OCD experts get candid about overcoming an invisible battle
Many have heard of Obsessive-Compulsive Disorder (OCD), but few know it’s an all-consuming condition that can rob one’s life of joy, replacing it with anxiety and self-doubt. We spoke with NOCD Co-founder and CEO Stephen Smith and Chief Medical Officer Dr. Jamie Feusner (pictured below), who shared insights into the severe impact of OCD and the difference that the right support and treatment can make.
Regence: Can you provide a brief explanation of OCD?
Stephen Smith: OCD is a chronic, severe, and often debilitating psychiatric health condition that affects approximately 1 out of 40 people worldwide in their lifetime, or over 180 million people globally. Despite its prevalence, OCD remains widely misunderstood and often goes undiagnosed for far too long, with diagnosis taking about 13 years on average. And while OCD is highly treatable, treatment is often misguided, as the condition is frequently misdiagnosed or missed entirely.
Regence: What are some common symptoms that people with OCD experience?
Dr. Jamie Feusner: One of the symptoms of OCD are obsessions, which are unwanted thoughts, images, bodily sensations, or urges. Intrusive thoughts that conflict with a person’s values or desires are some of the most prevalent types of obsessions. Common topics include sex, religion, and harm to oneself or others, but themes can vary widely.
These thoughts or feelings cause anxiety or other distress and when this distress becomes overwhelming, individuals with OCD will often turn to compulsions. Compulsions, another common OCD symptom, are mental or physical actions meant to relieve distress. While engaging in them might bring short-term relief, ultimately, compulsions only reinforce the distress a person is feeling. Over time, these actions can become incredibly time-consuming and have a severe impact on one’s quality of life.
Regence: How is OCD diagnosed?
Dr. Jamie Feusner: To diagnose someone with OCD, mental health professionals will ask questions to determine if they meet the criteria outlined for the disorder. According to the American Psychiatric Association (APA), the person must have the following symptoms: obsessions and/or compulsions that are time-consuming so as to take up at least one hour per day (OCD symptoms can wax and wane, notes Stanford Medicine, so there is leeway in this aspect), cause significant distress, or impair one’s ability to function at work or in social situations.
Regence: What evidence-based approaches do you use to help people manage their OCD symptoms effectively?
Dr. Jamie Feusner: A gold-standard treatment for OCD is exposure and response prevention (ERP) therapy. ERP is a type of cognitive behavioral therapy (CBT) that was developed to treat OCD and its effectiveness is backed by decades of clinical research. In ERP, people are gradually exposed to the situations that bring on their obsessions. During these exposures, they learn to tolerate uncomfortable emotions associated with the obsessions without engaging in compulsions. This process helps dissipate distress over time. The response prevention part of the treatment involves helping the person with OCD reduce and eventually eliminate compulsions.
Medication is also considered to be a first-line treatment for OCD, and the APA describes medication or ERP alone or combined medication and ERP, depending on the clinical situation, as part of expert consensus guideline approaches. For example, while many people experience life-changing results through ERP alone, for those whose symptoms prevent them from fully engaging in ERP, medication can be extremely beneficial. A licensed clinician can help people determine if medication might be right for them.
Regence: Can you share a brief example of a member’s journey using ERP therapy and how it’s helped them develop the skills needed to manage an OCD diagnosis?
Stephen Smith: There’s Tricia, who found motivation to step outside of her comfort zone and accept a new position at work; Michelle, who can enjoy spending time with her children again; and Christian, who was able to return to school to pursue his dream of becoming a doctor. These are just a few of the thousands of examples of how treatment helps save lives. We share many of the incredible, inspiring stories of our patients in the My OCD Journey section of the NOCD website.
Regence: Are there any advantages to treating OCD in a virtual setting?
Dr. Jamie Feusner: Research has found that video teletherapy can not only be an effective means for therapists to provide ERP for OCD in children and adults but also that positive outcomes could be achieved in under half the time needed for traditional ERP therapy in an outpatient setting, resulting in substantial monetary and time savings.
Virtual ERP overcomes geographical and accessibility barriers by bringing treatment into someone’s native environment, which has the added benefit of helping people manage their fears in the places where they are most triggered.
Regence: As a service provider treating patients with OCD, what advice do you have for anyone who suspects they or someone they know may be experiencing symptoms of OCD?
Stephen Smith: OCD’s ability to foster feelings of doubt makes many people question if they have the condition, even when they’ve received a diagnosis. If you suspect that you’re experiencing OCD, the best thing you can do is seek out a therapist who specializes in OCD and ERP, even if you’re having doubts. This specialization is important—OCD is complex, and it takes specialized training and expertise to diagnose and treat it. A specialized therapist will understand OCD and be able to help you work through doubts about what you're experiencing.
Finally, know that there is no shame in seeking help. You might think you’re the only one who’s ever had taboo or disturbing thoughts, but they’re so much more common than you think, even among people who don’t have OCD. An OCD specialist will understand that these thoughts aren’t indicative of your character and can help you learn to manage the distress they cause.
Regence: What can members expect from treatment at NOCD?
Dr. Jamie Feusner: NOCD provides effective, affordable, and convenient treatment for OCD and related conditions. Our therapists specialize in ERP therapy, the most effective OCD treatment. They’re trained by some of the top OCD experts and researchers in the world. Between sessions, patients get access to therapist messaging, a team of Member Advocates, 24/7 support from peer communities, free support groups and more.
We’re here to help
If you or your loved one needs emotional support or mental health care, we can help you find the behavioral health care option that fits your needs. In addition to NOCD for the treatment of OCD, most of our health plans offer virtual mental health treatment options from providers such as AbleTo Therapy+, Array, Doctor on Demand, Talkspace and Charlie Health . No referral is needed – you can visit the provider’s website and fill out their intake form for an appointment.
We encourage you to visit these providers’ websites or call us at the number listed on your member ID card to verify which virtual care and traditional behavioral health options are available through your health plan.