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Obsessive-compulsive disorder (OCD)

Explains obsessive-compulsive disorder (OCD), including possible causes and how you can access treatment and support. Includes tips for helping yourself, and guidance for friends and family.

Mae'r dudalen hon hefyd ar gael yn Gymraeg. This link will take you to a Welsh translation of this page.

Talking therapy for OCD

You may be offered talking therapy for OCD. This might be on its own, or along with medication. 

I started to learn how to manage my OCD when I spoke to a therapist.

Cognitive behavioural therapy (CBT) with Exposure and response prevention (ERP)

CBT with ERP is the most recommended talking treatment for OCD. It combines two types of therapy:

  • Cognitive behavioural therapy (CBT) focuses on how your thoughts, beliefs and attitudes affect your feelings and behaviour. See our page on CBT to learn more.
  • Exposure and response prevention (ERP) is designed to treat OCD. It encourages you to confront and accept your obsessions, and resist the urge to carry out compulsions.

You may be offered CBT with ERP in person or over the phone. And it could be one-to-one or in a group. It depends on your needs and the services in your area.

During ERP, your therapist may encourage you to do, say or think things about your obsessions or fears. Then they will help you to try to tolerate the distress or uncertainty, instead of doing a compulsion.

Your therapist should help you do this at your own pace and support you along the way. They will usually start with smaller challenges and help you build your confidence in resisting compulsions.

ERP aims to help you see that the uncomfortable feelings will eventually go away, even if you don't perform a compulsion.

This type of therapy can be challenging. At first, it might make you feel more distressed. It may help to talk to a healthcare professional about any concerns before you start ERP. They can answer any questions you have about what it involves.

Seeking therapy privately

Waiting times for therapy on the NHS can be long. And the services we need are not always available.

Because of this, you may consider going private. Unfortunately, this can be expensive so may not be possible.

Some private therapists offer a sliding scale of payment, depending on your circumstances. So it may be worth checking their website or contacting them to see if this is something they can do.

It's important to find the right support for your needs. Certain types of therapy that focus on your past experiences or on finding meaning in your thoughts are not recommended for OCD. They can make symptoms worse.

It may help to talk to any potential therapist and ask how much experience they have with treating OCD. Or it might help to search for people who include ERP within their therapy.

Visit our page on seeking private therapy to find out more. 

I met with the psychologist and she showed me there was a way forward. Each week I challenged a compulsion and I became one step closer to being the me I used to be

Medication for OCD

You may be offered the following medications for OCD, either on their own or alongside talking therapy:

Different people find different medications helpful. You can talk to your doctor about your options. You might find you need to try out a few different types of medication before you find one that works for you.

Medication helps some people. But isn't right for others. Before deciding to take any medication, it's important to have all the facts you need to make an informed choice.

This includes information about any potential benefits and side effects of the drug. If you don't understand any aspect of a medication you're offered, don't be afraid to ask as many questions as you feel you need to.

For more information, see our pages on things to consider before taking medication and your right to refuse medication. For guidance on how to come off medication safely, see our pages on coming off medication.

I've been on meds for the last three years and my OCD is so much more controllable.

How can I access treatment for OCD?

The first step to getting treatment for OCD is usually to visit your GP. Your GP should ask about your symptoms and discuss different treatment options.

If you live in England, you may also be able to refer yourself to an NHS talking therapies service directly. You can find your nearest NHS talking therapies service on the NHS website.

This service offers treatment for depression, anxiety, and some other mental health problems - including OCD. Waiting times for this can vary, and can sometimes be long.

The treatments you're offered will depend on how much OCD is affecting your life, and how much distress it's causing you. It may also depend on any treatments you've tried in the past, and whether these worked.

The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in healthcare – suggests that treatment for OCD should include talking treatments or medication, or both. The NICE website has full guidelines and recommendations for treating OCD.

If you feel a treatment isn't working for you, it's a good idea to discuss this with your GP. There may be others available.

What if I'm worried about talking to my doctor?

You might feel scared about telling anyone, even a doctor, about your intrusive thoughts.

You may worry you'll be judged about graphic or offensive thoughts. Or that the doctor might report you to the police or social services. Or you may find it hard to share how much time your compulsions take up.

This might might make it feel difficult to get the right help. But it's important to be as open as possible, so you can access the best treatments for you.

Before your appointment, it may help to note down the ways your OCD is affecting your life, how much your symptoms distress you and how much time they take up. This may help you to remember what you need to say in the moment. You could also ask someone you trust to go with you.

We have more information about talking to a GP about your mental health. OCD Action also has a page on preparing for a GP appointment about OCD. And OCD-UK has a GP Ice Breaker that you can print, complete and take with you.

Specialist OCD services

If your OCD is very severe and medication or talking therapy haven't helped, you may be referred to a specialist OCD service. Unfortunately, not all areas have specialist services and you might have to travel outside your local area.

OCD-UK has more information about NHS specialist OCD treatment services.

Social care support

Depending on how your OCD impacts your life, you may be eligible for social care.

Social care services support people who struggle to manage day-to-day activities. You can read more about social care in our guide to health and social care rights.

This information was published in October 2023. We will revise it in 2026.

References and bibliography available on request.

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