Obsessive Compulsive Disorder

It’s natural to get a little obsessive about things sometimes. But according to the Royal College of Psychiatrists, if you get bad thoughts coming into your mind, even when you try to keep them out, or you have to touch or count things or repeat the same action such as washing over and over, you may have obsessive compulsive disorder (OCD)(i).

While previously considered fairly rare, obsessive compulsive disorder (OCD) is now thought of as a common form of anxiety disorder that affects an estimated 12 in every 1,000 people in the UK – the equivalent of almost 750,000 people (ii). That amounts to more than a million people in this country. Celebrities aren’t immune to OCD either, with famous sufferers thought to include Charles Darwin, Florence Nightingale and the footballer David Beckham.

OCD usually starts when you’re in your teens or early 20s, but anyone can develop it at any age, even during childhood (some children develop OCD around the time of puberty). It’s also thought to sometimes run in families.

Obsessions and compulsions

Having OCD can make you feel very anxious and distressed. You’ll usually have obsessive thoughts, images or urges that keep coming into your mind. Then to relieve the distress these thoughts cause, you may develop compulsions that you think make you feel better.

These compulsions are thoughts or actions that you feel compelled to do or repeat – for instance, if you become obsessed with germs, you may wash your hands over and over. It’s possible to just have obsessive thoughts or just have compulsions. However, most people with OCD experience both (iii).

Some people find their OCD is simply a mild inconvenience. But if you have severe OCD it can make everyday activities difficult, such as family life, relationships and going to work. That’s partly because you may spend so much time carrying out your compulsions, you may not be able to get on with anything else.

The NHS claims people with OCD are often reluctant to get help because they feel ashamed or embarrassed about it, and are worried other people will think they’re ‘mad’(iv). But OCD is a mental health condition, just like any other. It doesn’t mean you’re not normal, and it also doesn’t mean you’ve done anything wrong.

However, if you don’t get professional help, you may risk developing mental health problems such as hoarding, generalised anxiety disorders, depression and eating disorders.

Meanwhile other conditions that are similar to OCD include body dysmorphic disorder (where someone becomes convinced they have physical defects, even when they don’t), hypochondriasis/health anxiety, Tourette’s syndrome (people with Tourette’s often also have OCD) and trichotillomania (where someone has urges to pull out their hair).

Some types of autism – such as Asperger’s syndrome – also have similarities to OCD, as those who are affected may have repetitive behaviours.

Symptoms of OCD

There are three main elements of OCD, say experts from the Royal College of Psychiatrists (i). These are obsessions (thoughts that make you anxious); the anxiety you feel as a result of having obsessions; and the behaviours that relieve your anxiety (compulsions).

Obsessions can take many forms, and are not the same thing as the worries everyone has about problems in their lives. These obsessions may be unwanted and unpleasant thoughts, images, urges, worries or doubts that you can’t get out of your head. Some common obsessions include the following:

• A need for symmetry or orderliness, such as being very precise in how you order or arrange things (perfectionism)

• A fear of harming yourself or others – either deliberately or by mistake, or a fear of making a mistake or behaving bad

• A fear of contamination by dirt, disease or infection

• A need to keep things other people might throw away (hoarding

• Unrelenting worries about things like doors not being locked properly, windows left open or appliances in the home being left on

• Obsessive thoughts of a violent or sexual nature (though it’s worth noting that experts believe people with obsessions do not become violent or act on their obsessive thoughts).

These thoughts are very likely to make you feel guilty, anxious, distressed or even disgusted with yourself. So to make yourself feel better or believe something bad isn’t going to happen, you may feel you have to carry out a compulsive behaviour over and over again (this is often referred to as neutralising). This may relieve your anxiety temporarily, but once you stop doing the compulsive behaviour your obsessive thoughts can return.

These repetitive behaviours take the form of rituals, including the following:

• Cleaning and washing your hands every few minutes

• Checking things over and over again, such as whether or not you’ve locked your door properly or that you’ve switched off appliances (ovens and stoves, for instance)

• Counting

• Arranging things in strict order or in a certain way

• Avoiding touching certain objects or avoiding places or situations that you fear could trigger obsessive thoughts

• Repeating words or phrases in your mind

• Asking other people for reassurance that everything is alright

• Hoarding possessions that are no longer useful (hoarding can be both an obsession and a compulsion)

According to the NHS, not all compulsive behaviours will be obvious to other people (v).

What causes OCD?

According to the NHS, it’s not clear exactly what causes OCD, though some things are thought to make it more likely (iv). One of these is having a family history of OCD – experts believe your chances of developing OCD are higher than average if you are the mother, father, brother, sister or child of someone with the condition. However, despite this suggesting there may be a genetic cause of OCD, no specific genes have been found that are linked with it.

Being under a lot of stress may also make you more susceptible to developing OCD, and according to the Royal College of Psychiatrists stressful life events bring on OCD in about one in three cases (i). It’s also thought that depression is linked with OCD, though most experts believe depression is often a symptom of OCD rather than a cause (vi).

Certain life stages can trigger OCD symptoms too, such as puberty, starting a new job, having a baby or a bereavement. Those who are very particular about things – neatness or being very methodical, for instance – may have personalities that make them more prone to OCD too. Having a severe infection may trigger the symptoms of OCD in children too.
 

Brain chemistry

Many experts believe certain parts of the brain are different in people with OCD compared with those who don’t have OCD.  According to OCD UK, brain imaging studies have been used to show the differences between the brains of people with OCD and those without the disorder (vi). But experts still don’t know exactly how these changes trigger OCD in those who are affected.

It’s also thought those who have OCD for longer periods may have an imbalance of a chemical called serotonin in their brain. In such cases medication that interferes with brain chemicals – or neurotransmitters – including serotonin may be helpful (these are called SSRI medicines, and are more commonly used to treat depression).

The severity of symptoms can vary greatly from one person to the next. OCD UK claims 50 percent of people with OCD have severe symptoms, with less than a quarter classed as mild cases (vii).

 

How to get help for OCD

The good news is OCD is a treatable medical condition. If you have mild OCD, you may well improve without any treatment. But those with more moderate or severe OCD tend not to improve without treatment, though some may find their symptoms go away at times then get worse when they’re stressed or depressed. In such cases treatment usually helps. This usually comprises psychological therapy or medication, or – in severe cases – both.

According to the NHS, the type of therapy recommended for OCD is cognitive behavioural therapy (CBT) with exposure and response prevention (ERP) (viii). If you have OCD, ERP therapy can sound alarming, as it encourages you to face the situations you fear and wait for your anxiety to disappear without doing your usual compulsive rituals. But according to the NHS many people find that when they confront their obsessions, the anxiety eventually improves or goes away (ix).

Meanwhile CBT is thought to improve OCD symptoms in more than three in four cases, though about one in four people with OCD say CBT is too stressful and not for them (x).

If psychological therapy doesn’t help – or if you have fairly severe OCD – you may need to take medication that increases the levels of serotonin in your brain. Six out of 10 people who take medication alone for OCD find it helpful, claims the Royal College of Psychiatrists – though there is more chance that the OCD will return with medication alone compared with medication and CBT together (i).

The charity OCD Action claims it takes 12 years on average for someone with OCD to get any treatment(xi). It’s thought that many delay getting help because they fear the stigma associated with OCD, or some may simply believe nobody can help them. But if OCD is controlling your life, it’s important to get treatment.

Treatment is available on the NHS through your GP, who can refer you to a local psychological therapy service. If you feel uncomfortable about talking to your GP about your symptoms, OCD UK has produced a document you can print out and present to your doctor at your appointment that may help break the ice – you can download it here.

Depending on where you live, you may also be able to refer yourself to a local psychological therapy service.

Many people with OCD also find joining a support group helpful, as it can make them feel less isolated and may give them the reassurance they need. There are three national charities that provide details of local support groups:

• OCD Action

• OCD-UK

• TOP UK

OCD UK also runs a forum on the Health Unlocked social network where you can chat online with other people who have the disorder.

If you think a friend or family member may have OCD, the NHS recommends talking to them about your concerns and suggesting they seek help.

Natural support for OCD

Besides getting help from your GP and OCD support groups, there are a few ways you may be able to help yourself. For instance, not getting enough sleep can cause anxiety, which in turn may lead to OCD behaviours. Why not read our article, Sleep and Insomnia, to find out more, it includes tips for sleeping better,

You may also want to try practicing a technique called mindfulness, which many natural health experts believe can help you to be present among your thoughts and, most importantly, to allow those thoughts to come and go. Mindfulness may be useful if you have OCD or intrusive thoughts, as it may help slow down your brain and nervous system. Yoga and dance are both techniques you can use to become more mindful, or you could try mindful meditation.

Find out more about mindfulness at Be Mindful, a website run by the Mental Health Foundation that also provides access to an online mindfulness course.

As stressful events are often thought to trigger the onset of OCD symptoms, it may be a good idea to learn how to manage stress and avoid pushing yourself too hard (discover ways of managing stress by clicking here). On the other hand, putting things off can cause anxiety – which to may lead to OCD behaviours – so you may want to try to avoid procrastination wherever possible.

Meanwhile, there are a few natural dietary supplements that may also be useful, including the following:

Myo-inositol

A vitamin-like substance (also sometimes called a pseudovitamin) found in many natural sources, myo-inositol – often called simply inositol – is a carbohydrate with a molecular structure similar to that of glucose. It’s found in high concentrations in the brain and is often used to relieve the symptoms of anxiety. In fact, there is evidence to suggest myo-inositol works similarly to anti-anxiety and antidepressant medications, as it increases the function of a receptor in the brain called GABA-A and enhances the sensitivity of serotonin receptors (xii).

There is also some evidence that myo-inositol may be significantly more effective at reducing the symptoms of OCD compared with a placebo (xiii). Some natural health practitioners also believe myo-inositol is effective for OCD symptoms as it may help the brain use serotonin.

Fish oils

While it’s widely believed the omega-3 fatty acids found in oily fish support brain health in general, there aren’t any positive clinical studies to back up the idea these fatty acids – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – may help alleviate all of the symptoms of OCD. There is, however, some evidence that fish oils may help with one particular symptom, namely anxiety (xiv).

Meanwhile if you’re a vegetarian or vegan you can still benefit from an omega-3 supplement, thanks to the availability of products that contain the natural triglyceride (TG) form of omega-3, which is sourced from plant organisms called microalgae rather than fish.

Vitamin B complex

Taking a good quality B complex supplement may also provide you with some B vitamins that have been linked with OCD. Researchers writing in the Indian Journal of Psychological Medicine have suggested OCD may indeed by an early sign of vitamin B12 deficiency (xv). The experts go as far as recommending those who have OCD should have their B12 levels checked. Vitamin B6 could be useful, as it may help convert the amino acid tryptophan into serotonin(xvi). Some natural health practitioners also recommend folic acid– another B vitamin – for patients with OCD, as it may be needed for serotonin production in the brain.

L-theanine

A non-protein amino acid found almost exclusively in green, black, oolong and pekoe tea, L-theanine is believed to stimulate the production of calming alpha brain waves (xvii). There’s also evidence it may help reduce stress (xviii), and some experts believe it may be useful for treating anxiety disorders (though the current research for this isn’t conclusive). There is also a theory that L-theanine increases GABA levels in the brain, which, along with serotonin, may help calm the brain and control anxious thoughts.

Managing OCD on a daily basis can become difficult at times, but this guide should help to make things a little easier. For more information on a number of common health conditions, feel free to visit our health library

References:

1. Available online: https://www.rcpsych.ac.uk/mental-health/problems-disorders/obsessive-compulsive-disorder

2. Available online: https://www.nhsinform.scot/illnesses-and-conditions/mental-health/obsessive-compulsive-disorder-ocd

3. Available online: https://patient.info/doctor/obsessive-compulsive-disorder-pro

4. Available online: https://www.nhs.uk/conditions/obsessive-compulsive-disorder-ocd/

5. Available online: https://www.nhsinform.scot/illnesses-and-conditions/mental-health/obsessive-compulsive-disorder-ocd#symptoms

6. Available online: https://www.ocduk.org/ocd/what-causes-ocd/

7. Available online: https://www.ocduk.org/ocd/introduction-to-ocd/

8. Available online: https://www.nhs.uk/conditions/obsessive-compulsive-disorder-ocd/treatment/

9. Available online: https://www.nhs.uk/conditions/obsessive-compulsive-disorder-ocd/treatment/

10. Available online: https://patient.info/mental-health/obsessive-compulsive-disorder-leaflet

11. Available online: https://www.ocdaction.org.uk/ocd-in-brief

12. Solomonia. R, et al. Myo-inositol treatment and GABA-A receptor subunit changes after kainate-induced status epilepticus. Cell Mol Neurobiol. 2013 Jan;33(1):119-27. Levine. J, et al. Controlled trials of inositol in psychiatry. Eur Neuropsychopharmacol. 1997 May;7(2):147-55.
    Rahman. S Neuman. RS, et al. Myo-inositol reduces serotonin (5-HT2) receptor induced homologous and heterologous desensitization. Brain Res. 1993 Dec 24;631(2):349-51.

13. Fux. M, et al. Inositol treatment of obsessive-compulsive disorder. Am J Psychiatry. 1996; 53: 1219-1221.

14. Kiecolt-Glaser. JK, Belury. MA, Andridge. R, et al. Omega-3 supplementation lowers inflammation and anxiety in medical students: A randomized controlled trial. Brain Behav Immun. 2011 Jul 19.

    Kuan-Pin Su et al., Association of Use of Omega-3 Polyunsaturated Fatty Acids With Changes in Severity of Anxiety Symptoms. A Systematic Review and Meta-Analysis. JAMA Netw Open. 2018 Sep;1(5): e182327. Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324500/

15. Valizadeh. M, Valizadeh. N. Obsessive Compulsive Disorder as Early Manifestation of B12 Deficiency. Indian J Psychol Med. 2011 Jul-Dec;33(2): 203–204.

16. Available online: http://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000337

17. Nobre. AC, Rao. A, Owen. GN et al. L-theanine, a natural constituent in tea, and its effect on mental state. Asia Pac J Clin Nutr. 2008.;17 Suppl 1:167-8.

18. Juneja. . Suntheanine and its relaxation effect in humans. Trends in Food Science & Tech. 1999;10;199-204.
    Kimura. K, Ozeki. M, Juneja. LR, Ohira. H, et al. . L-Theanine reduces psychological and physiological stress responses. Biol Psychol. 2007 :74(1):39-45.

 

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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 

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