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Yet the almost sing-songy declaration “I’m so OCD!” seems to be everywhere.

People with a common type of OCD can even have paralyzing anxiety over their own sexual orientation.

Since absolute certainty is rarely possible, almost no reassurance clears the yes, but hurdle, and that keeps the anxiety wheels spinning.

It’s common for people with OCD to believe that if they check the stove just once more, or Google just one more symptom of a disease they’re convinced they’ve got, then their mind will be clear.

“The brain is conditioned to alert us to anything that threatens our survival, but this system is malfunctioning in OCD,” says psychologist Steven Phillipson, clinical director of the Center for Cognitive-Behavioral Psychotherapy in New York City. “That can result in a tsunami of emotional distress that keeps your attention absolutely focused.”

For the person with OCD, he explains, the brain is signaling what feels like a life and death risk, and it’s hard to put a price on survival.

“Performing the ritual just convinces it that the danger is real and that only perpetuates the cycle.”

“It’s the moment when a panic marries a concept,”

If you can live with the uncertainty those dangers can cause—even if they make you uncomfortable—you likely don’t have OCD, or at least not a very serious case of it. If the anxiety is so great it consumes your thoughts and disrupts your day, you may have a problem.

Medications, including certain antidepressants, are often a big part of the solution, but psychotherapy—especially cognitive behavioral therapy (CBT)—can be just as effective.

progress up the ladder of perceived danger

Ahmari turned to mice and to optogenetics—whereby specific types of brain cells can be switched on and off in response to light. The cells of interest were engineered to express light-responsive ion channels, such that when the cells are exposed to light—by means of a fiber optic cable pointing a laser at the relevant brain region—the channels open, ions flood in, and nerve impulses fire.

But crucially, the teams had very slightly different targets in the striatum—the general ventral striatum in the case of Ahmari’s study and the specific fast-spiking inhibitory interneurons of the centromedial striatum in Graybiel’s study, suggesting that different neural circuits send inhibitory and stimulatory signals for certain OCD-like behaviors.

“they’ve been able to really delineate a pathway for compulsive behaviors in a more refined way than we’ve ever been able to do in humans, and that’s exciting because it points us in the direction of pathogenesis and pathophysiology of the disorder, but also . . . to new targets for potential intervention.”

But the worry that "something bad will happen" is not an ephemeral, occasional threat for OCD sufferers.

"Most people don't understand OCD at all, to begin with. Secondly, most people tend to get 28too distracted by the content of the obsessions. The content is irrelevant,

Obsessions fuel compulsions.

"If you listen carefully, patients will ask constantly agonize over their obsessions, asking, 'Why am I having these thoughts; how do I know that I wouldn't do this; why would I be thinking it if I didn’t want to do it?'"

"Most violent and dangerous people don’t sit there having these inner dialogues," he added.

When Zeki has put people who have fallen in love inside of fMRI machines and shown them photos of their lovers, he's detected reduced activity in the amygdala — a pair of brain regions that are involved in decision-making. Amygdala activity is typically heightened during fearful or stressful situations, and research suggests that we use it when making social judgements and trying to determine if other people are lying.

Given that we think of love as a positive emotion, it's a bit surprising that she found reduced levels of serotonin in these people, compared to controls. Even more surprising, though, is that they were as low as other study participants who had obsessive compulsive order — so low, she says, that "my biologists came back to me and assumed that the readings were from people who suffered from OCD."

a lack of serotonin may lead to the obsessive, irrationally jealous behavior we see in some people.

"When you're rejected in love, we still find activity in the VTA — you're still madly in love with that person, after all," she says. "But we also find elevated activity in other brain regions linked with craving, and in a part of the brain associated with the distress that goes along with physical pain."

One positive aspect of the study, though, was that the more time that had passed since the participants' rejection, the lower activity was in another brain region associated with attachment.

Activity was elevated in the VTA — just like in new lovers — but also the ventral pallidum, an area associated with maternal attachment in animal studies.

"Romantic love is giddiness, elation, euphoria, energy. When you're feeling a deep sense of attachment, you're much more calm, and contented."

It's still uncertain why people transition from the first phase of love to the second phase of attachment, but Fisher hypothesizes that they're driven by separate evolutionary mechanisms. The initial flood of obsessive love evolved, she thinks, in order to get you to focus on a single person in order to reproduce. The second phase of attachment, by contrast, evolved to link you to another person for an extended period of time, in order to raise a child.

DARPA hopes to do that with an implanted device that will take over some functions of the brain's hippocampus, an area that's important to memory. The agency has already used a device that does this in rodents, Ling said, and the goal is to move on to people quickly.

We believe that the tools and technologies that will come from this initiative will actually enable all brain scientists to do their work better, faster and with more impact,"

For several years now, people with Parkinson's have been able to reduce their tremors with a treatment known as deep brain stimulation.

But Dr. Tom Insel, director of the National Institute of Mental Health, said it's important to remember that the immediate goal of the BRAIN Initiative isn't developing treatments, but understanding the inner workings of the most complex system in the universe.

"They're interested in the brain as a way to understand who we are, what makes us different and what is special about the human brain."

Our brains are statistical organs that are built simply to predict what will happen next

This makes sense because, in prehistoric times, faulty predictions could lead to some very unpleasant surprises — like a tiger eating you or sinking in quicksand.

So-called prediction errors (like finding salmon instead of turkey on your plate on Thanksgiving) send us into a tizzy because our brains interpret them as a potential threat.

Keep doing what you’ve been doing, because you did it before, and you didn’t die.

all essentially subconscious efforts to make your world more predictable, orderly and safe.

Routines and rituals also conserve precious brainpower

It turns out our brains are incredibly greedy when it comes to energy consumption, sucking up 20 percent of calories while accounting for only 2 percent of overall body weight.

Our brains are literally overburdened with all the uncertainty caused by the pandemic.

Not only is there the seeming capriciousness of the virus, but we no longer have the routines that served as the familiar scaffolding of our lives

“It’s counterintuitive because we think of meaning in life as coming from these grandiose experiences

grandiose

grandiose

Of course, you can always take routines and rituals too far, such as the extremely controlled and repetitive behaviors indicative of addiction, obsessive-compulsive disorder and various eating disorders.

it’s mundane routines that give us structure to help us pare things down and better navigate the world, which helps us make sense of things and feel that life has meaning.”

In the coronavirus era, people may resort to obsessive cleaning, hoarding toilet paper, stockpiling food or neurotically wearing masks when driving alone in their cars. On the other end of the spectrum are those who stubbornly adhere to their old routines because stopping feels more threatening than the virus.

You’re much better off establishing a new routine within the limited environment that we find ourselves in

Luckily, there is a vast repertoire of habits you can adopt and routines you can establish to structure your days no matter what crises are unfolding around you

The point is to find what works for you. It just needs to be regular and help you achieve your goals, whether intellectually, emotionally, socially or professionally. The best habits not only provide structure and order but also give you a sense of pleasure, accomplishment or confidence upon completion.

It could be as simple as making your bed as soon as you get up in the morning or committing to working the same hours in the same spot.

Pandemic-proof routines might include weekly phone or video calls with friends, Taco Tuesdays with the family, hiking with your spouse on weekends, regularly filling a bird feeder, set times for prayer or meditation, front yard happy hours with the neighbors or listening to an audiobook every night before bed.

The truth is that you cannot control what happens in life. But you can create a routine that gives your life a predictable rhythm and secure mooring.

This frees your brain to develop perspective so you’re better able to take life’s surprises in stride.

I attended a Thanksgiving dinner several years ago where the hostess, without warning family and friends, broke with tradition and served salmon instead of turkey, roasted potatoes instead of mashed, raspberry coulis instead of cranberry sauce and … you get the idea.

Too many people are still longing for their old routines. Get some new ones instead.

It wasn’t that the meal itself was bad. In fact, the meal was outstanding. The problem was that it wasn’t the meal everyone was expecting.

When there are discrepancies between expectations and reality, all kinds of distress signals go off in the brain.

It doesn’t matter if it’s a holiday ritual or more mundane habit like how you tie your shoes; if you can’t do it the way you normally do it, you’re biologically engineered to get upset.

This in part explains people’s grief and longing for the routines that were the background melodies of their lives before the pandemic