Skip to main content
J. Connor Barnhart, MD

OCD (Obsessive-Compulsive Disorder) Treatment in San Francisco

Also known as: Obsessive-Compulsive Disorder, Obsessive Compulsive Disorder, OCD Disorder, OCD Anxiety, Compulsive Behavior Disorder

5 min readLast updated: 2026-02-23
Reviewed by J. Connor Barnhart, MD

Obsessive-compulsive disorder (OCD) is a mental health condition in which a person experiences intrusive and recurring thoughts known as obsessions, engages in repetitive behaviors known as compulsions, or both. These obsessions and compulsions can consume significant time each day, cause considerable distress, and interfere with daily activities, relationships, and work. OCD affects both children and adults, with symptoms typically emerging by young adulthood.

At a Glance

  • An estimated 1.2% of U.S. adults had OCD in the past year, with a lifetime prevalence of approximately 2.3%[1]
  • Among adults with OCD, approximately 50.6% experience serious impairment, with an additional 34.8% experiencing moderate impairment[1]
  • Past-year prevalence of OCD is higher for females (1.8%) than for males (0.5%)[1]
  • OCD symptoms typically first appear between late childhood and young adulthood, often between the ages of 7 and 12 or during the late teen years[6]
  • Evidence-based treatment for OCD includes specific types of psychotherapy combined with psychiatric medications that act on serotonin[7]

Affected Anatomy

  • Frontal cortex
  • Subcortical brain structures (basal ganglia, caudate nucleus)
  • Orbitofrontal cortex
  • Anterior cingulate cortex
  • Thalamus
  • Cortico-striato-thalamo-cortical circuits
  • Serotonergic neurotransmitter system

What are the symptoms of OCD (Obsessive-Compulsive Disorder)?

  • Unwanted, recurring thoughts, urges, or mental images that cause anxiety or distress (obsessions)
  • Repetitive behaviors or mental acts performed in response to obsessions or according to rigid rules (compulsions)
  • Spending significant time (more than one hour per day) on these obsessions or compulsions
  • Fear of germs, contamination, or illness leading to excessive cleaning or handwashing
  • Unwanted aggressive, sexual, or religious thoughts that cause significant distress
  • Need for symmetry, exactness, or order, with compulsive arranging or organizing
  • Repeated checking of locks, appliances, or other items due to persistent doubt
  • Difficulty tolerating uncertainty or the possibility that something may go wrong
  • Compulsive counting, praying, or repeating words silently
  • Avoidance of situations that may trigger obsessions

When to See a Psychiatrist for OCD

  • Intrusive thoughts, images, or urges that cause significant distress
  • Repetitive behaviors or mental rituals that consume more than an hour a day
  • Avoidance of situations, places, or people due to obsessive fears
  • Difficulty functioning at work, school, or in relationships because of OCD symptoms
  • Feeling unable to control unwanted thoughts or compulsive behaviors despite recognizing them as excessive
  • Using substances to cope with OCD-related distress

If any of these apply, consider reaching out to schedule a visit.

What causes OCD (Obsessive-Compulsive Disorder)?

Causes

  • Differences in brain structure and functioning, particularly in the orbitofrontal cortex, anterior cingulate cortex, and basal ganglia
  • Associated dysregulation in certain neurotransmitter systems
  • Genetics and family history of OCD or related disorders
  • Stressful or traumatic life events that may trigger onset in predisposed individuals

Risk Factors

  • Family history of OCD or other mental health conditions
  • Temperament characterized by a tendency to internalize, greater negative emotionality, and behavioral inhibition in childhood
  • History of childhood trauma or significant adverse life events
  • Co-occurring mental health conditions

How It's Diagnosed

  • 1Comprehensive clinical interview with a mental health professional to assess symptom history, severity, and functional impact
  • 2Assessment using standardized rating scales such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
  • 3Differentiation from other conditions with overlapping features, such as generalized anxiety disorder, body dysmorphic disorder, or some forms of psychosis
  • 4Physical examination and medical history review to rule out medical conditions that may mimic or contribute to symptoms
  • 5Evaluation of co-occurring conditions, as OCD frequently presents alongside mood, anxiety, and tic disorders

How is OCD (Obsessive-Compulsive Disorder) treated?

I offer several approaches for OCD (obsessive-compulsive disorder):

Psychodynamic Therapy

Psychodynamic therapy is an evidence-supported form of talk therapy rooted in longstanding psychoanalytic theory about how unconscious thoughts, past ...

Learn more →

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a structured, evidence-based form of psychotherapy that focuses on identifying and modifying unhelpful patterns ...

Learn more →

Psychotherapy

Psychotherapy, also called talk therapy, refers to a variety of treatment approaches that aim to help a person identify and change troubling emotions,...

Learn more →

Medication Management

Medication management refers to the ongoing, physician-supervised process of prescribing, monitoring, and adjusting psychiatric medications to treat m...

Learn more →

Lifestyle Optimization

Lifestyle optimization is an evidence-based approach to mental health that uses individually tailored behavioral interventions – including sleep hygie...

Learn more →

Prognosis and Recovery

  • Treatment helps many people manage symptoms effectively, even those with severe forms of OCD
  • A combination of CBT with ERP and medication often produces the most favorable outcomes
  • Approximately 50 to 60 percent of individuals who complete ERP treatment experience clinically significant improvement
  • OCD is typically a condition that fluctuates in severity over time
  • Early identification and intervention are associated with improved long-term functioning
  • Some individuals may require ongoing management and periodic adjustments to their treatment plan

Frequently Asked Questions

While the term is sometimes used colloquially, obsessive-compulsive disorder (OCD) is not merely a perfectionistic character trait, but rather a mental health condition characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors (compulsions) that a person feels driven to perform. These obsessions and compulsions can consume significant time, cause considerable distress, and interfere with daily activities, relationships, and work. OCD affects both children and adults.
OCD symptoms include two main components: obsessions and compulsions. Obsessions are unwanted, recurring thoughts or mental images that cause anxiety, such as fears about contamination, harm, or a need for symmetry. Compulsions are repetitive behaviors performed to relieve the distress caused by obsessions, such as excessive handwashing, checking, counting, or arranging items. A hallmark of OCD is spending significant time per day on these thoughts and behaviors, such that it substantially interferes with your life.
The exact cause of OCD is not fully understood, but research suggests it involves a combination of factors. These include differences in brain structure and functioning (particularly in the frontal cortex and subcortical regions), dysregulation of serotonin pathways, genetic predisposition, and environmental factors such as stressful or traumatic life events. Having a first-degree relative with OCD may increase the likelihood of developing the condition.
Consider seeing a psychiatrist if obsessive thoughts or compulsive behaviors are causing significant distress, consuming substantial time each day, or interfering with work, relationships, or daily functioning. A psychiatrist can make an accurate diagnosis and assist you in understanding whether therapy, medication, or a combination approach may help.
First-line treatment approaches typically involve specialized forms of psychotherapy, such as exposure and response prevention (ERP), often in combination with psychiatric medication. A psychiatrist can coordinate diagnosis and development of an integrated treatment plan.
OCD is typically a chronic condition, but many people achieve significant symptom improvement with appropriate treatment. Research suggests that approximately 50 to 60 percent of individuals who complete ERP treatment experience clinically meaningful improvement. While symptoms may fluctuate over time, ongoing management with therapy, medication, or both can help maintain gains and support long-term functioning.
Helpful strategies include practicing the skills learned in ERP therapy, maintaining regular physical exercise, prioritizing good sleep hygiene, using stress reduction techniques such as mindfulness, and connecting with support groups. Establishing consistent daily routines and limiting avoidance behaviors can also support symptom management. These self-care practices are most effective when used alongside professional treatment.
Dr. Barnhart takes an integrated approach to OCD, combining psychiatric management and close collaboration with specialized OCD therapists. His background in neuromodulation techniques, such as rTMS (repetitive transcranial magnetic stimulation), allow him to recommend these treatment options, when clinically appropriate. He also incorporates lifestyle optimization including stress management, sleep hygiene, and exercise to support overall wellbeing.
Yes. As a board-certified psychiatrist, Dr. Barnhart can prescribe SSRIs and other medications used in OCD treatment. He takes a collaborative approach, discussing the potential benefits and side effects of medications that are used alongside therapy and lifestyle strategies.

Your Practitioner

J. Connor Barnhart

J. Connor Barnhart, MD

Dr. J. Connor Barnhart is a board-certified psychiatrist and psychotherapist practicing in San Francisco. He completed his psychiatry residency at UCSF, where he trained in the Bipolar, LGBT, and Women's Mental Health specialty clinics and developed focused expertise in integrative psychiatry through a year-long rotation at the UCSF Osher Center. He attended medical school at the University of Pennsylvania's Perelman School of Medicine and graduated from Brown University with honors in Human Biology. His practice combines insight-oriented therapy, medication management, supplements, and lifestyle optimization to holistically address the root causes of mental health challenges including depression, anxiety, and difficulties with focus.

Medically reviewed by J. Connor Barnhart, MD · Last reviewed: 2026-06-19