The Science & Treatment of Obsessive-Compulsive Disorder (OCD) | Episode 78

In this episode, I explain the biology and psychology of obsessive-compulsive disorder (OCD)—a prevalent and debilitating condition. I also discuss the efficacy and mechanisms behind OCD treatments—both behavioral and pharmacologic as well as holistic and combination treatments and new emerging treatments, including directed brain stimulation. I explain the neural circuitry underlying repetitive “thought-action loops” and why in OCD, the compulsive actions merely make the obsessions even stronger. I review cognitive-behavioral therapies like exposure therapy and SSRIs, holistic approaches, and nutraceuticals, detailing the efficacy of each approach and what science says about how to combine and sequence treatments. I describe an often effective approach for treating OCD where clinicians use cognitive behavioral therapy (CBT) to deliberately bring patients into states of high anxiety while encouraging them to suppress compulsive actions in order to help them learn to overcome repetitious thought/action cycles. This episode should interest anyone with OCD, anyone who knows someone with OCD or OCPD, and more generally, those interested in how the brain works to control thoughts and actions, whether those thoughts are intrusive or not. Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman Thesis: https://takethesis.com/huberman Eight Sleep: https://www.eightsleep.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman. For the full show notes, visit hubermanlab.com. Timestamps (00:00:00) Obsessive-Compulsive Disorder (OCD) (00:03:01) Momentous Supplements, AG1 (Athletic Greens), Thesis, Eight Sleep (00:08:28) What is OCD and Obsessive-Compulsive Personality Disorder? (00:11:18) OCD: Major Incidence & Severity (00:15:10) Categories of OCD (00:21:33) Anxiety: Linking Obsessions & Compulsions (00:27:33) OCD & Familial Heredity (00:29:10) Biological Mechanisms of OCD, Cortico-Striatal-Thalamic Loops (00:39:36) Cortico-Striatal-Thalamic Loop & OCD (00:46:39) Clinical OCD Diagnosis, Y-BOCS Index (00:51:38) OCD & Fear, Cognitive Behavioral Therapy (CBT) & Exposure Therapy (01:01:56) Unique Characteristics of CBT/Exposure Therapy in OCD Treatment (01:10:18) CBT/Exposure Therapy & Selective Serotonin Reuptake Inhibitors (SSRIs) (01:22:30) Considerations with SSRIs & Prescription Drug Treatments (01:25:17) Serotonin & Cognitive Flexibility, Psilocybin Studies (01:31:50) Neuroleptics & Neuromodulators (01:36:09) OCD & Cannabis, THC & CBD (01:39:29) Ketamine Treatment (01:41:43) Transcranial Magnetic Stimulation (TMS) (01:46:22) Cannabis CBD & Focus (01:47:50) Thoughts Are Not Actions (01:51:27) Hormones, Cortisol, DHEA, Testosterone & GABA (02:00:55) Holistic Treatments: Mindfulness Meditation & OCD (02:03:28) Nutraceuticals & Supplements: Myo-Inositol, Glycine (02:09:45) OCD vs. Obsessive-Compulsive Personality Disorder (02:20:53) Superstitions, Compulsions & Obsessions (02:31:00) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter Title Card Photo Credit: Mike Blabac Disclaimer