Paul Hollywood health: Great British Bake Off judge’s battle with a mental disorder

What is OCD?

American Psychiatric Association said on their website: “Obsessive-compulsive disorder is an anxiety disorder in which time people have recurring, unwanted thoughts, ideas or sensations that make them feel driven to do something repetitively.

“The repetitive behaviours, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.

“For people with OCD, thoughts are persistent and unwanted routines and behaviours are rigid and not doing them causes great distress.”

Lessons on Anxiety From a Stray Cat

During New York City’s harshest weather, snowstorms and heat waves, my kitchen window in Brooklyn is usually open. The screen too. This lets in bugs, dirt, ice, or humidity, depending on the season. I expose myself to these elements so that a stray cat can come in through the window and seek shelter—if he wants to.

I moved into my apartment in the fall of 2014. It’s a first-floor railroad in a brick rowhouse overlooking a garden that none of the tenants have access to. As a result, the yard is a wild place. Its only human trespassers are the occasional handyman or gardener.

The cat appeared shortly after I moved in. He was a small grey and white tabby, with a fuzzy nub on his behind where a tail should be. I named him Nubbin. After seeing him dart through the yard a few times, I bought a can of Friskies, put it on a plate on the windowsill, and was happily surprised when he came and ate it all up. Now, I feed Nubbin two or three times a day.

Nubbin is an anxious and neurotic creature. He won’t let me pet him. When I put out his food, he jumps away and returns only when I’ve moved out of sight. When I proudly gave him a salmon filet I had bought and cooked just for him (I’m vegan), he didn’t take a single bite. Nor would he consider eating the seafood medley Fancy Feast I offered him. I’ve since learned he won’t eat anything but chicken-flavored food, or the original flavored Meow Mix dry food.

I’m an anxious and neurotic creature, too. I have issues around certain foods and textures, and eating in front of others. When I was a kid, I worried about germs and the cleanliness of my hands. I worried constantly that I was going to throw up or choke. I worried about whether my teachers hated me, and that a disease was slowly destroying all the cells in my body. As I got older, these anxieties persisted, and I eventually got a diagnosis of OCD, or obsessive-compulsive disorder.

A friend who lived in my apartment right before me told me he never saw any cat, not in the yard, and definitely not on the windowsill. I’ve decided Nubbin is a companion especially for me—a kind of spiritual familiar brought forth to teach me lessons, though ultimately, not the ones I expected.

When I met Nubbin in 2014, I was two years into talk therapy. As an adult, my contamination and illness phobias had remained, as did the fear of vomiting. I also developed a crippling amount of perfectionism; a desire to perform at an exceptional level—or not at all, nothing always being better than subpar.

Before therapy, I had resorted only to unhealthy means to quiet my frequently anxious mind. Heavy use of drugs and alcohol was one strategy, to smother anxious thoughts with inebriation. Avoidance was another. I simply did not do anything that made me anxious. To ward off perfectionism, I would skip, or completely ghost, classes—and nearly failed out of undergraduate college as a result. I avoided long car rides I thought would make me puke, or foods I thought would make me sick.

A more complex tack: completing a ritual of my own invention, like buying and throwing away groceries unopened or obsessively going to the doctor and getting medical tests and scans. There was one eight-month period during which I subjected myself to all sorts of painful tests, like an EMG, which sticks electrode needles into your muscles and shocks them. At the time, I was convinced I had Multiple Sclerosis. I even signed myself up for a spinal tap, until my partner was somehow able to convince me not to go through with it. These strategies were attempts at achieving my ultimate goal: a mind free from intrusive thoughts. If only I could know for sure that I didn’t have MS, or that I wouldn’t throw up, or that I wouldn’t do a bad job on anything, then I wouldn’t have anxious thoughts anymore, right?

With the help of therapy, by 2016, I was a lot better at coping. I had managed to go to graduate school, complete prestigious internships, and was launching my career while in a stable relationship. But despite—or maybe because of—my being so busy, OCD was creeping back into my life.



I was bogged down with rituals and intrusive thoughts again, and barely hanging on to my newfound functionality. So I enrolled in a clinical trial for Cognitive Behavioral Therapy (CBT) targeted at OCD. I excitedly thought that by the end of the trial, I wouldn’t have obsessions anymore, and that I’d regain complete control over my thoughts. I was wrong.

The trial incorporated a concept new to me: Acceptance and Commitment Therapy, or ACT. ACT is not about changing your thoughts at all—it asks you to accept that anxious thoughts exist, and instead shift the way you react to them. It was developed in 1982 by Steven Hayes, now a clinical psychologist at the University of Nevada, Reno. Hayes said the idea behind ACT emerged out his own anxiety disorder, which he described as a mix of panic disorder and social anxiety, with some obsessive compulsive features.

“I did all the logical, reasonable, sensible, pathological things people do with anxiety,” he told me. “I tried to run from it, tried to fight it, tried to hide from it.” None of that helped. So he stopped fighting, and ACT was born.

“We spend a lot of time trying to control anxiety and depression,” said Jon Ambramowitz, a clinical psychologist at the University of North Carolina and an OCD expert. “From an ACT perspective, we’re going to stop playing tug of war, we’re going to put down the rope. Instead of trying to win the game, we’re just going to say, ‘Okay, this is what I’m feeling right now.’ And learn how to be flexible and still do the things that we value in our life.”

The word “acceptance” can be misconstrued in ACT. It’s not about accepting that you will never get better, that you should give up, that you should never challenge yourself again. As I would learn, it was much more challenging to do nothing in the face of anxiety than to do something.

The exposure therapy part of cognitive behavioral therapy for OCD—in which someone with a phobia, say of germs, intentionally faces their fears, like by eating food off the ground—is notoriously difficult. But it was the ACT that I couldn’t grasp. Anxiety is your body’s alarm system and tells you when you are in danger. As such, anxious thoughts demand action. They beg you to do whatever it takes to make them go away. ACT is somewhat like lighting yourself on fire and trying not to move.

It seemed terribly wrong, even evolutionarily backwards, to simply let anxious thoughts continue to exist and live my life anyway. Abramowitz said this is a common misconception about treatment. “People come looking for a fix for their anxiety, but what we want to fix is their relationship to their anxiety,” he said.

I wanted certainty and control, not psychological flexibility. When I realized that the trial wouldn’t wash my mind clean of anxious thoughts, I dropped out.

Around the same time, I was determined to gain Nubbin’s affection. As he was eating, I’d hover just out of sight, psyching myself up to stick my hand out and pet him, even though I knew he would hate it. (I could never bring myself to do it.)

I tried putting his food on the inside of the windowsill to lure him in. He would bend down to take a mouthful of food, then hastily move outside to chew. This ploy to get him inside would leave behind a mess of extra food, attracting hordes of ants.

This is about the time I started buying extravagant wet food flavors and cooking filets of fish for him—all of which he turned his nose up at. On one of our many trips to the local bodega, the woman who rang us up asked how many cats we had. “None,” my boyfriend replied dryly. Her eyes widened ever so slightly as she bagged our cans of Friskies.

During a cold snap in early 2017, the temperature dropped so low that Nubbin finally relented. I had fed him and left the screen open, as I always did, and walked away into the next room. I heard a gentle plop on the ground and excitedly peeked into the kitchen. Nubbin had crossed the threshold.

For the next few days, he continued to come in from the cold. When I opened the screen, he’d sprint past us and into the living room, where he’d spend an hour or so napping on the couch. I was elated and immediately started scheming how I could further manipulate the situation to make this the new normal.

One night, after we had closed the kitchen window and gone to sleep, I woke up to a loud bang in the kitchen. Unbeknownst to me, Nubbin had still been inside. He was desperately trying to get out by launching his body against the glass, while yowling the horrible screech of a cat in distress. He hit the windowpane so hard he knocked the curtains down.

I rushed to open the window, but trying to advance while a cat-sized bullet ricocheted around me proved difficult. I caught sight of Nubbin’s face—ears flattened to his head and black pupils widened in panic—and felt a rush of guilt. How could I explain to Nubbin that if he just calmly waited, stopped trying so hard to escape, I could let him back out?

Seeing him crash into the glass over and over was a mirror I didn’t want to look into. I myself was constantly bashing into my anxious thoughts, frantically trying to escape them through brute force. But like Nubbin, all I was doing was hurting myself. If I could just be still, let the thoughts exist, they might eventually let me free.

When I finally got the window open, he shot out into the snowy night.

For almost five years, I tried to change this stray cat. I strove to break his resolve, make him less scared, more domesticated, more normal. For that same time period, I was also trying to change my thoughts. To shove them out of my mind through ritual, numb them with substances, or take great pains to avoid them altogether.

But as it turned out, that didn’t help either of us. The lesson I needed, which I eventually arrived at, was about giving up the one thing I prize the most: control.

When I see Nubbin sleeping in some corner of the yard, I ache to know that he’ll always be ok. It’s hard not knowing know where he is much of the time. One day, he could stop showing up, leaving me with a half-used stock of cat food and wondering whether he’s alive. Controlling him feels like the only solution to avoiding heartbreak, just like ruling my mind with an iron fist seemed like the only way to make it through each day. But in the end, I can’t make Nubbin come inside or rub his face against my hand any more than I can become a person who doesn’t have OCD.

I’ve been in CBT again for about two years, and am working with ACT again. In exposure therapy, I do things like eat yogurt that’s been sitting out (a trigger for my contamination anxieties), or imagine that people think I’m terrible at my job. When I do these things, the floodgates of anxiety open up. Instead of frantically swimming against the tide, splashing and exerting all my energy, I float. I try to accept that just because those thoughts are there doesn’t mean I have to do anything about them. That I’m not a failure for thinking them in the first place. A thought in my head can tell me a situation is unmanageable or unsafe, that I am imperfect, that a food will cause me harm, and I can let the thought exist—while living my life anyway.

Having a mental illness can make you feel like a failure. Simple tasks are exhausting—keeping a job, socializing, eating, having relationships, running errands, walking down the street. I don’t actually have to change that. ACT isn’t a panacea, but it is a tool for managing my anxiety during those basic activities.

I won’t go as far as to say that a cat single-handedly taught me how to let go of my need for certainty. But making peace with the fact that I couldn’t control him, and with the fact that my efforts were actually hurting him, did give me a tangible, visceral example of how little use—and even how damaging—holding on to control can be.

When new friends hear about Nubbin, they have all sorts of ideas for how I could make him mine. I could force him inside until he eventually adjusts, or put a GPS collar on him to see where else he goes. I’ll admit, it still tempts me.

But I don’t have to change Nubbin to have a relationship with him, to enjoy his presence. I don’t have to change my thoughts in order to be healthy, to enjoy my life. That’s a kind of freedom I never imagined myself having, as someone who previously thought I would be a broken person with anxious thoughts until the day I’d be a fixed person with no anxious thoughts. When the lesson was wrapped in a furry package, it was easier for me to receive.

I tend to get up early, when the sun is just starting to rise. Nubbin is usually waiting on the windowsill. We eat breakfast together in the silent morning light. When he’s done eating his original-flavored Meow Mix, he sticks around—tucking his paws under his body and gently closing his eyes while I write or send emails. I’ve still never touched him, but I’m finally okay with that.

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This article originally appeared on VICE US.

Here is what you need to know about mental health

Mental health is described as the level of psychological well-being or an absence of mental illness.

It is the stat of someone who is “functioning at a satisfactory level of emotional and behavioral adjustment “from the perspectives of positive psychology, mental health may include an individual’s ability to enjoy life activities and effort to achieve psychological resilience.

According to World Health Organization (WHO), mental health includes “subjective well-being, perceived self-efficiency, autonomy, competence inter-generational dependence, and self-actualization of one’s intellectual and emotional potential among others”

According to the U.K surgeon journal (1999), mental health is the successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and providing the ability to adopt to change and cope with adversity

Mental health problems might arise due to stress, loneliness, depression, anxiety, relationship problems, death of a loved one, suicidal thoughts, grief, addiction, attention deficit hypo activity disorder, self-harm or various mood disorders. Therapist, psychiatrist, psychologists and social workers can help manage mental illness with treatment such as therapy, counselling or medication but these aids can only help the person if he/she themselves want to be alright. A mentally healthy person can run and lead into every walk of life. Where as a person having mental illness often seems to be absent minded and inactive in every situation

Unemployment has been shown to have a negative impact on an individual’s emotional well-being, self-esteem and more broadly their mental health.

 Examples of mental illness include a depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.

Signs and symptoms of mental illness can vary, depending on the disorder, circumstances and other factors.

Mental illness symptoms can affect emotions, thoughts and behaviors; they include: feeling sad or down, confused thinking or reduced ability to concentrate extreme mood changes of highs and lows, withdrawal from friends and activities, significant tiredness and detachment from reality(delusions),paranoia hallucinations and suicidal thoughts.

Some symptoms of a mental health disorder appear as physical problems, such as stomach pain, back pain, headaches, or other unexplained aches and pains.

 Mental illness is a general term for a group of illness that may include symptoms that can affect a person’s thinking, mood or behavior. Mental illness can make it difficult for someone to cope with work, relationships and other demands.

The relationship between stress mental illness is complex but itis known that stress can worsen an episode of mental illness Most people can manage their mental illness with medication counselling or both. Here we list some of the more common mental health issues mental illnesses

1-ANXIETY DISORDER:

It is a group of mental health disorders that includes generalized anxiety disorder social phobias, panic disorders, obsessive compulsive disorder post-traumatic stress disorder. If we don’t take it serious so it may lead to impairment on people’s daily lives

2-BEHAVIORAL AND EMOTIONAL DISORDER IN CHILDERN:

It is very common in children including oppositional defiant disorder, conduct disorder. It can be treated by therapy, education mediation

3-BIPOLAR AFFECTIVE DISORDER

This is a type of mood disorder; I referred, as manic depressions. A person with this condition experiences episode of mania and depression. The person may be or may not be experience psychotic symptoms. The exact cause is unknown. It may trigger through environmental stress

4-DEPRESSION:

Depression is a kind of mood disorder characterized by lowering of mood, Loss of interest and enjoyment and reduced energy. It is not just feeling sad. These are different types of symptoms of depression it may lead to the levels of severity. Suicidal thoughts the worst risk of depression

5-DISSOCIATION DISSOCIATIVE DISORDERS:

It is a mental process where a person discount from their thoughts, feelings, memories and send of identity

6-EATING DISORDER:

It include anorexia, bulimia-nervosa. And other binge eating disorders of feet both females males can have serious psychological physical consequences

7-OBSESSIVE COMPULSIVE DISORDERS:

Obsessive compulsive disorder is an anxiety disorder. Obsession is recurrent thoughts, images or impulses that are intrusive and unwanted. Compulsions are time consuming and repetitive ritual. It may treated by cognitive behavior therapy and medication

8- PARANOIA:

 It is the irrational and persistent feeling that peoples are out to get you: paranoiac may be a symptom of conditions including paranoid personality disorders delusional disorder and schizophrenia. It is treated by medications and psychological support

9-PSYCHOSIS:

People affected by psychosis can experience delusions: hallucinations and confused thinking it can occur in a number of mental illness including drug induced psychosis, Schizophrenia and mood disorders. Medications and psychological support can relieve or even eliminate psychosis symptoms.

10-SCHIZOPHRENIA:

It is complex psychotic disorder characterized by disruptions to thinking and emotions and a distorted perception of reality. Symptoms are hallucinations, delusions, thought disorder: social withdrawal limit lack of motivation impaired thinking and memory. Schizophrenic patients are at high side of suicide.

More more people recognizing that they are suffering from troubles such as depressions and anxiety, or that people they know all. Raising our own awareness about it can help us do a few things. Oue, it helps make it okay to reach out for help, whether that be by telling with people we know trustor speaking with a helping professional. Two, becoming more aware of mental health in general helps us become more empathetic with people who may be troubled by concerns such as depression, anxiety or social anxiety. It may help us to reach out to people who we think may need our support. Third, awareness can also help us learn what is being offered through our workplace, our community, our provinces, and our nation.

Here, Some things that you can do for your mental health

  1. Treat yourself with kindness and respect, and avoid self-criticism. Make time for your hobbies and favorite projects. Or broaden your horizon
  2. Taking care of yourself physically can improve your mental health. Be sure to eat nutritious meals, avoid cigarettes, drink plenty of water exercise which helps decrease depression and anxiety and improve mood Get enough sleep.
  3. Surround yourself with good people. People with strong family of social connection are generally healthier than those who take a support network.
  4. Volunteer your time and energy to help someone else. You’ll feel good about doing something tangible to help someone in need.
  5. Like it or not stress is a part of life. Practice good coping skills. Try one minute Stress strategies. Research shows that laughter can boost immune system ease pain, Relax your body reduce stress
  6. Try mediating, mindfulness and prayer relaxation exercise and prayer can improve your state of mind and outlook on life
  7. Decide what you want to achieve academically, professionally and personally and write down the steps you need to realize your goals. Aim high but realistic and don’t over schedule
  8. Although our routines make us more efficient and enhance our feelings of security and safety a little change of pace can perk up a tedious
  9. Keep alcohol use to a minimum and avoid other drugs. Sometimes people use alcohol and other drugs to self-medicate but in reality alcohol and other drugs only aggravate problems
  10. Seeking help is a sign of strength not a weakness and it is important to remember that treatment is effective. People who get appropriate care can recover from mental illness and addiction and lead full, rewarding lives

Brain Immune Cells Linked to OCD and Anxiety

According to the National Institute of Mental Health, 1 in 3 people experience debilitating anxiety—the kind that prevents someone from going about their normal life. Women are also more at risk to suffer from anxiety. Yet the roots of anxiety and other anxiety-related diseases, such as Obsessive Compulsive Disorder (OCD), are still unclear. In a new study, scientists discovered a new lineage of specialized brain cells, called Hoxb8-lineage microglia, and established a link between the lineage and OCD and anxiety in mice.

Mice with disabled Hoxb8-lineage microglia exhibited excessive overgrooming behavior. The symptom resembles behavior in humans with a type of OCD called trichotillomania, a disorder that causes people to obsessively pluck out their own hair. Their experiments proved that Hoxb8-lineage microglia prevent mice from displaying OCD behaviors. Additionally, they found that female sex hormones caused more severe OCD behaviors and induced added anxiety in the mice.

“More women than men experience debilitating anxiety at some point in their lives. Scientists want help these people to get their lives back. In this study were able to link anxiety to a dysfunction in a type of microglia, and to female sex hormones,” said lead author Dimitri Tränkner. “It opens up a new avenue for thinking about anxiety. Since we have this model, we have a way to test new drugs to help these mice and hopefully at some point, this will help people.”

Discovery of a new microglia lineage

Microglia are crucial during brain development in the womb—they ensure that brain structures and neural circuitry all wire together correctly. Tränkner and colleagues showed that microglia belong to least two distinct sub-lineages of cells. One lineage called Hoxb8-lineage microglia makes up about 30% of all microglia in the brain but until now, no one knew whether they had any unique function.

Mario Capecchi, senior author of the study, had long suspected that Hoxb8-microglia were special. In previous research, he disabled Hoxb8-lineage microglia expecting some impact on development. But the mice seemed fine.

‘We didn’t really know what to make of the fact that mice without Hoxb8 appear so normal, until we noticed that they groom significantly more and longer than what would be considered healthy. And that’s how the whole thing started,” said Capecchi.

This is the first study to describe microglia’s role in OCD and anxiety behaviors in mice.

“Researchers have long suspected that microglia have a role in anxiety and neuropsychological disorders in humans because this cell type can release substances that may harm neurons. So, we were surprised to find that microglia actually protect from anxiety, they don’t cause it,” added Tränkner.

Female sex hormones drive symptom severity

The mice showed sex-linked severity in their symptoms; female mice’s OCD symptoms were consistently more dramatic than in the males. Females also exhibited an additional anxiety symptom that was lacking in male mice—the researchers designed and validated a new test showing that the pupils of female mice dilated dramatically, triggered by a fight-or-flight stress response.

To test whether sex hormones drove OCD and anxiety symptoms, Tränkner and colleagues manipulated estrogen and progesterone levels in the mice. They found that at male-levels, female mice’s OCD and anxiety behaviors resembled the male response, and at female hormone levels, male mice’s OCD behaviors looked more like the female’s severe symptoms and showed signs of anxiety.

“Our findings strongly argue for a mechanistic link between biological sex and genetic family history in the risk to develop an anxiety disorder,” said Tränkner.

What does this mean for humans?

For many, anxiety drastically impacts their work, friends, family and lifestyle. Scientists and health care professionals are always looking for ways to help people get their lives back. This study of mouse models links anxiety to dysfunctional microglia. Down the line, the findings could spark new microglia-focused studies in patients with anxiety and, eventually, help to better treat this debilitating disorder.

“It’s not that we discovered how to fix anxiety in humans, but we constructed a platform for the discovery of new drugs against anxiety,” Tränkner said.

Reference

Tränkner et al. (2019) A Microglia Sublineage Protects from Sex-Linked Anxiety Symptoms and Obsessive Compulsion. Cell Reports. DOI: https://doi.org/10.1016/j.celrep.2019.09.045

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

Feelings Of Hope Linked To Better Recovery From Anxiety Disorders, Study Suggests

When it comes to mental health, everybody’s experience differs, and so there is no immediate one-size-fits-all treatment. A new study in Behavior Therapy suggests that there is a key element that can help those dealing with anxiety, though. Don’t underestimate the importance of hope, they say.

Hope, according to the study, is a strong predictor of recovery from anxiety disorders, and therapists that incorporate it into cognitive-behavioral therapy (CBT) are more likely to see increasingly positive results from their patients in recovery.

While “hope” is a rather broad term, in psychology circles it is associated with other positive constructs, like optimism and self-efficacy, which have been linked to resilience to emotional disorders and shown to motivate recovery. In psychotherapy circles, it represents the capacity of a patient to identify strategies to achieve goals, and the motivation to pursue those strategies.

The study, led by Dr Matthew Gallagher of the University of Houston, is part of a much larger project on the efficacy of cognitive-behavioral therapy (CBT) for anxiety disorders. For this particular research, Gallagher and co. examined the role of hope in predicting recovery by putting together a clinical trial assessing 223 adults currently in transdiagnostic CBT, disorder-specific CBT, or, as a control group, waitlisted for CBT for four common anxiety disorders: panic disorder, social anxiety, obsessive-compulsive disorder, and generalized anxiety disorder.

Their results indicated that hope gradually increases during a course of CBT across all four disorders, and that increases in hope were experienced at a much greater level by those in active treatment compared to those waitlisted. Moderate-to-large increases in hope and changes in hope were consistent across all CBT treatment protocols. This, the researchers concluded, shows that instilling hope is a key factor in promoting recovery.

“In reviewing recovery during CBT among the diverse clinical presentations, hope was a common element and a strong predictor of recovery,” Gallagher said in a statement

“Our results can lead to a better understanding of how people are recovering and it’s something therapists can monitor,” he added. “If a therapist is working with a client who isn’t making progress, or is stuck in some way, hope might be an important mechanism to guide the patient forward toward recovery.”

Though encouraging hope can have a positive outcome, it’s also important to note that putting pressure on patients to feel things they perhaps don’t, or can’t at that time, may have a detrimental effect. On the other hand, there is the argument that without anxiety there can be no hope

Link found between unique brain cells and OCD, anxiety – News

According to the National Institute of Mental Health, 1 in 3 people experience debilitating anxiety-;the kind that prevents someone from going about their normal life. Women are also more at risk to suffer from anxiety. Yet the roots of anxiety and other anxiety-related diseases, such as Obsessive Compulsive Disorder (OCD), are still unclear. In a new study, University of Utah scientists discovered a new lineage of specialized brain cells, called Hoxb8-lineage microglia, and established a link between the lineage and OCD and anxiety in mice.

Mice with disabled Hoxb8-lineage microglia exhibited excessive overgrooming behavior. The symptom resembles behavior in humans with a type of OCD called trichotillomania, a disorder that causes people to obsessively pluck out their own hair. Their experiments proved that Hoxb8-lineage microglia prevent mice from displaying OCD behaviors. Additionally, they found that female sex hormones caused more severe OCD behaviors and induced added anxiety in the mice.

More women than men experience debilitating anxiety at some point in their lives. Scientists want help these people to get their lives back. In this study were able to link anxiety to a dysfunction in a type of microglia, and to female sex hormones. It opens up a new avenue for thinking about anxiety. Since we have this model, we have a way to test new drugs to help these mice and hopefully at some point, this will help people.”

Dimitri Traenkner, research assistant professor in the School of Biological Sciences at the University of Utah and lead author

The study published today in Cell Reports.

Discovery of a new microglia lineage

Microglia are crucial during brain development in the womb-;they ensure that brain structures and neural circuitry all wire together correctly. Traenkner and colleagues showed that microglia belong to least two distinct sub-lineages of cells. One lineage called Hoxb8-lineage microglia makes up about 30% of all microglia in the brain but until now, no one knew whether they had any unique function.

Mario Capecchi, Nobel laureate and senior author of the study, had long suspected that Hoxb8-microglia were special. In previous research, he disabled Hoxb8-lineage microglia expecting some impact on development. But the mice seemed fine.

‘We didn’t really know what to make of the fact that mice without Hoxb8 appear so normal, until we noticed that they groom significantly more and longer than what would be considered healthy. And that’s how the whole thing started,” said Capecchi, who is also a distinguished professor of human genetics at the University of Utah Health.

This is the first study to describe microglia’s role in OCD and anxiety behaviors in mice.

Researchers have long suspected that microglia have a role in anxiety and neuropsychological disorders in humans because this cell type can release substances that may harm neurons. So, we were surprised to find that microglia actually protect from anxiety, they don’t cause it,” added Traenkner.

Female sex hormones drive symptom severity

The mice showed sex-linked severity in their symptoms; female mice’s OCD symptoms were consistently more dramatic than in the males. Females also exhibited an additional anxiety symptom that was lacking in male mice-;the researchers designed and validated a new test showing that the pupils of female mice dilated dramatically, triggered by a fight-or-flight stress response.

To test whether sex hormones drove OCD and anxiety symptoms, Traenkner and colleagues manipulated estrogen and progesterone levels in the mice. They found that at male-levels, female mice’s OCD and anxiety behaviors resembled the male response, and at female hormone levels, male mice’s OCD behaviors looked more like the female’s severe symptoms, and showed signs of anxiety.

“Our findings strongly argue for a mechanistic link between biological sex and genetic family history in the risk to develop an anxiety disorders,” said Traenkner.

What does this mean for humans?

For many, anxiety drastically impacts their work, friends, family and lifestyle. Scientists and health care professionals are always looking for ways to help people get their lives back. This study of mouse models links anxiety to dysfunctional microglia. Down the line, the findings could spark new microglia-focused studies in patients with anxiety and, eventually, help to better treat this debilitating disorder.

“It’s not that we discovered how to fix anxiety in humans, but we constructed a platform for the discovery of new drugs against anxiety,” Traenkner said.

University of Utah

Tränkner, D., et al. (2019) A Microglia Sublineage Protects from Sex-Linked Anxiety Symptoms and Obsessive Compulsion. Cell Reports. doi.org/10.1016/j.celrep.2019.09.045.

Ontario program helps treat anxiety disorders during and after pregnancy that largely go unrecognized


Open this photo in gallery

Lacey Kempinski with her two sons, Pete, 4 and Zack, 2, taken in Paris, Ont., on Oct. 29, 2019.

Glenn Lowson/The Globe and Mail/The Globe and Mail

Lacey Kempinski’s first six months of motherhood were a blur of anxiety. She was terrified of dropping her first-born son down the stairs. She put signs up around the house to remind visitors to wash their hands before touching him and had trouble breathing when he was taken out of her sight. “There weren’t a lot of joyful moments,” said Ms. Kempinski, of Paris, Ont.

While pregnant with her second son, she was diagnosed with perinatal anxiety and enrolled in an experimental therapy program in Hamilton – one of the few in Canada for a condition that goes largely unrecognized, even though it is estimated that one in five women meet the diagnostic criteria for an anxiety disorder during pregnancy and the first year after delivery.

Now, after two years of monitoring participants and their outcomes, the program’s creators are sharing their findings in the hope that more women will get help.

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Clinical and health psychologist Sheryl Green said she created the program at the Women’s Health Concerns Clinic at St. Joseph’s Healthcare because she found no existing guidelines, recommendations or treatment protocols for women with perinatal anxiety – even though her clinic receives more referrals for this condition than for any other.

“Postpartum depression is on everybody’s radar, and that’s fantastic,” Dr. Green said. But since perinatal anxiety can also negatively affect everything from labour and delivery to the child’s development, “it is so incredibly important to have this effectively identified and treated.”

Perinatal anxiety is believed to be more common than postpartum depression, but it receives relatively little attention. Many women mistake their symptoms for the expected jitters of new parenthood, and those who do recognize that they have anxiety have few treatment options, especially non-pharmacological ones.

Postpartum depression often includes feelings of hopelessness or inadequacy and an inability to experience pleasure, whereas perinatal anxiety can involve excessive worrying, intrusive anxious thoughts, panic attacks and avoiding people, places or activities out of fear. Some women can experience both conditions concurrently (singer Alanis Morissette recently opened up about her own experience with both depression and anxiety after the birth of her third child).

While some psychiatric medications are considered safe during pregnancy, they are not risk-free, Dr. Green said, so many women are reluctant to take them while pregnant or nursing. Moreover, medication does not always deliver adequate relief.

So, she gathered elements of existing cognitive-behavioural therapy (CBT) programs for treating various anxiety and mood disorders, and assembled them into her own perinatal program.

CBT, a form of therapy aimed at changing dysfunctional thoughts and behaviours, is effective for treating anxiety disorders, but women who are pregnant or postpartum have very specific needs, Dr. Green said. Given the demands of motherhood, she shortened the typical CBT protocol of 12 sessions to six weekly group sessions and allowed women to bring their babies. She also made the content applicable to the concerns new mothers commonly face, from finances and work to relationships and personal identity.

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She and her team recently finished a two-year randomized control trial to test the program and said the results are encouraging. Women who participated in the six-week program had significant improvements in their anxiety symptoms, regardless of whether they were symptoms of social anxiety, obsessive-compulsive disorder (OCD) or any other type of anxiety, said Eleanor Donegan, a clinical and health psychologist and research analyst at the clinic.

They also had reduced depression and stress and maintained these improvements in a three-month follow-up.

Identifying women with perinatal anxiety is nevertheless a challenge. Nichole Fairbrother, a clinical associate professor at University of British Columbia’s department of psychiatry, who was not involved in the trial, said women with OCD can be reluctant to reveal that they have unwanted thoughts of harming their babies.

Even though they are not at risk of acting on those thoughts, she said, “no one talks about it because it’s terrifying to people to talk about.”

She said it is unlikely pregnancy or childbirth actually trigger most types of anxiety. But even if a woman’s anxiety predates her pregnancy, it is important to address it during the perinatal period, as it can affect the developing fetus, the woman’s birth experience and her parenting, Dr. Fairbrother said.

In Hamilton, the clinic continues to offer the program, which is covered by the province, and the team expects to publish its findings soon and is sharing its CBT protocol with other experts.

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Ms. Kempinski said she still uses some of the things she learned from the program, even though her sons are now 4 and almost 2. For example, when she panics, she uses something called the “best friend” technique: She thinks about what she would tell her best friend in the same situation. Another strategy involves thinking through all the “what if” scenarios and considering the likelihood of the worst possible outcomes.

The techniques don’t work all the time, she said, but she has learned to be easier on herself when she recognizes that she is having an anxious moment.

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Lauv Opens Up About His Battle with Depression and OCD: ‘I Had Fallen Out of Love with Everything’

PEOPLE is launching a year-long initiative to encourage readers to have vital conversations about their mental health. Our Let’s Talk About It campaign will highlight the stories of both ordinary people and celebrities who have dealt with mental illness and provide resources about where to get help and how to offer support to others. 

As more stars are being candid about their struggles with mental health, Lauv has joined the conversation and continues to open up about his experience.

In a post he shared on Twitter, the “I Like Me Better” singer, 25, revealed that he was dealing with a “case of intense obsessive anxiety and depression.” With support and encouragement from loved ones, Lauv decided to see a psychiatrist. In a heartfelt essay written exclusively for PEOPLE, he details his journey dealing with obsessive compulsive disorder and depression. —Darlene Aderoju

Lauv

Why is it that our generation seems to be more depressed and anxious than ever before? Or is it just that we’re talking more about it now?

Whether the latter is the case or it’s truly a result of the life we’re living —  a life full of distractions, constant information overload, social media syndrome (constant self-comparison, heightened insecurity, an unquenchable need for approval, and the endless dopamine loop) — it’s clear that this topic is more top of mind than ever.

We see more and more people opening up about their own experiences and encouraging others to do the same.

I was extremely nervous to open up about my struggles, especially before I was diagnosed with OCD, or obsessive compulsive disorder, and depression. This was largely due to a voice in my head that constantly told me my experiences were invalid.

RELATED: 5 Things to Know About ‘I Like Me Better’ Singer Lauv

In reality, I had spent almost the entire month of January in bed, trapped by obsessive negative thoughts and the need to organize them. My anxiety was at an all-time high, perpetually making me feel like life was on the brink of imploding.

But in my head, I thought I just had to think my way out of it. In reality, I had fallen out of love with everything I used to care about, including the one thing that always brought me purpose: music.

I was living with a vague, haunting sense of disconnection from everyone else (almost as if a blanket had been placed between me and the world). But in my head, I just had to find the one fix (which, by the way, was an ever-changing, made-up idea I had created in my mind).

Distraught and exhausted, I decided to let my friends and family in. And that helped a lot. But after weeks of endlessly cycling conversations with my friends, family and team, I realized I was stuck.

The thing with OCD is that talking about your obsessions can feel really good — like really, really good — because that is the compulsion: the act of relief. But that relief only lasts for a moment. Then, it’s back to obsessing.

Lauv

RELATED: How to Recognize a Mental Health Crisis — and What You Can Do to Help

I kept trying to pinpoint the fix for my sadness, but one of my best friends, who had his own struggles with bipolar disorder, told me I might “just actually be depressed.”  I didn’t understand what he meant, and I shrugged it off. It got worse.

At that point, my sister, who also had her own stint with extreme anxiety, was begging me to go see a psychiatrist. I knew therapy would be part of it, but medication? Reluctantly, I made an appointment with a psychiatrist.

I was diagnosed with OCD and clinical depression and was urged to get on medication. I could write a whole other article about my struggles with the decision to get on medication and the ups and downs of it all, but for the sake of staying on topic I’ll just say: in combination with therapy and a consistent practice of meditation, they worked really well for me.

As I started finding clarity and stability, I decided to open up to the world about my story. Growing up in a family where drawing attention to yourself was not highly encouraged, I was really nervous.

I began beating myself up before I even did anything. But after going through what I went through and having reflected on how the people around me who shared their struggles really helped me, I felt like I had to tell my story.

Still, as I was posting the note on my Instagram, I found myself coming up with every possible negative comment in my head, every possible reason that I was actually a fake and that I should just shut up. Luckily, I didn’t.

Looking back, I wonder if this feeling is the very thing that has historically kept people guarded. Perhaps this is the reason why there is such a prevalence of depression and anxiety, why the male stereotype has sustained emotional stoicism, why there is an abundance of people who feel lost, out of touch with themselves, and at worst, maybe it’s part of the reason why there are so many cases of unexplained suicide.

Perhaps it’s because we’ve undervalued emotional vulnerability for too long. Perhaps we’re so used to being emotionally out of touch that, when we experience moments of being in touch, it’s frightening. Perhaps we’re so used to dealing with it all ourselves, that when the opportunity arises to open up, we feel shame. Or we simply don’t know how.

Lauv

So, while it might start to seem that the increasing conversations about anxiety and depression are becoming cliché, we have to remember what’s really happening here. We are creating a new world where speaking up about one’s own problems is a good thing. A world where we find synchronicity with ourselves and analyze our feelings and experiences openly before they become unmanageable and life-destroying.

Could it be said that, in opening up about our mental health, we are facing a universal fear — the fear of not being accepted — and training ourselves to become less afraid of vulnerability in the future? Is it possible that we are creating a roadmap for a stronger generation and even stronger generations to come? I think so.

If you or someone you know is considering suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), text “STRENGTH” to the Crisis Text Line at 741-741 or go to suicidepreventionlifeline.org.

Anxiety Disorders: Hope is a Major Factor To Help Recovery – E

Hope is closely related to other positive psychology constructs, such as self-efficacy optimism, that have also been shown to have clear relevance to promoting resilience to recovery from emotional disorders

Within the positive realms of psychotherapy: “hope represents the capacity of patients to identify strategies or pathways to achieve goals, and the motivation to effectively pursue those pathways”. This succinct statement holds very true, and if sufferers can get the care they need, and have a psychologist who they feel they have some form of rapport and trust with, they could be motivated to see light at the end of the tunnel, which can make remarkable transformations possible.

A Beacon of Light

Matthew Gallagher, an associate professor of clinical psychology, at the University of Houston, has stepped up, and taken a stand on an age-old debate, the importance of hope. Indeed, back in the 16th century: “Martin Luther celebrated its power, claiming “Everything that is done in this world is done by hope. [Yet], two centuries later, Benjamin Franklin warned that “He that lives upon hope will die fasting.” [But taking his informed stand], Gallagher reports that psychotherapy can result in clear increases in hope and that changes in hope are associated with changes in anxiety symptoms”.

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So What Does the Research Say?

Writing in the journal, Behavior Therapy, Gallagher states that: “hope is a trait that predicts resilience and recovery from anxiety disorders”, and he has empirical evidence to prove it. – The clinical trial in which he is the first author, involves 223 adults, and puts a spotlight on how strong participants’ feeling of hope is, when it comes to anticipating recovery. The subjects received CBD (cognitive behavior therapy), for one of four well known anxiety disorders: obsessive-compulsive disorder; generalized anxiety disorder; panic disorder, and social anxiety disorder.

Gallagher, who noted that average-to-large rises in the participants’ feelings of hope, were uniform across the five detached cognitive behavioral treatment programs, remarked: “In reviewing recovery during CBT among the diverse clinical presentations, hope was a common element and a strong predictor of recovery”.

Of note, the conclusion drawn by the study authors, shows that at some point during the cognitive behavioral therapy protocol: “hope gradually increases during the course of CBT, and increases in hope were greater for those in active treatment than for those in the waitlist comparison”. – This is promising news indeed, and a wonderful accomplishment which was brought about by holistic therapy, as opposed to pharmaceuticals, with all their unwelcome side effects, and open ended use.

This very welcome study forms part of a bigger undertaking which examines CBD’s efficacy for the treatment of anxiety disorders. It is chaired by the founder and director emeritus of the Boston University Center for Anxiety and Related Disorders, David H. Barlow.

Excessive worrying? A psychologist sees a spike in anxiety and offers tips.

My patients worry about work, relationships, children, health and money. When worrying becomes persistent, long-lasting and difficult to control, it can seriously affect daily life. And if the unrelenting worry is accompanied by anxiety symptoms such as irritability, difficulty concentrating, muscle tension, fatigue and poor sleep, that person may be suffering from something called generalized anxiety disorder (GAD).

Investigators Suggest Better Predictors to Diagnosing Mental Illness

Claire Gillan, PhD

Claire Gillan, PhD

In a new study, investigators suggest a need for more individualized approaches to defining mental illnesses because of substantial overlap across different disorders.

A team of investigators, led by Claire M. Gillan, PhD, School of Psychology, Trinity College Institute of Neuroscience and Global Brain Health Institute, recently completed a 285-patient cross-sectional study in the US for individuals diagnosed with obsessive-compulsive disorder (OCD) and/or generalized anxiety disorder (GAD).

The investigators found self-reported compulsivity was more strongly linked with goal-directed deficits than a diagnosis of OCD compared with GAD.

The results could have implications for research assessing the association between brain mechanisms and clinical manifestations, as well as for understanding the structure of mental illness.

The aim of the study was to identify if deficits in goal-directed planning better identified by self-reported compulsivity or a diagnosis of obsessive-compulsive disorder. Each patient completed a telephone-based diagnostic interview by a trained rater, internet-based cognitive testing, and self-reported clinical assessments between 2015-2017.

The investigators collected follow-up data as well to test for replicability.

Performance was measured on a test of goal-directed planning and cognitive flexibility using the Wisconsin Card Sorting Test (WCST), as well as a test for abstract reasoning.

Clinical variables included a DSM-5 diagnosis of OCD and GAD, as well as 3 psychiatric symptom dimensions—general distress, compulsivity, and obsessionality—derived from a factor analysis.

Overall, deficits in goal-directed planning in OCD was strongly tied with a compulsivity dimension than with a OCD diagnosis.

The mean age of the 285 patients was 32, with a range of 18-77 years old. The patient population included 219 females, 111 individuals with OCD, 82 patients with GAD, and 92 patients with both disorders.

“A diagnosis of OCD was not associated with goal-directed performance compared with GAD at baseline (P = .18),” the authors wrote. “In contrast, a compulsivity dimension was negatively associated with goal-directed performance (P = .003).”

This pattern was also found with abstract reasoning tasks as well as WCST.

“The compulsivity dimension was associated with abstract reasoning (P  .001) and several indicators of WCST performance (P  .001), whereas OCD diagnosis was not (abstract reasoning: P = .56; categories completed: P = .38),” the authors wrote.

However, other symptom dimensions related to OCD, obsessionality, and general distress had no reliable association with goal-directed performance, WCST, or abstract reasoning.

Obsessionality also had a positive association with requiring more trials to reach the first category on the WCST at baseline (P = .04), while general distress was linked to impaired goal-directed performance at baseline (P = .01).

Despite this, neither survived correction for multiple comparisons or was replicated at follow-up testing.
 
In the past, dimensional definitions of transdiagnostic mental health problems has been recommended as an alternative to a categorical diagnosis. Using this technique allows clinicians to capture heterogeneity within diagnostic categories and similarity across them to bridge more naturally psychological and neural substrates.

“This study suggests that transdiagnostic compulsivity symptoms may have greater biological validity than a diagnosis of obsessive-compulsive disorder,” the authors wrote.

There are fundamental issues with using popular international categories for neurobiological research such as the DSM-5 and International Classification of Mental and Behavioural Disorders, 10th Revision.

While diagnostic groups are highly heterogeneous, patients often have the same diagnosis with vastly different symptom profiles.

Individuals without a psychiatric diagnosis usually differ from patients with a diagnosis in several ways beyond the diagnosis under investigation, including anxiety, depression, physical illness, and early-life adversity.

As a result, potential biomarkers, intermediate phenotypes, and etiologic substrates often can only show a modest association with a categorical clinical phenotype, but is unlikely to be specific to that phenotype.

The study, “Comparison of the Association Between Goal-Directed Planning and Self-reported Compulsivity vs Obsessive-Compulsive Disorder Diagnosis,” was published online in JAMA Psychiatry.