Obsessive-compulsive disorder, or OCD, affects 2% to 3% of the U.S. population, between 4-9 million people. Many who seek treatment for OCD wonder how long it will take for it to offer relief. Of course, everyone’s OCD journey is different, but with the help of a trained provider , treatment for OCD can begin to take effect relatively quickly.
How is OCD treated, and are the treatments effective?
If you have OCD, you have options when it comes to treatment, but the gold standard treatment is exposure and response prevention, or ERP. A two-pronged method, ERP involves exposing yourself to the stimuli that trigger your anxiety, and then choosing not to respond with a compulsive behavior. In other words, you expose yourself to fear and lean into uncomfortable emotions, then engage in response prevention where you choose to not escape from or neutralize the discomfort, instead letting it dissipate on its own.
For instance, if a dirty surface can lead to excessive hand-washing, ERP would have you touch the surface and not follow up with a rinse. It’s a challenging response to achieve permanently, but over time with the help of an expert to pinpoint what triggers you, ERP can be an incredibly effective method of treatment.
In fact, the success rate for ERP is approximately 65% to 80%. For comparison, using medication alone results in 40% to 60% effectiveness (although ERP in combination with medications can also be a highly effective treatment plan for some).
When should I seek treatment for OCD?
Here’s the tricky part: treatments and therapies are rather cut and dry, but actually getting diagnosed with the disorder can get sticky. For some, it can take years to learn they have the disorder. In fact, it takes 14 to 17 years on average for people to receive an OCD diagnosis. That’s why one of the biggest barriers to receiving treatment for OCD is being diagnosed with OCD in the first place.
Once diagnosed, however, you should seek treatment when your symptoms—ritualistic behavior, anxiety, depression, fear—become unmanageable and start interfering with your functioning, take up excessive amounts of time, and/or cause a great deal of distress. According to Science Direct, only about 200,000 people with OCD actually seek effective therapy.
So how long does ERP treatment for OCD take?
In a nutshell, it depends on a lot of things. For many, treatment is relatively quick, and its benefits can take immediate effect. The length of treatment can vary based on the severity of symptoms, but on average, people receiving ERP virtually will require around 2 months of treatment to achieve clinically significant results—though some people with more severe OCD can still achieve significant results with a longer timeline.
In online therapy for OCD, your therapist can do exposure exercises with you in the places that trigger your symptoms, so you can confront your fears in the appropriate environment. This can help you make progress faster and can mean your sessions may lead to better outcomes.
With ERP, the goal is for you to gain skills that will help you rely less on your therapist over time. While a therapist will be more involved in treatment at the beginning, in time you’ll be better equipped to handle the things OCD throws your way without them.
People with severe OCD might need elevated care before returning to individual therapy. That could look like an initial residential or partial hospitalization program, or perhaps an intensive outpatient program, for four to six weeks, and then sessions of ERP.
Bottom line: it takes as long as it takes. And that’s okay. Treatment is still worth doing even if it doesn’t produce overnight results. But many people can start seeing significant results in as little as two months’ time.
Is my OCD curable, or do I need to do ERP forever?
“Do I have to do ERP for the remainder of my life?” “Can ERP even completely cure OCD in the first place?” These are valid questions that elicit fuzzy answers.
OCD is chronic, so there is no guaranteed “cure”—rather, there are effective interventions and treatments that have proven successful. Over time, managing the symptoms of OCD can get easier, even becoming an afterthought. Intrusive thoughts or compulsive behavior may still arise, but learning innately to resist compulsions is the trick.
As mentioned earlier, the goal of OCD treatment isn’t to lean on a therapist for life. It’s to eventually learn how to “become your own therapist” – a point when you’re so skilled at doing ERP that you can manage an OCD episode. After seeing a significant reduction in OCD severity, your therapist should help you sustain results while slowly reducing the frequency at which they see you. For some people, this might take a few months. For others, it might take a few years.
With your therapist, you will learn practices to bring into your day-to-day life and hopefully decrease the impact of your compulsions. The intrusive thoughts or compulsions may still pop up every now and then, but people who have gone through — or are still going through — ERP therapy tend to be able to control their reactions to triggers by ignoring this background noise. So while you may always practice ERP to manage OCD, that doesn’t mean that OCD therapy itself is forever. For everyone, the long-term goal of ERP is the same: to be autonomous and fully functional in society without needing a therapist every week.
What if the treatment doesn’t work? When should I try a different method?
Although ERP is the leading treatment for children, adolescents, and adults with OCD, it isn’t guaranteed to work the same way for everyone. But just because ERP doesn’t work right away doesn’t mean it won’t work. It just may take a deeper understanding of what is actually triggering your OCD response.
It is a fairly common experience for someone to start ERP and think that it is not working for them, even though that may not actually be the case. When this happens, it doesn’t mean all hope is lost, but rather that we have to take a look at what might be interfering. For example, people may do exposures and find that their anxiety isn’t habituating over time or the exposures just aren’t getting anymore doable. In these situations, we have to thoroughly assess whether any compulsions or avoidance are occurring.
Sometimes OCD can be sneaky (not people with OCD—the OCD itself), and we can be engaging in compulsions that not even we know about or doing some avoidance that keeps us from engaging fully in the exposure! Trained ERP therapists will know to investigate any possible way we might be detaching ourselves from the exposure experience.
ERP, which requires working with a trained and specialized therapist, can be a marathon in these cases. Count on spending several sessions with your therapist, exhausting every aspect of the method as well as considering the addition of medication, before declaring the process a failure.
Where can I find ERP therapy?
If you are struggling with OCD, a free 15-minute call with our team at NOCD can give you all the information you need to regain your life from OCD. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.
Please also know, if you start treatment at NOCD Therapy and it isn’t right for you, we can connect you to another provider.
