Obsessive-Compulsive Disorder OCD

Obsessive-Compulsive Disorder (OCD) Treatment in Baltimore

Obsessive-Compulsive Disorder is a complex and often misconstrued mental health issue that impacts millions of people. As an experienced psychiatrist, Dr. Ranen has personally witnessed the negative impact OCD can have on one’s daily life. Learn more about OCD and our approach to treatment below.

What is OCD?

OCD, or Obsessive-Compulsive Disorder, is a mental health disorder characterized by repeated intrusive thoughts that often leads to unwanted rituals.  Repetitive behaviors or thinking patterns (compulsions) are performed with the intention of lessening these intrusive thoughts.  Those suffering from OCD cannot independently stop their thoughts or habits. Compulsions are frequently unfulfilling and often take up hours of one’s day.  These are the main types of symptoms experienced by someone experiencing OCD.


What are the symptoms?

The signs of OCD can be generally divided into two primary groups: obsessions and compulsions.


  • Recurrent unwanted intrusive thoughts, images, or urges that are distressing and often unwanted.
  • Thoughts and images may revolve around themes such as contamination, symmetry or order, harm to self or others, and intrusive sexual or aggressive thoughts. There can also be obsessive doubt and need for certainty, with constant second-guessing and need for reassurance.
  • Intense anxiety, shame, or guilt is often associated with obsessions.


  • Repetitive behaviors or mental acts that are performed in response to the obsessions, with the aim of reducing anxiety or distress.
  • Examples of compulsions include excessive hand washing, counting, checking, ordering and arranging, and repeating words or phrases.
  • Compulsions are time-consuming and interfere with daily life and activities.
  • Compulsions are not enjoyable and may cause additional stress and anxiety.


What causes OCD?

The exact cause of OCD is not known, but research suggests that several factors may contribute to its development, including:

  • Brain Structure and Functioning: Extensive research has demonstrated that individuals suffering from OCD could have diversities in regions of the brain responsible for interpreting behaviors, feelings, and thoughts. Moreover, there is evidence suggesting an imbalance in neurotransmitters such as serotonin may be connected to the emergence of Obsessive-Compulsive Disorder (OCD).
  • Genetics: Researchers have suggested a genetic predisposition to OCD due to its moderate-to-high heritability. This has been verified through various family, twin, and adoption studies that point toward the role of genetics in developing this disorder.
  • Environmental Factors: Trauma, stress, or life events, such as a death, divorce, or job loss, have been shown to trigger or worsen symptoms of OCD in some individuals.
  • Cognitive Factors: Perfectionism, black-and-white thinking, and an excessive need for certainty are among the thought patterns and beliefs that have been linked to the progress of OCD.


How is OCD diagnosed?

A psychologist or psychiatrist is responsible for diagnosing OCD. They will generally reach this conclusion following an in-depth assessment, which consists of:

  • Clinical evaluation: A mental health professional will conduct a thorough evaluation of the individual’s symptoms, medical history, and life circumstances.
  • Diagnostic criteria: To be diagnosed with OCD, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) implies that a patient must experience unreasonable obsessions or compulsions which interfere with everyday life. Obsessions are typically persistent thoughts while compulsions refer to repetitive behaviors/mental acts designed to reduce anxiety generated by the obsession.
  • Ruling out other conditions: Besides diagnosing potential mental health conditions, the mental health professional must also investigate other symptoms that may indicate depression, or other anxiety disorders.
  • Assessment of severity: The severity of OCD symptoms is also assessed to determine the best course of treatment.

 People with OCD may also suffer from co-occurring conditions, like depression and anxiety disorders or tic disorder. A mental health expert needs to assess these other issues in order to make an accurate diagnosis.  There are multiple types of OCD, Dr. Ranen can assess the present symptoms and understand which type of OCD may be affecting you.


What are the types of OCD?

OCD can present in many different ways and individuals may experience different symptoms and compulsions. Some common subtypes of OCD include:

  • Contamination Obsessions: Contamination-based thoughts and behaviors are prevalent in individuals with Obsessive Compulsive Disorder (OCD). An individual may become preoccupied by their fear of coming into contact with dirt, germs, bodily fluids or other substances. This anxiety might result in them engaging in obsessive rituals to prevent or undo contamination or alleviate the worry related to it.

Examples of contamination-related compulsions in OCD include:

  • Excessive hand washing or sanitizing
  • Avoiding touching door handles, light switches, or other potentially contaminated objects
  • Cleaning household items or surfaces repeatedly
  • Avoiding public restrooms or other public places perceived as contaminated
  • Refusing to shake hands or touch others out of fear of contamination


Harm Obsessions: This type of OCD consists of intrusive thoughts or images about injuring oneself or others. People with harm obsessions often feel an overwhelming sense of responsibility to avoid any potential damage, leading them to practice habits and rituals intended at stopping it from occurring.

Examples of harm-related compulsions in OCD include:

  • Repeatedly checking locks or appliances to prevent harm
  • Avoiding certain activities or situations out of fear of causing harm
  • Mental acts such as repeating words or prayers to prevent harm
  • Repeatedly seeking reassurance from others about the safety of loved ones


Symmetry and Ordering Obsessions: For this type, an individual is overly concerned with neatness and balance in their environment or possessions. These individuals may do repeated behaviors or mental activities to achieve a sense of symmetry, exactness, and orderliness.

Examples of symmetry and ordering-related compulsions in OCD include:

  • Repeatedly arranging objects in a particular order or pattern
  • Spending excessive time making sure that items are perfectly aligned or symmetrical
  • Repeatedly arranging and rearranging items to achieve a certain level of order
  • Avoiding activities or situations that may disrupt symmetry or order
  • Becoming extremely distressed when symmetry or order is disrupted


Sexual or Religious Obsessions: These involve intrusive and often distressing thoughts related to sex or religion and the associated compulsions may involve excessive praying, confessing, or avoiding triggers.

Hoarding Obsessions: This type of hoarding disorder often causes a person to possess an uncontrollable urge for gathering and saving items, regardless of their practicality or worth. These hoarding behaviors can take up space in one’s home and life, leading to distressful situations that may interfere with everyday activities. Hoarding may also involve a component of Attention Deficit Disorder


Examples of hoarding-related compulsions in OCD include:

  • Accumulating and retaining large amounts of items, such as clothes, paper, or books, even if they are no longer needed or used
  • Difficulty discarding items due to fear of losing something valuable or important
  • Avoiding activities or situations that may involve discarding items
  • Living spaces becoming can cluttered to the point of being uninhabitable


These subtypes are not mutually exclusive, and individuals may experience symptoms from multiple subtypes. Symptoms can also change over time and the subtypes are not meant to be used for a formal diagnosis.


What are the treatments for OCD?

There are several effective treatments for OCD, including:

  • Cognitive-Behavioral Therapy (CBT): CBT is a type of talk therapy that focuses on changing thought patterns and behaviors that contribute to OCD. The most proven form of CBT for OCD is Exposure and Response Prevention (ERP), which involves gradually exposing the individual to feared stimuli while preventing the performance of compulsive behaviors. ERP has been shown to be highly effective in reducing symptoms of OCD. Another form of therapy is Acceptance and Commitment Therapy (ACT).
  • Mindfulness-Based Interventions: Mindfulness-based interventions, such as mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR), have been shown to be effective in reducing symptoms of anxiety and depression, including OCD. These interventions focus on developing mindfulness and awareness skills to help individuals regulate their emotions and thoughts. Another popular therapy that falls under this heading is Acceptance and Commitment Therapy (ACT)
  • Medication: Several types of medications have been shown to be effective in treating OCD, including selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), and the tricyclic antidepressant clomipramine (Anafranil). Medication can be used alone or in combination with CBT.
  • Transcranial Magnetic Stimulation (TMS): During an TMS session an electromagnetic coil is placed against the scalp of your head. This coil delivers magnetic pulses that stimulate or suppress nerve cells in the region of your brain involved in OCD.
    • Deep Brain Stimulation (DBS): DBS has been shown to be effective in treating some individuals with severe and treatment-resistant OCD. It is a surgical procedure that involves the implantation of electrodes into specific areas of the brain. The electrodes are connected to a device that delivers electrical stimulation to regulate brain activity.

The best treatment for OCD will depend on the individual and the severity of the symptoms. Dr. Neal Ranen can work with the individual to determine the most appropriate treatment plan.

Why choose Dr. Neal Ranen?

His OCD and related disorders treatment center in the Baltimore, Maryland area creates a supportive environment for all those struggling with mental disorders. Dr. Ranen offers a safe, nonjudgmental environment for adults with OCD by providing cognitive behavioral therapy, medications, and individual therapy.