If you struggle with unwanted recurring thoughts and/or feel compelled to engage in repetitive behaviors, you may have Obsessive Compulsive Disorder. This common mental health condition affects about 1 in 40 adults and 1 in 200 children and is characterized by 2 things:
- Obsessions—thoughts that are anxiety-provoking (such as fears of germs, thoughts of violence, or mental images of forbidden sexuality)
- Compulsions—repetitive behaviors (such as excessive hand-washing, cleaning, or counting) that provide no pleasure but alleviate the anxiety of the obsessions
If you head to your primary care physician or a traditional mental health professional for help, the treatment is likely to focus on medication or certain forms of psychotherapy. Unfortunately, research in
Current Psychiatry shows that up to 40% of people diagnosed with OCD don’t respond to treatment and are considered treatment-resistant.
Why? There are many reasons why standard treatments for OCD may not work. In many cases, treatment failure may be due to something that’s often missed in conventional psychiatry.
Here are 10 things you need to know about OCD that traditional medical professionals may miss.
1. OCD isn’t just 1 thing.
OCD is part of a spectrum of disorders (OCSD) that may also include:
- Trichotillomania (hair pulling)
- Dermatillomania (skin picking)
- Onychophagia (nail biting)
- Tourette’s Syndrome (tic disorder)
- Kleptomania (compulsive stealing)
- Compulsive shopping
- Hoarding disorder
- Body Dysmorphic Disorder (unreasonably feeling a part of the body is excessively ugly)
- Hypochondriasis (excessive preoccupation with or worry about having a serious illness)
- Oppositional Defiant Disorder (persistent arguing)
2. OCD is associated with more than 1 type of brain pattern.
At Amen Clinics, brain SPECT imaging scans show that OCD is typically associated with hyperfrontality, which means there is too much activity in the frontal lobes. This pattern is often associated with rigid, inflexible, obsessive thinking, and compulsive behaviors. In people with hoarding disorder, however, the front part of the brain is underactive, which is associated with disorganization. Understanding the underlying brain structure can help find the most effective treatment, but most traditional psychiatrists never look at the organ they treat.
3. OCSD conditions may be linked to infections.
A growing body of
scientific research suggests that the acute onset of some OCSD conditions—such as obsessive compulsive behavior and tic disorders—may be triggered by an infection. In some children, symptoms develop suddenly or worsen following a streptococcal (strep) infection, which is called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections). The sudden onset of symptoms due to other infection agents, including Borrelia burgdorferi (Lyme disease), mycoplasma pneumonia, herpes simplex, common cold, influenza, and other viruses is known as PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Healing the underlying infection needs to be a critical part of any treatment plan.
4. People with OCD are more likely to have anemia.
A
2015 study among psychiatric patients that was published in
Neuropsychiatric Disease and Treatment found that over 25% of people with OCD were also suffering from anemia. Be sure to get your iron levels checked with a ferritin blood test. Levels between 50 and 100 ng/mL are ideal. Levels below 50 ng/mL can cause problems that exacerbate OCD symptoms.
5. OCD can look like other mental health conditions.
Many OCD symptoms overlap with those associated with other psychiatric issues. A
2015 study in the Journal of Clinical Psychiatry that looked at primary care physicians’ ability to identify OCD found that over half of OCD cases were misdiagnosed. OCD is often mistaken for
anxiety,
ADD/ADHD, or
bipolar disorder. In some cases, it is misdiagnosed as
autism,
post-traumatic stress disorder (PTSD), or
schizophrenia. If a medical professional doesn’t look at the brain with functional brain imaging, it is harder to distinguish conditions, and you be on the wrong treatment program.
6. People with OCD may not be getting the maximum benefit from transcranial magnetic stimulation (TMS).
TMS is a non-invasive treatment that can change the brain for the better. It uses brief magnetic pulses to stimulate activity in the areas of the brain known to affect mood, anxiety, and pain. The FDA has approved TMS for the treatment of resistant depression, but evidence in
The Journal of ECT shows it can potentially help improve a wide range of other brain-related issues, including OCD. At Amen Clinics, TMS is used differently than in most psychiatric settings. Based on the brain imaging work at Amen Clinics, settings can be changed based on an individual’s brain scans. Using the same treatment settings for everyone isn’t as effective as tailoring the therapy to your personal needs.
7. Neurofeedback may help.
Over 1,000 scientific studies have found that neurofeedback can help a wide variety of mental health and brain-related conditions. For example, a
2013 study in Neuropsychobiology showed that neurofeedback proved useful in improving symptoms of OCD.
8. Some foods make OCD worse.
Many healthcare professionals have yet to embrace the power of nutritional psychiatry, so you may not be aware that the foods you eat are either hurting or helping your symptoms. Typically, the best strategy to balance hyperfrontality in the brain—a pattern often seen in OCD—is to find natural ways to boost serotonin because it is calming to the brain. People with OCD may “self-medicate” with high-glycemic carbohydrates that quickly turn to sugar and increase serotonin. Although the serotonin boost can calm the brain, people with OCD may become addicted to simple carbohydrates like bread, pasta, and sweets. Avoid these quick fixes, because they can cause long-term health problems and may increase anxiety. Stick with smart carbs, such as sweet potatoes, most vegetables, and fruits like berries and apples.
9. Science-backed supplements can help balance serotonin.
Many psychiatrists and primary care physicians look to medications as the first line of defense and downplay supplements saying there’s no evidence they can be effective. Or they recommend supplements solely based on symptoms rather than on biology. Both of these approaches are flawed. A growing body of scientific evidence shows that certain nutritional supplements, such as 5-HTP (5-hydroxytryptophan) and saffron, can increase serotonin to calm the brain. And nutraceuticals can be much more effective when biological information from brain imaging is taken into consideration.
10. Exercise can soothe symptoms.
Physical exercise, which boosts serotonin, can be an effective treatment for OCD. The results of a
2017 trial in General Hospital Psychiatry showed that after 12 weeks of moderate aerobic exercise reduced OCD symptoms.
OCD, as well as other obsessive compulsive spectrum disorders, can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time.
At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.
