Son`s birth helped Megan Fox get over obsessive compulsive disorder


Son`s birth helped Megan Fox get over obsessive compulsive disorderLos Angeles: Actress Megan Fox says after giving birth to son Noah last year, she has noticed improvement in her obsessive compulsive disorder.
Fox had opened up about the disorder in 2010 and how it did not allow her to eat outside because she feared germs and worried too much about hygiene.

However, the situation has changed ever since her son with husband Brian Austin Green came in her life.

“I think Brian was waiting to see what I would do during the birth, because, you know, when they come out they are covered in all kinds of stuff. I took him right on my chest and, from that moment, nothing he does freaks me out,” Marie Claire magazine quoted Fox as saying.

“I don`t want to give him a complex. (The anxiety) has been significantly better since he was born. I would say, like, 80 percent better. Which is nice,” she added.

IANS

Megan Fox (Reuters file photo)

Actress Megan Fox has overcome her battle with obsessive-compulsive disorder after giving birth to her son last year.

The Jennifer’s Body star opened up about her issues in 2010, and admitted she was so terrified of germs that she couldn’t bear to eat out at restaurants.

But after the arrival of her firstborn Noah, the star reveals her anxieties about bacteria have eased up.

She tells Britain’s Marie Claire magazine, “I think (husband) Brian (Austin Green) was waiting to see what I would do (during the birth), because, you know, when they come out they are covered in all kinds of stuff. I took him right on my chest and, from that moment, nothing he does freaks me out. I don’t want to give him a complex. (The anxiety) has been significantly better since he was born. I would say, like, 80 per cent better. Which is nice.”

Monday, February 4, 2013

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Troubled Paul Gascoigne’s life in danger: agent

Paul Gascoigne’s life may be in danger, the troubled England football hero’s agent said.

Terry Baker told BBC radio that the former Newcastle United, Tottenham Hotspur, Lazio and Rangers star, who has battled alcoholism and depression for many years, “immediately needs to get some help”.

He spoke as shocking pictures of the 45-year-old, looking bloated and dishevelled, appeared in the Sunday Mirror newspaper.

“I heard from Paul this evening and my best assessment would be — and I’ve told him this — he immediately needs to get some help,” said Baker.

The agent said Gascoigne had seemed “fairly incoherent” when they spoke on Saturday evening.

“Maybe no one can save him,” he added. “His life’s always in danger because he is an alcoholic, as he says.”

Baker said his client drunk before a charity event last Thursday and had insisted on appearing on stage, against his advice. Gascoigne had to be led from the stage “shaking uncontrollably”, Baker said.

Appealing directly to the former star, Baker said: “Paul, listen to me because you know I’ve got your best interests at heart — you must do what you know you must do.”

Known to fans as “Gazza,” Gascoigne made 57 appearances for England and is considered one of the most talented English players ever.

He is best known for his exploits at the 1990 World Cup in Italy, where he helped England reach the semi-finals.

But he has struggled with addiction and depression since retiring in 2004 and has spent time in rehabilitation clinics, as well as undergoing treatment for bulimia and obsessive compulsive disorder.

He was detained twice under the Mental Health Act in 2008.

The former star was given a suspended prison sentence in 2010 after admitting drink-driving, while a separate charge of drink-driving was dropped in 2011.

He has also been involved in a much-publicised row with his ex-wife.

Baker said Gascoigne had been in a fragile mental state in recent days, after a friend “died while they were holding his hand”.

“It’s haunting him,” Baker told the BBC.

He described Gascoigne as “the nicest, most generous, lovely person”.

“All he does is give to other people,” he added. “He’s really funny. Despite what people think, he’s quick-witted. But at the moment he’s not very well.”

Super Bowl fan rituals: superstition or OCD?

In the movie “Silver Linings Playbook,” Robert De Niro is a Philadelphia Eagles superfan whose love for his home team translates to some odd outward behavior: During the game, he positions the TV remotes just so, he manhandles an Eagles handkerchief, and, most importantly, he needs to have his son (played by Bradley Cooper), at his side.

The movie, which received eight Oscar nods for its story of the many shades of mental illness, seems to want you to wonder: When do sports superstitions veer into obsessive-compulsive disorder? The line is blurrier than you might imagine, some clinical psychologists say, and it’s getting especially blurry this week in the homes of San Francisco 49ers and Baltimore Ravens fans, as they look forward to Super Bowl Sunday.

On Thursday, 49ers fan Steve Bowen (named for Niners legend Steve Young) began the four-day ritual he follows leading up to every Niners game by wearing his favorite team hat all day. On Friday he’ll wear the 49ers hat with a red shirt he’s owned for years. “The day after that, same hat, different Niners shirt. Day of the game, the hat and the same red shirt underneath [my jersey],” Bowen says.

The rules, as any good superstitious sports fan knows, are these: “You have to start at the beginning of the season and you can’t change it up over the season,” explains Bowen, a 24-year-old University of Utah student. “If you change ‘em up over the season, your team will lose.” As the Bud Light ad says, “It’s only weird if it doesn’t work.”

OCD, of course, can be a serious, potentially debilitating anxiety disorder, and we don’t mean to take it lightly. But specifically, there are some parallels between sports superstitions and an aspect of OCD psychologists call “hyper-responsibility obsessions.”

Jeff Szymanski, a clinical psychologist in Boston and the executive director of the International OCD Foundation, gives the example that a person with OCD may walk down the street and see a piece of broken glass. “And it occurs to me, ‘Oh, someone might get injured. Then it occurs to me, because I have OCD, ‘If I don’t pick it up, then I might have caused that injury.’”

For superstitious sports fans, “the process, I think, is similar: ‘If I don’t do this, then I’m responsible for a bad outcome,” Szymanski says.

Even the most superstitious of fans are aware that they’re being ridiculous — but, still, they keep up the ritual, just in case. Niners fan Daisy Barringer wears a cheap, woven bracelet that says “49ers,” a trinket from a friend’s trip to Mexico.

Daisy Barringer

Daisy Barringer’s lucky 49ers bracelet.

“This year, I’ve worn the bracelet nonstop. I haven’t taken it off the whole season,” says Barringer, who is 35 and lives in San Francisco, where she works as a freelance writer. While snowboarding a couple of weeks ago, she fell and hurt her arm. In the ER, she refused to take the bracelet off for the X-rays (“This was after they won the championship game!”) — and the doctor, a 49ers fan himself, understood and acquiesced. (Luckily, it was just a sprain.)

“I need to do everything I can to support them and not jinx them in any way, shape or form,” Barringer says. “Because even though I know, rationally, I can’t affect the outcome, there’s this little thing in me that’s like, ‘What if?’”

Besides the bracelet, Barringer has accumulated tons of Niners stuff over the years — maybe too much, because she says she doesn’t have a good idea of what’s lucky and what isn’t. “So I decided next year I’m going — this is going to make me sound like a lunatic — I’m going to keep a spreadsheet of what I wear,” Barringer says. “I want to start keeping track so I know what my lucky shirt is and what my unlucky shirt is.”

And we’ll just leave this point here: Bowen, Barringer, and Craig Notarange of Orlando, Fla. (a superstitious Ravens superfan who believes if he sits down during a Ravens game, the team will start losing) all reiterate the same point: They know it’s irrational, they say, therefore, their behaviors could not be symptoms of OCD. But here’s a line from the National Institute of Health’s definition of OCD: “The person usually recognizes that the behavior is excessive or unreasonable.” (You do with that what you will.)

But here’s where superstitions and OCD start to diverge: For a person with OCD, the imagined stakes are much more dire than the question of who will win a football game (even if that football game is the Super Bowl). 

“When you think about sports, I’m doing something for a hobby. It’s something that’s fun. Even if I feel like it’s kind of stressing me out, it’s all in the service of entertainment,” Szymanski says. “And that’s where it parts company from OCD. After the game’s over, preoccupation with superstition dies away. It isn’t preventing them from getting to work, it isn’t preventing them from having relationships with their spouse or kids.”

Jojo Whilden / AP file

Jacki Weaver, left, and Robert De Niro in “Silver Linings Playbook.”

And that’s part of the definition of any mental illness, in general: Is the behavior interfering with your life?

In the case of De Niro’s “Playbook” character, at least, the answer to that might be yes. Minor spoilers to follow, but in the movie, the De Niro character bets big money, which the family couldn’t afford to lose, on the Eagles. “It wasn’t like, ha-ha, here’s 10 bucks. He was doing really big economic things that were affecting the family based on these obsessions — and the betting was the compulsion,” says Gail Saltz, a New York City psychiatrist and psychoanalyst who’s also a frequent TODAY contributor.

Bowen, on the other hand, agreed to attend his girlfriend’s Christmas party, even though it was during a 49ers playoff game. “Do I feel anxiety or do I feel uncomfortable by not watching the game? No. I had a great time at the party,” Bowen says. He adds, “Except I did wear my jersey underneath the shirt I wore to the Christmas party.”

When Super Bowl Superstitions Cross Over Into Obsessive Compulsive Disorder

PHOTO: Athletic fans with obsessive compulsive disorder, or OCD, often associate certain colors and numbers with bad luck and must perform rituals to avoid negative outcomes.

As football fans don their unwashed jerseys, sit in their favorite couch seats or line up their remote controls like Robert De Niro’s character in “Silver Linings Playbook,” many might wonder whether their Super Bowl superstitions might be crossing over into something more serious — such as obsessive compulsive disorder.

People with obsessive compulsive disorder, or OCD, often associate certain colors and numbers with bad luck, just like people who don’t have OCD, but there are a few critical differences: When OCD patients see these colors or numbers — or have other intrusive thoughts — they feel they must perform rituals to avoid catastrophic outcomes, said Jeff Szymanski, clinical psychologist and executive director of the International OCD Foundation.

“OCD gets in your head and says, ‘Look, this is going to happen if you don’t act,'” said Shannon Shy, who lived with severe OCD for years until he found a way to manage it. “It’s as real to you as the sun rising.”

Click Here for More Coverage on Super Bowl XLVII


PHOTO: Athletic fans with obsessive compulsive disorder, or OCD, often associate certain colors and numbers with bad luck and must perform rituals to avoid negative outcomes.

PHOTO: Athletic fans with obsessive compulsive disorder, or OCD, often associate certain colors and numbers with bad luck and must perform rituals to avoid negative outcomes.













Shy, who is on the International OCD Foundation’s board, remembers how he would have to drive past the same log in the road 20 or 30 times to be sure it wasn’t a dead body. That was at the height of his disorder, when he hid the problem from the world and contemplated suicide.

“You decide, ‘How do I want to spend my day?’ but someone with OCD and superstitions doesn’t do that,” Szymanski said. “It’s distressing. It’s a have to, not an I prefer to.”

People with OCD — more than 2 million adults nationwide —
experience intrusive thoughts — obsessions — which can include fear of harm, contamination or losing control. To get rid of these thoughts, they perform rituals — compulsions — such as checking their stoves or washing their hands. Even praying can be a compulsion.

Join the ABC News Tweet Chat About OCD Today at 1 p.m. ET

In “Silver Linings Playbook,” the filmmakers showed De Niro’s character positioning remote controls just so and asking his son Pat (played by Bradley Cooper) to sit in a specific spot on the couch during Eagles games for good luck. Neither of these behaviors necessarily signaled OCD, Szymanski said. But the anxiety De Niro’s character displayed when he argued with his son for not sitting in the seat sounded to Szymanski like OCD.

OCD differs from putting on socks in a particular order to win a game, said Dr. Todd Peters, a psychiatrist at Vanderbilt Psychiatric Hospital in Tennessee

“That’s not really going to get in the way of life,” Peters said, adding that, in contrast, the person who anxiously has to repeat everything he did the day his team won probably has a problem. “Because life is ever-changing, they can’t expect other people to buy into their ritual or compulsion. … People get so stuck in their minds that they can’t get off that topic.”

Peters said people with OCD get “stuck” trying to rid themselves of anxious feelings through certain behaviors. Some of the behaviors are fairly logical, such as compulsive hand-washing to avoid germ contamination, but others are bizarre, such as needing to see a certain animal run to the right to keep a family member from dying. He’s seen patients exhibit both.

Obsessive Compulsive Reaction (Disorder)

An option was to use the internet and Google for a better and later version but some readers may see it as a thievery.

In this reaction the anxiety is associated with the presence in consciousness of unpleasant and morbid thoughts or repetitive impulses to perform apparently meaningless and realistic acts.  Although the patient may regard his ideas and behaviour as unreasonable, he is unable to control them. Either the obsessive thought or the compulsive ceremonial may arise singly or both may appear in sequence.   The patient regularly repudiates the distressing thoughts, which are often highly repugnant and concerned with violent aggressive or sexually perverse impulses.  However, the more he struggles to dispel his thoughts, the more insistently do they intrude.  Great fear may be associated with such ruminations, and a ritualistic act frequently serves as an attempt at mastery of the fear. 

The personality of obsessive-compulsive patients is characterized by inflexibility, constant doubt, vacillation and adherence to excessive standards of morality.   They tend to be over conscientious and inhibited in the expression of pleasure and in the capacity for relaxation.  A tendency toward checking and rechecking of the simplest acts contributes toward lack of productivity and the consumption of much energy in unprofitable and wasteful labour. 

The  Danger of Defence  Action

Although defence is undertaken in the service of self preservation, reason, mental equilibrium and social adaptation, such major interference with the natural forces in the human mind cannot fail to have serious consequences for the individual’s health and happiness.  The effort of maintaining a constant defence system is in itself a strain on the ego and may deplete it on energies needed for other constructive purposes.

Turning aggression against the self socializes the individual but simultaneously weakens his efficiency and creates a self destructive masochistic  attitude to life.   Regression may promise momentary safety from conflict but interferes severely as growth and development.  Repression above all is justly held responsible for damage to the personality.

Defence and Mental Illness

No neurosis maintains its structure   by employing one defence mechanism only, but always a combination of several.   Although defence mechanisms are an integral part of every neurotic structure, the presence of defensive activity in the mind is in itself no sign of pathology.  In cases where the defence is successful in controlling tensions, no symptomatology develops, although the effect may be crippling to the ego and impoverishing for instinctual life.

Where the defence mechanisms fail to ward off anxiety and “unpleasureâ€� and where repressed matter returns to consciousness, the ego is forced to multiply and over intensify its defensive efforts and to over stress the use of the various mechanisms.  It is in these instances, that, finally, the formation of neurotic symptoms is resorted to.  Such symptoms are compromise formations which express and represent at the same time the defensive tendencies of the ego and the pleasure seeking tendencies of the id.  Psychoses signify a sever breakdown in the defence system, characterised by the preponderance of the primitive mechanisms.

SOURCE: BRITANNICA  ENCYCLOPAEDIA   (1969) AND NO LONGER  IN PRINT


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Mount Sinai Opens New Center for Tic and Obsessive-Compulsive Disorders

New York, NY (PRWEB) January 24, 2013

Mount Sinai has officially opened a new center to treat and research tic and obsessive-compulsive disorders (OCD) in individuals of all ages. The opening coincides with a significant revision in the psychiatry field’s manual of mental disorders, which will now recognize OCD with its own category, rather than classifying it as an anxiety disorder.

The center is operated by a new Division of Tic, Obsessive-Compulsive, and Related Disorders (DTOR), created by the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai. The center is located in renovated space at 1240 Park Avenue on 96th Street, where a team of psychiatrists and psychologists see patients in a new clinical space. The patients also have access to ground-breaking clinical trials progressing just down the hall.

Obsessive-compulsive disorder (OCD) and tic disorders are known to be associated in many ways, including overlap of symptoms, genetic vulnerabilities, and neurobiological underpinnings. Both OCD and tic disorders may be associated with other problematic symptoms, such as mood, anxiety and behavioral difficulties, that need to be taken into account in comprehensive treatment planning.

“DTOR is in the vanguard of academic psychiatry because it embraces the concept that tic disorders and OCD frequently overlap and that these are life cycle disorders, not separate child and adult disorders,” said Wayne Goodman, MD, Chairman of the Department of Psychiatry at Mount Sinai and Chief, DTOR. “We are among the first medical centers to put this important concept into practice in a way that improves patient care and research. DTOR also anticipates changes in the upcoming DSM 5 manual, which makes OCD, currently listed under anxiety disorders, a separate mental disorder category.”

DTOR will offer treatments tailored to the individual’s unique diagnosis, age and severity of his/her symptoms. The clinical team also seeks to identify any additional clinical or environmental factors that may contribute to symptom severity or treatment effectiveness in order to provide the most comprehensive and sensitive care.

Adjacent to the new clinical space, DTOR researchers will study OCD and tic disorders and their relationship to each other using a variety of approaches, ranging from genetic analyses to functional brain imaging. Adults with treatment-resistant Tourette’s disorder (TD) will have access to a clinical trial of a promising medication currently used to treat seizures.

Other studies underway at Mount Sinai aim to identify specific genetic factors that play a role in the inheritance of tics, TD, and OCD; to evaluate changes in levels of a neurotransmitter called GABA in the brain of patients with TD; and to investigate changes in brain networks related to TD and OCD.

“The ultimate goal of our studying rare genes and their link to specific OCD and/or tic disorders is to identify new targets for treatment, whether pharmacological or behavioral, ” says Dorothy Grice, MD, Chief, Obsessive-Compulsive and Related Disorders Program.

OCD, which is characterized by recurrent, unwanted and distressing thoughts (obsessions) and repetitive behaviors (compulsions), affects one to two percent of the U.S. population. TD, the most complex among the tic disorders, is identified by repetitive involuntary movements and vocalizations, and affects approximately one percent of the U.S. population.

Barbara Coffey, MD, MS, Director of the Tics and Tourette’s Clinical and Research Program, gives one example of these co-existing disorders: “Approximately one-third of children with Tourette’s disorder continue to suffer from moderate to severe symptoms in adulthood, and most Tourette’s patients also present with other psychiatric disorders including OCD and ADHD.”

In many children with OCD or tics, two different forms of cognitive behavioral therapy—either exposure and response prevention or habit reversal, respectively—are often effective interventions. Medical therapy is another option for some patients. In the most severe and treatment-resistant cases of OCD, a neurosurgical procedure called Deep Brain Stimulation (DBS) may be considered.

DTOR’s clinical faculty of psychiatrists and psychologists includes world renowned specialists: Dr. Goodman; Dr. Coffey; and Dr. Grice.

New DSM 5 Category

Due out in May 2013, DSM-5, which provides a common language and standard criteria for classification of mental disorders, will include a separate category of disorders that contains OCD and so-called related disorders such as Body Dysmorphic Disorder, which involves repetitive body checking, Trichotillomania, which is compulsive hair pulling, and Hoarding Disorder. Dr. Goodman is an advisor to a national committee responsible for this revision, which is a major departure from the current DSM-IV wherein OCD is classified as an Anxiety Disorder.

About The Mount Sinai Medical Center

The Mount Sinai Medical Center encompasses both The Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai. Established in 1968, the Icahn School of Medicine at Mount Sinai is one of the leading medical schools in the United States. The Icahn School of Medicine is noted for innovation in education, biomedical research, clinical care delivery, and local and global community service. It has more than 3,400 faculty members in 32 departments and 14 research institutes, and ranks among the top 20 medical schools both in National Institutes of Health (NIH) funding and by U.S. News World Report.

The Mount Sinai Hospital, founded in 1852, is a 1,171-bed tertiary- and quaternary-care teaching facility and one of the nation’s oldest, largest and most-respected voluntary hospitals. In 2012, U.S. News World Report ranked The Mount Sinai Hospital 14th on its elite Honor Roll of the nation’s top hospitals based on reputation, safety, and other patient-care factors. Mount Sinai is one of just 12 integrated academic medical centers whose medical school ranks among the top 20 in NIH funding and by U.S. News World Report and whose hospital is on the U.S. News World Report Honor Roll. Nearly 60,000 people were treated at Mount Sinai as inpatients last year, and approximately 560,000 outpatient visits took place.

For more information, visit http://www.mountsinai.org/.

Find Mount Sinai on:

Facebook: http://www.facebook.com/mountsinainyc

Twitter @mountsinainyc

YouTube: http://www.youtube.com/mountsinainy

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Read the full story at http://www.prweb.com/releases/2013/1/prweb10355687.htm

Does my daughter have OCD? – Newstalk 106

Moncrieff’s Parenting Expert, David Carey, gives advice on how to spot and deal with OCD in teens.

I feel my 15 daughter has OCD. For example She finds it hard to concentrate at school due to intrusive thoughts and has checking compulsions but I can’t persuade her to go for professional help. Do you have any suggestions which would help me to persuade her to go?

Thank you for your question. At the start I would like to ask you a question. If you daughter was experiencing severe vomiting and a high fever would you be concerned about persuading her to go to a doctor or would you take control and get her to one?  The answer is obvious. Of course the comparison isn’t quite equal but the point is, I believe, simple: when a child needs help (and is under age 18) we take them for help. We don’t give them choices. Good parenting means doing what is right and taking charge.

Obsessive compulsive disorder (OCD) is a psychological condition effecting about 1.7 to 4% of the population. It is generally considered that in primary care settings (your GP) it frequently goes undiagnosed and as a consequence untreated. The condition is usually associated with anxiety and the obsession and compulsions are means to control the anxiety. Control is the central factor in OCD. The individual has a deeply rooted fear of loss of control. Rituals and compulsions become attached to the fear and are experienced as anxiety reducing tactics. The resulting cycle can be quite debilitation in  some cases.

It will be helpful to look at the best and mostly widely used descriptors of what behaviours or cognitions constitute obsessions and compulsions. This information is taken from the Diagnostic and Statistical Manual of Mental Disorders-4th edition (DSM-IV) which is used in the United States and Ireland to diagnose mental health conditions.

Obsessions are defined in the DSM-IV by the following 4 criteria:

  • Recurrent and persistent thoughts, impulses, or images are experienced at some time during the disturbance as intrusive and inappropriate and cause marked anxiety and distress. Persons with this disorder recognize the pathologic quality of these unwanted thoughts (such as fears of hurting their children) and would not act on them, but the thoughts are very disturbing and difficult to discuss with others.
  • The thoughts, impulses, or images are not simply excessive worries about real-life problems.
  • The person attempts to suppress or ignore such thoughts, impulses, or images or to neutralize them with some other thought or action.
  • The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without, as in thought insertion).

Compulsions are defined in the DSM-IV by the following 2 criteria:

  • An individual performs repetitive behaviours (eg, hand washing, ordering, checking) or mental acts (eg, praying, counting, repeating words silently) in response to an obsession or according to rules that must be applied rigidly. The behaviours are not a result of the direct physiologic effects of a substance or a general medical condition.
  • The behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. However, these behaviours or mental acts either are not connected in a way that could realistically neutralize or prevent whatever they are meant to address or they are clearly excessive.

I caution the reader that only a qualified mental health practitioner can assess for OCD. Do not use these criteria on your own and come to conclusions. They are meant as guidelines to help you recognise when someone needs professional assessment.

At some point in the course of the disorder the individual will recognise that their symptoms are illogical, out of control, not rational and interfering with life tasks. Reaching this point may take a long time. The people around the individual with OCD usually recognise this before the individual him or herself.

OCD is a condition that, if left untreated, will usually spiral out of control. The number, frequency and severity of obsessions and compulsions can increase dramatically. In severe cases attending to life tasks can become impossible. Children and adolescents with the condition will begin to have difficulties in school and with peers. Often they will try to conceal the symptoms through a variety of means or simply begin to isolate themselves. The earlier you go for help the easier it will be to treat the condition successfully.

Treatment

OCD is a condition that can usually be treated in an out-patient setting. Anxiety disorders (including OCD) are amongst the easier mental health conditions to treat successfully. Early intervention is essential. Treatment consists of a combination of relaxation therapy, cognitive behaviour therapy, family advisement and patient instruction and education. Even young children can be informed about their OCD and taught how to control it.

In some cases anti-depressant medication is required and it works best when combined with beahviour and cognitive behaviour therapy. Patients typically respond well to behavioural and cognitive interventions and recover well. Sometimes they experience a relapse and a short course of remedial therapy is required. In a small number of cases, the most severe ones, hospitalisation may be necessary. In severe cases there may be suicidal ideation associated with the condition but this is rare.

Conclusion

You need to bring your daughter to a qualified practitioner for assessment and possibly treatment. Get in touch with your GP soon for advice. Left unchecked the condition is likely to get worse. Treatment is usually short-term and quite effective. Your professional will liaise with your GP. Do not be afraid of upsetting your daughter. All children under the age of 18 need to know their parents will take control and get them help, regardless of how much they may oppose you in the process.

 

Moncrieff’s Parenting slot is every Wednesday at 3pm with David Carey,  a psychologist in practice in Stillorgan, Dublin. He is the author of the book, The Essential Guide to Special Education in Ireland.

Email your questions to the show afternoon@newstalk.ie.

http://www.newstalk.ie/Does-my-daughter-have-OCD-david-careyteenage mental health, mental health, Moncrieff, Parenting Slot, David Carey, OCD, Consulting pyschologist, adolescence advice

Caroline Clarke

Author image@carolineclarkewww.facebook.com/newstalkfm

Producer

Mind your mental health

We all feel down or panicky at times. But when does it translate to a mental illness requiring treatment? Kasmiah Mustapha look at seven recognised mental disorders and their symptoms

THERE are different types of mental illnesses and it is important to recognise the symptoms and to seek the right medical treatment. Here are some of them:

ANXIETY DISORDERS
The most common of mental illnesses, anxiety disorder is the umbrella that groups together panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social phobia (or social anxiety disorder), specific phobias and generalised anxiety disorder (GAD).

According to the US National Institute of Mental Health (NIMH), anxiety disorders last at least six months — unlike the relatively mild, brief anxiety caused by an event such as speaking in public or a first date — and can get worse if not treated.

Panic disorder is characterised by sudden attacks of terror, usually accompanied by a pounding heart, sweating and feeling weak, faint or dizzy. Those with OCD will have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.

A person who faces traumatic events can suffer from PTSD. They will lose interest in daily things, become irritable, aggressive or even turn violent.

Social phobia, also called social anxiety disorder, is when people become overwhelmingly anxious and excessively self-conscious in everyday social situations. They have an intense, persistent and chronic fear of being watched and judged by others and of doing things that may embarrass them.

They can worry for days or weeks before a dreaded situation. The fear may become so severe that it interferes with work, school and other ordinary activities, making it hard to make and keep friends.

NIMH states that most people who have one anxiety disorder may also have at least one more. Nearly 75 per cent of those with an anxiety disorder will experience their first episode by the age of 2.
•     Women are 60 per cent more likely than men to have an anxiety disorder at some point in their lives.
•  Famous people who suffer from anxiety disorders include Eric Clapton, Sheryl Crow, Johnny Depp, Anthony Hopkins, Nicole Kidman and Oprah Winfrey.

ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)
This commonly diagnosed mental disorder in children is more common in boys than in girls. It is usually discovered in the early years. The American Academy of Pediatrics expanded the age range of diagnostic guidelines to include children as young as 4 and up to age 18.

There are three subtypes: Predominately hyperactive-impulsive, predominately inattentive, and combined hyperactive-impulsive and inattentive.

A child may have all the symptoms in one category, or several from each. These include not paying attention to details, making careless mistakes, trouble focusing on tasks, not listening when spoken to directly, not following instructions, failing to finish work or chores (because of failure to understand, not defiance), having trouble organising activities and being easily distracted and forgetful in daily activities.

According to the Malaysian Psychiatric Association (MPA), a child may show inattention, distractibility, impulsivity, or hyperactivity at times but the one with ADHD shows these symptoms and behaviours more frequently and severely than his peers.

Children with ADHD would display these behaviours so frequently and severely that they interfere with normal activities, leaving them confused, frustrated or angry.

According to MPA, ADHD occurs in three to five per cent of school-going children. It usually begin before the age of 7 and  can continue into adulthood.
•     It runs in families, with about 25 per cent of biological parents having a similar condition.
•     People diagnosed with ADHD include  Britney Spears, Liv Tyler, Michael Phelps, Salma Hayek, Zooey Deschanel, Robin Williams, Justin Timberlake, Jamie Oliver, Will Smith and Jim Carrey.

BIPOLAR DISORDER
This serious mental illness, previously known as manic depression, is characterised by extreme changes in mood. Someone with bipolar disorder experiences alternating “highs” (what clinicians call mania) and “lows” (also known as depression).

Both manic and depressive periods can be brief, from just a few hours to a few days or longer and can last up to several weeks or even months.

Patients experience unusually intense emotional states in distinct periods called “mood episodes”. An overly joyful or overexcited state is called a manic episode and an extremely sad or hopeless state is called a depressive episode.

But because the pattern of highs and lows varies in individuals, bipolar disorder is a complex disease to diagnose.

When a sufferer is in a mania mood, he or she will be very happy or outgoing, behaves impulsively and takes part in high-risk behaviours. When experiencing depression, he or she will be restless, has trouble sleeping and eating, thinks of death or suicide and even attempt suicide.

Bipolar disorder is recurrent, meaning that more than 90 per cent of those who have had a single episode will go on to experience more.
•     Roughly 70 per cent  of manic episodes in bipolar disorder occur immediately before or after a depressive episode.
•     People who suffer from bipolar disorder include Carrie Fisher, Linda Hamilton, Sinead O’Connor, Vincent van Gogh, Catherine Zeta-Jones, Kurt Cobain and F. Scott Fitzgerald

BORDERLINE PERSONALITY DISORDER
The sufferers have brief psychotic episodes and experts originally thought of this illness as atypical or borderline versions of other mental disorders. According to NIMH, borderline personality disorder sufferers will show extreme reactions — including panic, depression, rage, or frantic actions — to abandonment, whether real or perceived.

They will have a pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love to extreme dislike or anger, distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future.

They will engage in impulsive and often dangerous behaviours, such as spending sprees, unsafe sex, substance abuse and binge eating as well as have recurring suicidal behaviours or threats or self-harming behaviour, such as cutting themselves.

The US National Education Alliance Borderline Personality Disorder (NEABPD) states that the illness rarely stands alone. People with borderline personality disorder often have other diagnosis. This is called co-morbidity or having co-occurring disorders. Common co-occurring disorders include substance abuse, eating disorders, anxiety disorders, bipolar disorder as well as other personality disorders. Over half of those with borderline personality disorder population suffers from major depressive disorder.

NEABPD states that the illness is more common than schizophrenia or bipolar disorder.
•     An estimated 11 per cent of outpatients, 20 per cent of psychiatric inpatients and six per cent of primary care visits meet the criteria for the disorder.
•     Obtaining an accurate diagnosis can be difficult.

DEPRESSION
We all feel depressed at one time or another. Some of us will be able to overcome the feeling but some may need to seek treatment as it can interfere with daily life and their ability to to function normally.

There are different types of depression —  major depressive disorder or major depression, dysthymic disorder or dysthymia, psychotic depression and postpartum depression.

Depression is characterised by a number of common symptoms, including a persistent sad, anxious, or “empty” mood and feelings of hopelessness or pessimism. A person who is depressed often feels guilty, worthless and helpless.

They also lose interest in activities or hobbies that they once found pleasurable. They experience fatigue and decreased energy, have difficulty concentrating and remembering details, insomnia (or they sleep excessively), overeat (or have no appetite), think of or attempt suicide and suffer aches and pain such as headaches, cramps, or digestive problems that do not ease with treatment.

The condition often goes undetected as we tend to dismiss the signs. Depression doesn’t need to strike all at once. It can be a gradual and nearly unnoticeable change from your normal life.

The World Health Organisation (WHO) has called for an end to the stigmatisation of depression and other mental disorders and for better access to treatment for all people who need it.

WHO states that globally, more than 350 million people suffer from depression but because of the stigma still attached to it, many fail to acknowledge that they are ill and do not seek treatment.
• People who have had to deal with depression include Ashley Judd, Billy Joel, Brooke Shields, Emma Thompson, Harrison Ford, Heath Ledger, J.K. Rowling, Olivia Newton-John, Owen Wilson and Rosie O’Donnell.

EATING DISORDERS
Eating disorders are real and treatable. They frequently coexist with other illnesses such as depression, substance abuse or anxiety disorders.

A person with an eating disorder may start by eating smaller or larger amounts of food but, at some point, the urge to eat less or more spirals out of control. Severe distress or concern about body weight or shape may also characterise an eating disorder.

Common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating. Anorexia nervosa is characterised by a relentless pursuit of thinness and the unwillingness to maintain a normal or healthy weight, an intense fear of gaining weight, a distorted image of one’s body, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight.

Those who suffer from bulimia nervosa seem to lack control over recurrent and frequent episodes of overeating. This is followed by forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise or a combination of these behaviours.

Some patients maintain what is considered a healthy or normal weight, while some are slightly overweight. But they also have the fear of gaining weight, want desperately to lose weight and are intensely unhappy with their body size and shape. Usually, bulimic behaviour is done in secret because it is often accompanied by feelings of disgust or shame.

The binge eating and purging cycle can happen several times a week to many times a day. With binge-eating disorder, a person loses control over his or her eating pattern but, unlike bulimia nervosa, this is not followed with purging, excessive exercise or fasting. As a result, sufferers are often overweight or obese. They experience guilt, shame and distress about their binge-eating, which can lead to more binge-eating.

People with anorexia nervosa are 18 times more likely to die early compared with people of similar age.
•     Singer Karen Carpenter died of complications from anorexia nervosa.
•     Others who have struggled with eating disorders include Paula Abdul, Lily Allen,  Victoria Beckham, Kate Beckinsale,  Kelly Clarkson, Katie Couric, Sally Field, Calista Flockhart, Lady Gaga, Demi Lovato, Mary-Kate Olsen and Oprah Winfrey.

SCHIZOPHRENIA
According to Mayo Clinic, schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in a combination of hallucination, delusion and disordered thinking and behaviour. It is not split personality or multiple personality.

Symptoms fall into three categories — positive, negative and cognitive. Positive symptoms reflect an excess or distortion of normal functions and include delusion, hallucination, thought disorder and  disorganised behaviour.

The negative symptoms refer to a diminishment or absence of characteristics of normal function. These include loss of interest in everyday activities, appearing to lack emotion, reduced ability to plan or carry out activities, social withdrawal and loss of motivation.

Cognitive symptoms involve problems with thought processes. These may be the most disabling in schizophrenia because they interfere with the ability to perform routine daily tasks. A person with schizophrenia may be born with these symptoms which include having a problem making sense of information, difficulty paying attention and memory problems.

Sufferers often aren’t aware that they require medical attention, so it is important for family members and friends to get them help.

Schizophrenia typically begins in early adulthood between the ages of 15 and 25. The average age of onset is 18 in men and 25 in women.
•     Schizophrenia onset is quite rare for people under 10 years of age, or over 40 years of age.
•     People with schizophrenia are not usually violent. In fact, few violent crimes are committed by people with schizophrenia who instead, are more inclined to  attempt suicide. About 10 per cent (especially young adult males) die by suicide.

 

Having frequent full-blown and long-lasting panic attacks mean treatment is required.

A child with ADHD often has trouble paying attention in class.

Catherine Zeta-Jones was diagnosed with bipolar disorder.

Depression is common yet many do not seek treatment even when the symptoms last a long time.

Karen Carpenter died of complications from anorexia nervosa.

Royce White Saga Takes Turn as Lengthy Daryl Morey Letter Surfaces

There’s a new development in the soap opera surrounding Royce White and the Houston Rockets.

Late Saturday night, the Houston Chronicle published a letter that Rockets general manager Daryl Morey sent to White on Nov. 20. The letter surfaced just hours after it was reported that White confirmed his desire for the team to hire a physician to monitor his mental health on a daily basis.

According to the Chronicle‘s Jonathan Feigen, Morey sent the letter to White after a series of meetings in November.

In the letter, Morey emphasized the team’s willingness to cooperate with White, and he states that the team has done everything it can to accommodate his needs:

As we have told you repeatedly, our goals are for you to be fully integrated into the Team and to have a healthy and productive season, both on and off the court. We have been committed to these goals from the day we drafted you, and have acted consistently with those goals ever since. We have bent over backwards to accommodate your requests and help you meet these goals…The bottom line is that we remain willing to work with you on issues that arise from legitimate medical need, but you have to come to games, practice and everything else that you are able to do, just like any other player.

Morey then listed some of White’s requests and how the team attempted to help him. He also says that White did not live up to his end of their agreements:

To revisit from the beginning, before we drafted you, you told us that your fear of flying was not an issue and that you were ready to be an NBA player. Shortly after we drafted you, you apologized for having to mislead us. You later indicated that you were feeling anxious about flying to the NBA’s rookie orientation program this summer. When you missed your scheduled flight, we arranged for a later flight and for Matt Brase to travel with you, working with the NBA to accommodate your concerns. Shortly after that, we informed you that we thought it would be beneficial for you to meet with Dr. Aaron Fink, a world-renowned psychiatrist, who could provide you with access to an appropriate professional in Houston to help should any situations arise. We gave you Dr. Fink’s contact information and several available times for an interview. You and your representatives responded that you viewed this as a very helpful step and confirmed that you would meet with Dr. Fink. You did not do so.

 

At the end of the letter, Morey quoted an addendum that White requested be included in his contract.

The page labeled “Mental Health Protocol” begins as follows:

In order for the working conditions to be safe and healthy for someone with mental illness/disability, it is the belief of the medical experts and myself credited for this document that a protocol has to be developed on how to appropriately deal with an individual in respect to mental illness(s)/disabilities from an operational and medical standpoint. A protocol will not only ensure the safe and healthy work conditions for a player like myself with mental illness, but also will lend a system of accountability for both the team and I to use to base what is the appropriate route of action.

Due to the lack of protocol regarding mental illness, this agreed upon document will serve as an addendum to insert into the medical category of the contract and team rules.

1. Protocol terms

a: Acknowledgment: Acknowledging mental illness/disability as being in the category of mental condition.

i. Recognizing the individualistic nature of mental illness

1. All mental illnesses unique to each individual despite similar diagnosis.

It’s unclear how the Chronicle obtained the letter, but it may not be a coincidence that it surfaced Saturday night. Earlier in the day, details emerged from White’s interview with correspondent Bernard Goldberg of HBO’s Real Sports With Bryant Gumbel.

White expressed various concerns about how the team was handling his highly publicized anxiety and obsessive compulsive disorders. The 16-minute segment will air Tuesday night.

The Rockets drafted White 16th overall in the 2012 NBA draft. He has yet to play a game with the team this season, and he hasn’t practiced with Houston since Nov. 6.

Odd: Ohio ex-teacher sues, says she fears young kids

CINCINNATI (AP) — A former high school teacher is accusing school district administrators of discriminating against her because of a rare phobia she says she has: a fear of young children.


Maria Waltherr-Willard, 61, had been teaching Spanish and French at Mariemont High School in Cincinnati since 1976.

Waltherr-Willard, who does not have children of her own, said that when she was transferred to the district’s middle school in 2009, the seventh- and eighth-graders triggered her phobia, causing her blood pressure to soar and forcing her to retire in the middle of the 2010-2011 school year.

In her lawsuit against the district, filed in federal court in Cincinnati, Waltherr-Willard said that her fear of young children falls under the federal American with Disabilities Act and that the district violated it by transferring her in the first place and then refusing to allow her to return to the high school.

The lawsuit seeks unspecified damages.

Gary Winters, the school district’s attorney, said Tuesday that Waltherr-Willard was transferred because the French program at the high school was being turned into an online one and that the middle school needed a Spanish teacher.

“She wants money,” Winters said of Walter-Willard’s motivation to sue. “Let’s keep in mind that our goal here is to provide the best teachers for students and the best academic experience for students, which certainly wasn’t accomplished by her walking out on them in the middle of the year.”

Waltherr-Willard and her attorney, Brad Weber, did not return calls for comment Tuesday.

Winters also denied Walter-Willard’s claim that the district transferred her out of retaliation for her unauthorized comments to parents about the French program ending — “the beginning of a deliberate, systematic and calculated effort to squeeze her out of a job altogether,” Weber wrote in a July 2011 letter to the U.S. Equal Employment Opportunity Commission.

The lawsuit said that Waltherr-Willard has been treated for her phobia since 1991 and also suffers from general anxiety disorder, high blood pressure and a gastrointestinal illness. She was managing her conditions well until the transfer, according to the lawsuit.

Working with the younger students adversely affected Waltherr-Willard’s health, the lawsuit said.

She was “unable to control her blood pressure, which was so high at times that it posed a stroke risk,” according to the lawsuit, which includes a statement from her doctor about her high blood pressure. “The mental anguish suffered by (Waltherr-Willard) is serious and of a nature that no reasonable person could be expected to endure the same.”

The lawsuit was filed in June and is set to go to trial in February 2014. A judge last week dismissed three of the ex-teacher’s claims, but left discrimination claims standing.

The lawsuit says that Waltherr-Willard has lost out on at least $100,000 of potential income as a result of her retirement.

Winters said that doesn’t make sense, considering that Waltherr-Willard’s take from retirement is 89 percent of what her annual salary was, which was around $80,000.

Patrick McGrath, a clinical psychologist and director of the Center for Anxiety and Obsessive Compulsive Disorders near Chicago, said that he has treated patients who have fears involving children and that anyone can be afraid of anything.

“A lot of people will look at something someone’s afraid of and say, ‘There is no rational reason to be afraid of that,'” he said. “But anxiety disorders are emotion-based. … We’ve had mothers who wouldn’t touch their children after they’re born.”

He said most phobias begin with people asking themselves, “What if?” and then imagining the worst-case scenario.

“You can make an association to something and be afraid of it,” McGrath said. “If you get a phone call that your mom was just in a horrible accident as you’re locking the door, you can make an association that bad news comes if you don’t lock the door right. It’s a basic case of conditioning.”

Can People Really Grow Out Of Autism?

English: A boy with autism. For the Artistic M...

A boy with autism. For the Artistic Mother’s Group: Samuel Study. (Photo credit: Wikipedia)

Let’s start with the headlines blaring the news about a recent autism study. They almost invariably use the phrase “grow out of autism,” even though the study itself does not use that phrase or even reference “grow” except to talk about head circumference. Instead, the authors of the report, published in The Journal of Child Psychology and Psychiatry, use the term “optimal outcomes” to describe what they detected in a group of 34 people who were diagnosed as autistic when they were under age 5.

As the study authors themselves state, this idea that autistic people might show reduced deficits to the point of losing a diagnosis is not new. In fact, first author Deborah Fein and colleagues cite studies identifying frequencies of “optimal outcomes” as high as 37% among autistic people. The lingering open questions relate to whether or not the autistic people in these studies had received the correct diagnosis in the first place. The only “novelty” of these latest results appears to be confirmation that indeed, the 34 people they identified as having an “optimal outcome” did receive an accurate diagnosis of autism in childhood. In other words, they are confirmed to have had a developmental disorder, a neurobiological condition called autism — yet, they “grew out of it.”

The rest? Nothing new. The people who show these optimal outcomes tend to have started out with, as the authors describe it, “higher cognitive functioning and somewhat milder initial symptoms.” Many of them had behavioral interventions in childhood. The researchers point out that the perception that everything’s all hunky-dory for the 34 people they evaluated does not rule out their having “residual difficulties” with various aspects of autism, including executive function–think project management–or language or social interaction.

For each participant, whose ages ranged from 8 to almost 22 years, the researchers interviewed the parents. One of the required parental answers for a participant to be considered for the optimal outcome category? The parent had to report that their child/adult child “had typically developing friends.” That question seems to imply a certain low expectation for autistic people, many of whom I know have “typically developing friends” despite themselves still being autistic. It certainly suggests that for people who continue to meet the criteria for an autism diagnosis, any pursuit of a friend of the “typical” sort would be futile.

How did those 34 “optimal outcome” participants do on the various measures of “are you autistic or not”? Well, seven of them–that’s 20% of the group–turned out to have “some impairment” in nonverbal social interaction. For reasons that are unclear, the researchers decided that these impairments were not the result of “an autistic quality” but of “inhibition, anxiety, depression, inattention and impulsivity, embarrassment, or hostility.” Of course, each of those themselves could be secondary to autism. Even though this 20% showed impairment, they were retained as being “optimal outcome” folk, those who, as the news media report might say, “grew out of” autism.

To determine whether or not these autistic people were still autistic, the research team administered a battery of tests; they list eight in their paper. Of these eight, three were parent completed. One consisted of clinician observation and scoring. One was an IQ test. One was a handedeness test (left-handedness is more common among autistic people), and the remaining two evaluated facial recognition and language. ETA: None of them examined if the participants retained any of the positive aspects of being autistic–refined sensory detection, detail orientation, pattern finding, etc.

Let’s go back to those news media stories. In one interview, lead author Fein commented that “these people did not just grow out of their autism.” She then goes on to credit the hard work of the parents and therapists of “these people” for any improvements, but I’d suggest that “these people” also did a lot of hard work–and probably still are doing so. The thing is, no one seems to have asked “these people” about that.

Among the many articles covering this study, I couldn’t find a single one featuring an autistic person commenting about the report. As you can see from how the researchers evaluated their 34 “optimal outcomers,” they don’t appear to have asked said optimals about how their internal function jibes with the external results or what they do to achieve those results. Because no one else seems to have bothered to ask autistic people these questions, I did. I polled the autistic community via social media, asking autistic adults what’s going on inside them when they appear outwardly typical and asking any readers if they felt they’d “grown out of” autism.

Their response was immediate and intense. “I don’t ‘look’ like I have it, but I do,” responded one autistic woman, who went on to describe how she’s learned over time about different expectations for behavior and tried to apply those. Others describe using pattern recognition to navigate socially, while still others report having an “optimal outcome”-like period in later childhood but then experiencing a trough of struggles in early adulthood as new responsibilities and expectations arose. They wrote to me about self-monitoring, about working hard to compensate in social situations but then experiencing crashing exhaustion afterward. They talked about self-selecting their social groups as adults as a way of feeling more socially at ease. The concepts that came up again and again and again were “compensating” and “coping.”

It’s not a huge surprise that autistic people with average or above-average cognitive abilities might be able to intellectualize social rules and algorithms and put them convincingly into practice. Does that ability mean that they aren’t really autistic? The real crux to answering that is this: Do we view autism only as a clinical diagnosis based solely on behavior and outward function, or do we talk about it as a neurobiological construct and identification, with an understanding of the context of the hidden disability and the hard work that those outward behaviors require?

Many conditions that we measure either directly with lab tests or behaviorally can lie under a mask of apparent normalcy or typicality. A woman with diabetes who maintains her blood sugar at a healthy level through diet and medication still has diabetes. A person with obsessive-compulsive disorder who fights successfully every second of every day against caving to obsession or compulsion still has the disorder. Anyone who has ever put on a public face when all they wanted to do was stay in bed should understand something about doing the internal hard work of compensating for a disability without showing outward manifestations of it.

Does that capacity mean, in the parlance of the news media reports or an editorial accompanying the paper, that the up to 25% of autistic people who can do this are “recovered” and no longer autistic? Or does it mean, rather, that they’ve become increasingly adept at meeting the interaction standards of the social majority?