How to battle ocd

6 Best Strategies to Combat Obsessive-Compulsive Disorder

The symptoms of obsessive-compulsive disorder (OCD) can be overwhelming and get in the way of living your life. It’s easy to feel helpless.

The good news is that even if you’re just getting started learning how to treat OCD, there are habits and practices you can use to lessen anxiety and manage your OCD stress.

strategies to combat OCD

Practice mindfulness to manage stress

Two key characteristics of OCD are high anxiety and the presence of intrusive thoughts. You can reduce both symptoms by practicing mindfulness. 

Mindfulness is the ability to be fully present in the moment, accepting your experience without judgment or the need to escape it. You can practice mindfulness anytime, anywhere. All you have to do is notice and observe your thoughts and feelings. Acknowledge that they exist and will pass, like a car driving by on the street outside, and that you don’t have to act on your feelings for them to go away on their own.

Don’t expect it to be easy right away. Acknowledging your thoughts without acting on them is easier said than done, especially with OCD. Find a practice that feels good to you, whether that’s meditation, yoga or something else entirely. Eventually, your OCD mindfulness practice will become easier and feel more natural.

Get plenty of exercise

Exercise is an effective way of fighting OCD stress and anxiety. It helps to refocus your mind when intrusive thoughts and compulsions arise. 

Experts recommend 30 minutes of aerobic exercise per day, but it doesn’t have to happen all at once. In fact, three 10-minute sessions of mindful exercise is much better than one 30-minute session of distracted jogging or bicycling. 

It’s possible to exercise and still be ruminating on something distressing, but it’s possible to exercise and still be ruminating on something distressing, but as you continue to practice mindfulness you may find that upsetting thoughts and ideas fade into the background more easily.

Effective, specialized OCD therapy is here

Learn more

Sleep well and enough

Like exercise, sleep is an anxiety antidote. Unfortunately, good sleep can be elusive for people with OCD, who have higher rates of insomnia than the general population. 

Intrusive thoughts can keep you awake long into the night, robbing you of the precious shut-eye you need to fight anxious moments the next day. Fortunately, there are things you can do to manage your OCD symptoms and get better sleep. For example:

  • Follow a bedtime routine to tell your body it’s time for sleep.
  • Limit your screen time before bed.
  • Try a supplement like melatonin or valerian route, or an herbal tea like chamomile.

Pay attention to what techniques work for you and build your bedtime routine accordingly. 

Avoid nicotine and alcohol

When you have OCD, especially when you’re just learning to manage it, self-medication can be tempting. Many people turn to alcohol and nicotine, substances that have a false reputation for calming and actually worsen OCD symptoms. Alcohol feels like it relaxes you at first, but as it wears off it increases your anxiety levels. Nicotine is a stimulant from the get-go and will exacerbate your OCD symptoms. 

Reach out to family and friends

OCD symptoms can sometimes be so intense that they take over your day-to-day life and keep you isolated from family and friends. Isolation can make OCD symptoms worse, so make sure you prioritize time with people you care about.

It’s okay and even helpful to talk about your OCD experiences with supportive friends. Just be careful not to ask over and over for reassurance. Excessive reassurance seeking is a common pattern in people with OCD, and while it seems harmless at first, it gets in the way of your ability to manage your symptoms independently.

Find an ERP therapist

OCD is a vicious cycle. It hijacks your brain and convinces you that you can only handle intrusive thoughts by doing compulsive rituals. Exposure and response prevention (ERP) therapy helps you learn otherwise, which is why it’s the first-line treatment for people with OCD. 

Find a therapist who can help you manage your OCD

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In ERP therapy, you explore your obsessions, avoidances and compulsions with a therapist and set goals for what you want to be able to do despite your OCD symptoms. You and your therapist then design exposure exercises to help you face your fears, starting with the least distressing. You practice working your way through scary situations without turning to avoidance or compulsive rituals. In time, your anxiety decreases and you learn how to healthily respond to triggers instead of letting OCD run the show.

Therapy is the most important tool in your OCD management arsenal. At NOCD, we can match you with a licensed ERP therapist who can help you to develop a personalized strategy and plan. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP. At NOCD, all therapists specialize in OCD and receive ERP-specific training. All it takes is a 15-minute call to get started.

International OCD Foundation | 25 Tips for Succeeding in Your OCD Treatment

by Fred Penzel, PhD
Psychologist/Executive Director; Western Suffolk Psychological Services
IOCDF Scientific & Clinical Advisory Board Member

This article was initially published in the Summer 2014 edition of the OCD Newsletter. 

I originally wrote this list for my own patients, and then I realized it would be useful to others out there who are just starting or who are currently engaged in treatment. Here are my 25 tips for succeeding in your OCD treatment.

1.  Always expect the unexpected. You can have an obsessive thought at any time or any place.  Don’t be surprised when old or even new ones occur.   Don‘t let it throw you.  Be prepared to use your therapy tools at any time, and in any place.  Also, if new thoughts appear, be sure to tell your therapist so you can keep them informed.

2. Be willing to accept risk. Risk is an integral part of life, and as such it cannot be completely gotten rid of.  Remember that not recovering is the biggest risk of all.

3.  Never seek reassurance from yourself or others.  Instead, tell yourself the worst will happen, is happening, or has already happened.  Reassurance will cancel out the effects of any therapy homework you use it on and prevent you from improving.  Reassurance-seeking is a compulsion, no matter how you may try to justify it.

4.  Always try hard to agree with all obsessive thoughts — never analyze, question, or argue with them.  The questions they raise are not real questions, and there are no real answers to them.  Try not to get too detailed when agreeing — simply say the thoughts are true and real.

5.  Don’t waste time trying to prevent or not think your thoughts.  This will only have the opposite effect and lead to thinking more thoughts. Studies have shown that you cannot effectively stop or push down particular thoughts.  Your motto should be, “If you want to think about them less, think about them more.”

6.  Try to not be a black-and-white, all-or-nothing thinker — don’t tell yourself that one slip up means you are now a total failure.  If you slip and do a compulsion, you can always turn it around and do something to cancel it. The good news is that you are in this for the long haul, and you always get another chance.  It is normal to make mistakes when learning new skills, especially in therapy.  It happens to everyone now and then.  Accept it.  Even if you have a big setback, don’t let it throw you.  Remember the saying, “A lapse is not a relapse.”  This means that you never really go back to square one.  To do that, you would have to forget everything you have learned up to that point, and that really isn’t possible.   Also remember the sayings, “Never confuse a single defeat with a final defeat,” (F. Scott Fitzgerald) and as they say in AA, “You can always start your day over.”  

7.  Remember that dealing with your symptoms is your responsibility alone.  Don’t involve others in your therapy homework (unless your therapist tells you to) or expect them to push you or motivate you.  They won’t always be there when you need them, but YOU are always there for YOU.

8.  Don’t get too impatient with your progress, or compare yourself to someone else.  Everyone goes at their own pace.  Instead, try to simply focus on carrying out each day’s therapy homework, one day at a time.

9.  When you have a choice, always go toward the anxiety, never away from it.  The only way to overcome a fear is to face it.  You can’t run away from your own thoughts, so you really have no choice but to face them.  If you want to recover, you will have to do this.

10.  When faced with two possible choices of what to confront, choose the more difficult of the two whenever possible.

11.  Review your therapy homework assignments daily, even if you think you know all of them. It is easy to overlook them — especially the ones you don’t look forward to doing.

12.  If your therapist gives you an assignment you don’t feel ready to do, you can speak up and tell them so.  As half of the therapist–patient team, you should be able to have a say in your own therapy. The goal is for the homework to produce some anxiety for you to get used to tolerating — not to overwhelm you with it and cause you a setback.  On the other hand, don’t be afraid to stretch yourself a bit whenever you can.

13.  Don’t wait for the “perfect moment” to start your therapy homework assignments. Procrastination is a feature of many people’s OCD, so start your therapy homework assignments the day you get them. The perfect moment is whenever you begin doing them.

14. Don’t be side-tracked by perfectionism. Perfectionism can be another feature of OCD. You may find your OCD telling you that if you don’t do your homework perfectly, you won’t recover.  If you do find yourself obsessing about having to do your homework perfectly, you risk turning it into another compulsion.  Watch out for having to do your homework according to the same rigid rules each time you do it.  Also, don’t do your homework so excessively that it takes up your whole day.  Remember that you still have a life to live.

15.  Try to read over your homework assignments at the start of each day.  Don’t assume that you know them all and will not forget them.

16.  When carrying out assignments, be careful to not provide yourself reassurance and undo your hard work. Telling yourself things like,“It’s only homework, and the things I’m saying and doing don’t count and aren’t real,” or “My therapist wouldn’t ask me to do something that would cause harm to me or others,” or “I’m only doing this because I was told to, so I’m not responsible for anything bad that happens,” can undermine all the work your doing.  

17.  Give your homework your full attention, focus on what you are doing, and let yourself feel the anxiety.  Try to not let yourself tune out when doing certain assignments, so that you don’t have to feel the anxiety.  People sometimes let the homework become routine and do it in a very automatic way as a kind of avoidance.  Also, don’t do homework while carrying out other distracting activities.  You are building tolerance to what you fear, and for that to happen you have to be in the moment with it.  

18.  When faced with a challenging assignment or an unexpected challenging situation, try to look at it as a positive. View it as another opportunity to get better instead of saying, “Oh, no. Why do I have to do this?”  Instead tell yourself, “This will be good for me — another chance to practice and get stronger.”

19.  Try to not rush through your therapy homework so that you don’t have to feel as much anxiety.  Take your time, and see if you can view it in terms of all the good it will do you.   Getting it over with as quickly as possible is not the goal — raising a moderate level of anxiety and staying with it is the goal.

20.  If your homework doesn’t really give you any anxiety, tell your therapist about it.  If your exposure homework doesn’t cause at least some anxiety, it isn’t going to help you that much.  On the other hand, try doing all new assignments for at least a week before deciding that they don’t make you anxious.  Some assignments can cause reactions later on, and it may take doing them a few times before the anxiety occurs.

21.  It is sometimes possible for OCD to try to make you doubtful about your homework.  It may tell you that you are not in the right treatment, that your assignments cannot possibly make you better, or that you really don’t understand what you are doing and won’t be able to make it work.  Remember that OCD was known as the Doubting Disease, and it will try to cast doubt on anything that is important to you.   To fight this, you may have to agree with it by saying, “Yes, that’s right.  I really won’t get better.”

22.  Never forget that you have OCD.  This means that you will not always be able to trust your own reactions or the things you think and feel, especially if they seem to be telling you very negative and extreme things.  If you are unsure if something is really a symptom, treat it as a symptom.  Better to do a bit more exposure than not enough.

23.  Remember that in OCD, the problem is not the anxiety — the problem is the compulsions.
If you think the anxiety is the problem, you will only do more compulsions to get rid of it (which will only create more anxiety).  If you recognize that the compulsions are the problem, stop doing them, and stay with the fearful situation, then the anxiety will eventually go away as you build up tolerance.

24.  Always take a moment to be proud of your own efforts and recognize your successes.  It’s a good way to help keep up your motivation.   Look back at earlier assignments that are no longer challenging if you believe you aren’t making progress.

25.  Overall, never forget that OCD is very paradoxical and rarely makes much sense.  The things that you thought would make you better only make you worse, and the things you thought would make you worse are the very things that will make you better.   

symptoms, how to get rid of and treat

Olya Selivanova

struggles with obsessive-compulsive disorder

Author profile

Since childhood, I have suffered from obsessive thoughts.

When I was nine years old, I was reading a book, when suddenly the thought occurred to me: “If you don’t finish reading today, your mother will die.” The thought frightened me, I put down the book and cried, but I had to return to reading so that my mother would not die.

From that moment on, the frightening thoughts were different. I could suddenly change the route, because the thought came to my mind: “It is not safe to go further. Get around." There were thoughts to harm loved ones: push, hit, pour over. At such moments, I thought that an evil force had entered into me, and I began to count to myself, imagined how the numbers increased in order in size and knocked bad thoughts out of my head.

By the time I was twelve, it all came to naught, and as a teenager, I decided that it was just childish oddities. But seven years later, the obsessive thoughts returned, and the doctor at the neuropsychiatric dispensary diagnosed me with Obsessive-Compulsive Disorder. I'll tell you how I was treated and how I live now.

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What is obsessive-compulsive disorder

Obsessive-compulsive disorder is a mental illness in which a person has obsessive thoughts and compulsive actions.

What is Obsessive-Compulsive Disorder - Mayo Clinic

Obsessive thoughts - obsessions - usually revolve around certain topics: fear of harming yourself and others, fear of germs and toxic substances, the need to organize everything. They appear suddenly or are provoked by external circumstances, such as a sharp object or the word "last".

Intrusive thoughts cannot be ignored, they cause anxiety or disgust. In response to them, a person has compulsions - a strong desire to perform certain actions that, according to his feelings, will get rid of such thoughts. Compulsions are difficult to resist: the anxiety will grow until the person gives up.

For example, the obsessive thought that a person will become infected after touching a doorknob will provoke compulsive actions - repeated washing of hands, sometimes for several hours in a row.


How much does it cost to support a relative with a mental disorder

I try not to touch doorknobs in public places and always make sure the door is closed.

Do I have OCD?

Sergey Divisenko


If a person's condition does not interfere with himself or others, then everything is in order, if it interferes, a disorder can be suspected. In the case of checking the door, one can say that checking if the door is closed once is not a problem, rechecking the door several times in a row and doing it systematically is already a problem.

To understand whether or not there is OCD, the doctor pays attention to how often the patient has obsessive thoughts and compulsive actions and how they affect his life. If symptoms occur more frequently in two weeks than in seven days and interfere with daily activities, it is probably OCD.

In this case, the symptoms should have the following characteristics:

  1. The person should evaluate them as his own thoughts and desires.
  2. There must be at least one thought or action that the person unsuccessfully resists.
  3. The thought of a person performing a compulsive action should not in itself be pleasurable. The fact that an action will help reduce anxiety is not considered pleasant in this sense.
  4. Thoughts or actions must be repeated.

How obsessive-compulsive disorder is treated

OCD is considered a lifelong disorder, but with treatment it is possible to achieve remission: to get rid of obsessive thoughts and compulsive actions for a long time or to reduce their number.

Medical treatment. The main drugs for the treatment of OCD are antidepressants of the SSRI group. They increase serotonin levels in the brain, making OCD symptoms less likely to occur.

Treatment options for OCD - NHS

Depending on the course of the disease and symptoms, along with antidepressants, the doctor may prescribe other drugs: tranquilizers, neuroleptics or mood stabilizers.

Cognitive behavioral therapy. This is a type of psychotherapy during which a person learns to control their emotional response to intrusive thoughts. As a result of therapy, obsessive thoughts cease to cause anxiety and compulsive actions.

Cognitive behavioral therapy - NHS

Order of the Ministry of Health of the Russian Federation of September 16, 2003 No. 438 "On psychotherapeutic care"

Psychiatrists, psychotherapists and psychologists are involved in the treatment of OCD in Russia. Psychiatrists prescribe prescription drugs. Psychotherapists and psychologists conduct psychotherapy sessions.

How I was diagnosed

At the age of 19, the development of the disease took a new turn. I was washing the kitchen knife and I had an obsessive thought that I was losing control and could cut myself and the guy who was nearby at that moment. So I began to avoid sharp objects, there was an irresistible desire to hide or throw them away.

Obsessive thoughts revolved around the topic of death: drinking nail polish remover, bleach, vinegar, throwing yourself under a vehicle or jumping out of a window. Because of this, I removed all dangerous liquids from the house and stayed away from open windows, highways and train station platforms. I didn’t sleep well at night, suffered from anxiety, considered myself crazy and dangerous, and began to move away from everyone.

I also doubted everything. Even if I just performed an action, it seemed to me that it was not completed. I opened the door to make sure that it had been closed before, closed it again, pulled the handle, asked those around me if the door was exactly closed. I could wake up at night and see if the stove was turned on, although before going to bed I went up to it and stared without blinking - so that it would crash into my memory that it was definitely turned off. My young man, seeing all this, insisted that we try to see a psychologist.

In Irkutsk, where I live, psychiatric care can be obtained free of charge at the regional psycho-neurological dispensary. I turned to the psychotherapeutic department of the dispensary for a consultation with a psychologist. At the reception, they brought me a card and said that there was no appointment with a psychologist for the next few days, but I could get to a psychiatrist: there are fewer people who want to see him.


How to get a certificate from the PND

At the appointment with the psychiatrist, I told about what was happening to me. The doctor was not surprised and said that it was an obsessive-compulsive disorder. It was the first time I heard my diagnosis, but I didn't believe it. On the Internet, I came across information that OCD is only pedantry, handwashing, fear of germs and perfectionism, and not the creepy things that come to my mind. The psychiatrist said that OCD was treated with antidepressants and offered to write a prescription, but I refused treatment because I thought they were serious drugs that would do more harm than help.

How a visit to a neuropsychiatric dispensary with OCD will affect later life

Sergey Divisenko


The patient could move freely, drive a car, use weapons and work.

With an OCD diagnosis, you can still work in any job, there are no legal barriers to this. With regard to cars and weapons, the situation has changed. In 2014 and 2015, government decrees appeared, according to which OCD became a contraindication for driving and owning weapons.

However, from a psychiatrist's point of view, a person diagnosed with OCD can drive a car and use a weapon. Doctors of the psycho-neurological dispensary still give a certificate about this, but they do it through a medical commission.


First hospitalization

My condition worsened, I tried to ignore obsessive thoughts. But the more I resisted them, the stronger they became. In addition, anger, irritability and constant fatigue appeared.

With new symptoms, I decided to see an endocrinologist, because I heard that this happens with problems with the thyroid gland. According to the results of ultrasound and hormone tests, the thyroid gland was in order. Then I made an appointment with a neurologist, but he also said that this was not his profile. Both doctors suggested that my constant fatigue, anger and irritability were symptoms of depression and advised me to seek psychiatric help.

Symptoms of clinical depression - NHS

I researched information about depression and realized that antidepressants could help, all I had to do was get a prescription. I came to the psychotherapeutic department again, but there was already another psychiatrist there. Since my condition worsened, instead of a prescription, he wrote out a referral for hospitalization in a day hospital. I had prejudices about a psychiatric hospital, so I did not want to visit the hospital. But there was no strength to argue with the psychiatrist.

This is how a referral for hospitalization to a day hospital looks like

The next day I was already in the hospital. During the registration, the psychiatrist on duty asked what I was complaining about, measured the pressure and examined whether there were injuries on the body. It turned out to be difficult for me to talk about the symptoms: there was a feeling that they would not believe me, or vice versa, they would believe me so much that they would put me in a round-the-clock hospital. But everything was fine, the psychiatrist wrote down the data on the card, gave it to the orderly, and together with him sent me to the head.

The manager looked at the card, confirmed the diagnosis of OCD and depression, and prescribed treatment: an antidepressant, an antipsychotic, a mood stabilizer, tranquilizer tablets, and injections of B vitamins.


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The routine in the hospital was as follows: I arrived at eight in the morning, had breakfast and took the prescribed pills, took injections, dined and went home. Tablets were issued immediately for one day, but they could also be issued for two days, for example, before the weekend. Once after the injection, I went to an appointment with a clinical psychologist, he gave various tests and questionnaires that tested logic and intelligence.

It was possible to move freely and receive visitors in the day hospital. The only limitation that distinguished the hospital from a regular hospital was that there were no forks and knives in the dining room. Part of the drugs used to treat psychiatric diseases cause drowsiness. Therefore, in the hospital there are wards where you can sleep. For example, after drip

About three times a week I went to see a psychiatrist in the same hospital. I told her about my condition and asked questions. I thought that as soon as I start taking medication, my mood will rise and my anxiety will go away. But this did not happen, so it seemed that everything was in vain and the treatment had to be abandoned. The psychiatrist explained to me that not all drugs begin to act instantly, she assured me that we were on the right track and we had to wait. These conversations made it easier. In my case, antidepressants began to work only on the third month of admission, when I no longer visited the day hospital.

Treatment at the day hospital lasted a month. All medications, medical consultations and meals were free. I spent money only on the road to the hospital and back - 600 R by public transport for the whole time.


“It reminded me of a strict regime sanatorium”: how much I spent on treating depression

After treatment, the symptoms of depression remained, but obsessive thoughts began to bother me less often: I stopped being afraid of open windows and was able to ride the escalator. Treatment had to be continued on an outpatient basis. Before I was discharged, the psychiatrist said that she would transfer my data to the psychiatric department. Now I will need to come to the local psychiatrist for prescriptions for medicines, and turn to him if the condition worsens or questions arise.

During the treatment in the hospital, I doubted everything. Even in being sick. Not only the psychiatrist, but also relatives helped to cope. They noticed the changes, but my young man did not let me stop the treatment


Visiting a local psychiatrist

After I was discharged from the hospital, I came to the registration office of the psychiatric department with a passport and I was immediately sent to the district police officer. The doctor did not change the treatment and wrote out a prescription for the same medicines that were given in the day hospital. In the future, a referral to the district police officer was also not required. I just came to the appointment when I needed to update the prescription.

Government Decree of July 30, 1994 No. 890 with a list of categories of beneficiaries who are entitled to free medicines

District psychiatrists were different: some were polite, some were rude and rude. Using the brute force method, I found two normal specialists - when I made an appointment at the reception, I began to ask to be directed to them. Usually the registrar complied with my request.

Spent in six months of outpatient treatment — 8895 Р

Preparation Spending
Antidepressants 5988 R
Normotimics 2384 P
Antipsychotics 419 P
Tranquilizers 104 Р


5988 R


2384 R


419 R


104 R

Free medicines for the treatment of OCD are provided to certain privileged categories of people. I’m not a beneficiary, so I bought everything with my own money. Pharmacies don’t require a passport, but they put the date of issue of the medicine on the back and don’t sell more than prescribed by prescription. For example, according to a prescription for three months, I was given only three packs of an antidepressant. When I wanted to buy one more to have a supply, the pharmacist refused


Second hospitalization and psychotherapy

After six months of outpatient treatment, the district psychiatrist recommended to be treated again in the hospital. Antidepressants helped: my mood improved, I got energy and I wanted to live, but I felt a side effect from antipsychotics. I was terribly sleepy, my handwriting changed, it was difficult to write in class and generally follow the train of thought of the teacher. In addition, there were more intrusive thoughts.

In the day hospital, I was treated by the same psychiatrist as the first time. She adjusted the drug treatment so that I was not bothered by intrusive thoughts. She also said that a psychotherapist had appeared in the hospital and referred me to her for a consultation.

Unlike the psychiatrist's consultations during the first hospitalization, we did not discuss drugs and their effects with the psychotherapist. We talked about what is happening to me and what other methods can be used to combat this, in addition to drugs. At the first appointment, I briefly talked about my lifestyle, obsessive thoughts, compulsive actions, and how I tried to resist them even before the treatment. Then the doctor explained to me what obsessive-compulsive disorder is and how it manifests itself, why my struggle only worsened the condition and led to depression.


How to choose a psychotherapist

We agreed that I would try to keep the number of compulsive acts to a minimum, and I would cope with anxiety from intrusive thoughts with the help of techniques.

Speak key phrases. Thoughts in themselves mean nothing, they can come to mind automatically. We agreed that when I had an obsessive thought, I would simply tell myself that it was a manifestation of OCD. Here are the two phrases that I used: “This is just my thought that…”, “I know that this thought is a manifestation of OCD…” So gradually I stopped identifying myself with my thoughts and realized that thinking about the bad is does not mean to be a bad person.

Separately, we discussed the issue of the materialization of thoughts. When terrible things are spinning in your head, and you hear from everywhere that thoughts are material, you get very worried. We discussed the fact that thoughts are intangible and you can’t invite trouble with them. This made it easier and the degree of emotions decreased.

Observe how the body reacts to anxiety. Every time I had anxiety from obsessive thoughts, I did not run away from it, but watched my body. I was shaking, my heartbeat increased, my breathing quickened, but I continued to live it. The psychotherapist said that I would not die from this. Yes, it is unpleasant and scary, but when you live emotions, you gradually learn to cope with them.

Keep a diary. In the course of the sessions, I became convinced that I cannot control the thoughts themselves - it is impossible, but I can control the reaction to them. So I started keeping a diary.


How psychotherapy works

It was necessary to take notes according to the formula: A - situation, B - my thoughts, C - my emotions. Using such records, it is easier to track the thoughts that cause negative emotions and work them out. For example, when I could not fall asleep for a long time, I began to think that something was going wrong, and this caused anxiety. Then I wrote down the whole situation in a diary and instead of negative thoughts I formulated new ones: "My sleep does not depend on my will, and this is normal." It helped to get rid of anxiety, stop trying to sleep and go about your business. About half an hour later I went to bed and fell asleep peacefully.

I filled out the diary for a week, and then the psychotherapist and I analyzed the notes
I also kept a mood diary. Before treatment, there was no point in monitoring the mood: it always turned out to be bad or indifferent On antidepressants, I began to make entries in a diary every day and could track what affects my mood
I also kept a mood diary. Before treatment, there was no point in monitoring my mood: it always turned out to be bad or indifferent On antidepressants, I began to make entries in a diary every day and could track what affects my mood

I also kept a mood diary. Before treatment, there was no point in monitoring the mood: it always turned out to be bad or indifferent. On antidepressants, I began to make entries in a diary every day and could track what affects my mood

In the day hospital, I was treated for a month and a half, during which time I had only five sessions with a psychotherapist. All sessions, meals and drugs, as in the first hospitalization, were free. The only thing I had to spend money on was the road to the hospital and back, as well as the original antidepressant instead of the analogue provided in the dispensary. The doctor recommended the original, it suited me better.

3202 Р

spent on medicines and transport for a month and a half of treatment in the hospital

When I was discharged, the doctor told me that I was in a stable condition, the treatment helped me. I myself felt it: the mood was consistently good, and I quickly coped with obsessive thoughts. I was canceled all the drugs, except for antidepressants, then I had to continue taking them, be observed by the district psychiatrist and monitor my condition.

Spent one and a half months of treatment in a hospital — 3202 Р

Expenditures Spending
Antidepressants 2422 P
Transport 780 Р


2422 R


780 R

How do I feel after treatment

I stopped taking antidepressants a year and a month after discharge I spent another 14,640 R on them. Sometimes I have obsessive thoughts and compulsive actions, but I do not scold myself for this. I know that if I get upset, the symptoms will become more frequent. The psychiatrist warned me that OCD symptoms may appear periodically, but this is normal.

14,640 Р

spent on antidepressants for a year and one month

Coronavirus last spring was a test of strength for me. The condition worsened, compulsive actions resumed, I stopped leaving the house, I began to choke on the street, obsessive thoughts about death appeared. But I managed it on my own with the help of techniques taught to me by the therapist. I kept in my head the idea that if it worked then, it will work now.

Before treatment, it was difficult for me to talk about my disorder. And now I openly talk about it and I can even joke about random manifestations of OCD. Almost everyone in my circle knows that I was being treated for OCD and depression. They help me notice compulsive actions and stop in time, treat me with understanding when I ask obvious things just in case - for example, did I close the door.

How often do people with OCD need to take drugs for life

Sergey Divisenko


With the help of treatment, you can achieve remission - for a long time to get rid of the symptoms of OCD or reduce their number. Remission can occur both against the background of taking medications, and without them, against the background of psychotherapy.

Approximately 80% of patients with OCD stop taking medication sooner or later.

How much does OCD treatment cost?

In total, I treated OCD for one year and nine months. Of these, she was treated in a day hospital for two and a half months, and for a year and seven months - on an outpatient basis.

In the hospital, I only spent money on transport to and from the dispensary. Even during the second hospitalization, on the recommendation of the doctor, she bought antidepressants at the pharmacy and took them instead of those given in the hospital. The rest of the drugs, consultations and meals were free.

6 useful services for finding a psychotherapist

Most of the expenses are medicines during outpatient treatment.

Spent on OCD treatment for 1 year and 9 months — 27,337 R

Expenditures Spending
Antidepressants 23 050 Р
Normotimics 2384 P
Antipsychotics 419 P
Tranquilizers 104 Р
Transport during hospitalization 1380 Р


  1. Obsessive Compulsive Disorder or OCD is a mental illness in which a person experiences obsessive thoughts and compulsive actions.
  2. OCD is considered a lifelong disorder, but remission can be achieved with the help of psychotherapy and drugs.
  3. OCD is treated in Russia by psychiatrists, psychotherapists and psychologists. Psychiatrists prescribe prescription drugs. Psychotherapists and psychologists conduct psychotherapy sessions.
  4. A visit to a neuropsychiatric dispensary will not prevent people with OCD from moving freely, driving a car, using weapons, or getting a job.
  5. Patients with OCD can receive care free of charge in state neuropsychiatric dispensaries or at their own expense in private clinics.

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Personal experience: what to do when you have a million obsessive frightening thoughts in your head?


Imagine that every second, frightening obsessive thoughts are born in your head: you are afraid to yell obscenities at a colleague, beat your mother, pierce your own eye with a fork during dinner. This is exactly what people with obsessive-compulsive disorder (OCD) experience. recorded a monologue of a journalist from St. Petersburg, whose life turned into hell because of such thoughts, but he managed to get out of it (and told how).

As a rule, most patients with obsessive-compulsive disorder have all sorts of intrusive and frightening thoughts in their heads. Such thoughts are actually called obsessions. And compulsions are rituals that supposedly help you cope with thoughts. The patient invents them himself: wash his hands 36 times so that nothing bad happens, pat his dog 15 times before leaving the house. I don’t know if I was lucky or not, but I didn’t have rituals (except for one - every time I closed my eyes for a second while driving, when I experienced an obsessive fear that I would now crash my car). But there were obsessions that ruined my life for years.

How it all began: a monster in a cap

I well remember the first obsessive thought - I was 13 years old, and my mother and I were on vacation in the Crimea. During the bus ride, I imagined a strange mythical creature with yellow teeth, a mouth like a hippopotamus, clawed paws and some completely wild grin. I imagined how this creature stuck to the glass of the bus. At the same time, the monster had a funny cap on its head - obsessions are often ridiculous, but at the same time very frightening. I couldn't get that image out of my head. He followed me throughout the rest. Later, I learned that in boys, the first symptoms of OCD appear exactly at the age of 13-15, and already at this age it is worth contacting a psychotherapist. However, I began to receive adequate treatment only after almost 10 years.

After that trip, the obsessions receded for a while and returned to me after finishing school, at the age of 17. They were the quintessence of all the most disgusting things my brain could generate. Evil and scary pictures, vulgar and depraved images associated with my friends and relatives ... The worst thing is that in real life I adhered to strict moral principles, but my thoughts made me doubt that I was a good person. Would a good person come up with the idea of ​​standing up and yelling at colleagues, beating the chef of the restaurant where he works, hitting his mother? And all these thoughts visited me constantly. Of course, it never came to direct action - I was absolutely harmless to others, thoughts caused suffering only to me. In general, contrasting obsessions always have a very unpleasant content for a person; they contradict his ethical principles. For example, if a person is deeply religious, while suffering from OCD, blasphemous thoughts related to religion and images of saints climb into his head.

How to live if you have OCD

By the age of 22, my illness had reached an acute phase - I had practically no episodes of respite, at least some kind of enlightenment during the day. Probably the best moment at that time was waking up: when I first opened my eyes, my head was still clear. But when faced with reality, the brain gave out flashes of obsessions. I could go into the kitchen and at the same moment the thought arose that now I would beat my mother. I was walking to the bathroom, and at that time an absurd word settled in my head. For example, a carburetor. I didn't know where it came from, but I couldn't throw it away. At some point, I began to spontaneously translate words into English. There doesn't seem to be anything wrong with that, but it bothered me a lot. English words brazenly climbed into my head, interfering with the normal train of thought.

Tip #1: Separate yourself from the disease. She's just trying to hit you where it hurts the most. Would you like bad thoughts to come true? Probably not. It turns out that you are not a scoundrel.

None of my acquaintances and friends knew exactly what was happening to me. But I behaved extremely strangely and began to avoid everyone. When you meet people, they talk about life, work, everyday affairs, girls, and obsessions swirl in your head (or you are completely afraid to yell obscenities at your interlocutors or hit them in the face), then communication turns out so-so. These thoughts greatly distracted me, they hit me on the head like hammers - bang, and complete disorientation sets in. In addition, I began to consider myself a very bad person, I was really ashamed of myself. It was only during the treatment that I realized that you are not your disease. And you should not think that you are a moral freak if, due to a mental disorder, frightening obsessions climb into your head. This is important knowledge for OCD patients that makes life easier.

Loss of job and relationships

When I was 23, everything went to hell - first I was fired from a job that I really liked. I worked as a journalist, but I couldn't write tests anymore. I sat down for an interview, and a fear arose in my head that I would pierce my eyes with a pen or bite off my tongue. Contrasting obsessions are often aimed at harming oneself. You're afraid of losing control, afraid of self-mutilation. The quality of my texts fell to the bottom, problems began in the editorial office. I had to leave my place of work (I honestly told my editor-in-chief that I was crazy), a month later the girl I loved left me. She was aware of my illness, tried to treat it with understanding, but could not stand everything that happened to me. I tried to catch on for dubious part-time jobs, but due to obsessions I could not stay even as a loader. In fact, I lost all ability to work.

It seemed to me that a huge tank fired at my inner world and blew it to pieces. Seeing no way out, I decided that I can safely put an end to it: after all, I will have to stay in this nightmare all my life. But later he began a long and serious treatment with a psychotherapist.

Unsuccessful attempts at treatment

In general, in my life there were three experiences of going to specialists. At the age of 17, my mother took me to a psychiatrist after I told her about my first obsessive thoughts. He prescribed neuroleptics for me, which most likely did not even suit me, and let me go. We did not do psychotherapy then - although, in my experience, it is it, and not drugs, that helps to bring the disease under control. But I found out about this later.

The second time I talked not with a psychiatrist, but with a psychotherapist. I came to him when I was 21, we worked with him for about two years. But in fact, he helped me cope with only one problem - he explained that if I have terrible thoughts due to illness, this does not mean that I am a bad person. I partially stopped self-flagellation, but the obsessions never left my head. Later, I realized that the doctor had little understanding of the treatment of OCD, and all our work with him was built incorrectly.

How to choose a competent doctor

The third doctor helped me cope with the disease - trips to him began just at the time when I hit the bottom. It seemed to me that my case was hopeless, but the initial trust in the specialist was still there: the psychotherapist I chose had a good education, authority in the professional environment, I liked talking to him. The doctor conducted a paid appointment, and at that time I was left without a job and, accordingly, money, so I turned to my family for help. This is an important tip for all patients with mental disorders: do not be afraid to tell your loved ones about your problem and together find money for adequate therapy. It is customary for us to collect funds for the treatment of physical illnesses, but for some reason, with a mental disorder, people are afraid to ask for help (and this is a big mistake).

At the first appointment, I told the doctor about my problem, about all the painful obsessions. I was afraid that I would not be able to express what I feel, but the words literally poured out of me. The doctor listened and asked questions, structured information about me. At the end of the appointment, he summarized everything I had described and told me about a method that is considered effective in combating OCD - this is cognitive behavioral therapy (CBT)

Tip # 2: adequate treatment of OCD is possible only with the help of a competent doctor. The most effective method of treatment is CBT. If you are faced with a disease, then start working with a specialist in this area.

If you have OCD or suspect you have any other mental illness, seek out a competent professional immediately. Self-medication is most often useless and even dangerous. Ask a potential doctor directly if he has experience in treating patients with OCD and what kind of psychotherapy method he uses in his work. In my experience, cognitive-behavioral therapy provides the most consistent and high-quality results, so it's best to have your doctor work within CBT. From the side, you will be able to distinguish it by its special structure and system: you are not just chatting with the doctor, but moving along a clearly defined treatment plan. CBT involves independent homework, it is an educational form of psychotherapy. Having mastered the techniques, you can apply them yourself, for example, to avoid a recurrence of the disease.

Why work with thoughts

During my treatment, the doctor combined pharmacology and psychotherapy. I took neuroleptics and antidepressants. Pills can be a good safety cushion, but I don't think they're paramount. Hoping to defeat OCD by suppressing medication without going through psychotherapy is, in my opinion, a hopeless path.

Cognitive Behavioral Therapy helps to fundamentally change the way of thinking and through this to achieve recovery. See, our emotions are caused by our thoughts. That is, our emotional reaction and our state depend on how we mentally perceive the world around us. After all, it’s not even the obsessions themselves that cause problems with OCD – all people have them to some extent. And the fact that these obsessions seem realistic to the patient. For example, you have the idea that you can hit a person. If you are healthy, then most likely you will think: "Well, okay, I'm not going to do this." A person with OCD is likely to perceive this thought differently: “Oh, what a scoundrel I am! How can I even think about such a thing? What if I lose control of myself and really do it. He will experience fear, horror, disgust. But if you change your train of thought, recolor it from negative to neutral, then it will be easier to endure the symptoms of OCD. Obsessions will not be perceived as something terrible, but as just thoughts. Over time, they will disappear on their own.

Imagine all the worst

The core of my work was the exposure method. The doctor explained to me what it is: if frightening thoughts come, you need not to suppress them, but on the contrary, try to strengthen and purposefully think about it until they weaken. This is a rather intimidating exercise, so at the beginning of treatment it must be performed under the supervision of a specialist.

During the exercise, I imagined bullying my dog. How I tear my beloved dog apart, break his jaws, hurt him. At first it was very hard for me to think about it. But after a few minutes of practice, I noticed that the thought that I would kill the dog caused me less and less anxiety. Another time, I imagined how brutally I raped and perverted members of my family. This was the hardest part because I hated those thoughts more than anyone else. It was painful to focus on the disgusting images, but I got over myself and continued. At the end of the practice, I again noticed that the thought that I was abusing my relatives caused me less and less anxiety. I continued to do these practices every day. My work began to bear fruit.

Tip #4: Don't be afraid to lose control and do what the contrasting obsessions dictate. People with OCD never do all the crazy things that come into their heads. It is only a thought, and thought does not equal action.

The exposure was not the only exercise: to help me cope with the disorder, the doctor used a whole range of techniques. For example, we made tablets of obsessive thoughts - I wrote out the obsession, then the emotion that it evokes in me, I gave it an assessment. Later, the therapist told me about the method of selecting alternatives. First I described the negative thought, and then the alternative to it, that is, my objection to it. The most common objection was: "It's just OCD, my thought has nothing to do with reality, I won't do what I'm afraid of." Yes, indeed, a large number of studies confirm that people with obsessive-compulsive disorder never commit obsessive actions. None of the OCD patients bit off their tongue, turned the steering wheel into the oncoming lane, or shouted obscenities at the interlocutor. Absolutely no one. These are just their irrational thoughts that have nothing to do with reality.

A person with OCD believes that his thoughts are material. We conducted a rather amusing experiment with the doctor. I advise everyone who is worried about the materiality of their thoughts to try it (after all, not only people with mental disorders sometimes suffer from this). Put a piece of paper on the table and try to move it to the side with the power of thought. Focus on this process. Repeat: "I order the piece of paper to move to the side." Nothing comes out? Does the paper stay in place? In general, this is not surprising. After all, thoughts do not determine our actions.

On the road to recovery

Another piece of advice is that when dealing with OCD, you need to prepare for a long job. Some patients hope to get the result quickly, but this is a big mistake, because of which many people abandon the treatment and lose hope. I didn't see a lasting positive effect for several months. But this is normal - the doctor was looking for a key to me, he understood my situation.

The effect of cognitive-behavioral therapy in severe cases of the disease (and mine was just like that) begins after 10-15 sessions. And I'm not talking about a complete recovery, but about positive changes. If the patient does not observe any positive effect even after so many meetings with the doctor, then it is worth discussing this with him directly.

Tip #4: Every job brings results. If you undergo adequate treatment under the guidance of a good specialist, you can defeat the disease. Are you doing nothing? OCD will only get worse and more and more poisonous to life.

Fighting OCD is a regular, monotonous job. You don't have to be a hero or a genius to do it. You will need diligence, patience, the ability to wait and the support of a competent therapist. I went to the doctor every week for six months. Then the sessions began to take place less frequently, but continued for two years.

I felt I had overcome my obsessions eight months after my first visit to my doctor. I was hired at my previous job, I began to feel confident, and the texts began to be written easily (of course, I was no longer afraid to bite off my tongue and fill my desktop with blood).

Do obsessive thoughts come into my head now

Having dealt with OCD, I really became a different person. Almost three years have passed since the moment when I felt free from obsessions, and a year ago the doctor completely canceled drug therapy. During the illness I was in a depressed state, and now I get real pleasure from life. I have a new job, I married a beautiful girl. Illness no longer poses any obstacle to my development.

An unexpected positive side of what I experienced: after such an experience, I seem to no longer be afraid of life's difficulties. A great thought popped into my head—if I can handle OCD, I can handle anything. It's like such a huge dragon that you defeated, so other dragons are not afraid of you. Before my recovery, I was a little man who had gone down with fear, now my character has been tempered and I have become impenetrable. Of course, I'm not an Ironman, but it's really hard to unsettle me.

Perfectionism is very common among people with OCD - they need to keep everything under control, they need everything to be perfect. If something is done wrong, it causes suffering to a person. At the same time, perfectionism reaches the point of absurdity. Patients arrange books alphabetically, and the pile on the carpet should be combed strictly in one direction. If the patient does not do everything “as it should”, he will be plagued by anxiety. I realized that perfectionism is a good feature of the disease, you just need to learn how to apply it in the right way. I started to use this trait in my work - I can’t do anything with my left heel and I take the process very seriously. Sometimes I go too far with my desire for excellence, but still a serious attitude to work affects life positively.

In general, obsessive-compulsive disorder is a disease that is considered chronic. Therefore, people who have experienced a problem should remember that the symptoms may return. But once you've had a good CBT course, you already know how to deal with this flare-up. OCD is an insidious opponent, it can stealthily watch for you and punch you in the face. But if you are well trained, you will block first and then win. So now I have no fear that the disease will return.

You might be wondering if I have obsessive thoughts? Sometimes they come. As well as all the inhabitants of the planet Earth. Once I was talking to my mother, asked if obsessions come to her.

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