“For me, it’s like someone else has control of your brain. Like you’re being forced to do an endless number of completely random, pointless tasks you don’t want to do. It’s so exhausting and emotionally draining — like your brain needs an off switch!” — Clarissa Chay
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If you would like to learn more about OCD Treatment at Owl & Eagle Health and Wellness in person at our offices in Golden or Greenwood Village, CO or via Telehealth anywhere in Colorado, Contact Us with questions or Book Now to request an intake appointment today.
Obsessive Compulsive Disorder (OCD) is more than being very organized or liking things to be tidy. OCD is a serious psychiatric disorder that causes people to have repetitive, intrusive thoughts, and to engage in compulsive behaviors. OCD can cause significant problems in school, at work, and in relationships, and can cause feelings of helplessness and hopelessness. We can help.
At Owl & Eagle Health and Wellness, our team of board-certified psychiatric nurse practitioners and psychotherapists have the knowledge, experience, and understanding required for accurate diagnosis and effective treatment of OCD. They design an individualized holistic treatment plan for OCD, combining medication, deep TMS, Ketamine Treatment, specialized psychotherapy, and evidence based integrative care including nutritional interventions, stress management, sleep hygiene, exercise, vitamins, supplements, yoga, and meditation. This approach to treatment can be highly effective for OCD, including cases that don’t respond to standard treatment, and can improve your OCD symptoms while helping to optimize your overall health and well-being.
For expert psychiatric evaluation and holistic psychiatric treatment for OCD in children, teens, or adults, either in person at our offices convenient to the Denver Metro area, or via telehealth throughout Colorado, contact us with questions or Book Now to request an intake appointment today.
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Obsessive Compulsive Disorder Q &A
What is OCD?
OCD causes uncontrollable, repetitive thoughts, fears, and urges that cause anxiety and distress. People with OCD compulsively engage in behaviors in an attempt to alleviate the anxiety and distress caused by their obsessive thoughts. People with OCD spend hours of their day on obsessive thoughts and compulsive behaviors, which can severely impair function in school, at work, at home, and in relationships.
Fortunately, effective treatment for OCD is available. With treatment, people with OCD can control their symptoms, regain function, and greatly improve their quality of life. At Owl & Eagle Health and Wellness, our team of board-certified psychiatric nurse practitioners and psychotherapists provides expert psychiatric care for OCD.
OCD Symptoms
Symptoms of OCD include:
- Obsessions: Obsessions are repeated, intrusive, and unwanted thoughts, images, or urges that cause distress, anxiety, or disgust. Common obsessive thoughts include fear of contamination, fears that something terrible will happen, fear of or urges to destroy things, aggressive urges, fears of saying the wrong thing or not saying the right thing, or the need for things to be perfectly arranged, in a specific order, or symmetrical.
- Compulsions: Compulsions are repetitive behaviors or mental rituals that the individual feels they have to do to relieve the distress caused by obsessive thoughts. Common compulsive behaviors include cleaning or washing hands over and over, repetitive checking, counting, ordering or arranging things, needing to confess, asking for reassurance, and touching or tapping.
People with OCD typically know that their obsessions and compulsions are irrational, but they still can’t stop them from happening. They will have obsessive thoughts, such as thoughts that a surface is covered with germs and touching it will cause illness, which will cause anxiety and distress. Then they feel compelled to perform a particular action, such as repeatedly cleaning the surface, to help with the distress or prevent the feared outcome. They will then have the obsessive thoughts and complete the compulsive behaviors over and over. People with OCD typically spend at least an hour, and often several hours, every day on obsessive thoughts and compulsive behaviors.
How common is OCD?
About 2.3% of people will develop OCD at some point in their lives. The actual percentage may be higher, because many people with OCD never get diagnosed or treated. Initial presentation of symptoms of OCD usually occurs in children, teens, or young adults. About half of people with OCD have severe impairment in function, and OCD is one of the top 10 causes of disability. Fortunately, with effective treatment, people with OCD can manage their symptoms and greatly improve their function and quality of life.
What causes OCD?
OCD has multiple risk factors:
1) Genetics. If someone in your family has OCD, you are more likely to have it yourself.
2) Psychological trauma and stressors. Adverse experiences such as abuse, neglect, and bullying increase risk for OCD.
3) Traumatic Brain Injury. People who sustain a head injury with loss of consciousness or confusion are twice as likely to develop OCD.
4) Bacterial and Viral Infections. OCD that develops in children after a Group A streptococcal infection is called Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection Syndrome [PANDAS]. OCD can also develop acutely after other bacterial and viral infections, including Mycoplasma pneumoniae, varicella (chickenpox), toxoplasmosis, and encephalitis.
What is the best treatment for OCD?
At Owl & Eagle Health and Wellness, our team of board-certified psychiatric nurse practitioners and psychotherapists have extensive experience and expertise in OCD diagnosis and treatment for OCD. We use a holistic approach to OCD treatment, combining medications, Deep TMS, Ketamine Therapy, specialized psychotherapy, and evidence based integrative treatments including dietary changes, vitamins, supplements, stress management, sleep hygiene, exercise, yoga, meditation, and breathwork. Research shows that this type of treatment can be highly effective for OCD, relieving OCD symptoms and improving overall health and wellness.
OCD Medication
Antidepressants, particularly SSRIs, are considered first line medications for treatment of OCD. Antipsychotics are commonly used as augmenting agents in OCD, when antidepressants alone are not sufficiently effective. Most medications for OCD have very manageable side effects, which typically resolve in the first weeks of treatment. Genetic testing can help identify which medications are most likely to be effective and well tolerated for you.
- SSRIs for OCD: SSRIs such as fluvoxamine, fluoxetine, or sertraline are considered first line treatment for OCD.
- Other antidepressants for OCD: If SSRIs are not effective enough or have too many side effects, other antidepressants can be used to treat OCD. SNRIs such as venlafaxine, or the Tricyclic/Tetracyclic clomipramine are frequently prescribed for OCD. OCD often requires higher doses of antidepressants and it can take longer for them to be fully effective than in depression or anxiety.
- Antipsychotics for OCD: Antipsychotics such as quetiapine or aripiprazole can be used as adjunctive treatment for OCD, when antidepressants alone are not sufficiently effective.
- Anxiolytics for OCD: Antianxiety medications such as hydroxyzine or propranolol can be used to augment the effects of antidepressants and/or as needed for breakthrough anxiety in OCD.
Therapy for OCD
Specialized psychotherapy for OCD includes Exposure Therapy, Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and Somatimotor Therapy.
- Exposure Therapy: Exposure Therapy, also known as Exposure and Response Prevention Therapy or ERP, is considered the gold standard in psychotherapy for OCD, because it has the most research supporting its efficacy. However, patients are sometimes hesitant to start ERP and drop-out rates can be higher than in other types of therapy. In ERP for OCD, the therapist exposes the patient to triggers for obsessive thoughts and compulsive behaviors, gradually increasing the intensity of the triggers. The therapist teaches the patient techniques to help stop themselves from engaging in those thoughts and behaviors. The therapist provides encouragement and helps the patient identify thoughts that reinforce anxiety and compulsive behaviors and replace them with thoughts that help improve tolerance of anxiety and ability to resist the urge to engage in compulsive behavior.
- Cognitive Behavioral Therapy: Cognitive Behavioral Therapy, or CBT, helps the patient identify, reframe, and restructure the distorted thought patterns that lead to dysfunctional behaviors. Improvement in thinking leads to improvement in behavior. Although there is not as much research on CBT for OCD as there is on ERP for OCD, the existing body of evidence suggests that CBT is as effective as ERP and it may be more readily accepted by patients.
- Acceptance and Commitment Therapy: Acceptance and Commitment Therapy, or ACT, can be used as an alternative therapy for OCD, or in conjunction with ERP or CBT. ACT encourages the patient to learn to accept the existence of OCD symptoms and to continue to engage in life activities despite their symptoms. More research is needed, but existing research on ACT for OCD supports its efficacy, and patients may more readily engage in ACT and drop-out rates are lower than in ERP.
- Somatimotor Therapy: Somatimotor Therapy can also be used as alternative therapy for OCD, or as adjunctive therapy with CBT or ERP. Somatimotor Therapy combines mindfulness with concepts from neuroscience. It uses the mind-body connection, encouraging the patient to identify and release physical manifestations of anxiety in their bodies, such as muscle tension or shallow breathing, which leads to improvement in the emotional state. Although more research is needed on Somatimotor Therapy for OCD, some research suggests that it can be effective, and it is readily accepted by patients and drop-out rates are low.
Treatment Resistant OCD
For cases of OCD that don’t resolve with standard treatments, we can add TMS or Ketamine Therapy to the treatment plan.
TMS for OCD: The type of TMS that we use, Deep TMS, is the only type of TMS that has been shown in peer-reviewed clinical trials to be an effective treatment for OCD, including treatment resistant OCD. In real world clinical practice, data from over 200 patients with OCD showed that 70% of patients receiving Deep TMS achieved response to treatment, defined as a 50% decrease in the severity of symptoms.
Ketamine for OCD: Ketamine treatment can be an effective adjunctive treatment for OCD. A recent metaanalysis showed that in 80% of studies on ketamine for OCD, ketamine treatment resulted in a significant reduction of obsessions and compulsions.
Integrative Treatment for OCD
Psychotherapy, exercise, vitamins, supplements, meditation, yoga, and breathwork can also be very helpful in improving OCD symptoms and overall wellness.
At Owl & Eagle Health and Wellness, our board-certified psychiatric nurse practitioners provide personalized holistic treatment for OCD, combining advanced medical treatment and evidence based integrative treatment to effectively manage OCD symptoms and help people with OCD achieve optimal mental health, well-being, and quality of life.
If you would like to learn more about psychiatric evaluation and holistic psychiatric treatment for OCD in children, teens, and adults at Owl & Eagle Health and Wellness, Contact Us with questions or Book Now to request an intake appointment today. Appointments are available either in-person at our offices in Golden or Greenwood Village, Colorado, convenient to the Denver Metro area, or via telehealth anywhere in Colorado. We look forward to meeting you!
Sources
https://www.mentalhealth.gov/basics/mental-health-myths-facts
https://mhanational.org/mentalhealthfacts
https://www.bmj.com/content/bmj/384/bmj-2023-077564.full.pdf
https://www.tandfonline.com/doi/pdf/10.31887/DCNS.2010.12.2/dmurphy
https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Obsessive-compulsive-Disorder
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9063577/
https://pubmed.ncbi.nlm.nih.gov/37213965/