Girl Talk: My Husband’s Obsessive Compulsive Disorder Was A Living Nightmare

My husband was always a little strange — but that’s par for the course in a marriage sometimes. Sure, he covered his face whenever he encountered the smell of bleach, and he took to maniacal cleaning rather than use poisons to eradicate a cockroach problem. He demanded we turned off the heat at night to protect his lungs. I thought all of it was cute. It took me a while to realize that his unusual quirks were actually symptoms of a terrible disorder.

I met John* on Craigslist. We were looking for a third roommate and he was one of the many people we interviewed that hot August day. He had a dark, curly mop of hair and a full face with dimples, and he seemed nice. He was from South America, and had traveled all around the world; I found him extremely compelling. We interviewed a few other people that day but felt that we connected the most strongly with John, so we asked him to be part of our household.

When he later moved out, we stayed in touch intermittently. It was April, the year after he moved out, when he contacted me again. We began spending lots of time together after that. We went out together. He took me shopping and helped me nail a work presentation. I was surprised to feel how I was falling for him, considering I didn’t necessarily feel attracted to him while we were living together. We finally made it official on a drizzly spring night. I was in love. We spoke about all of our previous issues as roommates and they all seemed to dissolve away. Soon after, I found out I was pregnant. Because we were in love, we decided that we wanted to marry right away. Things couldn’t have been better between us.

It took me a while to see the Obsessive Compulsive Disorder (OCD). OCD, as defined by the International Obsessive Compulsive Foundation, is a disorder of the brain and behavior which causes severe anxiety in those affected. It’s estimated that one in 100 people have the disorder, which means that somewhere between two and three million people are currently living with OCD. John’s symptoms began to emerge when we ordered a simple household test to be done. Because I was pregnant and we were living in an older building, we were concerned when we spotted some chipping paint. We wanted to get the apartment tested for lead, and after some wrangling with the landlord, she agreed to send a professional to have it tested. We were both dismayed when some rooms tested positive — and that’s when things began to unravel.

John’s disorder first emerged as a series of concessions he asked me to make for him. The first concession seemed perfectly reasonable. Otherwise, why would I have agreed to it? He asked me not to put magazines on the floor of the bathroom. See? No biggie. I agreed. Soon, though, one concession tumbled on top of the other, and I found myself buried in unreasonable requests.

It seemed that instead of being a normal couple planning for the rest of my pregnancy, our lives had now become committed to the prevention of accidental ingestion of lead. At this point, John was spending hours poring over the Internet, reading the most current research on this terrible toxin. According to his findings, it only took a piece of lead as big as a grain of salt to poison a child. Scary, I know. But with something that small, and invisible, how do you even begin to protect yourself from it? According to John, nothing short of extreme vigilance would do. He wanted to be sure we weren’t exposed to one errant piece of dust, and began to monitor my behavior everywhere in the apartment. My actions were being strictly controlled. Things started to get tense between us.

Soon, we ate, spoke and breathed lead. Okay, not literally, thank God, but something close to that. Since the bathroom had the highest levels of lead, anything brought in there needed to be wiped down after use. Any clothing that dropped on the floor anywhere in the apartment needed to be laundered immediately. It didn’t matter if it was only on the floor for a second, or my only clean outfit — it went straight into the laundry. I could have brought in dust from the bathroom which deposited itself on the floor in another room, he insisted. I’d have to wait in my pajamas until he could wash it. Only he could go to the laundromat since only he could follow proper procedure to get our clothes correctly cleaned.

After months of tension about all these things, and more, we decided the only solution was to move out. Our landlord offered to remediate our apartment, but he decided that whatever she wanted to do was going to put us in more danger and he refused. Money was tight, but he assured me he’d figure it out. The move, of course, necessitated that he did all the packing, which was the second major concession I made.  According to his findings, the only way we wouldn’t bring lead dust to the new apartment is if everything was dusted meticulously before we left. Being pretty sure that I had never done anything meticulously in my life, I agreed. It didn’t take me long to realize I had made a grave mistake.

It took John hours to pack each box. Although our bank account was cleaned out to make a security deposit, and I wasn’t working, he kept missing work anyway to keep packing. Our baby had now arrived and I was feeling especially protective, and became more and more alarmed. Since we didn’t have cash, moving expenses were covered with my credit card. A very pricey HEPA vacuum cleaner, a special filter for that, masks, special wipes, you name it, went on my credit card with neither of us having any idea when we were going to be able to pay it off. Desperate to be moved out by the date we agreed upon with the landlord, I purchased for him anything he said he needed. We had signed a special contract with her and wasn’t sure of the consequences if we broke it. I begged him to let me help and he wouldn’t budge. Something wasn’t right with this. Out of frustration I asked him to just throw whatever wasn’t packed out. “But, even if I’m throwing it out, I have to clean that too,” he said. “It’s not safe for me to handle otherwise.” I just yelled at him to do it. I never wanted to be in that apartment ever again.

Here’s the thing: John is an intelligent man. He must have a plan, I thought. I told myself we’d figure something out. Thankfully, the new apartment we’d selected was in perfect condition. We had made it. I was happy. We stared out the window at our new view and kissed passionately. But it didn’t take long for my husband to find hazards in the new apartment. Soon, I wasn’t allowed to walk by the windows of the apartment. I also was banned from the laundry room — all laundry had to be done by him. Months went by like this. He refused to unpack the few boxes we brought with us. Although still financially vulnerable due to all the work he missed, I found myself replacing the things in the boxes with our limited funds. Most of our things had been thrown out, and the promised money from the job he got wasn’t materializing. I realized this wasn’t a quirk, or something funny or interesting about his personality at all. It was a full blown disorder. And although he clearly had Obsessive Compulsive Disorder, he refused to get diagnosed, let alone treated. I was besides myself in frustration.

After months of feeling controlled and isolated from my friends, my tolerance level was low. It took one phone conversation to send me over the edge. That day, I had looked in the mirror that day to see how a new shirt I bought looked on me. He called, and when I told him what I was doing over the phone he started to scream. Why was I in the bathroom, what was I doing in there, he screamed. I had no clue I wasn’t allowed in my own bathroom. This was after a week of brutal fighting, and it seemed he had no limits as far as how he would treat me? I was concerned about how my son would be affected if he continued to see Daddy screaming at Mommy like that. I had made enough concessions for him, and this was one I could not make. So, on a sunny fall day I did the most difficult thing I had ever done in my life. I packed my bags and walked out on someone I loved.

It was later that day when he realized I had left. Drama ensued, of course, and we spent many hours speaking about my feelings over the phone. We talked about his disorder, and how I wanted him to get treatment for it. He refused. Naturally, he was extremely upset, but I refused to budge. I lived with my parents for several months, but eventually living in a small, rural town away from my friends and the city I’d known, began to wear on me.

And there was a bigger issue. Despite our problems, I still loved John. He cared about our baby more than anything, and wanted our son to be close to him. Things stabilized for us financially. Despite continued misgivings about how he treated me, I decided to move back in. Things still aren’t perfect, but we’re both trying. I have a dream, though, that despite all this, there will be a time when we can walk through our beautiful city unencumbered by our fears, without worrying about lead. Until that day happens, we are going to therapy, and I will continue to work on my patience. As a friend so wisely said, “With love there is hope.” So I’m continuing to hold onto that hope.

*Name changed to protect identity.

Pets/Bernhard Pukay: Stressed-out cat’s hair loss could have other causes

Question: My older female cat, Cinder, has suddenly lost all the hair on her tummy and the insides of her hind legs. We also have two male cats that are now about two years old and have been living with us since they were about six weeks old. Last fall they started challenging Cinder and chasing her around the house, which she does not like. She ends up trying to hide from them and growls if they come near her. This has been very upsetting for my husband and I because at times it sounds like a serious cat fight although it is all vocal. Could this stress be responsible for Cinder’s hair loss?

Answer: Absolutely. Some cats will lick themselves excessively as a form of obsessive-compulsive disorder (OCD) in much the same way that people bite their fingernails or mutilate themselves when stressed or troubled. In veterinary medicine the term psychogenic alopecia is used to describe this condition. It is usually due to some form of stress, whether anxiety, boredom, or some radical change in surroundings. In all probability, in the case of Cinder, the likely cause is stress caused by the conflict between her and the two males cats.

Cats can react to stress in several ways, such as by adapting to the stress, marking their territory with urine, or grooming themselves excessively, The excessive grooming can lead to hair loss and skin damage, primarily because a cat’s tongue is very rough and too much licking can quickly lead to self-excoriation. The tummy and insides of the hind legs are the most commonly targeted sites for excessive grooming although all four legs can be involved, as can any part of the body.

There are many other medical reasons for overgrooming, including fungal and bacterial infections, skin parasites, and even systemic illness. An especially common cause is allergies, especially food allergies, which can lead to a condition called eosinophilic granuloma complex. This condition can manifest itself precisely in the way that you have described. For this reason, it is a good idea to have your veterinarian examine Cinder to see what the cause is.

If, as you and I suspect, your veterinarian determines that the problem is indeed psychogenic, he or she will work with you to correct the underlying problem, or will prescribe medication (e.g. amitriptyline) to correct the behaviour. There is also a commercially available product called Feliway that has been shown to be effective in reducing the incidence of OCD due to stress in some cats. It is available as a spray or as a wall “plug-in�. It works by releasing a pheromone that reduces anxiety and stress.

Dr. Bernhard Pukay is an Ottawa veterinarian. Address letters to Pet Care, Ottawa Citizen, P.O. Box 5020, Ottawa K2C 3M4. Email: pets@ Due to the volume of mail, not all letters can be answered.

Man ruled unfit to stand trial in slaying of three people


CHESTERFIELD – A Dinwiddie County man accused of killing two Chesterfield women and suspected of killing his father was deemed mentally incompetent to stand trial Friday.

Herbert Bland Jr., 23, had to be guided by court officers when he appeared binded in handcuffs before a judge in Chesterfield General District Court. Bland’s rolling, blank gaze fell across those in the courtroom before officers nudged him toward the judge’s bench.

Bland did not answer any questions and swayed slightly as the judge decided to continue his case until July 10, during which time doctors will attempt to restore his mental competency.

“You need to cooperate with your doctors who are going to help you,” the Hon. James J. O’Connell III said. “And you need to keep in touch with John Rockecharlie [Bland’s defense attorney] who is going to help you.”

Bland will reappear in court July 10 for mental reassessment. If doctors are not able to restore his mental competency by that time, the judge may continue the case for another 90 days.

Bland’s court-appointed defense attorney John Rockecharlie said that he would not be surprised if the case is continued for six to nine months.

“I have dealt with people who are trying to fake it, and those that are not. He is definitely not faking it,” Rockecharlie said.

The judge based his decision on a court-ordered psychiatric evaluation that took place not long after Bland was charged for fatally shooting Elizabeth Fassett, 42, and her mother, Barbara Fassett, 65.

That evaluation, performed by court-appointed forensic psychiatrist Dr. Evan Nelson, found that Bland was mentally incompetent. Nelson based his findings on whether the defendant could understand the charges against him and whether he could help his defense attorney defend him.

“It is just clear that he is not connected to reality,” Rockecharlie said of his attempt to talk with his client.

Doctors from Central State Hospital will visit Bland at Riverside Regional Jail. They will likely give Bland a diagnosis, Rockecharlie said.

Police believe Bland killed the two Chesterfield women earlier in the afternoon of Jan. 7 before making the 20-minute drive back to his Dinwiddie home. An encounter with his father in that residence ended with the son shot in the chest and the father, Herbert Bland Sr., dead.

A UPS worker delivering a package to the Fassett home in the 5200 block of River Road in Chesterfield discovered the bodies of the two women later in the afternoon. Police believe Bland had been romantically involved with Elizabeth Fassett in the past.

Dinwiddie deputies were alerted to the Bland residence in the 2000 block of Harris Drive by Herbert Bland Sr. The father believed his son had taken his gun and used it in a shooting, according to court records.

When a deputy arrived at the scene, Bland Jr. stumbled outside the residence holding two pistols. He told authorities that his father had shot him and that he shot his father in the head, according to court records.

The killings came four months after the younger Bland completed two years of court-ordered psychiatric treatment. That court order stemmed from an August 2010 incident where the younger Bland was accused of physically assaulting his parents, court records show.

Dr. Walid Fawaz of the Virginia South Psychiatric Family Services placed the younger Bland on a variety of medications including Haldol, an anti-psychotic drug, Paxil, which is used to treat obsessive-compulsive disorder, anxiety and depression, and Risperdal, which is mainly used to treat schizophrenia.

Court records show that Bland Jr. attended all of the appointments and complied with the medications. He continued to live with his parents and was unemployed.

“He is doing a little better and does not feel paranoid … does still feel that people can control him,” Dr. Fawaz wrote in a progress report. “He has had no suicidal or homicidal ideas.”

The 2010 case was dismissed in September 2012, once Bland’s treatment was completed.

Charges against Bland in connection to the death of his father are still pending. Dinwiddie Commonwealth’s Attorney Lisa Caruso has said that she is waiting as Bland progresses through the Chesterfield court system.

– Vanessa Remmers may be reached at 804-722-5155 or

Nothing fashionable about anxiety illness

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

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

“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 can 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 approp- riate threshold for treating and medicating OCD, from which about 3 per cent 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.”



  • 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.


– © Fairfax NZ News

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What I Learned About Anxiety From ‘Girls’

By Eitan Kensky

Earlier this month, HBO’s “Girls” ended its second season with Hannah Horvath (Lena Dunham) incapacitated by anxiety-induced Obsessive Compulsive Disorder, her ebook on the lost generation of 20-somethings looking more and more unlikely; I read the first few chapters of Phillip Lopate’s new book “To Show and to Tell: The Craft of Literary Nonfiction” and Lopate’s thoughts on a writer’s obsessions; and I started to have a panic attack at the Brattle Theater in Cambridge, Mass., during a promotional screening of Shane Carruth’s “Upstream Color.”

It had been three medicated years since the last one, but I knew immediately what was happening. There is the initial trigger: a jolt, a kick, you’re aware that your breathing is a little unusual, or that your body isn’t reacting the way that it should. You extend your breathing to see if that will slow your heart, but your body is shifting, moving, trying to find a comfortable position. You become obsessed with the thought of relaxing. You notice that you wore really tight socks. You need to be composed, and stay composed. The thing you fear most is embarrassment. As soon as your conscious mind forms the words “panic attack,” it is over: that thought will metastasize, it will be the only thing in your brain. “Don’t pass out” becomes a hopeless mantra, and you lose consciousness.

Or: you realize what is happening. You grab your coat, leave, try to find somewhere quiet to settle down. Your head is a weird combination of heavy and light, your vision blurs. Outside the theater I propped myself up on one of those green plastic boxes where they dispense brochures for the Cambridge Center for Adult Education. But I need to sit down, and the only thing I see are the snow-wet steps leading to the Anthropologie on the second floor of the Design Research Building at 48 Brattle Street. I’m not sure how long I sat on the steps, relaxing. Two girls passed me: one only said excuse me; one asked me if the store was closed. There was an ambulance almost exactly in front of the theater. If it was there before, I didn’t notice. I wondered if they watched me keel over on the plastic box, and if they thought to help. By then I was feeling closer to normal. Those thoughts meant that I was close to normal. I pulled out my phone, saw there was a bus coming, and left. I’ll have to go back in April to see the movie.

I never wanted to write about “Girls” because so much has been written about “Girls.” By now it’s even cliché to start a piece on “Girls” by apologizing for adding to the pile of writing on “Girls.” But I also had nothing to add. The only thing I ever wanted to say about “Girls” was that the media debate over its Whiteness was really a proxy for the general lack of diversity on TV, and even a proxy for the fact that middle-class college graduates still cloister themselves in racially homogenous social groups. But that idea was taken before an editor could respond to my pitch.

Then Hannah had her breakdown. I know that Hannah’s anxieties aren’t the same as mine; to paraphrase Tolstoy, “every anxious person is anxious in her own way.” But I also know that I wouldn’t try writing about Hannah and “Girls” if I hadn’t experienced what I experienced this week — and that experience includes Lopate’s advice to a student worrying that she didn’t have the necessary obsessions to write, that “obsession was overrated.” Obsession is overrated. Ask Hannah.

Out of nowhere she started to do things in eights: she pinches herself eight times, turns her head eight times to one side, then eight times to the other. There was a cartoonish quality to it; it seemed more like someone’s imagination of what incapacitating OCD looks like than a mirror of personal experience. The show needed expository dialogue to fill in the gaps: Hannah’s parents were conveniently visiting, they saw their daughter counting, and diagnosed it as a recurrence of adolescent OCD. They took her to a child psychiatrist; he prescribed medication. She said she didn’t want to take medication because of the way it makes her feel. The episode ends with Hannah and her parents straphanging on the subway. The parents are weary, but Hannah is dopey. She clutches a pharmacy bag with her other hand.

The storyline grew more convincing as it continued. Medication (if she’s taking it) doesn’t resolve her problems. Her editor hates her writing. Her friends have disappeared. In a beautifully composed shot, Hannah stands in front of a mirror manically cleaning her ear with a Q-Tip, pushing it inside her body until she shoves it too far and winces in pain. The Q-Tip is stuck and she will have to go to the hospital to get it removed. The mirror makes the scene: Hannah watches her actions, she sees herself doing something she should not, she knows she should stop. She recognizes, clearly, what is happening. But recognition cannot stop the action. It almost never stops the action. Later, back home from the hospital, proudly bearing her bloody Q-Tip as a talisman, Hannah starts cleaning out the other ear, shoving a Q-Tip inside. Her obsessions won’t allow her to leave one side alone. This is what happens in anxiety attacks: you do things you know are irrational and bad for you. You need them, and then hate yourself for needing them.

Everything after this is an anti-climax. The last episode brings people together and splits others apart. But it was always going to be an anti-climax: you can’t honestly resolve obsessions and anxieties in a half-hour episode of a sitcom, not if you’ve been honest about those anxieties, as “Girls” did in the season’s penultimate episode, during the Q-Tip scene. All you can do is retreat to a moment of calm.

The most admirable part of the show’s treatment of anxiety is its refusal to connect Hannah’s breakdown and her ebook. The two coincide, and the viewer is invited to link them. It even comes up in her meeting with the psychiatrist. But they never explicitly say that Hannah’s anxiety is about writing and the pressure of being the voice of her lost generation. They never diagnose this as the cause, because it’s not the cause. Anxiety and panic are never as sudden as we imagine them to be. There’s a trigger, yes, but the attack is only set off because the sufferer is already in an elevated state of stress. Hannah’s OCD manifests itself not because she has to write a book, but because she had a terrible breakup, and her friends have moved away or betrayed her. Not even her parents will help her. They are too tired to help her. In a different mood, the book wouldn’t have triggered her attack. She could write if she weren’t so alone. On a different day, “Upstream Color” would have been just another movie.

Dunham has said that she suffers from OCD during times of extreme stress. Like her character, she counted in eights, and touched herself before bed. But despite our desire to use “Girls” as a lens on the youth of America, “Girls” is TV show, a half-hour comedy mixed with drama. (A dramedy? A sitcomerama?) Dunham could have had Hannah suffer from any anxiety disorder; OCD was an aesthetic choice, one chosen to say something about the character, one chosen to say something, perhaps, about writing.

As Lopate tells us,

Obsession tends to go nowhere. I have met obsessive types in my wanderings, and mostly they were pretty boring. Obsessives repeat themselves, while ignoring other people or stories breaking around them; it’s an exceedingly redundant form of thinking, so I’m not sure how useful it is in the production of nonfiction.

Hannah’s obsessions occlude everyone else from view. Hannah’s obsessions make it impossible to tell anyone else’s story. In a moment of desperation, her editor suggests making her memoir into a novel. He’s giving her a way to focus only on her self, to stay inward. Hannah refuses to listen.

The meeting with the editor is essential for understanding what Dunham is trying to do in “Girls.” Her editor fixates on her sex scenes and tells her to make up sex if she isn’t having it. The viewer cannot miss the reflexiveness of the situation: uncomfortable sex is the most talked about aspect of “Girls.” It was the centerpiece of Emily Nussbaum’s trendsetting New York magazine cover story. We fixate on Dunham’s body, and what it says that she’s willing to undress in nearly every episode. The focus on sex and nudity seems obsessive, taboo-busting for the sake of taboo-busting, or for the sake of verisimilitude. The editor wants her to concentrate on uncomfortable sex because he is a part of this media culture: he knows, with the right promotion, it will start a dialogue about her book.

That Hannah doesn’t immediately start writing about sex tells us something about “Girls.” The moment is a way of getting us to see that Dunham writes about sex not out of obsession with the act and with how uncomfortable it can be, but because of what it says about the people involved. Sex and intimacy are not the same. People lie about themselves in the bedroom. They hide their tastes, their fetishes, their true selves. Hannah’s ex, Adam, doesn’t know if he can be himself around his new girlfriend, a fact brought home in discomfiting, even horrifying fashion. A failed sexual encounter early in the season punctured the gloss of perfection around Marnie. Sex shows us what the show really is. When all is said and done, “Girls” is not a show about the lostness of a generation, but another show about relationships: how difficult they are, how isolating, how hard it is to tell what matters.

Everyone who suffers from anxiety problems knows their double-edge. Anxiety can make it impossible to work. Anxiety can shut you inside your apartment, indulging in your worst habits. Anxiety forces you to leave, or forbids you from entering. But anxiety can also be what lets you connect to others, what lets you write, what lets you remember what is important. You’re never quite sure if it’s a gift or a curse.

Season of Freedom

Barriers To Achievement

When Bakers Do Matzo

Mindfulness for OCD and Anxiety

Choosing a Different Route on the Anxiety Highway

Mindfulness can greatly enhance traditional
Cognitive Behavioral Therapy (CBT) for the
treatment of OCD and Anxiety

“Mindfulness” seems to be everywhere these days.  In the culture at large, mindfulness is becoming a common practice for many as a means to finding basic peace of mind. And in the field of mental health, mindfulness is quickly coming to be seen as a technique that can help relieve symptoms of OCD, anxiety, and other psychological conditions.

After reading the above paragraph, you may be thinking, “Sign me up!” After all, we live in an era of instant gratification, and most of us usually want a quick fix to our problems. But mindfulness is not something one masters overnight. It is a journey that requires effort, commitment, and dedication. While mindfulness may provide relatively rapid relief to one’s distress in certain situations, it is perhaps better conceptualized as a long-term shift in perspective that allows us to better manage the complexity of human psychological experience. Like learning a new language, mindfulness takes time and patience to master, and ongoing effort to remain fluent.

So what exactly is mindfulness, and how does it apply to OCD and anxiety?  A simple definition of mindfulness is that it is the practiced skill of non-judgmental awareness and acceptance of our present-moment experience, including all of our unwanted thoughts, feelings, sensations, and urges. Mindfulness teaches us to accept all of our unwanted internal experiences as a part of life, regardless of whether they are “good” or “bad”.  When treating OCD and related anxiety disorders, mindfulness is a tool that can supplement and enhance Cognitive Behavioral Therapy (CBT), which is the gold standard for managing these conditions.

Mindfulness originated in ancient eastern philosophy, and is based on the premise that our attachment to feeling good and our aversion to feeling bad are the cause of much of our suffering.  Much of the time, when things are difficult, we take up compulsive or avoidant behaviors in an attempt to make ourselves feel better.  I often joke with clients about the fact that we never find ourselves running out of our bedroom with our arms flailing above our heads screaming in fear, “Oh my, I am so happy! Why am I so happy?  What if I am happy forever?  What should I do?”  We only do this when what we are experiencing something we perceive as being “bad” or “wrong” or “unwanted”.

When discussing Obsessive Compulsive Disorder (OCD) and anxiety with clients, I often suggest that we conceptualize life as a metaphorical drive in the wilderness.  Imagine that you are driving a convertible car along a beautiful country road.  The roof is down and you are enjoying your surroundings. All of a sudden, a wave of anxiety comes over you.  You are hit with all sorts of wild thoughts and begin experiencing uncomfortable feelings that seem to come out of nowhere.  You quickly begin to feel so overwhelmed that you pull over.  After sitting on the side of the road for awhile, you realize that it all feels too scary to keep going.  After thinking it through to a point of exhaustion, you make yourself begin driving.

Out of desperation, you quickly put the roof up and roll the windows up as well.  You promise yourself that you won’t look out the windows just in case you might see something that will scare you again.  You fix your eyes on the road and won’t let yourself even dare to look out the windows.  If the anxiety gets bad enough, you may even shut your eyes tight and try to make your way home without looking.   Or you may call your family members or friends and make them reassure you that everything will be OK.  You may find yourself saying over and over again, “Do not think about anything that makes me anxious right now!” or “Just think good thoughts!”  When you return home, you may even vow to never go on that road again.  And if you must drive that road again, you may ask someone to come with you in order to ensure that nothing goes wrong throughout the entire drive.

Does any of this ring true for you?  Do you find yourself experiencing any of these common reactions to anxiety.  When we experience the discomfort of anxiety, we often move directly into reaction mode in an effort to control our feelings.  Or, we try to escape them at all costs.  Understanding our anxiety can be very difficult when it hits so hard and so fast.   Whether our anxiety is completely irrational (common in OCD and other anxiety disorders) or realistic (financial stress at home, relationship issues etc.), we can benefit if we stop to look at our reaction and see if it justifies the amount of energy we are giving it.

Below, I am going to walk you through a few easy steps that can help you be more mindful when faced with fear.  These simple steps can also be helpful when dealing with strong addictive urges, depression, and even pain. Using mindfulness, you can learn to view your unwanted thoughts and feelings in a more peaceful and non-reactive way, and strengthen your ability to sit with your discomfort.  Please note, this doesn’t mean that we are going to promote struggling or pain.  It simply means we are going to focus on learning to better accept unwanted thoughts and feelings, and on responding to them with fewer counter-productive behaviors.

Step One: Become Aware of Your Feelings

When we are anxious, we often react to our thoughts and feelings before we even know they are there.  Often, our clients report that they are performing compulsive behaviors before they even know that they are anxious.  Others report that while they may notice their feelings when they occur, they then focus all of their energy on trying to get away from them as fast as possible.  Step one is to slow down and notice what you are feeling.  Are you anxious? Irritable? Sad? Annoyed? Embarrassed?  Where do you feel it?  Is it in your chest?  Shoulders?  Stomach?  Is it racing in your mind or is it a sensation of heaviness in your entire body?  Don’t run from it.  Notice it.  Don’t immediately react.  Inquire first!

Step Two: Identify Your Feelings

Once we notice an unwanted feeling, we can choose to label it as “just a feeling”, and we can then begin to understand how our minds send us into reaction instead of acceptance.  When we identify what is really going on (discomfort), and not what our anxiety tells us is going on (unbearable catastrophe), then we can begin to work with it instead of against it.  Consider that while our unwanted thoughts and feelings may “feel” real, they may not be accurate or even remotely realistic.  It is often helpful to identify our thoughts and feelings as just thoughts or just feelings, not truths that are worthy of so much attention.

Step Three: View Your Feelings in a Non-Judgmental Way

Instead of saying, “I hate these feelings” or “these thoughts are very bad,” try to just look at the event and reply with something along the lines of “This event is just what it is”.  Taking a non-judgmental stance allows you to understand the event from a rational, objective point of view, instead of a biased and subjective point of view.  If you are struggling with this, you may find that talking with a therapist who is trained in mindfulness or Acceptance and Commitment Therapy (ACT) can help you immensely.

Step Four: Consider Other Behavioral Options

Once you begin to understand and label what is really going on, you can begin to consider other non-compulsive and non-avoidant options. When we are hit with a blast of anxiety, it may feel like a huge tidal wave that will destroy us.  In OCD and other anxiety disorders, we often move directly from experiencing an unwanted thought, feeling, or sensation, into immediately reacting.  We just want to make it all go away as soon as possible.  But we have the option of choosing to slow down and seeing how our brains have created an event that feels far more threatening than it actually is.  Perhaps putting the top up and rolling the windows up is not be the best idea!

Step Five: Take Action…By Not Reacting

This is the moment of truth.  In step five, you will have to be willing to take a risk and challenge your thoughts and feelings by not responding in a compulsive or avoidant manner.  You will have to be willing to experience discomfort instead of the relief of immediately being comforted.  This is a bold and courageous step.  It requires a full commitment to feeling your discomfort.  And this is where you will really begin to free yourself from the behaviors that have reduced the quality of your life.  In this step, you will make the decision to open your self to experiencing the unwanted thoughts, feelings, or sensations that you find so uncomfortable.

This is the moment where you have two options.  You can choose to avoid and/or control your thoughts, feelings, and sensations, or you can choose to allow the moment to be what it is.  It is the moment where you decide to either pull over and get short-term relief, or to sit with short-term discomfort in the hope of improving your long-term experience of life.

Step Six: Feel the Curves of the Road Beneath You

If you are willing to commit to sitting with your discomfort and getting back on the road, this step will help you to do it without doing compulsions.  Step six is all about just feeling the curves of the road beneath you and not trying to control or change anything about your experience.  Sit back and just be in the moment, letting the road and the wheels take you over all the bumps and sharp corners.  Take notice of the view, without placing any expectations on how the view “should” look, or how you “should” feel.  Let the car take the corners, without trying to hold on too tight.  Often, when we loosen our grip on how we want things to be and allow some flexibility, we enjoy our experience much more.

Accept whatever discomfort you are experiencing.  Befriend it and learn that it is rarely the horror that you fear it will be.  It is almost never the catastrophe that we anticipate.  I find it is often helpful to implement some kind of breathing training at this step.  Try to breathe into whatever it is that you are experiencing.  Breathe and take notice of your breath as you observe what your body is feeling.

The main goal of mindfulness is to accept whatever comes your way.  Pot holes!  Fear!  Cracks in the pavement!!  Irritability!  Huge hills!  Panic! Areas where there is no pavement at all!  Feeling out of control!  Try to take on each obstacle as it arrives, without anticipating or planning for a specific outcome.  Before you know it, you will be home and you will look back and be glad you took the drive.

Kimberley Quinlan, MA, is a psychotherapist at the the OCD Center of Los Angeles, a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related conditions.  She can be contacted

Image: “Country Roads” © Capn Madd Matt – Used under a Creative Commons license.

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Nothing fashionable about anxiety

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

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

“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 can 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 approp- riate threshold for treating and medicating OCD, from which about 3 per cent 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.”


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.

– © Fairfax NZ News

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Gitmo: The national anxiety disorder

Sam Sacks is a political commentator and journalist, the last five years spent covering politics in Washington, DC.

Ask the United States why the prison facility at Guantanamo Bay, Cuba is still open, and you’ll see only irrational answers and fear in return.

Ask someone with an obsessive-compulsive disorder (OCD) about
his or her often bizarre and inexplicable habits – like not walking
on cracks, endlessly washing their hands, and counting things over
and over again – and they’ll have trouble explaining exactly why
they do it.

That’s because OCD is a mental disorder. From the US National Institute of Mental Health:
“People with obsessive-compulsive disorder (OCD) 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.

The International OCD Foundation notes, “If you
have OCD, the warning system in your brain is not working
correctly. Your brain is telling you that you are in danger when
you are not.”

Sufferers genuinely believe that, for example, if they don’t
keep their books organized in a very specific way, then something
terrible might happen to them or their family. It makes no sense,
but they still do it, again and again and again.

They don’t understand that the danger is not real.

Now ask the United States why the prison facility at Guantanamo
Bay, Cuba is still open. You’ll get the same fidgeting, the same
irrational answers, and most importantly, the same fear. America
also doesn’t understand that the danger is not real.

As Bloomberg Businessweek pointed out:

“Of the 150,000 murders in the U.S. between 9/11 and the end
of 2010, Islamic extremism accounted for fewer than three dozen. Since 2000, the chance
that a resident of the U.S. would die in a terrorist attack was one
in 3.5 million, according to John Mueller of Ohio State
University,and Mark Stewart of the University of Newcastle. In
fact, extremist Islamic terrorism resulted in just 200 to 400
deaths worldwide outside the war zones of Afghanistan and Iraq—the
same number, Mueller noted in a 2011 report (PDF), as die in bathtubs in
the U.S. alone each year.”

In other words, Gitmo serves a better purpose keeping us safe
from the bathtubs that are installed there than the so-called
terrorists imprisoned there. 

But, out of fear, we tell ourselves that as long as we have that
prison down in Guantanamo Bay, Cuba, then the “terrorists” are down
there, in cages, unable to plot against us. We get some peace of
mind; we can sleep easier. Gitmo open = family safe.

And then we don’t think about it. But, as soon as there’s talk
about closing Gitmo, then all our wild delusions of fear well up
inside. Members of Congress are outraged!

For example, when President Obama’s first attempt to close the
facility in May of 2009 was rebuffed by the Senate, which voted
90-6 to block $80 million in funding to close Gitmo, Senator John
Thune (R-SD) made the argument, “The American people don’t
want these men walking the streets of America’s neighborhoods.”

He added, “The American people don’t want these detainees held
at a military base or federal prison in their backyard,

Later, in 2011, Senate Republicans attempted to pass legislation
to codify Gitmo as the primary detention facility for future
detainees. Senator Lindsey Graham (R-SC) said, “Whatever image problems that linger
around Guantanamo Bay pale in comparison to the risk of not having
a prison.”

Graham’s comments came one month after Wikileaks revealed the
truth about Gitmo. In releasing 700 secret government documents on
hundreds of Gitmo detainees, in April 2011, Wikileaks gave us
Americans some much-needed therapy about our Gitmo compulsion. We
were told that Gitmo isn’t necessary to keep us safe.

It’s true, of the 166 prisoners still at Gitmo, roughly 120 are
considered “high risk.” Although, Wikileaks revealed that 160 “high
risk” prisoners have already been transferred out of the facility
to other countries or freed altogether.

Among a myriad of other problems with Gitmo, all can be found
here, we
also learned that many of those “terrorists” imprisoned at the
facility were only there because they had the wrong wristwatch.

The Telegraph reported, “People wearing a certain model of
Casio watch from the 1980s were seized by American forces in
Afghanistan on suspicion of being terrorists, because the watches
were used as timers by Al-Qaeda.”

Also, “At least…150 people are innocent Afghans or
Pakistanis, including farmers, chefs and drivers who were rounded
up or even sold to US forces and transferred across the world. In
the top-secret documents, senior US commanders conclude that in
dozens of cases there is ‘no reason recorded for

And, to those who, like Senator John Thune, say Gitmo must
remain open because it’s too dangerous to hold these men in
facilities within the United States or try them in traditional
courts, consider this: Currently, there are 355 people convicted of terrorism charges
already being held in U.S. prisons. None have

Osama Bin Laden’s son-in-law faced a judge in a courtroom in New
York City earlier this month to plead not guilty to terrorism
charges. And guess what? Not a single New Yorker was injured or put
in danger during the arraignment. 

Gitmo does not keep some irrational danger at bay. In fact, just
like most OCD habits, it gets in the way of us living a normal,
healthy lifestyle. It’s the nation’s most expensive prison facility per capita, with
more than a million dollars spent annually on each inmate. It’s
also a foreign policy black eye on the United States that darkens
each year it stays open.

It’s the setting for torture, indefinite detention, military
tribunals censored from the media, and suicide (six inmates have
taken their own lives so far). As has been routinely said, the only
way out of Gitmo these days, tragically, is in a body bag. It’s
also been widely reported that Gitmo is used as a
terrorist recruiting tool abroad. 

For these reasons, the international community has, time and
time again, attempted to hold an intervention with us. The European
Union, the United Nations Commission on Human Rights, Amnesty
International, Human Rights Watch, and other organizations,
governments, and activists around the world have called for the
closure of Gitmo.

But, rather than taking the lead on this, the President enables
this irrational fear to continue. Bush and Cheney may have been the
trigger for it, but President Obama has cultivated it. He’s given
in to the national OCD. His promise on day one of his presidency to
close Gitmo has been the signature, unfulfilled promise of his

And today, nearly two years after the Wikileaks revelations,
four years after President Obama was first sworn in, and more than
a decade after the facility began housing prisoners of our endless
“War on Terror,” prospects for closing Gitmo have never been

At the start of 2013, the State Department office created in
2009 to specifically handle the closure of Gitmo was shut down. The special envoy in charge,
Daniel Fried, was reassigned. His position will be left vacant.

In the President’s State of the Union Address in February, there
was no mention of Gitmo at all. Prisoners at Gitmo actually watched
the address, hoping for some nugget of sanity to emerge regarding
their fate.

Marine Corps General John Kelly told the House Armed Services Committee about
the Gitmo inmates’ reactions to the speech, “They had great
optimism that Guantanamo would be closed. They were devastated
apparently … when the President backed off, at least [that’s]
their perception, of closing the facility.”

Today, many of those prisoners are on a hunger strike. This
week, the military confirmed that the number of detainees on a
hunger strike has more than tripled from 7 to 25. Attorneys for the
inmates claim, “Over two dozen men have lost consciousness.”
Eight of them are now being force-fed through a feeding tube in
their stomach. Apparently, that one option of leaving Gitmo in a
body bag has now been taken off the table.

Yet, reports just this week indicate that the
Pentagon is considering a $150 million renovation of the prison
camp. As though an upgrade of the dining hall will ease the
concerns of hunger-striking inmates suffering from racist and
Kafkaesque incarceration.

On top of that, the American people still overwhelmingly support
continuing our compulsive behavior of keeping Gitmo open. A 2012
Washington Post/ABC News poll showed 70% of American support keeping
Gitmo open, including more than half of “liberal Democrats” and
two-thirds of “moderate Democrats.”

We just can’t shake the fear.

And so, Gitmo just sits there, mostly emptied. It’s held nearly
800 inmates. There were only 242 left when President Obama took
office. And today, it’s down to 166 souls, trapped.  Of that,
86 have been approved for release, but are barred from leaving.
Plus, 25 are on a hunger strike.

The President, who will be a lame duck in two years, is focused
on the economy, immigration and gun control. There’s no time to
talk about Gitmo anymore.

It will stay open indefinitely, giving us “peace of mind” as we
continue our “war on terror” descent into national madness.

The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.

Comments (3)

Anonymous user 22.03.2013 22:17

Not only does USA lie about closing, they are spending 50 mil to build a new one!
Lies, lies, lies!

Anonymous user 22.03.2013 19:00

US only wants to keep jailing anyone opposed to its’ terror War vs. World. Any excuse will do.

Anonymous user 22.03.2013 18:49

Eurasian: You fella witness the reserection of the Spanish Inquisition! Nazism wasnt enough 4 them

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The Heart, a Home under Construction

In my Father’s house are many mansions: if it were not so, I would have told you. I go to prepare a place for you. —John 14:2

When Charlotte moved in with me in January of 2005, my Obsessive-Compulsive Disorder surged with such searing intensity that I had to schedule an emergency session with my therapist. I sought treatment in the first place because every time I tried to date someone, electric anxiety coursed through my central nervous system, threatening to trip all the breakers in my body.

“I don’t get it, Troy,” I said to my therapist, who diagnosed me with OCD in August of 2004.

“It’s not like I’m dating Charlotte—she’s a cat, for crying out loud! Why am I freaking out?”

One of my housemate’s coworkers needed to find a home for Charlotte, and I agreed to adopt her. I always wanted a cat to call my own, so I was shocked when my body betrayed me after I took her home.

“How will I ever love this cat if I’m so anxious about her?” I asked Troy. “If all I feel is fear, how will there ever be room in my heart for affection?”

I use the phrase “room in my heart” because I have long thought of the human heart as a physical space. I asked Jesus to live in my heart when I was nine, after all, and I figured that meant my heart had to be a home of some sort.

“Do you really feel like you’re incapable of loving that cat, Chad?” Troy asked. “Just because you feel that way doesn’t mean it’s true.”

The idea that feelings are not necessarily facts—especially for someone with OCD—challenged what I thought I knew about my situation with Charlotte. Sure, my heart was filled to capacity with anxiety, and then some. But did that mean I couldn’t add a wing to the home in my heart?

“What if you give yourself permission to keep your kitty for awhile, and just see what happens?” Troy asked.

This seemed like a reasonable idea to me. Maybe—just maybe—my anxious heart could make room for such a small creature.

I imagined a crew of construction workers toiling tirelessly in my heart to add an annex for Charlotte. In a matter of days, my heart became a cat’s home.

The same sorts of obsessive thoughts and feelings that interfered with adopting Charlotte had derailed all of my dating experiences, as strange as that may sound. With time, Troy helped me understand how to transfer what I learned from my experience with Charlotte to dating.

As I made progress in therapy, more room opened up in my heart. Four months after I brought Charlotte home, I adopted a second cat.

When my wife Becki and I married, she brought her three cats into my life, too. Just like that, my heart became a cattery.

Eighteen months into our marriage, Becki and I decided the spare bedroom in our house should belong to a baby. During her pregnancy with our daughter Evie, however, Becki worried she might not have room in her heart for a child.

“What if I don’t love her enough?” she asked. “I want to be a good mom, but I don’t know if I’m capable of being one.”

While I wondered how anxiety and affection could coexist in my heart, Becki wondered if her heart was too impoverished to ever lavish Evie with love. If Becki imagined a construction crew building a place for Evie, she probably pictured them cobbling together the shoddiest of sheds in her heart’s backyard.

I had seen how my own heart had expanded to accommodate Charlotte, so I told Becki I believed her heart would do the same for Evie—regardless of what she thought. Becki, who has always adored Dr. Seuss’s How the Grinch Stole Christmas!, knew the Grinch’s heart grew three sizes by the end of Seuss’s story. She hoped hers would enlarge for our little Cindy Lou Who, too.

During the second half of Evie’s first six months out of the womb, we hired construction crews to repair the foundation in our living room. The water table beneath our property had shifted, causing the floor to bow up, and ceramic tiles to crack underfoot.

The first crew jackhammered our old foundation, coating everything in our home in concrete dust, and leaving us with a dirt floor in our living room for a weekend. Our cats, who never leave our house, rolled on the bare ground, rejoicing that the outdoors had come indoors—just for them. After the workers installed new rebar and poured concrete, we scheduled a second group of contractors to install our laminate flooring.

The floorers had no openings until a month after the first crew finished its work. This meant we waited a month for them to visit and tell us that, while the floor was level by construction standards, it was not level enough for laminate installation.

We hired a third contractor to fix a few especially problematic places with a concrete grinder. He coated everything in our home with another complementary layer of concrete dust.

By the time the laminate company succeeded in installing our floor, Becki realized her heart had undergone renovations of its own, unbeknownst to her. None of the renovations involved building a shed either.

“I can’t believe how much I love Evie,” she said to me. “I love her more than I ever imagined I could.”

We knew parenthood would bring with it a wrecking ball that would demolish certain selfish parts of our hearts whether we liked it or not—we knew it would be difficult, too. But when the dust settled after the destruction, Becki found that her heart had become a mansion with infinite rooms for Evie to enjoy.

 This post is excerpted from Chad Thomas Johnston’s forthcoming e-book, Nightmarriage. Pre-order here [] for 20% off and receive a free audio version of the book when it becomes available.

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.

American Psychological Association:

National Institute of Mental Health:

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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.”

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