Saturday, December 8, 2012

Is OCD an Autoimmune Disease

ZZ Ward Put The Gun Down (right click to open in new window, ad at the beginning, my apologies, but song is rad.)

I haven't done much on OCD for this blog, which is silly. I mean, ask any psychiatrist about "organic" mental health disorders and OCD will top the list. It is highly inherited, and there are forms of it that, like rheumatic heart disease, even start after a bacterial infection. Is OCD an autoimmune disease? A fair question.


OCD by definitionObsessive-compulsive disorder (OCD) is an anxiety disorder characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). With obsessive-compulsive disorder, you may realize that your obsessions aren't reasonable, and you may try to ignore them or stop them. But that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts in an effort to ease your stressful feelings.
Clinical OCD is not the same as just liking all your stuff neat or writing notes in rainbow order with colored pens. OCD is a terrible burden. It means an hour long shower just so everything is done in the right order. Countless hidden routines and intrusive thoughts. Nasty, negative, sexual or homicidal intrisive thoughts that are so far from who you are that you are tortured by them. The disorder tends to start in childhood, so it becomes a part of who the person is.


There are certain cases of OCD that begin with a strep infection. These are thought to be due to PANDAS (pediatric autoimmine neuropsychiatric disorders associated with streptococcus infection.) Many childhood cases of OCD involve tics and other movement disorders as well. David Sedaris has a personal take on the experience. 

PANDAS strike with obsessive-compulsions and tics, also increased urinary incontinence, hyperactivity, and a deterioration in handwriting. The strep autoantibodies seem to be attacking the basal ganglia. Straight-up non PANDAS OCD doesn't seem to have these characreristics. So not every case of OCD is a PANDA. 


Classic therapy for OCD involves behavior therapy and SSRIs. And I have patients with OCD on clean paleo diets who still need SSRIs for symptom remission. A rather famous "paleo" character from Robb Wolf's site, "Squatchy" (or Chris Williams) came forward to me with his history of OCD. He said I could share his story. It was horrible for him. He tried doctors, pharmaceticals, everything, for years. Managing his lifestyle for good sleep and exercise and a paleo diet has helped him tremendously. 
It would make sense from a pathologic standpoint that some cases might have inflammatory dietary components that, if removed, would diminish the symptoms of OCD. This fact will not be true for all cases. In Chris' case, multiple factors were at play.



I started having problems with OCD, and Tourette's in about 1st grade. It would get especially bad during the summer. I was miserable, going to bed as early as possible so I wouldn't have to be awake, not wanting to be alive, etc. I had "good" number and "bad" numbers, and even some "good" and "bad" words, and would have to touch everything a certain number of times, usually while thinking certain thoughts when I did so. At times I even had to have some people around me, like my mom, do things a certain number of times, or say a certain word a specific number of times. To say that all of this was incredibly annoying would be a severe understatement. With the Tourette's I had head tics where I would nod my head forward quickly, vocal tics where I would make a sound that I could feel in the back of my throat, blinking, etc. 
...After some time I ended up transitioning into a paleo diet from my previous "healthy diet". Eventually I also stopped running as much, and started doing more strength and HIIT work. I noticed after a while that my OCD seemed to be a lot less prevalent than it used to. Eventually it got the point where it wasn't even noticeable most of the time. I would go through the day, touching things, closing doors, turning off light switches, and not even have OCD type thoughts. Now I would say it's not a problem or even something I do most of the time. In times of stress or if I'm more worried about something in particular, I notice a few OCD thoughts coming back here and there, but even then it's less than it used to be at baseline

More about the pathology of OCD in the next article.

6 comments:

  1. my husband was diagnosed with tourettes syndrome and was on halidol for a while. my daughter was diagnosed with PANDAS at 10. she started to blink and roll her eyes. she also started throat clearing. now she is 15 and the eye stuff and throat clearing are gone, but her most worrisome symptoms are distractability and being defiant (more so than the average teen). she also seems to have a histamine system problem that my husband also shares. she has a dust allergy and gets a lot of phlegm in the morning. she can get hives from eating certain junk food. and she gets really bad poison ivy when that season first begins and the temp goes up.

    excuse me if this is TMI, but she has really big poops. she needs to always drink water- bottles of it- and she likes to take natural calm magnesium to help with her bowel movements. she eats mostly paleo, although with the occasional junk. she is active in sports and does fairly well in school even though she tunes out in class. she says she basically teaches herself a lot of stuff (looking at examples in the text?)since she can't learn it from the teacher.

    she has mild OCD. she likes to pick at the cat's skin looking for rough spots.

    i am investigating supplementing vitamin b6 for her as this has been coming up in my research. my husband's tourette's is worse than hers. he also seems to have some ocd and gets manic too. he periodically cleans everything until his body hurts.

    my husband was raised mostly on a traditional chinese diet, with junk food not entering the picture until he was 14 (but he already had all the symptoms of tourettes before that).

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  2. I was reading about microbes functioning as organ systems in humans such as hypothesized here - http://www.ncbi.nlm.nih.gov/pubmed/19900764

    Then seen this article today - http://www.sciencedaily.com/releases/2012/12/121219142301.htm

    Then remembered that a lot of new research being done as late in the GABA/Glutamte area's for anxiety/OCD - http://www.psychologytoday.com/blog/the-perfectionists-handbook/201208/ocd-genetics-update


    I know it's not exactly what you're talking about but....

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  3. Hi!

    I've been eating according to the paleo diet for several years, but I still have OCD that is as bad as ever. What kind of treatment would you recommend, or do you have any suggestions?

    Thank you:)

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    Replies
    1. B Vitamin Complex
      Fish Oil
      NAC
      Magensium
      Paleo Diet

      I've had OCD since I can remember, and was on an SSRI for awhile with good results. I was not liking the side effects though so decided to try some a more natural approach. I went to a doctor who recommended these things to me and I am doing great! Been on it about a month and OCD is barely even noticeable and getting better everyday. Try it out and see how you do.

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  4. Hi, I posted before.

    So I been reading up OCD and autoimmune diseases because your post inspired me too ;).

    I found unpublished paper(well, rejected) about PANDAS in adults over at Dr.Goodman's blog. I found it after reading his own case studies he had at psychology today's website with adults with PANDAS.

    The paper can be found at -
    http://beverlyhillsshrink.blogspot.com/2012/03/adult-pandas-bare-facts.html

    What do you think?

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  5. My son was diagnosed with Tourettes Syndrome at age 10 and just recently has developed OCD with accompanying anxiety and depression. He is on clonidine, Klonipin (for anxiety), and Zoloft. None of these medications work and only seem to make him drowsy with ameliorating his anxiety which has become disabling. I agree that the most likely cause of TD and OCD is a combination of genetic susceptibility and an autoimmune disorder but am not certain that a change in diet will help. I am most interested in the use of IVIG as a treatment and would like to know the name of the investigator for the study published in Scientific American. TD runs in my family beginning with my grandfather.

    ReplyDelete