Obsessive Compulsive Disorder (02:38)
People on the street describe OCD in a lighthearted way; many think of it as perfectionism. Patients describe living in constant fear and anxiety. Uta Frith introduces the episode. (Credits)
Living with the Disease (02:17)
Firth will spend time with people who have been diagnosed with OCD, learn about the brain's processing, and look at new research. The disorder stems from recurrent thoughts; rituals are used as a coping mechanism.
Recurrent Thoughts (03:21)
Patients describe how OCD presents itself. Richard feels the need to remain clean; he performs a ritual to remove contaminants from the car. Sheets cover his furniture; his greatest fear is ingesting impurities.
Lunch Making Demonstration (02:07)
Richard makes a sandwich, washing his hands between each step. He explains that this is only a demonstration, as has not done everything exactly as needed, and it is overwhelming for him.
Richard Breaks Down (02:03)
Richard cannot figure out how to toss the sandwich into the trash without the plate getting dirty. He deteriorates into sobs. His father comforts him.
History Of OCD (02:16)
"The Anatomy of Melancholy" was written in 1621. Dr. Angus Gowland describes the purpose of the book, one of the first books to address different forms of mental illness; it includes the writings of Rufus of Ephesus from the first century.
Treatments for OCD (02:18)
Scholars originally thought the heart was the center of emotion, but discovered our identity is firmly rooted in the brain. Early treatments include frontal lobotomies which occasionally eased the symptoms.
Understanding the Brain (02:04)
In Cambridge, Firth meets Trevor Robbins who is leading a study of OCD patients. He explains how the disorder is similar to addiction where the habitual side of the brain has taken over the goal oriented side.
Robbin Experiments (02:04)
Robbins plays a game with Firth to illustrate OCD as an addiction to a specific behavior. When things change, a person afflicted with the disorder will not know how to adapt.
Dr. Annemieke Apergis Schoute's Experiment (03:03)
Volunteers with and without OCD participate in an experiment that will show what cognitive flexibility looks like in the brain. Electric shocks can be avoided by pressing the correct foot pedal when shown an image. Scans reveal hyperactivity in patients with the disorder.
O.C.D. Begins in the Orbital Cortex (02:00)
Dr. Paul John shows Firth a preserved brain. He dissects it to exhibit the basal ganglia.
How the Basal Ganglia Works (02:00)
Located at the base of the skull, the basal ganglia helps filter thoughts and processes. When there is hyperactivity such as with OCD, it is difficult to sort the thoughts. One possible explanation is that the basal ganglia searches for potential risks— when it is hyper-activated, it becomes overwhelmed.
Firth Interviews Marks (03:01)
In the 1960s psychoactive drugs began to be used instead of lobotomies. Isaac Marks became interested in behavioral therapy. He explains that in cases of OCD recurrent thoughts, he would ask the patient to not engage in any rituals for a half hour— the patient began to realize their need to perform a compulsion would diminish with time.
Patients Talk about the Recurrent Thoughts (03:37)
Firth watches Sophie's cognitive based therapy session. Dr. Laura Bowyer asks Sophie to confront her fears by bringing along murder weapons for her to try out. She tries to make Sophie understand her O.C.D. is a bully.
Dr. Bowyer asks Sophie to walk through London while a recording plays her deepest fears. She has seen immense improvement since she began CBT.
Successful Outcomes (02:04)
Dr. David Adam recounts his struggle with OCD. and why he sought help. After he began CBT and antidepressants the recurrent thoughts began to dissipate.
Controlling Brain Circuitry (02:05)
Dr. Susanne Ahmari experiments with how to control neural circuitry in the brain. She hopes that optogenetics can be used to treat OCD.
Working with Mice (03:24)
Ahmari uses mice whose frontal lobe cortex's connection to the basal ganglia has been optogenetically treated. She turns on the laser to hyper-activate the neurons— increased grooming occurs along with changes in cognitive flexibility. She can also install a microscope to see the neural pathways themselves.
Firth summarizes the episode. Patients discuss how they hope for a cure but they do not want to forget the experience.
Credits: Obsessive Compulsive Disorder (00:45)
Credits: Obsessive Compulsive Disorder
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