Internet Addiction Shares Similarities With Obsessive Compulsive Disorder, According To New Research

A new article published in Frontiers in Psychology offers insight into “Internet use disorder” — a condition characterized by excessive or poorly controlled urges and behaviors relating to Internet use that causes distress or interferes with normal life functioning. According to the authors of the research, a team led by Tania Moretta of the University of Padova in Italy, it is more likely to affect people who exhibit obsessive-compulsive symptoms.

To arrive at this conclusion, the researchers recruited 104 Italian adults to participate in an in-person survey. The researchers asked participants to fill out a series of questionnaires, beginning with an Italian version of the Internet Addiction Test, shown here:

Answer the following 20 questions on a scale from 0 (does not describe me) to 5 (describes me well) to measure problematic internet use. Add your scores together. Values of 30 or less indicate a normal level of internet consumption, scores between 31 and 49 indicate mild addiction, scores between 50 and 79 indicate moderate addiction, and scores of 80 or higher reflect severe internet dependency.

  1. Do you find yourself saying “just a few more minutes” when online?
  2. Do you fear that life without the Internet would be boring, empty, or joyless?
  3. Do you try to cut down the amount of time you spend online?
  4. Do you snap, yell, or act annoyed if someone bothers you when you are online?
  5. Do you find that you find yourself anticipating when you will go online again?
  6. Do you feel preoccupied with the Internet when offline, or fantasize about being online?
  7. Do you feel depressed, moody, or nervous when you are offline, which goes away when you are back online?
  8. Do you lose sleep due to late night log-ins?
  9. Do you try to hide how long you’ve been online?
  10. Do you choose to spend more time online over going out with others?
  11. Do you form new relationships with fellow online users?
  12. Do you prefer the excitement of the Internet to intimacy with your partner?
  13. Do you neglect household chores to spend more time online?
  14. Do you find that you stay online longer than you intended?
  15. Do others in your life complain to you about the amount of time you spend online?
  16. Does your job performance suffer or productivity suffer because of the Internet?
  17. Do your grades or schoolwork suffer because of the amount of time you spend online?
  18. Do you block out disturbing thoughts about your life with soothing thoughts of the internet?
  19. Do you check your email before something else that you need to do?
  20. How often do you become defensive or secretive when anyone asks you what you do online?

The researchers then requested that participants fill out scales measuring impulsivity, anxiety, depression, and stress, obsessive-compulsive symptoms, and the use of alcohol and cannabis. Finally, participants completed a questionnaire about their demographic characteristics, health status, and medical history.

The researchers found that participants who scored higher on the Internet Addiction Test tended to exhibit hoarding and obsessing symptoms from the obsessive-compulsive questionnaire. They also exhibited higher levels of depression.

They did not find evidence that Internet use disorder was linked with other problematic psychological or behavioral characteristics, such as increased anxiety, impulsiveness, or substance abuse.

“Overall, these findings suggest that Internet use disorder may be characterized by a pattern of symptoms resulting from a disturbance of networks and mechanisms underlying anxiety/mood disorders and OCD,” conclude the authors. “Based on current knowledge of this problematic behavior, an intervention should consider increasing emotion regulation capacity and awareness of the problematic behavior, coping with negative affect, and motivating individuals to consider goals different from Internet usage as the targets.”

A full interview with Dr. Tania Moretta discussing this research can be found here: What is Internet use disorder and how can it be treated?

How I Finally Learned to Manage My OCD Symptoms

When I was first diagnosed with obsessive compulsive disorder (OCD) in college, a psychologist gave me a book called The OCD Workbook. That night, in my dorm room, I read the book cover to cover and felt a wave of relief wash over me. Inside its pages were all the things I’d been going through: checking behaviors, ruminating thoughts and irrational health fears. For years, I’d been constantly checking to make sure doors were locked and appliances were unplugged. I’d then obsessively worry that I missed something while checking and it would cause something horrible to happen like a fire or a burglary. Although, it was comforting to know that there were other people like me in the world, but I didn’t fill out the workbook. I was embarrassed and didn’t want to admit I had OCD, so I stopped seeing my therapist.

What is OCD?

Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). Although people with OCD may know that their thoughts and behavior don’t make sense, they are often unable to stop them. Symptoms typically begin during childhood, the teenage years or young adulthood, although males often develop them at a younger age than females. 1.2% of U.S. adults experience OCD each year, according to the National Alliance on Mental Health.

My OCD symptoms affected my life at least as far back as first grade.

I didn’t develop OCD in college; I have always had it. Even though I was really outgoing, I was still an anxious kid. In first grade, I quit the Girl Scouts because I feared my mom would forget to pick me up afterwards. I didn’t have any fun because I was sick with worry the entire time. In fifth grade when a man’s leg rubbed up against mine while waiting for a ride in Disney World, I somehow thought I got pregnant. It ate at me the entire vacation until I finally caved and told my mom my concern, who reassured me that it was impossible for me to pregnant from one leg touching another leg. For years, I babysat but was always a wreck thinking the kids might die in their sleep. I’d check on them every few minutes to make sure they were breathing.

bridget mcguire in kindergarten

As I got older, my OCD got increasingly worse. I started taking pictures on my phone of all the appliances in my apartment before I left, so I’d know I didn’t start a fire. I’d circle the block of my house numerous times to make sure I didn’t hit anyone with my car. I bought Plan B regularly for fear I had sex and didn’t remember. But in February 2020, I found myself picking up $300 worth of anti-HIV medication that I did not need. I hit my OCD rock bottom.

Still, no one would know I was suffering, because I could act laid back when I needed to be. I have a loving family and friends, and I’ve been in serious relationships and take care of my dog. I have my own condo and a great job. On the side, I do stand-up comedy and tell self-deprecating jokes about my anxiety. Even though my career is in sales, I hold a master’s degree in social work. I studied OCD and still did nothing about it.

After I took that anti-HIV medication unnecessarily, I knew something had to give.

I made an appointment with a new therapist who specialized in OCD and promised myself I’d tell her the truth. I have been seeing therapists on and off for years, but I’d often lie. See, if I were honest, I’d have to stop these behaviors and the idea of that was too scary—they were my security blanket.

That’s not uncommon. There are actually several reasons a person might lie to their therapist, explains Kelley Kitley, L.C.S.W. The biggest? They’re ashamed or embarrassed by what they did, said, or thought. “With OCD, it’s difficult for patients to say their intrusive thoughts out loud,” she explains. “Even though the patient knows they’re speaking to a trained professional, there is still internal shame of saying it out loud. Keeping it all in, patients can feel very isolated and embarrassed. However, once it’s said out loud, it gets rigorously easier for the patient.”

Not telling the truth is a “protection mechanism,” she adds, which can thwart a person’s progress in therapy. “Some patients might not be ready to go there,” Kitley says. “Some aren’t ready to really make the change and don’t want to be held accountable.”

Once I explained all my behaviors to my new therapist and admitted that I never actually put any work into trying to manage my OCD, I felt free. She and I constructed a plan of how we would work together. We decided I would see her twice a week: one session for intensive OCD treatment and one for talk therapy.

bridget mcguire doing standup comedy

Everything was off to a great start, until the pandemic hit.

My therapist and I could no longer meet in person, so we switched to weekly phone calls in April 2020. However, my OCD was minimal at the time because my life wasn’t my life anymore. I wasn’t leaving my apartment, driving, dating, or going out with friends. I felt in control, at least for a moment.

Then, in June, my fear of STDs started to take over my thoughts again—and I spiraled. I emailed my gynecologist numerous questions and spent hours reading about STD symptoms online. I told my therapist I couldn’t stop myself and it was then she felt she couldn’t help me just by talking weekly on the phone. Instead, she recommended intensive outpatient treatment.

I had investigated a similar treatment plan years before, but I had every excuse for why I couldn’t do it. I might have a client event, dinner plans, or a stand-up comedy show. When would I work out? How could I date? But things were different during lockdown. In June 2020, I had nowhere to go: no events, dinners, shows, or dates.

I didn’t even have to leave my couch: The outpatient program was three hours each evening, four days per week, via Zoom. I literally had no excuse not to participate.

The idea of the treatment terrified me, but my OCD terrified me more.

The symptoms were paralyzing, and I wanted them to stop, so I agreed to do the program. For four weeks, I worked with different therapists, participated in group therapy that had an educational component, and practiced exposure response prevention (ERP) therapy.

The International OCD Foundation states that, the exposure in ERP refers to exposing yourself to the thoughts, images, objects and situations that make you anxious and/or start your obsessions. While the response prevention part of ERP refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been triggered.

So, for example, I had to stop taking pictures of my appliances when I left my apartment. In treatment, I’d write out a worst-case scenario repeatedly: I forgot to turn off my hair straightener, which then started a fire that burned down my building and killed my neighbors.

I hated writing this down. My chest would feel heavy, and my throat would close up. However, after writing it on repeat for an hour, the anxiety started to fade, and I eventually got bored of it. I realized it was just a thought, not a fact, and it had no meaning.

The next step was putting ERP into action. One Friday, I went to my sister’s house for the weekend. As I was leaving my apartment, I started feeling nervous. I had not left my apartment without taking a picture in 15 years. I told myself that my OCD could sit with me, but I wasn’t giving in. I did not take one picture. An elephant of anxiety sat on my chest as I got in my car. I wanted to turn around and go back, but instead, I started driving. About five minutes later, the anxiety was gone.

bridget mcguire

My life has completely changed since I finished the program.

I am not free from OCD, nor will I ever be—it’s simply how I am wired. The difference now is that I have the tools to help manage it, in addition to my weekly therapy sessions where I’m completely honest and open. I’ve come to realize that when life gets stressful, my OCD will flare up—but instead of letting it take control over me, I’m able to pinpoint it, do ERP exercises, and move on.

It may have taken a pandemic for me to realize it, but if you’re suffering from OCD, the best thing you can do is seek help and tell the truth in therapy. I wasted years of my life suffering over fake fears. I can’t get that time back, but I’m proud of myself for acting when I did and am excited for what the future holds, knowing that my OCD doesn’t control me.

It’s not just about being clean and tidy: What OCD really means and how to seek support

Obsessive-compulsive disorder symptoms can include a compulsion to order and organise everyday items

WE all experience things like worrying we’ve left an appliance on, or avoiding walking under scaffolding, but for most people, these random stresses and superstitions are short-loved.

Obsessive-compulsive disorder (also known as OCD), however, is a serious anxiety disorder, where worries and urges can have a debilitating effect on a person’s day-to-day, impacting both their mental health and relationships with others.

Based on current estimates for the UK, around three-quarters of a million people are living with OCD at any one time – around 1.2 per cent of the population.

Misunderstanding and stigma about OCD can make it difficult to reach out – but support is available, and it can make a significant difference for those affected.

What is OCD?

“Obsessive-compulsive disorder is an anxiety disorder that causes people to experience a variety of symptoms that typically fall into one of two categories: ‘obsessions’ and ‘compulsions’,” explains Priory consultant psychiatrist, Dr Paul McLaren (priorygroup.com).

“Obsessions are characterised by persistent and irrational thoughts or urges, and compulsions refer to physical or mental acts that people feel compelled to perform.”

McLaren explains that some people with OCD only experience one type of symptom, whilst others experience both.

“These irrational thoughts and behaviours can become extremely time-consuming,” adds McLaren, and the defining factor is that they feel impossible to stop or control.

OCD is ranked by the World Health Organisation as one of the top 10 causes of mental illness-related disability, but misconceptions around the term mean people often don’t treat it with the seriousness it deserves.

It’s often commonly implied that OCD simply means that you like to wash your hands a lot, and it’s not uncommon to hear someone describe themselves as a ‘little bit OCD’ if they like to be very tidy or organised.

Handwashing is a common compulsion if someone has an intrusive thought of being contaminated by germs, but as McLaren explains: “This is not the only form of OCD. Common presentations not only include contamination worries but also double-checking and hoarding behaviour, as well as ruminations and intrusive thoughts and images.

“These obsessions and compulsions can be overwhelming to someone living with OCD, despite their best efforts to avoid thinking and acting in a certain way.”

Hand-washing is a common compulsion among those with OCD

Why does it happen?

No one’s sure yet what causes OCD – but there are lots of different theories, and it’s likely that a number of factors are involved in its development.

“OCD can run in families,” says Glenys Jackson, clinical lead for mental health at Bupa Insurance (bupa.co.uk).

“If one of your parents or a brother or sister has OCD, it’s possible you may develop it too. Traumatic life events, social isolation or bullying could trigger OCD or make it worse, and it can also develop during pregnancy.

“The pandemic has put a huge strain on everyone’s mental wellbeing. Factors such as reduced social contact, feelings of isolation and fear associated with contracting or spreading Covid-19 all have strong links to poor wellbeing. These stressors are making OCD symptoms worse in some cases.”

How is OCD diagnosed?

If you think you may have OCD and it’s affecting your life, see your GP. Jackson says: “They’ll ask you a series of questions related to OCD to help make a diagnosis. These include how your OCD affects you personally and how it affects your life.

“You may feel embarrassed about your symptoms and it can be hard to talk about them. However, it’s important to be open and honest with your GP or therapist about any obsessions and compulsions you have.

“This will help them make the right diagnosis and recommend the best type of treatment for you.” Your GP may then refer you to a healthcare professional who specialises in mental health for further assessment or treatment.

Talking therapies such as CBT can be helpful in managing OCD symptoms

What kinds of treatment can help?

According to Jackson, most people with OCD “spend years struggling with their symptoms” before they seek help.

This is often because of stigma around having a diagnosed mental health condition, they are embarrassed to seek support, or they leave the symptoms to manifest in the hope that they will go away. But as Jackson stresses: “It’s so important to speak up and find a way to treat and manage your OCD.”

When you’re facing obsessive thoughts or compulsions, it can be hard to see them for what they are.

“With practice and help, it can become easier to identify when your thinking is affected by the symptoms within OCD and you can build techniques to reduce the impact and bring the symptoms under control,” assures Jackson.

“This might include actively exploring and confronting your compulsions or thoughts, maybe through exposure and response prevention where a therapist works with you to challenge the OCD.

“It might sound difficult, but it can help you to acknowledge that thoughts and compulsions don’t have power over you. It is important to talk to a professional to determine what pathway is most appropriate for your presenting symptoms.”

Cognitive Behavioural Therapy (CBT) can also help manage symptoms. This form of talking therapy helps you examine in detail how you think about certain situations in your life, how you behave in response to those thoughts, and how your thoughts and behaviours make you feel.

“CBT aims to give you the understanding and tools to carry on working towards recovery by yourself,” Jackson says. Your doctor may also prescribe medication if you have severe OCD, or if your symptoms don’t improve with therapy.

Self-care interventions are really important too, and it’s always good to remember that you’re not alone. “OCD is a common anxiety disorder. In fact, a large part of the population may have had some OCD traits at some point in their lives,” says McLaren.

“Don’t let it prevent you from talking to people and getting the help you will need. There are online forums and support groups that take place regularly.

“There is a lot of information available online regarding OCD, including testimonies from people with OCD and how they have dealt with it. This can help you put your difficulties into perspective, offer context, and give you more understanding in what may be helpful for you.”

My Life with OCD: Please Don’t Doubt My Diagnosis

Many well-meaning people have stereotypical ideas about OCD. These stereotypes can be extremely harmful to people with the condition.

Even when these stereotypes don’t come from a place of judgment, they’re damaging.

These stereotypes include the beliefs that:

  • all people with OCD are extremely clean and neat
  • all people with OCD are high-strung
  • being pedantic about neatness or cleanliness shows that you have OCD
  • people with OCD cannot be disorganized

Just as someone with a generally optimistic approach to life can have major depression, a person with OCD can be messy. These personality traits don’t immunize you against mental illness.

If we, as a society, truly want to prioritize mental health, we need to let go of the stereotypes we hold.

We need to be willing to admit when we don’t know too much about certain mental illnesses, and we need to educate ourselves (beyond watching TikTok skits and “psycho killer” horrors).

If you’re a person with OCD and your loved ones doubt your diagnosis, remember that they’re not experts on what’s going on in your brain — you are.

And if you do fit the diagnosis criteria for OCD, as guided by your therapist, you can use that label if it helps you.

For many of us, the label of having OCD can be scary — but it can also be empowering.

This is particularly so if it helps to explain some of the challenges we face.

Doubt and disbelief can be extremely hurtful, but it’s possible to move past it and get the treatment you need.


Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. As someone with multiple anxiety disorders, she’s passionate about using her writing skills to educate and empower readers. She believes that words have the power to change minds, hearts, and lives.

Signs and Symptoms of Anxiety Disorders

Many people experience anxiety at some point in their lives. In fact, anxiety is a very normal response to stressful life events like moving, changing jobs, or having financial troubles.

However, when anxiety symptoms become larger than the events that triggered them and begin to interfere with your life, they could be signs of an anxiety disorder.

Anxiety disorders can be debilitating, but people can manage them with proper help from a medical professional. Recognizing the symptoms is the first step.

In this article, we discuss common symptoms of an anxiety disorder, as well as how to reduce anxiety naturally and when to seek professional help.

How to Manage OCD: 6 Methods and Resources

OCD can create many dilemmas without offering a true resolution. When the dilemma arises, you feel compelled to constantly try and resolve the source of your anxiety. This pulls you into an endless loop of circular thoughts, or ruminations, that are hard to stop.

For instance, imagine you have an intrusive fear of hitting someone with your car, which is a common OCD anxiety. Let’s say you’re driving along one day, and you run over a pothole. The bump in the road triggers feelings of panic, and racing thoughts start to bubble up and overwhelm you.

The rational part of your brain knows that it was only a pothole. Regardless, your anxiety continues to increase, and you then misinterpret this anxiety as a signal that something terrible has happened.

To ease your anxiety, you feel compelled to drive back just to “check.” And even when you get home, the intrusive thoughts continue — your brain tells you that you didn’t look hard enough and that the police will be at your door any minute.

Why is your brain doing this?

Research tells us that when you have OCD, there’s too much brain activity in the area that detects errors — and too little activity in the areas that tell us to stop compulsive behaviors.

So the next time your OCD presents a dilemma that makes you anxious, see if you can try to resist the temptation to ruminate for too long or try to “solve” the problem by engaging in compulsions. The longer you sit with the feelings of uncertainty, the less power they will have over your behaviors. Your anxiety will reduce over time, a process known as habituation.

Obsessions and compulsions are difficult to overcome, and it takes practice. It can be very helpful to practice with the help of a trained mental health professional’s guidance.

It’s time to redefine obsessive-compulsive disorder | Opinion

I’m sure you’ve heard someone say to you, “I’m so OCD!” or “God, my OCD is so bad today!” when their pens aren’t in a straight line or their papers are out of order.

Obsessive-compulsive disorder is a term most people recognize but few fully understand. It’s usually something people casually refer to — an explanation as to why they’re organized.

But OCD is larger than that, and for many, including myself, it’s a real challenge dealt with daily.

In the United States, 2.2 million adults are affected by OCD, according to the Anxiety and Depression Association of America. This is about 1% of the U.S. adult population.

I’m convinced, however, that the numbers are greater than this in reality.

OCD is an anxiety disorder in which people have recurring, unwanted thoughts that make them feel driven to do something repetitively and cause distress or anxiety, according to the American Psychiatric Association.

There are two parts to OCD — obsessions and compulsions.

Obsessions can present themselves in the form of intrusive thoughts, which to put it simply, feels like a super annoying voice in your head, constantly telling you things you don’t want to hear and that mostly have no validity behind them.

Compulsions are a way for people with OCD to “avoid” the content of their obsessions.

For example, if you fear that an intruder will break into your house in the middle of the night, naturally, you will lock your door. But an OCD brain insists you check the lock again and again and again.

An OCD brain clings onto uncertainty and what-ifs and doesn’t recognize the fear is improbable. Validation and giving into compulsions only fuels the cycle, but it is possible to “cure” yourself — at least I know I have helped myself get out of a lot of my cycles.

For some people, commonly-acknowledged obsessions over germs or making sure everything is perfectly in order is a reality and a struggle.

However, it’s important to understand this is just the tip of the OCD iceberg and should not be the generalization for all those that have it. OCD makes it hard to distinguish between intuition and anxiety, making it feel like you can’t make a clear decision on much of anything without internal debate.

I always thought I was just an anxious, “Type A” person. As a kid, I worried about things other kids didn’t seem to be as worried about — “Will mom and dad get home from dinner safely? Will some unexpected tragedy happen?”

I worried about things past my years, and no decision was made without overthinking.

As I got older, those worries became easier to push aside as I gained a better grasp over my mind, and I subconsciously helped myself to beat some of my OCD.

But new concerns come about with age, and as we all know, the new responsibilities of young adulthood can be stressful.

Of course, the coronavirus pandemic didn’t help anything, and it was at this point when my worries about uncertainty and the future got out of hand.

I started seeing a counselor for what I thought was anxiety, but through my own research and the guidance of my counselor, I started to feel like there was something behind the anxiety. I stumbled across some OCD pages on Instagram and soon found I identified with every issue discussed.

Seven months later, at 19 years old, I had an official diagnosis and a medication plan that has actually proven effective.

The average onset of OCD, according to the ADAA, is 19 years old, which is crucial information for a college student to acknowledge, as many might be suffering without a diagnosis quite yet.

OCD can make you feel like you’re not doing badly enough to need help, or you’re really fine and you’re “making it up.”

This probably proves true for other mental disorders too, but it’s important to understand if you feel that you need help, get help.

Your problems are valid, even if someone else’s situations seem worse. Everyone has the right to better themselves, and although this can feel difficult at first, if you keep your eye on the end goal, it becomes easier to work through the hard times.

You are your own best advocate. Use this to change your life for the better.

A New, Innovative Therapy That Treats Depression and OCD

According to the International OCD Foundation, obsessions are thoughts or impulses that occur routinely and outside of a person’s control. Although patients don’t want to have these thoughts, obsessive compulsive disorder is tough to treat because patients often fear a loss of control by getting treated for their symptoms.

The Cincinnati Anxiety Center is a treatment facility that offers cutting-edge therapy including a new treatment called Transcranial Magnetic Stimulation (TMS). Clinical Director and Cincinnati Anxiety Center Owner Nathan Fite, PhD, says the new treatment is often used after exhausting other treatments such as medication therapy. However, it can also be a treatment you opt for first in your therapy plan. “It’s a very effective treatment of major depression, but recently was FDA approved for usage with a specific coil for obsessive compulsive disorder,” says Dr. Fite. “It’s an exciting new option for patients who haven’t responded to medication management and cognitive behavioral therapy. The beauty of the treatment is that it works and does not have any of the systemic side-effects of traditional medications.”

What is Transcranial Magnetic Stimulation (TMS)?

Neuromodulation therapies are often invasive and require surgery or inducing seizures. However TMS is a painless and noninvasive form that changes brain activity by using electromagnetic currents on the skull and directing them to specific brain regions. The outpatient treatment includes putting a magnetic coil up to the head of the patient at the specific regions of the brain that’s associated with depression or obsessive compulsive disorder.

How does TMS work?

The Cincinnati Anxiety Center offers two types of TMS. One is a standard, surface TMS that’s administered for a half hour once a day, five days a week, for about six weeks totaling 30 sessions. Depending on the patient there may be a three week taper. The second is a shorter three-minute session using Theta Burst. “The recent Three-Dee randomized non-inferiority study showed that it has comparable efficacy to traditional rTMS protocols for depression,” says Dr. Fite. “What’s traditionally given in 30 minutes, you can now get in three minutes.” The same number of sessions are necessary for both options. The treatment itself entails a machine that releases magnetic pulses into the dorsolateral prefrontal cortex, stimulating the brain cells to communicate through electrical pulses. Dr. Fite says most patients will begin experiencing results after 15–20 sessions.

How effective is TMS?

“A recent study that was conducted by Brainsway, [which makes TMS machines,] concluded that by using TMS in conjunction with elevating anxiety by presenting OCD fears while also stimulating the brain at an elevated anxious state, about 55 percent of patients have some level of response to the treatment,” Dr. Fite says. The clinically significant results are telling for the majority of patients, and now the treatment has FDA approval. As for traditional TMS for depression without additional intervention, Dr. Fite says results roughly follow the rule of two-thirds. One third of patients who haven’t responded to medication will remit from depression using TMS. Another third will have a clinically significant response. The other third won’t respond to it.

Seek medical advice to learn if this treatment is right for you

If you’ve exhausted all treatment options or would like to opt for less invasive options, the team at the Cincinnati Anxiety Center will evaluate and see if this treatment is right for you. Learn more about the treatments offered at the Cincinnati Anxiety Center.

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Living with OCD in a pandemic

Most people behave in one or more ways that others may consider peculiar, and I am no exception. I want my clothes to match, from shoes to eyeglasses and everything in between (including underwear — a challenge when packing for a trip). If visitors use my kitchen, they’re asked to put things back exactly where they were found. In arranging my furniture, countertops and wall-hangings, I strive for symmetry. And I label packaged foods with their expiration dates and place them in my pantry in date order.

I know I’m not the only one with quirks like these that others may consider “so OCD,” a reference to obsessive-compulsive disorder. But the clinical syndrome, in which people have unbidden recurring thoughts that lead to repetitive habits, is far more than a collection of quirky behaviours. Rather, it is a highly distressing and chronic neuropsychological condition that can trigger serious anxiety and make it difficult to function well in school, at work or at home.

For someone with OCD, certain circumstances or actions that most people would consider harmless, like touching a doorknob, are believed to have potentially dire consequences that require extreme corrective responses, if not total avoidance. A person may so fear germs, for example, that shaking someone’s hand can compel them to wash their own hand 10, 20 or even 30 times to be sure it’s clean.

For many, the COVID-19 pandemic only made things worse. Past research has found a potential correlation between traumatic experience and increased risk of developing OCD, as well as worsening symptoms. A person with OCD who already believes dangerous germs lurk everywhere would, understandably, have become paralysed with anxiety by the spread of the novel coronavirus. And indeed, a Danish study published in October found that the early months of the pandemic resulted in increased anxiety and other symptoms in both newly diagnosed and previously treated OCD patients ages 7-21.

How serious is OCD?

The disorder often runs in families, and different members can be affected to varying degrees. Symptoms of the condition often begin in childhood or adolescence, afflicting an estimated 1 per cent to 2 per cent of young people and rising to about 1 in 40 adults. About half are seriously impaired by the disorder, 35 per cent moderately affected and 15 per cent mildly affected.

It is not hard to see how the disorder can be so disruptive. A person with OCD who is concerned that they may fail to lock the door, for example, may feel compelled to unlock and relock it over and over. Or they may become unduly stressed and anticipate disaster if a strict routine, like switching a light on and off 10 times, is not followed before leaving a room. Some people with OCD are plagued by taboo thoughts about sex or religion or by a fear of harming themselves or others.

Comedian Howie Mandel, now 65, told MedPage Today in June that he has suffered from OCD since childhood, but wasn’t officially diagnosed until many years later after spending most of his life “living in a nightmare” and struggling with an obsession about germs. He has been working to help counter the stigma of mental illness and increase public understanding of OCD in hopes that greater awareness of the disorder will foster early recognition and treatment to avert its life-impairing effects.

How is OCD treated?

“Until the mid-1980s, OCD was considered untreatable,” said Caleb W. Lack, a professor of psychology at the University of Central Oklahoma. But now, he said, there are three evidence-based therapies that may be effective, even for the most severely afflicted: psychotherapy, pharmacology and a technique called transcranial magnetic stimulation, which sends magnetic pulses to specific areas of the brain.

Most patients are initially offered a form of cognitive behavioral therapy, called exposure and response prevention. Starting with something least likely to elicit anxiety — for example, showing a used tissue to people with an obsessive fear of contamination — patients are encouraged to resist a compulsive response, like repeated hand-washing. Patients are taught to engage in “self-talk,” exploring the often irrational thoughts that are going through their heads, until their anxiety level declines.

When they see that no illness has resulted from viewing the tissue, the therapy can progress to a more provocative exposure, like touching the tissue, and so forth, until they overcome their unrealistic fear of contamination. For especially fearful patients, this therapeutic approach is often combined with a medication that counters depression or anxiety.

One silver lining of the pandemic is that it may have allowed more people to get treated remotely through online health services. “With telemedicine, we’re able to do very effective treatment for patients, no matter where they may live in relation to the therapist,” Lack said. “Without ever leaving central Oklahoma, I can see patients in 20 states. Patients don’t have to be within a 30-mile radius of the therapist. Telemedicine is a real game-changer for people who won’t or can’t leave home.”

For highly impaired OCD patients for whom nothing else has worked, the latest option is transcranial magnetic stimulation, or TMS, a noninvasive technique that stimulates nerve cells in the brain and helps to redirect neural circuits that are involved in obsessive thoughts and compulsions.

“It’s as if the brain is stuck in a rut, and TMS helps the brain circuitry get on a different path,” Lack explained. As with exposure and response prevention, he said, TMS uses provocative exposures, but combines them with magnetic stimulation to help the brain more effectively resist the urge to respond.

In a study of 167 severely affected OCD patients at 22 clinical sites published in May, 58% remained significantly improved after an average of 20 sessions with TMS. The Food and Drug Administration has approved the technique for treating OCD, though many insurance companies are not yet offering coverage.

Where can I get help?

Bradley Riemann, a psychologist at Rogers Behavioral Health System in Oconomowoc, Wisconsin, said his organization, which has 20 locations in nine states, relies on treatment teams that include psychologists, psychiatrists, nurses and social workers to provide both outpatient and inpatient treatment for OCD patients as young as age 6. Too often, Riemann said, parents inadvertently reinforce the problem by clearing a path so that their child can avoid their obsessive fear and resulting compulsive response. For example, they might routinely open doors for a child fearful of contamination.

The nonprofit International OCD Foundation, based in Boston, can help patients and families find therapists and support groups for those struggling with the condition. A message can be left at 617-973-5801.

This article originally appeared in The New York Times.

COVID-19 Has Made It ‘Really Tough’ For People With Anxiety Disorders

Mental health professionals have reported surging demand from people seeking therapy since the start of the pandemic.

To learn more about how things have changed, WESA’s health and science reporter Sarah Boden is speaking with psychiatrists, therapists and social workers over the coming weeks about what they’re observing in their own practices.

In this first conversation, Boden spoke with Kristen Walker of the Counseling and Wellness Center of Pittsburgh. Walker is a cognitive behavioral therapist who focuses on treating anxiety disorders, which can cause people to fixate on worst case scenarios.

This conversation has been edited for length and clarity.

Sarah Boden: In many ways, COVID-19 and other recent events have confirmed our greatest fears. How do you help patients navigate this?

Kristen Walker: One of the things that can be really effective is helping people focus on what they can and can’t control: ‘Well, I have control over wearing a mask. I have control over whether I exercise. I have control over whether I eat a healthy meal.’ And all those things help manage some of that external anxiety.

Boden: I know that clinicians want to be careful to not over-pathologize a patient. But I do wonder, since March 2020, are more people developing anxiety disorders?

Walker: In my experience with folks I’ve been seeing, yes. I mean, in order to have that anxiety disorder, there are clinical markers that need to be met: feelings of being on edge, constant worry, difficulty sleeping, having a startle response, maybe avoidance of people in situations. All of those different kinds of things are hallmarks of what we would consider an anxiety disorder.

Boden: And are we just talking generalized [anxiety]? Or are you seeing all different types of anxiety disorders?

Walker: All different kinds. The social anxiety disorder has been tough for folks. One of the things we typically encourage folks with social anxiety disorder to do is to go out there, get in public, meet people, do things to do those exposures. And that’s been pretty limited with Covid.

Boden: Besides social anxiety disorder, I’m wondering how the pandemic has impacted other anxiety disorders like, for example agoraphobia, which is a fear of leaving your home, being in, I guess, unfamiliar places or places you can’t control the environment.

Walker: People with agoraphobia tend to not leave their home or I mean, if they do leave their home, they tend to stick close to a routine. Somewhere where they know that they can get out safely. So it’s harder for people to kind of rationalize for themselves. ‘Oh, even though this feels really uncomfortable, this is going to be a good thing for me to go,’ because now there’s this added layer of COVID-19.

Boden: Yeah, it’s so interesting. You’re talking about the sort of exposure therapy, I guess you could call it, [that] in some ways the exact opposite of what the public health guidance was at certain points earlier in 2020.

Walker: Yes, yes. That’s completely contraindicated for somebody with agoraphobia, or social anxiety.

Boden: I also want to ask about obsessive-compulsive disorder. I think in media, we might see this portrayed as somebody who’s constantly washing their hands, or always on the lookout for some sort of danger or calamity in the real world. How have people with this diagnosis been impacted by the pandemic?

Walker: The pandemic has been really tough. If somebody does have more of a fear of germs, for example, when they wash their hands they immediately feel better. And what that does is it brings down the anxiety for a temporary time period. Eventually it spikes back up and higher. Now, all of a sudden there’s the CDC guidelines coming out, especially early on in the pandemic where you were being told, wipe down your groceries, leave your deliveries outside for a couple of days, make sure you’re washing your hands. So that was really tough to navigate.

Boden: I suppose, really with any anxiety disorder, the behaviors are not always irrational. It’s just calibrating that sort of alertness or protective behaviors to the situation. But suddenly we’re in a situation where a lot of those behaviors are being reinforced.

Walker: Right. Right. Because it reinforces the need or the urge to isolate.

Boden: Looking towards the future, what do you think the long term effects will be of the pandemic on your clients?

Walker: It’s going to take time to reacclimate to being out there in the world again. So I think it’s going to require support, patience, care, gentleness for each other.

This story was produced as part of “Pittsburgh’s Missing Bridges,” a collaborative reporting project by the Pittsburgh Media Partnership. 

Osher Günsberg opens up about his anxiety and OCD to his old radio co-hosts

The Bachelor’s Osher Günsberg recalls how difficult it was hosting breakfast radio while on ‘heavy drugs’ as he speaks about his anxiety and obsessive compulsive disorder


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Osher Günsberg has talked openly about his mental health struggles and how he was a changed person when he was on ‘heavy drugs’.

The Bachelor host spoke about the difficult time with his old radio co-hosts, Matty Acton, Abby Coleman and Stav Davidson, as his SBS documentary on suicide in Australia, titled Osher Günsberg: A Matter of Life and Death, airs later this month.

The 47-year-old, who suffers from anxiety and obsessive compulsive disorder, said he found it really hard to form emotional relationships while he was heavily medicated. 

Struggles: The Bachelor's Osher Günsberg has recalled how difficult it was hosting breakfast radio while on 'heavy drugs' while speaking about his anxiety and obsessive compulsive disorder

Struggles: The Bachelor’s Osher Günsberg has recalled how difficult it was hosting breakfast radio while on ‘heavy drugs’ while speaking about his anxiety and obsessive compulsive disorder 

‘You guys knew me when I was on a whole lot of meds,’ Osher said during an interview on B105 FM’s Stav, Abby and Matt on Friday.

‘Remember when I told you that I had to come off the meds and I might be a bit weird for a week?’

‘It was so hard for you,’ replied Abby. ‘I found it hard when you were on medication. I found it really hard to connect with you. You were just so disconnected from your emotions.’

The reality TV host explained that he ‘needed to be on those heavy drugs’, but acknowledged there are ‘benefits and side effects’ when it comes to taking medication for mental health issues. 

Open: The Bachelor host spoke about the difficult time with his old radio co-hosts, Matty Acton, Abby Coleman (right) and Stav Davidson (left), as his SBS documentary on suicide in Australia, titled Osher Günsberg: A Matter of Life and Death, airs later this month.

Open: The Bachelor host spoke about the difficult time with his old radio co-hosts, Matty Acton, Abby Coleman (right) and Stav Davidson (left), as his SBS documentary on suicide in Australia, titled Osher Günsberg: A Matter of Life and Death, airs later this month.

‘It made it difficult for me to form emotional relationships. I know that Abby, I know that was hard,’ he continued, before reflecting on the times he went off his medication. 

‘The thing is guys – I couldn’t bear it. It was like running your motorbike in the red. I couldn’t be with that level of isolation of my head and, as I came back on my new meds, it was a lot better.’ 

Osher stated that ‘people have different brains’ and those who struggle with mental health need to be on and off different medication.

'I couldn't be with that level of isolation of my head': Osher reflected on the times he went off his medication. Pictured here with Australian Idol co-host James Mathieson

‘I couldn’t be with that level of isolation of my head’: Osher reflected on the times he went off his medication. Pictured here with Australian Idol co-host James Mathieson 

The TV star revealed this was the main reason he decided to do the documentary in the first place. 

‘This is just another thing that happens for people in our community and it’s no big deal,’ he added.

‘There’s solutions out there, and as long as we treat it like a problem to be solved it’s fine. ‘

Osher Günsberg: A Matter of Life and Death premieres at 8:30pm on Sunday the 19th September on SBS.

Coming soon: Osher Günsberg: A Matter of Life and Death premieres at 8:30pm on Sunday the 19th September on SBS

Coming soon: Osher Günsberg: A Matter of Life and Death premieres at 8:30pm on Sunday the 19th September on SBS


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What Is Trait Anxiety, and How Does It Compare to State Anxiety?

Everyone experiences some level of anxiety from time to time — it’s a natural response to feeling threatened or afraid.

Still, the anxiety that comes up for you will probably depend on different factors, including the specific circumstances of the situation as well as your own unique personality.

Here’s how to tell the difference between state and trait anxiety.

State anxiety

This form of anxiety tends to show up when you face a potential threat or other frightening situation. It usually involves a mix of mental and physical symptoms.

Mental symptoms might include:

  • feelings of worry
  • difficulty concentrating
  • irritability

In-the-moment physical symptoms might include:

  • trouble breathing
  • rapid heartbeat
  • upset stomach
  • muscle tension and pain

Of course, you can also experience state anxiety when there’s no actual physical threat. You just have to believe there’s one.

Say you’ve just received a terse email from your supervisor: “I need to see you in my office ASAP.”

No details, no explanation.

You know you’re not in any danger, and you can’t think of anything you’ve done that might require a reprimand. All the same, you walk down the hall to their office on slightly wobbly legs. You try to comb through your memories of the past few days to figure out what they might want, but your mind has gone completely blank.

Once you sit down in their office and they explain they just wanted to give you a heads-up about a potential software security issue, the wave of relief that crashes over you carries away those feelings of worry and fear.

Trait anxiety

Experts who distinguish between trait and state anxiety consider trait anxiety more of a fixed part of your personality — that’s to say, a personality trait.

A higher level of trait anxiety generally means you’re more likely to feel threatened by specific situations, or even the world in general, than someone with lower levels of trait anxiety.

You might tend to feel more anxious and stressed in everyday circumstances — even those that wouldn’t inspire fear or worry in others. For example:

  • Your partner seems a little distant? You start to worry they want to break up.
  • Still haven’t received any feedback on your thesis idea? Your professor must hate it. In fact, they’re probably trying to think of a way to explain you’re not cut out for a graduate degree, after all.
  • Never heard back from your friend after your last few texts? You must have done something to upset them.

Older research notes four dimensions of trait anxiety:

  • Threat of social evaluation. This might include criticism or conflict.
  • Threat of physical danger. This might include things like illness or car accidents.
  • Ambiguous threat. This might involve a more general sensation of doom or unexplainable worries.
  • Threat in daily routines or harmless situations. This might involve fears around meeting new people or making mistakes in your work.

To put it another way, you might consider trait anxiety something of a predisposition toward experiencing those feelings of worry and fear.

Chronic feelings of anxiety and worry can leave your nervous system on near-constant alert for potential threats. As a result, you might begin to notice longer-lasting anxiety symptoms, such as:

  • changes in your mood, like irritability and unease
  • trouble concentrating on tasks
  • tendency to avoid the source of your fear
  • insomnia and other sleep problems
  • appetite changes
  • fatigue
  • body aches and pains that have no clear cause