Are You Overwhelmed by Intrusive Thoughts or Compulsive Behaviors that Make it Hard to Live the Life You Want?

If you're wondering if it's time to seek help from an OCD psychiatrist, we're here to help walk you through the process.

In this guide, we'll talk about what OCD is, how it affects people, and the various treatment options available, including both traditional and integrative psychiatry approaches.

Our goal is to empower you with the knowledge and support you need to take control of your OCD and start living the life you deserve.

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‍OCD: When Your Thoughts Feel Like They're in Charge

Living with OCD can feel like you're trapped in a maze of your own making, with no clear way out. It can affect every aspect of your life including:

‍Relationships: OCD can strain connections with loved ones who might not fully understand your struggles.

School and Career: Time-consuming daily rituals can interfere with school and work as well as significantly reduce your productivity.

‍Self-esteem: The never-ending battle with your thoughts can wear down your confidence and self-esteem over time.

Physical health: Constant mental stress and anxiety can take a real toll on your body, causing issues with gut health and muscle tension.

‍But while OCD might feel all-consuming, it doesn't define you. You're so much more than your symptoms. You're a unique individual with gifts, talents, and a life waiting to be lived to its fullest.

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‍What is Obsessive-Compulsive Disorder? ‍

Obsessive-Compulsive Disorder or OCD is a mental health condition characterized by intrusive, upsetting thoughts, urges, or images (obsessions) and/or repetitive behaviors or mental acts (compulsions).

It's more than just a preference for order or cleanliness; OCD can significantly impair daily functioning and overall quality of life.

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‍How Does an OCD Psychiatrist Think About the OCD Cycle?

Understanding the OCD cycle is the first step towards breaking free from its grip. Let's take a look at how OCD might feel for you:

1. Trigger: Your day is going fine when suddenly, something catches your attention. Maybe it's a doorknob you touched, a thought about a loved one's safety, or an object that's slightly out of place. This is a trigger: an event, thought, or situation that sparks anxiety.

2. Obsessions: Your mind latches onto this trigger. You can't shake the thought that your hands are contaminated, or that your loved one might be in danger, or that everything will go wrong if that object isn't perfectly aligned. These thoughts can feel impossible to control. They keep coming back, no matter how hard you try to push them away. These are obsessions: intrusive, distressing, unwanted thoughts or images.

3. Anxiety: As these thoughts swirl in your mind, you start to feel anxious. Your heart might race, your palms might sweat, and you might feel a knot in your stomach. It can feel really overwhelming and you desperately want these feelings and bodily sensations to stop. This is anxiety: intense feelings of fear, dread, or discomfort.

4. Compulsions: To relieve this intense anxiety, you feel an irresistible urge to do something. Maybe you wash your hands twenty times, repeatedly call your loved one to check on them, or spend time arranging objects until they feel "just right." You know that these behaviors might not make logical sense, but in the moment, they feel absolutely necessary. These are compulsions: repetitive behaviors or mental acts undertaken to reduce anxiety.

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5. Temporary Relief: After performing a compulsion, you might feel a brief sense of relief. The anxiety subsides, and you think, "Okay, now I can relax." But deep down, you probably know this feeling won't last.

6. Reinforcement: Here's the tricky part - by performing the compulsion and feeling that temporary relief, your brain learns that the compulsion "works" to reduce anxiety. This makes the cycle even stronger the next time around. This is reinforcement: the OCD cycle strengthens, making future triggers more potent.

The cycle of OCD can be exhausting and frustrating. You might feel like it steals hours from your day, strains your relationships, and holds you back at work or school. It can feel like you're trapped in a loop that you just can't escape.

But here’s an important point to remember: While powerful, the OCD cycle is not unbreakable.

Dr. Ambardar is here to help you understand this cycle, recognize it in action, and develop strategies to interrupt it.

Together, we can work on techniques to help you face your triggers without resorting to compulsions, gradually reducing the power that OCD holds over your life.

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‍Types of OCD:

While the core features of OCD remain the same across types, the specific contents of obsessions and compulsions can differ widely. Let’s review some common types of OCD, keeping in mind that this list is not exhaustive and that you can have multiple types and different forms of OCD:

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Contamination OCD

"I can't stop thinking about germs. I wash my hands until they're raw, but it never feels like enough. I'm afraid to touch doorknobs or shake hands because I might get contaminated."

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Contamination OCD involves an intense fear of germs, dirt, or environmental contaminants. Sufferers may engage in excessive cleaning rituals, avoid touching certain objects, or experience extreme anxiety in situations where they feel exposed to potential contamination.

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Checking OCD

"I check the locks, stove, and appliances dozens of times before I can leave the house. Even then, I worry I missed something. What if I accidentally left the gas on and my house burns down?"

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Checking OCD is characterized by repetitive checking behaviors driven by fears of harm or disaster. Individuals may repeatedly check door locks, appliances, or important documents, often unable to trust their own memory or perception.

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Just Right OCD

‍"Everything has to be perfectly aligned or it feels wrong. I spend hours arranging objects until they feel 'just right'. If something's out of place, I can't focus on anything else."

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Just Right OCD involves a need for things to be perfectly ordered, arranged, or balanced. Sufferers may feel intense discomfort or anxiety when things aren't "just right," leading to time-consuming arranging and rearranging rituals. People with Just Right OCD often feel a sense of “incompleteness” or physical tension until things are perfectly aligned or symmetrical.

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Harm OCD

‍"I'm terrified of knives because I have these awful thoughts of hurting someone. I know I would never do it, but the thoughts won't stop. I avoid cooking and hide all the sharp objects in my house."

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Harm OCD involves intrusive thoughts about harming oneself or others, even though the individual has no desire to act on these thoughts. This can lead to intense anxiety as well as avoidance behaviors.

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Pure O OCD

‍"My mind is constantly bombarded with disturbing thoughts and images. I don't have visible rituals, but I'm always mentally reviewing and analyzing these thoughts. It's exhausting, but I can't stop."

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Pure O OCD involves distressing and intrusive obsessions without any visible compulsions or physical rituals. Sufferers may engage in mental rituals or thought suppression to cope with their obsessions.

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Religious or Moral OCD (Scrupulosity)

‍"I'm constantly worried that I've sinned or offended God. I pray for hours, confess repeatedly, and still feel guilty. What if I'm not truly faithful?"

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Religious or Moral OCD involves intrusive thoughts and doubts about one's faith, morality, or character. Individuals may obsessively worry about blasphemy, sin, or not being devout enough, leading to compulsive praying, confessing, or seeking reassurance.

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Relationship OCD

‍"I love my partner, but I'm plagued by doubts. What if I don't really love them? What if they're not 'the one'? I constantly analyze our interactions and seek reassurance, but the doubts always return."

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Relationship OCD centers on persistent, intrusive doubts about one's romantic relationships. Sufferers may constantly question their feelings, their partner's feelings and fidelity, or the relationship's quality, leading to compulsive behaviors like seeking reassurance or constantly mentally reviewing the relationship.

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It’s important to note that the OCD types listed here are not exhaustive, and many individuals experience symptoms that don’t fit neatly into one type. The key is to recognize that OCD can manifest in many different ways, all of which can be addressed with proper treatment.

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What is the Prevalence of OCD?

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Let's take a closer look at the prevalence of OCD:

• OCD has a lifetime prevalence of approximately 2.3%, which means 2.3% of the population experiences OCD at some point in their lives¹. Put another way, this means that approximately 2-3 out of every 100 people will experience OCD at some point in their lives.

• OCD typically begins in childhood, adolescence, or early adulthood²

• The average age of onset is 19 years old³

‍OCD in Men vs Women:

Interestingly, OCD affects men and women differently:

1. Overall prevalence: OCD is slightly more common in women than in men⁴
2. Age of onset: Men tend to develop OCD at a younger age than women⁵
3. Symptom presentation: Women are more likely to experience contamination and cleaning-related symptoms, while men more often experience sexual or religious obsessions⁶

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‍When to Seek Help from an OCD Psychiatrist

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If OCD symptoms are interfering with your daily life, relationships, work, or overall well-being, it's worth considering seeking professional psychiatric help. Signs that your OCD might require psychiatric support include:

• Spending more than an hour a day on obsessions or compulsions

• Difficulty completing daily tasks due to OCD symptoms

• Avoiding certain situations, places, or people because of your OCD

• Experiencing significant distress or panic related to your obsessions or compulsions

• Having trouble maintaining relationships or job performance due to OCD

Even if your symptoms seem "mild”, the earlier you get help, the better equipped you'll be to prevent OCD from getting in the way of your life, and the sooner you'll learn effective ways to manage it.

Remember, seeking help is a sign of strength, not weakness. You don't have to wait until OCD starts to significantly impact your daily life to take action.

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Dr. Ambardar will work with you to create a personalized treatment plan that's tailored to your unique needs. This can involve therapy, medication, or a combination of integrative approaches that work best for you. 

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‍How an OCD Psychiatrist Can Help

As an integrative psychiatrist, Dr. Ambardar believes in combining the best of traditional psychiatry with evidence-based complementary and integrative approaches.

This holistic lens allows us to address not only the symptoms of your OCD but also the underlying physiological or biological factors that may be contributing to your condition.

With integrative psychiatry, you'll have access to a more robust toolkit to help manage your OCD (see Integrative Psychiatry Approaches below)

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Treatments for OCD

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1. Medications

Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed medications for OCD because they are highly effective. Medications such as Luvox and Zoloft, as well as SNRIs such as Effexor XR and Cymbalta, as well as Mood Stabilizers such as Lamictal, can all work very well to improve OCD symptoms.

As an experienced psychiatrist, Dr. Ambardar will work with you to find the right medication and dosage that helps you feel better.

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2. Cognitive Behavioral Therapy (CBT) with Exposure and Response Prevention (ERP)

CBT is the gold standard psychotherapy for OCD. As a psychiatrist and therapist, Dr. Ambardar incorporates a specific type of CBT called Exposure and Response Prevention therapy (ERP) into our sessions.

ERP involves gradually and gently exposing you to anxiety-provoking situations while helping you resist the urge to perform compulsions. Over time, this approach can significantly help reduce your OCD symptoms.

ERP can be challenging but it is a highly effective treatment. It shows you that you can face your fears without relying on compulsions. This can lead to long-term symptom reduction.

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3. Integrative Psychiatry Approaches to OCD

Integrative psychiatry for OCD combines the very best of traditional psychiatry with evidence-based complementary therapies. Some integrative approaches we might consider include:

Advanced Lab Work: 🧪

Before recommending specific supplements and nutraceuticals, Dr. Ambardar may suggest optional lab work that can help us gain a deeper understanding of what your body needs.

Optional lab work can include:

• Neurotransmitter testing: to assess imbalances in serotonin, glutamate, dopamine, and other important brain neurotransmitters involved in OCD.

• Hormone testing: to assess levels of testosterone, estradiol, and pregnenolone which can all impact mood.

• GI/Gut Health Testing: to assess gut dysbiosis and overall gut health which can impact OCD symptoms.

• Micronutrient testing: to identify any deficiencies in micronutrients that could be contributing to symptoms.

• Gene testing: to (1) understand which medications might have fewer side effects for you and (2) ascertain if certain gene variations are present that could impact mood and benefit from specific supplementation.

It’s important to keep in mind that lab work is always optional and is not required or needed in order to start effective medication management treatment for OCD. However, advanced lab work can give us the ability to more precisely tailor treatment to your unique biology and biochemistry.

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Nutritional Psychiatry: 🥦

Emerging research suggests that nutrition may play a key role in OCD. Dr. Ambardar can work with you to help optimize your nutrition, addressing any micronutrient, mineral, or vitamin imbalances we may find.

For example, replenishing Magnesium, Vitamin B12, Vitamin D, Vitamin B9 (Folate), and Vitamin B3 (niacinamide) can all help with anxiety symptoms.

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The Gut-Brain Connection in OCD: 🧠

Recent research has highlighted the important role of gut health in mental health, including in OCD. After optional GI lab testing, Dr. Ambardar might recommend:

• Probiotics: Certain strains of beneficial bacteria (probiotics) have been shown to reduce anxiety and obsessive-compulsive symptoms

• Gut healing protocols: Addressing and treating any underlying gut health issues with, for example, herbal antimicrobials

• Dietary changes: Reducing inflammatory foods and increasing foods that support gut health can help with anxiety symptoms

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Supplementation: 🍓

Certain supplements have shown promise in supporting OCD treatment. Dr. Ambardar can suggest which supplements might be beneficial for your specific needs. Some helpful OCD supplements include:

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• N-acetylcysteine (NAC)

• Inositol

• Low-dose nutritional lithium

• L-theanine

• Ashwagandha

• GABA

• 5-HTP

• L-Tryptophan

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‍Mind-Body Approaches: 🧘🏽

Taking time out to relax and develop a connection with your inner self can be enormously beneficial on the OCD journey. Some approaches we might consider include:

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• Cultivating a regular spiritual practice

• Meditating for 5 minutes whenever you can

• Walking for 15-20 minutes a few times a week

• Trying to get 7-8 hours of sleep every night

• Joining an OCD-friendly support group

• Keeping a journal or diary to write down your thoughts, triggers, and fears

• Developing a regular creativity practice, whether that’s engaging in art, singing, dance, sports, or anything else fun

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‍The Journey of OCD Treatment

Treating OCD is a journey that involves teamwork, understanding, and a willingness to try new approaches. It's okay if it takes some time to find the right combination of treatments that work best for you—we're all unique, after all. 

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With the right mix of medications, therapy, and supplements, most patients see significant improvement in just a few months.

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Dr. Ambardar is here to support you every step of the way. Together, we'll create a personalized treatment plan tailored to your unique needs and goals.

This might include medication, therapy, healthy lifestyle changes, and exploring integrative approaches to help you feel more empowered and confident on your journey towards recovery.

Our goal is to provide a safe, nonjudgmental space for you to share your concerns and work towards a brighter, more fulfilling future.

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If you're struggling with OCD, please know that you're not alone and that there's hope for a happier tomorrow. With advancements in our understanding of OCD and continually improving treatment options, there's every reason to be optimistic about managing your symptoms effectively and living well with OCD.

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You don't have to face OCD by yourself - reach out for support today and let's work together to help you create a more peaceful, joyful life 🦋

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‍Take the First Step Towards Freedom from OCD

‍Ready to reclaim your peace of mind?  🕊️

We’re here to help you break free from intrusive thoughts and compulsive behaviors. We welcome you to get started today by filling out our simple contact form✏️

Your journey to healing starts here. Reach out today and let's start our work together to help you break free from OCD 🌷

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Sheenie Ambardar, MD is a Los Angeles-based OCD Psychiatrist who sees patients throughout California and New York via telehealth. Dr. Ambardar is a professional member of the International OCD Foundation (IOCDF) and specializes in the diagnosis and treatment of adult men and women with Depression, Anxiety, OCD, Panic Disorder, ADHD, Binge-Eating Disorder, and a host of other common mental health concerns.

Are you experiencing any of these conditions? Concierge psychiatry may be the solution you need. At The Happiness Psychiatrist®, we address the root causes of these issues—and many more—as well as give you the resources to build a fuller, happier life.

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References 📚

1. Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53-63.
2. Pauls, D. L., Abramovitch, A., Rauch, S. L., & Geller, D. A. (2014). Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nature Reviews Neuroscience, 15(6), 410-424.
3. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602.
4. Fawcett, E., Power, H., & Fawcett, J. (2020). Women Are At Greater Risk of OCD Than Men: A Meta-Analytic Review of OCD Prevalence Worldwide.. The Journal of Clinical Psychiatry, 81 4.
5. de Mathis, M. A., de Alvarenga, P., Funaro, G., Torresan, R. C., Moraes, I., Torres, A. R., ... & Hounie, A. G. (2011). Gender differences in obsessive-compulsive disorder: a literature review. Brazilian Journal of Psychiatry, 33(4), 390-399.
6. Torresan, R. C., Ramos-Cerqueira, A. T., de Mathis, M. A., Diniz, J. B., Ferrão, Y. A., Miguel, E. C., & Torres, A. R. (2009). Sex differences in the phenotypic expression of obsessive-compulsive disorder: an exploratory study from Brazil. Comprehensive Psychiatry, 50(1), 63-69.

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