Treatment

Obsessive compulsive disorder (OCD) is a treatable condition. The treatment recommended will depend on how much it's affecting your life.

The two main treatments are:

• psychological therapy usually a type oftherapy thathelps you face your fears and obsessive thoughts without "putting them right" with compulsions
• medication usually a type of antidepressantmedication that can help byaltering the balance of chemicals in your brain

A short course of therapy is usually recommended for relatively mild OCD. More severe OCD may require a longer course of therapy and/or medication.

These treatments can be very effective, but it's importantto be aware that it can take several months before you notice the benefit.

You can get treatment on the NHS through your GP, or in some areas by referring yourself to a local psychological therapy service.

Psychologicaltherapy

Therapy for OCD is usually a type calledcognitive behavioural therapy (CBT) with exposure and response prevention (ERP).

This involves:

• 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 fear and let the obsessive thoughts occur without neutralising them with compulsive behavioursyou start with situations that cause you the least anxiety first, before moving onto more difficult thoughts

The treatment is difficult and may sound frightening, butmany people find that when they confront their obsessions, the anxiety does eventually improve or go away.

People with fairly mild OCD usually need about 10 hours of therapist treatment, combined with exercises done at home between sessions. A longer course may be necessary in more severe cases.

Medication

You may need medication if psychologicaltherapy doesn'thelp treatyour OCD, or if your OCD is fairly severe.

The main medications prescribed areselective serotonin reuptake inhibitors (SSRIs).These canhelp improve OCDsymptoms by increasing the levels of a chemical called serotonin in your brain.

You may need to take the medication for 12 weeks before you notice any effect.

Most people require 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 medication for many years. Your symptoms may continue to improve for up to two years of treatment.

Don't stop taking SSRIs without speaking to your doctor first, as this can cause unpleasant side effects. When treatment is stopped, it will be done gradually to reduce the chance of this happening. Your dose may need to be increased again if your symptoms return.

Side effects

Possibleside effects of SSRIs include:

• feeling agitated, shaky or anxious
• feeling or being sick
• diarrhoea or constipation
• dizziness
• sleeping problems(insomnia)
• headaches
• low sex drive

There's also a verysmall chance that SSRIs could cause you to have suicidalthoughts or want toself-harm. Contact your GP or go to your nearest accident and emergency (A&E) department if this happens.

Most side effects improveafter a fewweeksas your body gets used to the medication, although some can persist.

Further treatment

Further treatment by a specialist team may sometimes be necessary if you've tried the treatments above and your OCD is still not under control.

Some people with severe, long-term and difficult-to-treat OCD may be referred to the National OCD Servicein London.

The service offers assessment and treatment to people with OCD who haven't responded to treatments available from their local and regional OCD services.

To be eligible for this service, you must have been diagnosed as having severe OCD and have received:

• treatment with at least two different SSRIs at recommended doses for at least three months
• at least two attempts at psychological therapy, both in a clinic and at home
• additional treatment with another medication, such as a different type of antidepressant called clomipramine,or an SSRI at a dose higher than normally recommended

Most people's conditionimproves after receiving treatment from the National OCD Service.