Is OCD Permanent?

Obsessive-compulsive disorder (OCD) can be a debilitating psychological disorder characterized by uncontrolled intrusive thoughts and ritualistic compulsions. It can be very hard for people with OCD to lead a normal life.

Thus, the question often asked is whether this condition is permanent or if it can be cured.

Symptoms of OCD

The symptoms of OCD include:

• Repeated thoughts, urges, or mental images that cause anxiety

• Repetitive behaviors, often ritualistic, in response to these things

These issues can cause significant problems in daily life. For example, checking that you turned all the lights off before leaving the house is customary. However, a person with OCD might be compelled to check six (or more) times that all the lights are off, making them late for wherever they are going. 

People with OCD don’t get pleasure from performing rituals but only brief relief from the anxiety, which rapidly returns.

Most people with OCD know that what they are doing is silly, excessive, and doesn’t make sense, but this doesn’t give them the power to stop it. Children with OCD may even see their behavior as entirely normal.

Can OCD go away?

Is OCD curable? No. OCD is a lifelong, chronic condition that has no cure. There is no magic pill that will stop obsessions in their tracks. OCD often goes into remission, sometimes for extended periods, but it comes back.

Lifelong management of OCD requires therapy and sometimes medications, and people living with OCD will have to deal with it their entire lives. Without treatment, OCD can affect your ability to hold a job and have good relationships with others. While it is not dangerous, severe OCD can ruin your life.

Fortunately, treatment options can mitigate the impact of OCD on your life and relationships.

How is OCD treated?

OCD is, unfortunately, challenging to treat, and a lot more research needs to be done on alternative therapies for those for whom the gold standard does not work.

Most people with OCD get some relief and potentially remission from a combination of therapy and medication.¹ The gold standard for OCD treatment consists of the following treatment options.

Exposure and response prevention therapy

The core of OCD is being unable to control intrusive thoughts and your anxious reactions to them. Intrusive thoughts are normal; we all get them sometimes. Most people recognize them as intrusive thoughts and consider them a mild annoyance.  

For example, you may think while in the airport, “Am I sure I didn’t leave the bathroom light on?” and then dismiss it as, first of all, unlikely to be true, and second of all, not important. 

However, if you have OCD, you might have to go back and check—and miss your flight. Or you might use a ritual compulsion before boarding to convince yourself that you didn’t leave the light on. You might also be convinced that leaving the light on, if you did, will result in catastrophic consequences such as a huge electricity bill or your house burning down.

Exposure and response prevention (ERP) therapy is a form of cognitive-behavioral therapy² designed to break that cycle by slowly exposing you to the anxiety-inducing stimulus in a controlled manner. With the help of your therapist, you can train your brain away from catastrophizing and prevent you from returning to check again and again or engaging in rituals. 

Over time, you develop the skills to react in less extreme ways. 

ERP therapy can continue to work after the treatment is stopped, although you will always have to use the skills you have learned.

Selective serotonin reuptake inhibitors

The second arm of treatment is selective serotonin reuptake inhibitors³ (SSRIs). These medications are also used to treat certain forms of depression and anxiety. These medications are effective, albeit not as effective as in other anxiety-related conditions.

A higher dose is used to improve efficacy.

SSRIs must be taken long-term, even if your symptoms have become mild or gone away. Stopping taking the medication greatly increases the risk of relapse. Treatment should be maintained for at least one year, and some people may need to take the medication for life.

For others, SSRIs control symptoms while ERP is performed, and the long-term benefits come from the therapy.

However, some people don’t respond well to SSRIs alone. In this case, your doctor might add an antipsychotic medication. However, the typical augmentation is with therapy.

The lowdown

OCD is a lifelong condition that can ruin your life if it remains untreated. It cannot be cured; however, it can be managed with a combination of medication and therapy. Most people with OCD can learn to handle their symptoms and function better in society and relationships.

The gold standard treatment with OCD is ERP therapy combined with SSRIs, but your doctor may add other drugs if SSRIs alone won’t work for you. If you suspect you or your child has OCD, it is important to seek treatment.