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A
I wasn't diagnosed with OCD until I was in my 30s. When I finally got diagnosed, I was losing, I don't know, like eight or ten hours a day to compulsive behaviors, to checking, to Googling, to researching, to repeating the same things over and over again. That was most of my fricking day for me. You know, there were two keys to really unlocking the life to come, the life I've had since. Number one was medication and number two was the correct form of therapy. Now I lose less than an hour, and most of that time is spent reminding myself of the tools that are in my toolbox. And those two things in combination kind of gave me my life back in a really extreme way.
B
Hi, everyone, and welcome once again to another episode of the get to Know OCD podcast. I'm Dr. Patrick McGrath, the Chief Clinical Officer for NOCD. If you're looking for help for OCD related conditions, check us out@nocd.com that's n o c d dot com. I'm happy to be back in studio once again with John Green. Hi, John.
A
Hi. It's great to be with you.
B
I'm so happy we are doing this a second time back in the same studio. I feel like there's almost a time machine has brought us back right to this spot on these very blue couches.
A
And we are as young and promising.
B
As ever and beautiful.
A
Indeed.
B
Indeed. So I loved our chat the first time and it was really great getting to know you. And now I was thinking it would be interesting if we talked a little bit more maybe about the progression of OCD in your life, because you've written turtles all the way down. It's been a focus of a lot of the work you've done with you and your brother, talking about it at times on podcasts and the YouTube shows that you do. But I'm wondering, looking back on your life now, I feel like this is your life, John. But looking back on it, when you were a child before, maybe you really understood what it was. Were you experiencing anxiety, depression, or how was this all kind of manifesting before it had a name?
A
Well, I was definitely experiencing anxiety and depression and I had those words. I didn't have the phrase ocd.
B
Sure.
A
So looking back, I had OCD symptoms from as far back as I can remember. I would have really intense anxiety spirals that I couldn't manage except with compulsive behaviors. And so I. I had ocd. I just didn't know that I had ocd. I knew that I had Anxiety. So I was diagnosed with anxiety when I was 12 or 13 years old.
B
Okay.
A
And I was really lucky, you know, in that time to be diagnosed with anything. Sure, right. I mean, to have any kind of mental health care when you're a teenager in the 1980s was exceptional. And so I was lucky in some ways. But I did not have the word OCD to describe what was happening to me for a very long time, unfortunately. And as a result, I think I maybe didn't get the proper care, which I think is really common for people.
B
So many. I want to go to all those areas. So let me kind of unpack some of that. So. So adolescence, you get a diagnosis of ocd, do you go to your parents and say, I need to talk to someone?
A
Well, I didn't get a diagnosis of ocd then. I got a diagnosis of anxiety.
B
Yes. Of anxiety.
A
Yeah. I went to. I mean, my parents were concerned about me just because I was a really, really anxious kid. I really struggled with intense, intense, debilitating anxiety. And so my parents were concerned about me. They took me to a therapist, and the therapist diagnosed me with anxiety, with, I think, general anxiety disorder, or whatever it's called. I also struggle. I've had periods in my life where I struggled with major depression, which is just crushing and really difficult. And I know now that OCD is, you know, often people often also have anxiety and depression issues alongside their ocd. And so, you know, it's not a surprise. Looking back now, when I would experience it, it was a surprise. You know, the thing about really intense mental health problems for me is that, like, when I'm. Well, I know that's temporary, but when I'm sick, it feels like forever.
B
Okay.
A
It feels like there's no way out. It feels like there's. This is going to last forever. And, you know, that's where really good mental health care comes in for me, because I need someone in my life to remind me, one, it isn't. And two, there's actually a path out of this.
B
Going back also to the 80s with that, obviously, OCD was still thought of as just hand washing. Or maybe you straightened up your house a lot. So what were some of your compulsions? Were they mental? Were they physical? Were they hidden?
A
Or they were both mental and visible. I guess I would have really intense anxiety when my parents left the house. I would believe that they were going to die. And so I would go outside and I would count cars, and I would tell myself, like, well, if they're in the next 50 cars, then they're going to be okay. And if they're not, then they're not going to be okay. And I would count to 50 and then they still wouldn't be back. And then I would not be able to calm myself down. And so I would say, well, we'll count to 50 again, and things like that. But I also had mental compulsions. Looking back, checking behavior, especially kind of reassessing, making sure that I did something in my mind, trying to replay things in my mind, conversations and feeling really intense anxiety, wanting reassurance around things like confessions, conversations I would have, being really afraid to confess something, but also needing to confess something that was, of course, like, quite, quite minor in the scheme of things. But that felt hugely difficult to me.
B
That's almost the scrupulous nature, right? That no matter what you do, it wasn't good enough and maybe run it past another person to get their opinion.
A
Yeah, exactly.
B
When does the OCD diagnosis come into play then?
A
So I had a period of major depression in my early 20s that was really difficult and life threatening. And then I got in pretty serious mental health care from there. But I wasn't diagnosed with OCD until I was in my 30s, actually. And what happened was that I went to a psychiatrist and I said, well, I have, you know, bad anxiety and I've had periods of depression. And this has had a big. This had a big part of my life. And I've been in therapy for a long time and, you know, here's what I'm doing to try to address this, and here's what's going on with me. And my doctor was like, I think you have ocd. I think that the symptoms you're describing are more like OCD symptoms than they are like classic anxiety. And then I went home and read a book called the man who Couldn't Stop by David Adam. And I had panic attacks reading that book because it was so intense for me. But it was also immediately clear to me that, like, oh, this is what I have. This is what I've always had.
B
The other thing that I say sometimes to people is, if you look at it from the outside, I think it's kind of obvious why depression would come along with ocd. Because obviously it's either for depression, you either feel depressed or you have a loss of interest or pleasure in things you once enjoyed. Well, if OCD attacks the things you love and you don't do those things anymore so that you could avoid obsessions or compulsions about them, then why wouldn't you feel depressed in a Situation like that.
A
Absolutely. And I think that's a big part of what I've experienced. I also think that, you know, it's debilitating. And enjoying life when you're experiencing this debilitating thing is really hard. You know, I mean, like, at the height of my ocd, like, when I finally got diagnosed, I was losing, I don't know, like, eight or ten hours a day to compulsive behaviors, to checking, to Googling, to researching, to repeating the same things over and over again. And that was most of my fricking day, you know, I mean, most of my day was spent in the thrall of this thing, trying to manage this incredibly intense fear.
B
Yeah.
A
And how can you be happy alongside that? It's very difficult. And so for me, you know, there were two keys to. To really unlocking the life to come, the life I've had since. Number one was medication, which helped tremendously in my case. And number two was the correct form of therapy, exposure and response. What's it called? Exposure response prevention therapy. Yeah, ERP and those two things in combination kind of gave me my life back in a really extreme way.
B
It is unfortunate that people, A, won't get diagnosed correctly and therefore B, won't get the right kind of treatment and then feel stuck and almost feel. I wonder if you ever felt defeated. Like, I'm in therapy for this long, and why am I still stuck in all of this?
A
Yeah, I did feel really stuck, and I felt really scared. I mean, mostly I just felt scared all the time because I didn't know what was happening to me. And it felt as real. Like, if I would, like, if I say, had a fear of cancer, that felt as real to me as. As. And like, the fact. The fact that I had cancer and was, you know, not being treated for it was as real to me as any other fact. And so, you know, the checking and compulsive behaviors I used to try to manage that fact were necessary. Sure. It was the only way that I could be okay even for a minute. And so it all felt as real as anything I've ever felt feels.
B
I think that's sometimes the hardest part for people who don't have ocd, where they'll look at you and say, well, just stop it.
A
Yeah, well, and I totally get that. I mean, and I feel that from my friends and family at times like, you don't have cancer, stop worrying about it. Like, that's doesn't make any sense and is also a little, like, problematic for people who do have cancer. And. And I would be like, yeah, right. But then I would go right back to my feeling because what I. What I was doing was making it worse by, you know, avoiding all kinds of engagement with it. And the fear. The fear that I had was so severe. And then eventually I realized that, like, I needed to go through ERP and take my medicine. And, you know, since then, my life is very different.
B
What was it like hearing a therapist say to you, we're going to have to do these things you're afraid of instead of. We're going to spend a lot of time trying to avoid them or figure them out.
A
It was scary, for sure. And. And. But look, I was so desperate for a solution, and I knew that the. The evidence is pretty strong for the solution, that I was also felt ready to do it, but it was. It was scary, and it's uncomfortable. It's supposed to be uncomfortable, you know, and doing things that are uncomfortable is not fun or desirable in the short run. But so often, like in life, doing things that are, in the short run comforting is, in the long run, problematic. Right. Like, I think about this with. When I'm a little socially anxious at a party, I'll immediately pull out my phone like a pacifier. And that makes me feel better in the moment, and it makes me feel worse in the long run. If I drink alcohol, it makes me feel better in the short run, it makes me feel worse in the long run. And with ERP it was that, you know, if I don't engage with these fears or I engage with them through the compulsive behaviors only, it makes me feel better in the short run. But of course, like, in the long run, it had become a. It had gotten to a place where it controlled my entire life.
B
Yeah, you've hit on so many things already. Because I always talk about there's five safety behaviors in ocd, Avoidance, reassurance seeking, distraction, substance use, and compulsions.
A
I've used all of this.
B
Yeah, I think you have. It sounds like it. Yeah. Yeah.
A
Yeah. Wow. I've never heard that before, but that's really interesting.
B
Yeah. So if you go for the short term fix, you can't learn how to handle things in the long term. Yeah, because. Because you're always trying to fix it now and feel better in the moment instead of feeling better later.
A
And I. And I understand the urge to feel better in the moment. I understand the urge to use those avoidance behaviors or compulsive behaviors to feel better, because I still do that. Like, I still struggle with it. And I Still have to go back. I mean, the thing about OCD is it's so nefarious. It always, like, finds a new way in for me. So, like, I'm. I'm feeling good now, and, you know, but that's. That's temporary. Like, it'll come back and it'll find some new way in, and it'll feel as real to me as anything else feels, and I'll have to deal with it again. But. But at least now I know that it's possible to deal with it.
B
Yeah. People ask me a lot on webinars. Why does it have to feel so real, like you were saying? And my answer is, because if it didn't, you wouldn't need me. Right. You would just be able to go, ah, well, that doesn't feel real.
A
Yeah. You'd be able to dismiss it the way you can dismiss most fears. Right. Like, you can be like, when it's something. I have fears that aren't OCD fears, you know, that, like, if they happen, they would be really bad.
B
Sure.
A
Just that they're not likely to happen. And I'm able to say, like, well, that's not very likely. And we'll worry about that if we need to. But with an OCD fear, I'm not able to say that at all.
B
I've called OCD the yeah, but what if disorder, that no matter what logical answer you get right, you will follow it with that phrase.
A
That's very much the case for me. So, like, for me, it was always about closing the loop. Your parents definitely aren't going to die. You definitely don't have cancer. This, this, this. And, like, I could never quite close the loop because OCD is very good at finding fears where you can't close the loop all the way, where you can't reassure yourself completely. And, like, on some level, like, I was right when I was a kid, my parents are gonna die. It's just that they aren't gonna die in a car accident on a. You know, every time they leave the house. Yeah. And so, like, being able to put those fears in their right place is really challenging.
B
With that in erp. And it's interesting you brought up that one. You were doing an interview recently, and you talked about a card in your wallet. Yeah, and I carry one in my wallet, too, actually. I was working with somebody almost 20 years ago, and they had a fear of, what if their parents died because they had an intrusive thought? So I have this card in my wallet that line three there says, I hope my Parents die tonight. Please, God. And there's a 666 at the bottom of the card, too. And that's been in my wallet now for almost 20 years.
A
Wow.
B
Because I made the promise to that person that I'm going to do this work with you. I'm not going to ask you to think something about your parents without me doing it too. And we built up from, I hope my parents stubbed their toe to I'm going to think something negative, my parents might die, and I'm not going to do something to try to neutralize it.
A
Right.
B
And so I said to them, if you ever see me at a conference or on the street, you come up to me and say, are you the. Do you still have the card in your wallet? And I'm going to be able to say, yes, I do.
A
Wow.
B
So.
A
Wow, that's really beautiful. And I think that's. That's exactly what we're talking about, though, is that ability to get from, you know, my intrusive thoughts are going to cause this terrible thing to happen to understanding that thoughts are just thoughts. And, like, you're going to have all kinds of thoughts in your life. You're going to have all kinds of weird thoughts. And like, you know, I remember, like, listening to a meditation app once where they were like, let the thoughts pass like cars on the highway. And I was like, no, man, I gotta get in the car. I gotta get in the car with that thought. That is just the nature of me. And I'm gonna. I gotta work really hard not to get in the car. But, yeah, I think that's the. That's. That's. It's funny because, like, the minute you said that, I was like, oh, I wonder if my intrusive thought thoughts will kill my parents. But of course they won't.
B
Yeah. And. And if they did, I don't know that anyone would have parents left because all of us, at least all of.
A
Us have had that thought. Yeah, yeah, yeah, yeah. Or my spouse or my kids or whatever, like, all of us have had those thoughts. And so understanding too, like, that. That thoughts are normal has been really revelatory for me. That, like, bad. What I think of as bad thoughts or intrusive thoughts are normal. I call them intraterials all the way down. I call them invasive thoughts because it feels to me like they invade from outside. But yeah, understanding that everyone has those and that they're normal has been really important for me.
B
And probably you've seen the evolution, Right? I'm sure you can look Back on some old thoughts and think, I don't know why I spent so much time on them.
A
Yeah.
B
But then a new one comes, and it seems the most important thing in the world.
A
Suddenly it seems as real as this couch.
B
Yeah.
A
I mean, I think that's for people who don't have ocd. It's really important to understand that, like, the. The fear, the. Seems as real as everything else in the world seems. And there is no way to. There is no way to separate that reality from the reality of this couch. It is unbelievably intense and real. Yeah.
B
I say a lot to people. Possibility equals probability and ocd.
A
Yes, yes, yes. The same thing as the. Yeah, but what if, like, if you can't close the loop on thought. If. If there is a possibility, it equals, like, overwhelming probability.
B
Yes. Yeah. And since it's overwhelming probability, it's best if I do something about it because.
A
Yeah, I got to figure out a way to manage this because this is truly terrifying.
B
You've gone through treatment. Medications have been helpful. How do you compare your life today? Because you still have OCD and it still hits you, right? So we don't say that treatment is. You're never going to have a thought again or an image or an urge that you don't want, and OCD is never going to spike that you have the tools to be able to look at it more objectively and go, oh, wait, I can manage this. I can live with this. I don't need to do compulsions. How. How has that transition been?
A
Well, I would say, like I said earlier, at the peak of this, I was losing eight or 10 hours a day, and now I lose less than an hour to kind of. And most of that time is spent reminding myself of the tools that are in my toolbox. And so in that sense, it's 80 or 90% better.
B
That's great.
A
But it's actually, it's even better than that, because reminding myself of the tools that are in my toolbox helps me to remember that I'm okay and that I've come a long way and that my life today is very different from my life, what my life looked like in 2008 when it was really bad and I'm doing the work. And that, to me, feeling like I'm on a path towards toward healing is really helpful. But to your point, it does come back. And when it comes back, it's really intense and it's really unpleasant. I had a really bad period a year ago, and it sucked, but it ended.
B
Yeah. Thank you for your personal story about it. And you have so many different platforms, you and your brother, with the blogs and things you do. How has what you've gone through personally emanated out into these other communities that you touch and just gather all these amazing people into?
A
Well, it's been really lovely to see people respond so generously to my talking about my story. I think it's really important, you know, because stigma is a big part of what stops us from getting help, of course. And so if I can break some of that stigma down by pointing out that it's possible to have a serious mental illness and also have a really wonderful life, then that's great. I worry a lot about young people with OCD and anxiety and depression. I think that we don't exactly know why, but it does seem to be getting worse, and I have a suspicion why. I think it's probably the social Internet, but who knows? And I just. I worry a lot for them because it's so. I remember how hard it was when I was young, and I think it's great that we have. We're talking about it more now. And so there's maybe a bigger awareness, which is wonderful. And people aren't as afraid to deal. Confront their mental illness publicly and in their own lives. But, man, I do worry about them because it's just so hard to be sick and young.
B
Yeah. There are people who are going to watch this who are maybe on the verge of treatment, wondering what to do, should they do it. What would be your advice that you give to them?
A
I understand it's really hard, and I think that's the first thing. You know, tools like NOCD make it a little easier, but it's still hard to take the step. And it's scary, and it feels like there's a lot at stake because there is a lot at stake. But part of what's at stake is your own wellness. And there really is. You know, I like to say that there is hope even when your brain tells you there isn't. And I think that's what I would say to people, is go ahead and take the step. It's hard, but what's on the other side of it is a much better life.
B
Awesome. Well, I'm happy for you to have found that much better life and for you and your family and everything, and that you get to live the life that you want to live and not the life that OCD wants you to live.
A
No, that's really well put.
B
Awesome. Well, thanks for being here. I appreciate it.
A
Thank you.
B
And thanks all of you for watching the get to Know OCD podcast. If you enjoy the work that we're doing, check us out@nocd.com you can subscribe to the get to Know OCD podcast on our NOCD YouTube channel. And NOCD is ready and available to help you out. So we look forward to working with you. And remember, be better to yourself than your OCD ever would be. We'll see you again.
Host: Dr. Patrick McGrath
Guest: John Green
Date: December 29, 2025
In this heartfelt and practical episode, Dr. Patrick McGrath sits down with acclaimed author John Green to explore John’s lifelong journey with OCD, its evolution from childhood to adulthood, and the profound impact of finally receiving the correct diagnosis and treatment. John shares candid insights into his struggles—including losing up to ten hours a day to compulsions—and the remarkable transformation that followed evidence-based interventions like medication and Exposure and Response Prevention (ERP) therapy. Alongside relatable anecdotes and memorable quotes, the conversation offers hope and actionable advice for anyone affected by OCD.
This episode blends candid vulnerability with practical hope. John Green’s story illustrates both the deep suffering untreated OCD can inflict, and the profound relief possible through persistence, evidence-based treatment, and connection with others. The discussion is frank, empathetic, and frequently humorous—making it both relatable and reassuring for those affected by OCD or seeking to understand it.
For more information or help with OCD: Visit nocd.com