What To Do About the Obsessions Part of OCD - How to Reduce the Obsessive Thoughts

Written by HealthyPlace.com Staff Writer

David: A few moments ago, luckydogs mentioned that he/she was taking Luvox and getting CBT, but it wasn't effective. Is there such a thing as treatment resistant OCD? If so, then what do you do?

Dr. Jenike: Yes, it depends on how you define treatment resistant OCD. There are about six drugs to try; you need to try CBT as well; usually in combination with medication treatments for OCD. If that does not work and someone is really disabled by OCD, there are treatment facilities like ours at McLean Hospital where people can stay for awhile to get daily intensive therapy. In extreme cases, neurosurgical procedures are done to interrupt physically the circuits in the brain that seem to be involved with OCD. There are also newer techniques, like deep brain stimulation where these same circuits are stimulated by implanted electrodes. I say this, just to point out that there is a lot of research going on, and that there is hope for people with severe OCD. Motivation to get better and willingness to put up with what needs to be done in treatment are key elements in getting better. Some of the sickest patients I have ever seen have gotten better.

Bea: How do you get a spouse to stop enabling the person with OCD without causing a lot of friction?

Dr. Jenike: That really depends on the situation. Some are easy; some are impossible. If the person is helping to keep a loved one ill by enabling them, you may have to cause friction. Often we have to work with family members for a long while, to get them on our side. The family, patient, and caregivers need to band together to fight the OCD, or all is lost. There is a book by Dr. Herb Gravitz, Obsessive Compulsive Disorder : New Help for the Family, that advises family members of an OCD patient. It would be worth reading in these situations. I spend a lot of time on this issue.

MYTWOGRLSMOM: Dr Jenike, My two-and-a-half year old little girl insists on washing her hands at times and will not touch anything that she thinks is "dirty". Could she have OCD, or acting on things she sees me do?

Dr. Jenike: It could be either. Kids at this age mimic what they see. If you have OCD, she may be watching you. Try not to let her see you do rituals; and work to get them under control. Have her seen to determine if she needs treatment. Often with kids this young, the treatment is very simple and quick. A good children's Cognitive Behavioral Therapist can help a lot.

roc: Dr. Jenike, is there a problem with taking antidepressant medication for the rest of our life? Why is it that every time I get off medications, I relapse. Nothing I've learned in CBT helps, but going back on medications my obsessions are controlled.

Dr. Jenike: Some people with OCD or depression are like this. There is no irreversible problem with staying on these meds for life. The neuroleptic medications are the ones that seem to be more toxic. Many patients are able to use CBT to keep the OCD away once they get a handle on it, but others need medications as well. Relapse, when you stop medication, usually does not occur right away, but more often 2-4 months later. It is very important to do the CBT exercises every day when you are stopping meds.

David: We are going to wrap it up for tonight. Thank you, Dr. Jenike, for being our guest tonight and for sharing this information with us. And to those in the audience, thank you for coming and participating. I hope you found it helpful. We have a growing OCD community here at HealthyPlace.com. Also, if you found our site beneficial, I hope you'll pass our URL around to your friends, mail list buddies, and others http://www.healthyplace.com.

Dr. Jenike: Thank you and good night!

David: Thanks again, Dr. Jenike. Have a good night everyone.

Disclaimer: We are not recommending or endorsing any of the suggestions of our guest. In fact, we strongly encourage you to talk over any therapies, remedies or suggestions with your doctor BEFORE you implement them or make any changes in your treatment.

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