Obsessive-compulsive disorder affects an estimated two to three million American adults. It is characterized by repetitive thinking and the inability to control or put a stop to this thinking process. As orthomolecular psychiatrist Dr. José Yaryura-Tobias explains, these thoughts become urges that are so demanding that it appears to the person who has them that they must be carried out. OCD can have a significant impact on daily living. Two of the main compulsions are double-checking and hand washing.
According to Dr. Yaryura-Tobias, “As to why this condition exists at all, we don’t have a sure answer to that question. The behavior may result from a learning process that takes hold during childhood. It may relate to changes in neurotransmitters—the chemical substances in the brain that build bridges between nerve cells so that they can transmit signals from the outside into our system or, in the reverse direction, direct us to act to affect the outside world. The key neurotransmitter that is being studied in this regard is serotonin.”
Dr. Yaryura-Tobias tells about some of the peculiar characteristics of obsessivecompulsive behavior: “It usually takes about seven years or so for a patient to come in for a consultation, which tells us that the condition tends to occur gradually, becoming part of the patient’s behavioral system in a very, very slow manner. It occurs with equal frequency in males and females. Fifty percent of obsessive-compulsive patients manifest their sickness during childhood or adolescence. Later on—primarily after the age of forty—it fades away, and it becomes very rare after age fifty.
According to the late Dr. Robert Atkins, there is some common ground here between conventional and alternative medicine. “Both orthodox medicine and complementary medicine recognize that if a certain neurotransmitter is in short supply, certain syndromes will result. A classic example is that a serotonin-deficient person will often be an obsessive-compulsive. These are the people who can’t get out of the house because they’ve got to make sure the light switches are off or the gas jet isn’t on, the people who have to wash their hands twenty times a day, and the people whose desks have to be perfectly neat. These people are serotonin-deficient.”
The difference between the conventional and the alternative medical communities lies in how they address the problem. Dr. Atkins described the conventional approach: “Now there are drugs that block the degradation of serotonin and allow the serotonin level to lift, but those drugs do a lot of other things: they poison a lot of enzyme systems, and that’s why so many people got into trouble with Prozac and drugs like that.” In addition to Prozac, other drugs used to treat obsessive-compulsive disorders are Anafranil, Luvox, and Paxil.
To treat obsessive-compulsive disorders, Dr. Yaryura-Tobias uses conventional behavioral therapy and an amino acid approach, along with some other nutrients.
“We basically treat with behavioral therapy. We try to use thought-stopping, exposure (flooding), and response prevention to prevent the brain from repeating the same thought. That is difficult, so we also use cognitive therapy to explain the reasons we think the things we do and try to modify the thoughts.”
Behavioral therapy is most effective in dealing with compulsions. Dr. YaryuraTobias explains that it’s important to expose the patient in some way to her fears. “If you have fears of AIDS or of blood, you are exposed to blood or taken to the hospital where there might be patients with AIDS. Or you will read articles on the condition.
“If it is contamination from dirt the patient is afraid of, we teach that person how to touch objects and not be afraid of them. Then we prevent the patient from washing her hands; in other words, she must remain unclean for a while. I’m talking about patients who, when they are seriously ill, might completely use up one or two bars of soap per day. They might engage in rituals of washing for many hours. They may wash their hands sometimes a hundred or more times a day. Some of these patients will also clean their hands with alcohol or other substances. Sometimes their skin becomes extremely raw. I’ve seen cases where patients require plastic surgery.
“Overall, the treatment takes about six months. With medication there is improvement up to 60 or 70 percent of the time.”
People with obsessive-compulsive and anxiety disorders often improve on the amino acid tryptophan. Dr. Yaryura-Tobias says, “My colleagues and I were the first to use tryptophan, and with it we were able to reduce and almost eliminate completely the use of drugs for this condition, and we obtained very good results. We were using between 3, 000 and 9, 000 milligrams per day.
“Then we used vitaminB6, 100 milligrams, three times a day. VitaminB6, pyridoxine phosphate, is a vitamin that is very important for the breakdown of tryptophan into serotonin. The idea behind this was that these patients didn’t have enough serotonin in their brains or were very dependent on serotonin or that the normal conversion of tryptophan into serotonin was not occurring.
“When we found by measuring that there was a lack of serotonin, this could be reversed by the administration of L-tryptophan with niacin and vitaminB6. Some medications also accomplish this result, but with medications we face many types of side effects.”
Not all patients see good results. “About 30 percent of patients do not respond to any form of therapy,” Dr. Yaryura-Tobias says. “But it is not a closed chapter for these patients either. An investigation has to be conducted. Now that we have brain imaging, we are able to visualize the brain. We can measure, for instance, the metabolism of sugar in the brain. We find, for instance, that the frontal and temporal lobes and the basal ganglia, which are related to Parkinson’s disease, are disrupted. We see the metabolism of the breakdown of sugar and also images of an abnormal brain. The same can be seen with some electrophysiological measurements of brain wave tests and so forth.
“Interestingly, work has been going on using pure behavioral therapy before and after measuring serotonin. With just behavioral therapy, we were able to modify the levels of serotonin in the body. In other words, we may not need medication to change or challenge the presence of a neurotransmitter such as serotonin. Behavioral techniques alone may have an effect.”
An increasing body of evidence is showing the benefits of natural modalities to overall health and well-being. Following is a sample of recent peer-reviewed scientific studies relating to obsessive-compulsive disorder.
A pilot study reported in 2015 in Cognitive Behaviour Therapy found that adding a twelve-week structured physical exercise program to cognitive behavior therapy for people with OCD had significant positive effects. A 2011 report in the Indian Journal of Psychological Medicine found that OCD may be one of the first signs of vitaminB12 deficiency.