T Nation

Should I Deal with OCD First? (SSRIs?)

before i jump on trt should i deal with the ocd first? people say low test causes depression and anxiety but not ocd? so if i do up my test ocd might remain? what to do if i cant take ssri to battle ocd? (severe. like really severe. interferes with sleep).

T fixed my OCD but beware of estrogens effect it will aplimify OCD symptoms at least in my case. Make sure to control E2 - T however will dramatically improve OCD symptoms. Personally I would never use SSRI, there are ways to improve serotonin deficiency through diet and exercise and natural supplements like tryptophan.

weird because i went with the doc just because of ocd and talk about my hormones and he said to take ssris knowing i have low t. could 12 of e2 low cause this?

Low E2 is just as bad as high - personally I would figure out and optimize my internal endocrine system (T, E, thyroid…) all before ever considering drugs. That’s me personally as my OCD was not that severe.

That’s like using gasoline to put out a fire, it just makes the problem worse. Prescription drugs should only be used in extreme circumstances because we know these SSRIs screw up hormone production.

An E2 of 12 would give anyone anxiety and even several anxiety and only worsens OCD. Getting estrogen and testosterone in a range that good for you will have a calming effect.

well shit. ill balance my hormones and then seek for psychological help

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It amazes me how psychologist don’t balance hormones using bioidentical hormones, instead they give you sedatives to numb the pain of hormones being out of balance.

We are way behind in certain areas of medicine, the reason is profit margins are higher in prescription drugs.

An E2 of 12 I wouldn’t at all be surprised at an osteoporosis diagnosis. You need estrogen to put minerals in bone.

I was thinking the exact same thing - ridiculous how undertrained these so called professionals are… in fact I was walking a video of a fairly highly regarded psychiatrist who himself has battled depression his entire life and in all his lectures he never once mentions checking to see if his hormones are all firing correctly.

Big Pharma isn’t into hormones, they’re into prescription drugs and that’s what doctors push on patients.

So weird you post this. I came off TRT cold-turkey this year and started having intrusive, repetitive thoughts coupled with severe anxiety. Was diagnosed with OCD a couple of months ago. Looking back, I think I’ve had it my entire life, but it wasn’t interfering with my functioning until my hormones crashed. I was referred to the best OCD specialist in my state. She says she wants to follow my case closely as she’s never done ERP (the standard therapy for OCD) on someone who’s taking exogenous hormones.

I will say that I just got back on TRT a little over 5 weeks ago. The obsessive thoughts come and go but they’re much improved since I started TRT again. I’m also on an SSRI which, along with ERP, helps with OCD more than just therapy alone or medication alone (I plan on coming off in the future though). To make it clear, I’d try going to ERP therapy before starting any medication and see how it goes. ERP will help you to become your own therapist in time and see those false brain signals for what they are.

If you have any questions let me know.

yeah its just weird mate. i spent 1 hour talking about psychology and hormone stuff and at the end he just offered me medications without therapy. but im guessing psychologist are the ones who do therapy.

yeah i noticed this.

thanks mate. it seems like trt helped a bit but you also took medications for it. im thinking of buying books to read and good meditation books too to be in the “present”

I’ve been on medication since March and still had intrusive thoughts the whole way through. Not sure how much medication helps but I had to mention it to keep all factors in mind.

It still seems that TRT is helping the most out of all the things I’ve tried.

My recommendation would be to stay away from SSRI’s. They have side effects, particularly sexual side effects which a guy with Low T needs like a hole in his head.
I would address any hormone deficiencies you have and then get some good cardio 3-4 times a week. If you swim, swim. If you run, run. If you bike, bike. Anything to get your heart rate up and get your lungs blowing for 1/2 hour at least. Exercise is great therapy for an overactive mind.

I like to hit the pool and do laps. I also like to hike. I ALWAYS feel better after doing those things.

psychiatrist or psychologist to treat ocd? im trying to find a good therapy for this by looking in the internet

PPeople need to understand OCD for what it is, it’s essentially serotonin seeking habit. We’re all familiar with the term adrenaline junkies or any type of risk taker type of person like chronic gamblers - these are actually dopamine seekers.

Our brains have 4 neurochemicals it’s constsntly trying to get more of demanded by the limbic system (the primitive non thinking brain that wants to feel). Endorphins, serotonin, oxytocin and dopamine. Hyper activity, risky behaviours, attention seeking is the brain attempting to get more dopamine. Endorphins are the pain numbing euphoria chemical, think chronic exercise enthusiasts or runners high, oxytocin seeking would be overly emotional behaviours like venting, constantly seeking solace in someone else’s arms, wanting to have a close relationship with others things of that nature and serotonin is about status.

People who grow up feeling little control over their own lives or not feeling much in terms of social status can either genuinely increase their social status like getting an education, high position job etc. Things that elevate you in your society leadership roles these things all raise serotonin levels. The “cheater” route is to start developing patterns and obsessive thoughts usually these start at a young age and go into adulthood. These patterns and thoughts OCD ppl convince themselves they are superior to others (fake social status) and that their super smart and can see things ppl can’t and things need to be a certain way and my house is so clean and organized I must be have high social status. Its mental masturbation much like masturbating to porn and convincing your body you’re actually getting laid… it’s a false narrative and the anxiety comes from this false narrative and being found out to admit to yourself that it’s all an act and you’re not really getting laid and you’re not really in a leadership or high ranking position - It’s basically the gist of it.

How to improve - stop playing mind games with yourself get in touch with your subconscious through affirmations or other meditations - go out into the world boldly and gain genuine respect and social status from your society. Along with that adjust your diet to emphasize meat and vegetables and reduce sugar and carbs, drink lots of water and take a good multivitamin along with a good zinc, b6 p5p and magnesium each night. SSRI does not increase serotonin production it tricks the brain into keeping the same stale chemicals around longer without letting it go through its natural recycling processs. One of the reasons Testosterone helps OCD is because it gives you the kick in the ass to be bold and assertive and go make something of yourself. And it’s also why high E makes OCD worse and OCD is MUCH more common among women.

You’re right that OCD is a maladaptive habit disorder formed over time but it’s biologically rooted to begin with. It is “a genetically inherited, neuropsychiatric disorder caused by overactive brain circuits in the error detection part of the brain that sits just over the eyes.” This is from Dr. Jeffrey Schwartz, who has spent the better part of his life researching OCD.

True OCD is with you for life, there is no “cure.” There can be, however, significant rerouting of brain circuitry to the point where it goes into long term remission. Stressors can bring it out at any point and it’s important that the person has built a good foundation to stand on when that happens. While it seems like “playing mind games,” it’s a legitimate physical malfunction. ERP is the best solution (SOME may need medication as well) because it forces the brain to see the error message for what it is, an untruth. Like you stated, one has to go out into the world the face the fear head on along with the knowledge that their brain is having an error.

OCD is so biologically rooted that children can develop it overnight from infectious diseases. This is known as PANDAS and it affects some adults too.

That’s fair but just like ADHD they have been treating it with amphetamines turning hyperactive children into zombies - studies now show people with ADHD all have severely low magnesium levels (a calming mineral) - some type of genetic disorder where their gut cannot extract or make dietary magnesium bioavailabile and it doesn’t help parents and adults give into sugar cravings and junk food which further exacerbates the problem - magnesium is responsible for 300+ enzymatic functions in the body. Definitely do the things to repair the biological aspects like balancing your T and E and Thyroid as well as diet and exercise. Environmental factors play a large role in it as well so self development will make a large impact on symptoms and like you said rewire those pathways in the long term.

Trust me, I wish the medical community would adopt a more holistic mindset when it came mental disorders. I’ve worked in mental health for a decade. Some “psychiatric” problems, as you stated, are resolved by simple vitamin/mineral supplementation or by establishing allergies.

There are those in my field who are more open-minded than others. Sometimes I have to hold my tongue or be very subtle when I’m advocating for someone’s health due to MD’s being dismissive or getting annoyed. In your case and my case for instance. Our problem was largely influenced by our hormones. Mine hasn’t remitted fully but I’m hoping in time it does. I’d be interested to see if other conditions could be treated in this way. I know systemlord has mentioned a study that showed 8 out of 10 men who had depression finding relief on HRT.