Healthy Living: Anxiety Disorders

Most Common Type of Mental Health Problem
By- Dr. David Prescott

More than 40 million Americans have Anxiety Disorders: Nearly 18% of American adults experience some type of clinical anxiety disorder. This makes anxiety disorders one of the most common types of mental health problems. Learning the different types of anxiety disorders is an important step in overcoming them and reducing the negative impact of anxiety on your life.

Normal Anxiety vs. Anxiety Disorders: It is entirely normal for people to experience anxiety. In fact, many of us perform better (for example at work, school, athletics) when we are mildly anxious. The line between normal anxiety and an anxiety disorder has to do with the intensity of anxiety, the frequency of periods of extreme anxiety, and how much anxiety interferes with your daily activities. When anxiety becomes intense, frequent, and prevents you from completing your work, family commitments, or daily tasks, it may be time to seek help.

Types of Anxiety Disorders:

Social Phobia: Social phobia (most common type of anxiety disorder) is a strong fear of being judged by others and of being embarrassed. People with social phobia are afraid of doing common things in front of other people. For example, they might be afraid to sign a check in front of a cashier at the grocery store, or they might be afraid to eat or drink in front of other people, or use a public restroom. Most people who have social phobia know that they shouldn’t be as afraid as they are, but they can’t control their fear.
Panic Disorder: Panic disorder involves sudden, intense and unprovoked feelings of terror and dread. People who suffer from this disorder generally develop strong fears about when and where their next panic attack will occur, and they often restrict their activities as a result. The most common age of onset for panic disorder is in the early twenties.
Generalized Anxiety Disorder (GAD): People with GAD are extremely worried about these and many other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks. Often, people with GAD will visit their doctor for problems like headaches or difficulty falling asleep.
Obsessive-Compulsive Disorder: True obsessive-compulsive disorder (OCD) occurs less frequently than other types of anxiety disorders, impacting about 1% of the adult population. People with OCD feel the need to check things repeatedly, or have certain thoughts or perform routines and rituals over and over. Examples of common compulsions include washing hands or cleaning house excessively for fear of germs, or checking work repeatedly for errors.
Post-Traumatic Stress Disorder: Someone who suffers severe physical or emotional trauma such as from a natural disaster or serious accident or crime may experience post-traumatic stress disorder. Thoughts, feelings and behavior patterns become seriously affected by reminders of the event, sometimes months or even years after the traumatic experience. Unfortunately, many new cases of post-traumatic stress disorder have occurred in people who served in combat situations. The current prevalence of PTSD is estimated to be around 7.7% of the population.

Treatment for Anxiety Disorders:
Treatments for anxiety disorders include counseling, or psychotherapy, and for some people medications. Counseling techniques for anxiety disorders are highly effective, and typically involve changing anxiety provoking thought patterns, or learning to encounter a feared situation in a state of increased relaxation.
Medications for anxiety disorders may include specific medications to reduce physiological anxiety, or for some people antidepressant medications. Antidepressant medications often take a few weeks before they have their full benefit.
For any type of treatment, people may contact a licensed psychologist or other mental health professional, or talk with their primary care physician.

FOR MORE INFORMATION
American Psychological Association: www.apa.org/helpcenter

National Institute of Mental Health: http://www.nimh.nih.gov/

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Postpartum depression can be red flag for other psychiatric illnesses

More than one in five women who have postpartum depression also suffer from bipolar disorder, and many also experience anxiety disorders and have thoughts of harming themselves, according to a new study described as the largest scale screening for depression among new mothers in the United States.

The study, published online by The Journal of the American Medical Association’s JAMA Psychiatry, screened 10,000 new mothers and conducted in-home visits with more than 800 who were found to be at risk, providing researchers with a greater understanding of the onset and complications associated with postpartum depression.

While it confirmed that depression most commonly arises between four to six weeks after the birth of a child, it found that 33 per cent of cases occurred during pregnancy and nearly 27 per cent of patients experienced depression before conception.

“Because a majority of the mothers had symptoms before delivery …, we really might need to consider depression screening early on,” said psychiatrist Dorothy Sit of the University of Pittsburgh School of Medicine, one of the co-authors of the study. “We may be waiting until [it] could be too late for some of these mothers.”

The study’s findings largely support what was previously known about postpartum depression. The condition is believed to affect between 10 and 20 per cent of new mothers, and can last up to a year after the birth of a child. (Nearly 14 per cent of mothers involved in the study screened positive for depression.)

According to the Canadian Mental Health Association, references to postpartum depression date as far back as the 4th century BC, but since it has not always been recognized as an illness, it is often underdiagnosed.

The definitive causes for the condition have yet to be confirmed, but researchers are investigating its links to biological factors, such as the major dip in hormone levels experienced after delivery, genetics, sleep deprivation and stress on circadian rhythms, and psycho-social risks, including lack of support.

Sit noted that her study’s findings suggest postpartum depression is a complicated form of depression; physicians and patients need to be mindful of addressing possible additional diagnoses, including bipolar disorder, obsessive compulsive disorder, social phobia and generalized anxiety. In some cases, these other disorders may be underlying conditions that are not identified until after the patients give birth.

Despite its prevalence, however, it can be difficult for new mothers to recognize they have depression, in part, because of the chaos involved in caring for a newborn and dealing with the transition to parenthood.

“Some mothers and family members could write it off as being part of the normal experience,” Sit said, but she noted that besides extreme fatigue and an inability to focus or concentrate, common signs of postpartum depression include not being able to enjoy the things one used to enjoy, not getting pleasure out of spending time with one’s family and the newborn, sleeping excessively, not eating, and feeling anxious about things that never previously caused worry.

“This is not a normal part of the postpartum,” Sit emphasized. “Those symptoms truly indicate it’s a major depression.”

Sit noted that it is important to treat depression as early as possible, especially as the study found that nearly 20 per cent of new mothers who suffer from it have thoughts of hurting themselves.

Treatment must also be tailored to address other possible disorders, since medications prescribed for depression can make patients with bipolar disorder worse. Antidepressants, for instance, can result in mania, rapid cycling, loss of sleep, agitation and irritability among those with bipolar disorder, who instead would benefit from mood-stabilizing drugs.

Patients with anxiety may also have a better chance of improving with a combination of medication and psychotherapy.

Obsessive Compulsive Disorder Affects 11% Of Post-Natal Women, Study …

Post-natal OCD may be a previously unrecognised mental problem faced by many women after giving birth, new research suggests.

Experts estimate that about 11% of women who have recently given birth experience symptoms of obsessive compulsive disorder, compared with 2% to 3% of the general population.

The incidence rate is almost the same as that for post-natal depression, which affects around one in 10 new mothers.

Scientists suspect the conditions may be two sides of the same psychological coin.

OCD: Could Bacteria Be The Cause?

Symptoms are generally focused on the baby and include fears about accidental injury, dirt or germs and obsessive checking for mistakes.

In about half the cases investigated, OCD behaviour began to improve after about six months. However, some women only begin to display symptoms this long after delivery and the risk remains for up to a year after giving birth.

“It may be that certain kinds of obsessions or compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene,” said lead researcher Dr Dana Gossett, from Northwestern University in Illinois, US.

“But when it interferes with normal day-to-day functioning and appropriate care for the baby and parent, it becomes maladaptive and pathologic.”

OCD is a mental condition characterised by obsessive and frightening thoughts, and an irresistible urge to dispel them.

This can result in repetitive actions, such as constantly washing hands or mental rituals that include counting or avoiding “unlucky” colours. In severe cases the disorder can have a devastating effect on work and social life.

OCD may be triggered by stress, which could explain its association with pregnancy and childbirth, say the scientists.

BLOG: How I Live With Obsessive Compulsive Disorder

Manifestations of post-natal OCD include washing and re-washing bottles, and constantly checking that a baby is still breathing or that its cot is secure.

Some women report intrusive fears that they might harm their baby.

The researchers recruited 461 women in hospital to have a baby and screened them for anxiety, depression and OCD.

Tests were carried out two weeks after giving birth and six months after the women had gone home.

The results, published in The Journal of Reproductive Medicine, showed an OCD rate among the women of 11% – around five times the risk for the general population.

About half the women reported an improvement in their symptoms by six months. But some women who had not experienced OCD symptoms at two weeks only then began to suffer them.

About 70% of women who screened positive for OCD were also found to be suffering from depression.

“There is some debate as to whether post-partum (post-natal) depression is simply a major depressive episode that happens after birth, or its own disease with its own features,” said co-author Dr Emily Miller, also from Northwestern University.

“Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”

Related on HuffPost:

Obsessive disorder overdiagnosed, expert says

  • Obsessive disorder overdiagnosed, expert says  (Source: Photos.com)

Obsessive-compulsive disorder is a serious illness that society has made fashionable, says an Otago University psychologist.

Senior lecturer Chris Gale, who specialises in anxiety disorders, said the newfound popularity of OCD had people led to “pulling out the textbook and ticking their symptoms off”.

“The Americans are in the habit of diagnosing everything and everyone, but we don’t actually need to medicate everything.”

He said it was of growing concern that people made light of OCD and compared a few individual quirks to a debilitating illness that could stop people functioning.

“The key thing to measure is the threshold for treatment, and to actually have a disorder it has to be making your life a misery.”

The Phobic Trust, which supports and treats people with anxiety disorders, was also concerned about how “loosely” some people used the illness to describe their own behaviours.

“It’s important that people with certain traits, such as liking things clean or ordered, are not necessarily confused with people who genuinely suffer from OCD,” a spokeswoman said.

Those at the extreme end had their day-to-day lives constantly interrupted. “For those who have severe OCD, it would be very hard to hold down a job or just function in life.

“Leaving the house and getting things done would be extremely difficult.”

For some OCD sufferers, their illness carried a real stigma that made it difficult to confide in friends and family.

“Some of the people we see are very secretive about it and, although we encourage them to tell their family, many choose not to disclose it,” she said.

Psychologists have yet to find middle ground on an appropriate threshold for treating and medicating OCD, from which about 3% of the population suffers.

OCD is an anxiety disorder causing unwanted and repeated thoughts, feelings, ideas, sensations, obsessions or behaviours that make the sufferer feel driven to do certain things.

“Sometimes it might be an experience that triggered it but for others it’s brain wiring,” the spokeswoman said.

“There are also cases where there is a genetic predisposition, and more than one person in the family has it.”

OCD ON SCREEN

Tony Shalhoub as Monk in the American detective series of the same name.

Jack Nicholson as Melvin Udall in the movie As Good As it Gets.

Leonardo DiCaprio as Howard Hughes in The Aviator.

Nicolas Cage as Roy Waller in Matchstick Men.

Jack Lemmon as Felix Unger in The Odd Couple.

Leonardo DiCaprio says he has to stop himself from letting it take over his life.

Billy Bob Thornton is versed in repetitive compulsive actions, and has a phobia of antique furniture.

Charles Darwin showed classic signs of suffering from OCD.

David Beckham is obsessed with symmetry and hates odd numbers.

Michelangelo is believed to have had it.

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OCD Info for Law Enforcement

You arrive on scene of a single vehicle injury accident; paramedics are en route.  A young man is outside a car that is wrapped around a tree.  His clothes are bloody and he has a large laceration across his forehead.  He is the only victim.  He is clearly agitated; pacing, wringing his hands and is counting to seven over and over again.  As you try to redirect him away from the smoking car his agitation increases and he begins screaming about the blood and the germs and tells you to back away….

Your partner is driving you crazy.  Every time you leave the car he remotely locks and unlocks the doors repeatedly.  In the car, everything has its place.  Deviation of more than ¼” results in a readjustment.  He dusts his perfectly polished shoes after every call.  He wouldn’t be caught dead without gloves.  Yet, his attention to detail makes him one of the best cops on the watch.

Obsessive compulsive disorder (OCD) is characterized by a subject’s obsessive and repetitive intrusive thoughts followed by related compulsions (tasks or rituals) which attempt to neutralize the obsessions.  It is one of several forms of an anxiety disorder.  OCD symptoms cause anguish, take up a lot of time (more than an hour a day), or significantly interfere with the person’s work, social life, or relationships. Unlike other compulsive behaviors (drinking or gambling) OCD compulsions do not give the person pleasure.

Most people are at least a little OCD.  However, as you look at the symptoms of OCD, you need to evaluate degrees of severity.  Only 2½ percent of the U.S. population has true OCD, the lifetime prevalence of the disorder is 5%.  Many more people demonstrate obsessive compulsive traits. Under most circumstances, those traits will not interfere with a person’s life the way that an obsessive compulsive disorder does.  However, having these traits is considered as risk factors for developing the disorder. 

Can you leave your home without it being totally tidy? Do you crave reassurance? Do you find yourself rechecking things? Do you re-read/re-write your reports many times? How about repeatedly counting in your head?  Do you have excessive superstitions?  How far out of your way do you go to avoid walking under a ladder? Do you have lucky socks or a lucky color or number you repetitively wear or play? These all could be symptoms of obsessive compulsive disorder.

The Facts

OCD typically begins during adolescence or early childhood and effects men and women equally. It is a brain disorder, a medical disease that causes problems in information processing. On average, people with OCD see 3-4 doctors and spend over 9 years seeking treatment before they receive a correct diagnosis. Sufferers are generally of above-average intelligence, as the very nature of the disorder necessitates complicated thinking patterns.

The OCD Process and Diagnosis

Obsessions are recurrent and persistent thoughts, impulses, or images that cause marked anxiety or distress, which is not related to real-life problems. The sufferer attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action. Compulsions are repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. The person recognizes that the obsessive thoughts, impulses, or images are a product of his or her own mind, and the sufferer realizes that his/her obsessions or compulsions are unreasonable or excessive. The obsessions or compulsions must be time-consuming (taking up more than one hour per day) to be diagnosed as OCD.  Additionally, it must cause distress or impairment in social, occupational, or school functioning.

New Mom Anxiety May Be Too Much

(dailyRx News) Once you have a baby, you realize the huge responsibility of taking care of another life. But it is possible to go overboard on worrying about your child’s safety and well-being.

A recent study found that a small percentage of women appear to develop obsessive-compulsive symptoms after having a baby.

Obsessive-compulsive disorder (OCD) is an anxiety disorder in which a person becomes obsessive about certain worries or compulsively does a number of behaviors to the point that it is mentally unhealthy.

It’s estimated that 2 to 3 percent of individuals have OCD. However, the researchers found that the percentage appears higher among women after giving birth.

Around 10 to 11 percent of women show obsessive-compulsive symptoms in the first six months after having their babies.

The study, led by Emily S. Miller, MD, MPH, of the Department of Obstetrics and Gynecology at Northwestern University’s Feinberg School of Medicine in Chicago, aimed to understand how common obsessive-compulsive behaviors were among mothers after giving birth.

The researchers gave 461 women screening tests for depression, anxiety and OCD symptoms about two weeks after they gave birth. At the start of the study, only 0.4 percent reported having previously been diagnosed with OCD.

Then, six months after having their babies, 329 of these women filled out the same screening tests again. The others were lost to follow-up.

The researchers found that 11 percent of the women showed a number of symptoms for OCD at two weeks after delivery, though most of these (10 percent of the women) showed mild OCD overall.

None of the cases found in the screening tests were severe. None of the women received official diagnoses for this disorder; the women self-reported their feelings and behaviors.

Among the fears the women had were worries about injuring their baby and worrying about germs. These concerns are certainly normal for new mothers, the researchers said.

However, if the worries become so intense that they interfere with a mother’s ability to function day-to-day, then they could indicate a mental health problem.

At the six-month follow-up, nearly half the women who had the OCD symptoms after delivery still had them. Meanwhile, another 5.4 percent of the women who initially did not have OCD symptoms now developed symptoms of OCD, for a total of 10.6 percent.

Women who were found to have anxiety and/or depression during the screenings were more likely to also develop the OCD symptoms. In fact, about 70 percent of the women with OCD symptoms also showed symptoms of depression at two weeks after delivery.

A total of 27.5 percent of those who screened positive for OCD at two weeks after delivery also screened positive for anxiety.

At six months after delivery, both these numbers dropped: 5.7 percent of those with OCD symptoms showed symptoms of anxiety, and 43 percent of those with OCD symptoms had symptoms of depression.

The researchers concluded that “the postpartum period is a high-risk time for the development of OCD symptoms” and that they are likely to persist for at least six months.

However, more research is necessary to determine where the threshold is between normal behaviors of new moms and more obsessive behaviors that might indicate a psychological disorder.  

“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features,” Dr. Miller said in a prepared statement.

“Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode,” she said.

The study was published in the March/April issue of The Journal of Reproductive Medicine. Information regarding funding was unavailable. The authors declared no conflicts of interest.

Managing Obsessive Compulsive Disorder

Obsessive Compulsive Disorder is an illness that affects many Malaysian, and more than that many will have experienced it at some time in their lives.

It was already 11pm and Raju told his wife, “Let’s go to bed”. While his wife walk to their bedroom to settle in, Raju went to the back of his kitchen to make sure the iron grill was locked.

Raju’s wife suddenly woke up, as she had dozed off while waiting for Raju to come to bed. She look at the clock by the bed and it was now close to 11:45pm.

“Where is Raju?” She gets up and walks to the back, towards her kitchen. There she sees Raju busy locking the door, then unlocking it and locking it again, and again, or again.

This is a true story of one of my OCD clients. If you saw Raju doing that repetitive “checking if the” grill was properly lock, you would conclude that this guy is crazy. But crazy he is not.

There was another client, a pretty actress who came to me for her OCD of constantly having to wash her hands for cleanliness. She said, she had to keep wash her hand during filming and a great disruption to the movie set production.

OCD can also be quite destructive and troubling, especially for a client who got obsessed and paranoid that his deity was being sexually assaulted. It was horrifying for him has these thoughts and images keep appearing in his mind and being a pious person, it was very troubling and left him in constant guilt feeling.

What is OCD?

Obsessive Compulsive Disorder (OCD) is an illness that affects many Malaysian, and more than that many will have experienced it at some time in their lives.

“Make sure you lock the door properly, here let me check if you did it correctly” or “The floor is so dirty and I need to mop and clean it at least twice each day” can be really annoying if you are with an OCD sufferer at home.

This condition and symptom can ranges from merely annoying to an emotionally crippling condition which, if left ignored and untreated, can affect a person’s relationships, work and family life and lead to depression and other problems. OCD creates unnecessary stress and resource wastage to the sufferer and its surrounding.

The core of the OCD is an obsession with something, such as cleanliness. In the world of hypnosis, the old definition was “checking”.

Constant checking and reaffirming whether something is done right or some condition is not threatening is the core of OCD. This anxiety generated by this obsession in OCD is dealt with by the associated compulsion, typically a repetitive ritual, such as continually washing the hands, often until they are raw.

This morning an elderly woman came with her husband about her OCD. The husband told me that living with his wife, caused his to be tolerant everyday with her OCD behavior and he felt so stressed.

His wife is paranoid about body cleanliness. Even when he touches her, she feels very uncomfortable that she needs to have a bath right away. He says, at times she spent about four hours have a shower.

She told me, when she is under the shower, she feels like she is filthy, and fear that the dirt will not come out. She told me that at times, she scrub her skin until her skin hurts. She had been such since she was in her teens.

To the onlooker, this behaviour can be quite comical and quite nonsense but, OCD sufferers are powerless to stop their compulsive behaviors, and may have elaborate “rules” as to how they must be done.

They will repeat them over and over until they feel they have got it right. However, unlike the obsessive compulsions to drink or shop, OCD compulsions do not give the sufferer pleasure, but only a measure of relief.

This is a good indication, for a hypnotic viewpoint that OCD is fuel by some hidden trauma or conditioned memory.

The mind is filled with thoughts “If I fail to do something or forget to do something a negative will happen to me”.

This thought is often fed from some subconscious connection of a past event in life. As an example, the person may have been told something when they were a child. “If you don’t do such you will get such”.

Because of this a fear develops and becomes rooted deep in the subconscious mind. It did not matter if there was any basis or actual fact that supports the reason. Because of lack of real life experience to test the statement the thought is accepted as factual.

The symptoms and behaviour of people with OCD

Let’s also understand the medical views of OCD. It is now generally accepted by the medical profession that the cause may be an imbalance of a neurotransmitter in the brain called serotonin.

This is a chemical messenger in the brain that is involved with controlling mood states and is believed to be able to regulate repetitive behaviours.

People with OCD symptoms take many forms, such as: contaminating obsessions where they focus on concern with dirt or germs, or excessive concern with chemical or environmental contamination.

Some have counting compulsions, having to count up to certain numbers, Then there are the ones with checking compulsions – checking doors, locks, stoves, brakes etc. The obsession with hoarding or collecting compulsions that makes their home becomes a warehouse of junk.

The more concerning OCD symptoms of repeating rituals, such as going in and out of doors; constant aggressive obsessions, like fear of harming people, imagining horrific images, or doing something embarrassing, or thoughts of terrible events like death, fire etc.

OCD can be in a common form that you may not be aware of its presence.  Even severe workaholics are sufferers. OCDs are sometimes accompanied by depression, substance abuse, eating disorders, attention deficit disorder and many other anxiety disorders.

This is because their OCD creates such behaviors that changes and inhibits their life styles and life quality on the long run.

Children also frequently suffer of OCD, but it can affect a person of any age. OCDs can come and go at any stage of a person’s life, disappear for a period of time and then return in a different form.

They range from mildly interfering to extremely incapacitating, lasting more than an hour a day.

Sufferers are aware that their behaviour is irrational and disruptive, but they have great difficulty in controlling it.

Dealing on a daily basis with someone with OCD can put a severe strain on families and relationships, so it is important to work with them as well as the sufferer.

Sensitivity is important, because sometimes these rituals are the only way the person has to communicate.

The second step is medication. Modern drugs can produce dramatic results and OCDs are normally treated by a class of drugs known as serotonin reuptake inhibitors (SRIs.)

SRIs such as Anafranil must be prescribed by a doctor because of their powerful effects on the brain and the body’s chemistry. Once you are on SRIs, it is dangerous to change the dosage or stop them on your own, even though you may experience unpleasant of side effects.

I have always worked with my OCD clients in integrative with their doctor. These clients are told to see their doctor for advice in terms of their medication even when they felt their OCD symptoms have become better.

I always refer them back to their doctor to report their feedback on how their condition had improved and what need to be done about the medication they are taking.

Hypnotherapy for treatment of OCD

The list of ways OCD starts can go on for several hours of reading. Treatment options are widely varied, and each has specific results.

Medication is effective but sometimes only masks the problem. It does nothing to address the underlying root cause, which resides at the subconscious level.

There are a number of therapies that are useful and cognitive behavioral psychologists have the longest track record. Group therapy led by an experienced facilitator is also effective.

Hypnotherapy can greatly assist suffers of OCD because it quickly gets to the roots of the obsession and helps to reframe it. It is also useful in helping the individuals regulate their own body chemistry, thus helping them avoid or get weaned from dependence on SRIs. The results of the side effects of medication can vary.

Typically insurance companies encourage this method of treatment because it is the least expensive in their eyes.

Hypnosis deals directly with the subconscious mind. If the root cause are unknown at a conscious level then, hypnotic technique known as regression can be very helpful in identifying any past events that had set their OCD in motion.

Once the cause is identified hypnosis becomes a powerful tool to set things right.

In order to find out the underlying cause of my OCD client’s disorder, I normally regress them in hypnosis back to a single trauma that turned out to have been the primary cause.

Over some sessions, I would be able to teach their unconscious mind how to change and then overcome this obsession. Testing is also an important process. I normally test these changes by taking them through a process of desensitization.

While OCD is essentially defined as a anxiety disorder, it can be treated with hypnotherapy with good results.

Julian Leicester is a London trained subconscious specialist with Hypno-Station. He is Malaysia’s most renowned clinical hypnotherapist, media personality, columnist, event host and book author. He can be contacted at julianleicester@gmail.com

Motherhood May Spur Obsessive-Compulsive Behavior

Motherhood May Spur Obsessive-Compulsive Behavior

Symptoms usually temporary, half of the women

By Robert Preidt

HealthDay Reporter

TUESDAY, March 5 (HealthDay News) — New mothers have a much higher rate of obsessive-compulsive symptoms than other people and these symptoms center on their baby’s well-being, a new study indicates.

For example, a new mother may constantly worry and check to see if her baby is still breathing; she may obsess about germs and whether she’s properly sterilized the baby’s bottles and then wash or rewash them; or she may be unduly concerned about injuring her baby, according to the study authors.

The researchers surveyed hundreds of new mothers and found that 11 percent of them had significant obsessive-compulsive symptoms at two weeks and at six months after giving birth. The rate in the general population is 2 percent to 3 percent.

These symptoms are usually temporary and could result from hormonal changes or may be an adaptive response to caring for a new baby, the researchers suggested. They found that about 50 percent of the women reported an improvement in their symptoms by six months. However, some women who did not have symptoms at two weeks developed them at six months.

“It may be that certain kinds of obsessions and compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene,” study senior author Dr. Dana Gossett, chief and assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital, said in a Northwestern Medicine news release.

But if these symptoms interfere with normal day-to-day functioning and appropriate care for the baby and parent, they may indicate a mental health problem, the investigators pointed out.

About 70 percent of the women who had obsessive-compulsive symptoms also had depression symptoms. This suggests that obsessive-compulsive disorder in new mothers represents a distinct mental illness, said study lead author Dr. Emily Miller, a clinical fellow in maternal-fetal medicine at Feinberg.

“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features,” Miller said in the news release. “Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”

The study appears in the March/April issue of the Journal of Reproductive Medicine.

More information

The Nemours Foundation offers a guide for first-time parents.

New Mothers At Risk Of OCD (Obsessive-Compulsive Disorder)

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Article Date: 07 Mar 2013 – 0:00 PST

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New mothers suffer from obsessive-compulsive disorder (OCD) symptoms more than the general population, according to new research carried out by Northwestern Medicine and published in The Journal of Reproductive Medicine.

The researchers identified symptoms of obsessive-compulsive disorder in 11 percent of women at their second week and sixth month following childbirth, compared to only 2 percent in the rest of the population.

This is the first study of its kind to observe obsessive-compulsive symptoms in mothers after giving birth.

The symptoms are generally only temporary and include such fears as injuring the baby or being exposed to germs. The researchers believe that if the symptoms interfere with their everyday functioning, then it could indicate a psychological disorder.

Dana Gossett, MD, senior author of the study and chief and assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, said:

“It may be that certain kinds of obsessions and compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene. But when it interferes with normal day-to-day functioning and appropriate care for the baby and parent, it becomes maladaptive and pathologic.” 

The researchers’ own upsetting thoughts following birth led them to set out to determine whether the feelings were common among all women.

Emily Miller, MD, and lead author of the study, said: “A compulsion is a response to those obsessive thoughts, a ritualistic behavior that temporary allays the anxiety but can’t rationally prevent the obsession from occurring.”

OCD can be caused by stress, which may explain why situations such as pregnancy can predispose women to the disorder.

The most common thoughts that were on the minds of women in the study were about dirt or germs, said Miller.

Some even had intrusive thoughts that involved harming their baby.

Miller said: “That can be emotionally painful.You don’t intend to harm the baby, but you’re fearful that you will.” 

Gossett mentioned that when she gave birth to her first child she constantly worried about damaging her baby somehow. “It comes into your mind unbidden and it’s frightening,” she said.

A total of 461 women participated in the study, they were all surveyed at their second week and then 329 were surveyed again at six months – following giving birth. They were recruited during their delivery at Northwestern Memorial. All symptoms were self-reported.

Close to half of the participants said that their OCD symptoms got better by six months. However, new women reported that they experienced symptoms that weren’t there during the first two weeks postpartum.

Gossett said: “If those symptoms are developing much later after delivery, they are less likely to be hormonal or adaptive.”

Miller said that postpartum OCD represents a distinct postpartum mental illness that isn’t that well classified, considering 70 percent of the women who screened positive for obsessive-compulsive symptoms were also found to have symptoms of depression.

Miller concluded:

“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features. Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”

Written by Joseph Nordqvist

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today

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‘New Mothers At Risk Of OCD (Obsessive-Compulsive Disorder)’

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New Moms Experience More Obsessive-Compulsive Symptoms

New Moms Experience More Obsessive-Compulsive SymptomsNew mothers apparently have a much higher rate of obsessive-compulsive symptoms than the general population, according to new research.

The study from researchers at Northwestern Medicine found that 11 percent of postpartum women experience significant obsessive-compulsive symptoms compared to just 2 to 3 percent in the general population.

The symptoms, which include fear of hurting the baby and worrying about germs, are usually temporary, according to the researchers.

Researchers speculate the obsessiveness could result from hormonal changes or manifest as an adaptive response to caring for a new baby.

But if the obsessive compulsions interfere with a new mother’s functioning, they may indicate a psychological disorder, the researchers warn.

“It may be that certain kinds of obsessions and compulsions are adaptive and appropriate for a new parent, for example those about cleanliness and hygiene,” said study senior author Dana Gossett, M.D., chief and assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine. “But when it interferes with normal day-to-day functioning and appropriate care for the baby and parent, it becomes maladaptive and pathologic.”

The researchers noted that their own obsessive and upsetting thoughts after giving birth led them to investigate if the experience was universal.

For postpartum women with obsessive-compulsive symptoms who otherwise are functioning normally, “it would be reassuring to hear that their thoughts and behaviors are very common and should pass,” Gossett said.

Obsessions are unwanted and repeated thoughts or images that create anxiety, the researchers explain. A compulsion is a response to those obsessive thoughts, described as “a ritualistic behavior that temporary allays the anxiety but can’t rationally prevent the obsession from occurring,” said Emily Miller, M.D., lead study author and a clinical fellow in maternal fetal medicine at Feinberg.

The women in the study reported that their most prevalent thoughts were about dirt or germs, followed by compulsions to check that they did not “make a mistake,” Miller said.

For example, new mothers may check and recheck baby monitors are working, the baby’s crib side is properly latched or bottles are properly sterilized.

Some women reported intrusive thoughts that they would harm the baby, according to the researchers.

“That can be emotionally painful,” Miller said. “You don’t intend to harm the baby, but you’re fearful that you will.”

Gossett recalled that after she gave birth to her first child, she routinely worried about falling down the stairs with her baby or that the baby would fall out of bed.

“It comes into your mind unbidden and it’s frightening,” she said.

The women in the study were recruited while hospitalized after delivering their babies at Northwestern Memorial Hospital. They completed screening tests for anxiety, depression and OCD two weeks and six months after going home. According to the researchers, 461 women completed the surveys at two weeks and 329 completed them at six months. Symptoms were self-reported and the women did not receive a clinical diagnosis by a psychologist, the researchers note.

About 50 percent of the women reported an improvement in their symptoms by six months, according to the researchers. However, some women who had not experienced symptoms at two weeks developed symptoms at the six-month mark, the researchers reported.

“If those symptoms are developing much later after delivery, they are less likely to be hormonal or adaptive,” Gossett said. The risk for psychological disorders persists for up to a year after delivery, she added.

About 70 percent of the women who screened positive for obsessive-compulsive symptoms also screened positive for depression. That overlap and the subset of obsessions and compulsions could indicate postpartum OCD represents a distinct postpartum mental illness that is not well classified, according to Miller.

“There is some debate as to whether postpartum depression is simply a major depressive episode that happens after birth or its own disease with its own features,” she said.

“Our study supports the idea that it may be its own disease with more of the anxiety and obsessive-compulsive symptoms than would be typical for a major depressive episode.”

The study will be published The Journal of Reproductive Medicine.

Source: Northwestern University

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Anxiety, Brain and Behavior, Depression, Emotion, Gender, General, Health-related, LifeHelper, Mental Health and Wellness, OCD, Parenting, Research

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‘Girls’ Recap: Too Many Freaks, Not Enough Circuses

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In the interest of full disclosure (a prerequisite for all good TV recaps), I watched last night’s episode after attending a fundraiser at New York’s UCB Theatre featuring monologues by Lena Dunham. As such, I am experiencing an all-time high when it comes to my personal opinion about the Girls creator. “Simply the bees’ knees” would be my description of her right now, so please take this week’s installment with a grain of salt. Or rather, eight grains of salt, thrown eight times over my left shoulder, because ladies and gentleman, introducing for the first time ever, Hannah’s crippling OCD!

Between her stressful split from Adam and the deadline for her ebook looming over her, the compulsions Hannah battled in high school are back with a vengeance. Looking over the shoulder, slamming the door, eating a precise number of potato chips, chewing them an exact number of times: anything Hannah does, she must do it in sequences of eight. Having recently diagnosed myself with Purely Obsessional OCD in a moment of panic after reading the Wikipedia entry (Read it! I bet you $5 you’ll think you have it too. Read the “Relationship Obsessions” part!), the grey area between “neurotic tic” and “life-altering anxiety disorder” is of particular interest to me. 

The 50 Funniest People Now: Lena Dunham

Fortunately/unfortunately, Hannah’s parents are in town to fight with their only child during the painful reemergence of her anxiety disorder. “If your head is filling up and you’re getting count-y, we can help you,” her dad tentatively offers. I’m honestly not sure why Hannah needs to deny her diagnosis of OCD despite her worsening symptoms, though I’m assuming it has something to do with her mom being a huge asshole about the whole thing. “We’re still married. We never raised a hand to you. It’s not our fault,” her mom declares during dinner. Man, these two need to have a screaming match one of these days, just so we can get into where all the mutual aggressive comes from. Not that her mom is the only nutbar in New York. “Fuck, you just hit me like five times,” a grown man yells in a swanky restaurant after Hannah nudges him over and over again. “It was eight times,” she meeps. Judy Collins was also there, looking like the beautiful, ethereal witch-goddess she is while humiliating Hannah. “Where you going, sweetheart?” she calls from stage when Hannah ducks out to get her count on. No wonder Hannah is forced to recite “You are fine and good” to herself in the bathroom mirror over and over again. She blew it in front of Judy Blue Eyes herself!   

With Jessa still disappeared, we finally have a little Shoshanna room in the show. “Where is she? What is she wearing? Is it linen?” Shosh muses about her missing cousin. Ray and Marnie are less than sympathetic toward their absent buddy. (If those two hook up, I swear to God . . .) With a misanthrope like Ray at home, it’s understandable why Shoshanna would leap at the chance to fly solo at a party thrown by Radhika, a rollerblading bon vivant who knows how to throw a party (White Castle burgers, champagne, mermaids filled with ashes.) Shoshanna might not consciously be aware of it yet, but the fact she ended up dry-humping a hot doorman while Ray waited in his pajamas at home means the nervous virgin we knew and love is dead and gone. Not that Shosh doesn’t still worry what will happen when the doorman leaves his post. “A tranny walked in last time and he was just walking around the floors, but it was nothing,” he reassures her as they go at it in the mailroom. “I swear to God.” 

Meanwhile Marnie . . . oh, God, Marnie. Things are going to get a lot worse for Marnie before they get better. Shocked to learn Charlie has sold an app for real cash money (and equity, I’m assuming), Marnie shows up at his office in flip-flops and boot cut jeans. Flip-flops! She should have been escorted out by security and taken immediately to a sanitarium for that alone, but instead she willfully endures the indignity of hearing about his app (Forbid, a app that prevents you from calling Marnie in the middle of the night) and having her mind blown by the lipdub-parties-and-free-Jake-Johnson-album-ness of it all. “I’m just here for support,” she says with a smile. “From me or for me?” Charlie retorts under his breath. Come on, man, the woman already has flared jeans on. How much lower do you need her to go? Besides, it’s not like she made you go up to the roof at Hannah’s party that one time and ostensibly ruin things with your new lady friend. Those aren’t magic flip-flops she’s got on! “I thought he was going to be broken for like six years,” she rages about Charlie at home. All of which is nowhere near as humiliating as when Marnie admits to Ray that her secret beyond secrets is wanting to sing.  “. . . What’s the second thing you want to do?” Ray inquires. Marnie counters with a little Norah Jones. It sounds fine. Marnie and her magician’s assistant outfit are in for a world of pain, and I’m excited to explore it with her!

And then there was Adam. Despite the fact that last time we saw him he abandoned Ray in Staten Island with a dog and literally ran away, Adam seems to be doing a lot better for himself, other than accidentally drinking rancid bedside milk. (On a side note, are kids not buying soy milk to avoid accidentally drinking spoiled milk anymore? There were two characters drinking regular milk in this episode! Two! Oh, how times have changed!) Revealing a surpassing mental maturity for someone with so many unfinished ladders in his apartment, Adam takes his ass down to AA, where his monologue turned into one of the more memorable emotional highlights of the show so far. “I wanted that chance to show someone everything,” he somehow ranted without making it cheesy. Taken by his honesty, height and “fresh look,” fellow group member Cloris begs him to go out with her daughter Natalia. I prayed that Natalia would show up and be an insane megamutant, but instead she’s gorgeous and equally hot for Adam. Mwuh uh! Hmmm, Adam laughing on a normal, fun date while Hannah discusses her compulsive masturbation with a new therapist? Hope Natalia enjoys getting punched in the face eight, 16 or 64 times. That’s all I’m saying. Though who would like that? No one. Not one person.  

Last week: Manifesting the Solution

Transgender male: ‘I never associated with being female’

On Sept. 28, 1992, Jill Gliko gave birth to an 8 pound, 3 ounce girl that she and her husband, George, named Monica Michelle.

She was the baby of the family, the last of three girls.

As Monica grew up, she was Daddy’s constant sidekick. The pair regularly traveled to Grandma’s ranch near Great Falls where they fished and camped, forging a storybook father-daughter bond. Monica loved driving the tractor and chasing cows with the four-wheeler.

She was a resolute tomboy, preferring jeans to dresses, G.I. Joe to Barbie. And, she was a talented athlete, excelling at volleyball and softball, and loving the hard knocks of hockey and flag football.

Her sports colleagues nicknamed her “Manica.”

“I was just another one of the little guys,” Gliko said. “I never associated with being female.”

And she didn’t think much of it until she entered seventh grade at Will James Middle School. She felt pressure from family and friends to dress up, primp and act like a young lady. She resisted.

Eventually, she found herself attracted to young women as well as men. It confused her. She felt like a boy trapped in a girl’s body and didn’t know there was a word for it.

Kids at school called her a “fag” and made crude jokes. She began cutting and mutilating herself, hoping someone would notice that she needed help. She became bulimic, melting to 98 pounds. She was diagnosed with manic depression and anxiety and was prescribed Prozac, which is commonly used to treat major depressive disorder, bulimia, obsessive-compulsive disorder and panic disorder.

At the end of her eighth-grade year, she chopped off 14 inches of her hair and began scouring the Internet for answers. Along the way, she stumbled upon a book, “Luna,” by Julie Anne Peters, a story about a boy who makes the transition to become a girl. It was a pivotal point in Monica’s life. At last she had a name for what she would become: transgender.

Monica made a bold declaration to her friends: “I think I want to be a boy.”

“Cool,” said Jessie Massey, 19, a friend since seventh grade. “What are you going to do about it?”

The first step was telling her parents.

Her mother readily gave her blessing, vowing to do everything she could to help her with gender reassignment. Her sisters were equally supportive.

Dad, a self-described conservative Catholic who describes himself as just shy of being “Archie Bunker,” had long suspected something was amiss. He was taken aback by her declaration, seeking time to process the news about his little girl. Though he ran the gamut of emotions, rage was not in his mix.

“How do you get angry with your child?” George Gliko asked. “I was shocked in that I never thought of it in that light.”

Still, the father-daughter relationship would become so strained they would barely speak to each other. Monica would legally change her name to Dominic “Nick” Liam Gliko, rotate in and out of a local psychiatric ward, attempt suicide on at least two occasions before beginning the process of becoming a man.

“There was a time in there when it was hard for us to talk,” George Gliko said. “I was lucky if I would get a ‘good morning’ out of her.”

Though his daughter’s desire to become a man was stunning, George Gliko said he never felt embarrassed. The only embarrassment came at his own missteps in using the wrong pronoun or mistakenly referring to him as Monica.

Gliko’s transition to becoming a man was a rocky road and began during her sophomore year. She traveled to Wyoming for testosterone injections.

The transition was disorienting and stressful. With the help of her mother, she was admitted to a local psychiatric ward for about two weeks.

“It was really overwhelming,” said Gilko, who now refers to himself as a he. “It was a lot of stress. Unimaginable stress. Transitioning through high school? It was rough.”

In fact, he spent much of his teenage years in and out of the local psychiatric ward. Some of the admissions were voluntary; others were not. In addition to Prozac and other drugs, he was prescribed Abilify, a powerful anti-psychotic drug.

He ballooned to nearly 200 pounds and grew more depressed.

“That really played with my emotional health because it was so hard,” he said. “I wasn’t who I wanted to be and I didn’t like the body I was in.”

He was later diagnosed as bipolar, given a new medication and dropped 50 pounds. He ended up back in the psych ward after a failed relationship with a woman. The woman’s family did not accept him.

By June 2012, Gliko was emotionally exhausted from failed relationships and living with a body that looked neither like a man nor a woman. He didn’t know how to be a man and did not want to be a woman.

He stopped by a Billings pawn shop to buy a gun. He wanted to kill himself. He was not yet 21 so there was no sale. He went home and swallowed a bottle of sleeping pills.

“I want this done,” he said. “I don’t want this anymore. It’s too much stress. It’s too much everything. I just wanted to give up.”

He was again taken to the psych ward.

He made a second suicide attempt in August 2012. He crawled into a bath tub full of water and dropped in a plugged-in toaster. The attempt failed.

“Unless you’ve been through something like that, you don’t know,” he said.

Both attempts were Gliko’s way of getting attention, his father said. They were also the most difficult part of this yearslong journey.

“In both cases we were very lucky,” George Gliko said. “My heart just about dropped out. I’ve been through one suicide in my family.”

George Gliko’s father killed himself in 1997 when he was 60.

“It’s taken me a long time to accept what he did and why he did it,” he said of his father’s suicide. “Dominic’s attempts opened up all of those old wounds again.”

Today, everything is “really good” between he and his dad, Gliko said. “I’m really happy for that because he was the big question mark.”

Today, Gliko is getting more comfortable with how he looks and is re-teaching his brain a new way of thinking. 

“That was really rough,” he said. “I didn’t know who to be. I know how to think and how to act. I know what’s acceptable and what isn’t. I’m not crazy.”

His advice to anyone wrestling with their sexuality is to be open about it and talk about it.

“Closets are for clothes,” Gliko said. “Get out. Be proud. Never, ever be ashamed to be who you are.”

He has started college and is engaged to a man. No wedding date has been set. He sees a therapist and surrounds himself with a strong support system of family and friends.

The strained relationship between Gliko and his father has healed. The two have a standing bowling date every Tuesday.