Episode
The Science & Treatment of Obsessive-Compulsive Disorder (OCD)
2:33:43
Published: Mon Jun 27 2022
Description
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 LMNT: https://drinklmnt.com/huberman Thesis: https://takethesis.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman Timestamps (00:00:00) Obsessive-Compulsive Disorder (OCD) (00:04:06) Sponsors: AG1, LMNT, Thesis, Momentous (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
Chapters
This episode discusses the difference between OCD and obsessive-compulsive personality disorder, the importance of understanding the specific behavioral sequence of each individual, and various therapy options for those suffering from these conditions.
00:00 - 02:58 (02:58)
Summary
This episode discusses the difference between OCD and obsessive-compulsive personality disorder, the importance of understanding the specific behavioral sequence of each individual, and various therapy options for those suffering from these conditions.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
The Huberman Lab podcast has a catalog of supplements that are being expanded rapidly, many of which are already listed on livemomentous.com/huberman for easy and optimized access.
02:58 - 08:56 (05:58)
Summary
The Huberman Lab podcast has a catalog of supplements that are being expanded rapidly, many of which are already listed on livemomentous.com/huberman for easy and optimized access.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
Obsessive-Compulsive Disorder (OCD) is defined by intrusive and recurrent obsessions that lead to compulsive behaviors and a loss of significant time in people’s lives that could be spent doing regular, everyday activities.
08:56 - 17:56 (08:59)
Summary
Obsessive-Compulsive Disorder (OCD) is defined by intrusive and recurrent obsessions that lead to compulsive behaviors and a loss of significant time in people’s lives that could be spent doing regular, everyday activities. Engaging in compulsive behaviors, interestingly, serves to make the obsessions stronger, and it is important to understand this point to know which treatments work against this disorder.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
OCD can have a genetic component, with about 40-50% of OCD cases having some mutation or inherited aspect.
17:56 - 33:34 (15:38)
Summary
OCD can have a genetic component, with about 40-50% of OCD cases having some mutation or inherited aspect. Researchers have examined identical twins and found different levels of genetic concordance.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
Thalamic reticular nucleus plays a crucial role in selectively allowing certain categories of sensory information to our conscious perception while suppressing others.
33:34 - 43:41 (10:06)
Summary
Thalamic reticular nucleus plays a crucial role in selectively allowing certain categories of sensory information to our conscious perception while suppressing others. It also determines which thoughts are allowed to pass up our conscious perception and which ones are blocked.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
The engagement of neural loops during different stages of OCD can affect the type of treatments that are most effective.
43:41 - 50:17 (06:35)
Summary
The engagement of neural loops during different stages of OCD can affect the type of treatments that are most effective. A checklist of symptoms can help diagnose the disorder and guide treatment options.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
Cognitive Behavioral Therapy and Exposure Therapy are used to treat mental disorders.
50:17 - 1:05:02 (14:44)
Summary
Cognitive Behavioral Therapy and Exposure Therapy are used to treat mental disorders. Cognitive Behavioral Therapy for OCD entails identifying the utmost fear and exposing patients in a hierarchical way to reduce anxiety.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
Dr. Helen Blair Simpson explains the importance of homework in Cognitive Behavioral Therapy and the use of exposure therapy in treating OCD.
1:05:02 - 1:13:18 (08:15)
Summary
Dr. Helen Blair Simpson explains the importance of homework in Cognitive Behavioral Therapy and the use of exposure therapy in treating OCD. She also discusses the significance of home visits in contextualizing the treatment.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
A combination of SSRI drugs and cognitive behavioral therapy can be the most effective treatment for OCD.
1:13:18 - 1:22:28 (09:10)
Summary
A combination of SSRI drugs and cognitive behavioral therapy can be the most effective treatment for OCD. However, cognitive behavioral therapy alone can be just as effective as the combination, highlighting the importance of therapy.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
Selective serotonin reuptake inhibitors can be effective in treating the symptoms of OCD despite there being little to no evidence that the serotonin system is disrupted in OCD, however, the general systems of serotonin have been shown to impact cognitive flexibility and inflexibility in the brain.
1:22:28 - 1:30:38 (08:10)
Summary
Selective serotonin reuptake inhibitors can be effective in treating the symptoms of OCD despite there being little to no evidence that the serotonin system is disrupted in OCD, however, the general systems of serotonin have been shown to impact cognitive flexibility and inflexibility in the brain.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
It's important to understand that drugs used to treat OCD are not acting specifically on the corticostriatophalamic circuit, and the side effects make sense given the numerous different neural circuits these neuromodulators are involved in.
1:30:39 - 1:40:05 (09:26)
Summary
It's important to understand that drugs used to treat OCD are not acting specifically on the corticostriatophalamic circuit, and the side effects make sense given the numerous different neural circuits these neuromodulators are involved in. Careful and systematic exploration of different drug treatments for OCD is encouraged, with the guidance of a psychiatrist.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
Obsessions and compulsions typically go hand in hand with those suffering from Obsessive Compulsive Disorder (OCD).
1:40:05 - 1:51:06 (11:01)
Summary
Obsessions and compulsions typically go hand in hand with those suffering from Obsessive Compulsive Disorder (OCD). While the best course of treatment involves a combination of behavioral therapy and drug treatments, some studies show that Transcranial Magnetic Stimulation (TMS) can also be effective in targeting the areas of the brain involved in the generation of motor action.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
A study found that females with OCD have elevated levels of DHEA and cortisol, while males with OCD have increased cortisol and reduced testosterone levels.
1:51:06 - 2:05:59 (14:53)
Summary
A study found that females with OCD have elevated levels of DHEA and cortisol, while males with OCD have increased cortisol and reduced testosterone levels. The study highlights the corticostriatal thalamic loop that reinforces obsession, anxiety and compulsion, and alternative treatments such as supplements require caution as they have potential side effects.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
A study on the brain activity and behavior of people with OCD and obsessive-compulsive personality disorder (OCPD) shows fundamental wiring differences, such as how intrusive the thoughts are, and psychological differences, such as an enhanced ability to delay gratification in people with OCPD.
2:05:59 - 2:21:54 (15:54)
Summary
A study on the brain activity and behavior of people with OCD and obsessive-compulsive personality disorder (OCPD) shows fundamental wiring differences, such as how intrusive the thoughts are, and psychological differences, such as an enhanced ability to delay gratification in people with OCPD. It is important to highlight that OCD is very intrusive when using the term 'obsessive-compulsive'.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
In this episode, Andrew Huberman discusses the research on the neuroscience of obsessive-compulsive disorder, cognitive-behavioral therapy, and drug treatments like SSRIs, as well as exploring alternative treatments like ketamine, psilocybin, and cannabis.
2:21:54 - 2:31:07 (09:13)
Summary
In this episode, Andrew Huberman discusses the research on the neuroscience of obsessive-compulsive disorder, cognitive-behavioral therapy, and drug treatments like SSRIs, as well as exploring alternative treatments like ketamine, psilocybin, and cannabis. He also touches on how people develop rituals and superstitions.
EpisodeThe Science & Treatment of Obsessive-Compulsive Disorder (OCD)
PodcastHuberman Lab
The Huberman Lab Podcast discusses the benefits of supplements for sleep, focus, anxiety, and more.
2:31:07 - 2:33:35 (02:28)
Summary
The Huberman Lab Podcast discusses the benefits of supplements for sleep, focus, anxiety, and more. They also offer a monthly newsletter with information on available supplements and related science tools.