A holistic approach to treating OCD
Obsessive Compulsive Disorder (OCD) is a debilitating anxiety disorder characterised by frequent and intrusive thoughts, compulsions, urges and behaviours. People with OCD experience high levels of fear, doubt and anxiety. The undesired thoughts and obsessions are often the underlying drive to repeat various ‘rituals’ in order to temporarily alleviate apprehension and tension. These rituals include checking behaviours, obsession about cleanliness, hoarding or orderliness. Many people with OCD have an over-estimated sense of responsibility including for the safety and wellbeing of others, sometimes believing that unless rituals are performed ‘something bad will happen’.
OCD is a condition that gradually develops over time or appears suddenly, following a traumatic or stressful time. Either way, for any sufferer and for those around them, it can be a highly disabling illness, greatly affecting a persons relationships, work and quality of life.
It is estimated over 1 in 10 people have some form or degree of OCD. 50% of cases will reach what is considered severe OCD.
Unless treated, OCD tends to get worse over time and is increasingly distressing.
What causes OCD?
There is no single identified cause for OCD. Scientists agree it is likely a combination of factors that lead to the development of OCD. This can include genetics, neurobiology, cognitive, behavioural and environmental influences.
This article focuses on the biological and psychological causes and combined integrative treatment to OCD.
Biochemical presentations related to OCD
An imbalance in serotonin is linked to obsessive-compulsive actions, depression and anxiety. Psycho-pharmaceuticals aimed to treat OCD are typically of SSRI (selective serotonin re-uptake inhibitor) variety. These aim to address the biochemical imbalance by blocking the re-uptake of serotonin, however this is not without many reported undesirable side-effects from medication, concerns of dependence and with little impact on organically supporting the production and development of natural serotonin in the long-term.
Research shows supporting the increase in serotonin can be effectively produced by orthomolecular medicine; specifically nutrition, psychotherapy, exercise and targeted micronutrient supplementation.
Psychological therapy for Obsessive-Compulsive Disorder
Psychological research has revealed useful insights into the profile of individuals with OCD and subsequently has helped develop effective psychotherapeutic approaches to treat OCD.
Cognitive Behavioural Therapy (CBT) show particular success in treating OCD and proposes that unhelpful beliefs and thoughts are often key. UK NICE guidelines recommends CBT as a first line psychotherapeutic treatment for obsessive compulsive disorder.
From a CBT perspective, it is regarded that earlier life experiences and critical incidents can trigger and influence a persons susceptibility to developing obsessive-compulsivity. An over interpretation of intrusive thoughts and underlying beliefs can contribute to the cause and maintenance of obsessive-compulsive rituals.
CBT treatment of OCD includes discussing the kinds of intrusive thoughts related to the obsessive-compulsive behaviours, challenging the underlying assumptions and beliefs, developing new responses to the thoughts and beliefs by trying some exposure experiments with the help of a specialist therapist. This in itself can offer a change in biochemistry. Trauma can also be highly linked to OCD and specialist trauma therapy to address the underlying and origins of obsessive-compulsive behaviours can also be very effective.
Addressing OCD with an integrative approach
Reviews and practice guidelines recommend CBT and SSRIs as the suggested first step for treatment for OCD. Thoughts, beliefs and emotion are essentially physical and can be addressed very effectively with talking therapy. However, many people do not want to take psychiatric medication and suffer the many undesired side effects that are commonly reported from taking them. As mentioned earlier, serotonin production can be boosted naturally through diet and lifestyle changes and so treating OCD with combined psychological and nutritional therapy can yield effective results - without related side effects or long-term dependency concerns.
OCD has been linked to brain activity in the right caudate, orbitofrontal cortex and thalamus regions. These areas are considered to largely involve neurotransmission of serotonin, dopamine, norepinephrine and GABA. Addressing imbalances in these areas can help reduce the presentation of OCD. OCD has been reportedly effectively treated with micronutrient supplements that are expected to support the organic biochemical functioning and activity in these areas.
To put simply, OCD is most highly linked to low levels of serotonin. Increasing the intake of foods high in certain vitamins and minerals that support related neurochemistry may help address nutritional deficiencies and reduce the intensity of OCD symptoms.
Nutritional support for Obsessive Compulsive Disorder
Healthy foundations: As part of any nutritional plan, it is always important to aim for optimal gut health in order to properly absorb nutrients. Bad gut bacteria is also linked to psychiatric illness. Taking a probiotic to support gut health is beneficial.
A number of key micronutrients work effectively together to help boost serotonin.
Amino acids are chemical building blocks that support the development and function of neurotransmitters like serotonin.
L-tryptophan: is one amino acid that is known for supporting the production of serotonin in particular. This can be found in a range of foods including bananas, cheese and chocolate. Supplements can be used with caution and under the guidance of a health professional or doctor. L-tryptophan supplements have been shown to increase the effectiveness of some anti-depressant medication due to increasing the foundation for serotonin. If you are unsure, speak to your doctor or health professional.
5-HTP: has received a great deal of attention in its effect on serotonin production and therefore support in reducing symptoms of obsessive compulsive disorder.
As with any supplementation, medical advice and caution should be used, especially if already taking psychiatric medication.
B12 & B6: B vitamin deficiencies are common in people with anxiety disorders and OCD. B vitamins are water soluble meaning daily intake is required. Foods high in B12 include shellfish - clams and crab, beef, liver, mackerel, soy and dairy products including milk, cheese and eggs.
B8 Inositol: Inositol is a fairly fast acting supplement that aids in blood sugar regulation and serotonin reception. Supplementing with inositol can help improve symptoms of mood disorders including OCD.
Omegas: omega 3, DHA and EPA, omega 6, GLA found in evening primrose oil reduce inflammations.
Zinc, calcium and magnesium can also reduce symptoms of inflammation and aid relaxation, calming racing thoughts and obsessional drives. Foods high in Zinc and Magnesium include nuts and seeds (especially pumpkin seeds), spinach, beans, lentils and whole grains like brown rice, meat (beef, lamb), and seafood (particularly oysters, lobster and crab).
Rich Calcium sources include dairy, cheese, yoghurt, milk or fortified alternatives, like soya milk or cereals.
As with any stress-related conditions like anxiety, panic or obsessive compulsive tendencies it can be related to inflammation. You can help reduce inflammation and increase relaxation steadily by adopting a regular yoga and/or meditation practice. Regular gentle exercise is always important and can be especially helpful if you have a tendency for anxiety or anxiety disorders like OCD. Walking, swimming, tai chi or jogging can also effect biochemistry, in particular to OCD can help boost l-trytophan and serotonin, and subsequently help reduce anxiety and increase a sense of wellbeing.
An Integrated Approach to OCD
Ideally, speak to a specialist nutritional advisor or informed mental health practitioner for further advice about addressing OCD with nutritional therapy. Testing for your own individual vitamin and mineral deficiencies is always advised before beginning any targeted change in diet or supplementation.
Combining CBT psychotherapy alongside nutritional adaptions may offer a greater chance of recovery due to the holistic and integrated biological and psychological approach.