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Holistic OCD Treatment — Keys to Taking Your Life Back, Pt. 2

Обновлено: 27 окт. 2023 г.

Alternative Treatment



Supplements


Before discussing more substantial topics, I would briefly go over some of alternative OCD-relieving supplements that might help you. Again, those are NOT promotions. No one paid me for presenting and describing those supplements.




N-Acetyl Cysteine


N-Acetyl-Cysteine (NAC) is a modified form of the amino acid cysteine.

It’s also the precursor to glutathione, your body’s master antioxidant.

More than one study has found that NAC can significantly improve OCD symptoms in more than half of OCD patients (PubMed | NCBI, PubMed | NCBI).


And a systematic review determined that NAC is effective at reducing the severity of OCD symptoms with minimal side effects (NCBI).” Source : Optimal Living Dynamics

You can check out this article all about the benefits of NAC.


“Four clinical trials and five case reports/series were identified. Study durations were commonly 12-weeks, using 2,400–3,000 mg/day of NAC. Overall, NAC demonstrates activity in reducing the severity of symptoms, with a good tolerability profile and minimal adverse effects.” Source : NCBI




Inositol


“Thirteen patients with obsessive-compulsive disorder completed a double-blind, controlled crossover trial of 18 g/day of inositol or placebo for 6 weeks each. The subjects had significantly lower scores on the Yale-Brown Obsessive Compulsive Scale when taking inositol than when taking placebo. The authors conclude that inositol is effective in depression, panic, and obsessive-compulsive disorder, a spectrum of disorders responsive to selective serotonin reuptake inhibitors.” Source : PubMed | NCBI



Zinc


“Researchers have found that patients with OCD tend to have much lower levels of zinc that individuals without OCD” (Source : PubMed | NCBI).


“And one study showed that zinc supplementation helped reduce obsessions and compulsions without side effects” (Source : PubMed | NCBI). Quotes source : Optimal Living Dynamics




Glycine and Sarcosine


“Glycine is an amino acid commonly found in protein-rich foods such as meat, fish, collagen and gelatin. Glycine is one of three amino acids that your body uses to make glutathione, the master antioxidant in your body.


Supplementing with 60 grams of glycine daily has been shown to reduce OCD symptoms (Source : PubMed | NCBI).”


“Another option is to take sarcosine. Sarcosine is a natural supplement that inhibits the uptake of glycine. By doing this, it increases the availability of glycine in the brain.


Researchers have found that sarcosine can lead to quick, profound and sustained improvements in OCD symptoms (PubMed | NCBI).” Quotes source : Optimal Living Dynamics



Curcumin


“Curcumin is the most heavily researched compound within turmeric, the spice that gives curry its yellow colour. Research shows that curcumin can significantly improve obsessive-compulsive symptoms by increasing serotonin (Source : NCBI).”


“Curcumin is a good option if you struggle with chronic inflammation, depression and OCD. Since curcumin is a fat soluble, take it with a fatty meal.” Quotes source : Optimal Living Dynamics


Milk Thistle


Silymarin, one of the flavonoids in milk thistle, has been shown to increase serotonin levels in the brains of animals” (Source : Taylor & Francis Online).


“And one human study found that milk thistle works just as well as a popular SSRI antidepressant at reducing OCD symptoms (Source : PubMed | NCBI).” Quotes source : Optimal Living Dynamics

Borage Oil


“Researchers have found that 500 mg of borage oil per day can reduce obsessive, compulsive and anxiety symptoms (Source : PubMed | NCBI).


Animal research also shows that it can have anti-anxiety effects similar to benzodiazepines (Source : PubMed | NCBI).” Quote source : Optimal Living Dynamics



Ashwagandha


“Ashwagandha (Withania sominifera) is a popular Indian herb that has been used for more than 3000 years. It’s sometimes called the “Indian Ginseng”.


It’s known as an “adaptogen”, which is a compound that balances the body and restores normal bodily functioning after chronic stress.


In one study, 30 people with OCD took ashwagandha for 6 weeks, and it notably and significantly reduced their OCD symptoms (Source : PubMed | NCBI).


Animal research also shows that ashwagandha causes anti-anxiety effects, reduces OCD-like behaviour and improves stress tolerance in rats (Sources : 8-13).


So it’s a pretty impressive herbal remedy for OCD and anxiety.


But how does it work?


By increasing serotonin and GABA in the brain, and lowering cortisol levels by 25 per cent (Sources : 14-17).” Quote source : Optimal Living Dynamics

Saffron


“Saffron is a spice derived from the Crocus sativus plant. It has a number of health benefits due to the medicinal compounds within it. Saffron is one of the best supplements for reducing depression, anxiety and stress. Safranal and Crocetin, two of the compounds within saffron, have been shown to stimulate GABA receptors and increase serotonin levels in the brain (PMC |NCBI, PMC | NCBI). As a result, researchers have determined that saffron can reduce compulsive behavior” (Source : PubMed | NCBI). Quote source : Optimal Living Dynamics




Valerian


“Valerian (Valeriana officinalis) is a natural herb, and the root of the herb has traditionally been used to treat insomnia.


But it also can reduce symptoms of OCD.


In one study, supplementing with 750 mg of valerian for eight weeks reduced symptoms by 25% in people diagnosed with OCD (Source : PubMed | NCBI).


And in an animal study, valerian demonstrated anti-obsessive and anti-compulsive effects and researchers determined it's a good candidate for treating obsessive-compulsive disorder (PubMed | NCBI).


Scientists have collected a massive amount of research demonstrating that the compounds in valerian naturally reduce symptoms of OCD by :



  • Partially activating serotonin receptors

  • Maintaining serotonin levels

  • Reducing stress hormone levels

  • Binding to GABA receptors in the amygdala, a brain region associated with fear and anxiety

  • Increasing GABA levels

  • Inhibiting the breakdown of GABA in the brain



([Pubmed | NCBI links : 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17]; [NCBI links : 1, 2, 3]; [Jama Network]).



As a result of this, it creates a calming effect similar to anti-anxiety drugs like Xanax and Valium.

This is why valerian is often called “Nature’s Valium”. Quote source : Optimal Living Dynamics



Personally, I have not had much of experience with supplements for OCD.

This list could include Phenibut, but due to several factors, such as side effects, potential for addiction, dependence and withdrawal; lack of proper clinical data backing up its actual usefulness (especially when evaluated with respect to side effects and risks); as well as the fact that phenibut is not some herb, but actual potent substance that should be taken responsibly, I would not write about phenibut much here, as well as I would not encourage anyone to take it.


However, I will note that phenibut may or may not actually be useful to people.



Phenibut molecule
β-phenyl-γ-aminobutyric acid

Phenibut (C10H13NO2) is a GABA-β agonist and goes by the names β-phenyl-γ-aminobutyric acid or phenyl-GABA. It is a synthetic form of GABA, or gamma aminobutyric acid, one of the brain’s inhibitory neurotransmitters. As could be deduced by the formula, phenibut is specifically the analogue of GABA with a phenyl ring substituted in at the β-position, allowing it to pass through the blood-brain barrier.


Phenibut is used for anxiety, insomnia, a type of anxiety that often develops after a terrifying event (post-traumatic stress disorder or PTSD), alcohol use disorder, and many other conditions. There is no good scientific evidence to support those uses. Also, phenibut is addictive, and can cause withdrawals.


(Some text snippets were taken from WebMD, Wikipedia and American Addiction Centers)




I used to have a friend, with whom, analysing the information we had about OCD and misophonia, along with the most recent clinical evidence, we came to the conclusion that phenibut, which was supposed to help restore GABA balance/GABA receptors in the brain, taken concomitantly with antidepressants that were supposed to restore serotonin balance/serotonin receptors in the brain, while maintaining a strict ‘dopamine diet’, were supposed to completely cure OCD; however the idea of such combination treatment was left aside due to my medical reasons, and seems to be abandoned — at least for now.


Much time has passed since then, and due to the fact that I had not given this topic a proper research in contrast to all the material I provide in this article, I DO NOT encourage anyone to follow up on this idea and try it by himself/herself.


This was our sketch left abandoned and untried; it should have been further evaluated and developed by consultations with qualified medical practitioners and further personal research, along with the trials themselves.


However, this box remains closed for now, and the material in it is raw. The reason I left this fragment here is because I want to provide any clue I have; and maybe, just maybe, a psychiatrist would collect this little thought fragment, and indeed, come up with something, that would finally help all those, suffering from OCD.


Again, I DO NOT encourage anyone to try any of the raw-sketched plans I mentioned above; I simply could not let myself hold a piece of information that might just be a useful cog for a relevant research. The sooner people with OCD get help — the better.

That being said, I state that I personally do not have experience with phenibut. If you are interested in potentially using it, then I strongly recommend doing your own research, using official reliable sources.


Last warning about phenibut — it has serious, potentially fatal side effects, when taken concomitantly with other substances, acting on GABA-receptors — such as alcohol.



The one drug I have a proper experience with is mirtazapine — an atypical antidepressant,“centrally active presynaptic α2-antagonist, which increases central noradrenergic and serotonergic neurotransmission.” Quote source : medicines.org.uk/emc


My experience with this drug is, perhaps, positive, however, I do not encourage anyone to start taking any medicines, which were not prescribed by a certified healthcare practitioner. I have just declared my personal medicinal use, relevant to the article, thus keeping a clear, scientific approach.




Spiritual and Mental Practices




Meditation is one of the most widely recognised alternative mental practices, which can aid in combat with any mental disorder, fight stress, alleviate anxiety and help to expand cognitive borders and promote mindfulness.


Meditation is a vast and diverse topic. Personally, I do recommend meditation, although when it comes to OCD, misophonia, anxiety and other neuropsychiatric disorders, there’s a catch : as previously discussed, neuropsychiatric disorders are problems with the brain wiring itself, and although techniques like meditation, CBT and counselling can aid you, it is futile only to try and fight the problem from sole perspective of psychological techniques – remember that the problem lies in biology, thus, before all, you have to solve it by means of biology.


My personal example : I spent unimaginable amounts of effort trying to combat the bloody thing in the mind itself — and while it did help greatly, it did not free my mind. Keep reading the article for biological solutions.


I encourage you to get acquainted with an article of International OCD Foundation on employing mindfulness, and combining it with ERP and CBT in a consonant way, as it offers some valuable information.


I did not write all this for a vivid chitchat with no proofs, and as for the scientific backup of usefulness of mediation against OCD, I am providing you references to relevant studies; there is also a bunch of personal stories in the internet, but I am not going to site them – I am referencing studies and not anecdotal reports.


“In one study, OCD patients received mindfulness training. They were taught meditative breathing, body-scan, and mindful daily living.


By the end of the study, they witnessed a “significant and large reduction” in their OCD symptoms. It was much easier for them to “let go” (Source : PubMed | NCBI).” Quote source : Optimal Living Dynamics

  • “A 2013 study (Wahl) examined the effectiveness of mindfulness and meditation compared to the use of distraction in 30 patients with OCD who were doing brief exposure to their unwanted thoughts. The results showed that those who used mindfulness skills (i.e. letting thoughts come and go without judgment) felt less of an urge to neutralize thoughts with compulsions, while those who used only distraction strategies (i.e. trying to think of something else) saw no change in their urge to use compulsions. [1]


  • A 2012 German study (Hertenstein et al.) researched the impact of an 8-week mindfulness-based group therapy program on adults with OCD. All study participants had already completed a course of ERP within a two-year period before the study began. Of the 12 participants, 8 reported having fewer OCD symptoms as a result of the group therapy program. Additional benefits reported by study participants included an increased willingness and ability to allow unpleasant emotions to surface, feeling able to handle these emotions more flexibly, a sense of living more consciously in the present, a calmer attitude towards their OCD, and generally improved mood and sleep. [2]



  • A small 2010 study (with only 3 participants) on intrusive thoughts in OCD (Wilkinson-Tough) looked at whether mindfulness-based therapy could help those who were using thought suppression (that is, trying to stop thinking certain things) and experiencing thought-action fusion (in other words, believing that thinking something in your head means it actually happens in real life). Three participants received a six-session mindfulness-based intervention with an emphasis on using mindfulness skills every day. Following treatment, all participants received improved scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), an assessment tool used to figure out which OCD symptoms are present and how severe they are. [3]


  • A 2010 study on group treatment for OCD (Fairfax) explored several different clinical interventions that could strengthen evidence-based practices and found that the participants responded well to mindfulness-based interventions in particular. The authors suggested that the use of mindful awareness and strategies focused on attention may support efforts to participate in ERP. [4]



  • A 2008 Dutch study (Hanstede et al.) examined the impact of mindfulness meditation on a group of 17 university students. Subjects were taught the mindfulness techniques of “meditative breathing, body-scan, and mindful daily living,” as applied to OCD, over the course of eight one-hour sessions. Researchers found that mindfulness meditation had “a significant and large effect” on OCD symptoms, specifically on thought-action fusion (again, the belief that having a thought is the same as acting on the thought), and the ability to “let go” of unwanted thoughts. [5]


  • A 2006 study (Twohig et al.) explored the effect of Acceptance and Commitment Therapy (ACT), a treatment modality that in part includes a focus on developing mindfulness skills and participants’ willingness to accept and tolerate unwanted obsessive thoughts. Study participants reported decreased avoidance of uncomfortable or unwanted internal experiences (negative thoughts and feelings), decreased believability of obsessions, and decreased anxiety and depressive symptoms, as well as fewer compulsions by the end of treatment for all participants.” [6] Quote source : International OCD Foundation




References :



1. Wahl, K. (2013). Managing Obsessive Thoughts During Brief Exposure: An Experimental Study Comparing Mindfulness-Based Strategies and Distraction in Obsessive-Compulsive Disorder. Cognitive Therapy & Research, 37(4), 752-761.



2. Hertenstein, E., Rose, N., Voderholzer, U,. Heidenreich, T., Nissen, C., Thiel, N., Herbst, N., Katrin Külz, A. (2012). Mindfulness-based cognitive therapy in obsessive-compulsive disorder – A qualitative study on patients’ experiences. BMC Psychiatry, 12:185.




3. Wilkinson-Tough, M. (2010). Is mindfulness-based therapy an effective intervention for obsessive–intrusive thoughts: a case series. Clinical Psychology & Psychotherapy, 17(3), 250-268.



4. Fairfax, H. (2010). A group-based treatment for clients with Obsessive Compulsive Disorder (OCD) in a secondary care mental health setting: Integrating new developments within cognitive behavioural interventions – An exploratory study. Counselling & Psychotherapy Research, 10(3), 214-221.



5. Hanstede, M., Gidron, Y., & Nyklícek, I. (2008). The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population. Journal of Nervous Mental Disorders,196 (10):776-9.



6. Twohig, M., Hayes, S., & Masuda, A. (2006). Increasing willingness to experience obsessions: acceptance and commitment therapy as a treatment for obsessive-compulsive disorder. Behavior Therapy 37(1):3-13.






Neurotransmitters and Neurotransmitter Receptors




Now we’re approaching the most important subject of this article. Health of neurotransmitter receptors.


I will not dive deep into molecular biology and heavy science, but convey the message rather briefly, so everyone could understand what I am talking about, while including light, broadly accessible references to aid my explanations. As before, I am not going to reinvent wheels, but reference relevant articles and input certain text snippets instead.



“A neurotransmitter receptor (also known as a neuroreceptor) is a membrane receptor protein that is activated by a neurotransmitter. Chemicals on the outside of the cell, such as a neurotransmitter, can bump into the cell's membrane, in which there are receptors. If a neurotransmitter bumps into its corresponding receptor, they will bind and can trigger other events to occur inside the cell. Therefore, a membrane receptor is part of the molecular machinery that allows cells to communicate with one another. A neurotransmitter receptor is a class of receptors that specifically binds with neurotransmitters as opposed to other molecules.” Quote source : Wikipedia


There are many different kinds of neurotransmitters, and not all existing neurotransmitters have been discovered.




Types of Neurotransmitters



“Neurotransmitters, at the highest level, can be sorted into two types: small-molecule transmitters and neuropeptides. Small-molecule transmitters, like dopamine and glutamate, typically act directly on neighboring cells. The neuropeptides, small molecules like insulin and oxytocin, work more subtly, modulating, or adjusting, how cells communicate at the synapse. To date, scientists have identified more than 60 distinct types of neurotransmitters in the human brain, and most experts say there are more left to discover. These powerful neurochemicals are at the center of neurotransmission, and, as such, are critical to human cognition and behavior.



Often, neurotransmitters are talked about as if they have a single role or function. Dopamine is a “pleasure chemical” and GABA is a “learning” neurotransmitter. But neuroscientists are discovering they are multi-faceted and complex, working with and against each other to facilitate neural signaling across the cortex. Here is a list of some of the most common neurotransmitters discussed in neuroscience.



Acetylcholine



Acetylcholine (Ach) was the first neurotransmitter discovered. It is a direct action small-molecule that works primarily in muscles, helping to translate our intentions to move into actual actions as signals are passed from the neurons into the muscle fiber. But it also has other roles in the brain, including helping direct attention and playing a key role in facilitating neuroplasticity across the cortex.



Dopamine



Dopamine (DA) is often referred to as the “pleasure chemical” because it is released when mammals receive a reward in response to their behavior; that reward could be food, drugs, or sex. It is one of the most extensively studied neurochemicals, mainly because it plays such diverse roles in human behavior and cognition.


DA is involved with motivation, decision-making, movement, reward processing, attention, working memory, and learning. But it isn’t just a pleasure chemical. New work suggests DA also plays an important role in Parkinson’s disease, addiction, schizophrenia, and other neuropsychiatric disorders.



Glutamate



Glutamate (GLU) is the most excitatory neurotransmitter in the cortex. Too much glutamate results in excitotoxicity, or the death of neurons due to stroke, traumatic brain injury, or amyotrophic lateral sclerosis, the debilitating neurodegenerative disorder better known as Lou Gehrig’s disease. Yet, it’s not all bad news. The excitement GLU brings is important to learning and memory: long term potentiation (LTP), the molecular process believed to help form memories, occurs in glutamatergic neurons in the hippocampus and cortex.



Serotonin


Serotonin (5HT), sometimes called the “calming chemical,” is best known for its mood modulating effects. A lack of 5HT has been linked to depression and related neuropsychiatric disorders. But 5HT is farther reaching, and has also been implicated in helping to manage appetite, sleep, memory, and, most recently, decision-making behaviors.



Norepinephrine



Norepinephrine (NE) is both a hormone and a neurotransmitter. Some refer to it as noradrenalin. It has been linked to mood, arousal, vigilance, memory, and stress. Newer research has focused on its role in both post-traumatic stress disorder (PTSD) and Parkinson’s disease.



γ-Aminobutyric acid (GABA)



If GLU is the most excitatory neurotransmitter, then its inhibitory correlate is GABA. GABA works to inhibit neural signaling. If it inhibits cells too much, it can lead to seizures and other problems. But this neurotransmitter also plays an important role in brain development. New research suggests that GABA helps lay down important brain circuits in early development. Like DA, GABA also has a nickname: the “learning chemical.” Studies have found a link between the levels of GABA in the brain and whether or not learning is successful.” Quote source : Dana Foundation



Full article on neurotransmitters on Dana Foundation could be downloaded as a PDF file : download

Neurotransmitters structure
Neurotransmitters structure | Image credit : COMPOUND INTEREST

In addition, here is a nice bright infographic with brief neurotransmitters’ functions overview (download)





Possible OCD Causes; Neurotransmitters and Neurotransmitter Receptors Density Health; OCD and Neurotransmitting System


OCD is a neuropsychiatric disorder, a biological dysfunction in the ‘brain wiring’. However, before going with the core subject of this section, I would like to go over the debates about roles of genetics and epigenetics in OCD. While genetic/epigenetic factors may or may not be detrimental factors regarding OCD, I keep the scientific approach, and thus, provide you with all the relevant bits of information.


There have been many researches going on about possible genetic causes of OCD. Scientists argue whether OCD is passed on genetically or not. Here is some relevant information :


“The cause of OCD is unknown. Researchers are investigating whether the condition might involve changes in the brain's response to chemical messengers (neurotransmitters) such as serotonin or dopamine. Problems with regulating the activity of and interaction between various parts of the brain are also thought to contribute to the condition.


Variations in certain genes that provide instructions for proteins that react to or transport serotonin have been associated with an increased risk of OCD. Variations in other genes involved in communication in the brain may also be associated with the condition. However, not all people with OCD have an associated variation, and not all people with the variations will develop OCD.


In addition to genetic factors, researchers are studying environmental factors that might contribute to OCD, including complications during pregnancy or childbirth and stressful life events. However, none have been conclusively associated with this disorder. It seems likely that environmental conditions interact with genetic factors to determine the overall risk of developing OCD.” Quote source : Medline Plus

As I mentioned, another potential factor that could, if not cause, then at least affect/aggravate OCD is epicgenetics. I will not go over this topic in this article, but you can do your own reading. Here are some papers on OCD and epigenetics :








Now, to the core subject.


“It’s common to see and hear mental health professionals describing the cause of OCD in terms of a ‘biochemical imbalance’. These approaches have focused on one particular neurotransmitter, serotonin.


Serotonin is the chemical in the brain that sends messages between brain cells and it is thought to be involved in regulating everything from anxiety, to memory, to sleep.


Through the accidental discovery in the late sixties of the effectiveness of the serotonin active tricyclic antidepressant clomipramine, which did not substantially impact on serotonin, led to the serotonin hypothesis.


Initially, it was suggested, that there was a gross deficit in serotonin; when this was not actually identified, increasingly subtle abnormalities were suggested, with the evidence overall remaining implausible at best.


In more recent years some researchers have argued that the most robust evidence for the serotonin hypothesis is the specificity of serotonin reuptake inhibitors (SRI) and selective serotonin reuptake inhibitor (SSRI) medication.


However, given that this effect was the observation that generated the hypothesis, it cannot reasonably be considered as evidence for it.


It’s worth noting that relapse is frequently associated with the withdrawal of SSRI medications in OCD, more so than in other conditions, especially where no behavioural therapy is in place, which is yet to be fully understood. This could mean that serotonin is an important neurotransmitter involved in the maintenance of OCD, if not a specific cause.


SSRI acting on a 5-hydroxytryptamine receptor
SSRI acting on a 5-hydroxytryptamine receptor | Image credit : OCD UK

Overall, there is a place for SSRIs in the treatment of OCD, especially where co-morbidity is present, provided that medication remains part of informed patient choice, and combined with psychological therapy like CBT.” Quote source : OCD UK


Later studies reveal that pathophysiology of OCD is more than just serotonin-related dysfunction.



“The differential effects of serotonin-reuptake inhibitors on obsessive-compulsive disorder (OCD) were sufficient to presume that a serotonin regulatory disorder is the most essential part of the pathophysiology of OCD. In patients with OCD, however, a high-dose of serotonin-reuptake inhibitor monotherapy may not be sufficient, and approximately half of patients were noted to be treatment-resistant. As results from previous studies have shown, there have been positive treatment responses to the dopaminergic antagonists. This suggests that other neurotransmitter systems, such as dopamine, are involved in the pathophysiology of OCD. Preclinical, neuroimaging and neurochemical studies have provided evidence demonstrating that the dopaminergic system is involved in inducing or aggravating the symptoms that are indicative of OCD.” Quote source : PubMed | NCBI


One quite interesting article I found, explaining the possible link of dopaminergic reward system and OCD on Emotion, Brain, & Behavior Laboratory website.


A paper, correlating the striatal dopamine D2 receptor (D2R) and OCD — (Dopaminergic System Alteration in Anxiety and Compulsive Disorders: A Systematic Review of Neuroimaging Studies)


There is evidence that GABA (γ-aminobutyric acid) (or its shortage, to be precise) also has a role in psychopathology of OCD (Brain Gamma-Aminobutyric Acid (GABA) Concentration of the Prefrontal Lobe in Unmedicated Patients with Obsessive-Compulsive Disorder: A Research of Magnetic Resonance Spectroscopy)


Another study, linking GABA and intrusive thought control : (Hippocampal GABA enables inhibitory control over unwanted thoughts)


Another paper, investigating a role of GABA in controlling intrusive thoughts, anxiety and psychiatric disorders like schizophrenia and PTSD — (Scientists identify mechanism that helps us inhibit unwanted thoughts)


This International OCD Foundation article suggests glutamate levels tend to be higher in Cerebrospinal fluid (CSF) of patients with OCD than in psychiatrically healthy controls (New Horizons in OCD Research and the Potential Importance of Glutamate. Can We Develop Treatments That Work Better and Faster ?)


There’s a little article from No OCD on glutamate dysfunction and BHV-4157 drug (Glutamate: Why it might matter for our mental health)


Although one study showed that OCD-sick people, in fact, have higher plasma levels of GABA and higher GABA/Glutamate ratio (Investigation of anterior cingulate cortex gamma-aminobutyric acid and glutamate-glutamine levels in obsessive-compulsive disorder using magnetic resonance spectroscopy)



Keep in mind, that there are plenty of [scientific] papers, linking neurotransmitters functioning and various neuropsychiatric diseases out there, if you want to do some research — the internet is still open for everyone. Referencing them all in this article would be a useless titanic amount of effort.

Also note, that neurotransmitting system is far from well-known, and a lot of important studies that will shed more light onto how this works and links with OCD and other mental disorders, are yet to come.


One article studied the role of multiple neurotransmitters in OCD pathophysiology :


“While no glutamate modulator can be considered proven as an efficacious treatment of OCD, promising suggestions of benefit have been reported for memantine and riluzole. The evidence is thinner for N-acetylcysteine, but this agent’s low cost and benign side effect profile make it a reasonable consideration in certain patients. Intriguing research on D-cycloserine and ketamine suggest potential benefit as well. It is notable that these agents all work by different, and in some cases opposite, mechanisms; this suggests that we have much to learn about the role of glutamate dysregulation in the etiology of OCD and of glutamate modulators in its treatment.” (Glutamatergic agents for OCD and related disorders)


Imaging studies have suggested that the brains of people with OCD function with characteristic differences. Genes that affect how the brain responds to the neurotransmitters dopamine and serotonin, for example, may play a role in causing the disorder.” Quote source : Medical News Today


Concluding all above, OCD’s main cause is most likely dysfunction in neurotransmitting system. But you are here far not just to know the cause of OCD, you are here to find out how to treat it. Well, we’re almost there.


Just let me introduce you to the realm of pain and pleasure, the world of addictions. And before we move on, I declare that I personally have no experience with drugs. I mean illegal drugs, not proper medicine.


One of the worst things you could be doing to your brain is cuffing it to an addiction.


Some people tend to find illegal access routes to buy drugs, ranging from prescription drugs like benzodiazepines, to relatively light substances like cannabis, to ‘hardcore’ synthetic drugs. Others would never do such things, but still get their own legal drugs and get addicted. Here is the thing : many might have unknowingly been kind of junkies since their childhoods.


There are drugs out there within everyone’s legal reach. Like alcohol. Or PMO. For instance.


That’s where NoFap comes in.


I have already released a post on my website on this topic before. I really encourage you to check it out.


Also read : Is NoFap Legit ?


This world is overfilled with legal drugs people regularly abuse, and the scariest part is, this is considered normal, healthy. Sadly, this is not the only example of ‘just because it’s legal, it does not mean it’s good and normal’. Please, note : I am NOT advocating for dystopian totalitarian regimes and freedom restrictions.


And you have probably encountered various alcohol and even sugar consumption warnings (if you haven’t, then you might just want to surf the web, it’s never too late), but you weren’t probably told that self-pleasuring might seriously mess up your brain wiring, were you ?


(Hairy palms and blindness don’t count).


I will illustrate the concept in terms of dopamine.


You have already learned (or recapped) what dopamine molecule is.


Our bodies are very complex biological machines, engineered over millions of years, designed for survival. I think you know the basics, so I’ll skip the lecture on evolution and primitive biology.


Your brain is programmed to keep homeostasis in neurotransmitter levels. Long story short, when you bombard your brain with large doses of dopamine (or other relevant neurotransmitter), the homeostasis is sustained by reducing the overall number of dopamine (or other respective neurotransmitter) receptors in the brain.



Dopamine receptor homeostasis infographic
Overflow of dopamine results in decrease in quantity of dopamine receptors in the brain | Image credit : Improvement Pill


“Studies have shown that people with low [number of] dopamine receptors have the following side effects :


  • Fatigue

  • Insomnia

  • Low libido

  • Lack of motivation

  • Stress

  • Mood swings

  • Memory loss

  • Social anxiety

  • Sugar cravings

  • Inability to connect with others

  • Inability to focus”



Quote source : Improvement Pill




As well as it is a proved direct cause of neuropsychiatric disorders.


As for the comparative quantitative dopamine increase —



Dopamine level increase bar chart
The graph above shows the comparison of increased dopamine levels induced by three activities/substances : sex/PMO, morphine and cocaine | Graph data source : Improvement Pill

While cocaine is hard and expensive to obtain, dangerous in use (overdose borders) and peaks dopamine for a couple of minutes, the process of PMO could be relatively infinite.


You’re probably wondering ‘How come we can have healthy sexual relationships, if sex has such devastating effect on health ?’


Well, healthy relationships and sex are not equivalent to PMO.


For starters, there’s this thing called the Coolidge effect.


“The Coolidge effect is a biological phenomenon seen in animals, whereby males exhibit renewed sexual interest whenever a new female is introduced to have sex with, even after cessation of sex with prior but still available sexual partners. To a lesser extent, the effect is also seen among females with regard to their mates.


The Coolidge effect can be attributed to an increase in sexual responsiveness, and a shortening of the sexual refractory period. The evolutionary benefit to this phenomenon is that a male can fertilize multiple females. The male may be reinvigorated repeatedly for successful insemination of multiple females.” Quote source : Wikipedia



Time to ejaculation vs. № of mates graph
Time to ejaculation vs. № of mates graph

Yes, Coolidge effect is also a thing in humans.


I reference this beautiful quote from The Reward Foundation :


“It is this flaw in our biology, the Coolidge effect, that has allowed the internet pornography industry to mushroom into a multi-billion dollar business. As soon as a person has ‘fertilised to satiety’ an apparently willing sexual partner, they will stop. This happens even if it is just an image of one. Then the brain produces less “go after it” dopamine and hunts around for new fertilisation opportunities. With around 10 million porn videos consumed in the UK alone every day, there is no shortage of apparently willing mates. All this goes on at an unconscious level but affects everyday behaviour none the less.
The good news is that we don’t have to be trapped by The Coolidge Effect. We humans are smart when we put our minds to it. By learning to reduce the effects of too much dopamine in the brain and redressing the balance with more oxytocin thus reducing stress levels too, we encourage more loving bonds and connection. These are sustainable and help us flourish both individually and together. For more information on this we heartily recommend this website is www.reuniting.info.”

The Reward Foundation is a key source of evidence-based information about love relationships and the impact of internet pornography on mental and physical health, relationships, attainment and legal liability. This website can shed light onto various topics, such as : Lesson Plans for Schools; New research; Brain Basics; Mental Effects of Porn; Love; Erectile Dysfunction; Relationships; The Law; Quizzes to check if porn is affecting you; Help with quitting porn etc.


A good video by the aforementioned organisation for additional information : Internet porn is free, but kids are paying the price | AGE VERIFICATION.


You can find a lot of useful content on their YouTube channel.


Reward Foundation additional reading link table
Reward Foundation additional reading link table

Links :


Of course, one could regularly and frequently switch sexual partners, but this does not have good consequences for psyche as well (and not just for psyche !). Although it would be really hard to try and switch partners as often as one could pleasure himself; at that point, STDs would probably become much more of both border and hazard.


Keep in mind that human brain is a very complex system, and even a frequent partner change won’t actually be equivalent for PMO (not saying it is better !) — evolution have not accounted for people watching porn just yet, this is not something seen in nature.


With porn on the other hand, one can consistently keep spiking his/her dopamine levels with every new video.


That is not all. The information I provided above was only regarding dopamine. However, dopamine is not the only neurotransmitter involved in sexual activity. Sex and orgasm also involve production of serotonin, endorphin, oxytocin, as well as hormones such as testosterone, estrogen and prolactine.


Other neurotransmitters like acetylcholine, glutamate and GABA are also involved in the process of arousal, sex and orgasm.


All neurotransmitters, as well has hormones, have their receptors, which are, possibly, too, subject to quantitative decrease, when being overstimulated.


While most pro-NoFap individuals advocate for it only with regards to dopamine and androgens, there is a much bigger picture.


PMO and other drugs wreak havoc not just on the dopamine system. They mess up all the pleasure-response system, the brain wiring, and the whole body, as well as psyche, suffers as result. Neurotransmitting and hormonal functions inevitably affect each other. Remember, your body is a complex machine that works as a whole.


But guess what, the industry of pleasure is enormous, it is literally the foundation of our society. No wonder you did not know all this. “Big guys” do not want you to. They want people to resume being hamsters, and pleasure seems to be the perfect wheel in a cage.


Keep in mind that PMO is not the only legal drug : examples of other stuff that can act in a similar way include alcohol, video gaming, movies, music and sugar. And while the latter four are not as severe in terms of wreaking potential, keep in mind that dosage/exposure time is a very important variable.


If one understands how those things work, he could understand, recognise and manage his activities reasonably. As a rule of thumb, you could avoid meaningless activities that consume resources (be it health, money and/or time) and give nothing good in return, asides for an instant burst of pleasure (dopamine etc. spike). Remember of an analogy of pushing a button. Are you pleasuring yourself with doing so ?



Pleasure button
Are you pleasuring yourself by pushing a button ?


I do not encourage you to completely ban yourself from watching movies, playing games, listening to music and irrevocably excluding all sugar from your diet, but rather advise you to do everything in a reasonable moderation.


There is a golden rule with an annex proverb quite famous in Russia : good things come in small packages («хорошего понемножку»).


So how long does it take to restore dopamine receptors health ?


It depends on various variables, such as the method/tool of abuse, duration, severity etc.


If we’re talking light PMO addiction, recovery could take around 90–120 days. Full restoration from heavy-duty PMO addiction could take up to a year or more. The estimate’s roughly same for drug abuse (such as methamphetamine) — on average, brain could fully recover in about 12–14 months, or, in more severe cases, it might not fully recover at all.


Note, however, that those periods are approximate, it’s not like brain has an embedded timer.


Empirical milestones of reported PMO reboot :


· 3–4 months : first milestone of drastic difference

· 6 months : even more substantial change

· 12 months : a whole different person

· 14–18 months : even better


OCD is diminished to almost negligible, a world is a much brighter and warmer place, life is much more colourful and meaningful, lots of motivation and energy — that’s how you should feel after you ‘reboot’.



Additional reading :



Not to mention all other devastating effects drugs can have on your body/brain (have your own research, as there are various hazards and tons of information and studies behind each), drugs can wreak havoc from the perspective of epigenetics as well. And yes, it correlates with neuropsychiatric disorders too, including OCD.



Alcohol :




Marijuana/tobacco :




Article, reviewing studies on Histone serotonylation/dopaminylation by Ian Maze — epigenetics roles of dopamine/serotonin neurotransmitters :



That’s how you start becoming an aware person. I also encourage you to check out Erin Janus’s content and this website, that might just guide you further in the process of epiphany.


You decide what are you going to do with all that information : you can accept and perhaps fact-check all the required information (never trust anyone without a personal mental filter, and, better, your own ‘research’), or you can just say I’m a weird crazy Russian vegan conspiracist with mental conditions, and perhaps, a clown. Then you can just get back to your life, as before, building a thick wall of denial.


And, of course, all this might be inapplicable in case you already know all that information.


If you choose to embrace the truth, maybe you’re better off with allotting sufficient time resources for your personal ‘research’, and what’s more important — making sure your ‘research’ is not bias. When someone wants and/or fears something badly, the decision making process could be heavily corrupted.


Fear is potentially your worst enemy.


If you choose to deny the given, then just make sure the denial wall is thick enough. You probably do not want it cracking, or what’s worse, collapsing one day. I warned you. Don’t blame me if it does.



Red and blue pill
Which do you choose ? | Image credit : Diy13

I have already written everything you need to make up your mind, in this article, although I can add that living clean is definitely worth it. Now, I cannot imagine how dumb would it be for an individual to self-handedly ruin himself, rendering his life joyless and existence blurred.


As I may have mentioned already, and will mention later in this article, I am still dealing with my weird health issues, and, hence, sometimes I use distractions such as movies or video games, to make my life easier (just as one would take painkillers for pain, and you probably know that those cause addiction pretty fast).


For instance, videogames. They help to pass time and be distracted from suffering, but I cannot imagine willingly sacrificing my precious quality time to something void, and, for instance, even seemingly innocent like playing video games. Watching other people root in front of their laptops for hours and days in their spare time triggers sad emotions.


Then again, it is one thing to spend some jolly time as an occasion, and other, to live and work only to get home and get another dose of artificial happiness.


You could often hear from people nowadays that they feel empty, or are dead inside, or something similar. If we assume that it is not psychiatric conditions influence, but a healthy individual, then there’s a reasonable question : filling yourself with void and illusions, what do you expect ?


And when it comes to PMO, again, this is some really nasty heavy-duty stuff that nukes dopamine receptors health.


Living in the mode of addictions and dopamine slavery is comparable to being a zombie — and actually is a huge part of modern people zombifying system, in my opinion.


Another sign [that one is being zombified] to watch out for, is if a person tends to cling and loop to some idea, thoughts, experience, memories — usually something negative — and keeps chewing it like a gum, over and over again. Of course, this is only loosely related to OCD, but it is a symptom. A symptom of a brain that cannot or does not want to the change subject(s), preferring to be stuck in its mental swamp. Something like an old grudge, guilt, fear etc. I repeat, this ‘thing’ does necessarily indicate that the person has OCD, and vice versa; although, it does correlate.


I will probably discuss those phenomena in future articles/videos, more related to self-awareness.


This “thing” can denote that one cannot let go of something; and it can interact and intertwine with OCD in nasty ways.


It is always good to remind yourself, that again, those are just illusions. Negative, draining illusions. People are being zombified into various factions ubiquitously, tricked into hatred, fear and narrow-mindedness. Just take some time to think if you have such chronic painful whirlpools you do not manage to swim out of, because those are huge cogs of impaired mental processing that might just correlate or interact with your OCD.


Then again, this does not always have to be negative; it will take some analysis to detect, and courage to admit, if you constantly give off your energy, time and effort to something void and useless — be it addictions, chronic grudges, political-driven hatred or other worthless things you might want to avoid in order to clear your mind.


Remember that all the brain junk is intertwined : the less you get bogged down with unhealthy life style and habits; negative emotions and attitudes — the more stable, calm and frictionless your gears will run.


With all that said, in my experience now, trying to consciously dive into the old marshes even a little (all for science’s sake, of course) feels terrible. Then I get a glimpse of the old memories — of how dark and painful it was. With my new chronic health issues, sometimes I think, that it used to be better before (when I hadn’t had nausea, for instance), but no. Having a little sip of the old me condition has a very bitter lingering taste. Poison to the brain. Feels like zombification.





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