OCD is a very disabling mental disorder: it involves obsessions, compulsions, avoidance of certain situations, loss of time in our daily lives… On top of all that, we tend to think that OCD is stronger than we are, that we can “do nothing about it”. Well, if you suffer from OCD, you should know that there are several types of treatment that can help you get out of it! So let’s see together what treatments and care are possible and effective against obsessive-compulsive disorder.
If you don’t know what OCD is, I invite you to read this article.
Now, let’s get to the heart of the matter!
I. The severity of OCD
There are different degrees of intensity in obsessive compulsive disorder:
OCD is said to be “mild” when it causes discomfort and suffering in daily life without altering social and/or professional life.
OCDs are said to be “severe” when they cause, in addition to daily suffering, an alteration of social and/or professional life. The person is then totally imprisoned by his symptoms.
NB: The severity of OCD fluctuates over time and can be influenced by external stressors.
It is important to note that people suffering from OCD often wait several years before seeking any kind of treatment, because they are ashamed or because they tell themselves that “it’s not serious, it will go away by itself”. The problem is that this disorder is vicious… It tends to worsen over time and to generalize to other areas of life if it is not taken care of (I start by checking my door 5 times, then 10, then 30, then I start checking the lights, then the gas…). When the OCD has been there for a long time, it has no desire to go away. So the longer you wait to tackle it, the harder it will be to get rid of it…
Of course, we all have “fads” like checking our front door before leaving home, which does not require management. The question of management must be asked when the “fad” begins to take up too much of our time, is repeated too many times, or begins to create recurring thoughts/ruminations.
II. The importance of the entourage in helping a person suffering from OCD
The people around a person suffering from OCD are important in the recovery process. Living with a person who suffers from OCD can sometimes be very difficult and annoying. However, yelling at them or making fun of them is unnecessary and harmful. You know why? Because it’s a disorder. In other words, telling someone who is performing a ritual “stop washing your hands 15 times an hour, it’s ridiculous” is like telling someone who has an intestinal disease “stop having a stomachache”: it’s not that simple.
Also, it is useless and harmful to participate in his OCD. That is to say that one should not do his rituals for him (for example “I will do your checks for you, it will be faster”, “I will open the doors for you, it will save you washing your hands 15 times”), nor succumb to his obsessions (it happens that young people suffering from OCD send messages to their parents after leaving home asking them to check the front door for example, and the parents do it). All of these behaviors should be banned. Participating in OCD makes it legitimate. But it is not!
III. The most effective types of treatment
Spoiler alert: treating OCD can be tedious and does not guarantee a 100% cure. However, it is better to try to reduce OCD (reduction of symptoms being frequent thanks to adapted treatment) rather than to do nothing and let OCD settle in, become more and more severe and/or invasive.
- Cognitive and behavioral psychotherapy
Behavioral therapy is based on the technique of progressive exposure with response prevention. Let’s take the example of a person who has an OCD of cleanliness. The principle of progressive exposure is to ask her to imagine, in her mind, touching an object without washing her hands. Gradually, she will have to touch an object in the therapist’s office while waiting 10 seconds to wash her hands, then 15 seconds, for 1 minute etc… By doing this, the person learns that not carrying out her ritual does not cause exponential anxiety. They will be anxious at the beginning, which is normal, but the anxiety always comes down at some point! Doing these exposures allows the brain to regain control of the fact that it thinks it must absolutely wash its hands the second after touching something, at the risk of being lulled by an anxiety that will never stop. By dint of repetition, the brain will integrate the information that not washing your hands directly after touching something is not necessarily a source of anxiety. It is like when we learn to write, at the beginning our letters are illegible, and with practice, our writing becomes more and more legible. Cognitive therapy allows the person suffering from OCD to realize the incoherence of his or her obsessions, and to see them in a more rational and objective way.
- Pharmacological treatment
The most prescribed and effective medications for OCD are antidepressants of the specific serotonin reuptake inhibitor type. The treatment can vary from 12 to 24 months and can be modified by the doctor according to the evolution of the symptoms. Stopping treatment with antidepressants must be done gradually and monitored by a physician. This medication can be prescribed alone or in addition to cognitive and behavioral therapy. The treatment decision between medication, psychotherapy or both depends on several factors (intensity of obsessions, intensity of compulsions, comorbidities, possibility of psychotherapy…). This decision is therefore made by a doctor (preferably a psychiatrist) with the agreement of the person suffering from OCD.
NB: Analytical or analytically inspired psychotherapy can help to discover the origin of the intrapsychic conflict that has generated the OCD, but is not intended to reduce the symptoms in the short term.
IV. Some techniques to do at home to help with your OCD
OCD is a disorder that is difficult to treat and difficult to eliminate. However, there are techniques that you can do at home to help you reduce your OCD and sometimes even get rid of it. These techniques are derived from cognitive and behavioral psychotherapy. Moreover, a youtuber and coach who herself suffered from OCD used them on herself and managed to get rid of her disorder! Just goes to show, anything is possible! Here is the link to her channel if you are interested.
Before I explain the techniques, I want to warn you. These techniques require a lot of investment, effort and they are difficult to put in place! So there will be times when you won’t be able to put them in place or maintain them. But don’t give up hope, it’s normal not to get it right the first time. Also, these techniques only work if you do them correctly and very assiduously, and they work mainly on “fads” and recent/low-level OCD. However, they are not infallible, and it is still more effective and preferable to go see a psychiatrist and/or a psychotherapist, even if your OCD is not very invasive. Here are some techniques that may help you reduce your OCD:
- Tracking/tracker: This technique involves writing down your obsessive thoughts and rituals throughout the day, and the time it takes you. For example, you can write down line by line: 9:30 am, check the front door, 12 minutes or 9:30 am, obsessive thought “did you check the front door?”, 25 minutes. You can also write them down in a table (in case the obsessions or rituals occur several times during the day) with on each line the obsessive thoughts and usual rituals, and on the columns the time it happens and for how long. You can also write down the emotions associated with them if you can identify and name them. Also, you can note every 3 hours, how long you had obsessive thoughts. This will allow you to realize your obsessions and rituals, the time it takes you during the day, to see your progress (when you compare the afternoon of one day with the afternoon of another day for example) and to set goals.
- Setting goals: this technique consists in setting small short-term goals. Tracking (see above) will help you set achievable goals. I advise you to write them down somewhere, it can be in the same place as your trackers. For example, if you could see that it takes you 12 minutes to check your door in the morning, you can try to reduce it to 11 minutes first. Once you have reached this first goal, you can set a new goal of 10 minutes and so on. Be careful, when you reach a goal, it is important to succeed in holding it for several days before setting a new one.
- Exposure: we have already talked about this above, but I will explain again in more concrete terms how to apply it. This technique consists in ignoring obsessive thoughts in order to ignore rituals. Concretely, it consists in delaying the ritual (when you have a compulsion, wait 10 seconds before doing it, then 30 seconds, then 1 minute, then 2 minutes etc.). Once you feel able to do this, you can try to move on to the next step which is to ignore your obsessions and compulsions. This technique is based on the idea that when you delay your ritual, your brain realizes that nothing bad has happened (when you don’t check your front door within 10 seconds, nothing bad is happening). Until your brain integrates the information and manages to say to itself “not checking does not mean that there will be a disaster”. It is the same principle for obsessive thoughts. Ignoring them will make your brain understand that the information is not relevant and therefore does not have to be there. And remember, not performing a ritual or trying to ignore your obsessive thoughts is very difficult, but it is a first step to recovery! You should also know that it will cause you anxiety, but contrary to what you think, the anxiety will eventually go down!
- Regulate your emotions: OCD is very much influenced by your emotional state. Did you notice that when you were stressed, you tended to perform more rituals, to have more obsessive thoughts? That’s why emotional regulation can help you reduce your OCD. I invite you to consult this article which gives you techniques to regulate your emotions.
V. What if these treatments don’t work?
If antidepressants and therapy do not work, it means that the OCD is resistant. In this case, other types of treatment may be recommended (only in the case of resistant OCD): other drug treatments, transcranial magnetic stimulation (a non-invasive technique that consists of sending a magnetic field repeatedly and locally to the brain), etc.
Also, hospitalization may be indicated in cases of very severe OCD to allow for intensive treatment over several days or weeks. There are also day hospitals that offer treatment for one or more days a week.
If you think you have OCD, you can get out of it. There are several types of treatment that will allow you to progressively feel better, including CBT psychotherapy and medication. If you don’t have the immediate possibility of going to see a professional, you can try to implement techniques such as tracking, goal setting, exposure and emotional regulation; they may help you to better manage your OCD, to reduce it and maybe even to get rid of it if your OCD is not too established. But I would like to point out that it is still preferable and more effective to be helped by a professional!
In addition, there is the French association of people suffering from obsessive-compulsive disorder which could allow you to get more information on the subject, to meet people in your situation, and/or to find professionals who can help you near your home. This association can also help the relatives of people suffering from OCD. If you’re interested, I’ll put the link to their website right here.