Obsessive-Compulsive Disorder (OCD) is a condition characterized by obsessive thoughts, fears, and compulsive behaviors that accompany these thoughts and fears. While it is possible for a person to have only obsessive thoughts or only compulsive behaviors, the two usually come together because the behavior appears as an irrational way of dealing with scary thoughts. This disorder can be well managed through a combination of therapy, understanding, and self-help methods (including overall lifestyle changes).
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Part 1 of 4: Treating OCD with Therapy
Step 1. Choose a therapist
Find a therapist who has experience treating OCD or related disorders. Ask your doctor, ask for references from family or friends, or try searching the internet.
Make sure the therapist you choose makes you feel comfortable and has the necessary qualifications to meet your needs
Step 2. Get a diagnosis of OCD
The diagnosis must be obtained from a professional because there are many other problems that have the same symptoms as OCD. Your doctor can refer you, but a qualified mental health professional should make the diagnosis. There are two groups of OCD symptoms, namely obsessions and compulsions. Obsessive symptoms are unwanted, constant, and lingering thoughts, urges, or images that trigger feelings of anguish or worry. You may feel that the thought or image keeps coming back even when you try to avoid it or stop it. Compulsion symptoms are behaviors that you perform to deal with the worries associated with the obsession. Such behavior is intended to prevent fears from becoming reality and usually manifests in rules or rituals. Together, the obsessions and compulsions create the following characteristic patterns:
- Those who are afraid of contamination and the spread of germs usually have a compulsion to clean or wash their hands.
- Others are constantly checking on all the things (that the door is locked or the oven is turned off, etc.) that they associate with a potential hazard.
- Some people fear that if things are not done right, something bad will happen to them or their loved ones.
- Many are obsessed with order and symmetry. They are usually superstitious about certain sequences and arrangements.
- Then, there are those who are afraid that something bad will happen if they throw anything away. This makes them compulsively store all things they don't need (such as broken items or old newspapers). This condition is called Compulsive Hoarding.
- To be diagnosed with OCD, you must have obsessions and compulsions on most days for at least two weeks. Or, you may be diagnosed with OCD if your obsessions and compulsions have a significant impact on your daily life (e.g. you're afraid of germs so you often wash your hands until they bleed and you can't touch anything outside).
Step 3. Try to control your compulsive behavior with a psychotherapist
This therapy focuses on Exposure and Response Prevention (ERP), meaning the therapist will expose you to things you fear or obsess over, and then help you find healthy ways to deal with that anxiety.
Therapy sessions may consist of individual sessions, family therapy sessions, or group sessions
Step 4. Talk to your doctor to find a suitable medication
You may have to try several drugs until you find one, and in some cases, a combination of several drugs may be more efficient at fighting symptoms than just one drug.
- The types of drugs commonly prescribed are serotonin reuptake inhibitors (SSRIs), such as citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and escitalopram (Lexapro). These drugs increase the activity of a neurotransmitter that helps balance mood and reduce stress (serotonin).
- Another commonly prescribed drug is the tricyclic antidepressant (TCA) clomipramine, which has been approved by the American FDA to treat OCD. SSRIs are usually prescribed more often than clomipramine because they have fewer side effects.
- Never stop taking medication without consulting the doctor who prescribed it. This can make your symptoms recur and a side effect of some kind of withdrawal.
Part 2 of 4: Using Exposure and Response Prevention (ERP)
Step 1. Learn about the vicious cycle of OCD
OCD occurs when unpleasant thoughts (for example, thoughts of spreading illness to your loved ones) happen to come to your mind, and extreme interpretations of those thoughts follow (perhaps thoughts that say you are evil for harming others through carelessness). This combination of thought and interpretation will cause great anxiety.
- Because anxiety is so uncomfortable, you act to make sure the thought doesn't come true. In this example, you might wash your hands every time you touch something and pray for your loved ones while washing your hands.
- While this ritual may temporarily relieve anxiety, bad thoughts will appear more and more frequently (because you're trying too hard not to think about them). This is called the vicious cycle of OCD.
- The main point of ERP is to expose yourself to situations that give rise to obsessions and then not engage in strategies that don't actually help them (i.e. compulsive behavior).
- If your OCD is very severe, you should try ERP under the guidance of a professional expert.
Step 2. Identify the trigger
Anything that triggers obsessions and compulsions (other situations, objects, people, or thoughts) is called a “trigger” because it can activate the OCD cycle. It's important to know the triggers because that's what you should be exposed to in an effort to practice refraining from compulsive anxiety-reducing behaviors.
Use this sheet to help keep track of what triggers your symptoms for one week
Step 3. Write down a sequence of your fears
After listing your obsessions and compulsions for a week, rank the situations you fear from lowest to highest.
- For example, if you're afraid of contamination, being at your parents' house might rank low. Visiting your parents' house only gives you a fear level of 1/10. On the other hand, using a public restroom probably ranks the highest and raises a level 8 or 9 fear.
- Use a different sequence of fears if there are multiple triggers. For example, all of the situations you fear related to the fear of illness would go in one order and the fears related to preventing catastrophe would go in another.
Step 4. Face your fear
For this exposure strategy to work, you should try to fight the compulsions during or after the exposure (to the maximum extent possible). This is because ERP teaches you to face fear without the compulsions that come with it.
- Then, ask someone you trust to show you how to do something that affected your OCD. Learning from other people's behavior will help because it's likely that you've had compulsions for a long time and can't remember how to deal with scary situations without compulsions. For example, people who compulsively wash their hands could ask their families about their hand-washing habits to gain a more general understanding of how and when to wash their hands.
- If fighting a compulsion completely turns out to be very difficult (especially in the beginning), try procrastinating instead of not doing it at all. For example, after leaving the house (exposure), wait 5 minutes before coming back in to check electronics, and only check 2 instead of 5. Gradually prolonging the delay will eventually help you to leave the action completely.
- If you later indulge in the compulsion, try repeating the exposure to the same scary situation immediately after, and repeat the exercise until your fear is reduced by half. So, leave the house again immediately after the above process, and keep repeating until your fear drops from “8” to just “4”.
Step 5. Increase exposure
If your anxiety is minimal after completing the exercise, you can move on to the next stage. Let's say that after some practice you feel very little anxiety while waiting 5 minutes before checking electronics after leaving the house. After that, you can challenge yourself to wait 8 minutes.
- Keep in mind that even if you feel very intense anxiety, the fear will spike and then come down again slowly. If you don't respond, the fear will go away on its own.
- Exposure is an experience that can be quite a test for you, and if you need additional support, don't hesitate to ask someone close for help.
Part 3 of 4: Learn to Overcome Obsessive Thoughts
Step 1. Record your obsessive thoughts
To challenge some of the unhelpful interpretations you pour into your obsession, you must first know what you're thinking. It is best to start noting two things: 1) your obsession, and (2) the meaning or interpretation you give to the obsession.
- Use this sheet to record three obsessions (and your interpretations) per day for a week.
- Take note of the situations that gave rise to your obsessions and obsessive thoughts in specific situations. When did you first have this thought? What happened the first time you experienced it? Also, record all your emotions when the obsession is present. Rate the intensity of your emotions during the obsession on a scale from 0 (no emotion) to 10 (as intense as you can imagine).
Step 2. Record your interpretation of the obsessive thought
When noting thoughts, also note the interpretation or meaning you give to those thoughts. To find out what you're interpreting (because it's sometimes hard to trace), ask the following questions::
- What's not fun about this obsession?
- What does this obsession say about me or my personality?
- Based on my own thoughts, what would I become if I didn't indulge this obsession?
- What might happen if I don't follow this thought?
Step 3. Challenge your interpretation
Fighting interpretations will help you see that for various reasons, your automatic thoughts are unrealistic. Not only that, your interpretation is also not helpful in guiding you to solve the problem the thought raises. Ask the following questions to prove you wrong:
- What evidence do I really have for and against this interpretation?
- What are the advantages and disadvantages of this kind of thinking?
- Am I wrong to take this thought as fact?
- Is my interpretation of this situation accurate or realistic?
- Am I 100% sure this thought will come true?
- Do I view possibility as absolute certainty?
- Was my prediction of what would happen just based on feelings?
- Would my friend agree that this scenario in my head would happen?
- Is there a more rational way of looking at this situation?
Step 4. Learn realistic thinking methods
Unhelpful interpretations are usually caused by confusion in the mind that is often found in people with OCD. Examples of common mind traps are:
- Catastrophe fantasies when you are sure (with no evidence at all) that the worst-case scenario is likely to occur. Counter this kind of thinking by telling yourself that worst-case scenarios are very rare.
- Filtering is a trap that makes you see only the bad things that happen and ignore and rule out the good. To counter these thoughts, ask yourself what parts of the situation escaped your consideration, especially the positive ones.
- Overgeneralization, i.e. overestimating one situation into all situations, such as thinking because you misspell a word, you always make stupid mistakes. Avoid overgeneralizing by thinking about evidence to the contrary (when you prove to be very intelligent or when you see and correct mistakes.
- Black and white thinking, meaning that the situation is only seen in extremes, between success or failure. For example, if you forget to wash your hands, your hands are full of germs so you are a lousy and irresponsible person. Try to shut down your black and white mind by seriously considering whether you've really had an adverse effect and reminding yourself that right now (and in fact at any time) is not a good time to judge your own personality.
- You can find out about other mind traps here.
Step 5. Resist the urge to blame yourself
OCD is a chronic condition, and unpleasant or unwanted thoughts are not something you can control. Realize that these thoughts are just distractions that have no effect outside your own head. What you think is just a thought, and does not define who you are as a person.
Part 4 of 4: Coping with OCD with Diet and Lifestyle Changes
Step 1. Recognize the link between OCD and lifestyle habits
Because OCD is a type of anxiety disorder, stress can trigger symptoms that make OCD even more difficult to treat and manage. A lifestyle that can keep stress and worry away from worrying may also help relieve OCD symptoms.
Step 2. Eat foods rich in omega 3 fatty acids
Omega 3 fatty acids can directly help increase the brain's levels of serotonin, the same neurotransmitter affected by medical drugs to treat OCD. That is, these foods also help deal with anxiety. Choose foods rich in omega 3 fatty acids rather than supplements. Among others:
- Flax seeds and walnuts
- Sardines, salmon and prawns
- Soybeans and tofu
- Cauliflower and pumpkin
Step 3. Limit caffeinated foods and drinks
Caffeine can actually suppress serotonin production in the brain. Foods and drinks that contain caffeine include:
- Coffee and coffee flavored ice cream
- Red tea, green tea and energy drinks
- Kola
- Chocolate and cocoa products
Step 4. Try to exercise regularly
Exercise not only improves muscle strength and cardiovascular health, it can also help fight anxiety and OCD tendencies. Exercise increases the body's production of endorphins, hormones that play a role in improving mood, reducing anxiety, and fighting depression.
Try to exercise for at least 30 minutes, five times a week. Examples of healthy exercise are running, cycling, lifting weights, swimming, and rock climbing
Step 5. Enjoy more time outdoors
Among its many benefits, the sun increases the synthesis of serotonin in the brain by stopping its absorption by nerve cells. By exercising in the sun, you will get two benefits at once!
Step 6. Cope with stress
When you're stressed, you're likely to notice an increase (or increase in intensity) of your symptoms. So, learning mental and physical methods to reduce stress will be very useful overall. For example::
- Make healthy lifestyle changes in the long term, such as a healthy diet and exercise.
- Using a to-do list
- Reduce negative self-talk.
- Applying the progressive muscle relaxation method.
- Learn sensitivity and visualization meditation.
- Learn to recognize the source of stress.
- Learn to decline an invitation if you know you can't handle it.
Step 7. Join a support group
There is a support group that contains people with the same problem as you. In the group, you can discuss your experiences and difficulties with the same people. These support groups are great for finding solace and reducing the feelings of isolation that often accompany OCD.
Talk to a therapist or doctor to find a support group in your area. Or, find a support group online
Tips
- Symptoms of OCD usually develop slowly and vary in severity over the sufferer's lifetime, but usually peak when they are triggered by stress.
- You should consult a specialist if your obsessions or compulsions are completely affecting your well-being.
- A diagnosis should be obtained from a mental health professional because there are many other problems that have symptoms similar to OCD. For example, if you feel generalized and all-encompassing anxiety, you may have Generalized Anxiety Disorder (COPD), not OCD. If your fear is intense but only about one or a few things, you may have a phobia, not OCD. Only a professional can make an accurate diagnosis and provide the treatment you need.
