Obsessive-Compulsive Disorder

Billie J. Sahley, Ph.D., C.N.C.

Obsessive-compulsive disorder (O.C.D.) is characterized by continuous anxious thoughts and ritualistic behavior you feel you cannot control. Those who have O.C.D. are plagued by persistent, negative thoughts or images and the urgent need to engage in obsessions and rituals. Obsessions are persistent impulses, ideas or images that control behavior. Compulsions are the result of the behavior from the obsessions. Compulsions are inseparable from the obsessions from which they arise. A compulsion is an obsession expressed as action. If obsessions and compulsions consume more than an hour per day this can cause occupational as well as social impairment and distress. Compulsions are repetitive behaviors that are in response to continuous thoughts in an attempt to neutralize them. The National Institute of Health reports that 80 to 90% of patients have obsessions and compulsions. Twenty percent are only obsessional. Ten percent will perform rituals to reduce anxiety and just feel better. Research has demonstrated that serotonin levels in the brain play an important role in O.C.D. behavior. As the serotonin level in the brain depletes compulsive behavior increases. Serotonin plays an important role in controlling O.C.D. impulses. Serotonin is the master controller and an inhibitory neurotransmitter involved in the regulation of mood, behavior and memory. O.C.D. rituals are very common. The four most frequent rituals are avoidance, checking, cleaning and counting. Phobias and avoidance go hand-in-hand with O.C.D. behavior. Fear is the master controller and the most powerful emotion. Research has established the area in the brain responsible for O.C.D. behavior is the caudate nucleus. The caudate nucleus acts as a sentry that prevents O.C.D. behavior from controlling specific circuits in the brain. The action is similar to a broken tape that plays continuous unwanted thoughts that keeps repeating, resulting in increased O.C.D. behavior. Many healthy people can identify with having some of the symptoms of O.C.D., such as checking the stove or doors several times before leaving the house. But O.C.D. is diagnosed only when impulses cannot be controlled and total impairment is obvious. Most adults with this condition recognize what they are doing is senseless, but they cannot stop it. Some people, especially children with O.C.D., may not realize that their behavior is out of the ordinary. O.C.D. strikes men and women in approximately equal numbers and afflicts roughly one in fifty people, or two percent of the population. It can appear in childhood, adolescence or adulthood, but usually starts in the teens or early adulthood. A third of adults with O.C.D. experience their first symptoms as children. The course of the disease is variable. Symptoms may come and go, but are intensified by stress, anxiety, depression or grief. They may ease over time or they can grow progressively worse. Balancing the brain's chemistry with enough neurotransmitters is the key. Evidence suggests that O.C.D. might also run in families. Research has shown a genetic link is possible. Depression or other anxiety disorders can accompany O.C.D. Some people with O.C.D. have eating disorders. Additionally, they will avoid situations in which they might have to confront their obsessions. They may try unsuccessfully to use alcohol or drugs to calm themselves. If O.C.D. behavior becomes severe enough, it can keep someone from holding down a job or from carrying out normal responsibilities at home, but in most cases with behavior therapy and supplementation it can be controlled. Research conducted by the National Institute of Mental Health allowed scientists and other investigators to the development of amino acids
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and behavioral treatments that can benefit people with O.C.D. The brain chemistry must be addressed and enough neurotransmitters taken on a daily basis. A combination of the treatments is often beneficial for most patients. Some individuals respond best to one therapy, some to another. Behavioral therapy, specifically a type called exposure and response prevention, has also proven useful for treating O.C.D. It involves exposing the person to whatever triggers the problem and then helping him or her forego the usual ritual. For instance, having the patient touch something dirty and then not washing his hands. This therapy is often successful in patients who complete a behavioral therapy and relaxation program. Results have been less favorable in some people who have both O.C.D. and depression, because depression must be addressed separately. The goal of behavior therapy for O.C.D. patients is to learn to modify their response to obsessions. If you want to establish exactly what your amino acid levels then consider having an amino acid profile run. This will outline your brain's specific amino acids and nutrient needs. Call the Pain & Stress Center at 210.614.726 for information. Suggested Nutritional Support Program: Brain Link Complex - 3 scoops dissolved in juice, first thing in the morning OR TotalVite one every morning Mood Sync **- 1 or 2 capsules, two to three times daily (for children use Teen Link and HTP10) OR use Tyrosine 850* - one in morning and one in the evening. If under 100 pounds, use tyrosine 500 milligrams, one in the morning and one in the evening. Glutamine - 1,000 milligrams three times per day; under 100 pounds, 1,000 milligrams twice daily. GABA - 1/2 capsule dissolved in water, midmorning and mid-afternoon. If under 100 lbs. use one Anxiety Control instead. Liquid Serotonin - 1/2 dropper four times per day.

Mag Link - two capsules twice per day; under 100 pounds, use one capsule daily. For smaller children mint-flavored liquid is available. Follow label instructions. 5HTP ** - 100 milligrams one hour before bedtime. If you are over 50 years of age consider adding DHEA and Pregnenolone every morning. LT (theanine), 50 milligrams For children over 12 and adults, take one to two capsules, four times as needed, to a maximum of 8 daily in divided doses. Theanine will increase the alpha waves in the waves producing a calm yet not drowsy feeling. Melatonin, 3 mg one capsule (30) minutes to an hour prior to bedtime to help with regulating your sleep pattern. * Do not use if you have PKU, have had a melanoma, are pregnant or lactating, or if you use MAO inhibitors or tricyclic antidepressants. ** Do not use if you are taking an SSRI, tricyclic, or MAO inhibitor antidepressant. NOTE: If diarrhea or loose stools occur with magnesium, decrease the amount or spread the dose out until the individual is bowel tolerant. References:
Kotulak, Ronald. Inside the Brain. Kansas City, MO: Andrews and McMeel, 1996 National Institute of Health Journal, June 1998, Issue 4, Vol. I Sahley, Billie J., Ph.D. and Katherine M. Birkner, C.R.N.A. and Ph.D. Heal with Amino Acids and Nutrients. San Antonio, TX: Pain & Stress Publications. 2005. Schatzberg, Alan F., M.D. and Charles B. Nemeroff, M.D., Ph.D., editors. The American Psychiatric Press Textbook of Psychopharmacology. Washington, D.C.: American Psychiatric Press, Inc. 1995

This article is not intended to give medical advice or replace the services of a physician. It is for educational purposes only. 2

Copyright 2010 Pain & Stress Publications May NOT be reproduced by any means without the written consent of the author. HER-40

Copyright 2010 Pain & Stress Publications May NOT be reproduced by any means without the written consent of the author. HER-40