Do You Need Medication?
A couple months ago, I wrote a blog post titled Do You Need a Therapist?, which addresses my thoughts on this oft-asked question by people suffering from OCD. As a follow-up to that, I also wanted to write a short blog post specifically on another frequently asked question: do you need medication to recover from OCD?
Before I explain my thoughts and perspectives on this question, let my first preface this by saying:
1) I absolutely believe that the right medication in the right situation can help certain people.
2) You should always consult with a professional mental health expert before deciding to take any medication (indeed, many anxiety medicines are not available over the counter and require a prescription).
3) Sadly, medication for mental illness has been stigmatized by society, which often prevents people from seeking out help when they really need it. But you should not feel ashamed if you need medication to help manage OCD or anxiety. It’s no different than taking melatonin to help sleep at night, or ibuprofen for pain relief. If medication for physical ailments is widely accepted by society, then no one should be ashamed to take medication for mental illness either.
All of that being said - to answer the original question: do you need medication to recover from OCD? My answer is a firm no. The right medication (prescribed by a mental health professional) can definitely help facilitate the OCD recovery process. But can you beat OCD without ever taking a single pill? Absolutely.
To explain my reasoning, I will start by saying that at its fundamental level, OCD is a disorder with the way your brain processes behavior. When an obsession or intrusive thought pops up in your mind, OCD has conditioned your brain to respond with a compulsion, which temporarily reduces the feelings of anxiety by bringing a sense of control to you. But this is always only a short term relief, and reinforcing this behavioral cycle by performing compulsions only strengthens OCD’s hold on you. It’s a classic Pavlovian response: if you train a dog to associate meal-time with the sound of a bell ringing, eventually the dog will salivate from hunger whenever it hears a bell, even if no food is present. The same is true with your brain and OCD: the more you respond to intrusive thoughts by performing compulsions to relieve anxiety, the brain will associate those compulsions with a feeling of relief, and hence the urge to do compulsions will only get stronger and stronger as you continually reinforce this behavior.
The reason why I am explaining this is because in order to beat OCD, you must break the underlying behavioral pattern, and you absolutely do not need medication to do this. In fact, the cognitive behavioral therapy techniques of ERP and ACT (which I have written about many, many times on this blog) are expressly designed to help you change your behaviors and mindset and address the root cause of the disorder. Practicing ERP and ACT are, in my mind, the only surefire ways to truly recover from OCD, and you don’t need medication to help you achieve this.
So, where and how does medication help in the OCD recovery process? In my opinion, medication and pills can be a great complement to ERP or ACT. That is to say, if you are having overwhelming anxiety during your exposure exercises which prevents you from properly completing ERP, then taking some medication to “blunt” the feelings of anxiety may help. The right pill or medication may take your anxiety levels from a 9 or a 10 down to a 4 or a 5, which in turn helps you complete your ERP exercises by making it easier for you to resist the urge to perform compulsions, which will eventually help “undo” the negative behavioral patterns which your brain has become locked into.
However, I would warn against relying on medication solely as a way to beat OCD, because in my opinion, medication doesn’t really address the root cause of the disorder. Medicine or pills may reduce the feelings of anxiety, but ultimately they aren’t changing the negative mental patterns which fuel OCD. This means that if you forget to take your medicine one day, or run out of it, you are in danger of falling into the same old compulsions and ruminations, because without medication, OCD is still alive and well in your brain. That is why I constantly preach so much about ERP and ACT - because changing your behaviors and mindset through cognitive behavioral therapy is the only true way to address the root cause of OCD.
Additionally, I would like to warn about the possibility of medication becoming a compulsion in and of itself. As a personal example, when I was in the worst parts of my struggles with OCD, I was desperate to find some sort of pill or “magic bullet” to fix this disorder. I wasn’t able to see a therapist and hence was unable to get prescription anxiety meds; hence, I instead turned to Google and looked for over-the-counter pills and home remedies to address anxiety. After spending days and weeks researching, I eventually started taking a daily cocktail of pills and vitamins to help “fix” my OCD: inositol, vitamin B, fish oil, L-theanine tablets, and vitamin D. But I ultimately found that in spite of all these pills, my compulsive behaviors and intrusive thoughts weren’t getting any better, and even worse, that taking these pills on a daily basis had turned into a compulsion. If I missed a day without taking them, or ran out of some pills, then my anxiety would absolutely skyrocket and I would become even more prone to performing compulsions to help relieve the overwhelming feelings of anxiety.
Now, there is a huge difference between prescription anxiety meds and the over-the-counter pills which I had been taking. So I again want to re-iterate that the right medication, prescribed by a mental health professional, can absolutely make a world of difference to someone struggling with OCD. But at the end of the day, I stand firmly by my opinion that while medication can help facilitate the recovery process, it alone is not enough to recover from OCD. The only true way to beat OCD is by fundamentally changing your behavioral patterns, and this is best accomplished by practicing a cognitive behavioral therapy like ERP or ACT, both of which can be done without medication. Medication can be a great complement to ERP/ACT, but ultimately is not the long-term solution for permanent OCD recovery.
I hope this post helps, especially for people who are struggling with the decision on whether or not to take medication to help with their OCD recovery. If you (and your mental health professional) believe that medication is right for you, then I absolutely think it’s a great tool which can be used in your recovery process. Medication can be a great boon to certain people, and I would hope that society’s stigmatization of medicine for mental health would not stop you from doing what’s best for yourself and your mind. Regardless of whether or not you are taking medication, I still would highly encourage you to practice ERP or ACT (or ideally, both!) to help rid yourself of OCD forever.
Eric