Condition guide
Obsessive-Compulsive Disorder (OCD)
Intrusive thoughts and the rituals that follow them
Overview
OCD involves unwanted intrusive thoughts, images, or urges (obsessions) and repetitive behaviors or mental acts performed to reduce the resulting distress (compulsions).
The relief compulsions provide is real but brief, and each repetition strengthens the loop. Treatment works by breaking that loop rather than by arguing with the thoughts.
Common symptoms
- Intrusive thoughts about contamination, harm, symmetry, or taboo subjects
- Excessive washing, checking, counting, or ordering
- Mental rituals such as reviewing, praying, or neutralizing
- Constant reassurance seeking
- Avoiding triggers to prevent obsessions
- Hours per day lost to rituals
- Significant distress and awareness that the rituals are excessive
Causes and risk factors
- Genetic and family history factors
- Hyperactivity in the cortico-striato-thalamo-cortical brain circuit
- Serotonin system involvement
- Stress or illness that triggers onset or worsening
- Reinforcement learning — compulsions reduce anxiety short-term and strengthen long-term
Treatment options we offer
- Exposure and response prevention (ERP), the gold-standard therapy
- CBT targeting beliefs about responsibility, uncertainty, and thoughts
- Deep TMS, FDA-cleared for OCD
- Family coaching to stop accommodating rituals
- Coordination with your prescriber on medication
Therapy approaches used
- Exposure and response prevention (ERP)
- Cognitive therapy for OCD beliefs
- Family accommodation reduction
- Relapse prevention
How TMS fits in
Deep TMS is FDA-cleared for OCD and targets the medial prefrontal cortex and anterior cingulate cortex. It is typically used when ERP alone or ERP plus medication has not produced sufficient improvement, and it's often combined with continued ERP.
Learn more about TMS therapyFrequently asked questions
Services that treat Obsessive-Compulsive Disorder (OCD)
Start with one conversation
Tell us what you've tried. We'll confirm eligibility, verify your benefits, and map out what treatment would look like.