Essentials: The Science & Treatment of Obsessive Compulsive Disorder (OCD)

Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science based tools for mental health, physical health, and performance. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today, we are talking about obsessive compulsive disorder or OCD. First of all, as the name suggests, OCD includes thoughts or obsessions and compulsions, which are actions. The obsessions and the compulsions are often linked. In fact, most of the time, the obsessions and the compulsions are linked such that the compulsion, the behavior, is designed to relieve the obsession. However, one of the hallmark themes of obsessive compulsive disorder is that the obsessions are intrusive. People don't want to have them. They don't enjoy having them. They just seem to pop into people's minds, and they seem to pop into their mind recurrently. And the compulsions, unlike other sorts of behaviors, provide brief relief to the obsession, but then very quickly reinforce or strengthen the obsession. OCD is extremely common. In fact, current estimates are that anywhere from two point five percent to as high as three or even four percent of people suffer from true OCD. That is an astonishingly high number. Another thing to point out is that OCD is currently listed as number seven in terms of the most debilitating illnesses, not just mental illnesses or disorders, but all types of illnesses, including things like asthma and cancer, etcetera. So you can imagine with that standing at number seven that it is both extremely common and extremely debilitating. And as a consequence, it's now realized that many hours, days, weeks, months, or even years of work performance or showing up at work of relational interactions really suffer as a consequence of people having OCD. With recurrent intrusive thoughts happening at very high frequency or even at moderate frequency, people are spending a lot of time thinking about this stuff, and they're thinking about the behaviors they need to engage in and then engaging in the behaviors, which as I mentioned before, just serve to strengthen the compulsions. And so they're not actually doing the other things that make us functional human beings, like commuting to work or doing homework or doing work or listening when people are talking or interacting or sports or working. Out. All the things that make for a rich quality life are taken over by OCD in many cases. Another thing you'll soon learn is that, sadly, a lot of the obsessions and compulsions in OCD often relate to taboo topics, and that's because the general categories of OCD fall into three different bins. Checking obsessions and compulsions, repetition obsessions and compulsions, and order obsessions and compulsions. The checking ones are somewhat obvious, checking the locks. Repetition obsessions and compulsions obviously can dovetail with the the checking ones, but those tend to be things like counting off of a certain number of numbers, like one, two, three, four, five, six, …