Podcast Summary: Get to Know OCD

Episode: John Green lost 10 hours every day to OCD — here’s how he got his time back

Host: Dr. Patrick McGrath
Guest: John Green
Date: December 29, 2025

Overview

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.

Main Discussion Points

John's Early Experiences and Missed Diagnosis

• Childhood Symptoms Without a Name
  • From an early age, John experienced intense anxiety but lacked the vocabulary or framework to identify it as OCD.
    • “I had OCD. I just didn’t know that I had OCD. I knew that I had anxiety.” (02:19, John Green)
• Early Diagnosis: General Anxiety and Depression
  • Diagnosed with anxiety at 12 or 13, John and his family were grateful simply for any mental health recognition in the 1980s, but OCD went unrecognized.
  • Major depression also intertwined with undiagnosed OCD, a common comorbidity.
    • “Looking back now...OCD is—you know, often people often also have anxiety and depression issues alongside their OCD.” (03:23, John Green)

Compulsions: Mental and Physical

• Visible and Hidden Rituals
  • John described both external (e.g., counting cars to predict parental safety) and internal (e.g., repeated mental checking, seeking reassurance) compulsions.
    • “If they’re in the next 50 cars, then they’re going to be okay...Count to 50 again...But I also had mental compulsions.” (04:46, John Green)
• Scrupulosity and Moral Anxiety
  • He struggled with guilt and the need to “confess” minor things to others, always seeking validation.
    • “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.” (05:53, Dr. Patrick McGrath)

Adult Life and Finally Receiving the OCD Diagnosis

• A Turning Point in His 30s
  • After years of intensive therapy for anxiety and depression, it was only in his thirties that a psychiatrist recognized his descriptions as classic OCD, not anxiety.
    • “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.” (06:22, John Green)
• The Impact of Discovering the Right Label
  • Reading The Man Who Couldn't Stop by David Adam was both traumatic and clarifying—“I had panic attacks reading that book...But it was also immediately clear...oh, this is what I have.” (06:44, John Green)

The Debilitating Nature of Untreated OCD

• Loss of Time and Joy
  • At the worst, John lost 8–10 hours daily to rituals—researching, checking, and repeating.
    • “That was most of my fricking day for me.” (00:05, John Green)
    • “Most of my day was spent in the thrall of this thing, trying to manage this incredibly intense fear.” (08:23, John Green)
• Relationship to Depression
  • OCD often robbed John of interest in activities and engendered hopelessness.
    • “How can you be happy alongside that? It's very difficult.” (08:24, John Green)

Keys to Recovery: Medication and ERP

• Medication
  • Pharmacotherapy played a crucial role in reducing symptom severity.
• Exposure and Response Prevention (ERP)
  • Learning to face, rather than avoid, feared situations and letting go of compulsive rituals was transformational.
    • “There were two keys to really unlocking the life to come...Number one was medication...Number two was the correct form of therapy, exposure and response prevention therapy. And those two things in combination kind of gave me my life back in a really extreme way.” (00:34, John Green; repeated/refined, 08:40–09:03)
• Emotional Response to Treatment
  • Beginning ERP was terrifying, but John was desperate enough to try and trusted the empirical evidence.
    • “But, look, I was so desperate for a solution, and I knew that the evidence is pretty strong for the solution, that I felt ready to do it.” (11:09, John Green)

The Illogic and Intensity of OCD Beliefs

• Outsider Misunderstandings
  • Friends and family didn’t understand the all-consuming reality of OCD fears.
    • “I feel that from my friends and family...you don't have cancer, stop worrying about it. That doesn't make any sense...But then I would go right back to my feeling...” (10:14, John Green)
• Why OCD Fears ‘Feel So Real’
  • The “yeah, but what if” loop: Logic doesn’t work; if it’s possible, it feels probable.
    • “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.” (13:55, Dr. Patrick McGrath)
    • “Suddenly it seems as real as this couch.” (17:27, John Green)
    • “In OCD, possibility equals probability.” (17:57, Dr. Patrick McGrath)

Tools, Relapse, and Ongoing Work

• Significant Improvement, Ongoing effort
  • John went from losing 8–10 hours a day to under one hour, and most of that is “reminding myself of the tools in my toolbox.”
    • “It’s 80 or 90% better...it’s even better than that, because reminding myself of the tools...helps me to remember that I’m okay and that I’ve come a long way.” (18:53–19:14, John Green)
• Ongoing Vulnerability
  • OCD can always “find a new way in,” but now he believes it’s possible to manage it.
    • “I still struggle with it. I still have to go back...The thing about OCD is it’s so nefarious. It always, like, finds a new way in for me.” (12:48, John Green)

Reducing Stigma and Sharing His Story

• Why John Went Public
  • Sharing his journey helps break stigma and offers hope, showing you can live a good life even with serious mental health issues.
    • “Stigma is a big part of what stops us from getting help...if I can break some of that stigma down...that’s great.” (20:15, John Green)
• Advice for the Undecided
  • Encourages listeners contemplating treatment to take the leap, even though it’s scary.
    • “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...is a much better life.” (21:35, John Green)

Notable Quotes & Memorable Moments

• On the power of proper treatment:
  • “Those two things in combination kind of gave me my life back in a really extreme way.” (00:34/08:40, John Green)
• On compulsions:
  • “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.” (04:46, John Green)
• On intrusive thoughts:
  • “Thoughts are just thoughts...you're going to have all kinds of weird thoughts...understanding that everyone has those and that they're normal has been really important for me.” (16:40, John Green)
• On the continuum of progress:
  • “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...” (19:13, John Green)
• On advice to others:
  • “There is hope even when your brain tells you there isn’t.” (21:35, John Green)
• On the felt reality of OCD:
  • “It is unbelievably intense and real.” (17:31, John Green)

Key Timestamps for Reference

• Diagnosis revelation: 06:06–07:12
• Compulsions and childhood: 04:46–06:00
• Describing the day lost to OCD: 00:00–00:40 & 08:23–09:03
• Finding ERP (Exposure and Response Prevention): 08:40–09:03, 11:09–12:34
• Notable therapy exercise (the “card in the wallet”): 14:42–15:44
• Stigma, going public, and hope: 20:15–21:35
• Final advice to listeners: 21:35–22:09

Tone & Takeaway

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