Gut Health and OCD

Recent years have seen innovative studies that examine newly uncovered connections between different biological and mental systems. Among them is the association between obsessive-compulsive disorder (OCD), gut health and the microorganisms that influence both. Read on to learn more on the subject.

Understanding OCD

OCD is a mental health disorder defined by obsessive thoughts on a destabilizing subject, compulsive actions that repeat themselves, or both. Between 1.1%-1.8% of the world’s population are believed to contend with OCD.

An individual experiencing OCD may initially be overwhelmed by thoughts or imagery about a subject they find concerning. The four most common OCD obsessions are:

• Cleanliness.
• Order/checking.
• Catastrophes.
• Immoral/taboo actions.

To distract themselves from these thoughts, the individual might begin to carry out repetitive actions of a ritualistic nature. While such behavior may start off by providing some relief, eventually the individual begins to feel compelled to perform it, as the behavior itself is incorporated into their condition. Feeding into each other, the loop of OCD-related obsessions and compulsions is set in place.

A number of possible root causes have been linked to OCD. Among them are:

• Abnormal brain activity.
• Genetics.
• Experiencing physical or sexual abuse as a child.
• Exposure to traumatic events.
• Higher negative emotionality.
• Gender, with males more likely to develop early-onset OCD.

The Gut-Brain Axis

The gut-brain axis refers to the connection between the central nervous system, the gastrointestinal system, and the trillions of microbiomes that exist within the gut. Research from the past years has uncovered a direct link between the gut and the brain, thereby drawing a relationship between the thoughts and feelings that stem from the brain, and the intestinal functions of the digestive system.

How OCD and Gut Health can Influence Each Other

The correlation between gut health and OCD appears to present itself through the intestinal microflora. A study from 2016 examined the stool samples of patients with OCD, and found they were significantly less diverse and contained a lower abundance of microorganisms, when compared to the general population. It should also be noted that in addition to scoring higher for symptoms of OCD, these patients were found to have a higher prevalence of depression, anxiety and stress than the general population.

The results of a more recent study from 2022 highlighted that patients with OCD usually have an imbalanced microbial biosystem, when compared to the general population. As a result, not only was there a trend toward lower levels of certain bacteria types and an influx in others, but the digestive system as a whole was more likely to suffer from inflammation.

Additional studies have similarly replicated the above finding that correlates OCD with increased inflammation of the gut. This stands to reason, since gut inflammation has been shown to facilitate greater permeation of the blood-brain barrier, allowing harmful cytokines to cross into the brain’s neural system and influence its functioning.

Exposure to both stressful events and excessive antibiotics have been suggested as possible root causes that originally altered the gut’s microbiota system, thereby setting the stage for an eventual onset of OCD symptoms. In terms of stressful life events, pregnancy in particular is being examined, as an experience that can bring about both OCD and changes in the mother’s gut health.

Treating OCD and Gut Health

Due to the bidirectionality of the gut-brain axis, treating one aspect of this connection can lead to improvement overall.

As mentioned earlier, OCD has been linked to irregular brain activity. This is particularly true for specific brain structures, such as the anterior cingulate gyrus. A number of treatments have been recognized by the FDA for their ability to help regulate this activity. Among them are:

• Selective serotonin reuptake inhibitors, or SSRIs. This family of medications has been shown to significantly alleviate OCD symptoms, by extending the activation period of the mood-regulating neurotransmitter serotonin. Considered to be relatively tolerable, the two most common SSRI side effects are weight gain and sexual dysfunction.
• Cognitive-behavioral therapy, or CBT. This goal-focused form of psychotherapy has also been approved to treat OCD for its ability to offer effective relief, without physical side effects.
• Deep Transcranial Magnetic Stimulation, or Deep TMS™. FDA-cleared to treat OCD, depression/anxious depression, and smoking addiction, Deep TMS is a noninvasive medical device treatment that utilizes electromagnetic fields to safely and effectively regulate brain activity in structures linked to the targeted condition. It does not use anesthesia, does not necessitate a lengthy recovery period, and does not cause any long-term or significant side effects.

Similarly, improving one’s gut health can lead to improvement in their OCD symptoms. Three ways shown to achieve this are:

• Improved Diet. Opting for a Mediterranean diet over a Western one can improve gut health by reducing inflammation and promoting consistent digestive functioning. Preferring fresh fruit and vegetables, whole grains and olive oil, and steering clear of red or processed meat, high-fat dairy products, white flour and candy, can all improve one’s gut health, and as a result, reduce their OCD symptoms.
• Probiotics. Incorporating probiotics—microorganisms believed to improve the diversity of the gut’s microflora—can also improve one’s mental health. A study from 2015, for example, found that probiotics help lower the production of the stress-inducing hormone cortisol that has been found in higher levels among patients with OCD.
• Sleep. A good night’s sleep has been shown to improve gut health, while a lack of sleep has been implicated in gut inflammation, immune dysfunction, and a leaky gut. OCD, as a disorder found in correlation to such digestive conditions, can similarly be influenced by improved sleep.