- 21297 Foothill Blvd. Ste 203 Hayward, CA 94541-1554
- (415) 636-9700
- hello@exxceedwellness.com
Obsessive-compulsive disorder (OCD) is a chronic but treatable condition. At Exxceed Wellness in Hayward, CA, we offer Deep TMS (BrainsWay H-coil) — the only TMS protocol FDA-cleared specifically for OCD — alongside medication management for adults whose OCD hasn’t adequately responded to standard treatment.
Obsessive-compulsive disorder is a psychiatric condition defined by two interconnected features: obsessions and compulsions. Obsessions are recurrent, intrusive, unwanted thoughts, urges, or images that cause significant distress. Compulsions are the repetitive behaviors or mental acts a person performs in response to obsessions, often in an attempt to neutralize them or prevent some feared outcome.
OCD affects an estimated 2 to 3 percent of adults in the United States. It is chronic for most people who have it, but with the right treatment, the great majority experience meaningful symptom reduction and a return to everyday function.
Washing or cleaning rituals, checking, counting, repeating words or actions, mental reviewing, reassurance-seeking, avoidance of triggers. Compulsions can be observable (washing, checking) or entirely mental (rumination, silent prayer, reviewing memories).
OCD diagnosis is clinical, based on a structured interview and a careful symptom history. There is no laboratory test for OCD. Diagnostic criteria typically include:
Severity is typically measured using validated tools like the Y-BOCS (Yale-Brown Obsessive Compulsive Scale), which we may use during your evaluation to track symptoms over time.
OCD is highly treatable. The first-line treatments are evidence-based psychotherapy (specifically exposure and response prevention, or ERP) and SSRIs. When these don’t produce adequate response, Deep TMS becomes a strong option.
The most evidence-supported psychotherapy for OCD. ERP gradually exposes patients to feared triggers while preventing the compulsive response, allowing the brain to learn that the feared outcome doesn’t happen. We refer to qualified ERP therapists when this is the right next step.
SSRIs (fluoxetine, sertraline, paroxetine, escitalopram, fluvoxamine) and the tricyclic clomipramine are FDA-approved for OCD. Effective doses are typically higher than for depression, and full response can take 8 to 12 weeks. We manage these as part of comprehensive OCD care.
The only TMS protocol FDA-cleared specifically for OCD, when standard treatment hasn’t produced adequate response. We deliver Deep TMS at our Hayward clinic. Learn more about TMS at our clinic ›
Whether you’re starting an SSRI, optimizing dose, evaluating augmentation, or coordinating care alongside ERP or Deep TMS, ongoing medication management is the connective tissue of comprehensive OCD treatment.
Deep TMS using the BrainsWay H-coil received FDA clearance for OCD in 2018, making it the first and only TMS protocol cleared for OCD specifically. Standard rTMS (figure-8 coil) is not FDA-cleared for OCD, even though it’s commonly offered for depression.
Deep TMS uses a different coil geometry than standard rTMS. The H-coil reaches deeper cortical structures, including the medial prefrontal cortex and anterior cingulate cortex, regions implicated in OCD’s neural circuits. The clinical evidence supporting Deep TMS for OCD is what FDA used to grant the OCD-specific clearance.
Deep TMS for OCD is typically considered when ERP therapy and SSRI medication trials haven’t produced adequate response, or when access to ERP is limited. It is delivered in-office over a course of approximately 6 weeks, daily 5 days per week, with each session running about 20 minutes.
OCD treatment at Exxceed Wellness is led by Nefretiri Abat, J.D., PMHNP-BC. Her training in interventional psychiatry, including Deep TMS protocol selection, makes our practice one of the few in the East Bay equipped to offer the OCD-specific FDA-cleared protocol.
Our typical OCD care path: comprehensive evaluation, optimization of medication and ERP referral if those haven’t been tried adequately, then Deep TMS when treatment-resistance is established. Telehealth medication management is available statewide for ongoing care between TMS courses.
Deep TMS for OCD is commonly covered by major California insurance plans, with prior authorization required. Coverage criteria typically include documented inadequate response to first-line treatment (SSRIs or ERP).
OCD is generally chronic but highly treatable. Most people who receive evidence-based treatment, ERP and/or appropriate medication, experience meaningful symptom reduction. The goal of treatment isn’t typically “cure” in the sense of permanent absence of symptoms, but durable, manageable improvement in daily function.
By a clinical interview using DSM-5 criteria, often supplemented with a validated symptom scale like the Y-BOCS. There is no lab test or imaging study for OCD; diagnosis is based on symptom history and current presentation.
Deep TMS is FDA-cleared for OCD based on clinical trials showing meaningful symptom reduction in patients who hadn’t adequately responded to standard treatment. Response varies by individual; we monitor symptoms throughout the treatment course.
Often yes, with prior authorization. Coverage typically requires documented prior treatment with SSRIs and/or ERP. Standard rTMS is not FDA-cleared for OCD, so the Deep TMS protocol specifically is what insurers cover for the OCD indication.
This is exactly the patient population Deep TMS was studied in and FDA-cleared for. Treatment-resistance to first-line care is the standard threshold for Deep TMS candidacy.
Yes. Deep TMS for OCD is typically delivered alongside ongoing SSRI treatment, not in place of it. Any medication adjustments are made by your prescriber based on response.
Pure-O describes OCD where compulsions are predominantly mental (rumination, silent prayer, mental reviewing) rather than observable behaviors. It is fully OCD and responds to the same evidence-based treatments — ERP, SSRIs, Deep TMS — though the specific therapy techniques differ for mental compulsions.
No. You can schedule a consultation with our practice directly. We’ll request your treatment history at intake.
If your OCD hasn’t responded to ERP or SSRIs alone, the next conversation is with a psychiatric provider who treats OCD specifically. We see patients in person at our Hayward, CA clinic and via telehealth across California.
