The Science & Treatment of Obsessive Compulsive Disorder (OCD) | Huberman Lab Podcast #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.
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Full show notes & links to peer-reviewed articles: https://hubermanlab.com/the-science-and-treatment-of-obsessive-compulsive-disorder
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
The Huberman Lab Podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user’s own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professionals for any such conditions.
Title Card Photo Credit: Mike Blabac – https://www.blabacphoto.com
44 Comments
Some people don't realize there is anything abnormal about their (thoughts) or (compulsions), even for years. Things need to be "just right"
OCD is hell, I just want a normal life.
I appreciate your presentation; however, I wonder why 5 minutes of advertisement on supplements…which again reinforces Obsession on its own!
Jesus you’re not making enough money from 6 million subscribers? You need all the promotions which are just draining people out of their hard earned money?
Good work
Just found on youtube on dr Berj channel how to cure ocd.
People are sharing thier successful supplements that helped them overcome ocd…
1:15:47
Thank you so much for this!
I have OCD since I’m a little girl. I’m on Luvox for many years. It doesn’t take OCD away; it just loosens it a bit
For a 12 year who will be starting ERP for the first time, would you recommend starting that therapy and then adding medication if needed. That is our thought to see if the ERP is enough without medication. She had some intrusive thoughts that bother her and some physical responses (touch face) or so something on both sides.
Robert Bray and his team on the OCD Recovery youtube page go way more in depth into specific themes and non medication related recovery
If you have OCD, please stay away from cannabis. It can turn OCD ‘nuclear’!
I have never seen so many adds in one program!!!
I don't know if I have ocd
Ketamine therapy did nothing for me. TMS did nothing for me. Maybe I’m a special case 😂
OCD is hell. Is like being bitten by those tarantula wasps. The sufferers and their caretakers become the living dead.
Thank you for this. My daughter has a severe case of contamination OCD and life is challenging all day everyday.
Is it possible for OCD to cause chronic fatigue syndrome?
OCD is time consuming. If task required 5 minutes of time to be completed, it will take 25 minutes for OCD person to complete that task. OCD is hell 😢. I hope this eposide will help me
You missed a big part of ocd which is missed often, which is imaginal ocd.
40:31
Despite the OCD, I encourage you to read the Quran to learn how to find stability and build resilience in life
As an OCD sufferer I can say that Andrew has done an exceptional job with this video
I’ve suffered from OCD since diagnosis at 14 and I am now 32. It makes it incredibly difficult to trust who I am, despite any amount of evidence stacked against my brain. Thank you for this and I am glad I found your podcast through this!
My first symptoms of OCD showed when I was 11 shaped as depersonalization episodes and health related obssesions. With the COVID pandemic worsened and now I’m 18, I tried taking antidepressants for 3 years and didn’t help. I also developed depression and I feel pyshically sick. It’s infuriating that people dismiss this disorder saying things like “Oh it’s not the big deal”.
I hate sm that people expect me to be functional and happy with my life, when it’s fucking hell waking up everyday knowing that I’ll have pain and anguish . I SWEAR If I didn’t have such loving parents I would’ve kms since I was 15.
To everyone who’s suffering I desire from heart that you could recover 😢❤
Thank you for this episode, it was very helpful. I actually have an idea for a topic. No one does it better then you, and i would like to know is there any thruth behind solfeggio frequencies, is there any real science behind sound therapy, or is that just nonsense. I dont mean only in terms of OCD but in general.
Thank you for your effort to bring people more knowledge
I hate ocd i want a normal life 🤧😭😭😭
Inspired by people sharing their experiences. I went into OCD treatment at a 37 on the Y-BOCS Scale. My theme was emetophobia. In 6 or 7 grueling weeks, I left at a 7 on the scale. I got my life back, was no longer considering suicide as an escape route. I’m back in treatment (for a couple of sessions at least) for Panic OCD. I’m super nervous and panic a lot. But I’m excited. I know there’s a light at the end of the tunnel. If you’re experiencing anything OCD related and for some reason sort YouTube comments by Newest, keep moving forward!
Thankyou
If he actually knew about OCD he would know anyone with it is going to struggle with a 2.5 hour video.
9 minutes into the podcast and it’s all advertisements so far.
Love the little surprise at the end!! Congrats!! ❤
I'm suffering in silence.
So , what do we do?
Kinda sucks you focused on generic forms of obsessive intrusive thoughts and compulsions. For more than 25 years I did the numbers/counting thing and some other weird stuff (to prevent “death of a family member”.) I got over it by doing self cbt for over 6 years. But I realize my obsessions had taken a turn. I am high achieving, but I’m tormented constantly by my intrusive thoughts. I’m never doing enough, I’m never good enough and that I need to do more, and at the very limit of my and anyone else’s ability. I’m going insane. it’s really affecting my mental health and my relationships.
46:00
You are a gem . Thanks
I am so tired of having OCD and other anxiety disorder. So, so tired of it. 😥
🙋raise your hand if you're here to learn more about yourself
Thank you for all the information
It’s ruminating in your head and trying to get something perfect but it never happens
50:00
Excellent podcast!
I'm a minute in, but I just got diagnosed with OCD after 10 years of getting the usual ADHD, MDD, GAD, AND PTSD. It literally almost killed me and I assume it's not gonna be any easier anytime soon just bc we've named it. I'm trying to learn as much as I can to get over this bc I've had it since childhood and it's just gotten worse in the shadows my whole life