The Underlying Cause of OCD/Perfectionism and What To Do About It

By Samantha Gilbert, FNC, CHNP, CNC     Last updated on September 23rd, 2021

The Underlying Cause of OCD/Perfectionism and What To Do About It

The Underlying Cause of OCD/Perfectionism and What To Do About It.

Picture this: you’re in college and you have to write a 23-page essay on Gericault’s 19th-century masterpiece, The Raft of the Medusa for your advanced art history class. You’re a go-getter and super driven, so naturally you aspire to create a well-researched paper detailing the finer points of this icon of romanticism.

And, let’s be honest, you also want to get an A on this paper.

You’ve spent countless hours researching and now you’re ready to put it all together. Books and notes by your side, you sit down to bang it all out on your computer.

Except your fingers won’t move. In fact, you’re suddenly frozen and you haven’t even started yet.

Then you begin to ruminate because “I’ve got all these other things to get done too”, even though your paper isn’t due for another week. At this point, you get distracted thinking about all these other things. Next, panic and anxiety come to visit and suddenly the room is much smaller and it feels as though the temperature increased 10 degrees. Then you think to yourself “you’re no Proust, but darn it get something done already.”

So, in a frenzy, you bang out a few paragraphs. After you’ve read and reread your two paragraphs 25 times, you delete one because it wasn’t intelligent, clever or unique enough. At this point, your throat has closed up a bit and you begin to worry that you may not get that A after all. Then it spirals into fear over what others will think of you, and that maybe you don’t even have what it takes to get your degree.

This was me in college and is but one facet of perfectionism. Something I know many of you can relate to.

Much has been written about this topic and the many ways to overcome it with this and that technique. If you’ve ever tried to rewire your brain, recite affirmations, or clear your soul, you know what I mean. The Paul Graham’s of the world that think perfectionism is an excuse for procrastination clearly don’t know anything about biochemistry.

And please don’t misunderstand me, it’s not that some of these techniques aren’t helpful, but personal experience has shown me that these types of approaches do little to help the situation until the underlying imbalance is corrected.

That’s because perfectionism, which is really a form of OCD, is a result of a methylation imbalance, due to elevated histamine.

This was such a revelation for me and explained my lifelong battle with depression, disordered eating, anxiety, amenorrhea (lack of menstruation), and massive inner turmoil.

Whenever I see perfectionism, I know there is underlying inflammation. And this makes sense because histamine plays a major role in the body’s inflammatory response mechanisms that are directly connected to methylation cycles.

So how do you figure out the underlying cause of your OCD/Perfectionism?

  • Get properly tested. Perfectionism and OCD are directly connected to undermethylation, a biotype determined by a high whole blood histamine level or SAM/SAH profile, and although they can be connected, undermethylation is not the same as mast cell degranulation/histamine intolerance because we have different systems for controlling histamine. I break all of this down for you here. Note: Overmethylators struggle with Obsessive-Compulsive Personality Disorder (OCPD), which is not the same as OCD.
  • Steer clear of folic acid and high folate foods. Folate is a powerful demethylating agent. In other words, it strips away what we already don’t have. Another way to put this is that we don’t do well on plant-based diets because they are high in folate and copper. Trust me, I learned this the hard way. You can learn more about folate here.
  • Add more protein. The amino acids we get from meat are powerful in their ability to generate methyl donors such as methionine that are essential to proper methylation synthesis. Protein is also high in zinc and vitamin B6, both of which are essential for a healthy functioning brain. Keep in mind that plant-based amino acids have no effect on methylation cycles.
  • Eat regularly. Blood sugar dysregulation is very common when methylation is imbalanced. Eating protein-rich foods regularly not only supports methylation pathways, but also balances mood, appetite, sleep, and thought patterns.

Do you struggle with perfectionism? If so, let me know how you’re doing in the comments below. It is through sharing your story that we create community, eliminate guilt and shame, and bring about healing.


41 thoughts on “The Underlying Cause of OCD/Perfectionism and What To Do About It”

  1. Samantha: When reading your bio? I began to think that you must be my daughter! Last year, I switched to a vegan diet (to save money). Not a wise idea. Thanks for verifying what I’ve been suspecting for sometime. I will be interested in following your advice, given the fact that (behaviorally) we are identical. God Bless.

  2. Ho Sami. I’m disoriented. I have very high serum histamine level and low DAO. I can’t have my whole blood histamine tested yet (it’s hard to find a lab testing it in my country). I suffer from moderate pure obsessional OCD and intermittent depression. I’m wandering if I could beundermethylated or I had histamine intolerance or both. Which other lab test hould I have done?

  3. Hi Sami! Over the past year my son has really developed debilitating OCD and perfectionism. When we look back, there were symptoms his whole life. Recently, we met with a psychiatrist who wants to put him on medicine, but I told her I wasn’t ready for that. I don’t have a scientific reason other than I feel in my heart that there must be a natural remedy, and one that won’t simply mask the problem.

    Struggling to find a natural imbalance, I asked his doctor if he could do blood tests for food sensitivities, sugar levels and the basic bloodwork to see if anything was out of balance. Everything looked fine.

    Your post gives me hope. I now want to get his methylation tested ASAP. Can you give me a suggestion for how I can do this quickly? When I asked his doctor for bloodwork, I had to first make an appointment before he could order anything.

    Any information you can give me for getting him tested quickly, and in an accurate method would be greatly appreciated.

    Thank you so much for what you’re doing!

  4. Fascinating! Definitely have a streak of perfectionism & may have methylation issues due to a couple of MTHFR gene variants. Was told I need more folate but I actually feel bad on higher folate supplements and really not so good on plant based diet. Have been eating more meat (a variety but definitely more quality beef.), much less plants the last month and have noticed I have much more energy, feel much more relaxed & no carb cravings which I have always struggled with.

  5. This describes me to a “t”. I was also diagnosed with suspected MTHFR mutation but was never tested to see which one. I was placed on Homocysteine Factors. Homocysteine levels normalized but have been dealing wit terrible anxiety and chronic pain. I tried a vegan diet for several months and it made things worse. Now I know why. Thank you!

  6. Hi. Do you treat estrogen intolerance? I have severe PMDD and each period that comes seem to worsen mi OCD

  7. Hi,

    I suffer from severe anxiety issues. I also have very low serotonin. Im curious does low serotonin cause undermethylation or does undermethylation cause low serotonin?

    1. Hi Ashley,
      Undermethylation is the cause of low serotonin or more accurately put, low activity at receptor sites. But please do not assume you are undermethylated because low serotonin came up on a neurotransmitter test. These testing methods do not provide accurate measurements.

      1. So your saying by addressing the Pyroluria or Methylation issues through a specific nutrient diet you can solve long term mental issues like OCD/Perfectionism, bipolar…

          1. Ive had severe OCD/Perfectionism/Social Anxiety/GAD all my life. What are my chances of turning my life around 180. Is this a definite cure?
            What tests should I take?

  8. I’ve been told by my naturopath that im an overmethylator. I recently discovered I am homozygous(+-+) for DAO A. I’m exploring the possibility that I’m histamine intolerant .

    Is there a way to find out for sure, and what steps do you recommend I take to know?

  9. Hi Sami,
    My whole blood histamine was 56 when last tested, which is within the proper functional range, but I do have OCD/perfectionism issues. Is there anything else that could be the culprit rather than a histamine imbalance? By the way, like the other Becky above, I have trichotillomania as well, for over 30 years.

    1. Hi Becky,
      Have you checked copper? Urine kryptopyrroles? Both can produce similar symptoms. Anti-histamines will also alter WBH results.

      1. Yes, I do have pyroluria (uncorrected kryptopyrolles were 9.33, just slighly over optimal, corrected at 6.90, last time they were checked), but my copper, zinc and histamine are within the Walsh functional ranges. I take antihistamines very rarely. I did a B6, P5P, Zinc (along with some other things) protocol with my integrative doctor, but it didn’t make any difference with OCD/perfectionism or anything else for that matter.

        1. The right diet for your biochemistry is also key, as the wrong diet for your biochemistry can negate the effectiveness of any nutrient protocol. Duration of nutrients and the correct dosage is also critical. Click here to schedule a complimentary consult with me to see how I can help.

  10. Hi Sami,
    I am also overmethylated (tested through Dr. Mensah) and have OCD and was wondering what your experience is with this vs. and undermethylated person with OCD. I don’t know if I’ve seen improvement in this area with Dr. Mensah’s protocol (been following it for a year).

    1. Hi Shiran,
      I’ll be honest, OCD is one of the hardest to treat and is different for both biotypes. Overmethylators tend to exhibit Obsessive Compulsive Personality Disorder (OCPD), while undermethylators exhibit true OCD. There are still times where I find myself being somewhat OCD, and unfortunately, our society in general perpetuates this behavior (this is why I’m very mindful of limiting my time on the internet and devices). My OCD didn’t really start to get better until well over a year into my treatment. Keep up the great work and stay the course. You’re on the right track! 🙂

  11. Hi Sami,

    Have you worked with anyone with trichotillomania (OCD spectrum)? I have suffered with it most of my life and my son does as well. He has been tested and his ND told me he’s under methylated with an imbalanced copper and zinc ratio (high copper/low zinc). His histamine is also extremely high. I was curious if the same nutritional principles apply as with OCD/perfectionism.

    1. Hi Becky,
      Yes, I do. Every undermethylator is different so I wouldn’t say the same nutritional principles apply, with the exception (most of the time) of a high protein diet. We need the amino acids in proteins to help with methylation synthesis. Keep in mind that plant-based proteins have no impact on methylation cycles.

  12. I suffer with severe OCD and yet I am OVER methylated. I tried Dr William Walsh’s Nutrient Therapy but unfortunately I saw no improvements in my OCD.

    1. Hi Eric,
      I’m sorry to know you’ve not seen any improvement. I’m curious, were you properly tested and working with a qualified practitioner?

      1. Hi Sami,

        Yes, I was properly tested and under the care of Margo Goldspink of the Olive Tree Clinic in London. She was trained in Dr William Walsh’s protocols and her contact details can be found on the Walsh Institutes website. Unfortunately, the treatment just didn’t work for me.

      2. I did reply last year to your questions but they were never displayed on your website. Anyway, Yes, I was properly tested by a qualified practitioner;
        ​Margo Goldspink, MA, PhD
        Olive Tree Clinic
        117A Harley Street
        London W1G 6AT
        Brampton UK Clinic: 01480 411291

        Margo is listed on Dr William Walsh’s website as a qualified practitioner who has been trained in his Nutrient Therapy protocols.

        1. Hi Eric,
          Thanks for your response. Unfortunately, your comment never came through. In overmethylation, we see Obsessive Compulsive Personality Disorder (OCPD), which is different from the traditional OCD we see in undermethylators. Few practitioners know and understand OCPD and its variants. At Mensah Medical we are skilled at treating OCPD as well.

          1. Thank you Sami for your quick response! I will research OCPD shortly. Hopefully, this will be the start of my recovery.

    2. I think ocd symptoms are due to an imbalance in neurotransmitters. High histamine, high serotonin = the person who doesn’t get anything accomplished and has a messy house. High histamine, high dopamine the person who doesn’t stop cleaning and has the perfect house. Essentially I would say you are high serotonin, low dopamine and oxytocin maybe. I would look at the thyroid. Iodine maybe necessary.

      1. Actually, undermethylated individuals (high histamine) have low levels of serotonin and dopamine, whereas overmethylators (low histamine) are high in both and typically have obsessions without compulsions. Keep in mind there are a wide range of variations that only proper testing with an assessment can uncover.

        1. Many sources say that when methylation is low, dopamine is also low. What is the source of information that dopamine is high because of undermethylation?

          1. It’s actually the other way around. Overmethylators have too much excitability (high serotonin and dopamine). Undermethylators are low in these important neurotransmitters.

  13. Yes life long struggle with perfectionism, just as you described it. I cant count the things that i gave up on because I couldn’t do them perfectly.

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