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

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:
https://athleticgreens.com/huberman LMNT:
https://drinklmnt.com/hubermanlab Waking Up:
https://wakingup.com/huberman Momentous:
https://livemomentous.com/huberman Timestamps (00:00:00)
Obsessive-Compulsive Disorder (OCD) (00:04:06) Sponsors: AG1, LMNT
(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
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