It’s not hard to find depictions of OCD (obsessive-compulsive disorder) in movies or on TV. It’s portrayed as a personality quirk—a need for organization or a fear of germs. The truth: OCD is a chronic illness that’s complex and varied. For people living with it, the fear, doubt, and shame can feel hopeless and debilitating.
But there’s another thing movies and TV leave out: OCD is treatable. If you think you might have OCD here’s what you need to know about finding help.
First, it’s pretty common. About 1 in 40 people are affected by OCD in their lifetime. And while what OCD looks like can vary greatly, there are two things most people living with it experience, and they’re both in the disorder’s name:
Obsessive thoughts: these are overwhelming, disturbing, unwanted thoughts in daily life. They’re usually about things that matter greatly to the person who’s experiencing them.
Compulsive behaviors: these are specific, sometimes repetitive behaviors a person does to make sure obsessive thoughts don’t come true.
Together, obsessions and compulsions can create a cycle that’s time-consuming, causes significant distress, and interferes with a person’s ability to function socially.
The exact symptoms of OCD can vary a bit from person to person, but there are some common signs that tend to manifest.
Let’s say a person is at home, cleaning their kitchen. A sudden thought pops into their head. “If I don’t do this right, something terrible is going to happen to my mother.” There isn’t a logical connection between the thought and the situation. It’s terrifying, and impossible to get rid of.
The person understands that the thought doesn’t make sense and feels ashamed of it. The person becomes intently focused on cleaning the kitchen right. Finishes once and starts over in a very particular way, thinking, “If I don’t do this right, my mother will die.”
In this case, the intrusive thought is, “My mother will die if I don’t do this right.” The compulsion is cleaning the kitchen in a very specific way to prevent that harm from happening. In reality, there’s no connection between the two: the health of the mother and the cleanliness of the kitchen.
The person experiencing these thoughts may even know that there’s no connection, but that does little to convince their brain that they can stop the compulsion. In fact, this lack of control over their thoughts and actions can be another source of suffering.
Cleanliness is just one way OCD might manifest.
The DSM-5 (a reference book many mental health professionals use to help diagnose and understand conditions) has a list of symptoms that includes:
These are just to name a few. If you feel you may have intrusive thoughts, or have thoughts coupled with actions that are causing distress, or interfering with your ability to work or socialize, it might be time to talk to a mental health professional, like a psychiatrist to help you better understand what’s going on.
There isn’t an exact cause. Research suggests that genetics, brain structure, and environmental triggers can be risk factors.
Once you’ve decided to seek help, likely the first thing your doctor or clinician will do is an evaluation, or OCD test. This is a great first step. Similar to other mental health conditions, OCD can come with a lot of shame and uncertainty. Remember, your clinician is there to help you, not judge. Here’s what an initial evaluation usually looks like.
There isn’t a definitive test for OCD. Your clinician will want to talk with you about what you’re experiencing, how you feel about it, what your past experience with mental healthcare is, and your medical history.
They’ll ask about your symptoms, when they started, and how they’re affecting you and your quality of life.
They’ll also ask about other factors (like family history) that might give them more information.
If your evaluation is with a Talkiatry psychiatrist, you’ll have a full hour to give you time to discuss what’s going on and to give you enough time to ask any questions you may have, too.
While this can feel scary, it can also be validating to finally put a name to what you’ve been experiencing. Your psychiatrist will help you navigate any emotions that come up and work with you on a path to move forward.
While OCD has no cure, treatment can drastically improve your symptoms. OCD treatment will depend on your needs and the severity of your symptoms. Your provider will work with you to make sure you are comfortable with your treatment plan.
Most commonly, OCD is managed with a combination of medication and supportive therapy.
The most common medications used to treat OCD are called serotonergic antidepressants. such as selective serotonin reuptake inhibitors (SSRIs). SSRIs work by keeping certain chemical messengers active in the brain. They help regulate serotonin (the “happy hormone”).
Examples of SSRIs include:
- Fluvoxamine (Luvox®)
- Sertraline (Zoloft®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®)
- Paroxetine (Paxil®)
Therapy can be an important tool to help with symptom management for OCD. It can take various forms:
Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 60 insurance partners, and first visits available in days. We treat patients with anxiety, depression, trauma, ADHD, and more. Get started with a short online assessment.
The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.
Dr. Mendez-Maldonado is double board-certified in general psychiatry and geriatric psychiatry. She received her medical degree from the University of Puerto Rico School of Medicine. She then moved to New York to complete her residency training At Mount Sinai Beth Israel where she stayed to complete her fellowship in geriatric psychiatry. After her fellowship, she proceeded to work at Woodhull Hospital where she worked as an attending before becoming unit chief and running their Special Pathogens Unit during the COVID-19 pandemic.
She focuses on medication management and offers this in conjunction with supportive therapy, cognitive-behavioral techniques, a focus on nutritional psychiatry, and 30-minute follow-up visits.
Dr. Mendez-Maldonado focuses on integrating nutrition, physical activity, and mindfulness techniques alongside pharmacotherapy to achieve a well-rounded approach to mental health.