1 00:00:03,200 --> 00:00:06,280 Speaker 1: Welcome to stuff Mom Never told You from how Stuff 2 00:00:06,280 --> 00:00:14,320 Speaker 1: Works dot com. Hello, welcome to the podcast. I'm Kristen 3 00:00:14,480 --> 00:00:17,120 Speaker 1: and I'm Caroline, and today we're gonna talk about obsessive 4 00:00:17,239 --> 00:00:20,560 Speaker 1: compulsive disorder or o c D, which is something I 5 00:00:20,600 --> 00:00:24,960 Speaker 1: have a feeling most of us are casually familiar with. 6 00:00:25,040 --> 00:00:27,680 Speaker 1: We might even joke about having, say O c D 7 00:00:27,960 --> 00:00:31,840 Speaker 1: in terms of having to do the dishes in a 8 00:00:31,880 --> 00:00:34,600 Speaker 1: particular kind of way load the dishwasher. I don't know 9 00:00:34,640 --> 00:00:38,400 Speaker 1: what you would be referring to Christen Conger dishwasher mistress. 10 00:00:38,440 --> 00:00:40,480 Speaker 1: I may or may not have a very particular way 11 00:00:40,520 --> 00:00:45,080 Speaker 1: of loading the dishwasher. But the fact of the matter is, 12 00:00:45,159 --> 00:00:49,960 Speaker 1: within the medical community a lot still isn't known about 13 00:00:50,000 --> 00:00:54,160 Speaker 1: o c D, and O c D isn't something for 14 00:00:54,200 --> 00:00:58,560 Speaker 1: people who actually experience it that is as casual to say, 15 00:00:58,760 --> 00:01:03,800 Speaker 1: really enjoying an orderly dishwasher, right, because I was accused 16 00:01:03,840 --> 00:01:07,000 Speaker 1: in college of being o c D because I follow 17 00:01:07,080 --> 00:01:10,280 Speaker 1: the same morning routine so strictly. Uh, you know, like 18 00:01:10,400 --> 00:01:12,920 Speaker 1: my roommate actually said, you know, God, are you just 19 00:01:13,000 --> 00:01:15,160 Speaker 1: like totally O c D? You know, you get up 20 00:01:15,240 --> 00:01:17,240 Speaker 1: the same time every day, and then you shower and 21 00:01:17,240 --> 00:01:18,680 Speaker 1: then you do this and this and this, and it 22 00:01:18,720 --> 00:01:21,480 Speaker 1: never deviates. And it's My response was, well, that has 23 00:01:21,480 --> 00:01:23,240 Speaker 1: way more to do with the fact that I have 24 00:01:23,400 --> 00:01:26,440 Speaker 1: not switched on my brain yet in the morning. It's 25 00:01:26,440 --> 00:01:28,880 Speaker 1: not that I, you know, I feel compelled to follow 26 00:01:28,920 --> 00:01:31,920 Speaker 1: a certain routine, but yeah, it's it's o c D 27 00:01:32,000 --> 00:01:35,920 Speaker 1: is so much more than just loading the dishwasher certain way, 28 00:01:36,400 --> 00:01:39,720 Speaker 1: following a certain morning routine. It's certainly more than just 29 00:01:39,840 --> 00:01:43,520 Speaker 1: how adorable the character Monk is on that television show. 30 00:01:44,040 --> 00:01:47,720 Speaker 1: Because the key to o c D that separates the 31 00:01:47,920 --> 00:01:52,440 Speaker 1: media representation from the real life reality is that people 32 00:01:52,600 --> 00:01:56,880 Speaker 1: with obsessive compulsive disorder don't actually enjoy the things that 33 00:01:57,000 --> 00:02:00,320 Speaker 1: they feel compelled to do. Yeah, and it is rather 34 00:02:00,400 --> 00:02:04,080 Speaker 1: ironic that we collectively approach o c D and talk 35 00:02:04,120 --> 00:02:07,360 Speaker 1: about o c D in such a casual, joking way, 36 00:02:07,360 --> 00:02:11,600 Speaker 1: whereas it is this disorder that still needs a lot 37 00:02:11,600 --> 00:02:16,119 Speaker 1: more attention. So, for instance, Johns Hopkins Hospital researcher Dr 38 00:02:16,160 --> 00:02:19,920 Speaker 1: Gerald Nestalt, who recently identified a gene linked to o 39 00:02:20,080 --> 00:02:23,799 Speaker 1: c D, told Newsweek quote, it never had the sexy 40 00:02:23,840 --> 00:02:28,000 Speaker 1: appeal of other psychiatric disorders, So we're fine with joking 41 00:02:28,040 --> 00:02:32,920 Speaker 1: about it. But the jokes have perhaps eroded our perception 42 00:02:33,040 --> 00:02:37,280 Speaker 1: of it as a serious mental disorder that affects a 43 00:02:37,320 --> 00:02:40,639 Speaker 1: lot of people. Yeah. Well, and the interesting thing too, 44 00:02:40,760 --> 00:02:43,919 Speaker 1: is that o c D this is not a new disorder. 45 00:02:43,960 --> 00:02:45,840 Speaker 1: This is not something that has just cropped up in 46 00:02:45,840 --> 00:02:48,880 Speaker 1: the past ten or twenty years that scientists are thinking, oh, 47 00:02:48,919 --> 00:02:52,400 Speaker 1: maybe we should finally study this. People have been writing 48 00:02:52,440 --> 00:02:57,240 Speaker 1: about and observing o c D symptoms for centuries. Yeah. 49 00:02:57,280 --> 00:03:00,160 Speaker 1: We found a lot of information about the medical history 50 00:03:00,200 --> 00:03:03,840 Speaker 1: of obsessive compulsive disorder over at Stanford, and it was 51 00:03:03,919 --> 00:03:07,840 Speaker 1: first described in medical literature in the sevent century as 52 00:03:07,960 --> 00:03:12,800 Speaker 1: quote symptoms of religious melancholy, and pretty much the entire 53 00:03:12,919 --> 00:03:15,480 Speaker 1: representation of it at the time seemed to be the 54 00:03:15,560 --> 00:03:22,040 Speaker 1: struggle between the mind and carnal thoughts and God right 55 00:03:22,200 --> 00:03:26,679 Speaker 1: and in Bishop John Moore defined it as trouble where 56 00:03:26,720 --> 00:03:29,840 Speaker 1: the trouble is over a doubt. When doubts are resolved, 57 00:03:30,240 --> 00:03:34,200 Speaker 1: he wrote that naughty and sometimes blasphemous thoughts which start 58 00:03:34,240 --> 00:03:36,880 Speaker 1: in their minds while they are exercised in the worship 59 00:03:36,920 --> 00:03:40,560 Speaker 1: of God, despite all their endeavors to stifle and suppress them, 60 00:03:40,840 --> 00:03:43,560 Speaker 1: the more they struggle with them, the more they increase 61 00:03:43,880 --> 00:03:47,800 Speaker 1: so that definition, while it is very very old, is 62 00:03:47,880 --> 00:03:52,400 Speaker 1: not that unfamiliar to people who have researched the disease today. 63 00:03:52,480 --> 00:03:55,960 Speaker 1: And in the nineteenth century, the more modern concept of 64 00:03:55,960 --> 00:03:59,840 Speaker 1: o c D really begins to evolve, with differentiations between 65 00:04:00,280 --> 00:04:05,880 Speaker 1: obsessions and delusions as well as compulsions and impulsions, in 66 00:04:05,880 --> 00:04:09,320 Speaker 1: other words, figuring out what the line is between maybe 67 00:04:09,600 --> 00:04:17,640 Speaker 1: just naturally impulsive behavior and unnaturally compulsive behavior. Right and one, 68 00:04:17,640 --> 00:04:21,440 Speaker 1: psychiatrists described it as a form of partial insanity. And 69 00:04:21,760 --> 00:04:24,720 Speaker 1: while this idea was abandoned by the mid nineteenth century, 70 00:04:24,760 --> 00:04:26,720 Speaker 1: so it didn't have a very long lifespan, what I 71 00:04:26,760 --> 00:04:29,679 Speaker 1: thought was interesting about it was that it's this partial 72 00:04:29,680 --> 00:04:32,200 Speaker 1: insanity idea that is sort of how o c D 73 00:04:32,400 --> 00:04:35,920 Speaker 1: is described today, because the whole thing is that someone 74 00:04:36,080 --> 00:04:40,560 Speaker 1: with o c D recognizes that the thoughts and behaviors 75 00:04:40,560 --> 00:04:43,640 Speaker 1: that they experience day in and day out, are not normal, 76 00:04:44,040 --> 00:04:47,120 Speaker 1: they are quote unquote crazy, and that they feel that 77 00:04:47,200 --> 00:04:50,240 Speaker 1: these are negative things that they just have no power 78 00:04:50,360 --> 00:04:53,520 Speaker 1: to avoid or ignore. And so this idea, while it 79 00:04:53,600 --> 00:04:56,599 Speaker 1: was abandoned, was sort of on the right track. And 80 00:04:56,800 --> 00:05:00,279 Speaker 1: around the same time the Germans were positive, saying that 81 00:05:00,320 --> 00:05:04,440 Speaker 1: it was a disorder of intellect and speaking of the Germans. 82 00:05:04,920 --> 00:05:07,760 Speaker 1: O c D gets its name in the late nineteenth 83 00:05:07,839 --> 00:05:11,440 Speaker 1: century from differing translations of the term forgive me if 84 00:05:11,440 --> 00:05:15,320 Speaker 1: I mispronounce it zvang wost a lung, which is a 85 00:05:15,360 --> 00:05:19,960 Speaker 1: compelled presentation or idea. Yeah, so in Great Britain they 86 00:05:20,000 --> 00:05:23,279 Speaker 1: translate this when you say the German term again, please Caroline, 87 00:05:23,279 --> 00:05:28,520 Speaker 1: because I don't trust my mangled German pronunciation uh zvang 88 00:05:28,600 --> 00:05:33,480 Speaker 1: wost a lung, So they translate that as obsession, whereas 89 00:05:33,520 --> 00:05:37,520 Speaker 1: in the United States it becomes translated as compulsion. And 90 00:05:37,680 --> 00:05:42,680 Speaker 1: so we agree to disagree and call it obsessive compulsive 91 00:05:43,240 --> 00:05:47,400 Speaker 1: disorder and moving away from Germany and into Austria. Of course, 92 00:05:47,440 --> 00:05:49,720 Speaker 1: Freud had something to say about o c D, but 93 00:05:49,760 --> 00:05:52,239 Speaker 1: we won't dwell on Freud for too long. But Freud 94 00:05:52,320 --> 00:05:55,360 Speaker 1: thought that o c D was simply the mind's maladaptive 95 00:05:55,480 --> 00:06:00,480 Speaker 1: response to quote conflicts between unacceptable unconscious sexual or aggressive 96 00:06:00,600 --> 00:06:05,039 Speaker 1: i'd impulses and demands of conscience and reality. So not 97 00:06:05,240 --> 00:06:09,640 Speaker 1: too far from that seventeenth century idea about what it was, 98 00:06:09,839 --> 00:06:13,600 Speaker 1: although that concerned more religion than just purely sex. In 99 00:06:13,680 --> 00:06:17,960 Speaker 1: the id well, if anything, all of these definitions seem 100 00:06:17,960 --> 00:06:20,159 Speaker 1: to have in common, this idea of o c D 101 00:06:20,680 --> 00:06:23,760 Speaker 1: as a mental tug of war. Really yeah, and speaking 102 00:06:23,880 --> 00:06:26,520 Speaker 1: of that mental tug of war, let's dive into what 103 00:06:26,560 --> 00:06:28,159 Speaker 1: it is. We've given you a bit of a history, 104 00:06:28,200 --> 00:06:30,919 Speaker 1: but let's turn to the National Institutes of Mental Health, 105 00:06:31,360 --> 00:06:34,560 Speaker 1: who define o c D as a disorder that's characterized 106 00:06:34,600 --> 00:06:39,240 Speaker 1: by frequent, uncontrollable upsetting thoughts a k a. Obsessions that 107 00:06:39,440 --> 00:06:43,320 Speaker 1: compel people to perform ritual behavior a k a. Compulsions. 108 00:06:43,680 --> 00:06:47,080 Speaker 1: And like we said earlier, these rituals are not pleasurable. 109 00:06:47,120 --> 00:06:50,800 Speaker 1: It's not the satisfaction you get from purging and organizing 110 00:06:50,800 --> 00:06:55,680 Speaker 1: your closet, from organizing your books on your shelf. Just so, 111 00:06:56,400 --> 00:07:01,240 Speaker 1: this is stuff that really interferes with daily life. And 112 00:07:01,279 --> 00:07:04,360 Speaker 1: we should also note that o c D is distinct 113 00:07:04,440 --> 00:07:09,360 Speaker 1: from obsessive compulsive personality disorder, which is a mental condition 114 00:07:09,400 --> 00:07:13,400 Speaker 1: in which a person is preoccupied by rules, orderliness, and control. 115 00:07:13,440 --> 00:07:16,480 Speaker 1: So it sounds pretty similar, and they do have similar symptoms. 116 00:07:16,520 --> 00:07:20,440 Speaker 1: But crucially, people with o c D usually know, like 117 00:07:20,520 --> 00:07:24,720 Speaker 1: we've mentioned, that those intrusive thoughts are illogical, whereas people 118 00:07:24,760 --> 00:07:28,720 Speaker 1: with o c p D believe they're right and often 119 00:07:28,800 --> 00:07:33,760 Speaker 1: get angry when confronted, and it's closely associated with perfectionism, 120 00:07:33,800 --> 00:07:37,120 Speaker 1: which Caroline me should absolutely devote a podcast to at 121 00:07:37,160 --> 00:07:40,000 Speaker 1: some point totally. And one source I found looking at 122 00:07:40,000 --> 00:07:43,160 Speaker 1: O c p D said that it affects both men 123 00:07:43,200 --> 00:07:47,080 Speaker 1: and women, but occurs more often in men than in women, 124 00:07:47,160 --> 00:07:49,800 Speaker 1: and it also starts later in life than O c D, 125 00:07:50,000 --> 00:07:52,080 Speaker 1: or it could just be diagnosed later in life than 126 00:07:52,120 --> 00:07:54,760 Speaker 1: O c D is. And you know, it's just another 127 00:07:54,880 --> 00:07:57,800 Speaker 1: condition that I assume I have because I turned into 128 00:07:57,840 --> 00:08:01,520 Speaker 1: a hypochondriac. Anytime you and I do a thing about mental, emotional, 129 00:08:01,680 --> 00:08:05,560 Speaker 1: physical health, and you do get very angry when I 130 00:08:05,560 --> 00:08:10,040 Speaker 1: confront of Caroline about rules about missing sandwiches. Yeah, well no, 131 00:08:10,160 --> 00:08:13,160 Speaker 1: it's it's the different O c p D. While they 132 00:08:13,160 --> 00:08:16,600 Speaker 1: still might have those obsessions, in those compulsions, like you said, 133 00:08:16,640 --> 00:08:19,280 Speaker 1: they think that they're right and that the you know, 134 00:08:19,320 --> 00:08:21,640 Speaker 1: when they I don't know, let me just pull something 135 00:08:21,640 --> 00:08:23,520 Speaker 1: out of my hat here, Like if they get mad 136 00:08:23,560 --> 00:08:28,000 Speaker 1: in traffic that people are, you know, breaking traffic rules, 137 00:08:28,200 --> 00:08:31,280 Speaker 1: then they might feel very like self righteous and like 138 00:08:31,400 --> 00:08:34,760 Speaker 1: they are correct in assuming that everybody else is driving 139 00:08:34,760 --> 00:08:38,040 Speaker 1: like a jerk and you are driving perfectly of course, 140 00:08:38,600 --> 00:08:42,760 Speaker 1: of course, and I'm smiling now. Well, we clearly need 141 00:08:42,800 --> 00:08:46,360 Speaker 1: to save O c p D and perfectionism for another podcast. 142 00:08:46,480 --> 00:08:48,800 Speaker 1: Is I think there's a lot for us to explore 143 00:08:48,840 --> 00:08:51,120 Speaker 1: their Caroline. I know I'm sensing a lot of energy 144 00:08:51,200 --> 00:08:54,719 Speaker 1: behind the um, but we really wanted to devote this 145 00:08:54,800 --> 00:08:59,240 Speaker 1: episode just to looking at obsessive compulsive disorder no p 146 00:08:59,600 --> 00:09:03,480 Speaker 1: involved all, and just for a little more insight into 147 00:09:03,840 --> 00:09:09,040 Speaker 1: how it impacts people who experience it. Dr Judith L. 148 00:09:09,200 --> 00:09:13,840 Speaker 1: Rappaport wrote in her groundbreaking study The Boy who Couldn't 149 00:09:13,880 --> 00:09:16,439 Speaker 1: Stop Washing, The Experience and Treatment of O c D, 150 00:09:17,000 --> 00:09:20,360 Speaker 1: that for people with o c D, quote, everyday life 151 00:09:20,400 --> 00:09:25,320 Speaker 1: becomes tyrannized by doubts, leading to senseless repetition and ritual 152 00:09:25,360 --> 00:09:29,640 Speaker 1: because again, there are these these obsessions and the recognition 153 00:09:29,720 --> 00:09:32,760 Speaker 1: that they are very likely illogical, and yet you are 154 00:09:32,800 --> 00:09:35,400 Speaker 1: compelled to do them over and over again. So it's 155 00:09:35,400 --> 00:09:39,280 Speaker 1: a very unpleasant, to say the least process. And so 156 00:09:39,320 --> 00:09:44,480 Speaker 1: it's for that reason, um realizing that their thoughts, compulsions 157 00:09:44,480 --> 00:09:47,240 Speaker 1: and obsessions are illogical, that people with o c D 158 00:09:47,400 --> 00:09:50,520 Speaker 1: are very effective at hiding their behavior. They don't want 159 00:09:50,520 --> 00:09:52,960 Speaker 1: to appear crazy. They already think that the thoughts that 160 00:09:52,960 --> 00:09:55,200 Speaker 1: they're experiencing are crazy, and so they don't want to 161 00:09:55,240 --> 00:09:57,800 Speaker 1: let on to others that they might be struggling with 162 00:09:57,840 --> 00:10:01,120 Speaker 1: a real, very real issue. Yeah, they might still perform 163 00:10:01,200 --> 00:10:03,960 Speaker 1: their ritually very likely or still performing their quote unquote 164 00:10:04,040 --> 00:10:08,400 Speaker 1: rituals in private, but just away from anybody actually seeing this, 165 00:10:08,840 --> 00:10:14,079 Speaker 1: unlike say something like schizophrenia, where there is no recognition 166 00:10:14,320 --> 00:10:19,280 Speaker 1: that what they're experiencing is delusion and disordered. And so 167 00:10:19,400 --> 00:10:22,960 Speaker 1: for that reason, because of the ability for people with 168 00:10:23,000 --> 00:10:27,640 Speaker 1: obsessive compulsive disorder to possibly indulge the disorder while keeping 169 00:10:27,640 --> 00:10:34,280 Speaker 1: it private, that can prolonged diagnosis and effective treatment. Yeah, 170 00:10:34,320 --> 00:10:36,640 Speaker 1: and so some of the basic symptoms. If you know 171 00:10:36,760 --> 00:10:40,559 Speaker 1: you are a hypochondriac type of individual like I am, 172 00:10:40,880 --> 00:10:43,520 Speaker 1: you might want to listen to the symptoms because o 173 00:10:43,679 --> 00:10:46,160 Speaker 1: c D is is very specific. It's not something that 174 00:10:46,160 --> 00:10:49,760 Speaker 1: can be mistaken for something else. So symptoms of c 175 00:10:49,880 --> 00:10:53,600 Speaker 1: D include repeated thoughts and images revolving around things like 176 00:10:53,640 --> 00:10:57,239 Speaker 1: a fear of germs, dirt, or intruders, acts of violence, 177 00:10:57,559 --> 00:11:02,800 Speaker 1: hurting loved ones, sexual acts, conflicts with religious beliefs, or 178 00:11:03,360 --> 00:11:07,960 Speaker 1: being overly tidy. And that's followed by here. This is 179 00:11:07,960 --> 00:11:11,560 Speaker 1: where the compulsions come in performing rituals over and over again, 180 00:11:11,559 --> 00:11:15,839 Speaker 1: such is washing hands, locking and unlocking doors, counting, keeping 181 00:11:15,920 --> 00:11:20,520 Speaker 1: unneeded items, or repeating the same same steps again and again, 182 00:11:20,600 --> 00:11:27,520 Speaker 1: which is compounded by this uncontrollability, which makes this entire 183 00:11:27,640 --> 00:11:31,359 Speaker 1: cycle often time consuming to the point of causing distress 184 00:11:31,400 --> 00:11:34,320 Speaker 1: and getting in one's way of daily life, because once 185 00:11:34,320 --> 00:11:38,599 Speaker 1: it starts, then you have to complete the entire process, 186 00:11:38,720 --> 00:11:42,760 Speaker 1: and one one action might sort of trigger another action. 187 00:11:42,960 --> 00:11:45,959 Speaker 1: It's it can often be sort of a domino effect 188 00:11:45,960 --> 00:11:47,920 Speaker 1: of all these things that you have to do, and 189 00:11:47,960 --> 00:11:51,640 Speaker 1: suddenly you're two hours late even leaving the house for 190 00:11:51,720 --> 00:11:56,680 Speaker 1: work because you have to unlock or lock or tap 191 00:11:56,840 --> 00:12:00,120 Speaker 1: or whatever it might be, wash your hands until you 192 00:12:00,160 --> 00:12:04,160 Speaker 1: feel able to relinquish it, and then go yeah. One 193 00:12:04,200 --> 00:12:07,120 Speaker 1: source we read a guy um picked up rocks and 194 00:12:07,200 --> 00:12:09,360 Speaker 1: sticks off the street because he was obsessed with the 195 00:12:09,400 --> 00:12:11,960 Speaker 1: idea that someone could hurt themselves, and so he was 196 00:12:12,000 --> 00:12:15,160 Speaker 1: constantly bending over and picking up rocks, and so in 197 00:12:15,200 --> 00:12:17,600 Speaker 1: that behavior, it's almost like, Okay, if I'm just passing 198 00:12:17,600 --> 00:12:19,640 Speaker 1: by a guy who's like bending down and picking something 199 00:12:19,679 --> 00:12:21,559 Speaker 1: up off the street, I'm not going to think that's strange. 200 00:12:21,559 --> 00:12:23,600 Speaker 1: But he said that eventually got to the point where 201 00:12:23,640 --> 00:12:25,360 Speaker 1: because he was doing it every day, you know, kids 202 00:12:25,360 --> 00:12:27,240 Speaker 1: on the street, you're watching him going like, why is 203 00:12:27,280 --> 00:12:30,120 Speaker 1: that guy picking up every single rock? And he would 204 00:12:30,200 --> 00:12:34,360 Speaker 1: try to try to exercise a degree of willpower and 205 00:12:34,360 --> 00:12:36,320 Speaker 1: just say no, I'm just gonna keep walking. But he 206 00:12:36,360 --> 00:12:39,080 Speaker 1: would literally double back and walk back almost a mile 207 00:12:39,240 --> 00:12:42,040 Speaker 1: sometimes to go pick up that rock that was in 208 00:12:42,080 --> 00:12:45,439 Speaker 1: the street. And so these things, these aren't just like oh, 209 00:12:45,480 --> 00:12:47,960 Speaker 1: I'm just gonna go check the iron one more time 210 00:12:47,960 --> 00:12:49,440 Speaker 1: to make sure I turn it off, or just go 211 00:12:49,559 --> 00:12:51,840 Speaker 1: make sure that I unplugged the whatever thing to make 212 00:12:51,840 --> 00:12:54,319 Speaker 1: sure it doesn't burn the house down. This is stuff 213 00:12:54,360 --> 00:12:58,000 Speaker 1: that really does interfere with your daily life, and it 214 00:12:58,120 --> 00:13:02,520 Speaker 1: has a high comorbidity with things like depression, social phobias, 215 00:13:02,559 --> 00:13:06,720 Speaker 1: and eating disorders, even Tourette syndrome and other conditions like that. 216 00:13:07,200 --> 00:13:11,000 Speaker 1: And there's no real gender difference though in whether or 217 00:13:11,040 --> 00:13:14,800 Speaker 1: how many comorbid conditions a person with o c D has. 218 00:13:15,440 --> 00:13:17,560 Speaker 1: We also read that there was a slightly elevated risk 219 00:13:17,679 --> 00:13:23,040 Speaker 1: for body dysmorphic disorder, hypochondria, and alcohol abuse. And so 220 00:13:23,200 --> 00:13:26,199 Speaker 1: as a result of all of this, study in the 221 00:13:26,280 --> 00:13:30,880 Speaker 1: Journal Molecular Psychiatry found that sixty of people with moderate 222 00:13:30,880 --> 00:13:33,600 Speaker 1: O c D and eight percent of people with severe 223 00:13:33,600 --> 00:13:38,360 Speaker 1: O c D experienced severe impairment with relationships, work, home life, 224 00:13:38,440 --> 00:13:44,560 Speaker 1: and social life. So my appreciation for an orderly dishwasher 225 00:13:44,840 --> 00:13:49,640 Speaker 1: loading process is something very finite. I get my dish 226 00:13:49,720 --> 00:13:52,200 Speaker 1: washer in one particular way, and then I'm done. But 227 00:13:52,280 --> 00:13:56,040 Speaker 1: if say I have to arrange and rearrange those dishes 228 00:13:56,160 --> 00:13:58,480 Speaker 1: over and over and over again and move the cups 229 00:13:58,480 --> 00:14:01,000 Speaker 1: all around in a certain way, that taking up so 230 00:14:01,200 --> 00:14:04,960 Speaker 1: much time and never allowing me to ever just leave 231 00:14:05,000 --> 00:14:08,520 Speaker 1: it be, and then impacting my personal life in that way. 232 00:14:08,800 --> 00:14:11,960 Speaker 1: Just as one example that that's the difference between me 233 00:14:12,120 --> 00:14:15,640 Speaker 1: just enjoying something in a particular kind of way versus 234 00:14:15,720 --> 00:14:19,440 Speaker 1: an actual disordered behavior. Yeah, and it would also it 235 00:14:19,480 --> 00:14:22,760 Speaker 1: also might be tied to almost a superstitious belief that 236 00:14:22,800 --> 00:14:24,960 Speaker 1: what you're doing has an effect on something else in 237 00:14:24,960 --> 00:14:27,200 Speaker 1: the universe. I don't know if you ever watched I 238 00:14:27,200 --> 00:14:31,320 Speaker 1: think it was MTVS. True Life series. Oh yes, of course, 239 00:14:31,360 --> 00:14:33,840 Speaker 1: but there was one featuring a young woman with O 240 00:14:34,000 --> 00:14:38,040 Speaker 1: c D and her compulsion was to turn light switches 241 00:14:38,520 --> 00:14:41,080 Speaker 1: so that they all pointed up because her mother was 242 00:14:41,200 --> 00:14:45,040 Speaker 1: very ill, and she had sort of developed this obsessive 243 00:14:45,240 --> 00:14:49,400 Speaker 1: compulsion and this behavior because she was convinced that, Okay, 244 00:14:49,440 --> 00:14:52,280 Speaker 1: if I just do this, then that is somehow going 245 00:14:52,320 --> 00:14:56,480 Speaker 1: to control my mother's health, and that if if I 246 00:14:56,560 --> 00:14:59,560 Speaker 1: fail at my compulsion, if I leave the light switches 247 00:14:59,600 --> 00:15:03,640 Speaker 1: pointing down, then she's going to get sick. And I 248 00:15:03,640 --> 00:15:06,320 Speaker 1: watched that exact exact episode of Carolina. I know exactly 249 00:15:06,360 --> 00:15:09,200 Speaker 1: what you're talking about, And I mean it might seem 250 00:15:09,280 --> 00:15:12,560 Speaker 1: so ridiculous of like, well, of course a light switch 251 00:15:12,600 --> 00:15:17,560 Speaker 1: isn't going to negatively impact your mother's health. But one 252 00:15:17,640 --> 00:15:20,760 Speaker 1: day if you don't do that and then something happens, 253 00:15:20,760 --> 00:15:24,240 Speaker 1: of course they're unrelated, but why would you ever take 254 00:15:24,320 --> 00:15:27,080 Speaker 1: the chance. That's a kind of you know, the sort 255 00:15:27,120 --> 00:15:29,440 Speaker 1: of thinking, that tug of war again between the logical 256 00:15:29,480 --> 00:15:32,680 Speaker 1: and illogical in your brain that makes this so I'm 257 00:15:32,680 --> 00:15:36,400 Speaker 1: almost addictive in the behavioral pattern. Yeah, exactly. And so 258 00:15:36,600 --> 00:15:40,120 Speaker 1: when does o c D surface? When is it diagnosed? Well, 259 00:15:40,120 --> 00:15:44,360 Speaker 1: it usually emerges during childhood or adolescents, but the average 260 00:15:44,400 --> 00:15:48,160 Speaker 1: age of diagnosis isn't until nineteen And there was a 261 00:15:48,160 --> 00:15:50,280 Speaker 1: two thousand four paper in the New England Journal of 262 00:15:50,360 --> 00:15:54,160 Speaker 1: Medicine that found that there is a seventeen year average 263 00:15:54,240 --> 00:15:59,240 Speaker 1: gap between the onset of symptoms and the diagnosis. But 264 00:16:00,000 --> 00:16:04,920 Speaker 1: hopefully that gap has actually narrowed in the past eleven years. 265 00:16:04,960 --> 00:16:07,640 Speaker 1: But there again, I mean, there hasn't been a ton 266 00:16:07,720 --> 00:16:11,480 Speaker 1: of research pointing to whether that's true. And Dr Christopher Pittinger, 267 00:16:11,480 --> 00:16:14,000 Speaker 1: who's the director of the Yale O c D Research Clinic, 268 00:16:14,800 --> 00:16:20,160 Speaker 1: is really invested in narrowing that gap because he points 269 00:16:20,160 --> 00:16:23,160 Speaker 1: out that it affects a lot more people than we 270 00:16:23,280 --> 00:16:26,720 Speaker 1: might realize. He points to a two thousand twelve study 271 00:16:26,720 --> 00:16:30,160 Speaker 1: which found one point two percent of the population have 272 00:16:30,320 --> 00:16:33,120 Speaker 1: o c D in any given year, and that rises 273 00:16:33,200 --> 00:16:37,240 Speaker 1: to a two point seven percent lifetime prevalence rate, which 274 00:16:37,600 --> 00:16:42,000 Speaker 1: translates to one and forty people or eight million Americans 275 00:16:42,320 --> 00:16:47,480 Speaker 1: and around one hundred seventies six million people worldwide. And 276 00:16:47,600 --> 00:16:51,560 Speaker 1: the individual symptoms are even more common. Yeah, And it's 277 00:16:51,600 --> 00:16:55,040 Speaker 1: interesting when you look at country by country breakdowns of 278 00:16:55,080 --> 00:16:59,880 Speaker 1: how many people experience o c D. The percentages are different, 279 00:17:00,360 --> 00:17:06,359 Speaker 1: reports of of Europeans experiencing symptoms up to of Americans 280 00:17:07,520 --> 00:17:11,640 Speaker 1: of Swiss citizens. But the whole thing there is that 281 00:17:12,040 --> 00:17:14,560 Speaker 1: people are defining o c D and o c D 282 00:17:14,680 --> 00:17:18,560 Speaker 1: symptoms and the threshold for being diagnosed in different ways. 283 00:17:18,640 --> 00:17:21,760 Speaker 1: And so it would be interesting to see if everybody 284 00:17:21,800 --> 00:17:25,360 Speaker 1: had across the globe a standard definition and a standard threshold, 285 00:17:25,400 --> 00:17:29,160 Speaker 1: what those numbers would do. And he emphasizes Dr Pittinger 286 00:17:29,560 --> 00:17:33,480 Speaker 1: that o c D is far more common than schizophrenia 287 00:17:33,600 --> 00:17:36,560 Speaker 1: and bipolar one disorder, which effect around one percent of 288 00:17:36,560 --> 00:17:41,439 Speaker 1: the population. But that also gets back to that quote 289 00:17:41,480 --> 00:17:45,399 Speaker 1: from Dr Gerald Nostal to Newsweek magazine saying that o 290 00:17:45,560 --> 00:17:48,080 Speaker 1: c D has never had this quote unquote sexy appeal 291 00:17:48,480 --> 00:17:51,640 Speaker 1: of other psychiatric disorders. And then that also relates as 292 00:17:51,640 --> 00:17:55,600 Speaker 1: well to the ability of people with o c D 293 00:17:56,000 --> 00:18:01,520 Speaker 1: to mask their o c D to possibly delay getting treatment. Yeah, 294 00:18:01,520 --> 00:18:04,920 Speaker 1: and back in the World Health Organization identified o c 295 00:18:05,080 --> 00:18:08,760 Speaker 1: D a is one of the top twenty global sources 296 00:18:08,800 --> 00:18:12,280 Speaker 1: of disability, and that's that number has since dropped due 297 00:18:12,320 --> 00:18:15,760 Speaker 1: to some methodological tweaks in the research. But I mean, 298 00:18:15,800 --> 00:18:18,240 Speaker 1: that's that's a huge deal because people, like we said, 299 00:18:18,280 --> 00:18:22,160 Speaker 1: people with o c D have a really high unemployment rate. 300 00:18:22,200 --> 00:18:25,600 Speaker 1: These people are not unaffected. Just because they can mask 301 00:18:25,720 --> 00:18:30,200 Speaker 1: their symptoms from day to day doesn't mean it's not debilitating. Now, 302 00:18:30,240 --> 00:18:33,399 Speaker 1: what about the gender, Because of course, if we're talking 303 00:18:33,440 --> 00:18:36,040 Speaker 1: about something on stuff I've never told you, we have 304 00:18:36,160 --> 00:18:40,040 Speaker 1: to unpack the gender differences. So before I started researching 305 00:18:40,200 --> 00:18:43,679 Speaker 1: for this episode, I had assume that we were going 306 00:18:43,720 --> 00:18:47,640 Speaker 1: to find that O c D tends to lean more women, 307 00:18:48,160 --> 00:18:50,840 Speaker 1: possibly because a lot of the O c D jokes, 308 00:18:50,880 --> 00:18:54,440 Speaker 1: whether self inflicted or jokes about other people having O 309 00:18:54,600 --> 00:18:58,280 Speaker 1: c D, seem to be more lady directed, maybe because 310 00:18:58,280 --> 00:19:00,639 Speaker 1: we are likelier to be loading the dish washer or 311 00:19:00,720 --> 00:19:06,320 Speaker 1: organizing our bookshelves and closets, whatever. But it turns out 312 00:19:06,359 --> 00:19:08,159 Speaker 1: that in the real world, away from all of our 313 00:19:08,200 --> 00:19:11,920 Speaker 1: casual jokes, it seems to affect men and women equally, 314 00:19:11,960 --> 00:19:14,960 Speaker 1: although there is some nuance within there. Yeah, and we 315 00:19:15,000 --> 00:19:17,000 Speaker 1: are going to get into that nuance. And we come 316 00:19:17,119 --> 00:19:28,360 Speaker 1: right back from a quick break. In the first half 317 00:19:28,359 --> 00:19:31,160 Speaker 1: of the podcast, we were defining a c D, giving 318 00:19:31,160 --> 00:19:32,800 Speaker 1: a bit of a history, and we were about to 319 00:19:32,840 --> 00:19:37,480 Speaker 1: dive into the gender differences. And as Kristen was saying, 320 00:19:38,400 --> 00:19:43,520 Speaker 1: there's not a huge gender difference, but some researchers have 321 00:19:43,600 --> 00:19:47,640 Speaker 1: found that there is a slightly earlier onset among boys. 322 00:19:47,920 --> 00:19:51,439 Speaker 1: One nine study, for instance, found that it's diagnosed in 323 00:19:51,520 --> 00:19:56,080 Speaker 1: boys around age nine and a half versus age eleven 324 00:19:56,080 --> 00:19:59,840 Speaker 1: in girls. But the thing is depending on the study 325 00:20:00,000 --> 00:20:03,720 Speaker 1: and depending on the methodology. Other researchers have found either 326 00:20:03,800 --> 00:20:06,879 Speaker 1: that there's no significant difference between onset and boys and 327 00:20:06,920 --> 00:20:10,520 Speaker 1: girls at all, or that it actually shows up earlier 328 00:20:10,560 --> 00:20:13,280 Speaker 1: in girls and women than it does in boys and men. 329 00:20:13,480 --> 00:20:17,280 Speaker 1: So what is going on there? Well, I wonder when 330 00:20:17,280 --> 00:20:22,000 Speaker 1: it comes to the diagnosis, if boys might be likelier 331 00:20:22,080 --> 00:20:25,639 Speaker 1: to receive an earlier diagnosis. Do a little bit to 332 00:20:25,760 --> 00:20:30,080 Speaker 1: gender stereotyping and socialization, because perhaps some of the most 333 00:20:30,280 --> 00:20:32,760 Speaker 1: visible symptoms of o c D might stand out more 334 00:20:33,400 --> 00:20:36,560 Speaker 1: in a little boy because it doesn't seem like little 335 00:20:36,560 --> 00:20:42,120 Speaker 1: boyish type of behavior to perhaps be washing his hands compulsively, 336 00:20:42,119 --> 00:20:45,600 Speaker 1: because we associate cleanliness and things like that more with 337 00:20:45,720 --> 00:20:49,160 Speaker 1: little girls. So the little girl is washing her hands 338 00:20:49,160 --> 00:20:52,639 Speaker 1: a lot. For instance, one of my sisters as a child, 339 00:20:52,680 --> 00:20:55,480 Speaker 1: and still to this day, I don't want to say 340 00:20:55,480 --> 00:20:57,920 Speaker 1: obsessively at this point, now that I understand o c D, 341 00:20:58,200 --> 00:21:00,600 Speaker 1: she didn't obsessively wash her hands, but she was very 342 00:21:00,680 --> 00:21:04,280 Speaker 1: concerned about having clean hands. And I don't think it 343 00:21:04,359 --> 00:21:07,399 Speaker 1: ever struck my parents as strange because she was just 344 00:21:07,520 --> 00:21:09,399 Speaker 1: a you know, a clean minded little girl. But I 345 00:21:09,440 --> 00:21:11,680 Speaker 1: think if one of my brothers had done it, it 346 00:21:11,720 --> 00:21:14,159 Speaker 1: would have raised more of an eyebrow. Yeah. I have 347 00:21:14,280 --> 00:21:17,560 Speaker 1: a friend with a little boy who is three or 348 00:21:17,880 --> 00:21:21,119 Speaker 1: four now, and from the time that he was very little, 349 00:21:21,160 --> 00:21:24,800 Speaker 1: like very very toddler, first learning to walk, he was 350 00:21:24,880 --> 00:21:28,159 Speaker 1: already exhibiting in her mind. I haven't witnessed it, but 351 00:21:28,240 --> 00:21:33,000 Speaker 1: in her mind o c D behavior, because he was 352 00:21:33,160 --> 00:21:36,119 Speaker 1: very obsessed from the earliest age, even before he could 353 00:21:36,359 --> 00:21:39,600 Speaker 1: say a full sentence, with making sure his toys were 354 00:21:39,600 --> 00:21:42,320 Speaker 1: in a very specific place, in a very specific order, 355 00:21:42,680 --> 00:21:45,720 Speaker 1: making sure that there was nothing on the floor, picking 356 00:21:45,800 --> 00:21:49,719 Speaker 1: up after himself. And so whether that does develop into 357 00:21:49,920 --> 00:21:53,560 Speaker 1: actual and actual o c D diagnosis will wait and see. 358 00:21:54,119 --> 00:21:58,240 Speaker 1: But she was definitely this is her firstborn, firstborn child, 359 00:21:58,600 --> 00:22:01,520 Speaker 1: oh boy, and here he is obsessed with cleanliness in 360 00:22:01,600 --> 00:22:04,840 Speaker 1: order to the point where he's pointing at his mother 361 00:22:05,040 --> 00:22:08,080 Speaker 1: to like pick stuff up and and clean stuff. I 362 00:22:08,080 --> 00:22:11,680 Speaker 1: mean to me, honestly, Caroline, a child at that age 363 00:22:11,720 --> 00:22:13,879 Speaker 1: that picks up after him or herself just sounds like 364 00:22:13,880 --> 00:22:16,080 Speaker 1: a dream, sounds like a total And that's what I 365 00:22:16,080 --> 00:22:17,359 Speaker 1: said to her. I was like, I don't think I 366 00:22:17,400 --> 00:22:21,359 Speaker 1: would worry about it yet. But my niece, one of 367 00:22:21,359 --> 00:22:24,640 Speaker 1: my nieces, one of my many nieces, did a similar thing. 368 00:22:24,960 --> 00:22:28,960 Speaker 1: She was very she's very interested in order, in lining 369 00:22:29,080 --> 00:22:31,199 Speaker 1: her toys up, especially when she was younger, in a 370 00:22:31,240 --> 00:22:36,160 Speaker 1: similar kind of way. But my sister never batted an eyelash. Again, 371 00:22:36,200 --> 00:22:39,160 Speaker 1: though I wonder if my niece were a nephew, if 372 00:22:39,240 --> 00:22:41,840 Speaker 1: maybe she would have been a little more nervous about 373 00:22:41,840 --> 00:22:43,840 Speaker 1: that behavior. But again, all I'm saying is a self 374 00:22:43,880 --> 00:22:48,760 Speaker 1: cleaning child, like a self cleaning imperfect. Does he change 375 00:22:48,760 --> 00:22:53,679 Speaker 1: his own diapert done? Perfect? Sign me up. But where 376 00:22:54,080 --> 00:22:58,520 Speaker 1: gender differences have been uncovered is in the way that 377 00:22:58,720 --> 00:23:02,320 Speaker 1: some of these behaviors and compulsions manifest themselves. And there 378 00:23:02,359 --> 00:23:05,679 Speaker 1: was a twenty eleven literature review on some of the 379 00:23:05,760 --> 00:23:12,879 Speaker 1: symptomatic distinctions, with male patients experiencing more social impairment, sexual, religious, 380 00:23:12,920 --> 00:23:17,680 Speaker 1: and aggressive symptoms, and co morbidity with ticks and substance abuse, 381 00:23:18,160 --> 00:23:21,760 Speaker 1: while female patients they found were likelier to have cleaning 382 00:23:21,800 --> 00:23:25,800 Speaker 1: and contamination obsessions and co morbidity with eating disorders and 383 00:23:25,920 --> 00:23:29,240 Speaker 1: impulse control disorders. And one of the things that uh, 384 00:23:29,280 --> 00:23:33,240 Speaker 1: this made me stop in wonder was you know, are 385 00:23:33,280 --> 00:23:39,520 Speaker 1: are these things manifesting along very gendery norm e uh lines, 386 00:23:39,720 --> 00:23:42,800 Speaker 1: Because like you said when we were talking about the kids, Kristen, 387 00:23:43,080 --> 00:23:46,040 Speaker 1: you know, girls are expected to be more clean and 388 00:23:46,040 --> 00:23:50,800 Speaker 1: well behaved and neat um and when people express anger, 389 00:23:51,240 --> 00:23:54,520 Speaker 1: masculine people are expected to be more you know, out 390 00:23:54,560 --> 00:23:58,199 Speaker 1: there with their anger, more physical and violent, and so 391 00:23:59,000 --> 00:24:01,359 Speaker 1: you know, and we also hear our reports of eating disorders, 392 00:24:01,359 --> 00:24:03,400 Speaker 1: typically in the media and wherever we hear more eating 393 00:24:03,400 --> 00:24:07,200 Speaker 1: disorder reports among women and girls. And so it's interesting 394 00:24:07,280 --> 00:24:11,200 Speaker 1: that these obsessions and compulsive compulsions in this behavior would 395 00:24:11,240 --> 00:24:15,200 Speaker 1: sort of emerge and blossom along these what we would 396 00:24:15,240 --> 00:24:18,199 Speaker 1: kind of consider gender norm e lines. Yeah. Well, and 397 00:24:18,640 --> 00:24:23,240 Speaker 1: unpacking all of that and figuring out where perhaps the 398 00:24:23,640 --> 00:24:28,920 Speaker 1: neurology meets the sociology is what a lot of doctors 399 00:24:29,000 --> 00:24:33,440 Speaker 1: today are trying to figure out. Because we have these 400 00:24:33,600 --> 00:24:35,760 Speaker 1: we have these symptoms that we can see and we 401 00:24:35,800 --> 00:24:40,600 Speaker 1: can identify in terms of say a cleaning or contamination, obsession, 402 00:24:41,160 --> 00:24:45,560 Speaker 1: or social impairment. But where does that route back to 403 00:24:46,040 --> 00:24:49,760 Speaker 1: stripping away the gender? If we look into biology, delving 404 00:24:49,800 --> 00:24:54,880 Speaker 1: into our brains, why is this happening? And there does 405 00:24:54,960 --> 00:24:58,680 Speaker 1: appear to be a genetic link, although the jury is 406 00:24:58,720 --> 00:25:02,320 Speaker 1: still out on exactly what it is. Um Earlier in 407 00:25:02,359 --> 00:25:07,240 Speaker 1: the podcast, we quoted JOHNS. Hopkins researcher Dr Gerald the Stalt, 408 00:25:07,720 --> 00:25:12,200 Speaker 1: who helped identify a genetic marker called protein tyro scene 409 00:25:12,400 --> 00:25:15,399 Speaker 1: phospholk and nase that seems to be associated with O 410 00:25:15,600 --> 00:25:20,119 Speaker 1: c D. So they're thinking there is probably a hereditary link. 411 00:25:20,440 --> 00:25:22,320 Speaker 1: That makes sense, or it makes sense to me and 412 00:25:22,400 --> 00:25:25,600 Speaker 1: my completely non scientific line of work. Well, and I'm 413 00:25:25,640 --> 00:25:28,399 Speaker 1: trying to remember, Caroline, whether we ran across any twins 414 00:25:28,480 --> 00:25:31,520 Speaker 1: studies on O c D because a lot of times 415 00:25:31,520 --> 00:25:34,600 Speaker 1: when we're trying to figure out whether something is hereditary, 416 00:25:34,640 --> 00:25:37,040 Speaker 1: you get a bunch of twins together and say who 417 00:25:37,119 --> 00:25:41,400 Speaker 1: has what? How does this happen? But again, the research 418 00:25:41,680 --> 00:25:46,199 Speaker 1: on all of this is still in a surprisingly like 419 00:25:46,280 --> 00:25:50,480 Speaker 1: elementary phase. Yeah, you would think, but I mean we 420 00:25:50,560 --> 00:25:52,760 Speaker 1: run across that and so many of the health episodes 421 00:25:52,800 --> 00:25:55,879 Speaker 1: we do that you would think that by now people 422 00:25:55,920 --> 00:25:58,000 Speaker 1: would know more, but you know, there's only so much 423 00:25:58,040 --> 00:26:03,040 Speaker 1: funding out there. Well, brain scans have shown that okay, 424 00:26:03,080 --> 00:26:05,440 Speaker 1: we might have this genetic link, but there does seem 425 00:26:05,480 --> 00:26:09,560 Speaker 1: to be a brain difference in someone with O c 426 00:26:09,640 --> 00:26:13,240 Speaker 1: D versus someone without o c D, which isn't surprising 427 00:26:13,400 --> 00:26:16,760 Speaker 1: considering again, this like tug of war, as we've termed 428 00:26:16,800 --> 00:26:20,959 Speaker 1: it between logical and illogical, this compulsion thinking about um 429 00:26:21,440 --> 00:26:26,640 Speaker 1: our brains with impulsivity and those kinds of behaviors. So 430 00:26:28,000 --> 00:26:32,159 Speaker 1: some medical researchers have highlighted a hyper connectivity between the 431 00:26:32,280 --> 00:26:35,480 Speaker 1: orbitofrontal cortex and the caught it nucleus. Caroline, can you 432 00:26:35,520 --> 00:26:39,439 Speaker 1: put that in plain English? Well, the orbitofrontal cortex is 433 00:26:39,440 --> 00:26:41,840 Speaker 1: the part of the brain that's involved in decision making, 434 00:26:42,320 --> 00:26:45,920 Speaker 1: and the caught it nucleus is part of the basil ganglia, 435 00:26:46,000 --> 00:26:50,080 Speaker 1: and it's responsible for voluntary movement. So you've got that 436 00:26:50,160 --> 00:26:55,159 Speaker 1: decision making linking up with movement, and this in turn 437 00:26:55,320 --> 00:27:00,520 Speaker 1: creates this irrational fear and response cycle and other brain 438 00:27:00,560 --> 00:27:03,440 Speaker 1: regions to have also been implicated, but it could also 439 00:27:03,520 --> 00:27:08,240 Speaker 1: be related to a disregulation of dopamine or serotonin. But 440 00:27:08,840 --> 00:27:12,359 Speaker 1: as Christopher Pittinger, that Yale O c D Research Clinic 441 00:27:12,480 --> 00:27:15,679 Speaker 1: heads says, the fact is the vast majority of the 442 00:27:15,680 --> 00:27:17,960 Speaker 1: time a brain scan and someone with O c D 443 00:27:18,480 --> 00:27:25,640 Speaker 1: looks completely normal. What Pittinger add another wrinkle to this mystery. Yeah, 444 00:27:25,720 --> 00:27:29,960 Speaker 1: he says that brain imaging hasn't obviously lead to a 445 00:27:30,080 --> 00:27:34,399 Speaker 1: cure because there isn't one there. There isn't an o 446 00:27:34,560 --> 00:27:38,080 Speaker 1: c D brain essentially, is what he's saying. Yeah, but 447 00:27:38,240 --> 00:27:41,199 Speaker 1: when we were reading these sources about brain imaging and 448 00:27:41,280 --> 00:27:44,000 Speaker 1: scans of people with o c D versus people without 449 00:27:44,000 --> 00:27:47,880 Speaker 1: o c D, they did include scans that showed some 450 00:27:47,960 --> 00:27:52,240 Speaker 1: o c D patients do have way more brain activity 451 00:27:52,280 --> 00:27:55,119 Speaker 1: in those regions that we mentioned than someone without. And 452 00:27:55,160 --> 00:27:58,280 Speaker 1: so it's not that there's never an indication on a 453 00:27:58,280 --> 00:28:02,360 Speaker 1: brain scan. It's just that sometimes there's not. Yeah, it's 454 00:28:02,359 --> 00:28:05,960 Speaker 1: not it's not consistent across the board. But that doesn't 455 00:28:05,960 --> 00:28:09,399 Speaker 1: mean that treatments don't exist, although Pitton, Jur and others 456 00:28:09,440 --> 00:28:13,640 Speaker 1: point out that existing options aren't terribly effective, especially when 457 00:28:13,640 --> 00:28:17,800 Speaker 1: it comes to medication, because current medications work for only 458 00:28:17,920 --> 00:28:22,920 Speaker 1: sixty to seventy of cases. Plus, The New York Times 459 00:28:22,920 --> 00:28:26,359 Speaker 1: reported that only one third of patients with o c 460 00:28:26,520 --> 00:28:30,920 Speaker 1: D even receive any appropriate pharmacotherapy, and fewer than ten 461 00:28:31,040 --> 00:28:34,960 Speaker 1: per cent RESI receive any kind of evidence based psychotherapy 462 00:28:35,080 --> 00:28:40,000 Speaker 1: such as um exposure therapy and effective therapy. A lot 463 00:28:40,040 --> 00:28:48,040 Speaker 1: of times is derailed because of misdiagnosis of depression or anxiety, 464 00:28:48,120 --> 00:28:52,120 Speaker 1: which might accompany o c D. But treating depression anxiety 465 00:28:52,160 --> 00:28:54,760 Speaker 1: is not the same as treating o c D. So 466 00:28:55,400 --> 00:28:58,840 Speaker 1: I mean, again, this points to that average seventeen year 467 00:28:58,920 --> 00:29:01,760 Speaker 1: gap that was indicated in that two thousand four study 468 00:29:01,800 --> 00:29:06,840 Speaker 1: between the onset of symptoms and actually getting a diagnosis. Well, also, 469 00:29:06,880 --> 00:29:08,880 Speaker 1: it makes sense if you have someone who is aware 470 00:29:08,960 --> 00:29:11,520 Speaker 1: that some of the the intrusive thoughts that they're experiencing 471 00:29:11,600 --> 00:29:15,320 Speaker 1: might be quote unquote crazy. Um, maybe they will just 472 00:29:15,360 --> 00:29:17,040 Speaker 1: go to their doctor and say, hey, you know, I'm 473 00:29:17,080 --> 00:29:20,400 Speaker 1: feeling really anxious, or I'm feeling really depressed, or something's 474 00:29:20,480 --> 00:29:23,720 Speaker 1: off or not right. You know, I've talked about on 475 00:29:23,760 --> 00:29:26,920 Speaker 1: the podcast before talking to my doctor about anxiety I 476 00:29:26,960 --> 00:29:29,360 Speaker 1: was experiencing and how quick she was to be like, oh, well, 477 00:29:29,400 --> 00:29:32,600 Speaker 1: here's an anti anxiety prescription. It's like whoa, whoa. You know, 478 00:29:32,680 --> 00:29:34,680 Speaker 1: I didn't take it because it's like, let's figure out 479 00:29:35,360 --> 00:29:38,680 Speaker 1: what's actually going on before I just start taking anxiety medication. 480 00:29:38,720 --> 00:29:41,400 Speaker 1: And so I can see how that could happen very easily, 481 00:29:41,440 --> 00:29:45,080 Speaker 1: where if someone maybe doesn't tell their doctor about the 482 00:29:45,120 --> 00:29:50,720 Speaker 1: intrusive thoughts or the obsessive behavior and they just complain 483 00:29:50,760 --> 00:29:53,720 Speaker 1: about a certain aspect of what's going on with them 484 00:29:54,120 --> 00:29:57,880 Speaker 1: that they could end up misdiagnosed or taking the wrong medicine. Yeah, 485 00:29:57,880 --> 00:29:59,840 Speaker 1: if you say I have a hard time forming and 486 00:30:00,000 --> 00:30:03,680 Speaker 1: intaining relationships and leaving my house, well here you go, 487 00:30:03,880 --> 00:30:08,520 Speaker 1: here's some zolof like some kind of antidepressant. And in fact, 488 00:30:09,080 --> 00:30:13,960 Speaker 1: SSR EYES combined with exposure therapy is one of the 489 00:30:13,960 --> 00:30:17,840 Speaker 1: most common treatment combinations, and exposure therapy is pretty much 490 00:30:17,840 --> 00:30:22,480 Speaker 1: what it sounds like. You gradually expose the patient to 491 00:30:23,880 --> 00:30:31,760 Speaker 1: the compulsive trigger to sort of break down the that 492 00:30:31,760 --> 00:30:34,400 Speaker 1: that logic barrier, to let them know that Okay, if 493 00:30:34,440 --> 00:30:37,600 Speaker 1: you flip the light switch, it isn't in fact going 494 00:30:37,680 --> 00:30:40,080 Speaker 1: to set off this chain of events. So, for instance, 495 00:30:40,080 --> 00:30:42,800 Speaker 1: with that that girl in the MTV show that Caroline 496 00:30:42,800 --> 00:30:46,680 Speaker 1: and I both watched probably in our early college days. Uh, 497 00:30:46,680 --> 00:30:49,920 Speaker 1: an exposure therapy might be having her leave her house 498 00:30:50,440 --> 00:30:54,560 Speaker 1: with maybe one to start off with light switch flipped 499 00:30:54,600 --> 00:30:58,080 Speaker 1: down rather than up, and just seeing what happens throughout 500 00:30:58,160 --> 00:31:00,240 Speaker 1: the day and whether it in fact changes any thing. 501 00:31:01,040 --> 00:31:04,640 Speaker 1: And one controversial figure in the treatment of o c 502 00:31:04,880 --> 00:31:07,600 Speaker 1: D is Dr Jeffrey Schwartz at U c L A 503 00:31:08,320 --> 00:31:14,840 Speaker 1: who relies on a trick called mindfulness meditation. He wants 504 00:31:14,880 --> 00:31:18,800 Speaker 1: to harness the brains neuroplasticity to allow patients to quote 505 00:31:18,840 --> 00:31:21,560 Speaker 1: rewire their thought patterns. And this is coming from an 506 00:31:21,600 --> 00:31:25,280 Speaker 1: article and Discover magazine that I thought was fascinating. And 507 00:31:25,920 --> 00:31:28,200 Speaker 1: so he has this group of people with O c 508 00:31:28,400 --> 00:31:33,200 Speaker 1: D who have suffered varying levels of obsessive and compulsive 509 00:31:33,240 --> 00:31:36,960 Speaker 1: thoughts and behaviors for years, to the point of hopelessness 510 00:31:37,120 --> 00:31:39,680 Speaker 1: of my life is never going to change. This is terrible. 511 00:31:39,720 --> 00:31:42,120 Speaker 1: I can barely make it through the day. Um, A 512 00:31:42,160 --> 00:31:44,880 Speaker 1: lot of people came to him with suicidal thoughts and 513 00:31:44,920 --> 00:31:48,840 Speaker 1: tendencies as a last resort. What do I do? And 514 00:31:48,960 --> 00:31:52,560 Speaker 1: so what he basically has them do is sort of 515 00:31:52,880 --> 00:31:56,600 Speaker 1: what practitioners of meditation in general tell you to do, 516 00:31:56,680 --> 00:32:00,960 Speaker 1: which is recognize the thoughts as they come to hold them, 517 00:32:01,160 --> 00:32:06,520 Speaker 1: examine them except that they are quote unquote trash thoughts basically, 518 00:32:06,600 --> 00:32:09,200 Speaker 1: and then sort of throw them away. And I mean, 519 00:32:09,200 --> 00:32:13,520 Speaker 1: I'm greatly simplifying his whole process, but it involves, you know, 520 00:32:13,600 --> 00:32:17,720 Speaker 1: realizing that these thoughts are junk, that they don't actually 521 00:32:17,760 --> 00:32:21,960 Speaker 1: affect your life. And that you have power over them, 522 00:32:21,960 --> 00:32:23,680 Speaker 1: and that seems like, oh my god, how do I 523 00:32:23,720 --> 00:32:26,120 Speaker 1: have power over them? I can barely, you know, make 524 00:32:26,120 --> 00:32:28,160 Speaker 1: it through the day without doing whatever ritual it is 525 00:32:28,200 --> 00:32:32,280 Speaker 1: I have to do um. But once he sort of 526 00:32:32,360 --> 00:32:35,920 Speaker 1: informed people that you've got to tell yourself that this 527 00:32:36,000 --> 00:32:38,560 Speaker 1: is the O c D. This is the disorder making 528 00:32:38,600 --> 00:32:41,160 Speaker 1: you do this. This isn't you actually wanting to wash 529 00:32:41,240 --> 00:32:44,520 Speaker 1: your hands fifty times or flip the light switch fifty times. 530 00:32:44,720 --> 00:32:46,760 Speaker 1: This is the O c D telling you to do 531 00:32:46,840 --> 00:32:49,600 Speaker 1: something that you don't actually want to do, because again, 532 00:32:49,840 --> 00:32:52,280 Speaker 1: these are behaviors and rituals that people don't get joy 533 00:32:52,320 --> 00:32:54,360 Speaker 1: out of. It's not like telling someone who loves to 534 00:32:54,440 --> 00:32:56,720 Speaker 1: organize the dishwasher, you've got to stop doing it because 535 00:32:56,720 --> 00:33:00,000 Speaker 1: they won't want to. These are people who are few 536 00:33:00,160 --> 00:33:04,600 Speaker 1: absolutely overwhelmingly controlled by rituals that they do not want 537 00:33:04,640 --> 00:33:09,160 Speaker 1: to participate in anymore. And so over time he not 538 00:33:09,320 --> 00:33:13,760 Speaker 1: only watched as these people sort of took control over 539 00:33:13,800 --> 00:33:15,760 Speaker 1: their lives, but at the end of the session I 540 00:33:15,800 --> 00:33:18,480 Speaker 1: think it was like ten weeks, he did another brain 541 00:33:18,600 --> 00:33:21,840 Speaker 1: scan and the the areas in the brain where people 542 00:33:21,880 --> 00:33:24,560 Speaker 1: had shown a lot of activity because of their I 543 00:33:24,680 --> 00:33:27,680 Speaker 1: c D. It suddenly was just like a flicker as 544 00:33:27,680 --> 00:33:31,480 Speaker 1: opposed to a giant glow. Yeah, because the idea is 545 00:33:31,680 --> 00:33:37,240 Speaker 1: with this kind of mindfulness meditation, which is becoming more 546 00:33:37,360 --> 00:33:40,280 Speaker 1: and more common, I feel like I'm hearing a bit 547 00:33:40,320 --> 00:33:42,479 Speaker 1: a lot. It's something that if you've taken a yoga 548 00:33:42,520 --> 00:33:44,640 Speaker 1: class you might have heard about or have just gone 549 00:33:44,640 --> 00:33:48,959 Speaker 1: to a general therapist. UM. Trying to harness that idea 550 00:33:49,080 --> 00:33:53,200 Speaker 1: of the brain's neuroplasticity of rewiring the patterns of our 551 00:33:53,240 --> 00:33:58,200 Speaker 1: thoughts through habit and repetition, and this idea of presence 552 00:33:58,320 --> 00:34:03,160 Speaker 1: and staying present is really really compelling when you apply 553 00:34:03,240 --> 00:34:06,640 Speaker 1: it to something like o c D, but also quite 554 00:34:06,680 --> 00:34:12,319 Speaker 1: controversial to apply it to something as ingrained as a 555 00:34:12,360 --> 00:34:14,440 Speaker 1: disorders as O c D, because some people in the 556 00:34:14,480 --> 00:34:17,360 Speaker 1: medical community say, no, this is kind of focus focus. 557 00:34:17,760 --> 00:34:22,080 Speaker 1: You can't actually, you know, just magically, And it's not magically. 558 00:34:22,160 --> 00:34:26,640 Speaker 1: I'm saying that magically in quotes rewire your own brain. Um. 559 00:34:26,680 --> 00:34:30,480 Speaker 1: But he seems to have had success with it. And 560 00:34:30,600 --> 00:34:34,319 Speaker 1: side note fun fact about Dr Schwartz. His claim to 561 00:34:34,440 --> 00:34:40,200 Speaker 1: fame is training Leonardo DiCaprio for his OSCAR nominated role 562 00:34:40,320 --> 00:34:44,440 Speaker 1: as Howard Hughes who had abilitating O c D in 563 00:34:44,480 --> 00:34:48,440 Speaker 1: the film The Aviator. So if you're curious about what 564 00:34:48,520 --> 00:34:52,760 Speaker 1: O c D can look like and what doctor Schwartz's 565 00:34:52,880 --> 00:34:56,160 Speaker 1: understanding of it is, you can watch Leo DiCaprio and 566 00:34:56,560 --> 00:35:00,560 Speaker 1: The Aviator. And apparently, as this Discover magazine profile of 567 00:35:00,640 --> 00:35:06,880 Speaker 1: him talked about, Leonardo DiCaprio's method acting embodiment of these 568 00:35:06,920 --> 00:35:11,439 Speaker 1: severe O c D behaviors were so impactful on him 569 00:35:11,880 --> 00:35:13,680 Speaker 1: that even I think it was something like a year 570 00:35:13,719 --> 00:35:16,440 Speaker 1: after filming, he was still sort of having to rework 571 00:35:16,520 --> 00:35:20,759 Speaker 1: his way back into the regular normal world, sort of 572 00:35:20,920 --> 00:35:24,560 Speaker 1: de engage himself from it. So talking, I mean, that's 573 00:35:24,640 --> 00:35:29,879 Speaker 1: kind of reverse neuroplasticity or reverse mindful mindfulness meditation. Yeah, 574 00:35:29,960 --> 00:35:34,880 Speaker 1: and it's interesting. I I totally this whole mindfulness meditation 575 00:35:34,920 --> 00:35:39,759 Speaker 1: thing sounds a lot like basically cognitive behavioral therapy, which 576 00:35:39,800 --> 00:35:43,840 Speaker 1: is experiencing a thought, recognizing that you're having it, and 577 00:35:44,040 --> 00:35:49,800 Speaker 1: actively working to change that thought and that behavior. Um 578 00:35:49,840 --> 00:35:53,640 Speaker 1: and over time, you know, practice makes perfect all that stuff. Um. 579 00:35:53,680 --> 00:35:56,800 Speaker 1: But it's interesting to hear that concept applied to something 580 00:35:56,880 --> 00:35:59,440 Speaker 1: like O c D, which you know, it's not just 581 00:35:59,680 --> 00:36:02,360 Speaker 1: and inn security like I'm gonna stop telling myself that 582 00:36:02,400 --> 00:36:04,720 Speaker 1: I look bad or whatever. It's This is a deeply 583 00:36:04,880 --> 00:36:08,440 Speaker 1: ingrained uh disorder that people suffer from, and so it 584 00:36:09,000 --> 00:36:12,560 Speaker 1: is interesting and it is controversial. But again, if it 585 00:36:12,640 --> 00:36:16,319 Speaker 1: works for people, that helps people, why not well, and 586 00:36:16,440 --> 00:36:19,560 Speaker 1: considering too, how debilitating it is for the people who 587 00:36:19,640 --> 00:36:22,799 Speaker 1: experience it and the prevalence rate, like we mentioned, it 588 00:36:22,920 --> 00:36:28,320 Speaker 1: is more common than schizophrenia and bipolar disorder. Yet Dr 589 00:36:28,360 --> 00:36:32,160 Speaker 1: Pittinger at Yale notes how O c D quote receives 590 00:36:32,200 --> 00:36:35,120 Speaker 1: far less attention from the major funders of research like 591 00:36:35,360 --> 00:36:38,920 Speaker 1: the National Institutes of Health and the pharmaceutical industry than 592 00:36:39,120 --> 00:36:44,319 Speaker 1: other conditions of comparable severity. So, for instance, a pharmaceutical 593 00:36:44,320 --> 00:36:48,920 Speaker 1: company Row has been conducting trials on an O c 594 00:36:49,160 --> 00:36:52,839 Speaker 1: D targeted drug as opposed to a drug that might, 595 00:36:53,040 --> 00:36:56,480 Speaker 1: as an additional side effect effectively treat O c D. 596 00:36:57,640 --> 00:37:01,040 Speaker 1: This specific drug is thest of its kind to be 597 00:37:01,120 --> 00:37:04,640 Speaker 1: even tested have any direct funding to it from the 598 00:37:04,640 --> 00:37:12,239 Speaker 1: pharmaceutical industry since, so I mean, considering the commonality of it, 599 00:37:12,239 --> 00:37:15,120 Speaker 1: it is sort of surprising that big pharma hasn't left 600 00:37:15,160 --> 00:37:20,720 Speaker 1: on it because it could be a decent money maker. Well, 601 00:37:20,760 --> 00:37:25,759 Speaker 1: I mean, you know, do do you have people. Have 602 00:37:25,840 --> 00:37:30,319 Speaker 1: you historically had people um sort of advocating for o 603 00:37:30,480 --> 00:37:33,959 Speaker 1: c D patients and suffers the way that you have 604 00:37:34,080 --> 00:37:38,680 Speaker 1: people you know, rightfully so in Alzheimer's breast cancer. I 605 00:37:38,719 --> 00:37:41,319 Speaker 1: mean those people are very vocal as well they should be. 606 00:37:41,600 --> 00:37:45,480 Speaker 1: But does o c D have champions that are that vocal? 607 00:37:45,600 --> 00:37:48,279 Speaker 1: And and that hasn't historically been the case until sort 608 00:37:48,320 --> 00:37:51,600 Speaker 1: of recently, we've we've seen sort of an upsurge in 609 00:37:51,880 --> 00:37:57,320 Speaker 1: attention paid to actual clinical life altering o c D 610 00:37:57,640 --> 00:38:02,000 Speaker 1: versus just the adorable like Mom character on TV or 611 00:38:02,520 --> 00:38:05,000 Speaker 1: Jack Nicholson's character and as good as it gets, I 612 00:38:05,000 --> 00:38:07,160 Speaker 1: think people with actual o c D are starting to 613 00:38:07,160 --> 00:38:09,719 Speaker 1: get more attention. Yeah, you have to wonder how much 614 00:38:10,000 --> 00:38:13,279 Speaker 1: our pop cultural depictions of o c D is just 615 00:38:13,400 --> 00:38:17,040 Speaker 1: kind of this this little character cork that some people have. 616 00:38:17,320 --> 00:38:19,839 Speaker 1: It makes men want to clean. How funny is that? 617 00:38:19,920 --> 00:38:22,680 Speaker 1: And also just our casual use of it, how that 618 00:38:22,920 --> 00:38:27,920 Speaker 1: might in a very real, real way negatively impact research 619 00:38:28,000 --> 00:38:31,600 Speaker 1: funding for it, Because if we look at o c 620 00:38:31,800 --> 00:38:37,240 Speaker 1: D in pop culture, we have movies like The Odd 621 00:38:37,280 --> 00:38:41,600 Speaker 1: Couple where Jack Lemon's character plays this guy who cooks 622 00:38:41,600 --> 00:38:44,239 Speaker 1: and he cleans and they can't have poker night at 623 00:38:44,239 --> 00:38:47,879 Speaker 1: Walter Matthol's apartment because he's constantly wanting to clean up 624 00:38:47,920 --> 00:38:50,640 Speaker 1: and like put coasters down so that they don't get 625 00:38:50,719 --> 00:38:55,200 Speaker 1: you know, stains on the table from their whiskey tumblers. Um. 626 00:38:55,280 --> 00:38:58,120 Speaker 1: And then you have shows like Monk that use o 627 00:38:58,280 --> 00:39:01,080 Speaker 1: c D as a comedic device, and of course there's 628 00:39:01,120 --> 00:39:03,600 Speaker 1: that gendered angle to it, because it's funnier for a 629 00:39:03,680 --> 00:39:07,000 Speaker 1: guy to have all these ticks as opposed to a woman, 630 00:39:07,120 --> 00:39:10,160 Speaker 1: it seems like. But one show that got a lot 631 00:39:10,160 --> 00:39:12,799 Speaker 1: of praise for not using o c D as a 632 00:39:12,800 --> 00:39:17,040 Speaker 1: comedic device at all was Girls. Actually, Lena Dunham, who 633 00:39:17,120 --> 00:39:20,000 Speaker 1: in real life has dealt with o c D since childhood, 634 00:39:21,000 --> 00:39:26,160 Speaker 1: had her character Hannah undergo a really traumatic o c 635 00:39:26,400 --> 00:39:29,960 Speaker 1: D experience basically in the wake of, you know, a 636 00:39:30,080 --> 00:39:33,160 Speaker 1: relationship trauma. She sort of reverts back to this o 637 00:39:33,320 --> 00:39:37,239 Speaker 1: c D behavior of counting um. And she writes about 638 00:39:37,320 --> 00:39:40,799 Speaker 1: her real life experience in her book Not That Kind 639 00:39:40,800 --> 00:39:44,000 Speaker 1: of Girl. Yeah, and this is just an excerpt of it. 640 00:39:44,400 --> 00:39:48,319 Speaker 1: And keep in mind too, how this relates to the 641 00:39:48,440 --> 00:39:52,760 Speaker 1: early onset of symptoms in childhood and adolescence. She writes, 642 00:39:52,920 --> 00:39:55,719 Speaker 1: I'm eight and I'm afraid of everything. The list of 643 00:39:55,760 --> 00:39:57,799 Speaker 1: things that keep me up at night includes, but is 644 00:39:57,840 --> 00:40:03,200 Speaker 1: not limited to, appendicida, typhoid, leprosy, unclean meat, foods I 645 00:40:03,200 --> 00:40:06,279 Speaker 1: haven't seen emerge from their packaging, foods my mother hasn't 646 00:40:06,320 --> 00:40:08,960 Speaker 1: tasted first, so that if we die, we die together, 647 00:40:09,160 --> 00:40:14,200 Speaker 1: homeless people, headaches, rape, kidnapping, milk, the subway, sleep. And 648 00:40:14,320 --> 00:40:17,759 Speaker 1: she goes on to talk about the process of being 649 00:40:17,760 --> 00:40:20,960 Speaker 1: in therapy as a child for O c D and 650 00:40:21,200 --> 00:40:23,720 Speaker 1: growing up with it, and it's something that she still 651 00:40:23,760 --> 00:40:27,120 Speaker 1: deals with, and she's talked publicly about how much it 652 00:40:27,320 --> 00:40:31,239 Speaker 1: grates on her nerves to hear people casually say oh 653 00:40:31,239 --> 00:40:34,160 Speaker 1: my god, I'm so O c D about X y 654 00:40:34,320 --> 00:40:37,040 Speaker 1: Z and she says, no, you're not. Yeah, and you 655 00:40:37,080 --> 00:40:40,400 Speaker 1: don't want to be because it's kind of awful. Yeah, yeah, 656 00:40:40,480 --> 00:40:42,640 Speaker 1: I this is definitely I feel like you and I 657 00:40:42,680 --> 00:40:46,160 Speaker 1: do a lot of episodes, Kristen, where we we learned 658 00:40:46,160 --> 00:40:49,080 Speaker 1: about something, we explore topic, and at the end we say, 659 00:40:49,400 --> 00:40:52,720 Speaker 1: maybe we should just cut that out. You know. Cankles, 660 00:40:52,800 --> 00:40:55,560 Speaker 1: We're not going to say cankles anymore. They're just ankles, people. 661 00:40:56,040 --> 00:40:57,680 Speaker 1: And it's the same with O c D. I mean, 662 00:40:57,760 --> 00:41:00,719 Speaker 1: this is an excellent Listening to this episode O my 663 00:41:00,840 --> 00:41:04,239 Speaker 1: Friends is a great opportunity to finally say, Okay, we're 664 00:41:04,239 --> 00:41:08,239 Speaker 1: gonna stop being offensive. We're gonna stop using O c 665 00:41:08,400 --> 00:41:10,640 Speaker 1: D as an adjective, because not only is it a 666 00:41:10,680 --> 00:41:13,239 Speaker 1: really horrible condition to have to live with and deal with, 667 00:41:13,520 --> 00:41:17,200 Speaker 1: but it has very real life awful consequences. There is 668 00:41:17,200 --> 00:41:21,520 Speaker 1: a strong relationship between O c D and suicidal ideations 669 00:41:21,560 --> 00:41:25,200 Speaker 1: and attempts. UM. The name John Cleaver Kelly might sound 670 00:41:25,280 --> 00:41:30,319 Speaker 1: familiar to some people. He in two eleven committed suicide. UM. 671 00:41:30,360 --> 00:41:33,480 Speaker 1: It was his third suicide attempt. UM. He had been 672 00:41:33,520 --> 00:41:37,120 Speaker 1: dealing with o c D his whole life and had 673 00:41:37,160 --> 00:41:41,280 Speaker 1: been in institutions and been to therapists and psychiatrists trying 674 00:41:41,320 --> 00:41:47,440 Speaker 1: to overcome it, and um it led to tragic consequences. Yeah, 675 00:41:47,680 --> 00:41:54,520 Speaker 1: and that unfortunately attracted national media attention to the life 676 00:41:54,560 --> 00:41:58,160 Speaker 1: threatening potential of O c D. And that's you know, 677 00:41:58,200 --> 00:42:00,880 Speaker 1: a big reason why it isn't It isn't such a 678 00:42:00,880 --> 00:42:04,080 Speaker 1: funny joke anymore. It isn't. It isn't cute to just 679 00:42:04,160 --> 00:42:09,600 Speaker 1: play off your um propensity for organization or your enjoyment 680 00:42:09,760 --> 00:42:13,719 Speaker 1: of like of nice color schemes or whatever. It might 681 00:42:13,760 --> 00:42:17,440 Speaker 1: be as just this this cute little pet thing that 682 00:42:17,520 --> 00:42:21,920 Speaker 1: you have, because it is, it's debilitating to the point 683 00:42:22,000 --> 00:42:25,160 Speaker 1: of being lethal. And that was one reason too why 684 00:42:25,200 --> 00:42:26,440 Speaker 1: And I don't have his name in front of me. 685 00:42:26,480 --> 00:42:31,799 Speaker 1: There's a blogger over at Psychology Today who hates the 686 00:42:31,880 --> 00:42:35,840 Speaker 1: depiction of Monk and that entire TV show because for 687 00:42:35,880 --> 00:42:38,480 Speaker 1: the same reason, he was just saying, no, this is 688 00:42:38,520 --> 00:42:42,920 Speaker 1: not like making it a communic device isn't helping anybody. 689 00:42:43,120 --> 00:42:47,239 Speaker 1: And there was one particular episode where Monk gets on 690 00:42:47,280 --> 00:42:50,879 Speaker 1: some kind of trial medication for o c D and 691 00:42:51,120 --> 00:42:56,360 Speaker 1: it magically cures all of his symptoms. But with that too, 692 00:42:56,520 --> 00:42:59,600 Speaker 1: it takes away his ability to solve crimes as well 693 00:42:59,640 --> 00:43:02,600 Speaker 1: as he does, so it turns o c D into 694 00:43:02,640 --> 00:43:05,359 Speaker 1: the superpower of sorts and also made the blogger mad 695 00:43:05,440 --> 00:43:09,000 Speaker 1: saying no, there is no cure and and don't make 696 00:43:09,040 --> 00:43:12,120 Speaker 1: this into something good. It just twists it and twist 697 00:43:12,160 --> 00:43:14,400 Speaker 1: and twist it. Yeah. He also wrote about his closet. 698 00:43:14,440 --> 00:43:18,279 Speaker 1: He's like, yes, I do enjoy a neat closet where 699 00:43:18,320 --> 00:43:20,400 Speaker 1: all of my things are color coordinatee and whatever. But 700 00:43:21,160 --> 00:43:23,600 Speaker 1: ladies and gentlemen, this is not a symptom of my 701 00:43:23,680 --> 00:43:25,959 Speaker 1: O c D. I just happened to like things neat. 702 00:43:26,320 --> 00:43:28,440 Speaker 1: I don't feel like I can't leave the house if 703 00:43:28,440 --> 00:43:32,560 Speaker 1: my hangars aren't hung. Just so, I have other symptoms 704 00:43:32,560 --> 00:43:34,399 Speaker 1: of O c D that I've had to work hard 705 00:43:34,440 --> 00:43:37,080 Speaker 1: to overcome. Yeah, and you, for instance, carrying out the 706 00:43:37,080 --> 00:43:41,120 Speaker 1: same morning routine in college is not a sign probably 707 00:43:41,239 --> 00:43:44,520 Speaker 1: of your obsessive compulsions, but rather it just a healthy lifestyle, 708 00:43:44,920 --> 00:43:49,120 Speaker 1: you know, just keeping it together, right, just making sure 709 00:43:49,160 --> 00:43:51,680 Speaker 1: I eat breakfast and brush my teeth. So people have 710 00:43:51,840 --> 00:43:56,000 Speaker 1: suggested that instead of using the off hand oh my god, 711 00:43:56,040 --> 00:43:58,879 Speaker 1: I'm so O c D, say something like, oh, you're 712 00:43:58,880 --> 00:44:03,680 Speaker 1: really hyper focused, you're diligent, you're detail oriented, or just say, yeah, 713 00:44:03,719 --> 00:44:09,480 Speaker 1: I'm really into cleaning. I enjoy cleanliness. Yeah done. I 714 00:44:09,560 --> 00:44:13,080 Speaker 1: like I like having my You can't even say like 715 00:44:13,120 --> 00:44:16,239 Speaker 1: having my CDs organized in alphabetical order anymore, because that 716 00:44:16,280 --> 00:44:19,839 Speaker 1: doesn't exist and now iTunes to finals. I like having 717 00:44:19,880 --> 00:44:22,560 Speaker 1: my records alphabetically organized. We could probably say, just to 718 00:44:22,640 --> 00:44:24,520 Speaker 1: keep this even more current for the future, I like 719 00:44:24,600 --> 00:44:28,640 Speaker 1: having my my cassette alphabetized, because you know that's coming back. 720 00:44:28,760 --> 00:44:34,880 Speaker 1: I can't roll my eyes any harder. So we're curious 721 00:44:34,960 --> 00:44:39,399 Speaker 1: to know if this rings a bell with anybody. Does 722 00:44:39,440 --> 00:44:43,520 Speaker 1: anyone listening have obsessive compulsive disorder or have someone in 723 00:44:43,560 --> 00:44:46,399 Speaker 1: your life who deals with this and perhaps it's gone 724 00:44:46,400 --> 00:44:49,040 Speaker 1: through treatment for it. What has been your experience and 725 00:44:49,080 --> 00:44:53,160 Speaker 1: what do you think about eliminating this casual jokey use 726 00:44:53,239 --> 00:44:56,680 Speaker 1: of o c D Because some people get bristly when 727 00:44:56,680 --> 00:44:59,520 Speaker 1: they hear things like let's not use phrases like that, 728 00:45:00,040 --> 00:45:02,160 Speaker 1: because I think, oh, well, it's not doing any harm. 729 00:45:02,760 --> 00:45:06,319 Speaker 1: Do you think that maybe it's fine to use O 730 00:45:06,400 --> 00:45:09,479 Speaker 1: c D in a casual joking way, or yeah, maybe 731 00:45:09,560 --> 00:45:15,279 Speaker 1: let's watch our language be a little more diligent about that. 732 00:45:16,120 --> 00:45:18,960 Speaker 1: Let us know your thoughts. Mom Stuff at how stuffworks 733 00:45:19,000 --> 00:45:21,359 Speaker 1: dot com is our email address. You can tweet us 734 00:45:21,400 --> 00:45:24,560 Speaker 1: at mom Stuff podcast or messages on Facebook as well. 735 00:45:24,880 --> 00:45:26,799 Speaker 1: And we've got a couple of messages to share with 736 00:45:26,840 --> 00:45:29,000 Speaker 1: you about another acorn and then we've talked about on 737 00:45:29,040 --> 00:45:36,879 Speaker 1: the podcast right now. Well, I have a letter here 738 00:45:36,880 --> 00:45:40,960 Speaker 1: from Taylor that actually touches on to different sminty topics. 739 00:45:41,560 --> 00:45:44,920 Speaker 1: She writes, I'm a female architect who was directed to 740 00:45:44,960 --> 00:45:47,719 Speaker 1: your podcast by a coworker yesterday, and I have to 741 00:45:47,760 --> 00:45:50,360 Speaker 1: tell you just how much I think that your stories 742 00:45:50,640 --> 00:45:53,120 Speaker 1: and research and p s a s are so well 743 00:45:53,160 --> 00:45:57,319 Speaker 1: informed and interestingly presented. I've just begun to uncover the 744 00:45:57,440 --> 00:45:59,920 Speaker 1: archive of your podcast and was struck by the timely 745 00:46:00,080 --> 00:46:02,759 Speaker 1: us of your Fibroids one on one podcast, because it 746 00:46:02,840 --> 00:46:05,520 Speaker 1: came out in December of last year, which was near 747 00:46:05,640 --> 00:46:08,080 Speaker 1: the time that I was dealing with learning I had 748 00:46:08,120 --> 00:46:11,160 Speaker 1: a uterine fibroid, but likely more than one. All of 749 00:46:11,200 --> 00:46:13,880 Speaker 1: the areas you covered, from race to treatment to taking 750 00:46:13,880 --> 00:46:17,040 Speaker 1: time off from work were all issues I encountered in 751 00:46:17,120 --> 00:46:20,920 Speaker 1: the fall. Often. I wanted to just share an abbreviated 752 00:46:21,000 --> 00:46:23,080 Speaker 1: version of my story because if I had heard this 753 00:46:23,120 --> 00:46:25,520 Speaker 1: podcast in December, I would have felt so much more 754 00:46:25,520 --> 00:46:28,640 Speaker 1: prepared for what I was undertaking. From my own research, 755 00:46:28,680 --> 00:46:31,480 Speaker 1: I already knew that African American women like myself were 756 00:46:31,560 --> 00:46:34,120 Speaker 1: much more likely to get fibroids. From my doctors, I 757 00:46:34,160 --> 00:46:37,160 Speaker 1: knew that they weren't cancerous, and from three different ultrasounds, 758 00:46:37,200 --> 00:46:40,080 Speaker 1: I knew my fibroid was larger than my uterus in 759 00:46:40,160 --> 00:46:43,920 Speaker 1: diameter and on the exterior wall of my uterus. I 760 00:46:43,960 --> 00:46:46,160 Speaker 1: wanted to say thank you for researching this topic because 761 00:46:46,239 --> 00:46:48,799 Speaker 1: uterine fibroids are indeed, a topic that not a lot 762 00:46:48,840 --> 00:46:51,360 Speaker 1: of women know exists or no could be the cause 763 00:46:51,360 --> 00:46:54,600 Speaker 1: of symptoms affecting them and be the options for treating 764 00:46:54,640 --> 00:46:56,879 Speaker 1: them are pretty slim for pre men posel women who 765 00:46:56,880 --> 00:46:59,759 Speaker 1: have yet to have children, like myself. In fact, other 766 00:46:59,800 --> 00:47:02,040 Speaker 1: than removal of my i U D because of the 767 00:47:02,080 --> 00:47:05,120 Speaker 1: size and location of my fibroid, I didn't receive any 768 00:47:05,160 --> 00:47:07,640 Speaker 1: treatment except for the recommendation to take a series of 769 00:47:07,680 --> 00:47:11,680 Speaker 1: non prescription supplements to regulate hormones. I also think that 770 00:47:11,719 --> 00:47:15,360 Speaker 1: the relationship between African American women and uterine uterine fibroids 771 00:47:15,400 --> 00:47:18,120 Speaker 1: is very interesting because the factors that range from genetics 772 00:47:18,320 --> 00:47:22,200 Speaker 1: to sociate economic status. I'm actually half black, my mother 773 00:47:22,239 --> 00:47:25,680 Speaker 1: being Caucasian, and I've never used hair relaxers. I consider 774 00:47:25,760 --> 00:47:28,360 Speaker 1: myself a member of the educated medal class, and I 775 00:47:28,400 --> 00:47:31,240 Speaker 1: also lead and was raised with a healthy, healthy lifestyle 776 00:47:31,280 --> 00:47:34,320 Speaker 1: that does not include eating red meat and an avoidance 777 00:47:34,320 --> 00:47:37,880 Speaker 1: of inorganically grown food or gluten. So, despite doing what 778 00:47:37,920 --> 00:47:40,520 Speaker 1: seems to have been healthy for the avoidance of fibroids, 779 00:47:40,840 --> 00:47:45,720 Speaker 1: I still am in that percentage of childbearing aged women 780 00:47:45,920 --> 00:47:49,000 Speaker 1: that have fibroids in the US. You both are doing 781 00:47:49,040 --> 00:47:51,160 Speaker 1: an amazing job with this podcast, and I was so 782 00:47:51,239 --> 00:47:53,560 Speaker 1: touched by the truth that you relate in this particular 783 00:47:53,600 --> 00:47:57,160 Speaker 1: episode that I was compelled to tell you really covered 784 00:47:57,200 --> 00:48:00,759 Speaker 1: this one, So thank you, Taylor. I have a letter 785 00:48:00,840 --> 00:48:05,040 Speaker 1: here from Laura about our Queen's Week, and she writes, 786 00:48:05,280 --> 00:48:08,440 Speaker 1: love the podcast. I eagerly listened to every episode and 787 00:48:08,480 --> 00:48:12,399 Speaker 1: have even gotten my fiance addicted. Thank you, Laura. As 788 00:48:12,400 --> 00:48:14,920 Speaker 1: a huge history nerd, I had to drop a line 789 00:48:14,960 --> 00:48:19,040 Speaker 1: about your Queen's Week. First of all, Woo loved having 790 00:48:19,040 --> 00:48:22,000 Speaker 1: a podcast look at Queen's from a more feminist perspective. 791 00:48:22,360 --> 00:48:24,759 Speaker 1: So many look at women rulers as stereotypes, so it 792 00:48:24,840 --> 00:48:27,319 Speaker 1: was good to hear them explored as real people. I 793 00:48:27,360 --> 00:48:29,920 Speaker 1: wish you could have turned Queen's Week into Queen's Month. 794 00:48:30,680 --> 00:48:33,520 Speaker 1: I was a big fan of the hat Chips episode, 795 00:48:33,600 --> 00:48:37,080 Speaker 1: but I was a little disappointed in your second choice, Victoria. 796 00:48:37,680 --> 00:48:41,240 Speaker 1: With a long list of kick ass female rulers, Victoria 797 00:48:41,360 --> 00:48:43,920 Speaker 1: was a bit of a downer. She was strongly against 798 00:48:43,960 --> 00:48:47,400 Speaker 1: women's suffrage and very outspoken about women's place in the world, 799 00:48:47,440 --> 00:48:50,719 Speaker 1: which was not exactly a feminist stance. I would have 800 00:48:50,800 --> 00:48:53,680 Speaker 1: loved to have heard an episode on Isabella who encouraged 801 00:48:53,719 --> 00:48:56,520 Speaker 1: study and ruled in her own right, or Jinga of 802 00:48:56,600 --> 00:49:01,319 Speaker 1: Angola who fought European invasion, or my ever Elizabeth, who 803 00:49:01,320 --> 00:49:04,600 Speaker 1: basically one at ruling during the late Middle Ages. I'd 804 00:49:04,600 --> 00:49:06,680 Speaker 1: love to hear an episode on women and families and 805 00:49:06,719 --> 00:49:09,400 Speaker 1: indigenous cultures around the world as well. I know in 806 00:49:09,440 --> 00:49:13,160 Speaker 1: Australia the Aboriginal cultures relationship with women is really complex, 807 00:49:13,480 --> 00:49:16,000 Speaker 1: as is the Maudi women's place in the family. Would 808 00:49:16,040 --> 00:49:19,480 Speaker 1: love to hear something on cultures around the world. Thanks 809 00:49:19,480 --> 00:49:21,760 Speaker 1: for the awesome podcast and keep up the good work 810 00:49:22,040 --> 00:49:25,280 Speaker 1: and thanks for your suggestions. Laura. I think that Victoria 811 00:49:25,480 --> 00:49:28,920 Speaker 1: was nonetheless a compelling person to talk about, because the 812 00:49:28,920 --> 00:49:31,200 Speaker 1: thing is, when it comes to women, they are not 813 00:49:31,320 --> 00:49:34,920 Speaker 1: always everything we hope that they will be, so her 814 00:49:34,960 --> 00:49:38,160 Speaker 1: complexity is kind of fascinating to me in that regard. 815 00:49:38,520 --> 00:49:41,600 Speaker 1: But now, thanks to you, we have some more incredible 816 00:49:41,640 --> 00:49:44,399 Speaker 1: ladies to spotlight and be sure to to check over 817 00:49:44,520 --> 00:49:47,560 Speaker 1: at Stuff You Missed in History Class because they have 818 00:49:47,640 --> 00:49:53,040 Speaker 1: done a number of podcasts on fantastic lady rulers over 819 00:49:53,080 --> 00:49:56,720 Speaker 1: the ages as well. And thanks to everybody who's written 820 00:49:56,760 --> 00:49:59,560 Speaker 1: into us. Mom Stuff at how stuff works dot Com 821 00:49:59,640 --> 00:50:02,040 Speaker 1: is our email address to find links to all of 822 00:50:02,040 --> 00:50:04,960 Speaker 1: our social media as well as all of our blogs, videos, 823 00:50:05,040 --> 00:50:08,240 Speaker 1: and podcasts with this one so you can read along 824 00:50:08,640 --> 00:50:11,879 Speaker 1: and learn about your possible O c D tendencies. Head 825 00:50:11,920 --> 00:50:19,200 Speaker 1: on over to stuff mom Never Told You dot com 826 00:50:19,239 --> 00:50:21,680 Speaker 1: for more on this and thousands of other topics. Is 827 00:50:21,719 --> 00:50:30,600 Speaker 1: it has stuff works dot com