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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