Therapy for OCD is usually a type of cognitive behavioural therapy (CBT) with exposure and response prevention (ERP).
- working with your therapist to break down your problems into their separate parts, such as your thoughts, physical feelings and actions
- encouraging you to face your fears and have obsessive thoughts without neutralising them with compulsive behaviours; you start with situations that cause the least anxiety first, before moving on to more difficult thoughts
The treatment is difficult and may sound frightening, but many people find that when they confront their obsessions, the anxiety eventually improves or goes away.
People with fairly mild OCD usually need about 10 hours of therapist treatment, with exercises done at home between sessions. If you have more severe OCD, you may need a longer course of treatment.
You may need medicine if psychological therapy does not help treat your OCD, or if your OCD is fairly severe.
The main medicines prescribed are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). An SSRI can help improve OCD symptoms by increasing the levels of a chemical called serotonin in your brain.
You may need to take an SSRI for 12 weeks before you notice any benefit.
Most people need treatment for at least a year. You may be able to stop if you have few or no troublesome symptoms after this time, although some people need to take an SSRI for many years.
Do not stop taking an SSRI without speaking to your doctor first because suddenly stopping can cause unpleasant side effects. Treatment will be stopped gradually to reduce the chance of getting side effects. Your dose may need to be increased again if your symptoms return.
Possible side effects of SSRIs include:
- feeling agitated, shaky or anxious
- feeling or being sick
- diarrhoea or constipation
- sleeping problems (insomnia)
- low sex drive
Most side effects improve after a few weeks as your body gets used to the medicine, although some can persist.
SSRIs are not usually recommended during pregnancy, particularly during the first 3 months (1st trimester). This is because there may be a risk to the baby.
However, exceptions can be made if the risk posed by a mental health condition outweighs the potential risks of treatment.
Further treatment by a specialist team may sometimes be necessary if you've tried psychological therapy and medicine and your OCD is still not under control.
Some people with severe, long-term and difficult-to-treat OCD may be referred to a national specialist OCD service.
These services offer assessment and treatment to people with OCD who have not responded to treatments available from their local and regional OCD services.
OCD UK has more information about NHS Specialist OCD Treatment Services, including adult and child and adolescent services.
OCD support groups
Many people with OCD find support groups helpful, as they can:
- provide reassurance and coping advice
- reduce feelings of isolation
- offer a chance to socialise with others
- provide information and advice for family members and friends
You may want to visit the HealthUnlocked OCD forum, where you can discuss all aspects of the condition with others who have OCD.
You can also find mental health apps and tools in the NHS apps library.