Category: Treatment

Therapy, medication, and helpful tips


The things we tried before we saw an OCD specialist

By Patrick,

Like many of you out there, a few members of the NOCD team have tried a whole bunch of things for obsessive-compulsive disorder, or OCD. Many people struggle with obsessions and compulsions for years, and it is by no means abnormal to have searched far and wide for something that actually works.

All of us landed, eventually, in evidence-based treatment with an OCD-trained therapist. We were fortunate enough to live within a reasonable distance of specialists we could afford; though our treatment trajectories varied quite a bit, and there’s no such thing as a cure, we’ve all benefited greatly from exposure and response prevention (ERP) therapy.

But… the path was neither simple nor easy for anyone on our team. That’s why I’ve been going around the NOCD office and gathering thoughts about some of the things we tried before we learned about — and began —  ERP therapy with OCD specialists.

Google

Yep, we all did a lot of this. It’s only natural to start by searching on the internet when you have no idea what’s happening, and it’s tempting to keep going back whenever your anxiety really flares up (this is why OCD specialists tend to view Googling as a compulsion).

As a NOCD team member put it: “Googling gave me a source of comfort when I was too afraid to talk with anyone about what was going on. But it also ended up preventing me from finding more useful ways to deal with the problem. It was like getting fast food when I needed to learn how to cook healthy meals.”

Snapping a rubber band

The rubber band trick is kind of old school, and has mostly fallen out of favor in the OCD treatment community. The idea: by snapping a rubber band on your wrist whenever you notice yourself obsessing you can bring yourself back into the moment and respond to the thought differently.

But this approach is no longer recommended because “thought stopping” isn’t useful, and can even be harmful, based on research. This may be because snapping your wrist makes you pay more attention to your thoughts, which is the opposite of what OCD treatment aims to do.

As a NOCD team member put it: “My first therapist told me to go around snapping a rubber band on my wrist all day. It wasn’t helping, and it seemed kind of weird to be inflicting a small amount of pain on myself whenever I was obsessing. It didn’t feel like a very advanced way of improving my psychological wellbeing.”

Avoidance

Netflix, video games, excessive sleeping, overexercising, drinking, drugs, texting, social media, and so on: the possibilities for avoidance are endless. Not to mention the most common form of avoidance—simply staying away from any situation that brings your obsessions to mind.

We all “tried” avoidance in the sense that it took us a while to even want to get OCD treatment. If we could’ve successfully gotten around the problem without the hard work, avoidance would’ve been helpful. But, like Googling, avoidance keeps you from getting the help you need. Depending on its exact nature, it can be harmful to your physical and mental health in other ways too.

As a NOCD team member put it: “Over time, I noticed that the activities I’d always enjoyed, like watching movies, had become compulsive for me. There was nothing quite like that escape from my most disturbing thoughts, especially when I’d spent the whole day struggling with them. But the OCD always caught up with me, and eventually I realized I would need to learn some strategies that didn’t involve my phone or laptop.”

Exercise


Exercise is generally a good thing, and people with OCD benefit from exercising just like anyone else. But this is a tricky one, because a “healthy” amount of exercise can easily slide into something else. Especially with something like OCD, where behaviors that relieve unwanted feelings transform pretty easily into compulsions. Moderation is hard to define, but being conscious of the way you’re using exercise, cutting yourself off after a pre-set amount of time, and taking regular days off are smart first steps.

As a NOCD team member put it: “For me, it’s important to think of exercise as a regular part of my lifestyle and a way to make sure I’m healthy and resilient, rather than a means of getting rid of my feelings. Getting reliable relief from stress and tension is one of main reasons I work out, but I have to make sure I’m exposing myself to imperfection here just as I do in other parts of my life. I’ve learned to exercise without it becoming a form of avoidance (or doing it until my physical health suffered), but it took a while to find this balance.”

Therapy

When most people think of therapy, they picture someone sunk into a comfortable couch, within reach of a Kleenex box, talking through problems while their therapist takes notes. This is what most therapy looks like, and it can be very helpful. Having a productive relationship with a good therapist — someone who’s experienced, empathetic, and knowledgeable — can work wonders for overall mental health. Specific therapeutic disciplines, like cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), can be especially effective for mood disorders, anxiety-based disorders, and other conditions.

Because most therapy works in this way, most people start here. And it’s important to know that doing any kind of therapy is a great step. But some forms can actually worsen OCD symptoms by making thoughts seem more important and providing reassurance. ERP is specifically designed for OCD and related disorders, and works directly on compulsions — the part of OCD that you can control.

As a NOCD team member put it: “There’s no denying the comfort I felt at having a compassionate, attentive listener each week. And I did gain a lot from working with my first therapist — we came up with plans for me to start exercising and sleeping more, talked through my family and relationship difficulties, and got me back on track. But after a year I realized the OCD part of my mental health wasn’t getting better, and asked for a referral to an OCD specialist. This made a huge difference.”

If you’re interested in speaking with an OCD-trained therapist, get in touch below!

Could my child have OCD?

By Patrick,

Mental health is never simple, but it can be especially complicated in children, who are always changing and developing new patterns in thought and behavior. Many parents write to us with concerns about OCD. Because we aren’t able to diagnose anyone at NOCD, there’s no definitive answer. But we’ve found some helpful resources– let’s take a look.

Like adults, kids with OCD have obsessions and compulsions and are prone to hiding these symptoms out of embarrassment or a lack of understanding. Compulsions in kids and adults serve the same purpose: getting rid of distress caused by obsessions, which are intrusive and unwanted thoughts, images, and urges. Both symptoms develop (and change) over time.

Parents might be able to spot these symptoms when their kids demonstrate sudden emotional changes, struggle to focus on schoolwork and other activities, and take a long time to make decisions or perform everyday tasks like brushing their teeth. There are plenty of other signs, but most involve excessive carefulness and evidence of resulting discomfort. Kids might also start to demand that their parents or other family members do things in the correct way, as dictated by their own obsessive-compulsive cycle.

Research suggests at least 1 in 100 children around the world has OCD. If you think your child might be among them, it’s important to start with empathy. It can be frustrating and confusing to feel like kids are acting out or unfairly demanding very specific things of their relatives, but try your best to step back and recognize that they’re probably not doing so in an attempt to make your life harder. In fact, they’re most likely acting out of intense fear and debilitating anxiety.

Even as you try to bring empathy to the situation, you don’t need to force yourself not to get frustrated or feel helpless at times. These feelings are common, as is the desire to solve the situation by yourself. But it’s probably unwise to try, considering you’re very close to the situation and don’t have the required expertise. Repetitive behaviors might seem predictable (and therefore simple to approach) after you’ve seen them so many times, but they’re actually complex– especially when you factor in all of the thoughts and feelings underlying them, invisible to you and embarrassing for your child.

The predictable, but most useful, next step is to take your kid to a child psychologist or child psychiatrist for an evaluation. Even the most research-backed, fanciest websites aren’t sufficient for you to make a diagnosis yourself, and a licensed professional will know what to look for. If they suspect a child has OCD, they can rule out physical causes like PANDAS and discuss treatment options with you and your child. Treatment might include therapy, medication, or a combination. It will likely involve some effort by the family as a whole, but your child’s clinician can help you make those changes.

Whether you’re waiting for your child’s first appointment or looking for inspiration during their treatment, check out the documentary UNSTUCK for helpful information and first-hand stories from kids with OCD and their family members.

Looking to discuss the complexities of parenting a child with OCD? Chat with sympathetic, well-informed people around the world in the NOCD app!