Obsessive-Compulsive Disorder (OCD)

OCD is characterized by obsessive thoughts and/or compulsive behaviors that significantly interfere with normal life. Obsessions are unwanted, recurrent, and disturbing thoughts which the person cannot suppress and which can cause overwhelming anxiety. Compulsions are repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of the obsessions. The obsessive and compulsive rituals can occupy many hours of each day. It affects men, women, and children, as well as people of all races, religions, and socioeconomic backgrounds.

  • OCD is a medical illness recognized by experts throughout the world.
  • OCD is the fourth most common mental illness and affects approximately 5 million people in the United States.
  • People with OCD are not “crazy”, although they may sometimes feel that way because they are troubled by thoughts and actions that they know are inappropriate.
  • People with OCD are often anxious and depressed.
  • People with OCD often believe they are the only ones who have irrational, obsessive thoughts, and are therefore often ashamed and afraid to tell anyone or to seek help.
  • Diagnosis is delayed until these symptoms are “unmasked”.
  • Having OCD is not a sign of weakness or a lack of willpower in stopping the thoughts and behaviors.
  • Although the exact cause is not known, experts believe that OCD may be caused by low levels of a chemical in the brain called serotonin.
  • OCD is a treatable disease, and effective medications and therapy techniques are available.
  • Sufferers can get better if they seek help and get the appropriate treatment.

What causes OCD?

OCD appears to be caused by increased activity in the orbital frontal cortex and caudate nucleus of the brain. OCD may also involve abnormal functioning of the neurotransmitter serotonin in the brain.

Stress does not cause OCD; however, a stressful event like the death of a loved one, birth of a child, or divorce can trigger the onset of the disorder.

Can someone have both obsessions and compulsions?

At least 80% of patients with OCD have both obsessions and compulsions. Probably under 20% have only obsessions or compulsions.

Obsessions can cause anxiety, causing the sufferer to engage in compulsions in an attempt to alleviate the distress caused by the obsessions. Carrying out these compulsions, or rituals, does not result in any permanent change, and in fact, the OCD symptoms worsen.

What are the most common obsessions?

  • Fear of contamination
  • Fear of causing harm to another
  • Fear of making a mistake
  • Fear of behaving in a socially unacceptable manner
  • Need for symmetry or exactness
  • Excessive doubt

What are the most common compulsions?

  • Cleaning/Washing
  • Checking
  • Arranging/Organizing
  • Collecting/Hoarding
  • Counting/Repeating

How do you treat OCD?

The two most effective treatments for OCD are conventional drug therapy and behavioral therapy. It is generally most effective if the two can be used together.

The most effective medications for OCD are the SSRI’s (selective serotonin reuptake inhibitors) Prozac, Paxil, Luvox, and Zoloft as well as the tricyclic Anafranil. Other medications may be added to improve the effect. More about these type of medications.

Behavioral therapy teaches people with OCD to confront their fears and reduce the anxiety without performing the rituals.

 


Conditions that suggest Obsessive-Compulsive Disorder (OCD)

Mental  

Depression

Depression is a common complication of OCD: “up to 80% of people diagnosed with obsessive compulsive disorder also suffer from depression” [Barlow, 1988]. This should not be surprising, given the distressing, time consuming, and interfering nature of obsessions and compulsions.



Nervous System  

Tourette's Syndrome

It is now recognized that obsessive-compulsive symptoms occur in about half of patients with Tourette Syndrome. One informal survey of TS patients found that 72% (18 out of 25) had obsessive compulsive traits.



Symptoms - Mind - General  

Obsessive compulsive disorder




Risk factors for Obsessive-Compulsive Disorder (OCD)

Hormones  

Histadelia (Histamine High)

Histadelics are often prone to obsessions, compulsions, and addictions.



 

Low Serotonin Level

Although the exact cause is not known, experts believe that OCD may be caused by low levels of a chemical in the brain called serotonin.



 

Histapenia (Histamine Low)

Histapenia tends to cause obsessions but not compulsions.



Infections  


Metabolic  


Symptoms - Mind - General  

Past obsessive compulsive disorder




Obsessive-Compulsive Disorder (OCD) suggests the following may be present

Mental  



Obsessive-Compulsive Disorder (OCD) can lead to

Mental  

Depression

Depression is a common complication of OCD: “up to 80% of people diagnosed with obsessive compulsive disorder also suffer from depression” [Barlow, 1988]. This should not be surprising, given the distressing, time consuming, and interfering nature of obsessions and compulsions.




Recommendations for Obsessive-Compulsive Disorder (OCD)

Amino Acid / Protein  

Tryptophan / 5 HTP

OCD may be related to a central disturbance in serotonin metabolism, a hypothesis which appears to explain the efficacy of serotonin reuptake-blocking drugs. L- tryptophan and 5-HTP are serotonin precursors.

Side effects were mainly drowsiness and headaches in those whose daily doses of L- tryptophan exceeded 6,000mg. [Clinical Psychiatry News, September, 1981] Supplementation may be contraindicated in OCD patients with a history of aggressive behavior since it may increase



Lab Tests/Rule-Outs  

Test for B12 Levels

In one study of OCD patients, 20% had abnormally low serum vitamin B12 concentrations compared to the two control groups. [Acta Psychiatr Scand 78(1): 8-10, 1988.]



Miscellaneous  

Reading List

Here is a website with information on the nutritional treatment of OCD.



Nutrient  

Inositol

One study showed that 18gm of inositol daily (2 tsp in juice 3 times daily) for 6 weeks significantly reduced OCD symptoms compared with placebo. At 3 weeks there were no significant effects of inositol. The mechanism may be that the desensitization of serotonin receptors is reversed by addition of dietary inositol. [Brain Res 631: pp.349- 51, 1993; American Journal of Psychiatry, September, 1996;153(9): pp.1219-1221]



Vitamins  

Vitamin B6 (Pyridoxine)

A study found plasma pyridoxal-5-phosphate (active vitamin B6) levels were about 48% lower in depressed patients than in controls, a statistically significant finding. 57% of depressed patients, but none of the controls, were B6-deficient. When B6 nutriture was evaluated by enzyme stimulation testing (a more sensitive method), all the depressed patients and none of the controls were deficient. [Russ CS et al. Vitamin B6 status of depressed and obsessive-compulsive patients. Nutr Rep Int 27( 4): pp.867-73, 1983]



Key

Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
May do some good
Likely to help
Highly recommended

Glossary

Anxiety

Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.

Serotonin

A phenolic amine neurotransmitter (C10H12N2O) that is a powerful vasoconstrictor and is found especially in the brain, blood serum and gastric membranes of mammals. Considered essential for relaxation, sleep, and concentration.

Neurotransmitters

Chemicals in the brain that aid in the transmission of nerve impulses. Various Neurotransmitters are responsible for different functions including controlling mood and muscle movement and inhibiting or causing the sensation of pain.

Obsessive-Compulsive

People with Obsessive-Compulsive Disorder (OCD) have obsessions and/or compulsions. Obsessions refer to recurrent and persistent thoughts, impulses, or images that are intrusive and cause severe anxiety or distress. Compulsions refer to repetitive behaviors and rituals (such as hand washing, hoarding, ordering, checking) or mental acts (like counting, repeating words silently, avoiding). These obsessions and compulsions significantly interfere with normal routine, functioning, social activities and relationships.

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