Essentials: The Science & Treatment of Obsessive Compulsive Disorder (OCD)
7/9/202636 min
In this Huberman Lab Essentials episode, I explain the biology and psychology of obsessive-compulsive disorder (OCD) and describe the neural circuitry behind repetitive "thought-action loops," including why compulsive actions actually strengthen the underlying obsessions rather than relieve them. I discuss the most effective treatments for OCD, including exposure-based cognitive behavioral therapy and SSRIs, and explain what the research shows about how these compare when used alone versus together. Finally, I describe a specific clinical protocol in which patients are guided into states of anxiety while learning to suppress compulsive responses, retraining the brain to break the OCD cycle.
Read the episode show notes at hubermanlab.com.
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Timestamps
(00:00:00) Obsessive-Compulsive Disorder (OCD)
(00:00:11) OCD Prevalence & Impact, Obsessions & Compulsions
(00:01:54) Categories: Checking, Repetition & Order; Contamination & Disgust
(00:04:30) Anxiety, Fear
(00:05:20) Sponsor: AG1
(00:06:40) Genetic Component of OCD
(00:08:45) Neural Circuitry, Cortex, Striatum, Thalamus
(00:10:16) Cortico-Striatal-Thalamic Loop; Imaging Studies, SSRIs
(00:14:30) Sponsor: Eight Sleep
(00:16:00) Diagnosis, Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
(00:18:00) Y-BOCS Categories, Identifying the Core Fear
(00:19:30) Tool: Cognitive Behavioral Therapy (CBT) & Exposure Therapy
(00:21:39) Anxiety Tolerance, Interrupting the Compulsion
(00:23:23) Dr. Helen Blair Simpson, Ritual Prevention, Exposure Sessions
(00:25:18) CBT vs Placebo vs SSRIs
(00:26:30) Sponsor: Rorra
(00:28:07) SSRIs & Serotonin System; Psychiatry & Causality
(00:29:13) Cannabis, CBD & OCD; Transcranial Magnetic Stimulation (TMS)
(00:31:48) Mindfulness Meditation, Holistic Treatments, NIH
(00:33:40) Nutraceuticals, Inositol; Recap & Conclusion
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Transcript preview
First 90 secondsAndrew Huberman· Host0:00
Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health, and performance. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today, we are talking about obsessive-compulsive disorder or OCD. First of all, as the name suggests, OCD includes thoughts or obsessions and compulsions which are actions. The obsessions and the compulsions are often linked. In fact, most of the time, the obsessions and the compulsions are linked such that the compulsion, the behavior, is designed to relieve the obsession. However, one of the hallmark themes of obsessive-compulsive disorder is that the obsessions are intrusive. People don't want to have them. They don't enjoy having them. They just seem to pop into people's minds, and they seem to pop into their mind recurrently. And the compulsions, unlike other sorts of behaviors, provide brief relief to the obsession, but then very quickly reinforce or strengthen the obsession. OCD is extremely common. In fact, current estimates are that anywhere from two point five percent to as high as three or even four percent of people suffer from true OCD. That is an astonishingly high number. Another thing to point out is that OCD is currently listed as number seven in terms of the most debilitating illnesses,