Kevin Huang, Bsc Pharm Candidate
How is OCD treated?
Last week, we had the opportunity to learn about what OCD is and busted some common myths. Like any illness, there will be challenges we’ll have to face. It may be difficult, but with time, patience, and mutual understanding, we can strive to make meaningful changes for anyone struggling with OCD.
When most of us think about treating our conditions, we often assume medications are our main approach – like with infections and antibiotics. With psychiatric conditions, this is not the case. Even though medications may help manage the disorder, they may not fully fix the issue. To truly address the illness, we must find the source of the problem, whether it’s determining the cause of one’s anxiety or understanding what exacerbates another’s depression. This is especially true when it comes to OCD – unless we pinpoint the cause of one’s obsessions and compulsion, we can only help on the surface level.
Due to this, many clinicians start their patients in a different direction: a psychiatric approach called Cognitive Behavioural Therapy. This technique is used by trained clinicians to identify their patients’ fears and help them find new ways to manage their anxiety. Although the initial process may be frightening, it’s proven effective in achieving major improvements where obsession is no longer a problem.
What is Cognitive Behavioural Therapy?
Before starting cognitive behavioural therapy (CBT), the most important thing is finding a therapist whom you can trust. This is especially important as your clinicians will challenge you to face your biggest fears – the obsessions themselves. You must be comfortable with being vulnerable and allowing them to find means to help manage your compulsions. This also means sometimes you may feel uncomfortable. If this affects your ability to continue with the therapy, don’t be afraid to express your concerns. Remember, your team always wants the best for you. So work with your clinicians, have faith, and be confident.
The most common CBT used is called Exposure and Response Prevention (ERP), a procedure that exposes the patient to numerous triggers (obsessions) which gradually increases in intensity. This repeated exposure encourages the patient to become familiar with their fears while helping them minimize the frequency and severity of their compulsions. Over time, the patient will become so comfortable with the “trigger” that they no longer need to complete a compulsion.1
For example, if the patient has an obsessive fear of contamination, the clinician may ask the patient to touch a chair. As expected, the patient will be afraid of the “germs”, resorting to washing their hands (compulsion). The clinician will then encourage the patient to delay the compulsion as long as possible, hoping they will start becoming familiar with their fears. Over time, the patient will be able to delay the response. It might be one minute to start, then two, and maybe even ten. With each exposure, they become more confident in their ability to avoid the compulsion. Hopefully, by the end of the treatment, the patient will realize that the chair might not actually be “contaminated” and thus can avoid washing their hands altogether.
Pharmacotherapy (Medications to the Rescue)
When CBT & ERP are not enough, the clinicians will introduce medications into the treatment plan. Since each patient will have a different experience of OCD, individualized therapy will be required to meet their specific needs. The most common type of medications used are the following classes of Anti-depressants:2-5
- SSRI (Selective Serotonin Reuptake Inhibitor) such as Fluoxetine
- SNRI (Serotonin-Norepinephrine Reuptake Inhibitor) such as Venlafaxine
- TCA (Tricyclic Antidepressants) such as Clomipramine
Working with anti-depressants can be a unique challenge. Anti-depressants will require some time before they start having effects, usually between 2-3 months.4 Furthermore, the team will have to adjust the dose to ensure the most benefit while mitigating side effects. This is why it’s incredibly important for everyone to be patient and collaborative. If you ever have concerns about the medications, let your team know! Only through communication can the team optimize your care.
Section 3: What can you do to help?
We’ve spent a lot of time talking about the treatments of OCD, but what if you know someone with the condition, perhaps a family or a friend? What can you do to make a difference in their life? Believe it or not, there are many things you can do.3
- Empathy: They will be struggling with things you might never fully understand. Sometimes it will not make any sense. That’s okay. Take the time to listen to their experience and remind them you are always there to support them. This is often much better than trying to give them advice.
- Encouragement: Celebrate every milestone. With encouragement, you can help keep them motivated to continue the process. Believe in them: every little step will help them reach their goal.
- Stress Management: Like any mental health illness, stress can exacerbate the symptoms, making it harder to manage the condition. If you can predict stressful events before they happen, take the time to make a plan or let them know you’re there to help. Any support is good support and can make the biggest difference..
- Self-Care: As important as it may be to take care of your loved ones, I would argue it’s vital for you to take care of yourself first. If you’re not at your best, then helping others isn’t the best idea. Avoid burning out and look for signs you may need self-care. Only when you’re ready will you be able to make meaningful changes in someone’s life.
As always, we hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at firstname.lastname@example.org with your feedback. We’d love to hear from you.
- Cognitive Behavior Therapy and ERP. (n.d.). Retrieved July 4, 2018, from http://beyondocd.org/information-for-individuals/cognitive-behavior-therapy
- Treatments for OCD. (n.d.). Retrieved June 26, 2018, from http://ocdcanada.org/treatments/
- Obsessive Compulsive Disorder (OCD). (n.d.). Retrieved June 26, 2018, from https://cmha.ca/documents/obsessive-compulsive-disorder-ocd ]
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