In February 2021, I released the world’s first guide to evidence-based nutrition for OCD recovery (Obsessive Compulsive Disorder), written by a New Zealand-registered clinical nutritionist and OCD survivor. Yet Nutrition for Your OCD Recovery offers much more than just nutrition advice. Read on for an excerpt of the book here. And, you can purchase the full ebook at my website.
From the foreword to Nutrition for Your OCD Recovery
It seems fitting that I am sitting in the sun, beginning this book on Nutrition for Your OCD Recovery, on the eve of the eight-year anniversary of finding my naturopath and going after my own OCD recovery (Obsessive Compulsive Disorder).
This book will not only help you learn about nutrition for your OCD recovery, but about wholistic recovery from OCD. As well as nutritional medicine, you will learn about stress reduction, self care, trauma recovery, understanding your genetics and how this can affect your health, the role of PANDAS in OCD, and more. All this information will help you learn to support the health of your nervous system and reduce and manage the symptoms of OCD. It is about creating a toolbox to support your mental, physical, and emotional health — a toolbox you can use for the rest of your life.
Additionally, I want to make it clear from the beginning that I strongly encourage you to use the tools discussed in this book alongside therapy for OCD, with a skilled counsellor or psychologist who has experience supporting people with OCD. You may pursue ERP therapy (Exposure and Response Prevention), CBT (Cognitive Behavioural Therapy), ACT (Acceptance and Commitment Therapy), or even try a combination of all three.
As an OCD survivor and nutritionist, I know two things. 1) Therapy for OCD can seem daunting, especially when your symptoms are moderate or severe. Therapy does require us to face fears that feel very real to us. 2) This is why I am a firm believer in combining nutritional support with therapy. Nutritional support helps calm and nourish your nervous system, which, in my experience, makes therapy less daunting. It is important to give yourself the best chance of completing therapy, and therapy becomes much more achievable when you are sleeping better, when your physical health (digestion, periods, etc.) is improving, when your blood glucose levels, mood, and energy levels are more stable, and when your macro and micronutrient needs are being met and your symptoms of anxiety are reducing as a result.
If you suffer from OCD, this book is for you. You may or may not have an official diagnosis of OCD — I didn’t. But I knew from being a keen observer of life and a keen reader what I had. As many of you without a formal diagnosis no doubt will too.
If you wish to be assessed for OCD, I recommend seeing a therapist experienced in working with OCD. The Yale Brown Obsessive Compulsive Scale (YBOCS) is a widely used and accepted healthcare tool for assessing the presence of and severity of OCD.
This book is aimed at you, the person living with OCD. While partners, friends, and family may find this a useful read, I am writing first and foremost for you.
I write as a person who lives with OCD and has overcome the worst of it, and as a registered clinical nutritionist who now supports people affected by OCD, anxiety, panic attacks, and other mental health problems.
I developed OCD at age 10, though it did not become severe and life-changing until I was 14. At age 16 I often thought of taking my life, to end the suffering OCD was causing me.
As it does for many of us, OCD waxed and waned for me. My later teens and early 20s were fairly symptom free. An abusive relationship around age 24 brought my symptoms back in full force, helping me realize the stress/OCD connection.
I was 25 when I first told another trusted soul what was going on for me, inside my head — the first person in my life who I felt truly cared for me and who I felt safe with and seen by. He is part of the reason I am alive today.
I was 29 when I hit rock bottom for the second time and finally went after recovery. Like far too many of us with OCD, I waited more than ten years to seek help (this statistic comes from the World Health Organization). It took me 19 years to ask for help.
My recovery was a mostly beautiful process, and was greatly supported by working one-on-one with a naturopath familiar with OCD. Nutritional medicine, herbal medicine, stress reduction, yoga, increasing the good things in my life, distancing myself from toxic and traumatizing people, pet therapy, and music therapy all played a role in my early recovery. Recovery began in late 2010 for me, and by February 2012, I could genuinely say I was living largely free from OCD and many physical health conditions I had been suffering from for years.
Since February 2012, I have lived 90% symptom-free of OCD. I had one relapse that lasted a few months from late 2014 to early 2015, that began after a sustained period of extreme stress in my life, and for which I sought ERP therapy. I am glad to have ERP therapy as part of my tool kit to complement my nutritional knowledge and tools.
I now work as a registered clinical nutritionist in private practice. I enjoy a level of mental, physical, and emotional health I never had during my teens or 20s. I value my health so much because I have known what it’s like to be without it, and to feel unable to see the future you hope for.
It’s my hope this book will 1) help you begin to navigate your recovery from OCD, and 2) help you learn more tools for your mental health toolbox — tools that I have seen help many people when they commit to using them. Additionally, many of the tools discussed in this book will also support you through times of stress, poor sleep, depression, and anxiety.
It is safe to use the tools recommended in this book in conjunction with SSRI/antidepressant and anxiolytic medications. I encourage you to discuss with your GP or psychiatrist which nutritional supplements you are taking and keep all members of your healthcare team informed about your choices and any concerns and questions you have.
In a spirit of building trust, the first chapter of this book details my experience of OCD. It touches on what I came to understand with hindsight and insight as the many factors that contributed to the development and worsening of my OCD. After this, we focus on recovery mindset, key aspects of nutrition for your mental health and OCD, gut health, the importance of stress reduction for your recovery, other health conditions that may contribute to OCD, and how trauma can play a role in the development of OCD.
If you prefer to read the chapters in a different order to how they are set out, you will still gain knowledge to support your holistic OCD recovery. Most chapters conclude with suggested actions for you to take to support your OCD recovery, and all chapters provide information to help you learn about the many pathways to consider in your recovery from OCD.
Ready to get started?
Chapter 1 — My Story
My own story still causes me some pain to share but I will share most of it with you. I have been there. I do understand the hell this illness can be.
It began when I was 10 years old.
We were living in the countryside, in a 100-year-old old farmhouse, on five acres with an old barn. We had many beautiful pets. It was a magical period in my childhood. Yet there were also disturbances that I remember.
A family member threatening to leave and packing their bags. Sometimes they would go away for a night, then come back.
This same family member venting to me — a child of 8 or 9 — about their problems. A lot.
A family member’s anger, which could be frightening. And which would, as I reached my teens and my OCD got worse, become violence.
It started for me with sensory hallucinations, contamination fears and checking.
I remember checking that everything was ‘in place’ in certain rooms in the house. This checking took no more than a few minutes each day, but I noticed it, and especially the intense urge that it had to be done in a certain order and before I could leave a room.
I remember having anxieties about family members deliberately putting their mucous on me (sensory hallucinations). The nature of these obsessions was distressing. Yet at that stage, OCD was not dominating my days. Just there now and then.
Around 12 to 13, my OCD morphed. As a nutritionist, it’s notable to me now that changes in my mental health began and intensified as I approached and hit puberty — and during a stressful time of change and loss in our family. My mother had lost her job and it was decided we had to sell our small farm. We moved to the nearby city, to a house with a smaller mortgage and away from the space, beauty and peace of the countryside into a much less nourishing environment. We also had to rehome all our beloved farm animals — two horses, a pet goat and a pet sheep. Cruelly, my mother was actually reinstated in her job just a few months later, but by then we had sold the farm.
My contamination fears became dominant and more present, and were linked mostly to my father, whose explosive anger had frightened me since I was a very young child and seemed to be worsening. My contamination fears became apparent to those around me, and my mother would scold me for using the vacuum cleaner in the evenings. But still, OCD remained an occasional happening at this point — it was not dominating my life.
Hearing my parents arguments around this time distressed me. And the way a family member frequently took their moods out on me but much less so on others.
Then, when I was 14, things changed suddenly.
It was like OCD had taken root, and suddenly this rotten weed bloomed. I can still remember suddenly thinking one day, around my contamination fears, “But if this person is contaminated, and they touch all these things that other people touch, then….everyone is contaminated. This whole house is contaminated. Everything is contaminated.”
And like that, seemingly overnight, I descended into severe OCD. What had previously been a few specific, scary things suddenly became danger everywhere and a complex separation of ‘worlds’: where was ‘clean’ and I could feel sort of relaxed, and where was ‘dirty’ and required complex management. And doing everything I could to keep these two worlds separate.
I was 14 and life had become very distressing. And there was no safe person to turn to.
I need not tell you that OCD takes over your mind. On the outside you may appear to be a withdrawn or unhappy teenager (a “moody little bitch”, as one family member once put it) or even a ‘normal’ teenager, yet on the inside you are in a world of turmoil.
And that OCD world can feel like it is ending if someone around you does the ‘wrong’ thing (not always deliberately, but sometimes, if the person is cruel). A person who you perceive as contaminated may want to hand you a book on a log-haul bus ride, and you feel unable to say no and are then stuck with no way to wash your hands. Or a person you perceive as contaminated goes into your room while you are at school…so your mind then races anxiously, considering everything they might have touched or brushed against, that will need to be cleaned — or thrown away if it cannot be cleaned.
That seemingly tangible feeling of ‘dirtiness’ on one’s hands, your whole being or on objects, which the OCD brain can’t ignore. That can only be relieved by washing the hands or showering or laundering…or throwing the object away. Or attempting to clean it and being unable to prevent this from damaging it — as in the case of a CD player.
In my case, a hand wash tended to last at least 60 seconds and involve a lot of lather. I remember the painful soap burns I developed around my wrists.
For the reader who does not have OCD, note that my contamination fears were never about germs, AIDs, disease, blood, dirt or anything like that. This can be the case for some people affected by OCD contamination fear, but not for all of us. And the uninformed stereotype can be annoying.
For me, the contamination fears I experienced all related to people and places that felt contaminated. With hindsight and insight, I believe this was my nervous system’s response to the trauma of the physical violence I experienced — which really could be sudden and terrifying and painful. I recall being thrown across a room. Punched in the side of the head. And it was a response to the emotional neglect and abuse I experienced — which was worse than the physical abuse, and worsened as I reached my teens and then adulthood. I remember the gas lighting, the scapegoating, the ongoing shaming comments, and vicious criticism. The conditional ‘love’. It took me years to understand that these behaviours were abusive, and to begin the work of unlearning the unhealthy emotional patterns they had established in me (especially anxiety).
Only a few years ago, I learned this type of OCD is called metaphysical contamination OCD. It is typically seen in people who have experienced trauma, and their OCD fears (obsessions) have arisen in response to people, places, and objects associated with the trauma. While some experts say this is an uncommon type of OCD, I have seen a number of clients who are affected by metaphysical OCD. The father of a teen who’d had traumatic experiences with a family member, and who brought his child to see me for support with OCD commented, “It’s like a mental contamination,” showing that he was aware his child’s OCD fears had nothing to do with germs or dirt.
Some of my worst OCD memories include:
Having to stay up until 2am on a school night, waiting for my night-owl father to go to bed and fall asleep so I could use the washing machine to launder my school dress. And then take a one-hour shower, so I could feel and be clean for my bed, school and the ‘outside world’ the next day.
The terror of not wanting to be caught doing this.
The persistent lack of sleep caused by trying to hide my compulsions.
The verbal and sometimes physical abuse I would encounter on the occasions I was caught. Never concern.
Eventually, sleeping on my ‘dirty’ bedroom floor became the norm, because I was too exhausted to shower to be able to sleep in my ‘clean’ bed. Including in winter. But then I’d be unable to go to school the next day. So I would either pretend to go to school and simply walk around various neighbourhoods all day, or pretend to leave the house and then sneak back in to my bedroom….and sleep in a spot not visible to anyone who might look into my room from just the doorway.
Having my freshly cleaned bedroom often entered by family members without permission and their lack of concern and instead anger at my intense distress and tears.
A family member scornfully mocking me about “your decontamination rituals”.
The self harming I carried out at age 16. I remember my father seeing the cuts on my arms on a warm day when I was wearing a tank top and asking, in alarm, “Why do you have cuts all over your arms?” Other family stood nearby and said nothing. I fled to my bedroom and it was never mentioned again.
Going from being a straight A student to a C student. The shame and hurt I felt.
Having to make up excuses when a friend suggested going to my house.
Having to make up excuses when I was given a last minute invite to a social event and there was no way I could take the hour-long shower I would need to take, to be able to feel ‘clean’ for the outside world.
Spending a year or so seeing a counsellor through my high school, who I never felt able to tell about my OCD. Like too many who suffer with OCD, I felt SO ashamed of what was going in my head. I blamed myself for what I thought and felt. It is difficult for a young person to develop self compassion when you have not been shown compassion.
When I was 15, my father developed cancer. It spread rapidly. A few months after my 17th birthday, he passed away. My response for about ten years that followed was terrible guilt and self flagellation. The break down in our relationship had been all my fault, I had been so horrible to my dad.
Now that I am older and have developed self compassion and deeper understanding — and importantly, greatly improved mental health — I know it was normal for me to feel anger and even hatred toward a dad who scared me and hit me. I now know that OCD highlighted issues in our family dynamic but did not cause them. I now know I did nothing wrong. I was a child with a mental health problem, and I deserved and needed love and help.
And I know my dad had issues with his own mental and emotional health, stemming from his own very traumatic childhood. I wish he hadn’t died so young. I wish we’d had the chance to know each other and become friends.
My dad looked me in the eyes before he died and told me he was sorry and that he loved me and had always loved me. I know he meant it, though it hurt me that he had to be dying to say it. I visit his grave when I have the chance and I still talk to him. I hold good memories of him too and learned some valuable lessons from him. I miss you, Dad.
I left home at 17 and moved to a town renowned for high sunshine hours. I stopped drinking coca cola every day (a significant source of sugar, caffeine, stress on the body and cause of nutrient depletion). I was so young and really had no idea how to look after myself, how to cook, even how to dress for cold weather in winter. How to have boundaries with other people. What type of respect and treatment I should expect from a boyfriend. But I did my best.
I didn’t see my family a lot but when I did, things were happier. To my thinking at the time, this was because the OCD had gone away and I was ‘no longer messed up’. The problems in my family dynamic continued any time I was in proximity to them. But when this is all you have ever know, it is your norm. Though I had started to get sick of it in the wake of my father’s death.
As it does for some of us, OCD waxed and waned. Through my late teens and early 20s it was always there, but mostly the OCD dragon was in the background, watching me from a distance. I remember thinking that it was done, a thing of the past. I remained a perfectionist in many ways but this is my preference — not an obsessive behaviour that controls my life.
Then, during a verbally and emotionally abusive relationship in my early 20s, the anxiety dragon got me firmly in its jaws again. I had the courage to leave at age 23, after the first time he physically attacked me, one evening when drunk. I only saw him once again after that, briefly, and I haven’t spoken to him since. And for this, I pat myself on the back.
I did begin to note at this point in my life that OCD would always seem to return when I was stressed, that it wasn’t magically going away as I hoped it would. That I seemed to meet a lot of toxic and bullying people — employers, female acquaintances and work mates or two-faced friends and boyfriends. That I had great difficulty standing up to these toxic people, even though I quietly knew they were so wrong in their assessments of me, their toxic projections and jealousies. I had also begun to really grasp that I never received any emotional support from my family, even during deeply distressing experiences. Worse still, that their actions often added to my pain during these times. And to this day, the word “OCD” has never once been spoken in my presence by my family members — though I did receive an email from one family member when I was in my early 30s telling me, “You use OCD as an excuse for having achieved nothing with your life.”
I worked in tourism for a few years, loving the majestic environments I got to live and work in. Fiordland National Park, with its granite peaks, waterfalls, and glacier-carved valleys. The silence of the high passes and saddles and bushy valleys, where I would happily hike and camp alone on my days off. The mountains I climbed and had a go at climbing. The kayak trips at dusk, where I once had a seal swim alongside me, surfacing and diving, while a full moon rose.
My work mates seemed to regard me as crazy and often asked me if I got scared. I found this strange. Being alone in these beautiful environments brought me peace.
At age 25, I met a soul mate. The first person in my life who I felt truly safe with. He was the first person I told about my OCD.
When we moved in together, he couldn’t help but notice my anxieties. Lying in bed one weekend morning, after something related to taking out the rubbish had caused an argument that he couldn’t understand, I finally felt safe enough with another human being to tell them what was going on in my head. At age 25. After living silently with OCD for 15 years. I can still see the scene clearly in my head, as we lay there and I spoke quietly to him.
Around the time I met my future husband, I had stopped working in poorly-paid-and-always-overworked tourism jobs and begun teaching ESL, and we were living in the big city, Auckland. It felt like my first proper, professional job. I also did freelance writing for newspapers and magazines. Writing has always been a love of mine and something my dad had encouraged.
Because I had grown up in an environment where I was emotionally neglected, self care just didn’t come naturally to me, at all.
So I worked all day as a teacher, five days a week, without eating breakfast. My perfectionist and over-giving, put-everyone-else-first nature (so common in those who have been emotionally neglected as children) meant I often spent my lunch break helping students talk over personal problems or study difficulties. Then I would spend hours of unpaid time trying to create the perfect lesson plan. When I got home around 5pm, I would finally eat my first meal of the day.
I lacked confidence in my abilities — in all things. My appearance, my intelligence, my value as a person. But it was being seeded, slowly. From the love of my soul mate. From the positive regard I received from my wonderful boss, Giuliana. From my lovely students. If you read this, Giu, thank you.
The OCD was still there, at a lower level. What was becoming more and more prominent was my physical health issues. PMS with painful cramping. Constant acne in my mid-20s — I’d never had it in my teens. Migraines a few times a year, which left me vomiting and immobile. Bloating. And the insomnia…the wicked, wicked insomnia.
Around age 27, I would lie awake all night — something that had been on-and-off through my life since I was a teen but had become more consistent. My mind would not switch off. I would be exhausted but wired.
Around 6am, I would fall asleep. Finally.
At 7am, the alarm would sound.
And I would go and teach for five hours, then lesson plan and do paperwork for several more hours on top of that. Eating my first meal of the day around 5pm. Eventually, I started taking muesli, tinned soup and crackers to work.
Then I had a run of difficult students and another bullying experience with an older, female colleague who was new to the school. She was the critical and unreasonable sort, who liked to give scornful and angry looks and deliberately upset. The type who seems to hate young, pretty women on sight.
I couldn’t take it anymore, I was so burnt out. I resigned from teaching and began to seek a job in writing or editing. I had completed a diploma in journalism at age 21, before I had taken my side trip into tourism for a few years. Eventually, I ended up working from home as a contract editor for several academic editing companies. It suited me — it mattered not if I hadn’t slept much, I could usually work odd hours that fit around my sleep or lack of. There was no commuting stress, no difficult colleagues. And we were able to rent a little house on the magical, wild, west coast of Auckland. And we got married.
Life was pretty good. I didn’t see my family much. I had finally begun to fully notice and get fed up with how selfish, critical, and unreasonable they could be. How one would dump all their problems on me and treat different family members differently. How my so-called family’s only interest in me related to what I could do for them. How they never had my back or took a genuine interest in me. And my husband noticed it too.
And yet, despite having moved into a lower stress job, my health spiralled down.
The OCD that had been at lower levels for some years heightened. New obsessions arose.
I now know it was the years of accumulated stress, the unaddressed trauma. Partly my poor diet — I was a vegetarian of about 14 years at that point, and an innocently clueless one at that, living on toast and pasta and salad mostly, fruit smoothies and lots and lots of soy burgers. So I had deepening nutrient deficiencies, especially protein, healthy fats, B vitamins and other nutrients (notably B12, B6, iron, zinc, EPA and DHA, which are crucial for mental health), was drinking too much coffee for my stressed nervous system, had ongoing sleep issues, and low self worth. And genetic factors were likely playing a role too, which would have been exacerbated by stress and my poor diet. And, I live with a health condition known as hyperhidrosis. This means I sweat a lot more than the average person. Ongoing sweat loss = ongoing mineral loss. I had multiple signs of serious magnesium deficiency, though I didn’t recognize it at the time. Not to mention the years of misguided neural pathways that OCD had carved and laid down. And did I mention the accumulated stress?
I also pushed myself hard. With work. With freelance writing projects. With climbing trips to Mt Ruapehu on the weekends in winter and longer trips to the Southern Alps — though don’t get me wrong, those trips and climbs in winter and spring remain some of the best experiences of my life. With running and hiking most days, for exercise. It never occurred to me to ease back and prioritize my health. I did not have the understanding then that I do now, that stress comes in multiple forms. That chronic lack of sleep, inadequate nutrition, trauma, over-exercising, caffeine, mineral loss and over-working all take their toll on your nervous and endocrine systems, on your health right down to cellular level.
I just quietly hoped the OCD would go away on its own, somehow.
But it didn’t go away, it got worse.
And finally, in late 2009, after an especially difficult year of OCD where new contamination fears related to places and objects had taken hold and seen me become partly house bound and hysterical most days with OCD fears, my husband sat on the sofa one afternoon and began to cry.
I had never before seen him cry.
And something finally clicked for me.
I was hurting him.
I was seriously, seriously ill.
My future was not looking bright.
If I wanted to stop hurting him, if I wanted to have the future I hoped for, I would have to do something about this.
I was sick of being sick. OCD wasn’t going to magically go away. I had to take action.
I began my research. Medication or therapy? Medication was a no for me — it just didn’t fit with my values. And having watched my father go through the medical system with cancer, for me there is something not quite right with the medical approach of treating the symptoms rather than the causes of chronic health conditions.
ERP therapy? I read a description online and felt terrified. Exposing myself to my contamination fears and then not carrying out the associated compulsions to make things feel ok again? No way. This was the source of all my distress. How could I willingly do that?
In 2010, I had what I call a false start, but it taught me valuable information that I can now pass on to you. I found a nice enough therapist who claimed to be experienced in working with people affected by OCD. But after two sessions, he clearly was not — and he kept doing stuff, forgetfully, during our session that spiked my OCD. I moved on, with no hard feelings toward him.
I can’t emphasize this enough — if you begin therapy for OCD, your therapist MUST be familiar with OCD and familiar with ERP therapy and other therapies for OCD such as CBT and ACT. And ideally, they will have some years of experience supporting people who have OCD. Do not waste your precious time or money on a therapist who doesn’t get it. You deserve to see a therapist who can genuinely help you, with your equal participation. Asking questions like, “How long have you been helping clients with OCD? Have you completed specific training in therapies for OCD? Are you familiar with ERP therapy?” should help you work out who to book in with and who to move on from.
On the afternoon of coming home from that second therapy session, feeling disillusioned, I sat on our bed in the rental house we had recently moved to, on Banks Peninsula. A place of sunshine and sun-drenched volcanic hills. Of redolent pine trees along coastal paths that overlooked sparkling harbours. Of the wide Canterbury skies that I have always found soul soothing. It still holds magic for me, always will. It is where I began my recovery.
I sighed and Googled ‘OCD support forum’.
I found a forum and noted, with surprise, a section of the forum called ‘Alternative remedies for OCD’ (it had fewer posts that other sections of the forum). Hmmm, I thought, and clicked my way in.
Within moments, I came across comments from a man in India who I would later form an email friendship with. He was declaring the importance of nervous system health for OCD recovery. He specifically mentioned “myelin sheathing”. I didn’t know it at the time, but this is the fatty coating on parts of the central and peripheral nervous systems. Nutrients, especially adequate saturated fats, omega 3 fats, iron and vitamin B12, play key roles in maintaining the structural health of our myelin.
I Googled again. And I found myself on the website of a naturopath in the United States. A naturopath is a person trained to support people with their health concerns by identifying and addressing the root causes of their health problems. Naturopaths are like nutritionists in their wholistic training and approach. Where they differ from nutritionists is they have additional training in herbal medicine.
For the next three hours, I read everything on her website, watched the videos, and took the assessment questionnaires. My mind was blown — how did this naturopath lady in the United States who I’d never met already know SO much about what was going on with my health? The questions….
“Do you struggle to fall asleep?”
“Do crowds and noisy places get on your nerves?”
“Do you experience gas or bloating?”
“Do you ever sound or voices that are not there?”
“Do you startle easily?”
“Do you have PMS?”
Me: yes, all the time, yes, I struggle with that, yes, yes, yes, yes…….
Then I emailed her. I felt real hope.
She emailed me back. And I got started on my OCD recovery.
And now I will share with you the tools I learned and have used consistently in my OCD recovery and the tools I have seen help my clients, to help you begin your OCD recovery.