Can I be Helped

Often times we are asked “Can I be helped?

Yes! Up until a few years ago we did not have effective treatments for OCD.  New medications and behavior therapy now give many patients significant relief.  In behavior therapy, the patient faces squarely the OCD difficulties either in a gradual step-by-step manner or in an aggressive one-step way.

The technical name for this process is exposure and response prevention.  Experts believe that behavior therapy is an effective treatment used by itself in certain patients with OCD if done well and vigorously.  Certain other patients will only respond to medication.  Many patients find the combined use of medication and behavior therapy most effective.

Anafranil (Clomipramine)
Luvox (Fluvoxamine)
Prozac (Fluoxetine)
Paxil (Paroxetine)
Zoloft (Sertraline)

Often the first medication tried will not work for a particular patient with OCD. That should not discourage you or your doctor since another medicine may work well. Side effects vary considerably depending upon which medicine is being used.

Experienced clinicians will readily attest to the fact that each medicine is unique and may behave differently especially with respect to side effects. ANAFRANIL, though having perhaps slightly more chance of effectiveness, has more disruptive side effects than the others listed. For that reason it is not used by some clinicians as a first choice.

Prozac, Zoloft, Paxil and Luvox are convenient remedies that usually have minimal effects (about 10-20% of people have either nausea, headaches, delayed orgasm or ejaculation, decreased sexual interest, or insomnia). medicines that must not be used with these medicines.  Psychiatrists are trained to know what medicines conflict with other medications.

Sometimes a psychiatrist may advise adding a second medicine to your SSRI to boost the power of treatment if your OCD is not responding.  Neuroleptic and benzodiazepine medicines are two commonly employed ‘booster’ medicines.
Other medicines used for this purpose are Buspar (buspirone) and the serotonin-2 antagonist/reuptake inhibitors: Desyrel (trazodone) and Serzone (nefazodone).

If you have OCD, you would be wise to be treated by a specialist who is well versed and experienced in using these medicines and behavior therapy at least until you seem to be recovered.

Some patients actually need nothing more than the medication. They make a full recovery and need no further treatment. Other OCD patients would definitely benefit from behavioral treatment called exposure and response prevention.
Exposure and response prevention mean that you expose yourself to whatever situation triggers the problem. You then prevent yourself from engaging in your usual ritual. For example, suppose that you have OCD problems with greasy substances. You might choose to allow yourself to become greasy while adding oil to your lawnmower (exposure). Instead of washing immediately, you prevent yourself from washing (response prevention).

By exposing yourself to your fear, anxiety increases temporarily. However, by continuing to avoid your usual compulsive behavior response, your anxiety is allowed to naturally diminish. The obsessive-compulsive cycle is broken, and the obsessive thoughts weaken. Confronting such fears is not easy and it may require special guidance from a trained professional.
In summary, if you have OCD you may be plagued by persistent, recurrent, intrusive and unwelcome thoughts or images, or by an urgent need to engage in silly or upsetting rituals. The problem is now treatable with medication and special psychological techniques.