What Is OCD? How to Understand It, Recognize It, and Treat It

Join us in this insightful video focused on Obsessive Compulsive Disorder, where we explore the DSM‑5 criteria, differentiate OCD vs generalized anxiety, and discuss the neurobiological roots of compulsive behavior. We cover practical guidance on exposure response prevention (ERP), using the Yale‑Brown Obsessive Compulsive Scale as a screener, and outline medication strategies like high‑dose SSRIs to support psychological treatment. Ideal for clinicians and anyone seeking to understand or treat OCD effectively.
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00:00:00 Intro
00:04:41 Breaking Down the DSM-5 Criteria for OCD
00:08:14 Differentiating OCD from GAD
00:13:01 Is OCD Biological or Psychological?
00:18:04 The Anatomy of OCD
00:21:33 Alternative OCD Theory: Repetition, Uncertainty
00:27:07 Case Study: The Link Between OCD Spectrum & Psychosis
00:29:12 How to Practically Screen for OCD (Using the Y-BOCS)
00:36:54 Treatment: What is ERP?
00:43:08 How to Implement ERP & Key Psychoeducation
00:49:51 OCD is Chronic
00:53:51 Final Thoughts

Obsessive compulsive disorder can hide in plain sight for years. In this episode Dr. Greg Malzberg joins Dr. Eric Fu to pull the curtain back on OCD, walking through DSM 5 criteria, the difference between ordinary intrusive thoughts and true obsessions, and the compulsive behaviors that keep the cycle alive. Real-world cases illustrate how easily clinicians miss classic red flags like repetitive checking, prolonged hand-washing, and covert mental rituals, leading to an average seven-year delay before proper treatment.

Next, the doctors map the five-step CSTC loop that drives obsessional thinking: trigger, intrusive thought, catastrophic appraisal, rising distress, and the compulsion that briefly neutralizes it. Listeners learn why intolerance of uncertainty, not thought content, fuels the disorder and why the Yale-Brown Obsessive Compulsive Scale is the fastest way to unveil hidden symptom clusters. Practical screening tips include asking about time-eating safety behaviors, “maybe, maybe not” doubt, and family frustration with ritualistic habits.

The heart of the show is a detailed primer on exposure and response prevention. Dr. Fu explains how to build a SUDS-ranked hierarchy of feared situations, from imagining a stove left on to deliberately sitting on a busy train platform. The hosts share creative ERP challenges—writing worst-case scripts, watching trigger videos, timing hand-wash cuts—and stress that the target is distress tolerance, not distraction. You will hear when to blend mindfulness, urge surfing, or self-compassion workbooks to keep motivation high and avoid swapping old rituals for new reassurance routines.

Pharmacologic pearls follow: why true OCD often needs sertraline 300-400 mg or escitalopram 30-40 mg, how to layer clomipramine or fluvoxamine when first-line SSRIs plateau, and when to avoid antidepressants in bipolar-OCD overlap. The team also outlines emerging data on glutamate modulators, antipsychotic augmentation, and mixed-reality ERP trials.

Finally, the pair revisit Greg’s cat-in-the-hallway anecdote to drive home the ERP principle: the brain learns safety only when we stop opening the door. Packed with research, clinical reflections, and plenty of humor, this episode is your complete, actionable guide to modern OCD treatment.