Learning about new research– and the hardworking people making it happen– is one of our favorite things at nOCD. It’s easy to get bogged down in the daily realities of living with mental health conditions, and we can forget that there’s this enormous, unceasing global effort to come up with more helpful solutions. So we’re talking with top researchers to get a better sense of what’s next.
Today we’re very excited to talk with Dr. Helen Blair Simpson, MD, PhD, Professor of Psychiatry at Columbia University Medical Center and Director of the Center for Obsessive-Compulsive and Related Disorders. Dr. Simpson also somehow finds time to be Director of the Anxiety Disorders Clinic at the New York State Psychiatric Institute. One of the foremost experts on OCD, her research is focused on improving treatment options for people with OCD and related disorders so they can live more productively. Without further ado, here’s our interview.
nOCD: What inspired you to conduct research on OCD?
The suffering I saw in my patients. It was an incredible experience to treat them and witness them master their OCD.
nOCD: What’s the most exciting thing you’ve worked on in your research thus far?
As a psychiatrist, it has been both intriguing and exciting to observe the power of cognitive behavioral therapy (CBT).
nOCD: What’s the biggest thing that’s currently missing in OCD treatment? In OCD research?
While there is substantial evidence for effective first-line treatments for OCD, many individuals fail to sufficiently respond. We need to better understand why these treatments work for some and not others, and which treatment may work best for each individual.
nOCD: What’s one big misconception about OCD that you’d like to challenge?
That we all have some OCD. Yes, we all have occasional intrusive thoughts (e.g., did I just say the wrong thing?). Many endorse some type of ritual or repetitive behavior (such as double-checking to make sure the door is locked). Most of us also have habits (like taking the same route to work). Some of us are very rigid in our views and perfectionistic. This is not OCD.
OCD is a specific illness characterized by obsessions (repetitive thoughts, images or urges) that generate significant distress and by compulsions (repetitive thoughts or acts) that the person feels driven to perform. To be OCD, these symptoms must cause impairment and be highly distressing and time-consuming (taking up more than an hour a day). Many OCD patients obsess and ritualize on and off all day.
Although most people with OCD have both obsessions and compulsions, the specific content can vary between individuals. The result is that different patients can have very different symptoms. Some common themes include: intrusive thoughts about harm with checking rituals; taboo (usually sexual, religious or violent) thoughts; concerns about symmetry and exactness with ordering and arranging behaviors; and obsessions about contamination with washing rituals.
Importantly, not all repetitive thoughts or behaviors are OCD. For example, people with depression can ruminate, those with generalized anxiety disorder can incessantly worry, and people with trichotillomania can repeatedly pull their hair. The point is that we do not all have OCD. Some people do, and they suffer.
nOCD: Sometimes it’s tough to feel hopeful about OCD. Could you share one or two things that might help people with OCD feel better about the future?
Up to half of people can achieve minimal symptoms with our current treatments. There are two effective treatments for OCD: medications called serotonin reuptake inhibitors (like Prozac, Zoloft and their siblings), and a specific form of cognitive-behavioral therapy (CBT) that includes exposure and ritual prevention. Either alone or in combination, these treatments help up to half of patients keep their symptoms to a minimum within eight to 12 weeks, even in adults who have been ill for decades. Additionally, researchers around the world, including our research group, are studying the brain mechanisms of OCD, with the goal of identifying new targets for treatment development. This offers hope to many individuals who may not get well with traditional first-line treatments.
nOCD: How can people find out more about your work?
For more information about our clinic, please visit our webpage.
If you have OCD, you might be eligible to participate in a study with Dr. Simpson involving an investigational medication that would be added on to your current treatment. To learn more, send a quick email to [email protected].
Dr. Simpson’s team at the Center for Obsessive-Compulsive Treatment and Related Disorders helped us coordinate this interview, which was conducted over email and on the phone. They’ve gathered an impressive group of people, and learning about their work makes us feel hopeful for the future of OCD treatment. We’re grateful in particular to Dr. Marina Gershkovich and Rachel Middleton for making this interview possible.