About OCD
OCD (obsessive-compulsive disorder) involves intrusive thoughts that cause distress and repetitive behaviours or mental rituals to reduce it. Cognitive-behavioural therapy with exposure and response prevention is the first-line psychological treatment.
Psychotherapists are professionals trained in one or more models of psychotherapy (psychodynamic, systemic, humanistic, cognitive-behavioural…). The protected title and requirements vary by country; profiles show each professional’s training and registration.
Getting mental health care in North Macedonia
Public health system · Public health system (Ministry of Health and Health Insurance Fund): community mental health centres and hospital psychiatry
Public mental health care is delivered through community mental health centres and hospital-based psychiatric services, with referral between primary, secondary and tertiary care. The national strategy for 2018-2025 aimed to decentralise care and reduce reliance on psychiatric hospitals. According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines. More information
How to check that a professional is licensed
- Chamber of Psychologists of North Macedonia (Комора на психолози). Only psychologists who hold a general and/or special licence issued by the Chamber may provide psychological services. A general licence requires a year of practice, a professional exam and entry in the Register of Psychologists, and a special licence requires additional specialised training. The Chamber publishes a list of licensed psychologists. Search the official register
Insurance and coverage
According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines in the public system.
Urgent help in North Macedonia
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 112 · Emergencias
Information reviewed in November 2026 · Sources: who.int, borgenproject.org, komoranapsiholozi.mk, lkm.org.mk
Signs to look out for
Many people have occasional intrusive thoughts or like things a certain way. OCD may be involved when unwanted thoughts, images or urges cause intense distress, and you feel driven to perform rituals, such as checking, washing, counting, seeking reassurance or mentally neutralising, to reduce the anxiety. These rituals take a lot of time, feel hard to resist and interfere with daily life.
What helps: treatments and professionals
Cognitive-behavioural therapy with exposure and response prevention (ERP) is the psychological treatment with the strongest evidence for OCD. It involves gradually facing feared thoughts or situations without performing rituals, at a pace agreed with the therapist. Clinical psychologists and psychologists trained in ERP usually lead treatment. A psychiatrist can assess whether medication may help, particularly when symptoms are severe.
When to seek urgent help
Having an intrusive thought about harm does not mean you want to act on it; this is common in OCD. However, if you feel hopeless, have thoughts of ending your life, or rituals prevent you from eating, drinking or caring for yourself, contact your local emergency services or go to the nearest emergency department. Sudden onset of OCD symptoms in a child should be checked by a doctor.
What you can do in the meantime
Learn from reliable sources how OCD works: trying to push thoughts away or seeking reassurance usually makes them stronger. Try to delay a ritual by a few minutes, or shorten it slightly, and notice that anxiety tends to fall on its own. Ask family members to support you without joining in rituals. Look after sleep and stress, which can intensify symptoms.
What does a psychotherapist do?
A psychotherapist helps people understand and change emotional, relational and behavioural patterns through a structured therapeutic relationship. Their work is shaped by one or more models, such as cognitive-behavioural, psychodynamic, systemic, humanistic or integrative therapy. They meet individuals, couples, families or groups, usually in regular sessions, and spend time outside sessions on notes, preparation and their own supervision.
When to see a psychotherapist
Psychotherapy suits people who want to work in depth on recurring difficulties: anxiety, low mood, relationship patterns, self-esteem, the effects of past experiences or major life transitions. It can also help when you feel stuck without a clear diagnosis. If you need a formal diagnosis, a specific psychological assessment or medication, a clinical psychologist or psychiatrist may need to be involved.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in North Macedonia cover psychological care?
Public mental health care is delivered through community mental health centres and hospital-based psychiatric services, with referral between primary, secondary and tertiary care. The national strategy for 2018-2025 aimed to decentralise care and reduce reliance on psychiatric hospitals. According to WHO Mental Health Atlas 2020 data, insurance fully covers mental health services and psychotropic medicines.
How do I check that a psychotherapist is licensed in North Macedonia?
Chamber of Psychologists of North Macedonia (Комора на психолози): Only psychologists who hold a general and/or special licence issued by the Chamber may provide psychological services. A general licence requires a year of practice, a professional exam and entry in the Register of Psychologists, and a special licence requires additional specialised training. The Chamber publishes a list of licensed psychologists.