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.
Show notes: https://go.hubermanlab.com/QiyKONh
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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; Genetic Component of OCD
00:07:39 Neural Circuitry, Cortex, Striatum, Thalamus
00:09:56 Cortico-Striatal-Thalamic Loop; Imaging Studies, SSRIs
00:11:02 Diagnosis, Yale-Brown Obsessive Compulsive Scale (Y-BOCS)
00:14:16 Y-BOCS Categories, Identifying the Core Fear
00:16:30 Tool: Cognitive Behavioral Therapy (CBT) & Exposure Therapy
00:18:36 Anxiety Tolerance, Interrupting the Compulsion
00:20:46 Dr. Helen Blair Simpson, Ritual Prevention, Exposure Sessions
00:22:20 CBT vs Placebo vs SSRIs; Combining Treatments
00:24:12 SSRIs & Serotonin System; Psychiatry & Causality
00:25:59 Cannabis, CBD & OCD; Transcranial Magnetic Stimulation (TMS)
00:27:53 Mindfulness Meditation, Holistic Treatments, NIH
00:30:00 Nutraceuticals, Inositol; Recap & Conclusion
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