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Call for questions: OCD (Patreon)

Published:
2025-03-27 16:02:01
Imported:
2026-06

Content

Next week, I'm honored to interview a pioneering researcher of Obsessive-Compulsive Disorder. In the 1980s, he co-developed the "gold standard" scale to assess OCD symptom severity and types. He's studied treatments from SSRIs to cognitive behavioral therapy to deep brain stimulation and continues to deliver forward-thinking research. He's a psychiatrist, a professor, and a Distinguished Fellow of the American Psychiatric Association. What questions do you have for one of the most accomplished experts on OCD?

Deadline: Sunday, March 30 at 5pm PST

(Last year, upper level patrons nominated and voted for topics they'd like to see on Ologies in 2025. OCD was one of the top 3.)

Comments

Kathleen Regovich

What are good ways to support family and friends who have OCD?

Kayla Meyer

why do we obsess about having to have things a certain way or checked upon multiple times??

Kathryn

This is so cool! As an OCD girlie myself I’m really excited for this one! My question: how are the perceptions we have of OCD changing, clinically and socially?

Adam Silk

Is there such a thing as obsession only ocd or True O ocd?

Linda English

I would like to know more about the connection between OCD and Hoarding. Is this treatable with medication or therapy or anything? Thanks!!

Tinnedfishfanatic

How can people with OCD learn to use it to help in their lives. Make it a strength instead of what most people see as a weakness?

Miranda Garniss

FTQA what's the connection between adhd and ocd?

Ellie Frances

I am diagnosed with OCD, specifically dermitillomania (probably spelled that wrong). There is a lot of stigma around OCD, do you feel that stigma in the medical world? What are your thoughts on those OCD jokes that many everyday people make?

Megan Younce

Curious if he'll touch on OCPD as well or if it's related enough!

Hannah McCain

A lot of people have started using OCD in regular language to describe traits that are not considered to be within the diagnostic range. Is there a spectrum that includes these symptoms, or an alternative method of describing this type of behavior?

Emily Staw-fur

Can you talk about the connections between intrusive thoughts and OCD? I struggled with these a few months postpartum even though I've never demonstrated other characteristics of OCD. I thought they were likely connected to my postpartum anxiety, but I keep seeing that they can be a form of OCD

Anastasia Press

I've heard that OCD, ASD, and ADHD often co-occur together. Is that true, and if so, do we know why?

Hope J 🏳️‍🌈

What determines the thing that your OCD or OCD tendencies focus on? Is it trauma from the past? Nature vs nurture? What determines the severity of someone’s OCD and symptoms? Why do people have such visceral reactions to things that trigger their OCD, like gagging and vomiting and, neurologically, why do our bodies have such a response? Is exposure therapy the best way to treat OCD? What happens when you experience too much exposure of the trigger all at once?

JENN 'Benthopelagic squirrel' ALVAREZ

Oh hai, just tag me next time..but seriously. Can you explain the different kinds of OCD? I have to do things, like I repeat patterns daily and I know nothing will happen but what if it does? I realize this isn't a rational fear. Thank you!

Rachel Nelson

Long time sufferer of OCD and I’m so excited to hear this episode! - I have a question on how to respond to harmful stigmas that people with OCD ‘just like things clean’ or when people say ‘I’m so OCD!’ Also that it’s an adaptation that people want to have because it makes me more organized? To hear the disorder that has caused me and my loved ones so much pain discussed this way is infuriating, but I never know what to say in the moment when it happens.

Nicky G

How do medications help treat people with OCD?

Anastasia Press

Can we talk about Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) in children? I've heard that it can cause the sudden onset of OCD, but do you treat it the same as OCD? Or do the OCD symptoms go away when the strep infection is treated?

Mykenzie King

I love this, I was an OCD therapist in partial hospitalization for adolescents for years before transferring to my PhD. My question is this: Can the colonist discuss the co occurrence of ASD diagnosis and OCD, and how to distinguish the two? The symptoms can be so similar depending on the OCD type

Rachel Nelson

Sorry one more question - what do we know physiologically about OCD? What happens hormonally or cognitively when I engage with a compulsion, or when I don’t engage with it? Does my brain/nervous system look different from someone’s who does not have OCD? Thank you so much!

Field Trip Mail Club

OMGOMGOMG I’ve been manifesting this episode for over a year ever since I got diagnosed with OCD 😭❤️ I’d love to hear them talk about the link between OCD and disordered eating, ARFID, and/or orthorexia And! The link between OCD and ADHD, Autism, neurodivergence as a whole. How can OCD develop as a result of untreated or unacknowledged neurodivergence?

Aubrey Nelson

What are some of the quiet or non visible symptoms of OCD, or any symptoms that are generally less widely known?

Bálint Novák

When I was doing my MA in cognitive psychology we've learned a bit about deep brain stimulation as a potential cure for medication-resistant OCD. Where does the research stand nowadays? What are the standard treatment recommendations? What do psychiatrist do if there's no reactions to oral medication? Is any of the psychiatric treatment being supplemented/combined with paychotherapy? What types of psychotherapy are effective for OCD? What are the hopes for future research? What kind of 'future cures' do the top OCD researchers dream of?

Nicole Robb

FTQA: I just learned about intrusive thought OCD, how many types are there?

Hannah McCain

What is the best way to look out for symptoms of OCD within your family or even yourself? Is OCD a spectrum? If so what does early signs look like compared to the very severe symptoms we typically hear about?

SoManyQuestions

What’s a way to tell when you or someone has or is crossing the line into needs-treatment-OCD? One of my childhood friends was diagnosed as an adult. My mother was shocked… while I remembered how she would “joke” about her OCD tendencies from the time we were pre-teens onward. I worry she probably spent more time than she should have needing help but not getting it, or even just feeling like she couldn’t be honest about this part of herself

Sara

Seconding this: all three seem to share a ton of similarities, and am interested in that connection

Anastasia Press

How do you treat OCD when the obsessions/compulsions overlap with trauma symptoms? It seems hard to "think" your way out of OCD when it the thoughts are so closely linked to real world experiences.

Hannah Black

As someone with OCD, seeking treatment was incredibly difficult around 2019 — my understanding was that there weren’t many therapists offering exposure and response prevention (ERP), and even fewer accepted insurance. Is that still the case 6 years later? ERP was incredibly effective for me — how common is it? Is it still considered an effective therapy?

Anastasia Press

How do you tell the difference between relationship-focused OCD and insecure attachment?

Ess

First time asker! When I was in my early 20s, psychiatrists couldn’t figure out what I had. I didn’t fit the bill for bipolar, depression, anxiety, etc., though I had bits and pieces of each. Through trial and error we arrived at lamotrigine and gabapentin as treatments, which did the trick, although I never got any kind of concrete diagnosis other than a vague “mood disorder, unspecified”. 15 years later (on this podcast!) I heard about how people with OCD can have too much glutamate in their brains (treated by lamotrigine) and not enough GABA (addressed by gabapentin). This got me thinking and I wondered if I’ve had OCD all this time. So here are my questions: 1- what research has happened on the connections between glutamate, GABA, and OCD? 2- Does everyone with OCD have this brain imbalance, or only some? 3- Are there any new and novel treatments for those with these imbalances or are lamotrigine and gabapentin still the standard? 4- Is OCD hereditary? 5- How do you diagnose OCD when it’s obsessive but not compulsive? 6- how do you disentangle OCD from autism? Are they frequently comorbid? 7- I’ve read studies about caffeine helping with OCD, how effective is it and is it a standard treatment option? Thank you!

Pattie Larson

I would be interested to learn about the differences and similarities between OCD and Obsessive Compulsive Personality Disorder.

Hannah Black

Thank you so much for covering this topic! I’ve dealt with OCD since I was 10 years old and no longer suffer because education on the disorder has become more common over the past decade — learning what was happening in my brain (and taking medication) has helped me live an awesome, often symptom-free life. 😊

Jordan Irons

What is the connection between trauma and OCD? Does early trauma cause OCD behaviors later in life?

mish the fish

a lot of people will say in conversation that they have ocd, for example, "my ocd keeps me organized". can you go over this phenomenon of people saying they have mental illness/mental illness symptoms about something banal? as someone who suffers from ocd i feel like those people are appropriating it or mixing it up with neurodivergence. it's really disheartening when people take your illness and use it to talk about their own preferences for where stuff should be. they never go into intrusive thoughts or repetitive behaviors when they appropriate it

Rori

How to ease the physical manifestation of rumination? Medication and mental strategies have worked wonders, but constantly clenching my jaw and shoulders is hella gnar gnar in the worst way

Maria Whamond

What is the distinction between overthinking and obsession only OCD?

Maria Whamond

Is rumination a mental compulsion or is that just overthinking?

Jordan Irons

What are some early telltale signs of OCD in both children and adults?

Oscar Courchaine

Does marijuana help with OCD symptoms? Anecdotally, it seems to help me get out of spiraling thought patterns.

Anne-Marie Lindsey

What can you say about the difference between OCD and postpartum OCD?

Emma Henson

Is there any researching about cannabis helping OCD symptoms? Iv been doing a study on myself for a couple years but a sample size of one doesn't really say anything.

Madelyn Dunkle

Dad! Ahhh! Fellow OCD friend here. Can you explain why ERP is the gold standard of treatment? And how exactly it works/why is it different from other forms of therapy? My compulsions are more Pure O driven so doing ERP has always been more challenging since it’s hard to tell what’s “normal” anxiety and what’s compulsive behaviors/intrusive thoughts

Sarah

First time question asker. What a great topic. Could the ologist discuss issues surrounding parents with OCD and little kids? My husband has OCD and is very cognizant of what behavior he is modeling for our toddler (trying to avoid washing his hands all the time when the kid is around, etc.). How does a parent’s OCD affect their children with respect to behaviors they learn, their own likelihood of developing OCD, and so on? What is genetic, what is learned?

Christine Valdes

What is the current research on OCD and gut health? Any recent breakthroughs?

Amanda Figueroa

I was just recently diagnosed with OCD and started doing ERP for my intrusive thoughts. Unfortunately I had to stop due to issues with my insurance (ugh) but something we never really got to cover in depth was skin picking. At what point is skin picking considered a compulsion, and what point is it “just” (for lack of a better term) skin picking?

Will Clark

Is there evidence that OCD could develop in children due to mental trauma/divorce/bullying... AND, then continue through adulthood?

Matt Ceccato

Is OCD a genetic trait or is it a learned condition? I ask because the men in my family, myself included, have OCD diagnoses.

Megan Lundy

What are signs that someone may develop OCD? Or are there no clear indicators towards a diagnosis later on?

Dawn Morse

It seems like people will use OCD as an excuse for being particular.....when is it OCD and when is it just someone's preference?

RJ Doidge

I feel like I know a few people where they express a plethora of comorbidities that present along with OCD; is that more common than a standalone diagnosis?

Joe Porfido

I'd like to know more about OCD skin picking and how it relates to self harm or not.

Joe Porfido

Second, and is it considered self harm (if bad enough)

Ellen Storm

What is something helpful to say to someone with OCD?

William Russell

Hi Anastasia, no expert here so forgive me if I come off as the sophomore male thinking they know everything. Currently seeing dramatic results or PANDAS treatment or a family member. Dartmouth Hitchcock has a Neuroimmune Psychiatric Disorders (NIPD) has a link for additional resources and research.

HannahBoNannas

I’ve heard that OCD treatment includes exposure therapy. How does that work? I would think it makes things worse— how does it make symptoms better?

Teresa & David

What are the percentages of the different kinds? What percentage of OCD patients have more than one type?

Spicy Native

Could the speaker elaborate on the connection between OCD and morality? Moral scrupulosity is something I struggle with + struggle to understand and would love to hear from an expert how and why these thoughts occur. I find that morality and OCD aren't spoken about much and leaves me wondering about the reasoning behind the thoughts + feelings.

Alyssa Berg

Regarding compulsions, from someone with clinically diagnosed health anxiety that includes OCD tendencies: How can my one brain be, at the same time, demanding that I do something while also begging that I stop? My compulsive behaviors are symptom checking, and I absolutely NEVER want to do it, I HATE doing it, but I can’t…not do it. Even to the point of causing myself physical discomfort or injury! How can one brain do all this at once and why can’t my “good brain” win? (Also I know this sounded bleak but recently, propranolol and Zoloft have made a HUGE difference for me particularly in quieting compulsions!)

Hannah Kish

At what point does it become OCD and not generalized anxiety disorder? My mother has severe OCD and I’m sure I learned some of those habits as a kid. However, it feels less like OCD and more anxiety about cleanliness. Is there a distinction? Follow-up: how do you determine if someone is simply “controlling” of their environment rather than presenting symptoms of severe mental illness?

Amanda Figueroa

Second question! I really struggled with the few sessions of ERP I went through because my OCD manifests primarily in intrusive thoughts regarding medical anxiety or loss of people in my life. Since these things are “hypothetical” (at least at this time in my life) it was difficult for me to find “exposures” that would actually heighten my distress enough to properly engage in the therapy. Are there any other therapies that could be more effective for people who struggle more with Pure O OCD?

OJ Carrasco

Is OCD something that can be cured? It seems like therapy is a lot of talking about my problems but I never get a solution. Am I going to the wrong type of therapist?

Ruby Gordon

What percentage of people act on the constant intrusive thoughts?

Gia Capra

Moral Scrupulosity!! Could you talk about moral scrupulosity as a subset of OCD? Also - does it bother you when people say “I’m so OCD” lightly? It always bugs me a bit, knowing that there are people who really struggle managing true OCD. Thank you Ologist for doing this important work, and thanks Dad Ward!

my-dad-vg

My therapist suspects I may have what they call pure-O OCD. Is pure-o ocd a recognized thing, and how does it differ from other OCD diagnoses when it comes to presentation, and potential treatment?

William Russell

Um, a number of questions. Really look forward to this episode. 1. Following up on Anastasia Press’ question: what is your take on PANDAS / PANS? It’s a new and emerging diagnosis, and not all researchers or clinicians believe it. (I’ve seen life changing results for a family member). Can you talk about how the diagnosis and treatment is different compared to non-neuroimmune OCD? 2. In the awesome episode with Russell Barkley, he described the use of fMRI to highlight the structural areas of the brain and provide much greater detail about the underlying causes for AHDH. Is there any similar research for OCD? Or, is it less biologically based? 3. Do you have any thoughts on I-CBT compared to ERP?

Athina Anastasiou

What triggers different types of Pure OCD (like HOCD and ROCD), and can it go away over time? How valid is this diagnosis, and what is the current state of research on it?

Nicholas Randell

Oh gosh the PANDAS question would be so good to hear an answer to!

Sydonie S.

How do I know when it's 'just' anxiety vs ocd? Is there a number/type of symptoms that go into the diagnosis?

Faith Stemmler

Do we know if OCD is an inherited trait or if it can present itself based off of life events? What can I do to alleviate anxiety for a close relative who may have OCD?

Sonjabird

Does it bother you how people throw the term OCD around to describe people who may just be detail oriented or very particular? I am sometimes labeled as such by others but don’t think I’m really OCD. With that in mind, can you talk about the varying degrees of OCD symptoms and behaviors, and how do we know if we need help or intervention? Or when it’s just others being judgy about us?

Erica!

I have OCD and I’m pregnant with my first child. How likely is it that I will pass it on to my children?

Kayla Tozier

Are consistent nightmares associated with OCD?

Gabrielle G.

I was diagnosed with OCD at 23 after years of misdiagnoses and ineffective treatments. I was told by my therapist that it was actually quite common for signs of OCD to be missed in children and then properly diagnosed in early adulthood. Is this true, and what could be the possible reasons for this?

Kayla Tozier

Can childhood trauma lead to OCD?

DeeDeeNoodle

I’m sure Alie will ask something a long these lines but just in case, how best to support someone you love with OCD? My boo has anxiety/depression/OCD. I hope there is a way I can help when he’s having a bad OCD time.

Nicholas Randell

Hi Alie! Long time Ologite, first time question asker here :) with two questions: 1. How fuzzy is the line between Generalized Anxiety Disorder and OCD? Are they often both present for patients? 2. I’d also love to hear your take on PANDAS (fun acronym, terribly traumatizing experience). Is it possible that underlying anxiety/obsessive compulsive tendencies predisposes certain children to PANDAS? Is it common for former PANDAS patients to deal with those symptoms chronically for the rest of their lives even when the acute episode was treated effectively? I’m so excited for this episode!!

Steve Bennett

I'm wondering about the efficacy of Internal Family System (IFS) as a treatment. Any experience? Any connections to the work of Bessel Van Der Kolk (The Body Keeps the Score)

real housewife of trash island

What are some effective methods for treatment in children? I've had OCD since about age six. At ten I briefly saw a therapist but the nature of OCD makes it difficult to talk about, and it's harder to believe that your fears aren't real at a young age. As an adult medication has been the most effective treatment, and I'm now able to address it in therapy. What options are there for someone who's too young for medication and talk therapy?

Nicholas Randell

Love this question! As someone who suffered from PANDAS as a kid I’d love to learn more about it now that I’m older.

DeeDeeNoodle

Also curious about any potential overlap with ocd and autism. I know the basics as a neurodivergent person myself, but at what point is there a difference between and autistic person’s needs in some cases for consistency or doing things a certain way vs. ocd behaviours? (Hope I worded that question well enough to get my point across without offending /misrepresenting any of my fellow NDs 🖤)

Will Clark

How are Tics and OCD related? Is the treatment different and can treating one address the other?

Maya Kakkava

Have been struggling with OCD three years now and i screamed when i saw the topic of this podcast. Im wondering, the longer that you've had OCD does it get progressively harder to recover? Does the brain somehow get used to the pathways of the disorder which then makes it tougher to unlearn the behaviors?

DeeDeeNoodle

Curious about this too as my partner has IBS and OCD and the OCD diagnosis came post-IBS diagnosis of I recall correctly

DeeDeeNoodle

My partner’s symptoms have improved a bit since starting on cannabis!

Maya Kakkava

Second question! Can someone with OCD make a full recovery? Is it considered treatable or curable?

DeeDeeNoodle

My partner’s symptoms seem to improve but don’t go away completely when he’s on cannabis.

DeeDeeNoodle

Turned out to be ADHD for me, my hyperactivity is all in my brain

Allie Paul

I also hate when people nonchalantly throw around "I'm so OCD". Doe the ologist have any quips, or good things to say to people who do that? Also curious if media representation has helped and/or hindered people actually living with OCD. Side note: the book Last Call at the Local by Sarah Grunder Ruiz has a main character with OCD, and (as someone without OCD) seemed to be a really good representation.

Chris Curious

How does someone break out of compulsion loops that lead them to completing the same task over again until it's "perfect"?

DeeDeeNoodle

He’s done CBT. He has cannabis to help with sleep and anxiety which also helps his symptoms a little. I wonder why symptoms are a little inconsistent, like his OCD is handwashing. But he doesn’t brush his teeth twice a day. Just once in the morning. My brains says ‘that’s all cleanliness related’ but I know it’s more complex than that.

Christy Brockett

Is ERP alone the best way to treat contamination OCD?

Organic Free-Range Lily

1. Why do some people develop OCD later in life? What triggers it? Had it always been there, latent and waiting? 2. Can we replace "OCD" with "CDO"? (Alphabetized, as it should be.)

MothxLamp

Can you please talk about the connection between OCD and dermatillomania? (skin picking disorder) I've suffered from this my whole life and I'm wondering what's the best way to treat this impulse and to get a better understanding of how my OCD influences this form of self harm.

Rayna

I have a very passionate request. Can they talk about the intrusive grippy sock type of OCD? This was very scary for me and I didn't seek help because I thought I was going to get hospitalized for saying it out loud. I think more people need to know the difference between s/cidal ideation or intent vs. intrusive OCD thoughts of self-harm-- it might help people realize they are just thoughts and that they can seek help without assuming they'll be sent to inpatient treatment right away.

Rayna

I second PANDAS!!

Ally

First time question asker: I worked in a research lab and now I’m always cognizant of what is floating in the air at all times (mostly harmless like free floating RNA) and sterility (like I can touch the outside of my water bottle lid but not the inside when I take it off to refill it or let the straw inside touch the counter or any other surface). Where is the line of “normal person who worked in a sterile setting who thinks intimately about the world they interact with” vs “OCD about sterility in non-sterile household objects”?

Ann McHenry

I would love to know approximately how many types of OCD there are. I was familiar with counting and checking but only recently have found out that overly ruminating on the past can be related. Asking for a friend but I'd also love to know!

Jacob Dassa

Hey! That's me! My episode!!! I'm wondering if he can explain/discuss newer therapies such as TMS and ketamine therapy, and their impact on treatment resistant OCD. Thank you!

Kathy

First time question asker: how can I best support my college aged son in finding help for his ‘contagion’ OCD. His challenge seems to be specifically about food poisoning & a fear of vomiting. It’s accompanied by anxiety, though I’m not quite sure how that ties in to food vs generalized anxiety.

Mariah Ramsey

Like some other mental health disorders, are OCD diagnoses genetically linked? From my own personal experience: I am diagnosed with OCD, ADHD, depression, and anxiety, all of which (minus ADHD) my mother also has been diagnosed with. So, are there any studies that have been done that show a potential genetic element to diagnosing OCD?

Lalie Broten

Please ask them about OCD tics; I clench/manipulate my jaw in a way that causes pain and damage to my TMJ... its awful, I a shoulder and finger tic as well. It suck how it feels completely out of my control, even as much as I don't want to do it cause it hurts... I can't stop it. Is there a way to gain control over OCD tics?

Courtney Herrenberg

First time question asker and long time listener! I have OCD and ADHD and found when I started medication for my ADHD my OCD symptoms got better and I became less anxious in relation to my OCD. I was curious about the link between the two and wanted to know how they can relate to each other.

Rachel Guthrie

I worked in a research lab processing wastewater samples to get data about COVID and I have similar thoughts about sterility of household objects and the things I touch. It doesn’t negatively impact my daily life, but at what point do those thoughts become OCD?

Lalie Broten

I don't really have the germ phobia OCD, not anywhere near as bad as the fear based OCD, i have very specific rituals for the kitchen appliances, front door lock and closet that took up an hour of my night till my sweet husband offered to take on the job for me. Is there a way to gain control over these symptoms... without my husband helping me I'd be at that door locking /re-locking the deadbolt over and over till my fingers ached and probably crying....

Heidi heidistrohl@mail.com

How do you know if it’s OCD or if you just particular and like things organized? Or is it all the same?

Heather Leonard

Is it possible to be mostly O and less C, or vice versa? Is there a connection between ADHD and OCD? My therapist made me realize I could have ocd tendencies when I insisted I wasn’t a perfectionist because I think perfectionism is bad so I intentionally do things imperfectly, among other signs. After some discussion I’ve come to understand that my obsessiveness has to do with my fear of causing harm to others and my own feelings of guilt. Is OCD related to traumatic experiences or often paired with PTSD? Does caffeine affect OCD symptoms? Any practical tips on being less compulsive? Like hair playing, nail biting, picking, etc. What can I do to lower my cortisol? Please don’t say meditation and exercise. If I get pregnant while having high anxiety levels, will my kid have anxiety? Will SSRIs help?

Hendrix

I have OCD and get stuck in a thought loop, especially about how things could go wrong. I've had to turn my truck around 20 mins down the road to make sure the oven was off, even though I KNEW I hadn't used it in days. How do I get off that crazy train?

Hendrix

Can perimenopause impact OCD tendencies?

Valerie Kirby

Please talk about the relationship between OCD and autism, and best practices for managing both together (e.g., how do you work on exposure therapy when someone gets emotionally overwhelmed very easily).

Cameron

FTQ asker: What has perpetuated the myth that OCD is the same thing as cleanliness. I am a very neat and tidy person which many people have conflicted with me having OCD (I do not).

Jmo

first time asker, and dad, I have a few: 1. is OCD viewed in the community as being something that is episodic and can be triggered? or does it build up over time? 2. current thoughts on links between OCD and alcohol use disorder and/or addiction in general. 3. OCD symptoms seem to be a wide spectrum. could they give a brief description of where some symptoms fall in terms of spiciness? mild to hot?

Sarah king

Are there different types of OCD? Like germs vs cleanliness vs morality thoughts

Sarah king

Can you see OCD in brain scans? If so what part of the brain lights up??

Jackie G

Like others, I'm curious about the lines between anxiety and OCD and also the line between OCD and eating disorders. Also do people shift between these things through their lives? What life events trigger swings between them? Is it common for someone to develop OCD late in life during the onset of dementia? (my grandma became obsessive about following her nutritionist's instructions to the letter, panicking if there was a missing prune and refusing an extra almond in her lunch and eating at very specific times, not a minute early.) (Sorry if this is a double post, I can't find my earlier post.)

Moss

INTRUSIVE THOUGHTS. I have very distressing intrusive thoughts that I would never say out loud. As someone too embarrassed and stressed out to seek professional help for them, do you have recommendations for good books that might make me more comfortable to do so and maybe just helpful in general (self-helpy, memoir, scientific, WHATEVER)?

Chris Curious

What can you do to look after your own mental health if you're a partner of someone with OCD?

redheadedscientist

ftqa: what do we know about the history of OCD? I know that of course, we can't diagnose historical figures, but were people in "pre-modern" (ie prior to the Industrial Revolution) times writing about this and discussing it? Were there any notable historical cases of someone who exhibited OCD symptoms? Is there a difference between how OCD is viewed in Western and Eastern medicine/cultures?

Alena Grilla

Any tips on coping with loved ones with OCD? I guess specifically with parents/guardians with OCD. I suspect one of my parents had/has OCD and it led to some extremely confusing situations for me. Later in life I understand them more now but I have some OCD traits because of how I was raised that I’m trying to unlearn now.

Sienna

I have been assessed for OCD and came up all C no O, but I think this might be another thing I don't properly understand. "Obsession" is a broad term, and sometimes I miss that I'm doing a thing that's not typical (late diagnosis autism and ADHD over here). I count in my head constantly and have a few physical patterns I repeat like finger flicking, teeth tapping and toe flicking, none of which is at all voluntary. Like I would very much like to stop. The counting thing is like having the dullest song in the world stuck in your head forever. In fact sometimes a song that is stuck in my head will get the lyrics swapped with numbers. Very annoying. Do these things sound like OCD or more autism? Sienna

SustainableSirenian

FTQ, Hi Alie. First, I love you. Thank you. 🩵🩵🩵 1. Why do I need certain things absolutely perfect (ex: my organized desk) or my brain doesn’t work, but I can be a feral trash goblin for other things (kitchen counter is always a dump place for anything and everything)? 2. My dad has OCD too and he NEEDS 1. A map 2. Tissue box 3. A clipboard with paper and a pen any and every time we got in the car, no matter the mileage or time being spent in the car. If he didn’t have those things and we tried to leave, he would, essentially, have a temper tantrum and the whole day would be messed up. Why would he get so mad? 3. He would always rip up newspapers or notes after he was finished with them before recycling it. I hated it. I hate it. I do it now too. It’s like my brain or my hands HAS to do it, I don’t even think about it until it is done and I hate it. WHY? 4. Why do I need tasks or information in bullet points/list format to understand it? Thanks again!

Emily Henry

I have OCD and just started i-CBT therapy. I’m curious what is considered the best form of OCD therapy? I went undiagnosed throughout my entire adolescent years— which is honestly wild because it was very obvious— but how long does it take people to get diagnosed?

James Nance

What is something you wish people who don't have OCD understood about people who do have it?

Christi Sullivan

I worked as a researcher studying Deep Brain Stimulation for OCD for 5 years and (got to administer hundreds of YBOCS over those years). From your experience what best predicts whether someone is going to respond to therapy vs medication vs Neuromodulation? As an aside, I didn’t get diagnosed with OCD until AFTER I started working in a lab studying OCD in my mid-20s. When meeting with treatment resistant OCD patients I quickly realized that needing to restart a nightly prayer and spending an hour getting it perfect every night so things don’t go “wrong” was in fact not just a quirk and was Just Right OCD. In your opinion is there a sub-type of OCD that is hardest to identify?

Annalise De Young

I came in to ask about this as well. I feel like trauma is very "trendy" in the mental health spaces, but also that it is trendy because it is a HUGE contributor to a lot of mental health things.

Ellen Durnal

How can I support my friend who has OCD?

Christi Sullivan

You should look into the Pure O sub type of OCD! The C’s are mostly mental so it presents different than what most people think of OCD.

Annalise De Young

In the ADHD episode and the long COVID episode there was discussion about mental health/brain changes being part of post-viral disease states (I think that's the right term), and I've also heard that theorized about conditions like schizophrenia. Any indications of SOME cases of OCD being related to a virus or other infection?

Lalie Broten

Wow I didn't know that you could be diagnosed with all one or the other and that makes so much sense now! Also yes I will repeat a sentence over and over in my head and have no idea why and then I'll find myself breathing in rhythm with the syllables... since I was a kid.

julia_loves_fun_facts

Seconding! Especially since an autism diagnosis can trump an OCD diagnosis (ie. a patient initially diagnosed with OCD may be later diagnosed with autism and told their OCD symptoms are not separate enough to warrant both diagnoses, or they are separate enough to warrant both diagnoses)

KatieLady

If you are interviewing one of the creators of the YBOCS, I WILL happy cry. As an OCD therapist, I am so grateful that you are interviewing this ologist. OCD continues to be misunderstood (even by those in helping professions), under-diagnosed and stigmatized; all of which can thwart folks from getting help. I don't have a question but just wanted to say thank you so much for interviewing them!

Capybara Gall

1. How often is the onset of OCD preceded by an illness or infection? 2. What percent of people become asymptomatic with CBT alone? 3. Is OCD more common in people with other mental health conditions? If so which ones? 4. Do the common forms of OCD vary based on the society a person grows up in? E.g., will someone who grows up in India use a different behavior to satisfy an intrusive thought than someone who grows up in the US? 5. How do you feel about the portrayal of OCD by Orson Scott Card or in media in general? It’s been years since I read his books but I vaguely recall he portrayed a society of people who idolized those with OCD, but were ignorant that’s what it was. And, like many others, I don’t think he portrayed any intrusive thoughts, just compulsions.

Justin Crawford

What are some of the different ways OCD manifests? What treatments are there?

Keerat Singh

When developing the scale for ocd symptoms, how do you judge abstract things like symptom experience and turn them into quantitative things like a scale? What goes into that?

Diana

i-CBT has been a literal lifesaver to me in my OCD treatment. As a newer form of treatment, it seems like it's still under the radar, yet has the potential to help a lot of people. Can you give an overview of what i-CBT is for those who may not have heard of it and how it differs from ERP?

Annie

can you talk about “pure o” ocd and how it might be treated differently than “regular” ocd? also WHY WON’T OCD THERAPISTS ACCEPT INSURANCE??????????? it can be SO expensive to access specialized care (not to mention the long wait lists!) and is a VERY REAL barrier that needs to be addressed! Thank you Alie 💜💜

Tom Boodry

Do these compulsions typically manifest by a certain age? Also, is it known that it gets worse as you get older?

PopsicleEmperor

As a person with OCD I'd love yo hear your opinion on the limitations of diagnostic tools like the DSM regarding OCD. I've been diagnosed before but because i "cope to well" i dont have "fully fledged" OCD from yhe perspective of the DSM. thankfully i had a really good psychiatrist discuss that doesn't mean it doesn't exist for me just that the way is does is different.

Grey

I was wondering how OCD works from a neurological standpoint and what treatments there is for it?

Ashley K.

I'm a Pediatric GI Psychologist and have a handful of patients with both OCD and functional GI disorders (e.g., functional dysphagia, functional constipation) and their OCD symptoms sometimes appear in interesting ways (e.g., repetitive swallowing, excessive wiping after stooling). Is there any research on overlap between OCD and the brain-gut connection?

Yuri

Does_he_ have ocd? How does real life actual patients perspectives differ from the conventional medical model. I feel pretty strongly about this, since most "founders" of a condition (in a medical context) usually deeply pathologize/simplify in ways that are ablist and harmful to that community. It happens over and over. I'm not ocd, but I am autistic, and we share a neurodivergence umbrella, and _very_frequently_ misdiagnosis. so many women in particular are misdiagnosed with OCD instead of autism, setting them back greatly from tools and supports that would help them, that it ought to be malpractice.

Deanna Day

I was also wondering about OCD and eating disorders.

Jennifer D Susskind

How do comorbitities of OCD and ADJD manifest in children and adults. I suspect this is a common cooccurrence that is rarely discussed.

Deanna Day

I also wanted to ask about this. The (few) people I’ve known with OCD either had traumatic experiences or had otherwise been in situations where they felt they had very little control. One also developed an eating disorder, which she described as giving her some feeling of control. If you are repeatedly in situations where you feel like having no control is dangerous, I could see how that might lead to OCD

Kayla Tozier

That was gonna be another one of my questions, whether OCD and certain eating disorders are linked! It definitely seems likely to me, but I’m not sure if it’s scientifically backed.

Dr. Lina Carpenter

(1) I know there's a lot of overlap amongst neurospicy acronyms, but I'm curious how different the definitions are for "diagnosis;" when we see comorbidities, how are they delineated? For example -- I've been diagnosed with "ADHD with OCD tendencies," but I can say with certainty I do *not* have a remotely comparable experience with someone who grapples with an OCD diagnosis, even if my "tendencies" disrupt my day-to-day. Is the "OCD tendencies" something that my long-ago diagnosing psychiatrist added as information for me/my parents, or is it something actually recognized in diagnoses? And/or is it a non-DSM idea used to describe the different categories of coping mechanisms individuals with ADHD create? For context, this diagnosis was made for a female 16-yr-old around 2005 and I suspect I may be on the spectrum, so there could be an issue of misdiagnosis due to gendered assumptions of how symptoms manifest. (2) There's a narrative that people "grow out" of ADHD. (Obliged here to point out the complexity of brain development + how adulthood can provide more control of one's environment, which may look like someone's "symptoms" have "disappeared.") Is there a similar narrative or research that people "grow out" of OCD? (3) How has the definition & diagnosis of OCD changed over time? In the current DSM, what issues do you think need to be remedied in the next edition of the DSM?

Ashley Marrs

Can you talk about the similarities and differences between codependency and OCD, specifically responsibility obsessions.

Marta Barnez

(First time question asker) What's the relationship between OCD and memory? I know the checking tic comes a lot from doubt in memory, but I've also seen some articles about it extending to compulsive memory hoarding for fear of forgetting and extreme doubt in perceptions of reality because of this. I'd love any elaboration! (here's an example of a good article I found) https://www.cambridge.org/core/journals/psychological-medicine/article/are-people-with-obsessivecompulsive-disorder-underconfident-in-their-memory-and-perception-a-review-and-metaanalysis/BFE38EAD3CDBDEB5FC03E60AD613B24D?utm_campaign=shareaholic&utm_medium=copy_link&utm_source=bookmark&fbclid=IwY2xjawJSguVleHRuA2FlbQIxMAABHQ8XAyhhArU1nyzBr8pU3MeCSYfIvBSsYChJpd7Pq7rq1PHDHrhfIq6ANA_aem_J0di4Actz29F79_n8mbwIA

Gigi Owen

Ooh yes! I have a couple of questions 1. I have often struggled to share the feeling of having OCD to others, without a lot of shame attached. Is there a good analogy you have found that could help others relate to what OCD is and how it feels? 2. OCD sometimes feels a lot like intuition, or listening to your gut, etc. How can a person quiet the OCD noise without losing connection to our intuition? 3. What's with all the counting and obsession with numbers (at least for me in my case)? Does that serve as a way to stave off intrusive thoughts? Are there overarching patterns/themes to the repetitions or rituals we construct for ourselves?

Justin Bowen

When I would visit my father during his last few years (he passed sixteen years ago at 59), I would tilt ever-so-slightly his pictures and paintings, misalign his stacks of coffee table magazines, leave dining table chairs at an angle to the table, and do other funny things like that just to mess with him. I would hear about it as he found my gifts over the following days and weeks. Is it measurably harmful or beneficial to do this to someone with OCD? Is there research on the impact of these kinds of actions? For example, if a man were to do this to his wife of just five years who needs things to be "in their place", is there research that might show that such marriages are destined to last?

GhoulNextDoor

Is OCD something that can come and go in waves of intensity at different points of life? Or is it fairly constant in its presentation?

beanbag the cat

I can speak to the 2nd question... insurance doesn't pay therapists a living wage

Erin Burbidge

As I age, I find myself developing more compulsive behaviours. Does the onset of OCD correlate with aging, and the onset of perimenopause in particular?

Rachel Fuller

OCD and attachment styles *cough cough* anxiousness & codependency; what’s up with that? Also… What is happening in an OCD brain nutrient wise? Are we lacking and/or have too much of something? I’ve heard B12 and vitamin D effect OCD. How big of a role are they playing and what are other nutrients we should keep an eye on?

Alli Barg

Can you explain the difference between thought based OCD and action based? I went undiagnosed for years because most of my compulsions involve things I have to think or say (to myself) to “neutralize” any bad thoughts or actions.

theo (nastygardenrat)

From my friend: What coping mechanisms work best for you when you're stuck in an intrusive thought loop? Do you have any advice for how to not let those thoughts bother you?

beanbag the cat

is there something about adolescence that brings out OCD-like behaviors in people? (maybe that it's a time of heightened anxiety?) I've noticed that a lot of teens/young adults without clinically diagnosed OCD will have OCD-like tendencies (needing inconsequential things to be a specific way like the volume on the stereo needs to be an even number for example, checking their appearance repetitively, having to do tasks in a certain order) and often times they grow out of them. Am I on to something?

Valerie

Can you ask about intrusive thoughts in OCD? I really do not want to drive my car into a tree or touch a hot stove. But in difficult times my brain has yelled at me to do such things.

Vin

As someone with OCD, I am SO STOKED to hear this episode and find out about this stuff!!

Julia L

OMG I have OCD and I have many thoughts. My ocd is centered around emetaphobia (fear of throwing up), can you ask about phobia based OCD and how treatment for that feels impossible? My brain adapts so fast to the tools and it changes so much, I feel like there isn’t a simple solution. Also, can you explain OCD and misdiagnosis. I was misdiagnosed for YEARRSSS bc I’m not a clean freak. WILL THE THOUGHTS AND COMPULSIONS EVER STOP!?? Sorry for the drama lol

beef

i'd really love to know the link between OCD and tourettes, and if there's any hope for recovering from OCD when tourettic OCD is involved. i have both, as well as the crossover of tourettic OCD and it can be really difficult to figure out what are tics and what are compulsions - it seems like often i will need to tic, but then i'll need to repeat that tic until it "feels right" at which point it seems more compulsive than involuntary, but still has that tic energy behind it. it gets confusing and i'd love to know more about it

beef

adding onto the train of people asking about the overlap of ADHD and OCD - i also have both, and i'm finding that i'm struggling to recover using ERP because my ADHD means i find it so difficult to stick to a routine and structure, so the whole "gradual exposure" thing feels out of reach, which perpetuates my belief that i'm beyond help because i struggle to keep up with ERP consistently!

Andy Pepper

Another vote to ask about neuro comorbidities—what's the overlap between OCD and ADHD, anxiety, and ASD? I have anxiety, and the others show up in my family, but I've wondered if my intrusive thoughts are like "diet OCD," and not quite "enough" to warrant that diagnosis.

Anna Wolf

I have OCD and a lot of my obsessions are identical to both of my parents, who both have ocd, but with different tendencies. OCD can be genetic, but do the specific tendencies of ocd get passed on from parent to child or is that more behavioral nurture? What causes these brain short circuits? I have both germ obsession ocd & intrusive thoughts with tics, which are consistent with my parents. Anna (Ahnuh) first time question asker!

Anna Wolf

Also I have struggled a lot with relationships and explaining to partners that there are certain accommodations (especially germ based) that I need. Do you have any advice for this? I have used DBT skills & tried to explain that this is fundamentally something i cannot change about myself but it still presents challenges. Absolutely any suggestions would be appreciated I’m so tired.

Mie [me-ay]

i’m adding to everyone asking about co-morbidities! i’m currently in long term recovery from anorexia (🎉), and noticed that over the course of my illness, i had developed OCD tendencies that eventually went away as i recovered from my eating disorder. is it possible to only develop it as a comorbidity or does there need to be an underlying susceptibility?

Mini Minnie

So many people asking about OCD getting worse with age, and mentioning intrusive thoughts. We’re pretty darn sure my mother in law has OCD; husband has told me she’s always had such tendencies, and they have gotten more and pore pronounced as she gets older (80 now). Things like unzipping and re-zipping each of the 592 zippers on her travel duffle 582 times (making up the number, but that’s what it feels like) before checking her bag. Walking back to her seat in the waiting area a dozen times to make sure she didn’t leave her boarding pass before boarding a plane… these are just two easy examples. Any way to ease her mind and get her to move on? Any medications help? Also - she definitely does NOT have intrusive thoughts. She is the absolute best at cognitive dissonance. If she doesn’t want it in her world it’s simply not true. I’ve never known anyone so good at simply blocking out anything negative she doesn’t want to address. Can cognitive dissonance be part of OCD? A way to keep control over her environment?

Emilia Phillips

I have been diagnosed with OCD, and I have been recommended for an autism assessment. What are the links and overlaps between the two?

Cecily Templeton

Curious about the history of OCD in pop culture. How/why did it become a word to describe people who like things to be neat and organized? Did that popular understanding of what OCD is have any repercussions on stigma, diagnosis, etc.?

Mr. Weevil

was just told i likely have ocd and i was wondering about the different types of ocd? is it not always an intrusive thought leading to a compulsion? mine seems to be a compulsion done to prevent anxiety.

Meredith Levine

I would like to know about the comorbidities of OCD (intrusive thoughts, contamination, etc. ), ADHD, and Autism. I also want to know about living with someone with OCD, both in ways to help and in ways to cope. (I know I am logged in here, but if this gets read on the Pod, please have it come from Anonymous).

Janet R.

I would love to understand the mechanisms of SSRI’s (usually prescribed for depression) for OCD symptoms. And echoing a number of other questions: how to discern symptoms of OCD from ASD.

Zuleika Pevec

Is it considered OCD if you have intrusive thoughts but no compulsions?

Love2Learn46

Can you please talk about the overlap and co-morbidities of OCD and eating disorders? Also, what is the best way to explain intrusive thoughts? Thank you!

Ettegoom

Does it bother you when people say that they have OCD, as a 'joke'/way of explaining something like checking the stove is off twice before going out, or being really particular about the correct spelling of their/there/they're? And is there a way to encourage people to see that things like that are ok, and that using 'OCD' as a joke devalues the diagnosis and makes the lives of people with OCD harder?

Ettegoom

Oh! This is what I was trying to say, but failed to articulate anywhere near as effectively as you have!

Ettegoom

This makes a lot of sense - and also maybe makes me wonder whether the stress of modern life and how things have just gotten faster and faster is making people feel like they are out of control and needing to develop rituals to try and manage stuff or make sure that it stays a little bit more in control than it feels?

Cecily Templeton

Yes! I spent way too long trying to figure out how to say it 😅

Jojo Emerson

Has the casual misuse of OCD as a generic term for organizational/perfectionist tendencies been overall harmful by misrepresenting people’s lived experience of OCD, or is there some positive aspects like inadvertently contributing to broader awareness? Is it maybe both/and?

Emma

Is it brain chemicals out of whack or is it learned behaviorally? Could it be genetic? Is there a way to get it gone for good? Diagnosed but untreated lifelong ocd haver here and i have many questions

Orla Spurr

I seem to have developed OCD in response to trauma. When it was at its worst, the stress manifested as paranoia, delusions verging on psychosis. Is this unusual?

Orla Spurr

What is the difference between OCD & OCPD? I have googled this many times and can't seem to grasp it

Fancynonna

Is it possible for OCD symptoms to come and go in waves? Does it depend on stress levels, if so? Or am I just too used to certain irrational anxiety thoughts and therefore I don’t think of them as OCD, unless I’m doing the i.e checking the door is closed a million times + positioning stuff in a certain way otherwise I can’t sleep, etc?

Sarah Cork Henderson

My son has OCD, ADHD, and is on the autism spectrum. I have mild OCD, mild Tourrettes, and possibly mild autism (not diagnosed). Why do OCD, ADHD, Tourrettes, and ASD often go together?

Orla Spurr

I wouldn't be surprised if she learned cognitive dissonance as a way to deal with the intrusive thoughts

Sarah Cork Henderson

Going through other people's comments and can also add disturbing intrusive thoughts without any compulsion to my symptoms. I always thought it was just me.

Orla Spurr

I have OCD, if somebody did this to me I would find it antagonistic, distressing and unhelpful

Brenda Graham

On behalf of my son-in-law, his question is: I've found that ADHD medication helps most, if not all, of my OCD symptoms. How often does he come across overlapping symptoms from other disorders, like ADHD, and how does he discern or diagnose between the two? I'm interested because they couldn't confidently diagnose my adhd because of overlapping symptoms, but the ADHD meds work.

Pink Puppy

Additionally, what studies are currently underway to explore effective treatments for OCD, especially in cases where there are comorbidities? These comorbidities can complicate access to treatment, as individuals may be too unwell for community services, yet when their compulsions are not being challenged, they may be deemed too stable for inpatient care. What steps can we take to enhance support for those who support people with OCD, particularly as they lessen their accommodations and are frequently met with aggression? Thanks

Lauren L.

Thoughts on the efficacy of any over the counter supplements to address some OCD symptoms (NAC, for example)?

Fancynonna

Also any connection to phobias like agoraphobia and such, where there is essentially a fear of not being in control, or a fear of not being safe?

Zoë Dunham

Long time ocd sufferer here: can you talk about the comorbidity of eating disorders and ocd and why it is so much harder to recover from an eating disorder as a person with preexisting ocd. I struggled with anorexia and found that traditional treatment wasn’t as effective for me, because my anorexic habits manifested as ocd behaviors. Are there any more useful forms of treatment for eating disorders or other mental illnesses for people with ocd?

Storm

is it true that ocd is often connected to other anxiety related disorders like eating disorders and anxiety

Storm

can we bust some flim flam that people with ocd only care about cleanliness and germs!!

CurtisDawg

At what point does this actually become a "disorder"? Asking for a friend :-)

Storm

not gonna lie i feel a little the same so not just you! maybe no verging psychosis but i definitely get paranoid to the point where i can’t sleep because ‘what if a guy with a knife’ comes thru the door i literally just locked but need to double check for the 13th time

Storm

why does my symptoms change with time? like i’ll be stuck on checking the door locks 11 times but then in a couple months the focus is something different with less stress about checking the locks

Lillian Wangler

1. I am diagnosed with OCD and a struggle I face with receiving mental health care is that often my providers see OCD as simply an anxiety disorder. Personally, I feel that this is not only incorrect but a huge disservice to people that are trying to receive help with managing their OCD symptoms. For example, a lot of SSRI's are prescribed to people with OCD but there is a lot of research to suggest that they need higher doses to mitigate any symptoms. I am aware that each person is different and will react differently to medication. However, I am curious what your studies have found in terms of effective medications to help people that have OCD? Specifically: intrusive thoughts and compulsions. 2. Recently there has been a huge increase in people ages 25-40 being diagnosed with OCD. Do you think this is due to a better understanding of what OCD is, or do you think it could be generationally specific? 3. OCD is not only considered to be under the "anxiety disorder" umbrella, but also the "neurodivergent" umbrella. Could you touch on this and explain what you think about these two umbrella terms vs. OCD on its own? 4. If you could have society understand one to three things about OCD (or people with OCD) what would you hope they know?

Brooklyn Baron

I have a couple of questions! What do we know about the brain chemistry reasons behind OCD? Are there any new treatments on the horizon that might help with underlying brain chemistry causes? Has there been any research on psychedelic assisted therapies for OCD? Is there any rhyme or reason behind why people develop various subtypes? I’ve heard that intrusive thoughts are generally ego-dystonic, which is why they’re so disturbing, but they can vary so much person to person (or even in one person). Lastly, tips for resisting mental compulsions, esp. rumination? Thank you!! 🙏

Rachel

OCD and entomophobic person over here! Piggy backing on the relationship between OCD and phobias. P.s. I’ve really appreciated the insect focused episodes to push myself while I’ve been working on my phobia in therapy over the years. Alie’s love and wonder for them is super disarming <3

Jennifer Lemon

How large is the overlap between OCD, depression, and autism?

Jazz

How far in generations can OCD go? Can it go all the way back to your great great grandparents?

Olivia Lester

hi Alie!! lots of q's to be had: is there a correlation between OCD and Judaism? How strongly connected is OCD to genetics? Is there a certain sex, gender, race or religion that is prone to OCD? What alternative treatments are being developed and/or used to address OCD? Is OCD automatically comorbid with anxiety disorder (i.e. does someone with OCD always have anxiety)? How does someone discern the difference between the two? Does OCD get progressively worse if left untreated/unaddressed and/or with age?

Christi Sullivan

What do we know about OCD and pregnancy? My OCD got WAY better while pregnant without changes to my medications. I was tempted to throw on an EEG cap or get in an MRI machine and enroll in a study to figure out if something was firing different in my brain or if pregnancy hormones somehow improved my symptoms? Any ideas of how pregnancy can positively or negatively impact symptoms and why?

Specs Owl

What's the difference between OCD and obsessive/compulsive autistic traits?

Ingrid Felsl

My friend had the same experience!! Her care team believes the oxytocin levels during pregnancy leveled out her OCD and ADHD symptoms, but it wasn't really "confirmed." Super interested if this question gets asked on the ep!

Christi Sullivan

That would make sense! I am still breastfeeding so my oxytocin levels are higher and my OCD has been really manageable. I’m slightly dreading the day when I stop in case it was the hormones keeping my OCD in check

Rachel

How would you recommend approaching/supporting a family member who may have OCD but who is scared to seek a diagnosis or treatment?

Leah Rebecca

32 and medicated (and in therapy) for ocd since elementary school. I still have contamination ocd that rears it’s ugly head in the worst times. I feel like I let my childhood self down because ocd still gets the best of me sometimes. Does OCD ever truly go away?

Mini Minnie

Well, my mother told me about the OCD habits she had as a young woman, and that was in the 1950’s, in a very small town. Not today’s fast pace. She did however, not have that much control of her life then.

Alexandra Roth

No questions of my own, but everyone else’s are great! Can’t wait for this episode.

cuxjmber

The term OCD is bandied about in pop culture all the time to just mean someone being type A or a even just very particular. What truly defines OCD as opposed to mildly obsessive, anxious, or perfectionist behaviors that a lot of us have?

Kiana Taylor

I have heard about different types of OCD, but Ive seen some people discussing OCD over more internal processes like a thought pattern. Is that true?

Phil Margetts

I would never claim to have OCD but people have commented that I have OCD-like tendencies. For example I feel the need to check a door is locked even though I’ve just locked it, was fully paying attention and know perfectly well that said door is now locked (three is a particular favourite in terms of number of times checking the door). Would this be considered a behaviour of someone with OCD or just someone who is very careful (also, do you have any advice on how I can break this cycle and avoid being late all the time and annoying people waiting for me?)

Phil Margetts

After reading other people's responses I've realised there's far more urgent matter to discuss! And this doesn't add much backbone to my previous question but... Monk? How much is accurate and how much is flim flam?

Julia Reichelt

How does OCD relate to ADHD? Do they sometimes or even often come together and could OCD mask ADHD?

Julia Reichelt

What is the difference between having OCD and scoring high on obsessive-compulsiveness as a personality trait? I don't have diagnosed OCD, but a therapist told me after some standardised testing that I score high on obsessive-compulsiveness as a personality trait. I never quite knew what to do with that.

Alyx Rose

FTQA Why is perfection OCD such a bitch?!

Alena Litin

Can ocd severity change throughout life, like that symptoms become more mild or more pronounced as you age?

Alena Litin

How do ocd medications work, like what is actually happening to your brain?

Rachael Mae

What can I do to support family members/friends/strangers on the street with their OCD?

Matt Hirschl

How harmful can it be to casually say “I have ocd” in casual conversation when you actually do not have ocd?

HazHydro

I am 60 years old and have had treatment resistant depression my whole life. Recently, my incredible therapist brought up the idea that some of the spinning in my head that completely overwhelms and paralyzes me, preventing me from doing things that we *know* will elevate my depression, are OCD-esque as per Patrick McGrath of NOCD. Would you and your guest discuss this? Sorry to be vague, but I am trying to simplify a lifetime of complex maladaptive and disregulated thoughts and behaviors to ask a question I don't fully understand, so of course, please feel free to rephrase. [I have been through hell the last year and a half: went off all my meds (per med advice); undergone TMS (which worsened the depression, gave me debilitating anxiety, but improved my chronic migraines); did six weeks of intensive outpatient hospitalization; have gone back on one of my meds (bringing elevated mood but also intense ringing in my ears and hand tremors); and have been doing Spravato esketamine treatments for the past nine months.]

Daisy Moser

Is OCD a spectrum ranging from particular to debilitating, or is there a hard and fast line that defines the actual diagnosis? If the latter, what is that defining line? Is it cruel or kind to challange people with OCD (in my case young students) to ignore their impulses?

Daisy Moser

Hey Leah, Special education teacher here. Just wondering what teachers have done in the past, that have helped or harmed you in the way of your OCD. I have some kiddos, that I want to support in meaningful ways. Thanks

Nadia_Fi

Also a first time question asker here! As someone with emetophobia I’m very interested in the relationship between OCD and phobias too - I’ve seen some other comments mentioning this.

Patrick Foye

I was told by a psychologist that OCD is based in anxiety. Is that true? And is OCD and ADHD’s hyper focus related? I know that mice injected with dopamine will increase their grooming activity to a significant degree. Since stimulants increase dopamine, can they increase OCD habits in those with it? Also, I knew someone whose severe OCD as a kids and was always constipated. He felt his traits lessened when he had to take laxatives to clean out for a colonoscopy or imaging of some sort. While that is anecdotal, could there be a relation between OCD and constipation.

Patrick Foye

I mentioned this in my question: I had a friend (who now works in medicine) and he said he had sever OCD tics as a child. He also tended to chronic constipation. As some point he had to either have a colonoscopy or imaging of some sort (or he just did a colonic) and had to clear out his digestive tract in preparation. He said after that, he felt his tics lessened to a significant degree. (He went from having to touch a plant or whatever he was near 10 times for every family member otherwise he’d think they would die…to not feeling the need to do so at all.) While this is anecdotal, I feel that since the gut produces neurotransmitters, there could be a connection.

Christine Hurley

haha reading your comment made me just go through my full sequence of cracking knuckles, jaw, left elbow.

Drew J

Can OCD come at different times of life and in different forms throughout life or is it something you are born with that comes to the surface of you everyday life at times?

cheesemonger

What research is still most needed to be done on ocd?

cheesemonger

How does it impact masc and fem people differently?

cheesemonger

How is it diagosed, especially when patients may already have other mental illnesses with overlapping symptoms?

cheesemonger

Did “Im Glad My Mom Died” do anything noticeable for awareness, research, or funding for OCD?

Leah Rebecca

Your kids are lucky to have someone as caring as you! I don’t have a great answer for this as I was extremely lucky. My mom was a teacher before she became a SAHM, and we were in a position where she could homeschool me while we were figuring it out. I will say I can’t imagine being in public school while dealing with those terrifying confusing thoughts. I think the best thing is to advocate for them with their parents to get the help they need- a really good childhood psychiatrist / psychologist.

Anna Elizabeth

how does OCD manifest in the brain? can you see it on a brain scan like you can depression?

Alice Rubin

How does/can hyper fixation (obsessive thoughts) shift to OCD? What is the difference between being obsessive and becoming clinically obsessive? How can people with OCD get help if they cannot make other changes in their external life to support trying to make improvements - like kids in bad living situations or people who do not have the means to change their jobs, homes, leave bad living situations, etc.?

Recovering neuroscientist

First-time question asker here: I'm really curious about the similarities and differences between OCD with purely cognitive manifestations (i.e., repetitive and intrusive thoughts, cognitive rituals to ease anxiety, etc.) and the more externalized presentation of OCD (i.e., checking the stove repeatedly to make sure you turned it off), particularly in how they compare in terms of the underlying neurophysiology and implications that might have for treatment. Thank you!

Erin Everton

I’ve heard people bring up “moral scrupulosity” (sp?) a few times when talking about OCD, can the ologist explain more about it?

Anna Wolf

curious about studies about COVID in relation to OCD? cuz the pandemmy sure made mine worse!

Kiubez

FTQA as well: I would also love to hear more on this. I've never received a formal diagnosis but I have suspicions about my own mental health. My 8-year-old son, however, is starting to show signs of anxiety and seems to be picking up on my compulsive behaviors. Are there clear markers that show up in kids that point toward OCD? How can I make sure I am not contributing to learned behaviors that could make things worse?

T Noz

I second this question. Do therapies used to treat OCD act as agonist/antangonist ligands for receptors in specific areas of the brain?

Julian

My partner asked about the similarities and differences between OCD and psychotic spectrum disorders. How can we best differentiate between these conditions other than looking at the positive symptoms in psychotic disorders?

Ashley Adair

Is OCD a manifestation of a constellation of symptoms that are common across other psychiatric disorders, or is it a separate disorder all its own? Is it heritable, or not heritable?

Katie Biardi

How can I best support my partner who has OCD? He's on medication that helps with most of the symptoms, but there are still some things that stress him out, for example traveling. Also, how can I best support him when his obsessive thoughts cause him anxiety?

Kyra Black

As a kid I remember thinking as I was leaving the house that if I didn’t go back and check if the door was locked…my parents wouldn’t love me, or if I didn’t touch a certain fence plank…my parents wouldn’t love me, etc. These thoughts have dissipated as I was diagnosed with anxiety and began taking different SSRI’s but I’m curious if this is a symptom of OCD? Or does OCD, anxiety, or even ADHD have overlapping effects? Thank you :)

Kait

Niche question: Can you tell me if there’s a name for this experience? When I was little, I’d touch things or do a behavior a certain number of times. When that was discouraged, I think I started internalizing it? I associated different shapes with corresponding numbers. And each number evoked a sort of …feeling* in me? Like they had a personality almost. Then, instead of touching objects, I’d do a sort of mental calculation of the shapes around me. Is it common for behaviors to get internalized? (Or whatever it was that I described?) I’m 37 and just started treatment for OCD last year, so it’s all new to me! (Also diagnosed with ADHD and anxiety. Triple threat 😎) *For anyone else who watched Severance: YEP, that part about feelings numbers freaked me out!

Elena B

How common is it to OCD to fluctuate over a person’s lifetime in regard to severity and type? For example, if someone is diagnosed with OCD as a child, how likely is it that their OCD symptoms will continue as an adult or shift (like someone going from having visible compulsions to having primarily “pure-O” OCD)?

Anton Kleynscheldt

I'll try to keep this short: I was diagnosed with ASD/ASC at 40 and four years later I got ADHD and OCD diagnoses as well. How common is it for someone to only have OCD? I'm asking because the symptoms overlap so much. How can you even be sure the person you're studying only has OCD?

Anton Kleynscheldt

I have a feeling that ASD, ADHD and OCD will become closer in their diagnostic criteria, and may even become part of a single diagnosis. I heard in the next edition of the DSM, ASD may become categorised as "a compulsive disorder," so they may merge. ASD and ADHD are genetic, so I expect OCD is as well

Anton Kleynscheldt

I only just got an OCD diagnosis because I masked my symptoms really well, without knowing it, and none of them are the stereotypical ones anyway, so I really had no idea I had it!

Anton Kleynscheldt

In my diagnostic process it became clear that I have compulsions that I know are nonsense, and know other people know are nonsense, but I can't stop myself anyway. That seemed to be a strong indicator for OCD in my case

Anton Kleynscheldt

I think you're onto something. I have a lot of mental number juggling and pattern finding going on that is probably related to one of my mental disorders. I love finding musical patterns in anything from Bach to Radiohead to Deadmau5. Few things make me happier than patterns like this being visualised in graphs, diagrams or geometric shapes.

Anton Kleynscheldt

It could be very offensive, but usually only indicates ignorance. I find people don't understand my ASD, ADHD, OCD, depression or anxiety, even if they claim they do. And "we're all a bit autistic" is one of the worse things I often hear.

Ashton McCall

FTQA: Hello! I have struggled with potentially OCD for most of my life, I am 34, (ADHD, MDD, GAD). I have picked my skin so badly that it's caused additional damage and skin issues to my body. I know it is incredibly damaging but cannot stop myself and it's even become subconscious at times. My PNP (Psychiatric Nurse Practitioner) has me taking NAC Supplements to help with my Skin Excoriation. Any thoughts on this treatment approach or are there studies on this? Very curious! Probably also have a million other questions but this will do! Thank you!

Kurt Swanson

What is the most realistic representation of OCD in media? Something that does not rely on the same old stereotypes of obsessive handwashing, counting, etc.

Keegan Newman

I was wondering how you diagnose people with OCD, and if you could touch on hoarding and OCD. Thanks!

Austin Broadwater

How does someone with OCD combat cognitive dissonance?

Matt Seccafien

FTQA: What is known of the relationship between eating disorders and OCD? Would treatments common for OCD be worth exploring for someone with body dysmorphia and/or a compulsive relationship with food? Is the overlap in obsessive and perfectionistic traits have a scientific/medical explanation?

Sarah Cork Henderson

Hi again. I have mild OCD, mild Tourrettes, and possibly mild autism. I also carry on a running conversation with myself OUT LOUD, all the time that I’m alone and sometimes when I’m not. Its something I’ve done all my life. So much so that when I had a roommate and her room was right next to mine, she could hear the running conversation through the wall and at first wondered who I was talking to. She even brought it up during my wedding dinner speeches. To be clear, I’m only talking to myself. I’m fully aware that I’m alone. There are no imaginary “friends”. I find it comforting and never get lonely. It also helps me figure things out . But often I’m just telling myself little annecdotes about things that recently happened. Entertaining myself. I even laugh at some of the things I say. In every other respect I’m pretty normal. Is this something you’ve seen in people with OCD and other co-morbidities. Or am I just weird?

EllenLouG

Is there a threshold for an official diagnosis of OCD? And is there a difference between OCD and general anxiety causing OCD-like tendencies like counting, repetitive movements, checking of things etc.? Also, how does the expert feel about the use of the term OCD in popular culture by people who don’t have a diagnosis but use it to mean they like to clean for example?

Alex Minor

1. What is your perspective on the relationship between trauma and OCD? Can trauma contribute to the development of OCD, or does it primarily exacerbate existing tendencies? 2. There’s discussion around OCD medications worsening ADHD symptoms and vice versa. Have you observed this in your practice or research? Why might some stimulant medications (e.g., Adderall) intensify OCD symptoms while others (e.g., Vyvanse) do not? 3. How effective is Exposure and Response Prevention (ERP) for individuals with both OCD and ADHD? Given the challenges ADHD presents, such as difficulty focusing, are there strategies to improve engagement—like gamification, which some find helpful?

Lauren R

What can cause OCD symptoms to shift from almost unnoticeable to debilitating? Or the areas of impact to suddenly & dramatically change?

Brianne Vanderwal

FTQA: What is the ologist's thoughts on adding drugs such as Abilify to SSRIs? How is the mode of action different than just increasing the SSRI dose?

Raja

Gosh, I don't know where to begin. Have been living with it and connected with people who live with it since I was a teenager in the 80's. It now seems to be increasing in symptomatic frequency in me, which might be stress related. I'll ask something harder to look up on my own: are there any dietary suggestions that have legitimately been found to be connected with OCD? Vitamin B12? Omega 3s and 6s? Looking for a magic pill that surely doesn't exist. Thank you for doing this episode.

Lalie Broten

Is OCD considered to be on the spectrum/neurodivergent?

Raja

Just putting this here in case other commenters are interested: Jon Richardson is a British comedian who has OCD and sometimes works it into his bits (I personally find him hilarious as I can relate!). He's also done a documentary of sorts about OCD where he visits people who live with it in significant ways. I found that a bit harder to watch as I was worried it would trigger new habits in me, but it was very good. I recommend checking him out though. He has a very funny bit about his roommates not doing things "the right way".

Lalie Broten

Is it true that ADHD and OCD co-occur at high rates? I believe I have both

Alicia Henning

I'd like to know more about OCD and Autism, and other comorbidities. How do clinicians sort out what is a symptom of Autism versus what warrants a dual diagnosis?

GirlieHippie

Do people with OCD have higher stressors/ cortisol levels?

Joey Zweig

Is ocd always compulsions and obsessions? I ask because I am diagnosed with OCD, but sometimes I feel like I don’t always have compulsions, though i definitely have in the past. But i always have intrusive thoughts/obsessive thoughts. Just curious!! (If you do use this question maybe just use my first name)

sleepystephy

Do you have any recommended therapy modalities, or specific coping techniques that you would recommend for newly diagnosed people? Also, thank you to everyone that puts together Ologies. You guys are the best~

Liliana

FTQA: *sorry for a rather intense question* I know many people with OCD experience intrusive thoughts, and some, like my friend, have especially distressing ones such as pedophilic intrusive thoughts, fears of cheating, or other scary and taboo topics. Could you speak about why OCD often involves such intrusive thoughts, what causes them, whether they are dangerous, and how people can manage them?

Spencer Aldridge

What's a good way to explain to someone who doesn't have OCD what the disorder actually is? How people really suffer from it opposed to how it is portrayed in media?

Brianne Vanderwal

I have an aunt that was treated for severe OCD with electroshock therapy. This was as recent as the early 2000’s. 😬 When was this abolished, or are such practices still used today?

Jennifer Froh

My OCD manifests mostly in intrusive thoughts nowadays and it's so annoying to have to explain it to people that it's not just "being neat and tidy". Uhg

Mamabee & DadAussie

Would love to hear more about OCD intrusive thoughts/images and especially how it may be affected or exacerbated during pregnancy and post partum.

Erin Sorensen

I’d love to hear more about OCD specifically as it relates to the rare young person autoimmune response called PANDAS.

Erin Sorensen

Does an OCD diagnosis have a correlation with intelligence or those with a diagnosis of 2E (twice exceptional)?

Jessica Arend

FTQA (last name pronounced “errand”)! I’d like to add: I’m a clinical psychology PhD student specializing in researching and treating psychosis disorders, and OCD is a pretty common comorbidity (or at least differential diagnosis) with those too. Are there suspected common biological or psychological mechanisms that drive these co-occurrences? As others are asking - what disorders are most commonly comorbid with OCD?

Reese Perini

Is OCD a heritable disorder or is it often trauma-induced? At what age are people usually diagnosed, and does it ever go away with time? Thank you!

Isa

How does OCD relate to perfectionism? I have always identified as a perfectionist, and have numerous perfectionist tendencies according to my therapist, however when I did my ADHD testing they also threw in an OCD test, which came back as negative (but positive on the ADHD and anxiety.) Thanks!

Mariah Walzer

How can we help loved ones with OCD?

Meagan Walker

Do folks have OCD on its own, or does it often come along with a friend?

Meagan Walker

Do OCD routines change much with age?

Bren Norman

My teen has OCD, anxiety ,dyslexia, yada yada. Through trial and error we've found a med that keeps her intrusive thoughts, ticks, and most compulsive behaviors at bay. Any chance she'll eventually outgrow of the OCD?

Hailey Bate

FTQA: how can I, an average person, help combat public misconceptions of OCD? Ex. most of the women in my family casually say they're "so OCD" about keeping things clean/organized. I wish I could say something about it w/out sounding rude or like a know-it-all.

Zinc

please talk about the links between OCD and autism

Kathleen Sachs

Why is it called OCD? Why aren't the letters in alphabetical order-- CDO-- like they're supposed to be?

Bonnie Gu

What can I do to convince my friend to get help for his OCD? He self-medicates with alcohol and currently doesn't see the problem with this (despite ruining countless relationships and friendships)

noa luna bader

i have struggled with ocd since i was 12. it has evolved and morphed into many different forms through the years, with various triggers that have come and gone, but it’s common thread is always a fear of physical contamination in response to painful or traumatic memories. anything relating to or associated with a memory; whether a person, location, object etc. can trigger a response feeling like i am physically contaminated. my compulsions have always involved hand washing, showering, disinfecting, even swimming as a way of cleansing. in my early twenties, i still experience the confines that my ocd brain keeps me in as i move through the world; scared to enter certain spaces or cross paths with certain people who have hurt me; because i will feel “dirty” until i have completed compulsion x, y or z. therapy has of course helped and i have seen improvements through the years, but i still have moments of feeling completely trapped by my mind. i am curious about ketamine therapy for treating ocd? can you share some about the research taking place?

Malorie Albee

What are some signs you have OCD that people generally don't think of?

Malorie Albee

I have multiple family members with OCD, and they all mention having to adjust/tense certain body parts to "even them out" on both sides. What is this about? Is it common to OCD?

Malorie Albee

Is OCD associated with skin picking (specifically picking scabs)?

SmoothKriminal

Two part question (asking for a friend): “Is OCD considered neurodivergence?” “OCD, ADHD, and Autism frequently co-occur, so how can we tell them apart?”

Sadie Vipond

How does one try to live in the moment with ocd instead of just dreading the next time it gets bad?

Chloe

What are some good and accurate representation of OCD in movies or books?

Jess

Do you think psilocybin could be a promising treatment for OCD? It seems like there is some interesting preliminary research and I'm curious what you think based on information so far.

Paulina Krasińska-Sroka

Oh no! I'm too late :( I was hoping to get a question in because I literally started talking about this with my therapist 2 hours ago and made some discoveries! The question is: How do I tell the difference between OCD and behaviors that simply bring me comfort? Are those the same, just differ in severity? . I've been talking to my therapist about my reluctance to implement new ADHD med, because of silly reasons like feeling the need to start it on Monday, not mid week, or because I still have some of my previous pills left. And she asked about other instances when I felt the need to do something "on a schedule" or was creating "order" for things that didn't really need it (like all the cups facing the same way on a shelf) and felt bad if it was upset. And the more we dug, the more I realized I always used sorting things out and creating organization schemes to calm me down and feel safe. It's mind blowing! But I don't know if that's OCD or just another coping mechanism of a person with rough childhood, undiagnosed until adulthood ADHD and depression.

The Awkward Cactus

Darn missed the cutoff! I’m SO HAPPY you’re doing an episode on this! As an OCD survivor and advocate I can’t wait to hear it! Exposure therapy has changed (saved) my life <3

Annie

Check out Alegra Kastens on instagram if you haven’t already. She talks a lot about taboo themes of OCD (e.g. pedophilia, violence, sex) and normalizes the experience (in the context of having OCD). She is also publishing a memoir about her personal experience with this but it’s not out yet. She is a fantastic resource!

Annie

Please check out Alegra Kastens on instagram! she discusses the intersection of OCD & EDs and she is brilliant. A fantastic free internet resource to start exploring this!

Katherine Aaron

Is there an answer to this question: Why do people with OCD always get so nervous?

Erica!

Can’t wait for this episode!

Rachel Marcotte

Have you heard "picking me"? It's a non profit that has supports for people with dermatillomania. https://pickingme.org/ Also TLC bfrb is another amazing organization with lots of information and support for bfrb's (body focused repetitive behaviors) https://www.bfrb.org/ I am 38 and have pretty much the same diagnosis' as you (GAD, ADHD, OCD)