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Holistic OCD Treatment — Keys to Taking Your Life Back, Pt. 3

Updated: Dec 30, 2023

Gut Microbiome and Mental Health



“…depending on the site of residence, local microbiomes can have additional functions. Most importantly and best characterised is the gut microbiome and its support in food digestion. This local microbial community metabolises otherwise unbreakable substrates and produces molecules that are important for our metabolism.


Now, research shows how the gut microbiome and its products also affect our mental health. As such, dysbiosis of the gut microbiome can even result in psychological disorders like anxiety or depression.



About the communication between the microbiome and the brain

The microbiota–gut–brain (MGB) axis represents the bidirectional communication between the brain and the gut microbiota. Many factors influence this interaction: the immune system and its chemokines and cytokines; metabolic pathways and metabolic products as well as the central nervous system and its stress hormones and neurotransmitters.


Different bacterial species can metabolise these hormones, metabolites and neurotransmitters in the gut. Additionally, stress and emotions affect the secretion of gastric acid, bile and mucus. Together, these factors alter the environment for microbes and thus the composition of the gut microbiome.


On the other side of the MGB axis, gut microbes produce metabolically active compounds like short-chain fatty acids. These cross the epithelial cell layer and modulate gene expression, neurotransmitter signalling and metabolism. Thus, a change in the microbiome composition can influence our emotions and stress behaviour.




A change in the composition of the gut microbiome can influence our emotions and behaviour.

Your behaviour shapes your gut microbiome shapes your mental health


Many factors like diet, physical exercise, drug treatment or geographical location impact the gut microbiome composition. By shaping the gut microbiome and thus the produced metabolites, these factors also influence our mental health status and behaviour.


For example, studies investigated the effects of foods that contain probiotic strains like Bifidobacterium infantis, B. longum, Lactobacillus helveticus ROO52, L. rhamnosus JB-1 or L. casei strain Shirota. These probiotic foods were shown to reduce depressive- and anxiety-like behaviour, memory dysfunction and even physical symptoms during stressful periods.


Also, prebiotics like fructooligosaccharide and galactooligosaccharide have similar impacts on our mental health and cognitive behaviour. Researchers claim that prebiotics increase the relative abundance of beneficial microorganisms and thus shape the MGB axis.


Gut and brain bidirectional relationship

We can influence our gut microbiome and mental health with more than food. For example, physical exercise not only helps the immune system and metabolism. It also leads to a richer gut microbiome that helps metabolise lactic acid from the muscle to produce more short-chain fatty acids.


On the contrary, increased alcohol intake or chemotherapy can have opposite effects on our mental health. These compounds harm the epithelial layer of the gut resulting in gut leakiness and inhibited microbial adherence. This changes the gut microbiota and can lead to an increased risk for psychiatric disorders, depression and anxiety.” Quote source : Federation of European Microbiological Societies






Gut Microbiome and OCD


“A bidirectional relationship exists between the gut and the brain through what is known as the gut-brain axis. In other words, our gut health impacts our mental health, and vice versa. The gut microbiome plays a fundamental role in influencing mental health through its effects on immune activation and neuro-endocrine responses [1]. To learn more, read the article Gut-Brain Axis and Probiotics on the Probiotics Learning Lab.


The gut microbiome is thought to affect symptoms of OCD in a similar manner [2]. It has been suggested that inflammation can be a contributing factor in the development of OCD symptoms [3]. Raised pro-inflammatory cytokines (chemical messengers) have been detected in some individuals with OCD when compared with healthy controls [4]. Dysbiosis (an imbalance in the composition of the gut microbiota) has also been associated with inflammation in OCD. Reduced diversity in the composition of the gut microbiome was found in individuals with OCD along with raised CRP levels, a marker of inflammation [5].


The gut could potentially be a source of this inflammation, as in ‘leaky gut’. Dysbiosis can lead to increased intestinal permeability or ‘leaky gut’, allowing the translocation of bacterial components and other substances through the lining of the gut, which can subsequently stimulate systemic inflammation [6].


A healthy gut microbiome plays a fundamental role in maintaining intestinal epithelial integrity. HPA axis activation, the body’s neuroendocrine system which responds to stress, can also lead to dysbiosis which in turn can lead to inflammation as previously outlined [7].





Probiotics for OCD



To date, there have been very few human studies released assessing the effects of probiotics alone on the symptoms of OCD. However, several notable preclinical animal studies have been published which may pave the road for future clinical studies. OCD-like symptoms can be induced by certain drugs in mice. The development of obsessive tendencies, in response to an OCD-inducing drug, was hampered in mice who were administered one billion CFU of the probiotic Lactobacillus rhamnosus GG3 daily for at least two weeks, compared with placebo[8]. Lactobacillus rhamnosus GG4 was shown to elicit similar reductions in OCD-like behaviours compared with the SSRI, fluoxetine, often used for OCD. Learn more about the research behind Lactobacillus rhamnosus GG3.

In a similar animal study, behavioural assessments demonstrated an improvement in OCD symptoms in rats with drug-induced OCD when administered 1 billion of Lactobacillus casei Shirota daily for four weeks, compared with placebo [9]. Learn more about the research behind Lactobacillus casei Shirota.


Of note, there is an ongoing clinical trial assessing the effects of Bifidobacterium longum Rosell-175 and Lactobacillus acidophilus Rosell-52 on OCD symptom severity, in 64 individuals diagnosed with OCD, when administered daily over 12 weeks [10]. The results of this trial are due to be published later this year. Bifidobacterium longum Rosell-175 and Lactobacillus acidophilus Rosell-52 have already been recognised for their effects on mental wellbeing [11]. Learn more about this research by reading Two probiotic strains for mental health.


This research behind the role of probiotics in OCD, although promising, is in its early days; more extensive research is required before the use of probiotics can be used in the clinical management of OCD.” Quote source : optibacprobiotics.com

Finally, I will add something from my personal experience, again. While working on this article, I started having issues with my gut. Long story short, acute gut lining inflammation sparked a really nasty mental condition : anxiety was aggravated drastically, I acquired depression-like mental state.


When severe inflammation flare up calmed down to a milder state, my psyche was also relieved, at least partially. I am still dealing with gut inflammation, and my mental state, along with general well-being is still compromised.


By the time the article was about to be completed, my old and new health issues managed to synergise, rendering constant or almost constant nausea that I, apparently, cannot control or ease anymore.


My health conditions render me really sensitive to things most people are not, even more so with their synergy of comorbidity. The positive side of this is that I can note things that are not apparent to people in common.


Therefore, I can anecdotally reflect that the connection between gut and brain is, perhaps, hugely underestimated.





References :



1. Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 2015;28(2):203-209. http://www.ncbi.nlm.nih.gov/pubmed/25830558. Accessed April 20, 2018.


2. Larkin D, Colin R. Martin. Probiotics in Mental Health. Chapter “Probiotics and Obsessive-Compulsive Disorder.”; 2018. https://books.google.ie/books?hl=en&lr=&id=f9tdDwAAQBAJ&oi=fnd&pg=PT152&dq=probiotics+and+OCD&ots=SzrgtOgMS6&sig=1tPHdB7SJuFl7genNoDjIdfaowo&redir_esc=y#v=onepage&q=probiotics and OCD



3. Turna J, Grosman Kaplan K, Anglin R, Van Ameringen M. “What’s bugging the gut in OCD?” A review of the gut microbiome in Obsessive-Compulsive DISO. Depress Anxiety. 2016;33(3):171-178. doi:10.1002/da.22454


4. Rao NP, Venkatasubramanian G, Ravi V, Kalmady S, Cherian A, Yc JR. Plasma cytokine abnormalities in drug-naïve, comorbidity-free obsessive-compulsive disorder. Psychiatry Res. 2015;229(3):949-952. doi:10.1016/j.psychres.2015.07.009



5. Turna J, Grosman Kaplan K, Anglin R, et al. The gut microbiome and inflammation in obsessive-compulsive disorder patients compared to age- and sex-matched controls: a pilot study. Acta Psychiatr Scand. 2020;142(4):337-347. doi:10.1111/acps.13175


6. Kelly JR, Kennedy PJ, Cryan JF, Dinan TG, Clarke G, Hyland NP. Breaking down the barriers: The gut microbiome, intestinal permeability and stress-related psychiatric disorders. Front Cell Neurosci. 2015;9(OCT). doi:10.3389/fncel.2015.00392



7. Farzi A, Fröhlich EE, Holzer P. Gut Microbiota and the Neuroendocrine System.


8. Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 2015;28(2):203-209. http://www.ncbi.nlm.nih.gov/pubmed/25830558. Accessed April 20, 2018.



9. Sanikhani NS, Modarressi MH, Jafari P, et al. The Effect of Lactobacillus casei Consumption in Improvement of Obsessive–Compulsive Disorder: an Animal Study. Probiotics Antimicrob Proteins. 2020;12(4):1409-1419. doi:10.1007/s12602-020-09642


10. Probiotic Treatment in Adult Obsessive-Compulsive Disorder - Full Text View - ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02334644. Accessed February 10, 2021.



11. Probiotic Treatment in Adult Obsessive-Compulsive Disorder - Full Text View - ClinicalTrials.gov. https://clinicaltrials.gov/ct2/show/NCT02334644. Accessed February 10, 2021.









OCD: Strategies, Self-Development



My Approaches and Strategies


Personally, I have developed lots of various strategies, approaching the problem from different perspectives; the information given here is solely a faint drop of all approaches, resolutions etc; I cannot recall everything and have written to the best of what I can remember (to try and recall everything and input it here would be comparable to an attempt of pulling a rubber on a truck). Especially in my current condition.


In general, there are two main kinds of approaches I take : first is to disarm OCD, render its urges useless; break the logic, that keeps operators looping in void tasks and sequences; second is to switch to other processes, thus narrowing the amount of ‘CPU’ that OCD uses.


Regarding the first type of approaches, I mainly utilise meditation-like time with myself, where my subpersonalities and sub-entities can meet and discuss the trigger topic, to the extent of huge inner-conferences; of course, it took me a long time to shape the procedure into its present form, but the idea is broad, versatile and can be achieved by anyone :


Find a physical location and time, where and when you will not be disturbed. Relax, sit in a comfortable position and take your time to speak to yourself.


Describing and teaching meditative processes and techniques is beyond the scope of this article, so I will skip those technical parts. You can adjust the extent of actual ‘meditativeness’ versus inner dia/polylogue to fit your mode.


There are various ways you can now attempt to get rid of the ‘viral scripts’ (obsessive ideas, thoughts, causing compulsions; trigger topic), as well as OCD-governing mind-set as well. Some of which include :


Logic. You can negate the logic behind your obsessions and the rules that OCD’s feeding you. Prove the absurdity and irrationality of it. Mock it to the point of your absolute inner agreement that following those rules is highly irrational, absurd and ridiculous. Motivate yourself to become a bigger entity and get a grip on your life; then get a life that you’ve always wanted; be a healthy and happy person. Look at yourself in the future. Do future you follow some absurd self-mind-gaming rules and loops silly rituals, or do you have control of what is going on in your life and mind ? Motivate yourself to become the person you want in contrast to the character you end up being, if you resume this nonsense. If you get angry, that’s good. Use it to light up flames of your inner revolution !


A couple of the most substantial things to acknowledge and control, when dealing with OCD — are attention and importance. The mental loops are authorised to run, because they are granted a certain degree of attention and importance — something that OCD-free individuals would probably never do.


You probably are not going to run three circles around a stadium, if you’ve seen a squirrel (unless you’ve been surgically implanted with a dog’s pituitary gland, and/or actually messed with squirrels).


Now, imagine your mischievous OCD orders you to run around the stadium three times, each time you see a squirrel. Ignoring the obvious conclusion that you are a new test subject of the Secret Squirrel Society, let’s just pretend your OCD.


If your OCD urge is stronger than your natural instinct of laziness, you will actually rush to the stadium, because it is a valid rule that OCD made up. This rule is given enough ‘gravity’ to actually make you abide it, and enough attention to make sure you follow the protocol.


It may seem obvious, but it is actually useful to keep the idea of manually decreasing the importance and attention of your OCD triggers.


Of course, the squirrel example is silly and ridiculous, because it’s a complex ritual, involving a lot of effort for a trigger that hardly anyone could obtain (for your own sake and for mine, let’s pretend there is no highly developed squirrel society out there, okay ?), but the point here should be clear.


One of the ways you could take, or, say, one of the topic you could bring up within your inner debates is the importance of the action. Why do this silly action ? What do you get by following the rule ? What do you risk by not following it, and what are the adequate chances of that ? Are your concerns proven by science, or is it just some irrational fear with a chance of occurrence so negligible, compared to the obvious odds of what is your life is going to be, if you resume abiding by silly rules that OCD mental parasite is making up ? Yes, once again, it might be useful to analyse the reasoning behind your rituals, bringing up common logic and science your psyche cannot argue with — especially if you put a healthy, reasonable life on the other plate of the scales.


Another topic you could bring up, is the amount of attention you are willing (not) giving to maintain the OCD’s grip on your brain : you could analyse to what extend small, simple rituals and casual everyday loops ruin your life experience and life itself. What does it ever give in return ? Is it reasonable of donating AT LEAST 0.1 % of your CPU to a ‘systemic’ virus, corrupting your existence and performance ?


It may seem that I am just repeating myself over what I have previously wrote above, but I really want to fully convey my ideas and thoughts — kind of ‘fight fire with fire’ situation.


Fast & Violent. Throw a proper Coup d’état. Kick out the roaches behind the wheel into the far shady prison corner, where you won’t interact with them. No explanations, no lectures, no meetings, just a sudden blitzkrieg. This kind of revolution might require a huge amount of rage and will power. Try going brutal 😎 (* see annotation in red below). Power of self-esteem and will can do miracles. No, you don’t give a rat’s grass about those silly insignificant thoughts. There are not worth your attention ! Just go and talk to a girl you like instead — as an option. (You can try taking her with just another blitzkrieg as well, followed by a proper Vernichtungsschlacht.) Brutal !



Cool guys don't look at explosions — even if it's their own mind


Cage your OCD sprouts. Thicken your mental walls with your self-esteem and motivation. OCD ‘creatures’ will scratch the wall. The more violent was the action/coup, the less arguments you provide, the more it scratches. It will try to escape your banish and come for you. Make sure to follow the proper biomental hygiene (i.e., neurotransmitters balanced, decent amounts of sleep etc.) to maintain the proper biological caging, especially during first times.


Speaking of walls. It is important to distinguish your inner voice of conscience, scratching the walls of denial versus OCD, bashing against your deliberately constructed confinement. If something’s telling you that it is in your powers to fix something, do something you should, or not do something you shouldn’t; that something in your actions or inactions isn't right, then maybe it is actually correct and wise to review the subject of matter rather than ignore it; maybe it is worth growing a nice pair of balls instead of caging your conscience.


Sycamore balls
Sycamore balls | Image credit : sheilaf2002

Let your logical reasoning and your heart be your gold standard yin-yang balance scales that stand on a book pile (knowledge, actual scientific data; confirmed and scientifically backed up information that you might not want to face).


In my personal experience, I had a case of my cruel denial walls fallen apart, brick-by-brick, throughout a certain time period; it is when I managed to take it down, I discovered a world full of [animal] pain, hidden from people. Intended to be hidden. It was then when I called myself vegan. Fancy having a peek ?


Back to OCD. It is important to note that OCD triggers may vary in complexity. The tiniest ‘tick’-looking rituals or intrusive purely mental (thought) obsessions are probably most dangerous and pervasive. It is again, that sometimes, smaller things tend to be the deadliest.


The timing and the adequacy of your current approach are important things to consider. Before taking up any extreme approaches, weigh out all the odds; you are taking the responsibility for all your actions — I am not. Is it the best time for a blitzkrieg ? Or is this a tactical nonsense in your immediate situation?


Also, consider going easy on yourself, if your brain neurotransmitting system is not in its best shape at the moment.


Hopefully, after you switch to a healthier lifestyle or/and proceed with relevant medication, you will forget your old terrible mode of existence. Although, keep in mind that if you return to your old life habits, addictions, toying around your brain — then you might just end up in the old nightmarish realm once again.


Remember, those who do not learn from their history are doomed to repeat it.


It is also important to note that the major, drastic ‘life changing change’ might not come in your one blow, but rather will be achieved stepwise, one milestone after another;


The degree of ‘OCD-ness’ varies hugely from one person to another; many people have mild OCD symptoms to some extent, a lot fewer suffer considerably, or even struggle to exist.


It could take one explosive blast to take down a relatively quiet OCD structure, but it could take months to siege bigger, older, ‘ossified’ strongholds, as there is more brain rewiring that has to be done.


Regarding the methods stated above, it is crucial to understand that it is not necessarily an OR choice strategy; those are strategies that could be combined and used in various steps throughout the whole ‘war’. Suit yourself with the tactics, develop your own plans; I am solely providing the ‘weaponry’, the ‘blueprints’.


It is important not to inflict judgment upon yourself, if you do not seem to succeed; it can turn on you and bug you as a new obsessive-compulsive entity.


When someone has severe OCD, anything can turn on the person — a slightest thought, memory, idea, image etc. can cling dead to one’s mind, causing lots of painful mind loops.



* Important notice : I am not ranking people by their ‘coolness’ depending on the approach they take. NO ! The approach varies from person to person, the type of their ‘brain wiring’, OCD ‘layout’ and cognitive preferences.


If you tend to take logical approaches, it does not mean you don’t have the balls. If you tend to take brutal approaches, it does not mean you’re less intelligent. It’s all about personal schemes !




A brisk reminder before moving on : everything written in ‘My approaches and strategies’ part is subjective — unlike, for instance, all scientific/general data I have provided. Hence, you might not find everything reasonable and/or useful for yourself in this part of the article.


Do not play by OCD rules. OCD is one pesky trickster. It will attempt to shove your fears in your face, and one of the main tricks is in the potential zugzwang situation : promoting thought gum by running thinking loops might not help, and so won’t trying to escape it (remember what I wrote about balance ?)


Facing your fears could be a more appropriate approach, which correlates to topics, written above.


However, fear is not the only tool — OCD is handy with other ‘negative’ feelings — hatred, rage, blame, guilt. Facing your negative emotions and deep dark thoughts should help — however, again, it is important to keep the balance, and not overthink, falling into endless ‘brainsturbation’ processes. Remember of yin-yang. Meditation could be much of a help.


The other face of many-sided ‘thought demon’ of OCD, which is close to guilt, would be unacceptance of oneself. Some people struggle to accept themselves. OCD does not help. In fact, it can considerably aggravate it — which is a huge hinge for OCD to cling to.


Learn to accept yourself for who you are, and learn to accept OCD for the ‘official’ part of your character, that does not make you less of a personality, as a character. It does not make you defective. Perhaps, on the opposite. Hardships tend to strengthen our characters.



! -- <insert inspiration quote or parable of your preference (such as “what does not kill us makes us stronger” or that one about boiling eggs, coffee, carrots and other foodstuffs [no, it’s not an alchemist’s cookbook])> -- !



I, personally, am very thankful to OCD regarding the person I have become. Although my experience with OCD has been tremendously tough — the character development turned out to be respectively vast.


Try seeing the benefits of having OCD — maybe one day you will realise, that all of it has been worth it; maybe even had a higher purpose — if you believe in greater purposes and bigger pictures, of course.


If certain people are not willing to accept you for who you are, maybe it’s time to start filtering your social circle ?


It took me a long time to accept my OCD is a part of myself; until that point I regarded it as something unnatural, rendering myself defective. Moreover, I had a lot of devastating loops of analysing, processing and subsequently categorising events, happening in my life; I stigmatised the events that happened due to my OCD (in other words, the offset of which was triggered by the influence of OCD) as ‘wrong’, being uncanonical to my life and story. Like ‘nexus events’, to make an analogy. I tried to aggressively erase those events and all their consequences from my life and this world. That’s right — I used to be correcting my timeline long before it was a mainstream.



Of course, it is physically impossible to really undo anything, since it requires manipulations with space-time (and even then, it really depends on real space-time configurations — how our reality works, in other words), however my strategy was to at least get rid of the ‘visible’/significant ‘errors’.


Of course, this did not lead anywhere good. One tiny ‘nexus event’ was a 'butterfly flap' that launched an uncontrollable chaos of consequential events, attempting to track which put an enormous load on my ‘CPU’.


'Nexus events'

Apart from inability to accept the events, occurring due to OCD, I had also had OCD-ish issues accepting events that happened because of “bad” and/or storyline-insignificant and/or malicious people.




Other

There are a lot of professional and/or empiric guidelines, strategies and information on how to deal with OCD, live with OCD and/or overcome OCD; stories of people who beat it, or managed to live with it. If you would like to get acquainted with other people’s strategies and/or stories, here are some links for additional reading :



These are third party articles I deemed reasonable to include here as additional information sources, in case you need them. I have briefly scrolled through them myself and have not read them, hence, I do not comment.


At first, I thought of embedding best strategies and methods I find online here, but then rejected this idea. Later on, I thought of properly moderating the articles before referencing them here, but this would have been a huge load of unnecessary effort. Besides, my subjective judgment is not exactly the universal objective decision making unit, hence, in my opinion, it would be reasonable to leave those sources unmoderated, awaiting for your own inspection, if you wish to do so.


In addition, you can always look for other articles in the global web. There are plenty.




Conclusion


It is important to balance yourself : let the psychological strategies and biological approaches be your yin and yang, your dual mental management.


I have a vast experience in OCD with these yin and yang separately and together; as well as them both at their minimum. I want to highlight that biological part of this multi-approach is crucial; you might work your brain out, developing strategies and achieving certain results, but it is impossible to keep the brain at healthy rest, if its neurotransmitting system is impaired.


A posteriori I discovered, that even if there are no active ‘official’ triggers/loops that impede and burden the mind, if OCD-prone brain’s neurotransmitter wiring is in lamentable condition, then mind will be running ‘ghost loops’ anyway, trying to cling on everything it percepts — either via imaginary escapism, or simply unreasonable background anxiety/restlessness, as if it was picking a fight — either directly with you, or inciting you into a conflict with some person or idea.


Within and beyond the scope of OCD-prone brains, neurotransmitting malfunction in the ‘central processor’ results in pathetic, depleted, emasculated and unleavened life experience. Poor neurotransmitter wiring foredooms a person for a grey life and lack of ‘spark in eyes’. The life that has all the colours sucked out of it, or at least dampened — even if we’re talking about a mentally healthy individual. The longer the brain functions under such circumstances, the messier becomes the wiring — and the more it will take to fix it afterwards.