Category Archives: meds

Supplements, Nutrition, & OCD: Guest Post by Leah Adair

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Leah is on the board of OCD Twin Cities with me, and she’s got the loveliest heart! She is a tremendous encourager, and she also knows more about natural ways to treat OCD than anyone I know. Leah herself has undergone ERP, and I know that she would never argue to replace ERP with the following … these are meant to complement exposure therapy.

With that said, here’s Leah!

xoxo Jackie

***

Jackie asked me to share a little bit about my experience with supplements/nutrition and treating OCD. I am not a doctor, dietitian, or a nutritionist. I am someone who suffers with OCD and I’ve done a lot of research on ways to treat it.


When the beast of OCD first began, I researched all of the possible ways that I could fight it/defeat it.


An interesting fact is that our gut is our second brain. 90% of what we feed into our body transfers to our brain. Fascinating, right?


I started taking a variety of different supplements that have been proven to help with OCD and also anxiety/depression.


I’ve been on meds combined with supplements and I’ve also done strictly supplements. It’s important to find what works for you. It’s also important to talk with your doctor or psychiatrist if you are planning to make any major changes. I had two sessions with a certified dietitian to help me understand supplements.


Nutrition:


It’s crucial to try to eat a healthy fat, protein, and carb at every meal. Carbs = fruit and vegetables. I’ve found that limiting dairy, gluten, and sugar has helped decrease anxiety quite a bit. I still LOVE pizza, , but I definitely feel a difference when I don’t eat a balanced meal.


Healthy fat is so important.
Think: BUTTER!!!  Our brains store fat and we are often lacking healthy fats in our diet. Examples of healthy fat: avocado, dark chocolate (who can argue with eating more chocolate!), eggs, olive oil/olives, fish, nuts, chia seeds, coconuts/coconut oil.


Exercise:


It’s super important to be active. When our bodies are moving, they produce endorphins which trigger a positive feeling equal to that of morphine (with out the addictive component). If exercise seems daunting to you, start small. Walk around the block or do a short video online.


This article highlights 13 reasons exercise benefits our mental health.


Supplements that help OCD:


My top 3 recommendations paired with medication are fish oil, a probiotic, and a multivitamin.


Fish oil: Fish oil helps support serotonin and build it into our bodies. It might sound like it would taste gross, but you don’t even notice the fish taste. I would highly recommend getting the “burp-less” kind. When I forget to take fish oil, I notice that my mood is much lower.


Probiotic: Probiotics are anti-inflammatory microbes that affect the gut in a positive way. Remember when I said our gut is our second brain? Probiotics have some similar effects to an SSRI. Probiotics can be purchased at Walgreens, CVS, or Target. They can also be purchased online. I get mine (with free shipping!) from www.nutrikey.net


Vitamin D: Vitamin D is what we receive from exposure to sunlight. Unless you are a lifeguard, work in construction, or some other job where you are exposed to the sun for several hours each day, you are lacking Vitamin D. This is especially important if you live in a colder climate. I actually take  take 3000 IU’s a day which is 3 tiny capsules. This article is by the Journal of Internal Medicine and highlights they ways that Vitamin D helps fight depression.


Multi-vitamin: It’s important for take a good quality multivitamin. Multi-vitamins have a lot of key nutrients that help our bodies beyond just mental health. Look for a multivitamin that has B vitamins and magnesium/calcium, like this.


5-HTP: I took this for awhile instead of an SSRI. It helps raise serotonin levels in the brain. 5-HTP is the closest natural alternative to an SSRI.


NAC:  I know of a few people with OCD who swear by NAC combined with an SSRI.  I do not take NAC, but I’m definitely considering it. It’s an amino acid/antioxidant. It significantly reduces glutamate which is a major neurotransmitter that leads to over stimulation. Here is an article from the International OCD Foundation on the benefits of NAC.


Inositol: Inositol is able to cross the blood/brain barrier and provide relief from over firing nerves, the stress reaction of over taxed, hyperactive minds. The multivitamin that I take has a small amount of Inositol in it. Inositol is in the B vitamin family. This can be purchased in powder form or capsules. Learn more here.


I hope this was helpful. Be kind and patient with yourself in this journey. It can take time to find the right combination that works for you.

Why Meds?

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A blog reader emailed me and asked, “If you are okay with sharing this, could you tell me why you chose to stay on your medication after ERP?”

My response:

For me, meds are a chemical tool to slow my serotonin reabsorption. ERP is a physical tool in that it rewires the brain and a mental tool in that it gives me a new mindset toward uncertainty. I’m grateful for ALL my tools. 🙂

 Also in my toolbox: prayer, deep friendships in which I can be vulnerable, essential oils when needed, Ativan when needed, talk therapy for non-OCD anxiety, and self-care (i.e. naps and ice cream).


 What I’m trying to say is that God has given me an extensive amount of assistance. Some tools only come with privilege or money (having insurance and a paycheck to pay for meds and therapy … and ice cream, ha!); some from transparency (I have the greatest friends); all are sheer grace.


I’m at a stage of my life and faith where my hands are open to all the grace I can get.

Talk about Your Medicines Month

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medicines

I was invited by the American Recall Center to blog about my medicines in October, and I agreed– there is still such a stigma attached to taking medication for mental illness (and to mental illness itself!), and I think that talking about things reduces stigma.

I started my search for a medication for my OCD as soon as I was diagnosed, which was back in 2003 or 2004.  It took five years before I ended up with the right “cocktail.”

The five years included:
* 3 psychiatrists
* 1 physician’s assistant
* SSRIs
* SNRIs
* TCAs
* a beta-blocker that I was allergic to (which almost killed me)
* tremors
* blocking/stuttering
* jello-legs
* drymouth
* lethargy
* vision blackouts
* rapid weight gain
* & a year in the middle when I avoided all medication due to the above.

But when I started meeting with my former psychiatrist (the now-retired OCD expert Dr. Suck Won Kim), he got me onto the right medication almost immediately. These days, I take a combination of Prozac (SSRI), Effexor XR (SNRI), and a teensy dose of Risperidone (an anti-psychotic).

Am I ashamed?

HA!

NO.

Am I grateful?

YES.

Do I rock the boat?

Not usually. Though my current psychiatrist (also a lovely, amazing man) helps me to feel confident in making slight changes to my regime as needed. For example, I now take Ativan for panic as needed.

Do I think medication is the right choice for all people with OCD?

No. It varies from person to person, and in EVERY case, I would recommend ERP as the first/best treatment. If I had to choose between my medication or my twelve weeks of ERP, ERP would win every time.

But isn’t taking medication like saying I don’t trust God to heal me?

What if medication is part of how God is healing me? Let me tell you a story about three boats …

Want to join the discussion? Comment below about your medicines (or mine!).

Being Me with OCD by Alison Dotson

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BeingMeWithOCDI first connected with Alison Dotson through the International OCD Foundation blog, where we realized that we were both from Minneapolis and made plans to get coffee.  I can still remember that first in-person meeting at Dunn Bros, one of those lovely times between two obsessive-compulsives finding joy and relief in saying, “Me too, me too!”

Alison’s book– Being Me with OCD— is aimed toward teenagers and young adults, but I think its audience is much wider than that.  It’s incredibly well-written, chock full of helpful information, and– most importantly, I think– it’s like sitting down with a friend.  While reading it, I kept thinking of my first meeting with Alison.  Her comforting, empathetic voice comes through so strongly in the book that you feel like you have a friend, a cheerleader, right beside you.

The book is part-memoir, part self-help, and is sprinkled throughout with personal essays from teens and young adults who offer wonderful insight into a variety of areas.  OCD is a strange beast in that, while it works the same way for most people, it manifests itself differently for each person, and the personal essays help the book touch on areas that haven’t been a part of Alison’s own personal journey with OCD.

I deeply appreciated her approach to medication.  I also loved that she dedicated considerable time discussing exposure and response prevention, even though she never underwent ERP herself.  Alison also spends time talking about overcoming stigma.

All in all, a great book for teens, young adults, or any age!  The best part is finding someone who gets it,
someone brave enough to share, someone on your team.

Read an excerpt. Buy the book on Amazon. Follow Alison’s blog.

Guest Post: OCD & Nutrition by David Novak

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I screen all guest post proposals, selecting only those that I think will be of high value for my readers.  When Healthline contacted me with this article by David Novak, I was totally won over.  I think you guys– especially those of you with hesitations about medications– will be very intrigued by what he has to say below.  Always make sure to run ideas by your doctor before implementing them!

OCD and Nutrition by David Novak 

ocd and nutrition picOCD or obsessive-compulsive disorder is a type of anxiety disorder, which affects 2.3% of the American population between the ages of 18 and 54. This condition is characterized by irrational or unwanted thoughts, obsessions, urge for repetitive rituals and compulsions. Symptoms usually start during early childhood or adolescence and the exact cause is still unknown. Theories to this condition suggest that OCD manifests due to personality defects and bad parenting, but this is not widely accepted.

OCD impacts the communication systems in the brain and according to the National Alliance of Mental Illness, it produces a chemical imbalance in the brain where low levels of serotonin have been recorded. Serotonin plays a crucial role in mood regulation, learning, calmness and sleep. Several medications can help in behavioral therapy for OCD, since it is known to be incurable. Selective serotonin reuptake inhibitors, or SSRIs, help in raising serotonin levels in the brain leading to reduced OCD symptoms.

Nutritional Therapy

Nutritious diet may not prevent an onset of OCD, but it can assist in managing the symptoms with the help of medications, supplements and mental health therapy.  Here are some nutrition sources documented as effective for reducing the symptoms:

  •  Tryptophan – This amino acid promotes the formation of serotonin, which is essential in mood regulation. It has been shown to be successful in treating OCD, and it’s also effective for other anxiety disorders. Tryptophan is formed from precursor coenzymes found in B-vitamins.  Example of foods with high tryptophan level include elk meat, goat, seaweed, soy, spinach, crabs, halibut and shrimps.
  • Inositol – Inositol is a nutrient related to vitamin B complex, which is needed for the cell membranes’ proper formation. It has an ability to affect nerve transmission as well as transporting fats within the body. Inositol also plays an important role in reproduction and prevention of neural tube defects. It can be found in certain foods such as oranges, cantaloupe, beans and whole wheat grain.
  • L-theanine – L-theanine is known to have a calming effect, which is found to be effective in subduing OCD behavior. It also helps in stimulating alpha brainwave production that promotes deep relaxation. IL-theanine also has properties that can protect against environmental neurotoxins. This amino acid can be found in green tea, black tea and boy bolete mushroom.
  • St John’s wort – This herb has been widely used in treating depression and other psychological disorders. It also has hypericum, which is a chemical that has been found effective in modulating serotonin levels.

Supplements

Natural supplements have a distinct advantage over drugs and medications. They provide larger amounts of raw materials to the brain for the development of serotonin. However, they may become ineffective if the person has deficiency in one or more critical nutrients needed in producing serotonin. It is best to consult your doctor on how you can address and relieve OCD symptoms, and whether these supplements are right for you.  Here are some well-known supplements that have helped many OCD patients:

  •  N-acetylcysteine – N-acetylcysteine is a nutritional supplement used in treating compulsive disorders such as OCD. It has been found to be very effective in hard-to-treat disorders like hair-pulling (trichotillomania).
  • Flax seed oil – Several studies show that taking flaxseed oil can help manage OCD behavior. It is rich in essential fatty acids, which enrich the brain cells’ communication and development.
  • Vitamin B complex – These B vitamins have been found helpful for those suffering panic disorders, depression and OCD. Vitamin B1 plays an important role in controlling blood sugar, which has a major impact on anxiety. Vitamin B3 is involved in several enzymatic processes, especially in serotonin synthesis. Vitamin B5 is also important for the adrenals when it comes to modulating stress. Vitamin B12 and folic acid support against heart stress, especially if you’re suffering from anxiety and depression.
  • Spirulina – This dietary supplement is known to have RNA. which has been found advantageous for the nervous system. It helps in nourishing myelin sheaths and nerves, which are helpful in reducing OCD symptoms.
  • Magnesium – Magnesium is a calming mineral that helps in minimizing the release of stress hormones in the body. There is still limited scientific evidence of magnesium’s effectiveness, but several research shows that herbal supplements containing magnesium may be effective in relieving stress and depression.
  • Lactium – Lactium is a supplement derived from the casein protein in milk. It assists in reducing stress-related symptoms, including anxiety and panic attacks.

David Novak picDavid Novak is a syndicated columnist, appearing in newspapers, magazines, radio and TV.  His byline has appeared in the Wall Street Journal, USA Today, Readers Digest and GQ. David is a specialist at health, wellness, exercise and diet, and he is a regular contributing editor for Healthline. For more information, visit http://www.healthline.com/.

Resisting Treatment for a Mental Illness

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Consistently, I …
* talk to people with mental illness who resist beginning treatment.
* hear from those who’ve gone through treatment who wish they’d sought help sooner.

I get frustrated with the first group, but then I remind myself that I used to be a long-time, card-carrying member.  My college mentor encouraged me time and time again to just meet with a therapist at my school’s free counseling services center, and I balked and balked and balked.

I wish I hadn’t.

Today, I want to address four of the excuses I hear most often for avoiding treatment along with my best argument against them.

Too much money.
First of all, if you had a life-threatening disease, I can almost guarantee you that you’d find the means to get treatment.  Mental illness are often life-threatening– not always in the sense of imminent death, but they reduce the quality of your life and deserve your reaction to their severity.  There are prescription assistance programs, such as Partnership for Prescription Assistance or Walmart’s $4 prescriptions.  More and more, I am seeing churches starting free or pay-what-you-can counseling sessions with highly-trained lay therapists.  Obsessive-compulsives are able to do self-guided exposure and response prevention therapy from their own homes with helpful and inexpensive books like Stop Obsessing! or Freedom from Obsessive-Compulsive Disorder.

Too much fear.
I can absolutely relate to this.  Some fear vocalizing their anxieties; some fear they will do so and be told there is no hope (in which case, it feels less scary to stay silent and hold onto the tiny thread that there may be a rescue coming).  Some fear the treatment itself (I can very much understand this, as ERP, the preferred treatment for OCD, is a particularly challenging therapy that exposes obsessive-compulsives to their greatest fears).

Therapy for OCD was one of the scariest things I have ever had to do in my life.  It was awful– but not as awful as daily life with OCD with no end in sight.  Short of a miracle, your mental illness will probably not just go away on its own.  Now is the time to declare war.

Too much pride.
A blog reader told me the other day that he was disconnected from reality, could hardly talk to his wife, and felt like the loneliest person on the planet– though too proud to see a therapist and admit there is something wrong.

This is so hard for me to understand– even though this used to be me!  To me, it’s the equivalent of breaking your arm and then being too proud to get it set in a cast.  What are you too proud of?  That you are invincible?  No one is, and you are fooling yourself if you think you are.  Ignoring a real problem is nothing to be proud of.  It’s like when you realize you took a wrong turn and are headed the wrong way.  It makes far more sense to turn around than to continue on in the same wrong direction.

Too much doubt.
I have a friend whose life is crumbling right now, yet he refuses to get help because he doesn’t think therapy works.  I want to shake him a little and say, “Look around you– what you are doing right now doesn’t work!”  I know how easy it is to get trapped by indecision and by the feeling that no direction is a good one (that’s why I took one year off from my medication search), but in the end, you’re probably going to have to take some sort of step toward healing.  Even if you take teensy-tiny baby-steps, that’s okay.  Find a trusted friend and work out the best baby-step possible.

I know it is an expensive, scary, humbling, and doubtful enterprise– but please, please keep reaching out for help.

choice

Medication vs. Exposure Therapy

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meds vs erpI have always been honest about my personal experience with OCD on this blog.  Faithful readers are well aware of my mama-bear protective instincts in regard to my medication.  I take Prozac, Effexor XR, and Risperdal each day and am utterly unapologetic about it.

That said, I completely understand that others have their own reasons (personal, medical, or otherwise) for avoiding medication, and that is perfectly fine by me (so long as no one tries to rob me of my meds, haha!).

People sometimes ask, Is it possible for me to treat my OCD and avoid medication all together?

While the answer varies from person to person, the best response I can give is that YES, it has been done with ERP (exposure and response prevention therapy) alone.  In fact, were I pushed to choose between my three daily doses of meds or my 12 weeks of ERP, it would be one of the easiest decisions of my life to choose ERP.

Every person is different.  I have an obsessive-compulsive friend who treats her OCD with only meds– she has never undergone ERP.  The son of one of my blogger friends uses only his tools gained from ERP– no meds.  Then there’s me, a girl who wants(/needs?) a full arsenal to treat her disorder.

So, what will it be for you?

The best treatment is ERP, hands down.  Start there.  See how you do.  If you can find an OCD specialist whom you trust, you may try to fold meds into the mix if you find that you need them.  It’s (unfortunately) a trial-and-error kind of thing.

Will you be okay without meds?  Maybe.  You’ll have to discover that for yourself.
Has it been done before?  Absolutely.

Hope that is helpful!

Just One Dose

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I had such a hard day recently– my anxiety levels were higher than usual (“usual” being not too bad for the last four years– thanks, ERP!).  I felt this strange depression, a strong desire to sleep, and a hovering sadness that wouldn’t lift.  My blood pressure felt through the roof, and the stress took a very physical toll on my body: by the time I crawled into bed for the night, my shoulders felt like cement blocks and my arms were throbbing with pain.

I realized that– while racing out the door that morning– I had not taken my Effexor XR or my Prozac.

Just one dose missed, and it was so terribly evident.

I have acknowledged that I may be on medication for the rest of my life, and I’m okay with it.  In fact, I’m quite protective over my right to take medication.

I read this awesome related post on the OCD Foundation’s blog recently.  And it turned out that Alison, the blogger, lives in Minneapolis … so we got coffee.*  Love my OCD community!

* And since then, we’ve accepted new roles at the Twin Cities affiliate of the International OCD Foundation (I’ll be the communications director)  … and have an event planned in Minneapolis for OCD awareness week!  Exciting!

prozac morning

Christian Culture’s (Sad) Response to Mental Illness

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It’s in the Title: Mental Illness is an Illness

Salads and sandwiches and a shared mental illness, all of it on the tiny table between us.

“There is help for OCD,” I told her.  “The most effective treatment is cognitive-behavioral therapy.  Between that and my medication, I got my life back.  I know you can too.”  (The evangelical zeal I have for this particular therapy reminds me of the way I love Jesus: both took me from darkness into light, both make me want to throw parades in their honor.)

“Oh, I don’t know,” said my friend, poking at her salad with a fork, sounding hesitant.  “I think before I take any extreme methods, I want to just pray about it more.  I know that God can bring me through this.”

I wanted to say, But you have been praying about this for years!  I also believe God can bring you through this—and I am telling you how.

There is a pervasive and unhealthy attitude in the Christian culture toward mental illness.  Many believe that one should be able to “pray away” a disorder.  Some think that mental illness is, quite simply, spiritual warfare; some think it’s the result of unresolved sin issues.  One of my friends has said before that a real Christian can’t be clinically depressed.  I saw a Facebook status once that read, “Depression is a choice.”

These sentiments light a fire in me, especially for the way that they marginalize a group of people that are often already more susceptible to guilt.  I know that in my OCD hey-day, I felt continual guilt and severe shame; for someone to intimate to me that these feelings were the appropriate ones would only mean that my Christian brothers and sisters were siding with my disorder—and against me.

Mental illnesses are just that: illnesses. 

friendsGod and Satan can work through them just the same way as they could through, say, cancer or diabetes.  All issues are spiritual issues, simply because we are spiritual beings, but it is not helpful to label a chemical issue with a giant term like spiritual warfare.  To say that a Christian cannot be depressed is like saying a real Christian can’t get the flu.  To say that depression is a choice is like saying strep throat is a choice.

If you break a bone, do you get it set in a cast?  If you learn you’re diabetic, do you take insulin?  If cancer steps into your body, do you pursue chemotherapy?

The answer is usually yes.  Yes—and pray.  (Don’t get me wrong: I’m all for prayer!  And for medical innovation!)

That is why I am unashamed of my OCD, my depression.  Instead, I am proud of my God for seeing me through a therapy as difficult as CBT and for being my strength through five years of side effects in the search for the right medication.

Unfortunately, my friend left the sandwich shop that evening feeling obligated to “pray away” a spiritual flaw instead of feeling empowered to fight illness, in spite of my best efforts.  My voice is being drowned out by the multitude of louder voices of the Christian culture, a culture that should be supporting this demographic, not alienating it.

Side Effects: Blocking

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As I pursued the right cocktail of medication to help treat my obsessive-compulsive disorder, I encountered my fair share of side effects.  My vision would black out.  I had jello-legs.  Dizziness in spades.  Rapid weight gain.  Tremors.  Drymouth.  Lethargy.  Excessive sweating.  Lactation (yes, really).

But perhaps the most frustrating side effect was the blocking.

Blocking is a form of stuttering– but probably different from what you’d imagine.  It’s not the usual “t-t-t-t-today, junior!” where repetition features heavily.  It’s where your mouth physically stops from saying a word or syllable.

I found this description online, emphasis mine:

Blocking is not usually present in normal dysfluency and, as such, it is a principal indicator of stuttering. Blocking typically occurs when two articulators come together with excessive force, e.g. when the two lips come together to form the consonant sound ‘b’, as in the words book, boy and Bob. Rather than parting the two articulators rapidly and easily, the speaker is unable to release the contact between them and a great deal of tension may build up. In severe cases a speaker may be unable to release a blocked sound for around 5-10 seconds. Owing to the adverse effects on the person’s breathing – because the person is typically holding their breath during a block – talking can become quite exhausting. In addition, the sense of fatigue when speaking can be exacerbated by the increased muscle tension around the head and neck area and in the chest.

I’ll try my best to explain what would happen to me.  In the middle of speaking, my tongue (especially the base of it) would seize, and I would be physically incapable of saying the word for several seconds.  My mind has always worked faster than my mouth, but this was out of control.

The words were there but unable to come out of my mouth.

Not gonna lie, I’m a good speaker.  I’m articulate, and I can hold an audience’s attention.  For my job, I do a fair amount of public speaking– presentations at churches, schools, etc.– and it’s an area in which I feel confident.

All of that was stolen from me with the blocking.

stutterI was suddenly terrified of speaking opportunities, felt silly even in one-on-one appointments when I couldn’t just SAY. WHAT. I. WANTED. TO. SAY.  It felt like one more thing OCD was stealing from me– not just my public speaking ability, but my confidence.  I was so frustrated and shed a lot of tears around this time.

Thankfully, my brilliant psychiatrist knew what was causing the blocking (for me it was a too-high dose of Risperdal), and once he reduced it (I now only take half a milligram daily!), the blocking went away.

At a writing conference Q&A, a man in the crowd asked several questions, and his phrases were filled with blocking.  It was even on the same letters as me– b’s and p’s, those darn plosives!– and as he spoke, I could almost feel my tongue freeze inside my mouth, feeling like a thick, inoperative muscle– a weapon against me instead of for.