Luke Combs is lifting the veil on his lifelong battle with a “particularly wicked” form of obsessive-compulsive disorder.
The country music star recently opened up about his battle with Pure Obsessional OCD, or Pure O, which triggers relentless, irrational thoughts — including some that veer into violent territory.
“When it hits, man, it can be all consuming,” Combs told “60 Minutes Australia” in an interview. “If you have a flare-up … you could think about it 45 seconds of every minute for weeks.”
OCD, which affects 2% to 3% of Americans, is marked by persistent, intrusive thoughts and repetitive behaviors. The exact number of people with the Pure O subtype is unknown, but one estimate suggests that up to 10% of those with OCD in the UK experience this particular form.
While most people associate OCD with physical rituals, like excessive handwashing or touching objects a specific number of times, those with Pure O are haunted by unwanted, uncontrollable thoughts and internal compulsions that remain mostly invisible, according to Verywell mind.
“They cause you stress, and then you’re stressed out, and then the stress causes you to have more of the thoughts, and then you don’t understand why you’re having them, and you’re trying to get rid of them, but trying to get rid of them makes you have more of them,” Combs said.
Although Pure O sufferers don’t display obvious physical behaviors, they often resort to mental rituals to try to ease the anxiety triggered by their obsessions. These compulsions can include replaying memories or past conversations, silently repeating mantras, and making mental lists.
The obsessive thoughts themselves can vary widely as well. “I’ll be worried that I’m about to have a heart attack or a stroke, and it becomes this very obsessive thing that you can never have an answer to,” Combs shared.
For many, Pure O sparks relentless, disturbing thoughts about harming themselves or others. Some are overwhelmed by intense anxiety surrounding religion, plagued by fears of sinning, while others struggle with doubts about their sexual orientation.
People with the Pure O subtype often report experiencing deep feelings of guilt and shame triggered by their intrusive thoughts, which can significantly impact their sense of self.
“They will identify with the thought and feel convinced it reveals something about who they are as a human being,” said Dr. Nicholas Farrell, Director of Clinical Development and Programming at NOCD. They might think, “I just had a dream about harming someone — that means I must be a violent person.”
Combs, 35, has been dealing with Pure O since he was 12. While he said he’s “really good” at managing the disorder now, he recently suffered his “worst flare-up” in years while on tour.
“It’s really tedious to pull yourself out of it,” said the husband and father of two. He added that he’s become “an expert” at managing these episodes.
“It’s weird, sucks, hate it, drives me crazy, but … The less that you worry about having the thoughts, eventually they go away,” Combs said. “You giving any credence to what the thoughts are is irrelevant and only fuels you having more of them.”
Treatment for OCD often involves therapy, but there are self-help strategies that can ease the grip of Pure O. Relaxation techniques like deep breathing and mindfulness meditation, along with aerobic exercise, have been shown to be effective.
Medications, such as selective serotonin reuptake inhibitors, which boost serotonin levels in the brain, can also provide relief.
Though Combs is now equipped with coping mechanisms, he admits that it wasn’t always this way.
“I definitely want to spend some time at some point in my life doing some outreach that kids who deal with this,” he said. “It held me back so many times in my life where you’re trying to accomplish something, you’re doing really great and then you have a flare up and it ruins your life for six months.”
