will lose power over time.

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