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Living with recurring uncontrollable thoughts, ideas, and behaviors can be challenging both mentally and physically. These are just some of the symptoms that characterize obsessive-compulsive disorder (OCD). Understanding what OCD is and how to treat it, with home remedies and medications, is essential for managing the condition.
What is OCD?
Obsessive-compulsive disorder (OCD) is a chronic mental health condition that is marked by recurring, uncontrollable thoughts and behaviors. It’s estimated that OCD is the sixth most common psychiatric disorder. People with OCD often feel a need to perform certain routines repeatedly (compulsions) or have intrusive thoughts that occur repeatedly (obsessions).
OCD can cause people to have obsessions and compulsions that range in topic and severity such as fear of being harmed, the need to rearrange objects, or repeatedly washing hands. The type of obsessions and compulsions will vary from person to person. OCD requires a medical diagnosis and is typically treated with medications, talk therapy, or a combination of the two.
How is OCD diagnosed?
The exact cause of OCD is not known, but doctors and researchers believe it could be caused by multiple factors such as family history, changes to the chemistry and functioning of the brain, and other mental illnesses or environmental factors. Anyone can experience OCD, but those who’ve been through stressful or traumatic events, or have family members who have OCD, will have a higher risk of developing the condition.
Symptoms that a doctor will look for to help determine whether or not someone has OCD include the presence of intrusive thoughts or urges, persistent thoughts or behaviors, obsessions or compulsions, and ritualistic behaviors. A person’s symptoms will often center around a certain theme such as keeping clean or avoiding personal harm. Stress typically makes symptoms worse, and the compulsions to repeat obsessive actions can be stressful, which can create a cycle that’s hard to break.
The severity of symptoms varies. Some people have mild to moderate symptoms, meaning they spend around one to three hours per day obsessing or completing compulsive behaviors. While severe symptoms may cause people to have nearly constant compulsions and obsessions, which can make it nearly impossible to function in daily life.
A primary care physician may refer you to a psychiatrist or psychologist who can properly diagnose OCD. If you think you have OCD and are planning to see a medical professional, here are some questions you could ask at your visit:
- How can treatment help me?
- If I do have OCD, what are the best treatment options?
- What can I do on my own to help myself?
During a trip to the doctor’s office that will likely include a mental and physical exam, a doctor may ask questions similar to these:
- When did your symptoms first start?
- How do your symptoms affect your daily life?
- Do you have repetitive thoughts or behaviors?
- Do any of your relatives have a mental illness?
- Does anything improve your symptoms?
Medical professionals typically recognize four themes or “symptom dimensions” for the types of symptoms OCD patients exhibit. If someone is diagnosed with OCD, they will probably have symptoms in one or more of these categories:
- Cleaning and contamination. People with this type of OCD will have symptoms such as worrying about germs, excessive hand washing or feeling unclean. They may have washing or cleaning rituals, may avoid potential sources of contamination, and they may have ongoing fear about coming into contact with unclean or toxic substances.
- Taboo, or forbidden thoughts and impulses. This type of OCD is characterized by stress related to thoughts that the patient thinks are wrong or forbidden. People may obsess over aggressive, sexual, or religious ideas, and may need frequent reassurance that they are capable of not acting on their intrusive and repetitive thoughts.
- Ordering and symmetry. Symptoms of this type of OCD include compulsions and rituals that are centered around arranging items in a certain way, repeating actions, or counting objects. People may feel incomplete or believe that something bad will happen to them if they don’t arrange or organize things in a particular way.
- Harmful thoughts. Having this type of OCD often comes with intrusive thoughts and feelings that may include fear of harm or injury happening to themselves or others. People may worry about causing something bad to happen if they don’t repeat certain actions, such as checking on things around the house or completing certain routines.
OCD treatment options
There is no cure for OCD but it can be treated symptomatically. Many people will live with OCD their entire lives but can learn to manage symptoms for a higher quality of life. Treatment of obsessive-compulsive disorder often involves a comprehensive approach that includes psychotherapy, medication, and lifestyle changes.
The most popular type of psychotherapy that mental health professionals use to treat OCD is called cognitive behavioral therapy (CBT). CBT works by helping the patient to cope with and change problematic behaviors, thoughts, and emotions.
“A specific type of cognitive behavior therapy (CBT) called exposure and ritual prevention (ERP) is the treatment of choice for OCD. This involves ‘on-purpose’ exposure or interaction with the situations that trigger thoughts and rituals (touching the floor, doorknob) and rather than engaging in the ritual to neutralize the anxiety of that moment, riding out the anxiety and ‘under-reacting.’ Because of neuroplasticity, the brain is able to relearn that those situations do not require redoing, rewashing, checking, etc., and over time the person with OCD re-wires their brain to not send danger signals about those stimuli,” explains Tamar Chansky, Ph.D., psychologist and founder of the Children’s Center for OCD and Anxiety.
Other than psychotherapy, certain medications can be very helpful for people with OCD. Anti-anxiety medications and antidepressants are commonly prescribed for OCD, and many people respond well to a combination of psychotherapy and some type of medication. Talking with a doctor or healthcare professional is the best way to determine if medications are the right choice based on your individual OCD symptoms.
OCD medications
Antidepressants and anti-anxiety medications are the most popular medications that doctors prescribe for patients with OCD. The type of medication prescribed will depend on the individual, symptoms, medical history, and response to treatment. It can take several weeks for medications to become effective, and patients may need to try several different medications to find the most effective option for them.
Antidepressants
Antidepressants are approved by the Food and Drug Administration (FDA) to treat OCD and work by increasing levels of certain neurotransmitters in the brain that help control obsessive thoughts and compulsive behaviors. Selective serotonin reuptake inhibitors (SSRIs) are a subcategory of antidepressants that are especially effective at treating OCD symptoms. Antidepressants may cause side effects such as dry mouth, nausea, trouble sleeping, and decreased sexual desire. Here are some of the most commonly prescribed antidepressants:
- Anafranil (clomipramine)
- Luvox (fluvoxamine)
- Prozac (fluoxetine)
- Paxil (paroxetine)
- Zoloft (sertraline)
- Lexapro (escitalopram)
- Celexa (citalopram)
Here’s a list of resources that could be helpful for comparing OCD medications:
What is the best medication for OCD?
There is no one universal OCD medication that’s best for everyone. Individual symptoms and responses to treatment vary. A doctor can determine the best medication for OCD based on an individual’s symptoms, medical history, and response to treatments. Here’s an overview of popular medications that a doctor may prescribe.
| Best medications for OCD | ||||
|---|---|---|---|---|
| Drug name | Drug class | Administration route | Standard dosage | Common side effects |
| Anafranil (clomipramine) | Antidepressant | Oral | 1, 25 mg capsule taken daily at bedtime, then increased over time up to 100 mg daily | Dry mouth, tremor, dizziness, headache, constipation, sexual dysfunction, nausea, sweating, feeling tired, trouble sleeping |
| Prozac (fluoxetine) | Antidepressant | Oral | 10-20 mg taken daily, then increased over time up to 40-80 mg daily | Trouble sleeping, nausea, headache, drowsiness, anxiety, weakness, yawning |
| Luvox (fluvoxamine) | Antidepressant | Oral | 100-300 mg taken daily at bedtime | Nausea, headache, trouble sleeping, drowsiness, weakness, dry mouth |
| Paxil (paroxetine) | Antidepressant | Oral | 20 mg taken once per day, then increased over time to 40-60 mg daily | Drowsiness, nausea, weakness, trouble sleeping, headache, decreased sexual desire |
| Zoloft (sertraline) | Antidepressant | Oral | 50 mg taken daily as directed, may be increased over time up to 200 mg daily if needed | Nausea, diarrhea, trouble sleeping, dry mouth, dizziness, drowsiness |
| Lexapro (escitalopram) | Antidepressant | Oral | 10 mg taken once per day, then increased over time to 40 mg daily | Headache, nausea, trouble sleeping, diarrhea, drowsiness |
| Celexa (citalopram) | Antidepressant | Oral | 20 mg taken once per day, then increased over time to 40 mg daily | Nausea, dry mouth, drowsiness, trouble sleeping, sweating |
Dosage is determined by your doctor based on your medical conditions, response to treatment, age, weight, and other factors. Other possible side effects exist. This is not a complete list.
What are common side effects of OCD medications?
As with any medication, there is always the potential for side effects. Common adverse effects of OCD medications include trouble sleeping, dizziness, nausea, dry mouth, irritability, nervousness, and reduced sexual desire. Although it’s rare, some people may experience allergic reactions from taking medication that result in hives or difficulty breathing. Allergic reactions can be life-threatening. You should seek immediate medical care if you believe you are experiencing an allergic reaction.
This list of side effects is not comprehensive. Ask a healthcare professional for more details regarding the possible side effects of a particular medication.
What are the best natural remedies for OCD?
Many people rely on home remedies, natural treatments, and lifestyle changes to help with their symptoms of OCD. It’s important to note that many natural supplements are not approved by the FDA. Here are some popular natural and home remedies for OCD:
- Getting enough sleep. Making sure that you’re well-rested is a great way to lower levels of the stress hormones cortisol and adrenaline. Lowering stress levels can improve your mood and brain chemistry.
- Meditation and mindfulness are clinically proven to improve OCD symptoms. Adopting some form of meditation or mindfulness practice daily can help with symptoms of stress, anxiety, and compulsive thoughts.
- Seeking social support. Having a strong support group of friends and family has been proven to lower levels of stress. Lower stress can help manage OCD symptoms, and having a social support system can help those with OCD manage potential symptoms of isolation or embarrassment from their condition.
- Getting enough B12. Low levels of vitamin B12 have been linked to depression, anxiety, and nervous system problems. Getting your levels of B12 checked may be a good idea to rule out whether or not being deficient in this vitamin could be causing some of your OCD symptoms.
- Taking milk thistle. This herbal supplement has been associated with increasing levels of serotonin, a mood-enhancing neurotransmitter. The active component in milk thistle is silymarin. If you take supplements, check that they are from a safe and reliable manufacturer.
Frequently asked questions about OCD
How long does OCD treatment take?
It can take up to four to six months to see full results from OCD treatments. Many medications that are prescribed by doctors to help with OCD symptoms can take several weeks to start working. Behavioral therapy is often done in sessions, and it can take anywhere from 12-20 sessions to see results. Even though therapy and medications have been shown to be very effective at treating OCD, it’s likely that continual therapy and medication may be necessary throughout the entirety of someone’s life.
Can OCD be cured?
There is currently no cure for OCD, but its symptoms can be managed with proper treatment. Treatment for OCD typically involves behavioral therapy such as exposure and ritual prevention (ERP), medication, and lifestyle changes. Some people even use natural and home remedies with some success. With a comprehensive treatment plan, many people see an improvement in their OCD symptoms.
What are the four types of OCD?
Doctors and medical health professionals typically recognize four themes or “symptom dimensions” for the types of symptoms OCD patients exhibit:
- Cleaning and contamination
- Taboo, or forbidden thoughts and impulses
- Ordering and symmetry
- Harmful thoughts
Does OCD get worse if not treated?
OCD can potentially get worse over time if it goes untreated. As symptoms get worse, some people may experience a loss of function at work or school, social isolation, or other negative impacts. In extreme cases, OCD can cause secondary conditions such as substance abuse, depression, or suicidal thoughts. Seeking treatment for your OCD, even if you believe it’s mild, is the best way to make sure it doesn't get worse.
Can you treat OCD with no medications?
It may be possible for some people to experience relief from their OCD symptoms without medication. Cognitive behavioral therapy is very effective for some people, but often a comprehensive treatment program will include medication. Some people choose to use natural and home remedies to help with their symptoms. The best way to determine whether or not you might need medication to treat your OCD is to speak with a medical professional.