How to treat obsessive-compulsive disorder

OCD is treatable. The best results come from therapy, medicines or both, delivered by mental health professionals.

Step 1: assessment

A psychiatrist or psychologist asks about obsessions, rituals, time taken and distress, and checks for anxiety, depression, tics and other conditions. They may use a rating scale such as the Y-BOCS.

Step 2: psychotherapy

• Exposure and response prevention (ERP): the main therapy. You gradually face feared situations and practise not doing the ritual. It is done step by step with a therapist, and it works for most people who complete it.
• Cognitive behaviour therapy (CBT): helps change how you respond to obsessive thoughts
• Family involvement: helps relatives avoid joining rituals

Step 3: medicines

SSRIs and sometimes clomipramine, prescribed by a doctor. Used with therapy for moderate to severe OCD.

Step 4: if symptoms persist

Add-on medicines, intensive outpatient or day programmes, or specialist treatments such as TMS or, rarely, surgery for severe cases.

Step 5: relapse prevention

Keep practising skills, follow up and act early if symptoms return.

Self-help

Routine, exercise, sleep and support groups.

Where Ayurveda fits

Yoga, breathing and relaxation can be calming adjuncts. Herbs or rituals must not replace treatment.

Help now: thoughts of self-harm need urgent help. Call 112, or Tele-MANAS at 14416 in India.

Remember

Recovery is realistic. Stay with treatment, because improvement often takes weeks to months.

When to get help

See a psychiatrist or psychologist if thoughts and rituals take more than an hour a day, cause distress or limit your life. Do not stop or replace prescribed medicines with herbs, and do not give herbs or home remedies to children without a paediatrician's advice. If you have thoughts of harming yourself, call 112 or Tele-MANAS at 14416 in India.