(850) 692-9355
Elevating Psychiatric care What We Treat


Obsessive compulsive disorder (OCD) is a common and often chronic mental health disorder that affects people of all ages and walks of life. It is an anxiety disorder that affects about 1.2% of Americans.  Most people are diagnosed by age 19. People with OCD often feel it to be irrational, they may be hesitant to discuss their symptoms and feel shame. Almost 50% of people with OCD have a severe form which significantly affects their function and quality of life. However, distress is substantial in even mild and moderate forms. Sadly many people with OCD delay seeking care for up to eleven years often out of shame or embarrassment.

OCD is characterized by persistent and uncontrollable obsessions, or unwanted and intrusive thoughts, that lead to compulsions, or repetitive behaviors that one feels compelled to do to try to ease the anxiety caused by the obsessions.

Obsessions vary from person to person. Some common obsessions include a fear of contamination, a need for things to be symmetrical or in order, unwanted sexual thoughts, thoughts of harming themselves or others, and more. Obsessions are uncontrollable, even when they are perceived as inappropriate.

Compulsions are intense urges to perform certain rituals or compulsions to try to ease the anxiety caused by the obsessions. Examples include excessive handwashing and cleaning, counting, checking, and rechecking, ordering, and arranging things in specific ways, and more. People with OCD may also engage in mental rituals like counting, double checking and praying in an attempt to neutralize disturbing thoughts.

OCD can cause a significant of distress and interfere with daily life. For some people, OCD may be mild, while for others it can be severe and debilitating. However with treatment, many people with OCD can live full and productive lives.

The cause is not known but is believed to result from a combination of factors including genetics and environmental factors, and certain structural differences in the brain of people with OCD.

Some studies report that a childhood infection may be a trigger. Other research suggests that certain psychological features like difficulty coping with uncertainty, or “magical thinking” based in superstition or religious dogma may be risk factors.

45% of people with OCD have close relatives who have OCD.  Additionally, stressful life events or experiences (such as abuse or trauma) may trigger OCD symptoms in people who are already predisposed to the disorder. It is also important to note that OCD is not caused by poor hygiene or housekeeping habits.

There is no single test or physical finding to diagnose OCD. Many other disorders, such as other anxiety disorders, depression, tics or Tourette’s syndrome, and certain medical conditions can have similar symptoms. A formal diagnosis will be made according to diagnostic guidelines which require that the patient spend more than one hour per day consumed by obsessions and compulsions, or that these cause significant daily distress and interfere with their quality of life.

During his evaluation, he will ask about your symptoms, when they began and whether you can identify anything that triggered your obsession. He will also inquire about your family’s medical history, including any history of mental illness. He will also consider whether any other mental health disorders are present. Many people with OCD also have other mental health disorders, including other anxiety disorders, depression, or tic disorders.

Treatment involves a combination of medication and psychotherapy. Most people experience relief from symptoms with this approach. Serotonin reuptake inhibitors (SSRIs) are useful to reduce symptoms but can require several months to find the right medication and allow it to begin working. When this class of medications don’t provide relief, some patients respond well to antipsychotic medications to manage symptoms.

Cognitive behavior therapy (CBT) and related therapies can be as effective as medication for many. CBT requires the patient to actively participate in their recovery, which can restore a sense of control and self-confidence. You will learn coping skills that are valuable for healthy living. While treatments may be short, they often provide sustainable relief from distress.

Exposure Therapy teaches the client to become less sensitive to a feared situation or object and is effective to treat OCD.

When you or a loved one seeks assistance and support for OCD, contact Dr. Poulakos at his New York City office to schedule a consultation where you will learn about the ways he can help you manage your symptoms and improve your quality of life.

Dr. Poulakos offers evidence-based, individualized treatment using medication and psychotherapy, and state-of-the-art therapies. When people are directly involved in creating their own treatment plan including wellness goals and support services, they experience improved outcomes. He is a caring and compassionate doctor who will work with you to find solutions that meet your unique needs.

At a Glance

Dr. Paul Poulakos

  • Attending Psychiatrist at Mount Sinai Beth Israel Medical Center
  • Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai
  • Past Clinical Assistant Professor of NYU Langone Medical Center
  • Learn more