YOUR HEALTH: Those with compulsive disorders could get new help

WACO, Texas – OCD, Obsessive Compulsive Disorder, only affects about two percent of the population but symptoms are usually severe.

Now, clinical trials are targeting new receptors in the brain.

Some of those trial are being conducted by the very people who can be helped.

“I’ve lived with OCD since childhood,” said Elizabeth McIngvale, assistant professor of Baylor College of Medicine’s Menninger Department of Psychiatry and Behavioral Sciences.

“I was diagnosed when I was 12 and have been in treatment ever since.”

She used to ask her mom if it was okay that she touched something in school.

“Then it transferred into a lot of contamination rituals, spending a lot of time in the shower,” said McIngvale.   “Fearing I hadn’t done something enough, I wasn’t clean enough. I was going to contaminate other people.”

OCD is rooted in fear which feeds the anxiety and brings about the unwanted behavior.

Psychologists used cognitive behavioral therapy in some cases, as well as traditional anti-depressants aimed at serotonin and dopamine brain messengers.

But researchers are now seeking something new, glutamate in the brain, a neurotransmitter that sends signals to other cells.

“Some recent information suggests that there might be a third messenger that naturally occurs called glutamate. thereby have improved response to anti-depressants,” explained Eric Storch, a professor on that team of researchers.

NEW TECHNOLOGY:   Researchers have been looking into glutamate.   Glutamate is the most abundant excitatory neurotransmitter in the brain.   It helps with communication with cells in all the circuits in the nervous system.   Too much can cause neuron damage which can lead to conditions like stroke or ALS.   The levels of glutamate could be high as a consequence of OCD.   There are many medications out there now that can help lower the levels.   Rilutek, an FDA approved medication for ALS, helped in some patients.   The medication can not only help adults but they also help children.   Namenda, a memantine, affects how the neurons respond to glutamate.   It is FDA approved, and it can benefit both kids and adults going through normal therapy.   Researchers want to do a more controlled study in order to better understand the drug`s impact.

And, for Elizabeth McIngvale who might only get several minutes a day without intrusive thoughts, it’s clearly critical to find a better way.

“I can understand someone’s pain and I can truly believe with all my belief system, that they can get better,” said McIngvale.

The study of this new drug is being conducted at 59 centers across the country.

Elizabeth McIngvale has also started the Peace of Mind Foundation, dedicated to providing help with OCD.

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jim.mertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.

What Type of Anxiety Do You Suffer From?

Anxiety disorders are common — and treatable.

If you live in the U.S. and are coping with an anxiety disorder, you have lots of company. “They’re super-duper common,” says Debra Kissen, executive director of the Light on Anxiety CBT Treatment Center in Chicago. She’s also co-chair of the Anxiety and Depression Association of America’s public education committee. Anxiety disorders affect 40 million adults in the U.S. annually, accounting for 18% of the population, according to the ADAA. That makes anxiety disorders the most common mental illness in the U.S., affecting more people than depression. Having one condition doesn’t preclude having the other. It’s not uncommon for someone who has an anxiety disorder to also suffer from depression, or vice versa, according to the ADAA. The good news is that anxiety disorders are typically highly treatable, Kissen says. “As uncomfortable as it is, an anxiety disorder is treatable and with some hard work can be moved past,” Kissen says. Anxiety disorders are typically treated with cognitive behavioral therapy — a type of talk therapy — and medication. Anti-anxiety medications such as Zoloft, Prozac, Paxil and Lexapro are among the antidepressants health care professionals often prescribe to patients. These medications, known as serotonin reuptake inhibitors, are often prescribed in combination with cognitive behavioral therapy, Kissen says. “If people (with anxiety) gradually face their fears and stop counterproductive safety-seeking behaviors, they can make excellent progress,” she says. Here are six types of anxiety disorders:

1. Generalized anxiety disorder

If you’re constantly worrying that disaster could strike every aspect of your life, you may well be suffering from generalized anxiety disorder, says Dr. Dale A. Peeples, a psychiatrist and an associate professor at the Medical College of Georgia at Augusta University in Augusta, Georgia. People with generalized anxiety disorder “worry about their finances, their health, their family’s health, work and school,” he says. “When they really confront themselves about all the worries, they are able to see that it’s a little overblown and irrational, but they can’t get their mind to stop thinking about all the worst-case scenarios.” This can lead to symptoms such as irritability, headaches and stomach discomfort. GAD affects nearly 7 million adults in the U.S., or more than 3% of the population, according to the ADAA.

2. Panic disorder

People who suffer from panic attacks are overcome with an overwhelming sense of fear, in which “the body’s fight-or-flight system kicks in just like it would if you were being chased by a bear,” Peeples says. “Your heart races, you start hyperventilating, your vision narrows, you get shaky and it feels like the world is coming to an end. It’s your body’s natural defense system, but when your body goes into that mode and there really isn’t something to flee from, it just leaves you terrified.” Sometimes panic appears with no apparent trigger; sometimes it’s prompted by a specific stressor or phobia, he says. Some panic attacks are so intense that people suffering from them end up in the emergency room.

3. Obsessive-compulsive disorder

Someone suffering from obsessive-compulsive disorder would have obsessions about ordinary events and compulsions to behave in certain ways, Peeples says. For example, someone may be obsessed with whether he or she left the stove on at home, despite having a clear memory of turning it off. A classic example of compulsive behavior would be someone who washes his or her hands multiple times a day out of excessive fear of germs, Peeples says.

4. Social anxiety disorder

Previously known as social phobia, social anxiety disorder is characterized by dread of social situations because of irrational fears of humiliation, embarrassment or rejection, says Dr. Diana Samuel, assistant professor of clinical psychiatry at Columbia University Irving Medical Center in New York City. “Someone with social anxiety may avoid social situations or endure them with great angst. This in turn may affect not only their social life, but also their professional or academic life, such as by not participating in a classroom discussion or a team project.”

5. Specific phobias

Many people have trepidation about flying or undergoing an MRI, but most overcome their discomfort and get on that plane or into that tube, Kissen says. Specific phobias can affect a person’s ability to live his or her daily life, Kissen says. “(A phobia) causes moderate to severe distress and impacts a person’s ability to function,” Kissen says. “Someone could have a fear of spiders, and that’s fine if they don’t live near spiders. But if they avoid going to parks or taking their kids to baseball games to avoid spiders, then it’s affecting their functioning.”

According to the ADAA, specific phobias often focus on:

— Animals.

— Insects.

— Germs.

— Heights.

— Thunder.

— Driving.

— Flying.

— Public transportation.

— Dental or medical procedures.

— Elevators.

6. Agoraphobia

Agoraphobia is similar to specific phobias, but broader in that it encompasses fear of leaving one’s home and going beyond what one considers a “safe zone,” Kissen says. Among the places people with agoraphobia might avoid are shopping malls, public transportation, open spaces like parking lots or enclosed spaces like movie theaters, according to the ADAA. Agoraphobia disproportionately affects women. People with panic disorder are at a higher risk for agoraphobia; approximately 1 in 3 people with panic disorder will develop agoraphobia, the ADAA says.

To recap, here are six types of anxiety disorders.

— Generalized anxiety disorder.

— Panic disorder.

— Obsessive-compulsive disorder.

— Social anxiety disorder.

— Specific phobias.

— Agoraphobia.

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What Type of Anxiety Do You Suffer From? originally appeared on usnews.com

‘Inflated responsibility’ may trigger OCD and anxiety • Earth.com

A need to prevent danger or harm. Feeling to blame for negative events. Focusing on a problem, even when there isn’t a solution. These mindsets can lead to a sense of inflated responsibility, and that in turn can trigger OCD or an anxiety disorder, according to new research.

Occasional worrying is normal, and everyone thinks negative thoughts down and then. But when these thoughts begin disrupting day-to-day life, they could indicate obsessive-compulsive disorder or generalized anxiety disorder.

“People with OCD [are] tortured by repeatedly occurring negative thinking and they take some strategy to prevent it … GAD is a very pervasive type of anxiety. [Patients] worry about everything,” co-author Dr. Yoshinori Sugiura of the University of Hiroshima said in a press release.

It’s the difference between checking that the stove is off after dinner, and checking repeatedly throughout the evening and even into the next day even though you know it’s off, just in case.

Sugiura and his co-author, Dr. Brian Fisak of the University of Central Florida, took a look at “inflated responsibility” as a potential cause of these disabling mental health challenges. They hoped to streamline several competing theories about what triggers OCD and GAD.

For their study, Sugiura and Fisak sent online questionnaires to U.S. university students asking questions about responsibility and about thoughts and behaviors common in OCD and GAD. They found that the students who reported feeling a higher sense of responsibility also tended to show more anxiety and compulsive behaviors.

Sugiura and Fisak were quick to note that more research is needed before doctors can settle on inflated responsibility as the cause of these disorders. Their sample size was not large, and the majority of respondents were female university students, they said.

But they believe that helping patients reduce their sense of responsibility may help bring these disorders under control.

“[A] very quick or easy way is to realize that responsibility is working behind your worry,” Sugiura said. “I ask [patients], ‘Why are you worried so much?’ so they will answer, ‘I can’t help but worry,’ but they will not spontaneously think, ‘Because I feel responsibility’ … just realizing it will make some space between responsibility thinking and your behavior.”

The study has been published in the International Journal of Cognitive Therapy.

By Kyla Cathey, Earth.com staff writer

Feel too responsible? You may be at risk of OCD or anxiety disorder

Brain
inflated responsibility can lead to PCD

Inflated responsibility could lead to Obsessive Compulsive Disorder (OCD) or Generalized Anxiety Disorder (GAD)

A new study has found that people who reported intense feelings of responsibility were susceptible to developing Obsessive Compulsive Disorder (OCD) or Generalized Anxiety Disorder (GAD). The study was published in the International Journal of Cognitive Therapy.

“People with OCD [are] tortured by repeatedly occurring negative thinking and they take some strategy to prevent it… GAD is a very pervasive type of anxiety. [Patients] worry about everything.” describes Associate Professor Yoshinori Sugiura of the University of Hiroshima.

Anxiety and OCD-like behaviors, such as checking if the door is locked, are common in the general population. However, it is the frequency and intensity of these behaviors or feelings that make the difference between a character trait and disorder.

A sense of inflated responsibility is often the latent reason behind Obsessive Compulsive Disorder and Generalised Anxiety Disorder, the AUTHORS SAY

“For example, you’re using two audio recorders instead of one,” says Sugiura when interviewed. “It’s just in case one fails … having two recorders will enhance your work but if you prepare [too] many recorders … that will interfere with your work.”

A problem Sugiura identifies in psychology is that each disorder that sufferers experience has several competing theories regarding their cause.

“There are too many theories and therapies for mental disorders for one expert to master them all.” elaborates Sugiura.

The goal of this research team (consisting of Sugiura and Associate Professor Brian Fisak (University of Central Florida)) was to find a common cause for these disorders and simplify the theories behind them.

Sugiura and Fisak first defined and explored “inflated responsibility”. The team identified 3 types of inflated responsibility: 1) Responsibility to prevent or avoid danger and/or harm, 2) Sense of personal responsibility and blame for negative outcomes and 3) Responsibility to continue thinking about a problem. The research group combined tests used to study OCD and GAD as there had been no previous work that compared these tests in the same study.

To establish whether inflated responsibility was a predictor of OCD or GAD, Sugiura and Fisak sent an online questionnaire to American university students. Through this survey they found that respondents who scored higher in questions about responsibility were more likely to exhibit behaviors that resemble those of OCD or GAD patients. Personal Responsibility and Blame and the Responsibility to Continue Thinking, had the strongest link to the disorders.

The researchers would like to clarify that this preliminary study is not representative of the general population due to the small scale and skewed population (mostly female university students). However, the promising findings suggest that this format can be applied to a larger population and yield similar results.

Sugiura is currently looking into how to reduce responsibility and the preliminary outcomes are positive. When asked for any tips to reduce anxiety or obsessive behaviors he said:

“[A] very quick or easy way is to realize that responsibility is working behind your worry. I ask [patients] “Why are you worried so much?” so they will answer “I can’t help but worry” but they will not spontaneously think “Because I feel responsibility” … just realizing it will make some space between responsibility thinking and your behavior.”

Being too harsh on yourself could lead to OCD and anxiety: A correlation was found between strong feelings of responsibility and likelihood of developing OCD or GAD

“People with OCD [are] tortured by repeatedly occurring negative thinking and they take some strategy to prevent it… GAD is a very pervasive type of anxiety. [Patients] worry about everything.” describes Associate Professor Yoshinori Sugiura of the University of Hiroshima.

Anxiety and OCD-like behaviors, such as checking if the door is locked, are common in the general population. However, it is the frequency and intensity of these behaviors or feelings that make the difference between a character trait and disorder.

“For example, you’re using two audio recorders instead of one,” says Sugiura when interviewed. “It’s just in case one fails … having two recorders will enhance your work but if you prepare [too] many recorders … that will interfere with your work.”

A problem Sugiura identifies in psychology is that each disorder that sufferers experience has several competing theories regarding their cause.

“There are too many theories and therapies for mental disorders for one expert to master them all.” elaborates Sugiura.

The goal of this research team (consisting of Sugiura and Associate Professor Brian Fisak (University of Central Florida)) was to find a common cause for these disorders and simplify the theories behind them.

Sugiura and Fisak first defined and explored “inflated responsibility.” The team identified 3 types of inflated responsibility: 1) Responsibility to prevent or avoid danger and/or harm, 2) Sense of personal responsibility and blame for negative outcomes and 3) Responsibility to continue thinking about a problem. The research group combined tests used to study OCD and GAD as there had been no previous work that compared these tests in the same study.

To establish whether inflated responsibility was a predictor of OCD or GAD, Sugiura and Fisak sent an online questionnaire to American university students. Through this survey they found that respondents who scored higher in questions about responsibility were more likely to exhibit behaviors that resemble those of OCD or GAD patients. Personal Responsibility and Blame and the Responsibility to Continue Thinking, had the strongest link to the disorders.

The researchers would like to clarify that this preliminary study is not representative of the general population due to the small scale and skewed population (mostly female university students). However, the promising findings suggest that this format can be applied to a larger population and yield similar results.

Sugiura is currently looking into how to reduce responsibility and the preliminary outcomes are positive. When asked for any tips to reduce anxiety or obsessive behaviors he said:

“[A] very quick or easy way is to realize that responsibility is working behind your worry. I ask [patients] “Why are you worried so much?” so they will answer “I can’t help but worry” but they will not spontaneously think “Because I feel responsibility” … just realizing it will make some space between responsibility thinking and your behavior.”

I’ve spent my whole life convinced I’d never fall asleep

“That’s a weird one,” my doctor told me with a look of curiosity. This was 2017, and I was sitting in her office trying hard to hide my shame. I was deeply grateful that my face didn’t flush. I knew my sleep anxiety is weird. I just wanted an official mental-illness diagnosis so I could leave.
She gave me one: I had generalized anxiety disorder and obsessive compulsive disorder, both of which came as no surprise based on the many phobias I’ve lived with my entire life.

I am now 32 and I still live with the sleep anxiety I developed in my teenage years. I also have a Ph.D in Infection and Immunity and am a full-time researcher in the field of respiratory immunology. I am a mental-health advocate, an award-winning teacher, an award-winning research presenter, a freelance writer, a doting aunty and godmother, an active window shopper, and a collector of ceramic pineapples. While my sleep anxiety has affected me deeply, I’m not convinced I would have been more productive without it.

My typical evening involves me getting home before the sun has fully set, where I will begin my unwinding rituals: my evening devotion time including prayer and some Bible reading, followed by a hot shower and dinner no later than 8 p.m. I allow myself to binge-watching some Netflix, then switch off the lights just after 10 p.m.

Once the lights are off, I still allow myself to peruse social media or watch relaxing YouTube videos (my current favorites being on soap-making). I do this despite the fact that there is evidence to show that bright screens can negatively affect our sleep patterns. But it is imperative that I close my eyes by 11 p.m.
This unwinding ritual, which has remained unchanged for the past decade, is my comfort blanket and part of my coping strategy for the longest-lasting fear which I have still been unable to overcome. I’ve gotten so used to my routine and my arbitrary bedtime that divergence induces panic that is just not worth it.

It is imperative that I close my eyes by 11 p.m.

My unrelenting sleep anxiety is the fear that I might not be able to fall asleep. It first started when I was 15 , when my sister, with whom I had always shared a room, was preparing to go off to university.
My sister and I had our beds arranged in an “L” shape so our pillows nearly met. One night, in a half-sleeping panicked state, I reached out my hand to make sure my sister was still there. She sprang up from bed afraid that a mouse (my hand) had jumped on her head. The next morning I confessed to what had actually happened. We laughed, and then I slept fine for some time.

But soon I was finding it hard to fall asleep. This period of time also coincided with me starting at a new secondary school. My worries intensified: what would it be like moving from an all-girls school to a mixed-gender one? I could be socially awkward, would it be hard for me to fit in? After struggling to fall asleep the night before my first day at this new school, the seed for my sleep anxiety was planted in the form of a kind of self-fulfilling prophecy: that I would struggle to sleep every single night. As is the case with most phobias, what began as a faint whisper soon firmly took root in the marrow of my mind.

As with many worries, the fear of not falling asleep was present but the object of the fear never materialized: I would, in fact, be able to eventually fall asleep every night. The next day, however, the fear would consume me, beginning with a creeping despondency that spread across my mind. By dusk it would be debilitating. I tried to tell my family, but I was scared and ashamed: why was I so weird? How could I even begin to articulate what I didn’t understand? What did I do to make myself this way? Why was I abnormal?

I had always been a worrier, but I relied upon the notion that I could eventually grow out of my phobias. They were seasonal, maybe. They were phases. Years before my sleep anxiety manifested, I’d already started being conscious of certain things that my childlike mind noted as societal norms that I didn’t adhere to. I’d ask my friends what time they went to bed, and would start feeling guilty that my bedtime was an hour later. I’d take note of innocent comments other children made about how I always “worried about everything,” and how they’d laugh at me for scratching at my hands when I was washing them just to make sure they were clean. I’d ensure that when I walked out of a room, I used the same route I did as when I entered in a bid to maintain spatial symmetry.

The fear of not falling asleep was present but the object of the fear never materialized: I would, in fact, be able to eventually fall asleep every night.

Just before I turned eight, I began to fear that my heart would stop beating at any moment but I would still be alive; my nervous little palm would automatically check for the reassuring lub-dub. I was able to overcome all these on my own with no help, so why was my sleep anxiety so different? Why was I failing at fixing myself?

Sleep anxiety meant that during my university years I wasn’t interested in nightlife. On the occasions when I did go out with friends, I always had a knot in the pit of my stomach, worried sick about how my sleep routine would be affected.

This has also meant that in my lab-based research career I’ve always gravitated towards projects in which I can control experiment timings. But I still find myself paying the price for the social aspect of my invisible illness. I still wasn’t able to tell the postdoctoral researcher who put so much dedication into training me during the first six months of my Ph.D about why I always grew quieter in the evenings. I remember her once telling me, very gently, that I would need to get used to flexibility in my schedule because it is natural that some experiments run longer than the allotted time. How I longed to tell her that I wasn’t lazy, I was just an adult woman scared from the pit of my stomach because it was already dark outside and my mind was screaming that my nighttime ritual would be affected.

It has taken me a decade to dull the sharp pain of my sleep anxiety. Moving on my own to the U.K. for my Ph.D required me to develop comfort in my own company and the ability to study and understand my mental illness. Currently, my sleep anxiety is a throb that never leaves me; I’ve accepted that it may remain with me always.

This acceptance has been crucial to the development of my coping strategies. Self-care to 32-year-old me encompasses being honest with myself, my family and friends about my mental illness (and only going into detail when I absolutely feel the need to), being honest about needing medication (50 mg of sertraline a day, for just over two years), being open to therapy (even though I have yet to find a therapist), being ok with crying (although I still prefer to do so privately), challenging myself to set boundaries, and challenging my catastrophic thoughts.

For example, what would be the worst thing that could happen to me if I never fell asleep? I’d be exhausted the next day, but I’m sure I could get by. Or what if I do indeed ever become an insomniac? I’m sure there are coping strategies I could use to help myself; I know some people who struggle with insomnia who thrive in life and in their careers. Knowing that 51 percent of the women surveyed in the U.K. Sleep Council’s Great British Bedtime report from 2017 also said that they have sleeping problems due to worry and stress has also put things into perspective for me. I realize that my extreme self-criticism has often led me to pathologize my experiences as unique, whereas there are so many others dealing with the same thing.

I had always been a worrier, but I relied upon the notion that I could eventually grow out of my phobias.

Mental health expert Ayomide Adebayo explained to me how my generalized anxiety disorder has perpetuated my sleeping anxiety. “The key feature in generalized anxiety disorder is, as the name implies, an anxiety sometimes described as ‘free floating’ — it’s not attached to anything in particular, but is just sort of almost permanently present,” he said. “It’s twice more common in females than males, and especially in young females with a history of childhood fears. It tends to be lifelong.”

Part of my self-acceptance has also required that I dig a little deeper to identify the root cause of some of my fears. And it has indeed been uncomfortable to admit that my craving for the construct of normalcy I built in my mind when I was younger catalyzed the development of my phobias. Of this, Adebayo said that “normalcy is the worst way to think about mental illnesses.” He continued: “And the reason why I think so is that ‘normal,’ in the context of a new (and long-term) problem really means ‘going back to how things used to be.’ The problem with that is there’s no ‘back’ to go to. There’s only forward, and a focus on ‘normal,’ on ‘going back‘ really ends up being an inability to move forward.”

Being determined to study and familiarize myself with the fears I experience has empowered me in its own way. Knowing that I’m able to call my little demons by their names has allowed me to identify ways and means in which they can be exorcised. It’s also important to me to speak about this just in case there are currently individuals experiencing this exact fear who need to know they are not alone.
I also still have complicated feelings about how close to “normal” people think I am. Perhaps the key to my further healing is accepting that normalcy is, as Adebayo said, just as much a phantom not unlike many of the things that I fear.

Four Steps to Manage Obsessive-Compulsive Disorder

When I was a young girl, I struggled with obsessive-compulsive disorder. I believed that if I landed on a crack in the sidewalk, something terrible would happen to me, so I did my best to skip over them. I feared that if I had bad thoughts of any kind, I would go to hell.

To purify myself, I would go to confession and Mass over and over again, and spend hours praying the rosary. I felt if I didn’t compliment someone, like the waitress where we were eating dinner, I would bring on the end of the world.

What Is OCD?

The National Institute of Mental Health defines OCD as a “common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.” OCD involves a painful, vicious cycle whereby you are tormented by thoughts and urges to do things, and yet when you do the very things that are supposed to bring you relief, you feel even worse and enslaved to your disorder.

The results of one study indicated that more than one quarter of the adults interviewed experienced obsession or compulsions at some point in their lives — that’s over 60 million people — even though only 2.3 percent of people met the criteria for a diagnosis of OCD at some point in their lives. The World Health Organization has ranked OCD as one of the top 20 causes of illness-related disability worldwide for individuals between 15 and 44 years of age.

Whenever I am under considerable stress, or when I hit a depressive episode, my obsessive-compulsive behavior returns. This is very common. OCD breeds on stress and depression. A resource that has been helpful to me is the book Brain Lock by Jeffrey M. Schwartz, M.D. He offers a four-step self-treatment for OCD that can free you from painful symptoms and even change your brain chemistry.

Distinguishing Form from Content of OCD

Before I go over the four steps, I wanted to go over two concepts he explains in the book that I found very helpful to understanding obsessive-compulsive behavior. The first is knowing the difference between the form of obsessive-compulsive disorder and its content.

The form consists of the thoughts and urges not making sense but constantly intruding into a person’s mind — the thought that won’t go away because the brain is not working properly. This is the nature of the beast. The content is the subject matter or genre of the thought. It’s why one person feels something is dirty, while another can’t stop worrying about the door being locked.

The OCD Brain

The second concept that is fascinating and beneficial to a person in the throes of OCD’s torture is to see a picture of the OCD brain. In order to help patients understand that OCD is, in fact, a medical condition resulting from a brain malfunction, Schwartz and his colleagues at UCLA used PET scanning to take pictures of brains besieged by obsessions and compulsive urges. The scans showed that in people with OCD, there was increased energy in the orbital cortex, the underside of the front of the brain. This part of the brain is working overtime.

According to Schwartz, by mastering the Four Steps of cognitive-biobehavioral self-treatment, it is possible to change the OCD brain chemistry so that the brain abnormalities no longer cause the intrusive thoughts and urges.

Step One: Relabel

Step one involves calling the intrusive thought or urge exactly what it is: an obsessive thought or a compulsive urge. In this step, you learn how to identify what’s OCD and what’s reality. You might repeat to yourself over and over again, “It’s not me — it’s OCD,” working constantly to separate the deceptive voice of OCD from your true voice. You constantly inform yourself that your brain is sending false messages that can’t be trusted.

Mindfulness can help here. By becoming an observer of our thoughts, rather than the author of them, we can take a step back in loving awareness and simply say, “Here comes an obsession. It’s okay … It will pass,” instead of getting wrapped up in it and investing our emotions into the content. We can ride the intensity much like a wave in the ocean, knowing that the discomfort won’t last if we can stick in there and not act on the urge.

Step Two: Reattribute

After you finish the first step, you might be left asking, “Why don’t these bothersome thoughts and urges go away?” The second step helps answer that question. Schwartz writes:

The answer is that they persist because they are symptoms of obsessive-compulsive disorder (OCD), a condition that has been scientifically demonstrated to be related to a biochemical imbalance in the brain that causes your brain to misfire. There is now strong scientific evidence that in OCD a part of your brain that works much like a gearshift in a car is not working properly. Therefore, your brain gets stuck in gear. As a result, it’s hard for you to shift behaviors. Your goal in the Reattribute step is to realize that the sticky thoughts and urges are due to your balky brain.

In the second step, we blame the brain, or in 12-step language, admit we are powerless and that our brain is sending false messages. We must repeat, “It’s not me — it’s just my brain.” Schwartz compares OCD to Parkinson’s disease — both interestingly are caused by disturbances in a brain structure called the striatum — in that it doesn’t help to lambast ourselves for our tremors (in Parkinson’s) or upsetting thoughts and urges (in OCD). By reattributing the pain to the medical condition, to the faulty brain wiring, we empower ourselves to respond with self-compassion.

Step Three: Refocus

In step three, we shift into action, our saving grace. “The key to the Refocus step is to do another behavior,” explains Schwartz. “When you do, you are repairing the broken gearshift in your brain.” The more we “work around” the nagging thoughts by refocusing our attention on some useful, constructive, enjoyable activity, the more our brain starts shifting to other behaviors and away from the obsessions and compulsions.

Step three requires a lot of practice, but the more we do it, the easier it becomes. Says Schwartz: “A key principle in self-directed cognitive behavioral therapy for OCD is this: It’s not how you feel, it’s what you do that counts.”

The secret of this step, and the hard part, is going on to another behavior even though the OCD thought or feeling is still there. At first, it’s extremely wearisome because you are expending a significant amount of energy processing the obsession or compulsion while trying to concentrate on something else. However, I completely agree with Schwartz when he says, “When you do the right things, feelings tend to improve as a matter of course. But spend too much time being overly concerned about uncomfortable feelings, and you may never get around to doing what it takes to improve.”

This step is really at the core of self-directed cognitive behavioral therapy because, according to Schwartz, we are fixing the broken filtering system in the brain and getting the automatic transmission in the caudate nucleus to start working again.

Step Four: Revalue

The fourth step can be understood as an accentuation of the first two steps, Relabeling and Reattributing. You are just doing them with more insight and wisdom now. With consistent practice of the first three steps, you can better acknowledge that the obsessions and urges are distractions to be ignored. “With this insight, you will be able to Revalue and devalue the pathological urges and fend them off until they begin to fade,” writes Schwartz.

Two ways of “actively revaluing,” he mentions are anticipating and accepting. It’s helpful to anticipate that obsessive thoughts will occur hundreds of times a day and not to be surprised by them. By anticipating them, we recognize them more quickly and can Relabel and Reattribute when they arise. Accepting that OCD is a treatable medical condition — a chronic one that makes surprise visits — allows us to respond with self-compassion when we are hit with upsetting thoughts and urges.

The Dangers of Cyberchondria

We’ve all done it, or at least most of us have. I know I’m certainly guilty of it. I’m talking about turning to the internet for answers to our health concerns.

Just type in our (or our loved ones) symptoms and away we go. That rash we have? Turns out it could be anything from contact dermatitis to cancer. Which is it? Not sure? Well, search some more. There is always another website to check. And as many of us know, these searches can be never-ending.

Excessively scouring the internet for answers to our health concerns is known as cyberchondria. One in three people, among the millions who seek health information in this manner, report feeling more anxious after searching for answers than before. Yet they keep searching even as their worry escalates. Cyberchondria has the potential to disrupt many aspects of a person’s life and studies have even linked it to depression. Those with cyberchondria tend to either avoid going to their doctor, or go too much — both out of fear.

What drives people to engage in a behavior that often makes them feel worse than before?

Thomas Fergus, a psychology professor at Baylor University, links cyberchondria to a dysfunctional web of metacognitive beliefs, which are really just thoughts about thinking. We all have these types of belief systems. For example, it is considered normal to believe that deliberating over a challenging problem will lead to a satisfying solution. In cyberchondria, however, metacognitive beliefs morph into a mental trap — people search online health content incessantly.

Dr. Fergus and Marcantonio Spada, an academic psychologist at London South Bank University, have shown that these metacognitive beliefs in cyberchondria overlap somewhat with those of anxiety disorders. People with health anxiety, for example, hold maladjusted views about the role worry plays in maintaining their emotional and physical well-being. It is these same sorts of dysfunctional belief systems, Fergus says, “that send people with cyberchondria back for long sessions at the computer.”

In 2018, Fergus and Spada published research that, not surprisingly, links cyberchondria with features of obsessive-compulsive disorder (OCD). People with OCD perform compulsions to ease their anxiety, and those with cyberchondria engage in ritualistic searches for health information to dispel their anxiety. In both cases, people will only stop when they feel certain that all is well. As many of us know, online health content is too vast to allow us to be certain about anything. In fact, certainty is not actually attainable when it comes to most aspects of our lives.

So how can we escape the vicious cycle of cyberchondria? Appropriate therapies for anxiety disorders such as Cognitive Behavioral Therapy (CBT), mindfulness, and even antidepressants might be helpful. In addition, metacognitive approaches that encourage people to question the value of going online to relieve their anxiety can be beneficial.

There is another solution to spending countless hours on the internet trying to figure out your latest ailment. Go see your doctor for a proper diagnosis — once. Then you can use the other therapies mentioned to learn how to not only stop searching for answers, but to also learn to accept the feelings of uncertainty that are inevitably connected to our health.

Child and Adolescent Anxiety May Be Associated With Later Alcohol Use

Child and adolescent anxiety is positively associated with later alcohol use and disorders, according to research published in Addiction.

The systematic review of 51 prospective cohort studies from 11 countries included publications from PubMed, Scopus, Web of Science, and PsycINFO that were published in English, involved human participants, investigated anxiety exposure in childhood or adolescence and alcohol outcome, and included at least 6 months of follow- up. Study sample sizes ranged greatly, from 110 to 11,157 participants, exposure ages ranged from 3 to 24 years, and alcohol outcomes ranged from ages 11 to 42 years.

Across the 51 studies, 97 associations were categorized by anxiety exposure, including generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder, and specific phobias. Alcohol use outcome was categorized by drinking frequency and quantity, binge drinking, and alcohol use disorders.

Evidence for an association between anxiety and later alcohol use disorders was found in the narrative synthesis. However, the association between anxiety and later drinking frequency and quantity as well as binge drinking were inconsistent. The discrepancies were not explained by type and developmental period of anxiety, follow-up duration, sample size, or cofounders.

While the data suggests an association between child and adolescent anxiety and later alcohol use disorders, researchers state that the evidence is “far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.” Further research will be necessary to investigate this potential association.

Reference

Dyer ML, Easey KE, Heron J, Hickman M, Munafò MR. Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta‐analysis of prospective cohort studies [published online March 19, 2019]. Addiction. doi:10.1111/add.14575

Super Awesome Science Show: The science of spring fever


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We’ve all heard about spring fever, although medically speaking, it’s not really an illness. Instead, it refers to a change in our behaviour that happens to align with the changing of the seasons. On this week’s Super Awesome Science Show, we explore some of the science behind these changes and offer some perspective on how to deal with the consequences.


READ MORE:
Spring sniffles — Are you suffering from allergies or the common cold?

Our first guest may know a reason for the effects of spring fever: we are being exposed to more light. Kathryn Roecklein, an associate professor of psychology at the University of Pittsburgh, reveals the effects of sunlight on our brains and how the change in seasons may alter how we act. She also reveals that we may no longer see such a dramatic shift due to our continual exposure to artificial light.

The change of the seasons also means a rise in certain mental health concerns. Statistics have shown spring brings with it a rise in suicides and greater unhappiness in some people. We speak with Jon Abramowitz, a professor of psychology at the University of North Carolina and an expert on coping with anxiety and obsessive-compulsive disorder, who reveals the truth about living with these problems and how to cope.


WATCH:
Spring fever has hit the school

In our SASS Class, we explore one of the stereotypes of spring fever – the urge to find new mates. Our guest teacher is Maryanne Fisher. She is a professor of psychology at St. Mary’s University but she is better known as the relationship doctor. We discuss the process of trying to find a new mate and how this can be complicated by competition. She also reveals that looking back to the 18th century may help people figure out how to win at love today.

If you enjoy The Super Awesome Science Show, please take a minute to rate it on Apple Podcasts and be sure to tell a friend about the show.

Thanks to you, we’ve won a Canadian Podcast Award as Outstanding Science and Medicine Series. Thank you all very much for helping us keep this show AWESOME!

Contact:

Twitter: @JATetro
Email: thegermguy@gmail.com

Guests:

Kathryn Roecklein
Web: http://psychology.pitt.edu/people/kathryn-roecklein-phd
Twitter: @roecklein

Jon Abramowitz
http://www.jabramowitz.com/
Twitter: @DrJonAbram

Maryanne Fisher
http://www.smu.ca/future-students/relationship-doctor.html
Twitter: @ml_fisher

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