Learn about the possible benefits of supplements like selenium, zinc, vitamin B12, and NAC for managing OCD symptoms. Plus, find out why exposure and response prevention (ERP) therapy is the most effective treatment for OCD.
Searching for any and all solutions for your obsessive-compulsive disorder (OCD) symptoms can feel empowering. You want to feel better, after all! Which is why asking Google for things that you may be able to take over-the-counter—like supplements—in addition to your other treatments, can be so appealing. Plus, you may be interested in managing your OCD in a more holistic or natural way.
Whatever your reason for considering supplements for OCD, here’s what you need to know about whether they can really help or not, according to the research, along with what the best treatment for OCD actually is.
Why do people use natural remedies for OCD?
When you have OCD, you experience a cycle of obsessions and compulsions. Obsessions are intrusive, unwanted thoughts, sensations, images, feelings, or urges. And because they’re intrusive and unwanted, they can be extremely distressing. Compulsions are behaviors that are done to neutralize the distress caused by obsessions, or prevent a feared outcome.
There are many reasons people turn to holistic means of treating their OCD, including barriers of access to effective care, like insurance or time commitment issues. Or they might be getting the wrong type of care and are relying on natural remedies to alleviate their symptoms. Even people receiving evidence-based treatment like exposure and response prevention (ERP) therapy may want to supplement their treatment with complementary therapies.
Supplemental therapies for OCD can include transcranial magnetic stimulation, or lifestyle changes like dietary or sleep interventions, mindfulness practices, and regular exercise.
For some people with OCD, exploring the use of supplements may stem from a fear of using medication. ”Some people just have this idea that putting chemicals in your body is a bad thing and they don’t want to do it,” says Dr. Patrick McGrath, PhD, Chief Clinical Officer at NOCD. “Others read about all the side effects and think that natural things would have fewer side effects than things made in a lab.”
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What to know about over-the-counter supplements
Dietary supplements include vitamins, minerals, herbs, amino acids, and enzymes that are designed to either fill gaps in your diet or help manage certain medical conditions.
However, just because you can pick supplements up in any grocery or drug store without a prescription doesn’t mean that they’re without risk. While the U.S. Food & Drug Administration (FDA) has some regulation over supplements, it does determine whether or not they are effective or require them to be approved. This means that it’s up to the supplement producer itself to ensure the accuracy and safety of what their bottle contains. You can see how this could be a problem, and research has shown that everything from product claims to the amount of the active ingredients on the label can be inaccurate.
That’s why it’s important to talk with your healthcare provider about any supplements you plan to take, so you can ensure the supplement is safe for you depending on your health history. If you’re taking medication, Dr. McGrath advises talking with your prescriber before testing out any supplements. “If you are not on any prescribed medications, you might want to talk to your general practitioner just to make sure [the supplements] are not dosing to levels that might be having a hindrance on you,” he adds.
Dr. Farrell advises that you treat supplements as exactly what they are: a way to supplement your OCD treatment plan—not as a replacement for evidence-based treatment. What’s more, much of the available research on supplements and OCD is limited, inconclusive, contradictory, or funded by the manufacturer.
Here’s a rundown of the vitamins, minerals, and supplements that may be worth looking into and discussing with your healthcare provider. Remember, using them alone will not treat your OCD—and doing so could also delay your efforts to improve symptoms—but they could be a part of your overall treatment plan.
Selenium and zinc
According to a 2020 study published in General Psychiatry reviewing the research on supplements for OCD, there are some nutrient deficiencies that appear to be common among people with mental health disorders.
Two of these deficiencies include selenium and zinc, and the evidence suggests that supplementing with these minerals may be associated with a reduction in OCD symptoms. This is possibly because selenium and zinc affect antioxidant processes in the body that could influence the development of OCD. If you are concerned about your nutrient levels, talk to your healthcare provider about getting them tested.
Vitamin B12
There is a potential link between low levels of vitamin B12 and OCD, according to a meta-analysis of studies published in Frontiers in Psychiatry. B12 is necessary for certain biochemical processes that affect neurotransmitters—chemical messengers in the body that can impact mood regulation. The study authors found that inadequate B12 in the blood vastly increases OCD symptoms, suggesting that physicians should keep tabs on levels of this vitamin in patients with OCD.
This doesn’t necessarily mean that popping B12 supplements will get rid of your obsessions and compulsions, but it may be worth talking to your doctor. A simple blood test can measure your levels and start a conversation about whether it’s a good idea to supplement, whether for OCD or your general health.
N-acetyl cysteine (NAC)
NAC is a compound that’s traditionally been used to treat cystic fibrosis, acetaminophen overdose, and chronic obstructive lung disease. One of NAC’s functions is to break up mucus, as well as acting as an antioxidant and anti-inflammatory. However, it also may aid in the treatment of psychiatric conditions, such as schizophrenia, bipolar disorder, and OCD, according to research published in the Journal of Nutrition and Metabolism, as NAC may improve your mitochondria’s resilience against stress. (Mitochondria is the energy powerhouse inside each cell.)
The study’s authors also note that randomized clinical trials have shown that when used alongside antidepressants like selective serotonin reuptake inhibitors (SSRIs), NAC may help reduce the severity of OCD symptoms, and also improve anxiety in people who have treatment-resistant OCD. However, the research—while promising—isn’t conclusive, and more studies are needed.
While the hypothesis is that NAC regulates high glutamate levels–which have been linked to OCD, Dr. McGrath isn’t too convinced. “ I haven’t seen a double blind study that says that adding NAC does anything better than a placebo at this point,” he says.
Adaptogens
Adaptogens, like ashwagandha or rhodiola, are medicinal herbs that are believed to improve the body’s response to stress. Since OCD creates a lot of anxiety within a person, finding something you can take as a supplement—or drink as a tea—can be a relief. And, indeed, a small randomized double-blind placebo-controlled trial found that people on SSRIs who were assigned to take an ashwagandha extract for six weeks reported fewer OCD symptoms compared to a placebo group. These adaptogens were also found to be safe.
Again, this was considered to be a supplemental treatment for OCD and was not intended to be used alone to manage the disorder. “Many folks with OCD end up over relying on products or substances like adaptogens to try to downregulate their stress and anxiety. And these are seldom a long-term viable solution,” says Dr. Farrell. “You can never rid yourself of your body’s ability to experience anxiety and fear—nor should you want to. That distinction is really important to understand for long-term recovery.”
The most effective treatment for OCD
If you’re looking for a clinically-proven way to manage your OCD, it’s a specialized form of cognitive behavioral therapy (CBT) known as exposure and response prevention (ERP) therapy. With the help of a trained therapist, you confront your obsessions and fears related to OCD by putting yourself in situations that you’re trying to avoid. Then, you’ll make the choice not to engage in compulsions in order to neutralize the distress you feel.
“ERP encourages more natural—or normalized—behavior in response to common triggers or stimuli,” says Dr. Farrell. By withstanding the distress, rather than trying to fix it with a compulsion, you will learn that you can push through the discomfort and are stronger than you think. Eventually, this process will habituate your brain to your OCD triggers so that they’re no longer something to fear. Your obsessions may even become boring.
“We don’t know of any literature that supports a ‘natural remedy’ that’s anywhere near the volume of science that supports frontline interventions like ERP and pharmacological strategies,” says Dr. Farrell.
What’s important is that you should undergo ERP with a therapist who is specially trained in the treatment. Your therapist will teach you response-prevention skills so that you can avoid performing your compulsions. Sometimes, ERP is all that’s needed to treat OCD. Some people may opt for a more intensive residential treatment program for OCD, or add acceptance and commitment therapy (ACT) to their treatment plan.
In some instances, medication is used as a first-line OCD treatment, the most common being SSRIs. The combination of ERP and a prescribed medication is often more effective than either one of them alone. Starting these medications doesn’t mean you’ll be on them forever. In fact, many people find that they’re able to decrease or stop taking their antidepressant after a year or two (under the care of their healthcare provider or psychiatrist).
Bottom line
It’s important to talk to your therapist and doctor and discuss any supplements you’re taking—or are interested in trying. If you have questions or concerns about any treatment, don’t hesitate to share them, so you can understand why they’re being recommended.
”[Supplements] aren’t going to have you facing your fears and learning how to handle them,” Dr. McGrath says. To break the OCD cycle, consider starting with an evidence-based treatment like ERP therapy.
Key takeaways
- Supplements on their own are not effective at treating OCD because there’s limited research showing their success and safety.
- Exposure response and prevention (ERP) therapy, a specialized form of cognitive behavioral therapy (CBT), has been proven to be effective for treating OCD.
- Some people have seen improvements in their mental health by supplementing their OCD treatment with natural remedies such as vitamins and minerals.