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

Huberman Lab

Scicomm Media

Science, Health & Fitness, Life Sciences

4.8 • 26.2K Ratings

🗓️ 27 June 2022

⏱️ 154 minutes

🔗️ Recording | iTunes | RSS

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Summary

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. For the full show notes, visit hubermanlab.com. Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman InsideTracker: https://insidetracker.com/huberman Thesis: https://takethesis.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman Timestamps (00:00:00) Obsessive-Compulsive Disorder (OCD) (00:03:01) Momentous Supplements, AG1 (Athletic Greens), InsideTracker, Thesis (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

Transcript

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0:00.0	Welcome to the Huberman Lab podcast where we discuss science and science-based tools for everyday life.
0:09.0	I'm Andrew Huberman, an Omer Professor of Neurobiology and Ophthalmology at Stanford School of Medicine.
0:15.0	Today we are talking about Obsessive Compulsive Disorder, or OCD.
0:19.0	We are also going to talk about Obsessive Compulsive Personality Disorder,
0:23.0	which, as you will soon learn, is distinct from Obsessive Compulsive Disorder.
0:28.0	In fact, many people that refer to themselves or others as Obsessive or Compulsive or, quote, unquote, having OCD, or OCD about this or OCD about that,
0:37.0	do not have clinically diagnosable OCD.
0:40.0	Rather, many people have Obsessive Compulsive Personality Disorder.
0:44.0	However, there are many people in the world that have actual OCD.
0:49.0	And for those people, there is a tremendous amount of suffering.
0:52.0	In fact, OCD turns out to be number seven on the list of most debilitating illnesses, not just psychiatric illnesses, but of all illnesses, which is remarkable and somewhat frightening.
1:04.0	The good news is, thanks to the fields of psychiatry, psychology, and science in general, there are now excellent treatments for OCD.
1:13.0	We're going to talk about those treatments today.
1:16.0	Those treatments range from behavioral therapies to drug therapies and brain stimulation and even some of the more holistic or natural therapies.
1:25.0	As you'll soon learn for certain people, they may want to focus more on the behavioral therapies, whereas for others, more on the drug-based therapies, and so on and so forth.
1:35.0	One extremely interesting and important thing I learned from this episode is that the particular sequence that behavioral, and-or-drug, and-or-holistic therapies are applied
1:44.0	is extremely important.
1:47.0	In fact, the outcomes of studies often depend on whether or not people start on drug treatment and then follow with cognitive behavioral treatment or vice versa.
1:55.0	We're going to go into all those details and how they relate to different types of OCD, because it turns out there are indeed different types of obsessions and compulsions, and the age of onset for OCD and so on and so forth.
2:07.0	What I can assure you is, by the end of this episode, you will have a much greater understanding of what OCD is and what it isn't.
2:13.0	And what obsessive-compulsive personality disorder is and what it is not.
2:18.0	And you will have a rich array of different therapy options to explore in yourself or in others that are suffering from OCD.
	...

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