Ruminating thoughts: How to stop them

Numerous strategies can help with rumination. People with depression, anxiety, or other mental health diagnoses may find that they need to try several strategies before one works.

It can be useful to keep track of effective strategies so that when rumination feels overwhelming, it is possible to turn to a list of methods that have worked previously.

People may find the following tips helpful:

  • Avoid rumination triggers: Some people find that specific factors trigger rumination. They may wish to limit access to these triggers if it is possible to do so without undermining their quality of life. For instance, a person could try putting themselves on a media diet if the news makes them feel depressed, or they could stop reading fashion magazines if these publications make them feel unattractive.
  • Spend time in nature: A 2014 study found that people who went on a 90-minute nature walk reported fewer symptoms of rumination after their walk than those who walked through an urban area instead.
  • Exercise: Numerous studies have found that exercise can improve mental health, especially over time. However, a 2018 study reported that even a single session of exercise could reduce symptoms of rumination among inpatients with a mental health diagnosis. People may find that pairing exercise with time outside gives them the best results.
  • Distraction: Disrupt ruminating thought cycles with something distracting. Thinking about something interesting and complex may help, while fun, challenging activities, such as complex puzzles, may also offer relief.
  • Interrogation: People can try to interrogate ruminating thoughts by considering that they might not be helpful or based in reality. Perfectionists should remind themselves that perfectionism is unattainable. Those who tend to concern themselves with what other people think should consider that others are more concerned with their own perceived shortcomings and fears.
  • Increase self-esteem: Some people ruminate when they do poorly at something that is very important to them, such as a beloved sport or important academic achievement. By expanding their interests and building new sources of self-esteem, a person can make a single defeat feel less difficult.
  • Meditation: Meditation, particularly mindfulness meditation, may help a person better understand the connection between their thoughts and feelings. Over time, meditation can offer people greater control over seemingly automatic thoughts, making it easier to avoid rumination.

Read about different apps that can help treat mental health issues such as rumination.

Alternatively, therapy may help a person regain control over their thoughts, detect signs of rumination, and choose healthier thought processes.

Some forms of mental health therapy, such as rumination-focused cognitive behavioral therapy (RFCBT), specifically target rumination to help a person gain more control over their thoughts.

While traditional cognitive behavioral therapy focuses on changing the content of thoughts, RFCBT attempts to alter the thinking process instead.

Learn more about cognitive behavioral therapy here.

New home for adults with mental illness to be named after slain police officer

A housing unit for adults with mental illness set to open in Fredericton in the new year will be named after one of the police officers killed in a shooting last year.

Costello House will be run by the non-profit New Brunswick Community Residences and is named after Const. Robb Costello, one of the officers who responded to a shooting at a Brookside Drive apartment complex on Aug. 10, 2018.

He died that day along with Const. Sarah Burns and two civilians, Donnie Robichaud and Bobbie Lee Wright.

Costello’s partner, Jackie McLean, chairs the board of the non-profit and said that while Costello deserves the honour, he would probably feel self-conscious receiving it.

“I feel that while we don’t know exactly why this tragedy occurred, I feel like it’s highly likely that there is a mental health component involved.” (Maria Jose Burgos/CBC)

“He would say he didn’t deserve the attention, that, you know, name it after somebody who is more important than he is,” McLean said. 

“I don’t think that he knew how important he was to so many people and the community.”

‘A lovely environment’

Costello House will have six beds and be for people recently released from the hospital.

Stephanie Brewer, the executive director of New Brunswick Community Residences, said the home will be on the north side of the city and cater to adults with a variety of mental illnesses.

“It could be any type of mental health, mental illness or emotional difficulties that somebody might be experiencing,” said Brewer. 

“A lot of our clients may be suffering from schizophrenia, obsessive compulsive disorder, anxiety disorders, depression and the list goes on.”

McLean said the home, which will be one of four owned by the non-profit in the city, will have a “homey” vibe.

She said this is important to people entering the home from an institution like a hospital.

“The most important thing for us is that these people have a home, not an institution or not something that’s clinical and cold,” said McLean.

Stephanie Brewer is the executive director of New Brunswick Community Residences. She said the new home on the north side for adults struggling with mental illnesses will have a “homey” vibe. (Kirk Pennell/CBC)

“It’s a really lovely environment and we’re really proud of how it’s turned out.”

Brewer said the building still needs a few things to make it feel like a home, and she’s hoping for donations from the community.

“We need bedroom furnishings for six bedrooms, living-room furnishings for two living areas, kitchen equipment,” said Brewer.

Costello House said the facility will be located on the north side of the city and will cater to adults with a variety of mental illnesses. (Kirk Pennell/CBC)

“Just anything you would need in your own home basically”

Mental illness still a stigma

McLean said Costello always supported her work in the organization and was always involved with the Fredericton community at large.

“He knew the value of what New Brunswick Community Residences offer,” said McLean.

“For these individuals to have the stability of a home and those supports meant that Rob wouldn’t have to necessarily deal with them through his work professionally, because a lot of their needs were already met.”

McLean said she thinks society has a long way to go in how it treats people with mental illnesses.

She said that after her partner died, she was diagnosed with post-traumatic stress disorder and anxiety.

Costello House will have six beds for people recently released from the hospital. (Kirk Pennell/CBC)

“There is stigma attached to that,” said McLean.

“A lot of people don’t understand it and mental illness is not a choice and because it’s an invisible condition people assume that you’re OK.”

A tragedy that ‘could have been avoided’

McLean said the ultimate goal is to open another three facilities over the next decade and have them named after the other three victims of the shootings.

While she doesn’t want to make a direct connection, she believes mental health played a role in the death of her partner.

“I feel that while we don’t know exactly why this tragedy occurred, I feel like it’s highly likely that there is a mental health component involved,” said McLean.

“I like to believe that had this individual received community support for mental illness, that maybe the tragedies could have been avoided.” 

The Newest Way to Understand the Angry People in Your Life

Anyone can have trouble controlling their anger from time to time. You may be frustrated because you’ve just made a huge mistake in a big project and have to start again from scratch. Perhaps you’re stuck in a long commute and will be an hour late getting home. You might be angry at a relative who just won’t back off from demanding your time and attention. All of these are situations that can lead anyone to yell out in rage, if only at the fates.

How about people you know who chronically seem ready to explode with little or no provocation? What kinds of situations arouse them to higher and higher levels of fury, or are they always on the verge of exploding over nothing? And when they release their anger, what happens next? They’ve yelled at their partner over practically nothing, and now the partner walks out the door, annoyed and disgusted at being treated in such a rude and offensive manner. This rejection only inspires even more of their outrage.

Why might anger be such a problem for some people? According to psychologist Nienke de Bles and colleagues (2019), of Leiden University in the Netherlands, the source of both chronic anger and episodes of rage may lie in the psychological disorders of anxiety and depression. For example, the authors note that there is a surprisingly high 50% rate of irritability among people with major depressive disorder, with 26 to 49% experiencing attacks of anger. People with dysthymia, a chronic but less extreme form of depressive disorder, have a similarly high rate of anger attacks, estimated at 28 to 53%. Among people with an anxiety disorder or obsessive-compulsive disorder, there are also high rates of hostility and anger.

As impressive as these statistics are, the Dutch authors believe that the data may be flawed. Research studies establishing these percentages used measures of anger that, the research team points out, were not sufficiently validated. In some cases, the statistics were based on very short tests of anger and irritability, ranging from a single item to perhaps four drawn from another assessment not initially intended to examine anger.

Furthermore, previous studies didn’t separate what’s known as “trait” anger (the tendency to be angry all the time) from “state” anger (being enraged at the time of testing). As the authors note, “Making a distinction between patients with an angry disposition as a constant factor embedded in personality, and patients that respond angrily to an immediate situation, is of clinical importance” (p. 260).

To test the role of both forms of anger in anxiety and depressive disorders, de Bles et al. drew participants from a large-scale longitudinal study based in the Netherlands that followed people for a period of four years. The original sample consisted of nearly 2,900 adults ages 18 to 65 years of age recruited from a variety of treatment sites in the community, although there were also controls who did not have a lifetime history of psychological disorders. The data for the anger study came from nearly 2,300 who participated in the fourth wave of the follow-up.

Included in the study were not only the anger scales but also demographic measures including educational background, body mass index, smoking history, lifetime history of alcohol dependence and abuse, and use of drugs in the past month. The average age of the sample was 46 years old, with most between 33 and 59 years of age; two-thirds were female. As might be expected in a psychiatric sample, those with anxiety and depressive disorders were more likely to smoke, had higher body mass, and reported having a history of alcohol dependence and abuse.

To measure trait anger, the Dutch authors asked participants to complete a 10-item scale widely used in personality research. Half of the trait anger items assessed a general disposition for experiencing anger and eventually expressing it (temperament); the remaining five asked whether participants were more likely to express anger after some sort of provocation. Sample trait items were “I get annoyed quickly” and “I am quickly irritated.” The tendency to express anger in the form of an outburst, or the more state-like quality, was tapped by a self-report scale in which participants stated that they frequently experienced irritation, overreacted to minor annoyances, inappropriately expressed anger and rage toward others, and had at least one anger attack in the past month. To be counted as an anger attack, participants had to check off symptoms such as feeling their heart was racing or short of breath, trembling, feeling dizzy, sweating, feeling like attacking others, and throwing or destroying objects.

The researchers divided their participants into five diagnostic groups that included those with a current depressive disorder (204 participants), anxiety disorder (288), comorbid (joint) depressive and anxiety disorder (222), no psychiatric diagnosis (470), and a history of past anxiety and/or depressive disorder that was no longer active (1107). As the authors predicted, the scores on the trait anger measures were highest in the comorbid anxiety and depression group, with approximately 45% classified as above the 75th percentile of scores. The combined group also had a higher prevalence of anger attacks, at approximately 23% within the past month. The highest rates of anger attacks occurred for people with major depressive disorder and, of the anxiety disorders, social phobia, panic disorder, and especially generalized anxiety disorder.

Of all the other predictors, only past month use of a drug predicted higher rates of anger attacks. However, participants with remitted disorders also had higher trait anger scores and rates of anger attacks, so that even in recovery, anger remains a problem for individuals with a history of these psychological disorders.

An important takeaway from this study, according to the authors, is that clinicians working with people who have these disorders may easily overlook the trait of anger and anger attacks because “they are not part of core … symptoms, and insight and self-consciousness of feelings of anger may be hampered” (p. 262). Notably, people who experienced worry and symptoms of depression had higher levels of anger, suggesting a more general problem with emotion dysregulation, or the inability to maintain control over their feelings. It is also important, as the authors point out, to address anger among people with these psychological disorders as a public health precaution, given the many adverse outcomes that can be associated with an anger outburst in people whose anxiety and depression go untreated.

To sum up, the study shows the unrecognized but important role of anger in psychological disorders not usually conceived of in terms of the tendency to experience rage. Looking at the findings from another perspective, if people you know seem unusually angry and ready to explode, consider the possibility that anxiety and depression may be the source of their emotional turmoil. Helping them manage their psychological disorders may prove, in the long run, to help them be better able to manage their angry emotions.

Stray pet tree wins Erie festival – Lifestyle

The tree, sponsored by a supporter of Because You Care, placed first at the Festival of Trees at the Bayfront Convention Center.

A Christmas tree dedicated to finding homes for stray pets was the winner of the 2019 Festival of Trees at the Bayfront Convention Center.

“A ’Fur’ever Home for the Holidays” was decorated by Elizabeth Gutting and sponsored by a supporter of Because You Care. It placed first among the 72 professionally decorated trees at the event, sponsored by Saint Vincent Hospital.

A tree decorated by Saint Vincent Neonatal Intensive Care Unit nurses and sponsored by the Children’s Miracle Network placed second, followed by a tree decorated by Potratz Flower Shop and sponsored by Lilly Broadcasting.

The event is a fundraiser to help Saint Vincent form a women’s behavioral health program to treat women with mood and anxiety disorders including depression, obsessive-compulsive disorder, bipolar disorder and perinatal depression.

The Obsessive Outsider: One woman’s journey from severe Obsessive-Compulsive Disorder to a life lived abundantly

The books author, Kerry Osborn, is a mental health/OCD advocate, mental health blogger, public speaker, writer and founder of The Obsessive Outsiders digital ‘mentally misunderstood’ movement. Osborn is a long time sufferer of Obsessive-Compulsive Disorder, which set in as a young adult with no genetic history of mental illness.

Kerry Alayne Osborn lived a completely normal life until the sudden onset of Obsessive-Compulsive Disorder (OCD) at the age of seventeen. Her charmed life turned upside down as her new diagnosis of OCD set in, leaving her life spinning out of control. While trying to live a normal life, as she battled through the maze of OCD, she found her OCD mind had different plans. Unlike the common stigma of OCD, Kerry found herself with a case of OCD that is the exact opposite of the known ‘perfectionism’, and ‘cleanliness’ oriented disorder.

Several dark years later, bound in the chains of OCD, the outsider found herself on a leather couch in a manic state, sitting across from the one therapist who would go on to mentor her to live an abundant life. Once confined to the isolation of her dorm room with no friends, a loss of identity, and betrayal of her own mind, Kerry pushed through to break the foundation of her dire belief system in OCD.

Passing through the waiting rooms of many untargeted therapists, Osborn finally found Jim Sterner, LMFT and enrolled in The Gateway Institute’s Intensive Therapy Program in 2010. It was during the program Kerry initially realized the disconnection of her magical thinking OCD. Osborn has worked for years to live a normal life credited to behavioral therapy and perseverance. Jim Sterner’s reflection on his work with Kerry over the years is profound, stating, “Coming from unimaginable depths of OCD, Kerry’s entire life was completely entangled in her intrusive thoughts, and almost every hour of every day was committed to neutralizing her fears and anxiety through hundreds of compulsions. After committing herself to intensive OCD treatment, Kerry has risen to improbable heights. Not only has she learned to live free of OCD, she has written a beautiful memoir about her personal journey, and is leading a website that has reached thousands of people that are continuously learning and benefiting from her experience. Kerry is a testament that if one dedicates themselves to treatment; one can overcome this dreadful disease in an overwhelming fashion. I am immensely proud of her progress along with her commitment to disseminate her knowledge for the benefit of others suffering from OCD.”

As Kerry slowly immersed back into living life again, she noticed the lack of patient-to-patient memoirs on the market demonstrating living a successful life after the worst of OCD. She decided to create the book of hope she wished she had found during her years of suffering. Osborn credits the book to being the friend she never had for other OCD sufferers to feel less alone and see first-hand that with the proper therapy, tools and perseverance, one can absolutely live an abundant life amidst Obsessive-Compulsive Disorder, in a state of ongoing OCD Recovery.

Kerry’s infectious, unapologetic, and refreshing voice doesn’t hold back. In her book, The Obsessive Outsider, she shares her journey, giving sound advice on how to tangibly do something about OCD. Putting the good, bad and the ugly on display for the world, she chooses to be a face for the misunderstood disorder that almost cost her everything. Kerry is devoted to proving that a life in recovery from the worst of OCD is possible, given the right tools and perseverance.

The Obsessive Outsider is now available to be purchased on Amazon in both print Kindle versions internationally, Apple iBooks, Barnes Noble, Nook, Kobo, Kobo Plus, Tolino, Baker Taylor, Scribd, 24 Symbols, OverDrive, Bibliotheca, Hoopla, !ndigo, Angus Robertson. The book is also available via ISBN on IngramSpark for library and bookstore purchases.

ISBN #: 978-0-578-57708-1

I’m trying not to let my OCD control me


brenna-header

I have a vivid memory of lying on the cold tile floor in my dark living room one night when I was 13. I was drowning in my own thoughts. I was alone and afraid. 

There were routines I had to follow every day. I checked my window five times before I went to sleep; I tapped my leg four times before the refrigerator door closed; I couldn’t wear a shirt again if I’d worn it on a bad day.

I knew what I was doing was illogical, but I couldn’t stop. 

I thought I might have had some general anxiety, but little did I know it was so much more than that. I tried therapy in eighth grade because my thoughts became too much for me to handle on my own, but nothing seemed to be working.

My therapist at the time never diagnosed me with anything specific, but I knew what I was feeling wasn’t normal. There’s no way anyone could manage living like this for the rest of their life, I thought. 

I don’t remember the exact age I was when I first read about obsessive-compulsive disorder, but I do remember being shocked at how much I related to the symptoms. 

A lot of people believe OCD is limited to people who are germaphobes or “neat freaks.” But not all people with OCD deal with those specific issues, and not all people who have germophobia or think of themselves as “neat freaks” deal with OCD. 

Because so many people overgeneralize OCD, it was hard for me to identify with the disorder because I thought I had to be extremely organized or afraid of shaking someone’s hand. However, I eventually figured out that OCD was what I was dealing with, as well as general anxiety disorder and depression. 

At 13, that’s a lot to handle. 

I remember thinking, “It’s going to be OK, I won’t have to deal with this forever. When I’m an adult, this will be gone.” 

How wrong I was. 

I spent the next six years completely consumed by my mental disorders. I felt like I was in a prison in my own head and had no control over my own life. A common feeling among those with mental illnesses, I felt like the only person I had to blame was myself.

Fast forward to last year. I was 19 and probably at the lowest point in my life, I felt consumed and paralyzed by my thoughts. 

It felt hopeless — I couldn’t escape from my own head. I would come home after class and just lay in my dark bedroom and sleep. 

It came to a point where I knew my OCD and depression were going to completely take over if I didn’t do something about it. I began searching for a therapist and ended up with the one I have today. I remember my thoughts trying to invalidate me, telling me “you’re not that bad, you don’t have OCD.” The thoughts grew louder and louder until my therapist finally diagnosed me with OCD. 

I felt a blanket of relief fall onto me. I know that may sound strange — that I was happy when I was diagnosed — but the diagnosis meant I was finally validated, and I wasn’t crazy for thinking that I had OCD. 

Things didn’t change overnight. It took a lot of work to get to where I am now. I was prescribed medication and was constantly working in therapy to control my OCD, instead of letting it control me. 

I have good and bad days like anyone else. I know now that this is something I will have to continue battling probably for the rest of my life, and I’ve accepted that. I will battle the intrusive thoughts every day because I deserve to live my life. 

Living with OCD feels like you are stuck in a box and you aren’t allowed to move, otherwise, everything will collapse on top of you. 

What’s so ironic about it is that my OCD would tell me that if I carry out these routines and compulsions, that I will have control over everything in my life, when in reality, I had lost all control and the disorder was controlling me. 

I also know that OCD is a coping skill, and part of its purpose is to help me — but it’s a toxic relationship. 

It’s like the boyfriend who tells you he loves you, but you’ll be nothing without him. Living with that in your head every day and not being able to escape from it can be torturous. 

My toxic OCD boyfriend never left me, and I don’t think he ever will, but I’m much better at shutting the door in his face before I let him inside my house. 

Because of therapy, I have tools in my toolbox that allow me to better manage what I can control in my life. These learned skills allow me to sit with OCD and tell it to leave when it has overstayed its welcome.

Editor’s note: For mental health services on campus, visit https://eoss.asu.edu/counseling. For immediate assistance, call 480-921-1006.


Reach the reporter at bstoshne@asu.edu and follow @itsbrennaaaa on Twitter. 

Like The State Press on Facebook and follow @statepress on Twitter.


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Lili Reinhart defends OCD comment from Tonight Show interview following critcism

18 November 2019, 16:08 | Updated: 18 November 2019, 16:27

By Katie Louise Smith

Lili made a comment about obsessive compulsive disorder while speaking to Jimmy Fallon which caught some backlash from viewers.

Riverdale and Hustlers star Lili Reinhart has always been a vocal public figure when it comes to having honest and candid discussions about body image and mental health.

Last week, it was revealed that Lili had been included on TIME’s 100 Next list, as one of the rising stars shaping their industries and the future. She also recently did a cover interview with Glamour magazine, where she opened up about how depression has affected her life.

READ MORE: Riverdale’s Lili Reinhart admits playing Betty Cooper has “damaged” her natural hair

“I’ve experienced depression and anxiety. Not constantly, but I’m still experiencing it,” she shared. “I have spells of time where I feel completely unmotivated, I don’t want to do anything and I question myself…I find that talking about it and sharing my experience with other people, and reminding myself that I’m not alone has been incredibly therapeutic.”

Discussing all her recent successes, Lili stopped by The Tonight Show with Jimmy Fallon last week (Nov 14) but her comment about OCD appears to have been taken the wrong way and now she’s taken to Twitter to defend what she said.

Lili Reinhart defends her OCD comment on Tonight Show.

Picture:
Andrew Lipovsky/NBC/NBCU Photo Bank via Getty Images


Speaking about how she managed to pull off her hilarious vomit scenes in Hustlers, Lili explained that the prop department mixed up a concoction of animal crackers and Sprite to act as fake vomit.

“I thought I was gonna have a problem here because I have this really OCD thing with floaters in water and drinks. Like if my drink has a little floater in it, I’m like [heaves],” Lili explained. “So like, having basically a cup full of something that looked like floaters was my worst nightmare but it was fine.”

Following the interview, Lili’s comments were clearly met with some backlash because it prompted her to respond and clarify her comment on Twitter.

“I actually do suffer from OCD, it wasn’t just a little quip I made on a talk show,” she wrote. “I’ve had OCD since I was in elementary school. So, yes. I do have the right to talk about it. Thanks.”

OCD (which stands for Obsessive compulsive disorder) can manifest in individuals in several different ways and can be brought on by a multitude of things. It can be incredibly debilitating for those that have been diagnosed with the condition but it’s also often used as an off-hand comment by people who don’t necessarily have it.

Following Lili’s tweet, fans flocked to the replies to thank her for always speaking so openly about her experiences and mental health issues.

“All the negative comments are childish, when they have absolutely no idea or control over the situation,” one commenter wrote. “So happy you’re openly speaking out about this, because there aren’t many people who do so.”

Another said: “People never take my ocd seriously. That’s because everyone claims to have it.”

Yesterday (Nov 17), Lili also called out a photo editing app “BodyTune” on Instagram for perpetuating unrealistic body image expectations.

Taking to Instagram stories, she wrote, “This is not okay. This is why people develop eating disorders. This is why social media has become hazardous to our health. This is why people have unrealistic expectations of their bodies.”

“Looking skinnier on Instagram is not worth the detrimental psychological effects that these photoshopping apps have given our generation.”

Lili, you’re doing amazing sweetie.

CBT improves long-term outcomes for anxiety-related disorders

Cognitive behavioral therapy may improve outcomes for anxiety-related disorders compared with control conditions up to 1 year after treatment completion, according to results of a systematic review and meta-analysis published in JAMA Psychiatry. Beyond 1 year, effects vary by specific disorder, researchers noted.

“Anxiety-related disorders are characterized by a chronic course, thus sustainable treatment effects are important,” Eva A. M. van Dis, MSc, of the department of clinical psychology at Utrecht University in the Netherlands, and colleagues wrote. “The results of this meta-analysis suggest that, on average, CBT was associated with moderate symptom reductions in anxiety disorders, PTSD and [obsessive-compulsive disorder] until 12 months after treatment completion. After 12 months, these effects were still present for [generalized anxiety disorder], [social anxiety disorder] and PTSD, but not for [panic disorder with or without agoraphobia].”

According to van Dis and colleagues, meta-analytic evidence on long-term outcomes of CBT on anxiety-related disorders is sparse. In the present study, the researchers compared long-term outcomes of CBT with care as usual, relaxation, psychoeducation, pill placebo, supportive therapy and waiting list for OCD, PTSD and anxiety disorders. They analyzed data from 69 randomized clinical trials that included 4,118 outpatients and at least 1-month follow-up effects of CBT compared with control conditions.

They found that among the included trials — most of which were “of low quality” — CBT compared with control conditions was associated with improved outcomes after treatment completion, as well as at 1 to 6 months and 6 to 12 months for the following:

  • generalized anxiety disorder (Hedges g = 0.07-0.4);
  • panic disorder (Hedges g = 0.22-0.35);
  • social anxiety disorder (Hedges g = 0.34-0.6);
  • specific phobia (Hedges g = 0.49-0.72);
  • PTSD (Hedges g = 0.59-0.72); and
  • OCD (Hedges g = 0.7-0.85).

These associations remained significant after 12-months follow-up for generalized anxiety disorder, social anxiety disorder and PTSD, but not for panic disorder. Associations could not be calculated for specific phobia and OCD, according to the researchers. Among six randomized clinical trials, relapse rates after 3 to 12 months were 0% to 14% — predominantly for panic disorder.

“More high-quality randomized clinical trials on long-term treatment effects (preferably beyond 12 months after treatment completion) and relapse are warranted to facilitate more reliable long-term effect size estimations,” the researchers wrote. – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.

One in five autistic adults may have an anxiety disorder

Young man looks out of window, anxiouslySilent condition: Anxiety in autistic people often goes undiagnosed.

VMJones / Getty Images

Adults with autism are more than twice as likely as neurotypical people to be diagnosed with an anxiety disorder, a new study suggests1. Their non-autistic siblings are also more likely than the general population to receive an anxiety diagnosis.

The study is among the largest to probe the prevalence of anxiety in autistic adults. And unlike many earlier studies, it looks at specific anxiety disorders, such as post-traumatic stress disorder and panic disorder2,3.

Little is known about the prevalence of these conditions among adults with autism, says Dheeraj Rai, consultant senior lecturer in psychiatry at the University of Bristol in the United Kingdom. “We are still very far behind in terms of how we measure [anxiety] in autistic adults.”

The new study also underscores the need for clinicians and caregivers to monitor anxiety in autistic adults.

“Anyone working with autistic people ought to be looking at anxiety carefully,” says Mikle South, professor of psychology and neuroscience at Brigham Young University in Provo, Utah, who was not involved with the work.

High anxiety:

Rai and his colleagues studied the health records of adults aged 18 to 27 in the Stockholm Youth Cohort. Of the 221,694 people they sampled, 4,049 have an autism diagnosis.

The team cross-referenced the health records with registries of people who have psychiatric diagnoses to identify adults with anxiety disorders.

They found that 20 percent of the autistic adults have an anxiety disorder, compared with less than 9 percent of the typical adults. Nearly 3.5 percent of the autistic adults have obsessive-compulsive disorder and about 3 percent have social phobia, compared with about 0.5 percent of controls for each condition. The work appeared in October in the Journal of Autism and Developmental Disorders.

The differences may in fact be even bigger because anxiety often goes unrecognized in autistic people, experts say.

“Most of the tools to measure and diagnose anxiety have been developed on neurotypical populations, which leaves the rest of us wondering how reliable and valid they are in people with autism,” says John Herrington, assistant professor of child psychiatry at the University of Pennsylvania, who was not involved in the research.

Family factors:

The fact that non-autistic siblings of autistic adults also have higher odds of anxiety than the general population suggests that genes or shared environmental factors may contribute to the overlap between the two conditions, the researchers say.

Anxiety diagnoses are most common among autistic adults of average intelligence or above. This may be because anxiety can be especially difficult to diagnose in adults with intellectual disability, who may be minimally verbal.

“Being able to diagnose anxiety requires someone to tell you about it,” South says. “If there’s low language, there’s going to be much less ability to report the anxiety.”

The new results parallel those of a previous study of the Swedish cohort, in which the same team found higher odds of depression among autistic adults of average intelligence or above than among those with below-average intelligence.

The next step, researchers say, is to understand why anxiety is so prevalent among autistic people, and to find better ways to assess and treat it.

Lili Reinhart clarifies she has OCD, but what are the symptoms of the condition?

Many of us would likely admit to making a flippant quip about being ‘a little bit OCD’.

In fact the shortened term for Obsessive Compulsive Disorder is bandied about so regularly in everyday chat that sometimes the fact that it is a real mental health disorder is completely overlooked.

Actor Lili Reinhart has been accused of doing just that.

Last week, the ‘Riverdale’ actress appeared on ‘The Tonight Show Starring Jimmy Fallon’ to discuss scenes from the film ‘Hustlers’, in which her character reacts to stress by vomiting.

“It was actually animal crackers and Sprite mixed together,” Lili said of the fake vomit used.

“I thought I was going to have a problem here because I have this really like, OCD thing with floaters in water and in drinks.

“Like if my drink has a little floater in it, I’m like, get it out. That’s when I want to throw up! So having a cup of something that basically looked like ‘floaters’ in water was like my worst nightmare.”

READ MORE: The most common mental health conditions – and where to get help

After her interview, she faced some criticism, with some suggesting she was making light of the disorder.

However, Lili has set the record straight and revealed that she wasn’t joking and in fact she has been diagnosed with OCD.

“I just want to put out there re: my Fallon interview— I actually do suffer from OCD, it wasn’t just a little quip I made on a talk show,” she tweeted.

“I’ve had OCD since I was in elementary school. So, yes. I do have the right to talk about it. Thanks.”

Since clearing up the situation, a number of fans have praised the 23-year-old for helping to throw light on the condition. 

Most of us would admit to occasionally dropping a light-hearted reference about being a little OCD, even if we don’t actually suffer from the condition, so it’s understandable people initially mistook Lili’s statement as something similar.

While most quips likely aren’t intended to mock people who have a mental illness, they are symptomatic of how society views the condition.

But while OCD is something that many of us are aware of, what is not widely known is just how vast OCD can be and the full effect it can have on someone’s life.

READ MORE: Boohoo are under fire for ‘Obsessive Compulsive Christmas’ PJs

According to the mental health charity Mind, OCD affects an estimated 1.2 per cent of the population in the UK.

Having OCD isn't something we should joke about [Photo: Getty]Having OCD isn't something we should joke about [Photo: Getty]

What is OCD?

“Obsessive Compulsive Disorder (OCD) is an anxiety-related mental health condition which, when severe, can be disabling,” explains Abie Taylor-Spencer, TMS Technician at mental health clinic Smart TMS.

“OCD affects men and women equally and although it typically tends to occur during late adolescence or early adulthood, it can begin at any age.”

What are the main symptoms of OCD?

According to Abie Taylor-Spencer the main symptoms of OCD can be categorised into two significant areas; obsessions and compulsions.

Obsessions: “These are uncontrollable thoughts, images, worries or urges which someone experiences recurrently and can trigger intense distress,” she says.

“The intrusive thoughts can be difficult to ignore and occur frequently, causing extreme anxiety and preoccupation which prevents the individual from regular day to day functioning.

Abie says that common obsessions in OCD include; causing or failing to prevent harm, perfectionism, scrupulosity (concern with religious issues such as morality and blasphemy) and the fear of contamination and illness.

Compulsions: “The compulsions are repetitive and time-consuming behaviours which an individual performs in an attempt to relieve the anxiety caused by the obsessive thoughts,” she explains.

“These can be physical actions or rituals, such as washing or cleaning excessively, arranging things in a specific way, checking that appliances are turned off and that doors are locked.

Abie says that many compulsions involve numbers; for example, compulsions may involve activities (such as turning on a light switch) having to be repeated a specific number of times without the ritual being interrupted.

What are the causes of OCD?

According to Abie there are different factors which may contribute to the development of OCD.

“The condition may be triggered by a combination of genetic, neurological, behavioural, cognitive, and environmental factors,” she explains.

“Imbalances in neurotransmitters such as serotonin and glutate have been recognised as potential factors in the development of this disorder.”

And having relatives with OCD can significantly increase the likelihood of an individual developing OCD.

OCD misconceptions

According to Dr Dimitrios Paschos, Consultant Psychiatrist at Re:Cognition Health Obsessive Compulsive Disorder can manifest in a myriad of different ways, affecting each individual differently.

“One of the biggest misconceptions is that people with OCD like having everything ordered, keeping things organised and neat and tidy,” he explains.

“Another misconception is that they like washing their hands constantly, keeping themselves clean and germ-free; they do it because they enjoy it.

“OCD is much more than keeping things organised, clean and germ free and it is certainly not an enjoyable experience for the individual. In fact, it is a serious mental health condition that presents with high, often crippling levels of anxiety and distress.

 “People with OCD have compulsions to perform particular rituals in order to appease anxiety that builds up, which can be deliberating. The most common OCD compulsions include counting, repetitive movements, ordering things in a particular manner, hoarding (newspapers, magazines) excessive cleaning, handwashing and touching objects. 

“OCD is a medical condition; it’s not just eccentric or quirky behaviour and it requires medical treatment,” he adds.

READ MORE: Having OCD is not a joke and it’s time we stopped treating it as such

What are the treatment options for OCD?

There are currently a few different treatment options that are available for people who are suffering from OCD.

  • Psychological treatments which include cognitive behavioural therapy (CBT) and exposure and response prevention (ERP). This involves exposure to the unwanted thought or situation to achieve habituation, which is where the compulsive response can be prevented over time.

  • Medications are available to treat OCD, which are typically used when an individual does not respond to psychological treatment. Commonly, selective serotonin reuptake inhibitors (SSRIs) such as citalopram and sertraline are used to alter the balance of chemicals in the brain. A tricyclic antidepressant such as clomipramine may be prescribed. But around 40% of individuals with OCD do not respond to medication.

  • Transcranial magnetic stimulation (TMS) can also be used to treat OCD. Research has found that OCD is linked to increased activity in the supplementary motor area (SMA), and reducing activity in this area can lead to improvement in OCD symptoms.

Lili Reinhart clarifies that she does have OCD, but what are the symptoms of the condition?

Many of us would likely admit to making a flippant quip about being ‘a little bit OCD’.

In fact the shortened term for Obsessive Compulsive Disorder is bandied about so regularly in everyday chat that sometimes the fact that it is a real mental health disorder is completely overlooked.

Actor Lili Reinhart has been accused of doing just that.

Last week, the ‘Riverdale’ actress appeared on ‘The Tonight Show Starring Jimmy Fallon’ to discuss scenes from the film ‘Hustlers’, in which her character reacts to stress by vomiting.

“It was actually animal crackers and Sprite mixed together,” Lili said of the fake vomit used.

“I thought I was going to have a problem here because I have this really like, OCD thing with floaters in water and in drinks.

“Like if my drink has a little floater in it, I’m like, get it out. That’s when I want to throw up! So having a cup of something that basically looked like ‘floaters’ in water was like my worst nightmare.”

READ MORE: The most common mental health conditions – and where to get help

After her interview, she faced some criticism, with some suggesting she was making light of the disorder.

However, Lili has set the record straight and revealed that she wasn’t joking and in fact she has been diagnosed with OCD.

“I just want to put out there re: my Fallon interview— I actually do suffer from OCD, it wasn’t just a little quip I made on a talk show,” she tweeted.

“I’ve had OCD since I was in elementary school. So, yes. I do have the right to talk about it. Thanks.”

Since clearing up the situation, a number of fans have praised the 23-year-old for helping to throw light on the condition. 

Most of us would admit to occasionally dropping a light-hearted reference about being a little OCD, even if we don’t actually suffer from the condition, so it’s understandable people initially mistook Lili’s statement as something similar.

While most quips likely aren’t intended to mock people who have a mental illness, they are symptomatic of how society views the condition.

But while OCD is something that many of us are aware of, what is not widely known is just how vast OCD can be and the full effect it can have on someone’s life.

READ MORE: Boohoo are under fire for ‘Obsessive Compulsive Christmas’ PJs

According to the mental health charity Mind, OCD affects an estimated 1.2 per cent of the population in the UK.

Having OCD isn't something we should joke about [Photo: Getty]Having OCD isn't something we should joke about [Photo: Getty]

What is OCD?

“Obsessive Compulsive Disorder (OCD) is an anxiety-related mental health condition which, when severe, can be disabling,” explains Abie Taylor-Spencer, TMS Technician at mental health clinic Smart TMS.

“OCD affects men and women equally and although it typically tends to occur during late adolescence or early adulthood, it can begin at any age.”

What are the main symptoms of OCD?

According to Abie Taylor-Spencer the main symptoms of OCD can be categorised into two significant areas; obsessions and compulsions.

Obsessions: “These are uncontrollable thoughts, images, worries or urges which someone experiences recurrently and can trigger intense distress,” she says.

“The intrusive thoughts can be difficult to ignore and occur frequently, causing extreme anxiety and preoccupation which prevents the individual from regular day to day functioning.

Abie says that common obsessions in OCD include; causing or failing to prevent harm, perfectionism, scrupulosity (concern with religious issues such as morality and blasphemy) and the fear of contamination and illness.

Compulsions: “The compulsions are repetitive and time-consuming behaviours which an individual performs in an attempt to relieve the anxiety caused by the obsessive thoughts,” she explains.

“These can be physical actions or rituals, such as washing or cleaning excessively, arranging things in a specific way, checking that appliances are turned off and that doors are locked.

Abie says that many compulsions involve numbers; for example, compulsions may involve activities (such as turning on a light switch) having to be repeated a specific number of times without the ritual being interrupted.

What are the causes of OCD?

According to Abie there are different factors which may contribute to the development of OCD.

“The condition may be triggered by a combination of genetic, neurological, behavioural, cognitive, and environmental factors,” she explains.

“Imbalances in neurotransmitters such as serotonin and glutate have been recognised as potential factors in the development of this disorder.”

And having relatives with OCD can significantly increase the likelihood of an individual developing OCD.

OCD misconceptions

According to Dr Dimitrios Paschos, Consultant Psychiatrist at Re:Cognition Health Obsessive Compulsive Disorder can manifest in a myriad of different ways, affecting each individual differently.

“One of the biggest misconceptions is that people with OCD like having everything ordered, keeping things organised and neat and tidy,” he explains.

“Another misconception is that they like washing their hands constantly, keeping themselves clean and germ-free; they do it because they enjoy it.

“OCD is much more than keeping things organised, clean and germ free and it is certainly not an enjoyable experience for the individual. In fact, it is a serious mental health condition that presents with high, often crippling levels of anxiety and distress.

 “People with OCD have compulsions to perform particular rituals in order to appease anxiety that builds up, which can be deliberating. The most common OCD compulsions include counting, repetitive movements, ordering things in a particular manner, hoarding (newspapers, magazines) excessive cleaning, handwashing and touching objects. 

“OCD is a medical condition; it’s not just eccentric or quirky behaviour and it requires medical treatment,” he adds.

READ MORE: Having OCD is not a joke and it’s time we stopped treating it as such

What are the treatment options for OCD?

There are currently a few different treatment options that are available for people who are suffering from OCD.

  • Psychological treatments which include cognitive behavioural therapy (CBT) and exposure and response prevention (ERP). This involves exposure to the unwanted thought or situation to achieve habituation, which is where the compulsive response can be prevented over time.

  • Medications are available to treat OCD, which are typically used when an individual does not respond to psychological treatment. Commonly, selective serotonin reuptake inhibitors (SSRIs) such as citalopram and sertraline are used to alter the balance of chemicals in the brain. A tricyclic antidepressant such as clomipramine may be prescribed. But around 40% of individuals with OCD do not respond to medication.

  • Transcranial magnetic stimulation (TMS) can also be used to treat OCD. Research has found that OCD is linked to increased activity in the supplementary motor area (SMA), and reducing activity in this area can lead to improvement in OCD symptoms.

Khloe Kardashian sees a therapist over her obsessive compulsive disorder and anxiety

Speaking on the reality TV show “Keeping Up With The Kardashian”, Kris said: “Khloe is the most organised, cleanest, most obsessive person I know in her own home. But lately, she’s on another level. I mean, the apple doesn’t fall too far from the tree. When we were raising the kids, I was always cleaning and organising and re-organising and moving things around, so I kind of feel responsible.

“But the one thing that I’ve learned through the years is that this desire to have everything perfect can really drive you crazy.

“If you have kids, everything isn’t going to be perfect all of the time. Ever since she finished doing renovations on her house, I’ve been more worried about Khloe’s obsessive cleaning…. It just is starting to really concern me.”

Kris then encouraged Khloe to see an exposure therapist who specialises in anxiety and obsessive compulsive disorder, and although she was sceptical at first, she agreed to do one session with her, reports femalefirst.co.uk.

She said: “She does these exercises with you that will help you learn how to deal with the anxiety that you’re feeling right now. You’ve got to see somebody. Just do it for me.”

The therapist pushed Khloe out of her comfort zone by making her deliberately mess up her home and swap her colour-coded food for random places.

Khloe said: “Being the control freak that I am, this experience is torture.”

Although she wasn’t cured in one session, she wants to keep practising.

She said: “What I take away from this experience is taking pride in your home, in your things — there are things that I like and they just can’t have power over me. This has been embedded in me my whole life, so acting a certain way is not going to happen with a couple of exercises, I’m not going to change.

“But I’m working on it, because it’s not a good way to live. I’m actually really proud of myself, I feel like I’ve got it together. I’m not as crazy about things. I’m better, I let it ride a little more.”

My baby bread baker!!! We bake bread together a few times a week I pray we continue this weekly tradition forever ♡

A post shared by Khloé (@khloekardashian) on Nov 16, 2019 at 8:11pm PST

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