Welcome to the first article in The OCD Series!
First of all, an introduction... I’m Francesca, a New Zealand Registered Clinical Nutritionist who has lived with OCD since I was 10. At age 15 and then again at age 29, I hit rock bottom with OCD – it was so distressing and debilitating that it left me feeling suicidal and at one point, partially housebound. Now, after investing time, money and effort in creating a mental health tool box and fighting for my health and happiness, I have been living largely free of OCD since 2012. And I’m sharing everything I’ve learned to support people with OCD who want to get their lives back.
When you're suffering with OCD and:
-your fears and obsessions bring you to the point of hysteria
-you’re struggling to leave your house / work / socialize
-just the thought of ERP therapy is terrifying (let alone actually doing it!)
-and you have all kinds of other health issues going on (such as insomnia, acne, PMS, migraines, digestive troubles, fatigue, bladder weakness...)
nutrition is a powerful tool for rebuilding the foundations of your physical and mental health and helping to reduce your symptoms.
Ok, let's get started.
Protein builds your neurotransmitters
When I began seeing my naturopath in 2010 for support with OCD recovery, one of the first things I learned from her was the importance of eating enough protein foods for the body to be able to make neurotransmitters. Protein foods such as eggs, fish and meats are made up of all the amino acids your body needs (amino acids are the building blocks of protein). And it’s amino acids that are necessary for making neurotransmitters like GABA (gamma aminobutyric acid).
Neurotransmitters are chemical messengers that aid communication within your brain and between your brain and body/organs. They play a significant role in your thoughts, emotions, sleep, and ability to feel calm, focused and relaxed. In particular, the inhibitory neurotransmitter GABA – which literally slows down your brain's nerve cell activity – has been identified as playing a central role in the regulation of anxiety. The GABA neurotransmitter system is targeted by Benzodiazepines and other drugs used for anxiety for this reason. Interestingly, research has found decreased levels of GABA in the brain may be linked to OCD.
From a nutritional perspective, it stands to reason that adequate protein intake is important for anyone experiencing OCD and anxiety - otherwise, how will your body make adequate calming, anti-anxiety GABA?
Additionally, protein-rich foods such as eggs, chicken, fish, lamb and beef contain good amounts of vitamins B6 and B12 and the mineral zinc, which are also necessary for building neurotransmitters and maintaining the structural health of your nervous system, particularly the myelin sheathing, which medical imaging research has repeatedly found is deficient in the brains of people who have OCD.
Protein for stable blood glucose levels
Many of the clients who see me for support with OCD, when they come to their first appointment we talk about how they're either skipping breakfast, having coffee and toast for breakfast, just a few mouthfuls of cereal or a juice.
Skipping breakfast will leave you with low blood glucose, which your body will then try to compensate for. And a refined carb-based or fruity breakfast that lacks protein will deliver rapidly digested glucose that spikes and then leaves your blood glucose plummeting - think of a rollercoaster here.
When blood glucose levels plummet either from food choices or lack of food, your body compensates by releasing cortisol, which prompts the release of stored glucose from your liver to get you out of 'starvation mode' (as your brain perceives it). However, peaks in cortisol may lead to exacerbation of OCD symptoms.
Interestingly, one study found cortisol levels were elevated in the morning in children and adolescents with OCD. And a recent study found low levels of the hormone adiponectin in people with OCD, which is notable given adiponectin's role in regulating blood glucose and the link many people observe between skipping meals and worsening of their OCD and rumination.
So how do you get off the blood glucose rollercoaster and avoid triggering cortisol release?
Protein for breakfast! Protein is gradually digested and so delivers a steady rise in your blood glucose, rather than a rapid spike. It also helps you feel fuller for longer. Leftover dinner such as roast chicken or Bolognese for breakfast is an excellent idea if you're working on OCD recovery. Eggs cooked any style are a more traditional breakfast option, and a hemp protein-based smoothie is a quick option for those who lack time to cook in the mornings.
So, for the person with OCD, it makes sense to provide your body with good amounts of the building blocks for GABA. And meats, eggs and fish are your best sources of the amino acids, vitamins and minerals that are necessary for making GABA. They are also an excellent source of blood-glucose-stabilizing protein.
Why I stopped being vegetarian
If you follow me on social media, you may know that I was an ethical vegetarian for 15 years, from age 15 to age 30. While I did eat mostly whole foods – fruit and veges every day, home-grown herbs, home-cooked meals, olive oil, whole grains, free range eggs a couple of times a week, very little fast food – the reality is that fruit and yoghurt smoothies, toast/bread, Japanese noodles or pasta and veges were the foundation of most of my meals.
There was almost no protein (and precious little fat) in my food choices.
The thing is, if you’re not eating enough protein, your body will have a harder time making GABA and other neurotransmitters, as well as keeping your blood glucose stable. It's also harder or impossible to get nutrients like B12, B6, zinc, heme iron, saturated fat, choline, iodine and omega 3 if you're not eating animal foods, or are eating only small amounts of them. And all these nutrients are necessary for the structural and functional health of your nervous system.
You'll hear me talk a lot about the importance of looking after the health of your nervous system for OCD recovery.
After I stopped being vegetarian in late 2010, I experienced increased calm, better sleep, reduced frequency and intensity of OCD thoughts, thicker and shinier hair, clearer skin, more energy, less bloating. Happier periods and no more migraines.
I still support animal welfare in other ways (by adopting rescue animals, buying only cruelty-free body products) and am selective about the meat and eggs I buy, leaning toward free range and organic, from smaller producers. Being honest, during the last few years I was vegetarian, I had been craving meat. And feeling guilty about it – I was good at being really hard on myself back then. When I started eating meat again and started feeling better, I realized my intuition had been trying to tell me something. My nervous system knew what I needed.
I'd like to address the common argument that a person can meet their daily protein needs by eating nuts, seeds, beans and lentils.
A large handful of nuts or seeds provides about 2-3 g of protein.
One cup of cooked lentils or beans provides about 12g of protein.
Given humans need around 1g of protein per kilo of your body weight every day (and more if you are pregnant, growing, healing from injury or surgery or very active), you would need to be eating many, many handfuls of nuts and several cups of beans or lentils every single day to meet your daily protein requirements.
Let me be clear – I’m not saying don’t be vegetarian, I'm saying be an informed vegetarian.
And regardless of whether you are a vegetarian or regularly eating meat, if you’re suffering from OCD and striving to improve your health, completing a 3-day food diary noting how many grams of protein you’re eating each day (in the form of pea protein powder, eggs, beans, lentils, fish or meats) would be an excellent step to take.
The amino acids in protein are also necessary for your liver to carry out detoxification processes. Without adequate protein, liver detoxification processes won’t be optimal, which can lead to health conditions like PMS, migraines, headaches, acne and excess estrogens (all of which I experienced). And a malnourished liver may struggle with its many other jobs, such as producing the bile needed to break down fats, which are also vital for your mental health.
We'll look at which fats nourish and support your nervous system and your mental health in the next article in The OCD Series.
Increasing the amount of good-quality protein you're eating makes sense if you are seeking to reduce the symptoms of OCD. Because protein foods support your nervous system structure and function, and nourishing your nervous system is key to recovery from OCD.
If you’d like to learn how nutrition can support your OCD recovery, I invite you to get in touch. I offer online appointments worldwide.