Obsessive Compulsive Disorder (OCD) is more than being very organized or

liking things to be tidy. OCD is a serious psychiatric disorder that causes

people to have repetitive, intrusive thoughts, and to engage in compulsive

behaviors. OCD can cause significant problems in school, at work, and in

relationships, and can cause feelings of helplessness and hopelessness.

We can help.

 At Owl & Eagle Health and Wellness, our team of board-certified

psychiatric nurse practitioners and psychotherapists have the knowledge,

experience, and understanding required for accurate diagnosis and effective

treatment of OCD. They design an individualized holistic treatment plan for

OCD, combining medication, deep TMS, specialized

psychotherapy, and evidence based integrative care including nutritional

interventions, stress management, sleep hygiene, exercise, vitamins,

supplements, yoga, and meditation. This approach to treatment can be highly

effective for OCD, including cases that don’t respond to standard treatment,

and can improve your OCD symptoms while helping to optimize your overall

health and well-being. For expert psychiatric evaluation and holistic

psychiatric treatment for OCD in children, teens, or adults, either in person at

our offices convenient to the Denver Metro area, or via telehealth throughout

Colorado, Contact Us with questions or Book Now to request an intake

appointment today.

303-736-9697

OCD Q&A

What is OCD?

OCD causes uncontrollable, repetitive thoughts, fears, and

urges that cause anxiety and distress. People with OCD compulsively engage

in behaviors in an attempt to alleviate the anxiety and distress caused by their

obsessive thoughts. People with OCD spend hours of their day on obsessive

thoughts and compulsive behaviors, which can severely impair function in

school, at work, at home, and in relationships. Fortunately, effective treatment

for OCD is available. With treatment, people with OCD can control their

symptoms, regain function, and greatly improve their quality of life. At Owl &

Eagle Health and Wellness, our team of board-certified psychiatric nurse

practitioners and psychotherapists provides expert psychiatric care for OCD.

OCD Symptoms Symptoms of OCD include:

Obsessions: Obsessions are repeated, intrusive, and unwanted thoughts,

images, or urges that cause distress, anxiety, or disgust. Common obsessive

thoughts include fear of contamination, fears that something terrible will

happen, fear of or urges to destroy things, aggressive urges, fears of saying

the wrong thing or not saying the right thing, or the need for things to be

perfectly arranged, in a specific order, or symmetrical.

Compulsions: Compulsions are repetitive behaviors or mental rituals that the

individual feels they have to do to relieve the distress caused by obsessive

thoughts. Common compulsive behaviors include cleaning or washing hands

over and over, repetitive checking, counting, ordering or arranging things,

needing to confess, asking for reassurance, and touching or tapping.

People with OCD typically know that their obsessions and compulsions are

irrational, but they still can’t stop them from happening. They will have

obsessive thoughts, such as thoughts that a surface is covered with germs

and touching it will cause illness, which will cause anxiety and distress. Then

they feel compelled to perform a particular action, such as repeatedly

cleaning the surface, to help with the distress or prevent the feared outcome.

They will then have the obsessive thoughts and complete the compulsive

behaviors over and over. People with OCD typically spend at least an hour,

and often several hours, every day on obsessive thoughts and compulsive behaviors.

How common is OCD?

About 2.3% of people will develop OCD

at some point in their lives. The actual percentage may be higher, because

many people with OCD never get diagnosed or treated. Initial presentation of

symptoms of OCD usually occurs in children, teens, or young adults. About

half of people with OCD have severe impairment in function, and OCD is one

of the top 10 causes of disability. Fortunately, with effective treatment, people

with OCD can manage their symptoms and greatly improve their function and

quality of life.

What causes OCD?

OCD has multiple risk factors: 1)

Genetics. If someone in your family has OCD, you are more likely to have it

yourself. 2) Psychological trauma and stressors. Adverse experiences such

as abuse, neglect, and bullying increase risk for OCD. 3) Traumatic Brain

Injury. People who sustain a head injury with loss of consciousness or

confusion are twice as likely to develop OCD. 4) Bacterial and Viral Infections.

OCD that develops in children after a Group A streptococcal infection is called

Pediatric Autoimmune Neuropsychiatric Disorder Associated with

Streptococcal Infection Syndrome [PANDAS]. OCD can also develop acutely

after other bacterial and viral infections, including Mycoplasma pneumoniae,

varicella (chickenpox), toxoplasmosis, and encephalitis.

What is the best treatment for OCD?

At Owl & Eagle Health and Wellness, our team of board-

certified psychiatric nurse practitioners and psychotherapists have extensive

experience and expertise in OCD diagnosis and treatment for OCD. We use a

holistic approach to OCD treatment, combining medications, Deep TMS,

specialized psychotherapy, and evidence based

integrative treatments including dietary changes, vitamins, supplements,

stress management, sleep hygiene, exercise, yoga, meditation, and

breathwork. Research shows that this type of treatment can be highly

effective for OCD, relieving OCD symptoms and improving overall health and

wellness. OCD Medication Antidepressants, particularly SSRIs, are

considered first line medications for treatment of OCD. Antipsychotics are

commonly used as augmenting agents in OCD, when antidepressants alone

are not sufficiently effective. Most medications for OCD have very

manageable side effects, which typically resolve in the first weeks of

treatment. Genetic testing can help identify which medications are most likely

to be effective and well tolerated for you.

SSRIs for OCD: SSRIs such as fluvoxamine, fluoxetine, or sertraline are

considered first line treatment for OCD.

Other antidepressants for OCD: If SSRIs are not effective enough or have too

many side effects, other antidepressants can be used to treat OCD. SNRIs

such as venlafaxine, or the Tricyclic/Tetracyclic clomipramine are frequently

prescribed for OCD. OCD often requires higher doses of antidepressants and

it can take longer for them to be fully effective than in depression or anxiety.

Antipsychotics for OCD: Antipsychotics such as quetiapine or aripiprazole can

be used as adjunctive treatment for OCD, when antidepressants alone are

not sufficiently effective.

Anxiolytics for OCD: Antianxiety medications such as hydroxyzine or

propranolol can be used to augment the effects of antidepressants and/or as

needed for breakthrough anxiety in OCD.

Therapy for OCD Specialized psychotherapy for OCD includes Exposure

Therapy, Cognitive Behavioral Therapy, Acceptance and Commitment

Therapy, and Somatimotor Therapy.

Exposure Therapy: Exposure Therapy, also known as Exposure and

Response Prevention Therapy or ERP, is considered the gold standard in

psychotherapy for OCD, because it has the most research supporting its

efficacy. However, patients are sometimes hesitant to start ERP and drop-out

rates can be higher than in other types of therapy. In ERP for OCD, the

therapist exposes the patient to triggers for obsessive thoughts and

compulsive behaviors, gradually increasing the intensity of the triggers. The

therapist teaches the patient techniques to help stop themselves from

engaging in those thoughts and behaviors. The therapist provides

encouragement and helps the patient identify thoughts that reinforce anxiety

and compulsive behaviors and replace them with thoughts that help improve

tolerance of anxiety and ability to resist the urge to engage in compulsive

behavior.

Cognitive Behavioral Therapy: Cognitive Behavioral Therapy, or CBT, helps

the patient identify, reframe, and restructure the distorted thought patterns

that lead to dysfunctional behaviors. Improvement in thinking leads to

improvement in behavior. Although there is not as much research on CBT for

OCD as there is on ERP for OCD, the existing body of evidence suggests that

CBT is as effective as ERP and it may be more readily accepted by patients.

Acceptance and Commitment Therapy: Acceptance and Commitment

Therapy, or ACT, can be used as an alternative therapy for OCD, or in

conjunction with ERP or CBT. ACT encourages the patient to learn to accept

the existence of OCD symptoms and to continue to engage in life activities

despite their symptoms. More research is needed, but existing research on

ACT for OCD supports its efficacy, and patients may more readily engage in

ACT and drop-out rates are lower than in ERP.

Somatimotor Therapy: Somatimotor Therapy can also be used as alternative

therapy for OCD, or as adjunctive therapy with CBT or ERP. Somatimotor

Therapy combines mindfulness with concepts from neuroscience. It uses the

mind-body connection, encouraging the patient to identify and release

physical manifestations of anxiety in their bodies, such as muscle tension or

shallow breathing, which leads to improvement in the emotional state.

Although more research is needed on Somatimotor Therapy for OCD, some

research suggests that it can be effective, and it is readily accepted by

patients and drop-out rates are low.

Treatment Resistant OCD For cases of OCD that don’t resolve with standard

treatments, we can add TMS to the treatment plan.

TMS for OCD: The type of TMS that we use, Deep TMS, is the only type of

TMS that has been shown in peer-reviewed clinical trials to be an effective

treatment for OCD, including treatment resistant OCD. In real world clinical

practice, data from over 200 patients with OCD showed that 70% of patients

receiving Deep TMS achieved response to treatment, defined as a 50%

decrease in the severity of symptoms.

Integrative Treatment for OCD Psychotherapy, exercise, vitamins,

supplements, meditation, yoga, and breathwork can also be very helpful in

improving OCD symptoms and overall wellness. At Owl & Eagle Health and

Wellness, our board-certified psychiatric nurse practitioners provide

personalized holistic treatment for OCD, combining advanced medical

treatment and evidence based integrative treatment to effectively manage

OCD symptoms and help people with OCD achieve optimal mental health,

well-being, and quality of life.

If you would like to learn more about psychiatric evaluation and holistic psychiatric treatment for OCD for children, teens, and adults at Owl & Eagle Health and Wellness, Contact Us with questions or Book Now to request an intake appointment today. Appointments are available either in-person in our offices in Golden or Denver, Colorado, convenient to the Denver Metro area, or via telehealth anywhere in Colorado. We look forward to meeting you!