Obsessive-compulsive disorder affects an estimated 2.3% of U.S. adults over their lifetime, yet it remains one of the most misunderstood psychiatric conditions. For patients in St. Cloud and the surrounding Central Minnesota region, accessing specialized OCD care can mean navigating a mental-health landscape that is already resource-limited for more commonly discussed conditions, let alone the nuanced and often severe presentations of OCD that require focused expertise. At Aurora Mental Health & Wellness in Waite Park, we evaluate and treat OCD with the same clinical rigor we bring to every complex psychiatric presentation, and we want patients in this region to understand what their options can look like.
Understanding OCD and First-Line Treatment
OCD is characterized by persistent, intrusive obsessions — unwanted thoughts, images, or urges — paired with compulsive behaviors or mental acts performed to reduce the distress those obsessions generate. What distinguishes OCD from everyday worrying or preference for routine is the degree to which the cycle of obsession and compulsion becomes time-consuming, distressing, and functionally impairing.
First-line OCD care commonly includes exposure and response prevention (ERP) therapy — a specialized form of cognitive behavioral therapy — and serotonin reuptake inhibitor medication when clinically appropriate. This combination helps many patients. However, some patients continue to experience substantial symptoms despite appropriate treatment, and that treatment gap is where a more comprehensive evaluation and advanced options may become relevant.
At Aurora Mental Health & Wellness, every patient evaluation begins with a comprehensive psychiatric review. For OCD, this means confirming the diagnosis carefully — distinguishing OCD from related conditions such as anxiety disorders, PTSD, and body dysmorphic disorder — and understanding the specific symptom patterns driving a patient’s experience. OCD can present through contamination fears, checking behaviors, intrusive harm thoughts, symmetry concerns, and mental compulsions that may not be visible to others.
Emily Luitjens, FNP-BC, PMHNP-BC, approaches each case with the diagnostic precision she developed while treating complex psychiatric presentations in VA settings, where co-occurring conditions and treatment resistance were common. We take time to understand your treatment history, symptom severity, and the factors that may be affecting progress.
TMS Therapy for OCD
TMS Therapy holds particular relevance for adults with OCD who have not received adequate relief from first-line treatment. The NeuroStar Advanced Therapy System is FDA-cleared as an adjunct treatment for adults with OCD.
TMS uses targeted magnetic stimulation to influence brain regions involved in OCD symptoms. It is noninvasive, does not require anesthesia, and does not involve systemic medication. Treatment is completed through a series of sessions, and the appropriate schedule depends on the individual patient and treatment plan.
For patients who have not responded adequately to ERP and medication, TMS Therapy may offer a non-medication option to discuss during a comprehensive evaluation. Results vary by individual, and we review candidacy, expected treatment commitment, and potential risks before recommending any treatment.
IV Ketamine and Co-Occurring Depression
IV ketamine treatment is an off-label treatment option that has been studied for OCD. Early research suggests ketamine may reduce OCD symptoms for some patients, but the evidence remains limited, and individual response can vary substantially.
Psychiatric uses of IV ketamine are off-label, and the FDA has not approved ketamine for OCD. At Aurora Mental Health & Wellness, we discuss the current evidence honestly and evaluate each patient’s complete clinical picture before determining whether ketamine may be appropriate.
For patients who have OCD alongside a separate diagnosis of treatment-resistant depression,SPRAVATO® may be relevant for its FDA-approved depression indications. SPRAVATO® is not approved to treat OCD itself. When appropriate, we consider how to address co-occurring depression while the overall treatment plan continues to target OCD through evidence-based approaches.
The Importance of ERP-Specific Care
One significant barrier to OCD care in Central Minnesota is the scarcity of therapists trained specifically in ERP. Effective ERP requires a clinician with focused training in exposure and response prevention; general supportive therapy or generic CBT without an ERP component is not an equivalent approach for OCD.
Many patients in the St. Cloud area have been told they “tried therapy” without having received OCD-specific treatment. That is why it is important to review what type of therapy was provided, how it was structured, and whether it included true exposure and response prevention. Ourmedication-management approach and psychiatric evaluations consider the whole treatment picture, including whether ERP-specific therapy coordination may be needed.
Another barrier is shame. OCD can produce thought content that feels deeply disturbing, even though those thoughts do not reflect a person’s character or intentions. People may feel hesitant to disclose intrusive thoughts involving harm, contamination, taboo subjects, or symmetry. That hesitation can delay appropriate care for years.
We want every patient reading this to know that OCD thought content does not define who you are. At Aurora Mental Health & Wellness, we approach these conversations with clinical objectivity, respect, and compassion. Results vary by individual, and we will discuss your options based on your specific symptoms, history, and goals.
Frequently Asked Questions
What makes OCD different from general anxiety or worry?
OCD involves a cycle of intrusive, unwanted obsessions paired with compulsive behaviors or mental acts intended to reduce distress. General anxiety often involves worry about realistic concerns, while OCD obsessions can feel intrusive, unwanted, and inconsistent with a person’s values. The distinction matters because ERP requires a different therapeutic approach than standard anxiety treatment.
Is TMS Therapy covered by insurance for OCD in Minnesota?
Coverage for TMS Therapy varies by insurance plan, diagnosis, treatment history, and authorization requirements. We encourage patients to contact our team before assuming TMS is inaccessible so we can discuss their individual circumstances and availablefinancing options.
Can IV ketamine help with OCD?
IV ketamine has been studied for OCD, but it remains an emerging, off-label use. It is not FDA-approved for OCD. At Aurora Mental Health & Wellness, we discuss the evidence, possible risks, and patient-specific considerations before determining whether IV ketamine may be appropriate.
How long does TMS Therapy for OCD take?
TMS Therapy for OCD involves a series of treatment sessions over multiple weeks. The specific protocol, schedule, and treatment duration depend on the device, your clinical history, and your individualized treatment plan. We walk through those expectations during the evaluation process.
What should I bring to my first appointment at Aurora Mental Health & Wellness?
Bring a complete list of current and past medications, including doses and approximate duration. Prior psychiatric evaluations and records from previous therapy can also be helpful, especially information about the type of therapy you received. This history helps us better understand your symptoms and determine what next steps may be appropriate.
Key Takeaways
OCD is a serious condition involving intrusive obsessions and compulsions that can become distressing and disruptive.
ERP is a specialized, evidence-based therapy for OCD, and some patients need further evaluation when first-line treatment has not provided adequate relief.
The NeuroStar Advanced Therapy System is FDA-cleared as an adjunct treatment for adults with OCD.
IV ketamine is an off-label option that has been studied for OCD, but the evidence remains emerging and results vary by individual.
SPRAVATO® is FDA-approved for specific depression indications, not OCD; it may be considered only when a separate co-occurring depression diagnosis supports its use.
At Aurora Mental Health & Wellness, we evaluate OCD in the context of each patient’s complete psychiatric history, current symptoms, and treatment goals.
Conclusion
OCD can quietly consume years of a person’s life while they cycle through treatments that provide incomplete relief. In Central Minnesota, the path to specialized care may not always be obvious. At Aurora Mental Health & Wellness in Waite Park, we work with patients who are ready to explore what a comprehensive psychiatric evaluation and advanced treatment discussion may offer.
TMS Therapy, IV ketamine, medication management, and psychiatric services may all be considered depending on your diagnosis, treatment history, and individual clinical needs. For patients with a separate diagnosis of treatment-resistant depression, SPRAVATO® may also be part of the conversation for its approved depression indications. Discuss your current situation with your provider, thencontact our team to schedule a comprehensive evaluation.
About Emily Luitjens
Emily Luitjens, FNP-BC, PMHNP-BC, is the lead provider at Aurora Mental Health & Wellness in Waite Park, Minnesota. She brings more than 10 years of experience from VA medical centers, where she specialized in complex presentations involving physical and psychological symptoms. Her dual training as both a family nurse practitioner and psychiatric mental health nurse practitioner gives our team a comprehensive clinical lens for evaluating anxiety, depression, PTSD, OCD, and other mental-health concerns. At Aurora Mental Health & Wellness, we offer medication management, psychiatric services, and individualized care plans grounded in careful clinical evaluation.
Works Cited
1. Carmi, L., Tendler, A., Bystritsky, A., Hollander, E., Blumberger, D. M., Daskalakis, J., Ward, H., Lapidus, K. A. B., Goodman, W., Casuto, L. S., Feifel, D., Bar-Gad, I., & Zangen, A. (2019).. American Journal of Psychiatry, 176(11), 931–938. https://pubmed.ncbi.nlm.nih.gov/31109199/
2. International OCD Foundation. (n.d.).. https://iocdf.org/about-ocd/ocd-treatment-guide/
3. National Institute of Mental Health. (n.d.).. https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd
4. Rodriguez, C. I., Kegeles, L. S., Levinson, A., Feng, T., Marcus, S. M., Vermes, D., Flood, P., & Simpson, H. B. (2013).. Neuropsychopharmacology, 38(12), 2475–2483. https://pmc.ncbi.nlm.nih.gov/articles/PMC3799067/
5. U.S. Food and Drug Administration. (2022).. https://www.accessdata.fda.gov/cdrh_docs/pdf21/K212289.pdf
6. U.S. Food and Drug Administration. (2025).. https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/211243s016lbl.pdf
Disclaimer
This article is for educational purposes only and is not a substitute for individualized evaluation, diagnosis, or treatment from a qualified healthcare professional.