Digestive Health: Critical for Mental Health

Healthy digestion allows us to absorb nutrients from food properly, nourishing our bodies and our brains. When digestive function is compromised mental health symptoms can be exacerbated.  Your gastrointestinal tract (GI) includes the mouth, esophagus, stomach, small intestine and colon.  Let’s talk about some basic nutrients that you can get from food and supplements that will support a healthy digestive tract.  

GI and immune support should include healthy bacteria, or probiotics, because 70% of your immune cells are in your gut.  When your GI tract is healthier seasonal allergies are often less severe because this system acts as a protective barrier from irritants.  Eating a whole foods diet including fermented foods (like yogurt, kefir, and refrigerated sauerkraut) with lots of vegetables and fiber, rather than packaged and a highly processed diet, contributes to bacterial diversity which is important for good health.  When purchasing a probiotic supplement note the potency (the number of live bacteria per pill). Retail products can range from a half billion to 100 billion in potency.  That seems like a lot, but we have 10x more bacteria than we do cells in our entire body.  Rotate probiotics when purchasing new bottles so you get a variety of healthy bacteria to repopulate your GI tract.  

Different types of bacteria live in the mouth, small intestine and colon.  There are two main families of healthy bacteria that live in your intestines.  This is a complex field, but basically supplements contain Lactobacillus strains, which are needed in the small intestine, and Bifido strains, which are needed in the colon.  

If someone has diarrhea, try a probiotic with more Lactobacillus strains.  Be cognizant of the risk of dehydration and losing electrolytes, especially in young children, the frail, and senior citizens.  See a doctor if necessary.  To stay hydrated drink more water, electrolyte mixes, use Himalayan or sea salt, coconut water or herbal teas including nettle, alfalfa, horsetail, red raspberry leaf and rosehips.  Ginger, chamomile, fennel, fresh basil and peppermint can reduce cramping.  Suggestions to slow GI transit time include Kudzu root dissolved in water or broth, unsweetened Carob powder or chips, or a homeopathic formula for diarrhea relief

For those prone to constipation, try a product with a higher ratio of Bifidobacterium. Feed colon cells with butyric acid from grass-fed butter or ghee.  Add fiber to your diet by eating more vegetables or using a fiber supplement.  Plenty of water is necessary in these circumstances.  A general rule for water intake is to consume half your body weight in ounces of water per day.  Drink most of your water between meals and keep a water bottle with you wherever you go. Always increase your water intake when adding fiber supplements.  Caffeine and alcohol are dehydrating so additional water is necessary if you drink those. 

An irritated digestive tract can be soothed with bone broth, unsweetened dissolved gelatin, the inner filet of aloe vera juice, slippery elm, marshmallow root, DGL (deglycyrrihized licorice), L-glutamine, and zinc carnosine. Saccharomyces Boulardii is beneficial yeast that aids in gut repair and is available as a supplement.  

We secrete digestive enzymes to break down our food making the nutrients contained therein available for use by the body and brain.  There’s the possibility that your own enzymes have been knocked out during illness so supplementing these before meals can help you digest food more thoroughly.   Beware, however, of the possibility that digestive enzymes can speed the food through too fast when one is already experiencing rapid gut motility.  

These suggestions are the building blocks to improve your digestive health.  When beginning supplementation start slowly, begin only one new supplement at a time, and listen to your body and brain.  If the reaction is unfavorable, discontinue use.  Look for a practitioner who can individualize a plan for you such as an integrative medical doctor or a functional nutritionist. Always keep your doctor informed of supplement changes, especially if you are taking prescription or over the counter medications.  

Inflammation’s Impact on Brain Function

It’s easy to recognize when your body is stiff and achy.  This usually means that inflammation has gotten out of control leading to pain.  Inflammation, in moderation, is normal.  It’s part of the healing process, for example, after an injury.  However, long-term chronic inflammation puts a huge strain on us and is far from ideal.  What you may not have considered is that the brain also experiences inflammation!  Brain inflammation impacts a number of crucial processes such as brain communication and circulation in the brain.  Healthy circulation carries nutrients throughout the body and brain. Poor brain circulation feels like your brain is in a fog, which makes it difficult to think clearly or make decisions because mental speed is slow.  It can be difficult to concentrate for very long because the brain is fatigued. 

Let’s take a look at healthy eating strategies to calm down, or modulate, a brain with inflammation. 

• Grass-fed beef contains a healthier fat profile than grain-fed beef.  When cows eat grass they make omega-3 fat. Omega-3 fats modulate, while omega-6 fats increase, inflammation.  Grass-fed animals contain a 3:1 ratio of omega-6 to omega-3 fats.  Grain-fed animals can contain as high as 27:1 omega-6 to omega-3 fats. 
• Salmon is a wonderful source of omega-3 fats.  Purchase wild caught rather than farm raised fish. 
• Curry seasoning.  Curries contain a variety of spices and turmeric is common in these blends.  Spices are very nutrient dense and they make food so much more palatable!  The curry blends are known to support healthy inflammatory levels. 
• Flavonoids are phytonutrients found in fruits and vegetables and they have antioxidant effects.  Berries contain high amounts of flavonoids and are considered one of the top foods to support brain health.  Also consider green and red vegetables such as peppers, broccoli, artichoke and celery for lutein.  Fresh spices such as parsley with apigenin, and thyme with luteolin, are flavonoids that dampen brain inflammation.  Chamomile also contains apigenin and is relaxing when steeped as a tea. 
• Green tea contains high levels of catechins which support healthy blood flow in the brain.  Theanine in green tea is calming on the brain while still allowing the ability to concentrate and learn.  Green tea contains considerably less caffeine than coffee. 
• Leafy green vegetables contain the flavonoids lutein and zeaxanthin.  Some options are kale, spinach, and collard greens.  To maximize nutrient absorption gently boil greens for three minutes until they are bright green, but not mushy.  Throw away the water.   

Incorporating these foods and spices into your weekly diet offers more than just brain support.  Some other reasons to eat them are for healthy detoxification, immune health and eye health.  Since it is difficult to get the necessary 8-10 servings of vegetables and fruit daily, you may want to consider one of the many greens drinks on the market.  They can be purchased in powdered form, so they don’t spoil like fresh food does, and they can be added to water, smoothies, or even food.

Many of the nutrients mentioned here are also available as supplements. 

• Fish oil supplements with a high ratio of DHA to EPA. Brain cells need DHA. 

• Curcumin is the active ingredient in turmeric.  The turmeric root contains about 5% curcumin. Supplements are typically standardized to contain 95% curcumin so they will be more effective than food sources at taming the fires of inflammation.  Take curcumin supplements on an empty stomach, or at the beginning of a meal, with a healthy fat (such as fish oil) to maximize absorption.  
• Lutein and Zeaxanthin supplements are typically used for eye health, they are often together in blends, and they are needed in high concentration in the brain.  Take them with a meal containing healthy fat.

• EGCG is a key property in green tea.  It plays a role in neuron formation, especially in the hippocampus which is involved in learning and memory.

Supplements contain higher amounts of these nutrients than food can.  Today’s environment, the quality of our food, and chronic illness are reasons to consider supplementing.  It may take more of a nutrient than what is available from food alone to correct long-term imbalances, and this includes mental illness.  Always follow the dosing instructions on supplement bottles or work with an integrative medical doctor, naturopathic doctor, nutrition therapist or functional chiropractor for individual recommendations.   If you are using prescription medicines, research whether diet or supplement changes will interfere with the medicine’s efficacy or your safety. 

Curry Stir Fry

§         1 pound ground meat.   Or use beef, chicken or fish cut into bite sized pieces.

§         Brown protein in a large skillet till almost done.  Drain excess fat. 

§         Next add 1 small chopped onion and cook slightly.

§         Stir in chopped vegetables of choice:  broccoli, carrots, celery, leafy greens, peppers and zucchini. 

§         Add 1 can of coconut milk, 1 tablespoon sweet potato puree, curry spices to taste, and blend thoroughly.

§         Stir in 1 cup cooked rice (rice blends, wild rice, or brown rice).

§         Simmer until vegetables are tender.  Stir frequently to prevent food sticking to skillet. 

Top with chopped fresh cilantro or parsley. 

How the Stress of OCD Interferes with Health

Obsessive Compulsive Disorder, and other anxiety-related disorders, puts a huge strain on the function of the adrenal system.  When this happens, a person will feel fatigued more often, while the ability to focus, concentrate and learn can be altered.    

Let’s look at this scenario where physical and emotional health can be connected.  Folks in the height of OCD operate in panic mode much of the time. They can’t relax, at least not easily, because they feel they’re always on the brink of disaster. Sleep may not be restorative anymore.  Their hyper-vigilant minds continue endlessly even when they are physically exhausted.  Anxiety puts a heavy burden on the adrenal system.  This is one area where an integrative professional, such as a Nutrition Therapist, can help. 

Nourishment of the adrenal system is often necessary because it is being overused.  Think of it this way:  If a person is sick with a cold, they are probably using more antioxidants to fight the virus. Likewise, if the adrenal system is continually experiencing fight or flight mode, it will use up more of the nutrients necessary to keep that system running.  Adaptogenic herbs, adrenal glandular supplements and B vitamins can help.  Examples of adaptogenic herbs, those that support the body’s ability to adapt to stress and change, are ashwaganda, rhodiola, licorice root, and ginseng.  Unlike stimulants, these herbs are nourishing the adrenal glands. 

Some commonly ingested food and drink activate, or stimulate, the stress response.  These include caffeine, alcohol, sugar and processed foods.  They may give short term relief, but will degrade adrenal function in the long run and should be reduced or eliminated.

The B vitamins are needed throughout the nervous system.  Starting with a B complex supplement is useful.  There are specific individual B vitamins that stand out as useful.  Vitamin B12, taken as a lozenge so it is absorbed well, supports the nervous system and the brain.  Pantothenic Acid, Folate, and vitamin B6 are also important.  You can find combination formulas that contain a blend of some of these nutrients that are mentioned.

Additionally, there are a few things that stand out for support of focus and concentration.  Following are components of brain cell membranes which facilitate the firing and interaction of neurotransmitters.  Phosphatidylserine (PS) and choline are phospholipids that surround cell membranes.  Interestingly, PS also helps balance the adrenal feedback loop to the brain.  DHA, a component of fish oil, is also needed in brain cell membranes.   

Taking omega-3 fish oil supplements is very helpful for most people.  Fish oil contains DHA, for focus and concentration, and EPA which supports many functional needs of the body and brain.  The brain is 50-60% fat, so we must feed it healthy fats.  Another brain-friendly fat is coconut oil, which is great fuel for the body also. 

Eating a whole food diet of protein, healthy fats, and vegetables will provide many more nutrients than those available from processed foods in bags and boxes.  For those who need more energy, make sure to include starchy vegetables such as sweet potato and squashes.

Healthy fats include olive oil, butter or ghee, coconut oil and seed/nut oils such as avocado and walnut oils.  Hydrogenated oils, or trans-fats, are very damaging to the cell membranes. 

Neurotransmitters are built from amino acids which we get from eating protein in the diet.  Animal proteins are generally absorbed better than vegetarian proteins from grains and legumes.  It is possible to supplement amino acids also.  Acetyl-L Carnitine is an amino acid that crosses the blood-brain barrier.  It helps burn fats and carbohydrates for energy. 

Balancing meals with a whole foods diet is also important.  Try to eat protein, healthy fat, and carbohydrate together at every meal and snack.  (Note that vegetables are carbohydrates!)  Balancing these macro-nutrients helps to minimize blood-sugar fluctuations.  When blood sugar is too high or too low, it interferes with brain function.  This can feel like mood imbalances, inability to concentrate and having food cravings.  This is another reason why those packaged foods are so damaging, so avoid crackers, cookies, cereals, etc.  Nuts and seeds are usually good snacks. 

Another area to consider is whether the gastrointestinal (GI) tract is healthy.  If it is not, then this must be explored and corrected.  Poor GI health inhibits the absorption of nutrients.  Poor GI health has the ability, over time, to degrade other systems in the body. 

Exploring Food Intolerances

There are many tools to support mind and body wellness.  Often overlooked in our modern society is that food is what has always nourished and sustained us.  As a species, we thrived with the diet that was adopted by our Paleolithic ancestors and our brains grew. (See the DVD “In Search of the Perfect Human Diet.”).   In our modern, fast-paced life what passes for food is altered, and so is our health.  To understand and regain our health, we require not only the help of medical experts, but also nutrition specialists. 

Here is a brief description of what happens when a person has a food intolerance.  If a person eats a food that is not suited to them, they cannot fully digest it.  The undigested food irritates the digestive tract, creates an inflammatory response and degrades the functionality of that system.  As more food is eaten, the suboptimal digestive tract allows it to pass through the intestines and enter the blood stream without being properly digested.    This alerts the immune system in an attempt to clean up the food immune complexes (FIC) that are not supposed to be there.  When the FIC’s get into circulation, they can land virtually anywhere outside the digestive tract and cause inflammatory/immune reactions at that site.  This is why food intolerance symptoms are so vast, and why family members often don’t recognize that the same issue may be the reason for many different types of disease or imbalances.  It is known that a food intolerance can lead to autoimmune diseases later in life. 

The brain needs nutrients to function properly, and its function can be hindered when something toxic enters it.  Gluten is problematic to the body and brain function; how that manifests may look different in individuals even in the same family.  Nonetheless, the basics that the brain requires are universal, and the Standard American Diet lacks these.  For instance, omega-3 essential fats such as fish oil are commonly lacked in today’s diet and are crucial for brain function.  See other articles in my blog and the resources listed below for tips about brain health. 

A person does not need to be Celiac to experience significant problems from gluten.  They can be simply gluten intolerant and have any one or number of difficulties such as learning and behavior disorders, unbalanced moods, digestive distress, autoimmune diseases, inflammatory reactions, etc.  There can also be multiple food intolerances.  The major foods that cause problems for people are ALL grains (but gluten-containing ones especially) corn (a grain), all dairy products, eggs, and yeast.  Testing for antibodies against these foods can be done, as can genetic testing for gluten.  These antibodies are the immune response when the body is overloaded, and they indicate that the body is attacking some part of itself.  Antibodies show up most reliably in the stool or saliva.  Blood tests for antibodies can show false negatives if the right tests are not done for that individual.  I recommend people work with a Nutrition Therapist, Naturopathic Doctor, or a Chiropractor that regularly test for food intolerances.  U.S. residents can work with Entero Lab directly. https://www.enterolab.com/

References you can explore include:

Dr. Mark Hyman wrote “Ultra Mind Solution”

http://www.ultramind.com/epidemic_ocd.php

Dr. David Perlmutter wrote “Grain Brain”

https://www.google.com/search?q=gluten+sensitivity+and+the+brain&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a&channel=fflb

Living Without is a magazine for those living gluten free.

http://www.livingwithout.com/issues/1_11/untreated_gluten_sensitivity-1800-1.html

Dr. Tom O’Bryan works mostly with and is an educator about gluten intolerance.

http://www.thedr.com/

About the Author

                      

Diane Shepard is a 2007 graduate of the Nutrition Therapy Institute in Denver, Colorado.

She is Board Certified in Holistic Nutrition and a member of the National Association of Nutrition Professionals.  Since becoming a Master Nutrition Therapist Diane has consulted with hundreds of clients.   

Her clientele includes many who have complex health concerns, both physical and emotional.  She helps her clients get to the root of their discomfort and teaches them how specific whole food nutrition choices, quality supplements and healthy lifestyle recommendations can help to rebalance the body and mind. 

Her passion is assisting people on their path to mental wellness and enlightening them on how good physical health and nutrition play a role in this.  She also has extensive experience helping clients with gastrointestinal health, food sensitivities, thyroid and adrenal support, autoimmune conditions and balancing blood sugar.   

Diane has logged 150 hours as presenter on nutrition topics from 2008 through 2013.

During these six years, she has attended over 225 hours of nutrition seminars and continuing education. 

Past client comments include: 

“Your advice was spot on.”

“You were the only one to tell me these things. Thank you”

 “I feel so much lighter emotionally.”

She is the author of the blog RethinkOCD.blogspot.com.  She co-facilitated the Boulder OCD Support Group from the late 1990’s to 2004, and is described as a stalwart member of that group.

And, she has personally developed over 100 recipes. 

Winter Doldrums

I suspect a lot of us wish we could allow ourselves some extra time to relax and decompress from our busy schedules.  Most of us inherently want to do this when the cold weather arrives.  Somehow, what’s normal the rest of the year is more difficult to accomplish in the winter months.  Despite our best efforts, many may be experiencing a period of stagnation right now.     

I wouldn’t say my current schedule has slowed down, but I wish it could!  Fortunately, I have considerable inner drive.  Or, maybe that’s not so fortunate; it’s all about balance.  What is critical during the dark months, though, is that I plan more carefully because I know there are times when I feel like I’m walking in slow motion. 

I put extra attention into how I will be healthy in the winter.  I continually revise my techniques based on how my body is responding.  There is no magic pill that works for everyone, but you might try incorporating some of these ideas:    

1. Get enough sleep.  We all want, and may need, more sleep when it’s darker out. 

2. Make sure your pantry includes:

· Virus fighting supplements, teas, throat sprays and lozenges to support the immune system.  You can find many blends of herbs, but some of the commonly used ones are Echinacea and goldenseal.  Elderberry surrounds a virus which slows its growth. 

· Don’t forget the foods that are helpful and can be incorporated into many meals.  Garlic fights infections.  Ginger is warming, decongests the sinuses, and soothes digestive disorders.   I love raw honey and coconut oil on the throat.  Chicken broth thins mucous.  Homemade bone broths are nourishing even when someone can’t eat much solid food.  Cook broths and freeze extra portions so they’re available when illness strikes. 

· Probiotics.  Digestive support helps with all sorts of maladies.

· Vitamin D.  Everyone should have their Vitamin D levels tested.  This is done via a blood draw at a lab.  We cannot make Vitamin D from the sun from November through February in Denver, so we will deplete our levels during this time.  This occurs in other parts of the U.S., and world, too. Vitamin D plays a role in healthy mood. 

If you’re sick, take a hot bath, curl up with a book and tea, or go to bed.  This is not the time to be running out to the store. 

3. Understand how food and drink will affect your health and mood. 

· Alcohol will disrupt sleep.   It can also exacerbate anxiety and OCD for several days after just one drink.  Everyone has to access their mental health and ask themselves if they can manage the possibility that their symptoms could worsen. 

· Many people are reacting to common foods whether they realize it or not.  Food intolerances cause many symptoms and those will vary by individual.  Not everyone will have digestive distress.  Many will experience an inflammatory response that can cause trouble throughout the body.  Food intolerances also interfere with mood. 

· Gluten interferes with brain function.  A person does not have to be Celiac for this to occur.  Gluten acts like opiates in the brain, which may feel good at first but one’s ability to balance their own neurotransmitters can be altered.  This can result in poor mood, heightened anxiety responses and obsessive thoughts! 

4. Schedule some enjoyment.  I find a couple activities rejuvenating, and can usually devote at least one hour a week to them. 

· I have recommitted to my hiking group.  Despite the cold temperatures and wanting to sleep more, I feel better having gotten outside, moved and laughed with my friends.  The rest of the day is easier when I do.

· I am learning to play the saxophone.  My lessons are a highlight of my week.  It is one thing I do regularly that’s just for me.  There’s no agenda, but lots of laughter. 

5. Pamper yourself with essential oil aromatherapy.  You’ll find these precious oils in natural cosmetic, hair care and cleaning products.  Some have antiviral properties, or are beneficial for different skin conditions.  (Do not apply the oils undiluted directly on the skin.) 

My favorite use of essential oils is for emotional balancing.  Have some fun by finding which oils balance you both physically and mentally.  I frequently mix my own blends.  I add 10-20 drops of my favorite oils into a small glass spray bottle of water.  I refresh my bedding, mist a room, and myself!  You can also use them in a bath. 

· Calm the nervous system and muscle tension, and enhance mood with lavender or chamomile. 

· The refreshing scents of orange and lemon can lift the winter blues. 

· Relieve anger and anxiety with the floral scents of rose or ylang ylang.

· Clary sage and rosemary can reduce stress and mental fatigue, yet revitalize and wake up the brain.  

· Support the immune system with thyme, eucalyptus, and tea tree oils.

· Light some candles, and feel the peace of more natural light flickering nearby. Many have natural essential oils in them.  I love the outdoorsy scents of pine and fir at this time of the year. Cinnamon and peppermint are festive and invigorating. 

6. Plan some downtime and respect your limitations.

· My game table is up in front of the fireplace.  I take short breaks to relax, and then go back to the task that needs to be done. My husband sets up a puzzle during the winter months.

· Say no to something, and save some time for yourself. 

· Don’t pack even more into your schedule. 

My wish for you is that you feel healthy and emotionally peaceful.  By incorporating some of the above ideas, you’ll have a better chance of this.  You can fight those winter blues! 

Disaster Brings Connection

Being a Boulder County resident, reminders of the Colorado flooding are still around me.  You’ve probably seen in the news that this was what experts have called a 1,000-year rain and a 100-year flood.  By Thursday, September 12^th, I saw gushing rivers where there had been only small streams. That night we were gathered with neighbors watching the nearby creek as it rushed through and took over the surrounding golf course. What most of us didn’t know was how this amazement of Mother Nature would turn to true fear before the night was over. 

Our neighborhood wasn’t alone.  Many areas experienced rising water that entered homes via sump pump pits, basement window wells, or through garage doors.  I was on the phone checking in with one friend, and borrowing her sump pump for another, when my husband came into the house and told me to hang up the phone. Things were getting potentially serious for us.  My friend, who had a different vantage point of the street than I did, explained that "...fourteen inches of water is rushing down the street right now, so we can’t get the pump to the other neighbors.”  I hung up the phone and learned from my hubby that the water was flowing up our driveway and into our garage.  We rolled up throw rugs to barricade the bottom of the garage doors and vacuumed up about an inch of water that had flowed five feet into our garage.  The driveway and streets were covered in muck.  After our barricade, we moved what we thought most important from our basement.  Then the water receded.  We were so lucky! 

After a flood there are huge amounts of debris including rocks, sticks, and mud. (We’ve been warned about what lurks in the mud and remaining water).  There are also a lot of exhausted people.  When the word came out this week that the golf course invited volunteers to pick up sticks and rocks from the destroyed property, I went to help.  I don’t golf, but I’ve walked this neighborhood for years and thought “I can pick up sticks.”  I couldn’t work for long, but did enjoy chatting with people as we dug out rocks from the clay in what was once a grassy area on the golf course.  There were almost seventy volunteers on that crisp, sunny day.  I will be there, too, when the Boulder County Parks & Open Space ask for assistance to restore the hiking trails. 

My flood story is not compelling compared to others’ experiences.  Personally, all I had to do afterward was wash those throw rugs we’d used in the garage.  They’d hung on our fence like survivors’ flags for two weeks before I hauled them to the laundermat.  I can imagine what it must be like for those who had water and mud inside their homes.  Since I talk with someone new almost daily about what they’ve been through, I have a pretty good idea, and I’m happy to listen.  I’m thankful for those that did the same for me. 

I’ve spent some time feeling a bit guilty for surviving this disaster without personal loss.  One person described it as “survivor’s guilt.”  I’ve never considered that term before, but could immediately relate to it.  Our neighborhood has now set up an online site so that we can better communicate with each other.  That is progress.  My introduction to this site included:  “It is a shame that some of my neighbors could have used a helping hand and I didn't know it!”

So, why is all this on my RethinkOCD blog?  Like I’ve said before, Obsessive Compulsive Disorder is a barometer and stress is something that can make people’s OCD worse.  Those in Colorado who’ve added flood trauma to their already full stress levels are in my thoughts.  From a statistical viewpoint, I’m sure they’re out there.  I am grateful for being emotionally well, though admit that I needed some time after that rainy week to rest up and restore myself.  Folks in the height of OCD operate in panic mode much of the time.  They can’t relax, at least not easily, because they feel they’re always on the brink of disaster. It really does feel that way.  Their hyper-vigilant minds continue endlessly even if they are physically exhausted.  Unfortunately, this constant state of anxiety is not making them tougher in the long haul; it will only wear them down.  Allowing time to rest is part of the self-care necessary to be present and ready to help others.  It is really critical for people who live with anxiety.  So keep working on your therapy and physical wellness.  Do whatever it takes, even though that therapy may be tougher for you than anything else you’ve ever done. 

OCD folks are some of the most thoughtful, intelligent and hardworking people I’ve met. The time will come when others really need you, if it hasn’t already, and you’ll want to be able to pitch in with a clear head.  There is more to do than the repetitious tasks of OCD.  All that determination is useful elsewhere.  Get involved in a new mission, which can help you jump off the well worn path you’ve been circling on.  Helping others can take us away from our fears and make us feel useful.  It is rewarding.  It is in efforts like these that I see optimism and hope emerging.  You can rise above your worries, but it may take some more support.  Make sure your OCD doesn’t get in the way of being able to connect with others.  That would be a loss to you and the world.