0:00 Hey everyone, my name is Dr. Aluk
0:01 Kenoja. I'm a Harvard trained
0:02 psychiatrist and today we're going to
0:04 talk about OCD. So, obsessivecompulsive
0:07 disorder is characterized by two things.
0:09 Obsessions, which are intrusive,
0:11 unwanted, and repetitive thoughts, and
0:14 compulsions, which are behaviors or
0:16 mental reactions, which we engage in to
0:19 reduce the anxiety from our obsessions.
0:23 Compulsions can be repetitive behaviors.
0:25 Things like washing my hands seven times
0:27 when I'm afraid I have germs. Or they
0:30 can even be mental reactions like
0:32 repeating certain thoughts in your head
0:34 over and over and over again until that
0:36 feeling of anxiety goes away. The
0:38 scariest thing about OCD is that you may
0:40 have it and never realize it. And even
0:43 if you see a mental health professional,
0:45 there is a very, very good chance that
0:46 you will get misdiagnosed with something
0:49 like an anxiety disorder. Let's take a
0:51 look at a couple of really quick
0:52 statistics. 90% of lifetime respondents
0:55 with OCD met the criteria for another
0:57 lifetime disorder. 79.2% of cases of OCD
1:01 began after comorbid anxiety disorders.
1:03 Only a minority of severe cases receive
1:06 treatment for OCD. So this diagnosis is
1:08 incredibly easy to miss. Why is that?
1:11 Because OCD feels like really bad
1:14 anxiety. 65% of people with OCD rank as
1:19 severely impaired on a disability scale.
1:22 So why is that? So let's understand
1:24 something, okay? We have two kinds of
1:26 psychiatric illnesses. We have the
1:28 psychiatric illnesses that we give names
1:30 to based on how they feel like major
1:34 depressive disorder or generalized
1:36 anxiety disorder. And we have other
1:38 psychiatric diagnoses like OCD in
1:40 schizophrenia that are named based on
1:43 what causes them. So I know that sounds
1:45 kind of confusing. So let me just
1:47 explain. Okay. So if we have something
1:48 called a mocardial infarction, this is a
1:51 heart attack. This means that there's a
1:53 part of my heart that is not receiving
1:55 adequate blood supply. Maybe I have a
1:57 blocked coronary artery. So there's a
1:59 part of my heart that is essentially
2:01 suffocating. So myioardial infuction
2:03 doesn't describe what it feels like. So
2:05 when someone has an MI or heart attack,
2:08 you know, it feels like crushing
2:11 substeral chest pain. So you feel like
2:13 there's an elephant sitting on your
2:15 chest. So Mario myioardial inffection is
2:17 a good example of a diagnosis that is a
2:20 technical diagnosis and what it feels
2:22 like to a patient. If we look at the
2:25 psychiatric illnesses the they also fall
2:27 into those categories. So major
2:29 depressive disorder feels like you're
2:31 depressed all the time. Generalized
2:33 anxiety disorder feels like you're
2:35 really anxious. Social anxiety disorder
2:38 feels like you're anxious in social
2:39 situations. And then we have
2:41 obsessivecompulsive disorder, which
2:43 based on social media portrayals and
2:45 things like that, everyone's like, "Oh
2:47 my god, I'm a little I'm so OCD. Oh my
2:49 god, I'm so OCD because I have to have
2:51 my pens arranged in a particular way."
2:53 That's not what OCD feels like. OCD
2:57 feels like crippling anxiety. Anxiety
3:00 that won't go away no matter what you
3:03 do, except for the one thing that
3:06 actually makes it go away. So, if you're
3:08 someone who has crippling anxiety and
3:10 there's one thing that works, you should
3:12 seriously consider getting evaluated for
3:14 OCD. Like I've said, one of the most
3:16 frustrating things about OCD is how
3:19 often it gets misdiagnosed. People can
3:21 spend years trying to manage anxiety,
3:24 depression, or even something else
3:25 entirely without realizing that
3:27 underneath it all, it might actually be
3:30 OCD. And because it's so misunderstood,
3:32 it gets missed. Another study showed
3:35 something like 50% of people with OCD
3:37 get misdiagnosed at first, which means
3:39 they don't get the right kind of support
3:41 early on. And even when it is diagnosed,
3:44 not every therapist is trained in the
3:46 specific treatment that is effective for
3:48 OCD, like exposure and response
3:50 prevention or ERP. But here's the real
3:53 challenge. There's a shortage of OCD
3:55 specialists out there. That's where our
3:57 sponsor, NOCD, comes in. It's a telealth
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4:04 in ERP. Our scientific advisory board
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4:13 they were genuinely impressed by the
4:15 level of rigor and understanding there.
4:17 So, if you're dealing with intrusive
4:18 thoughts or you find yourself stuck in
4:20 loops of obsessive thinking or
4:22 repetitive behaviors, it might be worth
4:24 talking to someone who really knows what
4:26 to look for. 155 million Americans have
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4:37 sessions, so you're never alone. You can
4:39 schedule a free 15-minute call with no
4:42 using the link in the description below.
4:45 So, what we're going to start with is
4:46 someone who is lucky enough to not have
4:49 OCD. So, here's you. Let's hope that you
4:52 don't have OCD. So what happens is
4:54 you're in a particular
4:56 situation and the situation creates a
5:00 thought. The thought will create an
5:02 emotion. So let's say that the situation
5:04 is that my partner who I'm in a
5:06 long-distance relationship is boarding a
5:08 plane and is going to come visit me. So
5:10 the situation is a visit and then I have
5:12 a thought. I hope that the plane doesn't
5:14 crash. I hope they're safe. I hope
5:15 everything is okay. And then this
5:17 thought leads to anxiety. Now, in a
5:20 normal brain, someone without OCD, there
5:23 are a couple of different things that
5:24 can happen to this anxiety. The first
5:27 thing, as I'm sure y'all are aware, is
5:29 that we can habituate to it. So, we have
5:31 to explain this for a second. Okay?
5:33 Anytime we have a negative experience
5:35 within our body or our mind, like let's
5:38 say I feel hungry, we don't feel hungry
5:40 forever, right? We feel hungry for a
5:42 little while and then my brain sort of
5:43 my body figures out, okay, we're not
5:45 going to get food right now, so we're
5:46 going to suppress hunger signals for
5:48 some amount of time. If you wait an hour
5:51 or 2 hours later, the hunger signals
5:53 will come back. But our brain and our
5:54 body basically suppress negative signals
5:57 after a little while. Another really
5:59 great example of this is like body odor.
6:01 So sometimes you step into a place where
6:03 like someone is a little bit smelly or
6:05 you step into, you know, a place that's
6:07 smelly and then it smells really bad for
6:09 the first few seconds and then over time
6:12 the badness kind of goes down, right?
6:14 It's not that you ever forget the smell,
6:15 but that you habituate to it. So you
6:17 kind of get used to it. This can be true
6:19 of temperature, it can be true of smell,
6:21 it can be true of hunger, it can even be
6:23 true of anxiety. So if you're lucky
6:25 enough to not have OCD, you'll feel
6:27 anxious about something and the anxiety
6:29 will naturally decrease. The second
6:31 thing that we do with anxiety is that we
6:33 tend to distract ourselves. So, this one
6:36 is my favorite. It's the funnest way to
6:38 deal with your anxiety, we can do things
6:39 like I've had patients who enjoy when
6:41 they're feeling anxious, getting high
6:42 and playing video games. We have all
6:44 these devices that give us dopamine that
6:46 allow us to distract ourselves from our
6:49 anxiety. Let's say I have a test on
6:51 Friday and today is Monday. So, the test
6:53 is in 4 days. So, I think to myself, "Oh
6:55 my god, I need to study. I'm anxious
6:56 about the test. Instead, I'm going to
6:58 just play video games all day." So
6:59 Tuesday rolls around and I'm like, "Oh
7:01 my god, I still have this test, but I
7:02 feel anxious about it. So I'm going to
7:03 get high and play video games again." So
7:05 I'm going to use certain mechanisms to
7:09 regulate my emotions, right? So I'm I
7:12 feel bad. I'm going to do something to
7:13 make the feelings go away. But then if
7:16 I'm lucky, Wednesday rolls around, and
7:19 this is really important. Now I've
7:20 wasted two days and then I have
7:23 something that works, right? I can get
7:24 high and play video games. But Wednesday
7:28 rolls around and I think to myself, you
7:30 know, that's not really a great idea. I
7:32 really should study on this test for
7:34 this test. And you all may know this
7:36 that there are certain days that you do
7:37 the wrong thing. But there's a voice
7:40 inside you that then inhibits the wrong
7:43 thing. So we call this response
7:47 inhibition. Right? So what we're going
7:48 to do is we are going to stop the
7:53 emotional regulation that is unhealthy.
7:55 So, we'll distract ourselves for a
7:56 little while, maybe we'll spend 15
7:58 minutes on our phone, but then
7:59 eventually we inhibit that response and
8:01 we get back to what we should be doing.
8:04 And so, then hopefully what happens is
8:05 once I'm inhibiting my response, then I
8:07 end up taking appropriate action. So, I
8:10 end up basically fixing it. So, this is
8:12 the brain of someone who does not have
8:14 OCD. We have a situation, we have a
8:16 thought, we have an emotion, and we have
8:18 three ways that we sort of deal with the
8:19 emotion. We habituate to it. we distract
8:22 ourselves or regulate that emotion and
8:25 then even if we're regulating that
8:26 emotion eventually we learn how to stop
8:29 regulating that emotion in that way and
8:31 we take definitive action to fix our
8:33 problem. So how is the brain of someone
8:35 with OCD different? So the first thing
8:38 that
8:39 happens is the
8:41 situation. So already we know that one
8:44 thing is different. People with OCD have
8:46 an
8:48 overestimation of threat. Okay. So,
8:52 there's a situation. Someone is boarding
8:54 a flight. If I were to ask you, are you
8:56 worried that the plane will crash? A
8:57 normal person may say, or a person
8:59 without OCD may say, yeah, you know, I'm
9:00 worried about it. What do you think the
9:02 chances are? Oh, I think the chances are
9:03 less than 1%. But for someone with OCD,
9:06 the chances of a plane crash are 10%.
9:08 Or, I know this sounds a little bit
9:10 crazy, no pun intended, and not trying
9:13 to offend anyone, or the chances may be
9:16 100%. If you're someone who has a
9:19 thought of a potential danger that feels
9:22 like it is going to happen 100% unless
9:25 you do something about it, you may have
9:28 OCD. So this creates a thought and then
9:31 this creates anxiety. So we also know
9:34 that there are changes in the amygdala
9:36 of people of OCD. This is our fear and
9:38 threat center of the brain and it tends
9:40 to get ramped up very easily. So we are
9:43 overestimating the threat and our
9:45 amygdala is hyperactive which means that
9:47 we feel an intense intense amount of
9:50 anxiety. Remember this anxiety is so bad
9:52 that it is severely disabling for 65% of
9:57 people. Then we get to another problem.
10:00 So remember how we habituate to negative
10:03 things like we're you know in a smelly
10:05 we step into the restroom smells really
10:07 bad but then slowly the smell kind of
10:09 goes away and then when we step out we
10:11 feel really good but we're not tortured
10:12 while we're in the bathroom the whole
10:14 time. So we know that in the brains of
10:16 OCD people fail to habituate. So whereas
10:19 a neurotypical brain may get used to a
10:23 bad smell a feeling of of anxiety it'll
10:26 kind of tone things down. the brains of
10:28 people with OCD, they fail to habituate.
10:30 So they don't habituate nearly as
10:32 easily. So that function doesn't work.
10:34 The other thing is that they have a lot
10:36 of difficulty even distracting
10:38 themselves. They can try, but there is a
10:40 lack of something called cognitive
10:43 flexibility in OCD. So what does this
10:45 mean? So when I'm worried about
10:47 something, let's say I'm worried about
10:48 my test on Friday, in order to distract
10:52 myself with video games, my brain needs
10:55 to stop thinking about the test and
10:57 start thinking about video games. Even
10:59 this degree of cognitive flexibility is
11:02 impaired in OCD. So usually my patients
11:05 with OCD will feel like once a thought
11:08 gets stuck in their head or a thought
11:10 gets stuck really lodged in there, it's
11:12 like a pitbull that is bitten onto
11:14 something and refuses to let go. So
11:16 whereas your friends may be able to
11:18 distract themselves pretty easily. They
11:20 can forget about it in a way that seems
11:22 completely foreign to you. You get stuck
11:25 in this almost obsessive degree of
11:27 anxiety. So distractions don't really
11:30 work as well. And this is also
11:31 associated with emotional regulation
11:37 deficits. So our capacity to calm
11:41 down the amygdala is impaired. Okay? So
11:45 it's hard for us to calm ourselves down.
11:47 It's hard for us to distract ourselves.
11:49 So there's an emotional regulation
11:51 deficit. Now, here's the worst part of
11:54 the
11:55 illness. Remember how we talked about
11:57 response inhibition?
12:00 So remember that. Okay. So for the first
12:02 two days on Monday and Tuesday I'm going
12:03 to get high and test it on Friday. It's
12:05 not that big of a deal. Whatever I'll
12:06 figure out later. Wednesday rolls around
12:08 I'm like you know that is not a good
12:10 idea. I basically did something for a
12:12 couple of days and then I inhibit that
12:14 response and start studying. This is the
12:17 most critical thing that is impaired in
12:19 OCD because once someone with OCD finds
12:22 something that
12:24 works, they continue to engage in that
12:27 behavior no matter the cost. So this is
12:31 impaired. Okay? So they'll have some
12:33 kind of thought like, "Oh my god, I'm
12:35 going to get HIV if I touch anything in
12:38 a public restroom." So they feel an
12:39 intense intense anxiety. The anxiety is
12:43 crippling. It doesn't go away. I try to
12:45 distract myself. It doesn't really work.
12:47 And then what happens is I wash my
12:49 hands. I'm like, "Oh my god, I feel so
12:50 anxious. I feel so anxious. So I'm going
12:52 to I'm going to wash my hands. I'm going
12:53 to wash my hands." And then what happens
12:55 when I wash my hands is my anxiety
12:57 improves. This is really important to
12:59 understand. It is the only thing that
13:02 makes my anxiety feel better. Remember
13:04 that thought sticks in your mind,
13:06 doesn't actually go away. The anxiety is
13:08 still there. So I think to myself, okay,
13:10 let me wash him again. And then I wash
13:12 him again. And now I feel, oh my god, I
13:14 feel 75% better. I feel so much better.
13:17 Let me make sure. Then I wash him a
13:19 third time. Oh my god, that feels so
13:21 much better. Now I'm 90% better. Let me
13:22 watch him a fourth time, fifth time,
13:24 sixth time. So OCD is actually a deficit
13:26 of learning. Okay, so there's anxiety
13:30 andor uncertainty with goal- directed
13:32 behaviors and then a compulsivity with
13:34 habitual behaviors. So our brain learns
13:38 that this thing is going to work. there
13:40 are brain changes as a consequence is a
13:42 cause and consequence of OCD. So now
13:44 let's talk a little bit about what
13:45 obsessions actually look like. So the
13:47 one that we've used today is an
13:49 obsession with contamination. So this is
13:51 incredibly common where people are
13:53 germaphobes. They feel like they have to
13:54 wash their hands. They can't touch
13:56 particular things. They uh maybe need to
13:58 shower excessively. I've seen really bad
14:00 cases of that. The second obsession
14:02 that's really common is danger towards
14:05 yourself or others. So, this can look
14:08 like the scenario that we talked about
14:09 where you're, you know, your your
14:10 partner is boarding a plane. You're
14:12 afraid that the plane will crash. I've
14:13 had patients who will be worried every
14:15 time a loved one gets into a car and has
14:18 to drive somewhere, they're afraid that
14:19 there will be a crash. You know,
14:20 there'll be some kind of accident.
14:22 People can be what's something that
14:24 people are more familiar with are like
14:25 concerns about a danger about the house
14:27 burning down. So, this is why people
14:29 will turn off and on the stove seven
14:31 times or people will turn off and on
14:34 light switches, but what's going on in
14:35 their head? Unless I make sure that the
14:37 light is off, maybe there's some kind of
14:39 electrical signal that will cause a
14:43 spark and my house will burn down. So,
14:45 they will have a lot of concerns around
14:47 danger. I had a patient who anytime a
14:49 loved one was in transit. They would
14:52 have to say a prayer in their head. It
14:54 was almost like a magical protective
14:56 spell where they would say the sequence
14:58 of things. This person is leaving this
15:00 place. They will be safe and they will
15:01 arrive on time or something like that.
15:03 They would say some kind of prayer and
15:04 they would say that in their head seven
15:06 times every time a loved one was getting
15:08 into a car or plane or anything like
15:10 that. So I I hope y'all can imagine how
15:13 debilitating this is because every day
15:15 when 5:00 p.m. rolls around and everyone
15:17 is leaving work, they have to stop
15:19 whatever they are doing and say this
15:21 prayer seven times for every person who
15:24 they know who they care about. Oh my
15:26 god, this person is boarding a flight.
15:27 They would set an alarm, repeat the
15:29 prayer in their head. So compulsions can
15:31 absolutely be in your head. Other forms
15:33 of obsessions in involve things like
15:35 checking and counting. We've sort of
15:37 talked about that a little bit. So what
15:39 a lot of people don't realize is that
15:40 obsessions can be like really nasty. So
15:43 I've had patients who will have
15:45 intrusive thoughts about hurting other
15:48 people. I've had uh patients who have
15:50 intrusive thoughts about sexual acts. So
15:53 sometimes obsessions can be sexual in
15:55 nature. Um they can also be towards
15:57 really inappropriate people. So I've
15:59 unfortunately had to work with patients
16:01 I mean unfortunate for them that you
16:03 know they'll have intrusive sexual
16:04 thoughts about their parents and this is
16:06 why OCD is like so hard to diagnose
16:09 because when someone has really negative
16:11 thoughts they feel like a really bad
16:14 person. So if you think every day about
16:17 having sexual a sexual relationship with
16:19 someone that's really inappropriate, you
16:21 feel really guilty. You feel like am I
16:23 really screwed up? Am I a sociopath? The
16:25 number of people with OCD who I've I've
16:27 worked with who think that they're like
16:29 a sociopath is astronomical. But
16:31 remember the nature of OCD is that an
16:34 obsession is not that you're like
16:35 obsessed with something like, "Oh my
16:37 god, I'm so obsessed with this celebrity
16:40 or this influencer." That's not what
16:42 we're talking about. You didn't want
16:43 this. It doesn't say anything about you.
16:45 You don't care about it. You don't like
16:46 it. Most of the time, what OC what
16:48 people with OCD want is they want their
16:50 obsessions to go away more than anything
16:52 else. So if you have a persistent
16:55 intrusive thought that you don't like
16:57 and you tend to have some kind of
16:59 ritualistic behavior, that's behavior
17:02 that you repeat over and over and over
17:04 again in response to the thought, that's
17:06 really what characterizes OCD. So if you
17:08 have OCD, what do you do about it? So
17:10 this is where OCD is one of the most
17:12 undertreated disorders. Remember, only
17:15 30.9% of people with OCD actually
17:19 receive OCD specific treatment. A lot of
17:22 people will misdiagnose OCD as a severe
17:25 anxiety disorder and they actually get
17:27 treatment for anxiety. OCD responds
17:29 really well to biological treatments.
17:31 Now what do I mean by that? So if we
17:33 look at psychiatric illness, there are
17:35 kind of like two sources of psychiatric
17:37 illness. It can come from your brain or
17:40 it can come from your mind. Okay? So if
17:43 we look at like diseases that come from
17:45 let's say from your mind, I mean they
17:46 still come from the brain in some way.
17:48 But if we look at something like let's
17:49 say a mood disorder like major
17:51 depressive disorder, only about onethird
17:54 of people with major depressive disorder
17:56 respond really well with medication.
17:58 What we know about major depressive
18:00 disorder is that a lot of psychotherapy
18:02 can be incredibly effective. You can
18:04 treat depression by targeting your
18:08 thoughts, changing the way that you
18:10 think without necessarily doing anything
18:13 to your brain. Right? So we don't have
18:14 to take a pill or do electrocomvulsive
18:17 therapy or have some kind of surgery for
18:19 our brain in order to treat depression.
18:21 We can treat it using psychotherapy. Now
18:23 this is also true of something like
18:25 generalized anxiety disorder or
18:27 socialized anxiety disorder. Especially
18:29 if we look at these illnesses like
18:31 narcissistic personality disorder. There
18:33 really no medications that help with
18:35 your personality. The personality sort
18:38 of exists within your mind. So we can do
18:40 psychotherapy to help you with your
18:42 mind. There are some psychiatric
18:44 illnesses however that I think are a lot
18:46 more in the brain. So the number one
18:49 example of this is something like
18:51 dementia. So when someone has dementia
18:53 and they have Alzheimer's disease and
18:55 they have all these like plaques in
18:57 their brain when their brain tissue is
18:58 kind of deteriorating. I just realized
19:00 how terrible this is to talk about in a
19:02 video about OCD. I'm not trying to freak
19:03 y'all out. But what I mean is that there
19:05 are some illnesses where there are
19:06 changes in the brain which then affect
19:08 the way that we feel and affect the way
19:10 that we think. So I think OCD is more in
19:13 the brain than it is in the mind. So we
19:15 know that there are all these
19:16 neuroscientific uh changes that we know
19:18 like for example failures of habituation
19:21 um inability to distract yourself sort
19:23 of repetitive learning habitual learning
19:26 towards one thing the compulsion which
19:28 is the only thing that relieves your
19:29 anxiety but there are a couple of other
19:31 indicators for example 40% of OCD is
19:34 basically heritable which means that we
19:36 know that about 40% of the illness has
19:38 to do with your genetics. Some of the
19:39 most interesting literature at the
19:41 intersection of OCD neurology is that
19:43 describing obsessivempulsive symptoms
19:45 that are precipitated by streptocockal
19:47 infection so-called pediatric autoimmune
19:50 neuroscychiatric disorders associated
19:52 with streptococcus pandas. So what does
19:55 this mean? This means that some children
19:57 who get a streptocal infection will have
20:00 an autoimmune reaction that will alter
20:03 the way that their brain kind of
20:05 functions and they will actually develop
20:06 OCD. But we just have a lot of data that
20:09 suggests that OCD can be related to
20:11 things like infections in childhood.
20:13 That may be how you develop it. Most
20:15 people develop OCD between the ages of
20:17 18 and 29, but there are cases that it
20:19 kind of gets developed in childhood. And
20:21 if you're past 30, the likelihood that
20:23 you will develop OCD is really low. The
20:26 likelihood that if you're past 30 and
20:28 you think you've had anxiety that has
20:30 not responded really well to treatment
20:32 or therapy hasn't worked great, then
20:33 there's a decent chance that you may
20:34 have OCD. So, get that re-evaluated. So
20:37 first line treatment for OCD tends to be
20:39 medication. We have some medications
20:40 that tend to work pretty well. About 50%
20:43 of people who uh take medication for OCD
20:46 will not have a great or sufficient
20:49 response. It can be kind of a stubborn
20:51 illness. But this is also where I love
20:53 it because there are particular modes of
20:55 psychotherapy. So my favorite uh thing
20:58 to prescribe to patients, I don't do it
21:00 very much is something called exposure
21:02 and response prevention. So the cool
21:04 thing is we have tailored certain kinds
21:07 of psychotherapy specifically to OCD and
21:09 instead of going to a therapist and
21:11 talking about your feelings which there
21:13 are absolutely that can work. There are
21:15 good papers that suggest that
21:16 psychonamic therapy can be very
21:18 effective for OCD but I personally like
21:21 really like when patients do exposure
21:22 and response prevention. So what does
21:24 that look like? Remember we had this
21:26 diagram. So what exposure and response
21:28 prevention does is it trains you to stop
21:32 this. You train this in therapy where
21:34 you like train your mind. It's like
21:35 doing push-ups for your brain and your
21:38 mind where when you have a certain
21:40 situation, the situation will an
21:42 exposure will create a response, right?
21:45 So that response can be cognitive, it
21:47 can be a thought, it can be emotional,
21:49 which is anxiety and then it can be the
21:51 response can also have a behavior or a
21:53 compulsion. So how do we uncouple and
21:57 relearn how to deal with these
21:59 situations in a healthy way? Because
22:01 remember that OCD is a an illness of
22:04 essentially inappropriate learning where
22:06 our brain learns that only one thing if
22:09 I feel like I'm afraid I have a
22:11 contamination on my hands. The only
22:13 thing that helps is washing my hands
22:15 seven times. So what we actually do in
22:17 exposure and response prevention is we
22:19 expose oursel to the scary thing but we
22:21 do it in a graduated manner where we can
22:23 basically handle the degree of thought
22:26 or obsession that arises and then we can
22:29 stop washing our hands in a very
22:30 damaging way. And then the cool thing
22:32 about that is once you stop relying on
22:34 the compulsion to manage your anxiety,
22:36 you can start to develop other ways to
22:39 manage your anxiety. And the coolest
22:40 thing that I've seen in my patients is
22:42 they will start to develop habituation.
22:44 And once they stop relying on washing
22:46 their hands, their anxiety, they feel
22:48 really anxious and then the anxiety
22:49 actually habituates and it just goes
22:50 away on its own. So there are a lot of
22:52 we've shared a we're going to show a
22:54 quick treatment algorithm. As y'all can
22:56 see, it's long, it's complex, but the
22:58 truth of the matter is it works
22:59 incredibly well and you can get better
23:02 from OCD. But the good news is that if
23:04 you get tailored treatment to OCD,
23:06 there's a really good chance that you
23:08 can get substantially better and you do
23:10 not have to live with severely impairing
23:12 anxiety anymore. Hey y'all, hope you
23:15 enjoyed today's video. We talk about a
23:16 bunch of topics like this on the
23:18 channel, so be sure to subscribe for
23:19 more. If you're already subscribed, GG
23:22 and we'll see you in chat.
23:24 [Music]
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