I say it over and over again when I write about OCD. The evidence-based psychological treatment for obsessive-compulsive disorder is a type of Cognitive Behavioral Therapy known as exposure and response prevention (ERP). Medication is helpful for some individuals as well. With proper treatment, most people with OCD will improve.

But what if you don’t? What if, after attempting these traditional therapies, there is no improvement and you are still suffering with severe OCD? While I’ve written before about some people with OCD erroneously being labeled treatment-resistant, there are indeed a small number of people who receive no benefit from ERP therapy and/or medication.

Is there any hope for those who are truly treatment-resistant? Absolutely. There have actually been some alternative treatments around for a while. I’ve written about Deep brain stimulation, focused ultrasound, and neurofeedback which have all shown promising results for those with treatment-resistant OCD.

But there’s more. The research continues and in the Winter 2016 OCD Newsletter published by the International OCD Foundation, there is an excellent article about brain-circuit-based therapies for OCD. I’ll give a synopsis but I highly recommend reading the article for detailed information.

So what are brain-circuit-based therapies? The article explains:

Your brain is made up of cells called “neurons” which communicate with each other. When several neurons work together, they are referred to as a circuit or network. If you’ve ever taken apart a computer or other electronic device, you’ve likely seen a green plastic board covered in gold circuits. Much in the way electricity travels through this circuit board to convey information from one part of the computer to another, your brain uses neural networks to convey information from one part of the brain to the other. So, instead of targeting neurotransmitters (the chemicals used to communicate between individual neurons) using medications, researchers are now looking at how neural networks function to communicate from the parts of the brain that regulate, say, emotions to the part of the brain that regulates movement. It is our hope that new treatment methods that focus on neural networks may offer help to those individuals who have not had success with other treatment methods.

Non-invasive treatment options do not involve surgery and have minimal side effects. Those discussed in the article include:

  • Transcranial Magnetic Stimulation (TMS)
  • Transcranial Direct Current Stimulation (tDCS)

Invasive procedures involve neurosurgery which involve a small risk of infection or seizures. Those discussed include:

  • Anterior Cingulotomy
  • Anterior Capsulotomy
  • Deep Brain Stimulation

Again, I highly recommend reading the article for details about each procedure as well as the success rates. What I find most interesting about most of these techniques is that those who were previously considered treatment resistant were often able to benefit from ERP therapy and/or medication after undergoing one of the procedures. How great is that – they were no longer treatment resistant!

Brain-Circuit-Based Therapies seem to hold a lot of promise as researchers continue to try to unlock the mysteries of OCD. But for most people, good ‘ol fashioned ERP therapy, a lot of hard work and commitment, and medication if necessary will be enough to triumph over OCD.