What is the role of diet in improving severe anxiety and Obsessive-Compulsive Disorder (OCD)?

From the Guidelines

Diet plays a complementary role in improving severe anxiety and Obsessive-Compulsive Disorder (OCD), but comprehensive treatment including therapy and possibly medication is typically required for optimal outcomes. The most recent and highest quality study on the treatment of OCD suggests that cognitive behavioral therapy (CBT) is the most evidence-based form of psychotherapy for OCD 1. While diet can be helpful in reducing anxiety symptoms, it should be viewed as part of a holistic treatment plan rather than a standalone solution for severe conditions.

Key Dietary Recommendations

• Incorporate omega-3 rich foods like fatty fish (salmon, mackerel), flaxseeds, and walnuts to support brain health and reduce anxiety symptoms
• Include complex carbohydrates such as whole grains, oats, and sweet potatoes to help regulate serotonin levels
• Consume probiotic-rich foods like yogurt, kefir, and fermented vegetables to support gut health and mental wellbeing
• Eat magnesium-rich foods (dark leafy greens, nuts, seeds) and foods high in zinc (oysters, beef, pumpkin seeds) to help reduce anxiety symptoms
• Reduce consumption of caffeine, alcohol, refined sugars, and highly processed foods, which can exacerbate anxiety and OCD symptoms

Comprehensive Treatment Approach

• Cognitive Behavioral Therapy (CBT) or Exposure and Response Prevention (ERP) therapy are effective treatments for OCD, with CBT being the most evidence-based form of psychotherapy 1
• Medication such as SSRIs (like fluoxetine, sertraline, or escitalopram) may be necessary at therapeutic doses for at least 8-12 weeks
• Computer-assisted self-help interventions without human contact may be a promising way to overcome barriers to treatment, but their effectiveness and adherence need to be further examined 1

Prioritizing Treatment Outcomes

• Morbidity, mortality, and quality of life should be the primary outcomes when considering treatment options for severe anxiety and OCD
• Comprehensive treatment approaches that include therapy, medication, and lifestyle changes (such as diet and exercise) are likely to have the best outcomes
• Patients should work with their healthcare providers to develop a personalized treatment plan that prioritizes their unique needs and circumstances.

From the Research

Role of Diet in Improving Severe Anxiety and Obsessive-Compulsive Disorder (OCD)

There are no research papers provided that directly discuss the role of diet in improving severe anxiety and Obsessive-Compulsive Disorder (OCD) [@].

Treatment Options for OCD

• The first-line treatments for OCD include selective serotonin reuptake inhibitors (SRIs), cognitive-behavioral psychotherapy (CBT), and exposure and response prevention (EX/RP) [@2@, @3@, @5@]
• Combination treatment of CBT and SRIs may be effective in promoting remission in patients who partially responded to drugs and in promoting response in resistant patients [@1@, @2@]
• A sequential administration of CBT after medications has been found useful in promoting remission in patients who partially responded to drugs and in promoting response in resistant patients [@1@]

Pharmacotherapies for Treatment-Resistant OCD

• Serotonin reuptake inhibitor (SRI) medications are well established as first-line pharmacotherapeutic treatment for Obsessive-Compulsive Disorder (OCD) [@4@]
• Pharmacotherapeutic interventions that have been explored as augmenting or alternative treatments for treatment-resistant OCD include medications with dopamine antagonist activity, glutamatergic and anti-inflammatory pathways [@4