OCD is not about being tidy or organized. For people who live with it, obsessive-compulsive disorder can feel like a constant battle with your own mind: intrusive thoughts that will not let go, and rituals that promise relief but only feed the cycle. Many people spend hours a day caught in these loops, often hiding them from others out of fear of being misunderstood.
At Psychiatric Pathways in Bloomington, Brenna Christie, FNP-C, PMHNP-BC, provides compassionate, evidence-based OCD treatment for adults across the Twin Cities. Our clinic combines psychiatric medication management and ketamine therapy, works closely with your ERP therapist, and offers Spravato for patients whose OCD occurs alongside treatment-resistant depression.
Understanding OCD
Obsessive-compulsive disorder is a brain-based condition involving two connected parts. According to the National Institute of Mental Health, about 2.3% of U.S. adults will have OCD at some point in their lives, and among adults with OCD in the past year, about half experienced serious impairment.
- Obsessions: Recurring, unwanted thoughts, urges, or images that cause intense distress, such as fear of contamination, fear of causing harm, taboo thoughts, or a need for things to feel “just right.”
- Compulsions: Repeated actions or mental rituals used to lower that distress, such as washing, checking, counting, arranging, mentally reviewing, or seeking reassurance.
Compulsions bring brief relief, but they teach the brain that the obsession was a real threat, which makes the cycle stronger over time. Research links OCD to overactive signaling in brain circuits involved in error detection and habit loops, which helps explain why it can feel impossible to “just stop.”
Common Types of OCD Symptoms
- Contamination: Fear of germs, illness, or dirt, often leading to excessive washing or cleaning.
- Checking: Repeatedly checking locks, appliances, or messages out of fear of harm or mistakes.
- Intrusive thoughts: Unwanted violent, sexual, religious, or relationship-related thoughts that feel deeply at odds with who you are.
- Symmetry and order: A need for things to be even, exact, or arranged in a specific way.
- Mental compulsions: Counting, repeating phrases, praying, or mentally reviewing to neutralize a thought.
Many people with OCD know their fears do not fully make sense, which can add shame and isolation. Intrusive thoughts are a symptom of OCD, not a reflection of your character or a sign you will act on them.
OCD Treatment in Minnesota Led by Brenna Christie
Brenna Christie is dual board certified as both a Family Nurse Practitioner and a Psychiatric-Mental Health Nurse Practitioner, with 13 years in practice. She trained at the University of Colorado and the Rocky Mountain University of Health Professions and is a member of the American Society of Ketamine Physicians, Psychotherapists and Practitioners (ASKP3). Her areas of expertise include OCD, anxiety, and treatment-resistant mood conditions.
At Psychiatric Pathways, OCD care is built on:
- A judgment-free space: You can talk openly about intrusive thoughts, however disturbing they feel, without fear of being judged.
- Whole-person care: Her background in family medicine means physical health, sleep, and co-occurring conditions are part of the picture.
- Coordinated care: We work closely with your therapist, including Exposure and Response Prevention (ERP) specialists, so medication and therapy support each other.
- Shared decisions: Every treatment choice is made with you.
Treatment for OCD: Our Approach
The most effective treatment for OCD usually combines a specialized form of therapy called Exposure and Response Prevention (ERP) with medication. ERP helps you face triggers without performing compulsions, while medication can lower the intensity of obsessions enough to make that work possible. When standard treatment is not enough, advanced options can help.
| Treatment | How It Helps | Often Used When |
| Psychiatric medication management | SSRIs or clomipramine, often at higher doses, to reduce obsessions and compulsions | Starting treatment, alongside ERP therapy |
| Ketamine therapy | Works on glutamate pathways that may be involved in OCD | Symptoms have not responded enough to standard medications |
| Spravato | FDA-approved esketamine for treatment-resistant depression, often covered by insurance | OCD occurs alongside depression that has not improved |
Because we offer all three in one place, your care can change as your needs change without starting over with a new provider.
Psychiatric Treatment for OCD
Psychiatric treatment for OCD adds an accurate diagnosis, carefully chosen medication, and close follow-up to the skills you build in therapy.
What to Expect During Your Evaluation
- Diagnostic assessment: We map your specific obsessions, compulsions, triggers, and how much time and distress they cause.
- Medical and mental health review: We look at past treatment, physical health, and co-occurring conditions such as depression, anxiety, tics, or bipolar disorder, which can change which medications are safe and effective.
- Personalized plan: We build a plan that pairs medication with ERP therapy, and we can help you find an ERP therapist if you do not already have one.
Medication Management for OCD
Medication for OCD often looks different from medication for depression:
- SSRIs: The first-line medications for OCD. Fluoxetine, fluvoxamine, sertraline, and paroxetine are FDA-approved for OCD and are often used at higher doses than for depression.
- Clomipramine: An older, FDA-approved medication for OCD that can help when SSRIs are not enough. It requires closer monitoring for side effects.
- Augmentation: When symptoms remain stubborn, a second medication may be added at a low dose to boost the response.
OCD medications usually take 8 to 12 weeks at a therapeutic dose to show their full effect. We monitor your progress, adjust doses, and manage side effects along the way.
When Standard Treatment Is Not Enough
Standard medications help many people, but not everyone. According to a 2025 review in the Journal of Clinical Medicine, 40% to 60% of patients show only partial or no response to SSRIs at standard doses. If that describes your experience, it does not mean you are out of options. It often means it is time for a different approach.
Ketamine Treatment for OCD
Ketamine has been used safely in medical settings for decades as an anesthetic. At much lower doses, it is being studied for mental health conditions that have not responded to standard treatment. Unlike SSRIs, which target serotonin, ketamine acts on the brain’s glutamate system. Glutamate is involved in cognitive flexibility and habit-forming circuits, and research suggests it may play a role in OCD.
Ketamine is not FDA-approved for OCD, so its use is considered off-label. Research on ketamine for OCD is still early and based on smaller studies. We recommend it only after a thorough evaluation confirms it is medically appropriate for you.
How Ketamine May Help
Some patients describe feeling mentally quieter, less consumed by intrusive thoughts, and more able to resist compulsions after treatment. Some also find it easier to engage in ERP. While SSRIs can take months, some people notice changes within hours or days. Results vary, and ketamine is not a cure, but it may be an important part of a broader plan that includes therapy.
What to Expect During Treatment
Treatment begins with a complimentary consultation, which typically takes about an hour. IV ketamine infusions are given slowly over about 40 to 60 minutes in a calm, monitored setting, and each visit takes about two hours in total. You stay awake and may feel deep relaxation, a floating sensation, or mild dissociation. These effects are temporary and closely supervised. Most patients begin with a series of treatments over several weeks. We also offer ketamine injection therapy as an alternative for some patients.
Ketamine infusions are $395 per session and are self-pay. We accept HSA and FSA, and we can provide a superbill that may allow partial reimbursement depending on your plan.
Is Ketamine Safe?
When administered in a professional medical setting, ketamine has a well-established safety profile. Some patients experience temporary nausea, dizziness, elevated blood pressure, or dissociation during treatment, and our team monitors you throughout. Certain medical conditions, active substance use, or psychiatric concerns may require additional evaluation.
Spravato Treatment for OCD With Co-Occurring Depression
Depression is common among people with OCD, and living with relentless obsessions and compulsions can wear down mood over time. Spravato (esketamine) is an FDA-approved nasal spray for treatment-resistant depression, and it works on the same glutamate pathways as ketamine.
Spravato is not approved to treat OCD on its own. However, it may be an appropriate option for patients whose OCD occurs alongside depression that has not improved after trying at least two antidepressants. Spravato is administered in our office under direct supervision, with monitoring for at least two hours after each dose, and you will need someone else to drive you home. Because it is FDA-approved, it is often covered by insurance, including Optum, UnitedHealthcare, Medica, UMR, Humana, and Aetna. Learn more about our Spravato treatment center.
Conditions That Often Occur Alongside OCD
Most people with OCD also experience at least one other condition. The most common include depression, anxiety, and PTSD. Bipolar disorder can also occur with OCD and changes which medications are safe, which is why a careful evaluation matters.
What to Expect at Your First Visit
Your first visit focuses on understanding your experience: what your obsessions and compulsions look like, how much time they take, what you have tried, and what relief would look like for you. You do not need to share anything before you are ready. If you are able, it can help to:
- Write down your main obsessions and compulsions and roughly how much time they take each day.
- List past medications, including doses, how long you took them, and any side effects.
- Note whether you have tried ERP or other therapy, and what helped.
OCD Care Across the Twin Cities
Our clinic is located at 3601 Minnesota Dr #510 in Bloomington, serving adults throughout the Twin Cities, including Minneapolis, Edina, Richfield, Eden Prairie, and surrounding communities. Many follow-up visits for medication management can also be held via telehealth. We are in-network with several major insurance plans and accept HSA and FSA payments.
Frequently Asked Questions About OCD Treatment
When should I see a psychiatric provider for OCD?
Consider an evaluation if obsessions or compulsions take up more than an hour a day, cause significant distress, or interfere with work, relationships, or daily life, or if therapy alone has not helped enough.
What is the difference between OCD therapy and psychiatric treatment?
OCD therapy, especially ERP, teaches you to face triggers without performing compulsions. Psychiatric treatment adds medical diagnosis and medication to reduce the intensity of symptoms. Many people do best with both.
What is the most effective medication for OCD?
SSRIs, often at higher doses than for depression, are the first-line medications. Clomipramine is another FDA-approved option, often used when SSRIs are not enough.
How long do OCD medications take to work?
Usually 8 to 12 weeks of steady daily use at a therapeutic dose.
Does ketamine work for OCD?
Early research is promising, and some patients experience meaningful relief, but studies are still small. Ketamine is used off-label for OCD and works best as part of a broader plan that includes therapy. We will help you decide whether it is a good fit.
Can Spravato treat OCD?
Spravato is FDA-approved for treatment-resistant depression, not OCD on its own. It may be recommended when OCD occurs alongside depression that has not improved with other treatments.
Do intrusive thoughts mean I will act on them?
No. Intrusive thoughts in OCD are unwanted and distressing precisely because they go against who you are. They are a symptom of the disorder, and they are treatable.
Can I keep seeing my current therapist?
Yes. We encourage it, and we are happy to coordinate with your therapist or ERP specialist so your care stays aligned.
If OCD or depression ever leads to thoughts of suicide, call or text 988 (the Suicide & Crisis Lifeline), or call 911 if there is immediate danger.
Take the First Step Toward Relief
OCD can make it hard to imagine a quieter mind, but relief is possible, even if past treatments have fallen short. At Psychiatric Pathways, Brenna Christie and our team are here to help you break the cycle and take back your time.
Call (952) 592-5421 or schedule your complimentary consultation today.