This article is for educational purposes only and is not a substitute for professional medical advice. If you are in crisis, call or text 988 or visit your nearest emergency department.

Quick take: is a treatable condition marked by obsessions (intrusive, upsetting thoughts/images/urges) and compulsions (repetitive behaviors or mental rituals done to reduce distress). The gold-standard treatment is Exposure and Response Prevention (ERP) therapy; SSRIs (often at higher doses) and, in select cases, clomipramine can help. Family “accommodation” (participating in rituals) keeps OCD stuck—reducing it is part of care.

What is OCD?

• Obsessions: unwanted, intrusive thoughts/images/urges (e.g., contamination, harm, sexual, religious/scrupulosity, symmetry) that feel ego-dystonic—not aligned with your values.
• Compulsions: repetitive behaviors or mental acts (washing, checking, reassurance seeking, repeating prayers, counting, mental reviewing) aimed at easing anxiety or preventing a feared event.
• Cycle: obsession → spike of anxiety/uncertainty → compulsion → short relief → OCD grows and asks for more.

At CHARIS MIND & BODY WELLNESS, we teach patients (and families) to recognize the OCD loop so treatment targets the right link: response prevention.

Common presentations (beyond “neat and tidy”)

• Contamination/washing (germs, chemicals, bodily fluids)
• Checking (locks, appliances, health signs, driving routes)
• Harm OCD (fear of harming self/others; intrusive images)
• Religious/scrupulosity (fear of moral failure; mental rituals)
• Sexual orientation/relationship OCD (doubt about identity or partner)
• Symmetry/“just right” (arranging, repeating until it feels right)
• Pure-O (covert mental rituals—neutralizing, reassurance seeking, praying, reviewing)

If you’re avoiding places, people, utensils, knives, playgrounds, prayer, or intimacy because of intrusive thoughts, that may be OCD—not “who you are.”

How OCD is diagnosed

A clinician evaluates frequency, distress, time spent, impairment, and rules out look-alikes (generalized anxiety, autism-related routines, tics/Tourette, psychosis, eating-disorder rules, body dysmorphic disorder). We also assess depression, panic, tics, and sleep, which often co-occur and affect planning.

What actually works

1. Exposure and Response Prevention (ERP) — first-line

   ERP gradually faces triggers (exposure) while blocking rituals (response prevention). Over time, the brain relearns safety and distress drops without compulsions.

   • We build a fear/ritual hierarchy (from easier to harder).
   • Exposures are collaborative and paced (starting with doable steps).
   • Family sessions reduce accommodation (e.g., answering reassurance questions, “helping” with rituals).

   At CHARIS MIND & BODY WELLNESS, we tailor ERP to your subtype (e.g., contamination vs. harm vs. scrupulosity) and track progress weekly so wins are visible.

2. Medications (often alongside ERP)
   • SSRIs (sertraline, fluoxetine, fluvoxamine, paroxetine, citalopram/escitalopram) at moderate-to-high doses; response can take 10–12+ weeks.
   • Clomipramine (a TCA) can help when SSRIs fail but needs side-effect/ECG monitoring.
   • Augmentation (specialist-guided) may include certain atypical antipsychotics for severe, refractory cases.
3. Skills & lifestyle to support ERP (not replace it)
   • Uncertainty acceptance (the “muscle” ERP trains)
   • Delay & dilute rituals (shrink duration/frequency as a bridge to prevention)
   • Sleep stabilization and steady movement (better distress tolerance)
   • Reassurance diet: friends/family practice support without feeding OCD (“I care about you—and I won’t answer that OCD question.”)
4. What usually doesn’t help
   • Benzodiazepines (can blunt learning in ERP and risk dependence)
   • Endless reassurance (brief relief, long-term worse)
   • Complicated safety-seeking rules (“I’ll touch it, but only with wipes in my pocket”)

Special situations

• Children/teens: ERP with parent coaching is highly effective; schools can support with plans that reduce reassurance and enable exposures.
• Perinatal OCD: intrusive harm/contamination thoughts about baby are common and terrifying—not psychosis if insight is intact. ERP + SSRI can be life-changing; coordinate with OB/peds for medication/breastfeeding questions.
• Tic-related OCD: ERP still works; plans may incorporate habit-reversal strategies.
• Religious/scrupulosity: we respect faith; ERP is designed with values-congruent exposures (e.g., tolerating uncertainty vs. violating beliefs).

A week-one action plan (starter)

1. Name one OCD loop you want to change (trigger → compulsion).
2. Create two easier exposures (e.g., touch the doorknob, wait 2 minutes without washing).
3. Loop in one support person; script a no-reassurance response.
4. Start a sleep anchor (fixed wake time), hydrate, move 10 minutes/day.
   (Then build a full ERP plan with a trained clinician.)

Bottom line: OCD is treatable. With ERP and, when needed, medication, most people reclaim time, relationships, faith practices, and freedom. If this resonates, consider an OCD-informed evaluation—with us at
CHARIS MIND & BODY WELLNESS or a trusted local provider.