New program in Houston helping teens with anxiety and OCD


New program in Houston helping teens with anxiety and OCD

Dr. Elizabeth McIngvale has learned how to work through her own bouts of obsessive-compulsive disorder, or OCD, through years of therapy and is now sharing her knowledge and expertise, as the Director of the McLean OCD Institute in Houston.

A new program is helping teenagers deal with symptoms of anxiety and obsessive-compulsive disorder. Researchers have found a specific therapy can make a life-changing difference.

Dr. Elizabeth McIngvale has learned how to work through her own bouts of obsessive-compulsive disorder, or OCD, through years of therapy and is now sharing her knowledge and expertise, as the Director of the McLean OCD Institute in Houston.

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“McLean, which is a part of Harvard Med School, acquired us, so we became a part of their bigger system in Boston, but we’re still the same program here in Houston. This is the first time they’ve gone outside of Boston, so it’s exciting for Houston,” exclaims Dr. McIngvale.

It’s also timely because of the rise for help when it comes to mental health.

“We are certainly seeing a huge increase in people accessing mental health care, and I think that we’re all seeing higher symptom severity, long waitlists, everyone is struggling across the board, and it’s hitting all mental health providers,” says Dr. McIngvale.

Here is how to recognize the warning signs.

“When we’re talking about anxiety and OCD, it’s really about looking for any changes in the behavior that’s significant. So often we talk about a change in sleep, a change in appetite, a change in social interactions, but also just noticing that increase in anxiety. So are the kids asking if they can stay home from school, not wanting to go, wanting to withdraw? Are you seeing the anxiety increase overall? Are they asking you repetitive questions? Are they getting stuck in worry loops and you have to help navigate that with them,” questions Dr. McIngvale.

RELATED: COVID-related stress weighs heavily on Gen Z

With the right treatment, Dr. McIngvale says most people can fully function comfortably with anxiety and OCD.

“The great news is not only is treatment really effective, and we know that the outcomes are quite incredible for individuals to be able to get back to full functioning. It’s also tools they’ll use for the rest of their life,” explains Dr. McIngvale.

She says the preferred treatment is cognitive behavioral therapy, to expose anxiety-causing events to patients in a controlled situation so they can learn how to cope.

“What happens is – we have these thoughts, they give us anxiety, that brings on distress and unwanted feelings, so we tend to either want to suppress it, run away from it, avoid it, or rituals to feel better. What we’re teaching you is actually how to change your behaviors and the way you respond to anxiety so that anxiety isn’t accompanied with fear, and it’s no longer something you’re afraid of, but something you’re willing to address head-on,” states Dr. McIngvale.

RELATED: Parent to Parent: COVID-19 and mental health in children

To reach even more people, the McLean OCD Institute is offering an online program that takes place three days a week in late afternoons/ early evenings. Depending on the patient, the program lasts approximately 8-12 weeks. 

It’s important to note that mental health care may be more affordable than you realize.

“For example, here at McLean Houston, we are a training institute, which means we have students, we have trainees, and so we have sliding-scale options and all sorts of options that are available that you might not know exist,” says Dr. McIngvale.

Many others offer something similar.

“We’re so lucky to have the medical center and the Texas Medical Center really does allow if you have insurance for you to receive really great evidence-based interventions through big centers, whether it’s Baylor College of Medicine or UT Health, right? There’s lots of options. If you don’t have insurance, or you’re using a gold card right Harris health has incredible resources,” explains Dr. McIngvale.

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It’s all about finding the right resources.

“You can always go to your local MHMRA chapter, so you can really get talk to them about here’s where I stand and here’s what I need help for, and they can help point you in the right direction. Don’t try to do it on your own. You don’t have to find the help on your own, because you can partner with some of the bigger organizations we mentioned, like Harris health or MHMRA that have resources to lead you in the right direction for affordable care,” states Dr. McIngvale.

For more information visit www.mcleanhospital.org/treatment/ocd-institute or theharriscenter.org

Generalized anxiety disorder: Study looks at heart-brain link

People with GAD experience an excessive and pervasive worry about everyday life events. This makes it difficult for them to complete tasks at work, maintain healthy relationships, and take care of themselves.

“People with generalized anxiety disorder worry excessively and constantly about everything going on in their lives, and they find it very difficult to control this worry,” said Dr. Olivia Remes, a psychologist and researcher at the University of Cambridge in the United Kingdom, during a TED Talk on coping with anxiety.

As the neural basis for this anxious arousal in GAD is unclear, it is one of the most difficult anxiety disorders to treat. People with GAD often show resistance to drug treatment and talking therapies.

Hyperarousal symptoms, such as accelerated heart rate, shortness of breath, and sweating, are common among individuals with GAD.

However, these symptoms do not always correlate with physical responses. In other words, the person’s perception of their physiological state, which is called interoception, often does not match their physiological state. For instance, they might feel as though their heart is racing, but it is not. This inconsistency is a characteristic of GAD.

The authors of the new study hope that identifying why there is a disconnect between interoception and physiology might “provide novel targets for treatments.”

What OCD is — and what it isn’t: ‘There are a lot of misperceptions’

Obsessive compulsive disorder, or OCD, is a common, chronic mental health disorder. (Photo: Getty Images)

While obsessive compulsive disorder, or OCD, is an actual mental health condition, the term has been co-opted by the public to describe times when someone is having an anal-retentive moment. But mental health experts say that OCD is so much more than that.

“As we’ve gained awareness and acceptance of mental health conditions, it seems their labels have found their way into popular vocabulary,” psychologist Alicia H. Clark, author of Hack Your Anxiety, tells Yahoo Life. “OCD, like panic and anxiety, has gained traction to reference everything from tidiness to a controlling attitude to wanting to do something a lot.”

Samantha Farris, assistant professor in the department of psychology and director of The Rutgers Emotion, Health and Behavior (REHAB) Laboratory at Rutgers University, agrees. “There are a lot of misperceptions about obsessive compulsive disorder,” Farris tells Yahoo Life. “It’s not the same as just having a preference for things being a certain way.”

Hillary Ammon, assistant professor of clinical psychiatry at Penn Medicine, tells Yahoo Life that this likely stems from how Hollywood has portrayed OCD. “While some movies and TV shows have done a better job than others at accurately reflecting symptoms of OCD, the characters typically only present with OCD symptoms like a need for order or cleanliness,” Ammon says. “As a result, it seems the general public primarily think of these traits as symptoms of OCD.”

Here’s what you need to know about what OCD means — and what it doesn’t.

What does OCD mean?

OCD is a chronic mental health disorder that causes a person to have uncontrollable, repeated obsessions and/or behaviors known as compulsions, according to the National Institute of Mental Health (NIMH). A person with OCD feels the urge to repeat these compulsions over and over.

While cleanliness and order is often associated with OCD, there are actually different forms of the condition that can lead to a range of symptoms. People with OCD, which is typically diagnosed by around age 19, may have symptoms of obsessions — meaning, repeated thoughts, urges, or mental images that cause anxiety — or compulsions, or both, the NIMH explains.

OCD obsessions can include a fear of germs or contamination, aggressive thoughts toward yourself or others, needing things to be in a perfect order, or dealing with taboo intrusive thoughts involving sex, religion or harm, the NIMH says. Compulsions can include needing to do excessive cleaning or hand washing, ordering things a certain way, repeatedly checking on things and compulsive counting.

“With OCD, the thoughts are associated with needing to do something,” Farris says. “It’s really distressing because folks feel like they’re compelled. They have to act in order to address the distress that they’re having.”

OCD also “costs a great deal of time and energy, gets in the way of someone’s life and generally is something dreaded by its sufferer,” Clark says. “No one wakes up wanting to burn their hands washing them, or engage the time-consuming rituals they do to leave their apartment. Instead, they feel trapped by their symptoms, and deeply afraid of doing anything different.”

Obsessive thoughts also tend to be “highly negative and catastrophic,” such as worrying that people will die or horrible things will happen, if compulsions don’t take place, Clark says.

How has the COVID-19 pandemic impacted people with OCD?

Experts say it’s been a mixed bag. “The isolation of the pandemic has allowed more OCD sufferers to avoid social and public situations that can be stressful,” Clark says. “Especially people with hygiene and germ phobias, the pandemic has normalized many of their cleaning and social distancing rituals. Many have commented feeling more normal having many of their rituals normalized.”

But the increase in stress and uncertainty that comes with living through a global pandemic has also increased anxiety in some people and made taking control more challenging, Clark says. “This has been more true for the OCD personalities that rely on planning, control and order to manage anxiety,” she explains. “Uncertainty hasn’t been kind to these more controlling coping strategies, where flexibility and contingency planning has been required.”

Clark adds: “Like for everyone, the pandemic has created stress and a demand to broaden coping skills in general.”

Ammon says she’s seen “varying impacts” on people with OCD. Some feel that treatment has actually helped prepare them for the pandemic. “Many people shared that, for the first time, it felt like collectively a lot of other people in the world could relate to their experience with OCD in that there was so much uncertainty in the world related to the pandemic and people were figuring out ways to manage their anxiety and gain a sense of control and security,” Ammon says.

She continues: “Furthermore, they shared that they felt better equipped to cope with the uncertainty of the pandemic, as compared to their counterparts who did not have OCD…because they learned to tolerate uncertainty through treatment.”

How is OCD treated?

OCD is usually treated with medication, psychotherapy or a combination of both, Farris says. Medications include taking serotonin reuptake inhibitors (SRIs) or selective serotonin reuptake inhibitors (SSRIs) to help reduce symptoms. In some cases, doctors may recommend anti-psychotic medications, NIMH says.

Psychotherapy usually includes cognitive behavioral therapy (CBT), and a specific form of CBT called Exposure and Response Prevention (EX/RP). With Exposure and Response Prevention, patients will spend time in situations that trigger their compulsions but they’re prevented from immediately acting upon them. So, if someone has an hand washing compulsion, they may be asked to touch an object with dirt on it and encouraged to wait to wash their hands.

Ammon stresses that it’s possible to live a normal, healthy life with OCD. “Individuals who complete EX/RP for their OCD not only approach their fears and manage their presenting symptoms of OCD, but also often learn to tolerate uncertainty better,” she says. Clark agrees, noting there are “incredibly effective treatments available, and many practitioners who are trained in them and able to help.”

Clark adds: “OCD does not have to keep ruling your life, and you do not have to suffer alone.”

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Can’t Stop Thinking About Past Mistakes? This May Be Why

If your thoughts about the past are a symptom of a mental health condition, a professional may be able to help. By addressing the underlying cause, you can find relief for all of your symptoms — including rumination.

“With a supportive therapist, you can work through not just problematic thoughts but any mental health condition in its entirety, as well as circumstances that may be contributing to it,” explains Peterson.

Addressing rumination directly can also help. These tips may support you in the process:

Try quieting your inner critic

“You are not bad, weak, or flawed for ruminating,” says Peterson. Focusing on the past and putting yourself down for ruminating might reinforce negative thinking and increase your distress.

You may not be able to change what happened in your past, but you can create new experiences from this second on.

Going over what you did or didn’t do right won’t change anything. You did what you could with the resources at hand.

Self-compassion will go a long way, and it can start by simply not putting yourself down.

Consider the possibilities

Thinking about the things that are important to you may help you step away from painful rumination.

Instead of focusing on the things you don’t want, try to identify what you do want in your life. This can be relationships, jobs, hobbies, or places to be.

“When you catch yourself ruminating, gently shift your attention to an image of your valued life,” suggests Peterson.

Changing directions may help

When you find yourself hitting reverse, try to switch gears and move forward. You may even set it at neutral.

Peterson explains that grounding yourself in the here and now may allow you to redirect your thoughts. So, even if it doesn’t come naturally at first, try to come back to the present whenever you find yourself thinking about the past.

For example, look in front of you and try to find every possible detail of the first object you set eyes on. You can look at shapes, textures, colors, shades, and positions.

How to Help Someone With Anxiety: What to Do and What Not to Do

Here are some ways you can actively show your support and help someone with anxiety.

1. Learn about the different types of anxiety and signs of them

“Anxiety is a natural emotion and physiological shift that occurs when people perceive potential harm toward oneself or others,” says psychologist Timothy Yen, PsyD. “Anxiety gears them up for a fight-or-flight response to address the danger, either to eliminate the threat or run away from it.”

Understanding the different types of anxiety — and the common signs and symptoms — can help you help your loved one. Here’s what you need to know.

Generalized anxiety disorder

Generalized anxiety disorder (GAD) is what typically first comes to mind when people think of anxiety. GAD is characterized by:

  • chronic anxiety
  • exaggerated worries and tension

Panic disorder

A common panic disorder symptom is panic attacks.

“With panic attacks, it’s first important to learn the signs so that you can help your friend identify what’s happening to them,” says psychologist Heather Z. Lyons PhD.

Here are some signs to look out for:

  • unexpected episodes of intense fear
  • chest pain
  • heart palpitations
  • shortness of breath
  • dizziness
  • stomach probs like gas, cramping, or diarrhea

Social phobia (or social anxiety disorder)

Social phobia (aka social anxiety disorder) is characterized by:

  • overwhelming anxiety
  • excessive self-consciousness in everyday social situations
  • fear of eating in front of others
  • fear of public speaking
  • fear of being in public

Keep in mind, symptoms can range from mild to severe. Some folks have no problem socializing in certain situations. But other folks can find any type of social setting to be triggering.

Obsessive-compulsive disorder (OCD)

Common OCD symptoms include:

  • recurring unwanted thoughts (obsessions)
  • repetitive or ritualistic behaviors (compulsions)

These “rituals” tend to lend temporary anxiety relief. But failing to do them can trigger feelings of unease.

Post-traumatic stress disorder (PTSD)

PTSD can happen if someone is exposed to a traumatic event like:

  • violence
  • natural disasters
  • accidents
  • military combat
  • abuse of all kinds

Signs of anxiety to look for

Again, anxiety symptoms can vary from person to person. But there are some general signs to look out for:

  • irritability
  • lack of focus
  • frequent muscle clenching
  • avoiding social situations
  • teeth grinding
  • seeking constant reassurance
  • second-guessing themselves
  • compulsive actions
  • restlessness
  • shortness of breath
  • easily fatigued
  • constantly expecting the worse
  • jumping to conclusions

2. Provide validation

Sometimes a simple validation can make a big difference. That means taking the time to really listen to what they’re going through and acknowledging their feelings.

“Oftentimes we move too quickly toward reassurance that ‘everything is going to be okay,’” says Yen. This can underscore a person’s feelings and might make them feel judged.

Instead, Yen recommends first letting them know that you get where they’re coming from.

For example:

  • Say: “I understand why you’re worried about this test. You’re concerned that failing could jeopardize your acceptance to your top school.”
  • Don’t say: “C’mon, it’s just a test. You’re overreacting. You just need to chill out and study.”

Once your friend feels validated and heard, you can open the convo up a bit.

3. Try a grounding exercise

During a panic attack or anxiety episode, people might feel disconnected from the world around them. Grounding is a great way to refocus someone’s attention back to reality.

Here are some grounding techniques to try together:

Feel the floor beneath your feet

Gravity’s a trip, y’all. Since we can’t concentrate on everything at once, our selective attention doesn’t typically notice things like the feeling of the floor beneath our feet or the chair we’re sitting on. So, ask your friend if you could take a moment together to just notice the physical world that’s holding them up.

Focus on your breath

Breathwork is where it’s at. Exercises like Sama Vritti (aka equal breathing) can calm the mind and reduce racing thoughts. Try to inhale for 5 seconds then exhale for 5 seconds. Repeat as needed.

Listen to the world around you

Lyons recommends turning your friend’s attention to a repetitive sound or music. Just make sure it’s slow and soothing, like the hum of a heater or the sound of a soft piano piece. The consistency and repetitions can be very comforting.

Meditate

Meditation is worth the hype. It’s a great way to reduce stress and alleviate anxiety. Ask your friend to participate in 10 minutes of silent meditation or guided imagery. Psst. Here’s a Greatist guide to meditation for anxiety.

4. Determine your support role

There are lots of different roles you can take to support a person with anxiety.

“When our loved ones are in distress, they often need us to either distract them by cheering them up, be with them by listening and ensuring our availability, or help them with what we can do for them,” says Lyons.

Here are examples of things you can say, depending on your role.

Distract

When you distract someone, you can offer ways to take their mind off their anxiety.

  • “Let’s watch *insert fave escapist show* together, what do you say?”
  • “Maybe we should go to yoga class.”
  • “Let’s grab some food.”

Do

When you do, you take direct action.

  • “I’ll help you organize your closet.”
  • “I have a really good therapist. I can ask for a referral for you.”
  • “I’m going to pick up a pizza for you.”

Be

Being can be as simple as letting them know you’re always there for them.

  • “Do you want to talk about it?”
  • “Do you want me to stop by? If not, do you want to FaceTime?”
  • “You’re not a burden and I always have your back.”

Brain Imaging Gives New Insight Into Hoarding Disorder

Widespread white matter (WM) abnormalities may offer new insight into hoarding disorder (HD).

In a neuroimaging study, investigators led by Taro Mizobe, Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, compared brain scans of individuals with and without HD.

Results showed that compared with healthy family members, participants with HD had anatomically widespread abnormalities in WM tracts.

In particular, a broad range of alterations were found in frontal WM related to HD symptom severity, as well as cortical regions involved in cognitive dysfunction.

“The finding of a characteristic association between alterations in the prefrontal WM tract, which connects cortical regions involved in cognitive function and the severity of hoarding symptoms, could provide new insights into the neurobiological basis of HD,” the researchers write.

The findings were published online January 18 in the Journal of Psychiatric Research.

Limited Information

“Although there are no clear neurobiological models of HD, several neuroimaging studies have found specific differences in specific brain regions” between patients with and without HD, the investigators write.

Structural MRI studies and voxel-based morphometry have shown larger volumes of gray matter in several regions of the brain in patients with HD. However, there have been no reports on alterations in the WM tracts — and studies of patients with OCD and hoarding symptoms have yielded only “limited information” regarding WM tracts, the researchers note.

Diffusion tensor imaging (DTI) studies have yielded “inconsistent” findings, “therefore little is known about the microstructure of WM in the brains of patients with HD,” they add.

The current study was designed “to investigate microstructural alterations in the WM tracts of individuals with HD” by using tract-based spatial statistics — a model typically used for whole-brain, voxel-wise analysis of DTI measures.

DTI neuroimaging can assess the microstructure of WM. In the current study, the investigators focused on the three measures yielded by DTI: fractional anisotropy (FA), which is an index of overall WM integrity; axial diffusivity (AD); and radial diffusivity (RD).

Participants underwent MRI and DTI scans. Brain images of 25 individuals with hoarding disorder (mean age, 43 years; 64% women; 96% right-handed) were compared with those of 36 healthy controls matched for age, sex, and handedness.

Participants with HD had higher scores on the Hamilton Rating Scales for depression and anxiety than those without HD (P .001 for both).

Of the patients with HD, 10 were taking psychiatric medications such as antidepressants, tranquilizers, or nonstimulant agents for attention deficit hyperactivity disorder (ADHD).

Most (n = 18) were concurrently diagnosed with other psychiatric conditions, including ADHD, anxiety disorder, major depressive disorder, posttraumatic stress disorder, or obsessive-compulsive disorder.

The researchers also conducted a post hoc analysis of regions of interest “to detect correlations with clinical features.”

Microstructural Alterations

Compared with healthy controls, patients with hoarding disorder showed decreased FA and increased RD in anatomically widespread WM tracts.

Decreased FA areas included the left superior longitudinal fasciculus (SLF), left uncinate fasciculus, left inferior fronto-occipital fasciculus (IFOF), left anterior thalamic radiation (ATR), left corticospinal tract, and left anterior limb of the internal capsule (ALIC).

Increased RD areas included the bilateral SLF, right IFOF, bilateral anterior and superior corona radiata, left posterior corona radiata, right ATR, left posterior thalamic radiation, right external capsule, and right ALIC.

Post hoc analyses of “regions of interest,” revealed “significant negative correlation” between the severity of hoarding symptoms and FA, particularly in the left anterior limb of the internal capsule, and a positive correlation between HD symptom severity and radial diffusivity in the right anterior thalamic radiation.

Those with HD also showed “a broad range of alterations” in the frontal WM tracts, including the frontothalamic circuit, frontoparietal network, and frontolimbic pathway.

“We found anatomically widespread decreases in FA and increases in WD in many major WM tracts and correlations between the severity of hoarding symptoms and DTI parameters (FA and RD) in the left ALIC and right ATR, which is part of the frontothalamic circuit,” the investigators write.

These findings “suggest that patients with HD have microstructural alterations in the prefrontal WM tracts,” they add.

First Study

The researchers say that, to their knowledge, this is the first study to find major abnormalities in WM tracts within the brain and correlations between DTI indices and clinical features in patients with HD.

The frontothalamic circuit is “thought to play an important role in executive functions, including working memory, attention, reward processing, and decision-making,” the investigators write.

Previous research implied that frontothalamic circuit-related cognitive functions are “impaired in patients with HD” and suggested that these impairments “underlie hoarding symptoms such as acquiring, saving, and cluttering relevant to HD.”

The decreased FA in the left SLF “reflects alterations in WM in the frontoparietal network in these patients and may be associated with cognitive impairments, such as task switching and inhibition, as shown in previous studies,” the researchers write.

Additionally, changes in FA and RD often “indicate myelin pathology,” which suggest that HD pathophysiology “may include abnormalities of myelination.”

However, the investigators cite several study limitations, including the “relatively small” sample size, which kept the DTI analysis from being “robust.” Moreover, many patients with HD had comorbid psychiatric disorders, which have also been associated with microstructural abnormalities in WM, the researchers note.

Novel Approach

Commenting for Medscape Medical News, Michael Stevens, PhD, director, CNDLAB, Olin Neuropsychiatry Research Center, and adjunct professor of psychiatry at Yale University School of Medicine, New Haven, Connecticut, said the study “provides useful new clues for understanding HD neurobiology” because of its novel approach in assessing microstructural properties of major WM tracts.

The study’s “main contribution is to identify specific WM pathways between brain regions as worth looking at closely in the future. Some of these regions already have been implicated by brain function neuroimaging as abnormal in patients who compulsively hoard,” said Stevens, who was not involved in the research.

He noted that when WM pathway integrity is affected, “it is thought to have an impact on how well information is communicated” between the brain regions.

“So once these specific findings are replicated in a separate study, they hopefully can guide researchers to ask new questions to learn exactly how these WM tracts might contribute to hoarding behavior,” Stevens said.

The study had no specific funding. The investigators and Stevens have disclosed no relevant financial relationships.

J Psychiatr Res. Published online January 18, 2022. Abstract

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Can obsessive-compulsive disorder be prevented through early detection?

A neuron culture in an image provided by Oxford University.
A neuron culture in an image provided by Oxford University.Rebecca Nutbrown

Each one of the more than 80 billion neurons in the human brain can establish between 1,000 and 10,000 contacts, or synapses, with other neurons. And because these are cells with permanent electrophysiological activity, it is impossible for us to imagine, using the brain that these cells have created, the sheer scope of the functional revolution that is permanently taking place inside our supreme organ.

We still don’t know how the brain creates thoughts and imagination, but we are convinced that both are the result of those impressive functional dynamics, of that permanent and varied energy flow that neurons make possible by connecting and disconnecting among themselves. Detecting those dynamics and highlighting their stability or their temporal and local variations is one of the best methods we have right now for understanding how the brain works to create both normal and pathological behavior.

The neuroscientist Carles Soriano, of the Bellvitge Institute for Biomedical Research in Barcelona, along with other researchers from various centers and universities in Spain and the United States, used functional magnetic resonance imaging to evaluate those temporal fluctuations between different brain regions in more than 200 healthy children with some obsessive-compulsive symptoms. This allowed them to identify regions with stable patterns of neural connectivity and to compare them with the altered patterns of adults with obsessive-compulsive disorder (OCD), which is characterized by an intolerance of uncertainty and feelings of anxiety that create intrusive thoughts and impulses, leading to repetitive behavior such as frequent hand-washing, the need to keep objects in perfect symmetry, or constantly wondering whether one has left the lights or the stove on. This kind of repetitive behavior is meant to reduce the anxiety or fear felt by the individual with OCD.

The reason for comparing the brain functions of healthy children with those of adult OCD sufferers is that previous research has shown that the appearance of certain obsessive-compulsive symptoms in children may be a sign that they are predisposed to suffer the condition as adults. This kind of knowledge could help establish preventive therapies.

Researchers working with these children found four areas where information converged in parts of the cerebral cortex, the striatum and the thalamus that were associated with adult OCD; three of those areas are associated with severe forms of the disease. After analyzing the genetic maps of those regions in more than 100 subjects, researchers identified genes that could be potentially related to the association between brain activity fluctuations and OCD. Two of those genes were related to glutamate, a neurotransmitter whose activity could serve as a biomarker to predict the risk of developing the disease as an adult, and even as a therapeutic target in prevention strategies.

The study has been published in the journal Biological Psychiatry Global Open Science and even if it is a correlational study, it is the first one to combine information from various sources to detect the possible origins of a disorder affecting between 1% and 3% of the general population and whose true nature we still know little about.

BrainsWay Announces Final Local Coverage Determination Issued by Regional Medicare Administrative Contractor Palmetto GBA Providing Coverage of Deep TMS™ for the Treatment of OCD

Palmetto GBA Covers Medicare Patients in Seven States

BURLINGTON, Mass. and JERUSALEM, Jan. 31, 2022 (GLOBE NEWSWIRE) — BrainsWay Ltd. (NASDAQ TASE: BWAY) (“BrainsWay” or the “Company”), a global leader in advanced noninvasive neurostimulation treatments for mental health disorders, today announced that a final Local Coverage Determination (LCD) has been published providing coverage applicable to the BrainsWay Deep TMS™ system for the treatment of obsessive-compulsive disorder (OCD).

The final LCD was issued by the Medicare Administrative Contractor (MAC) Palmetto GBA, which covers Medicare patients in Alabama, Georgia, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia, representing over 9 million covered lives. The final LCD was published following a formal meeting hosted by Palmetto last year and a subsequent review period. The formal LCD will be effective on March 13, 2022.

“This formal policy issued by Palmetto, one of seven MACs in the U.S., brings the total number of covered lives eligible for Deep TMS OCD coverage to approximately 60 million, an important reimbursement achievement for our company,” said Christopher von Jako, Ph.D., President and Chief Executive Officer of BrainsWay. “This final LCD is supported by the large body of compelling clinical evidence demonstrating the meaningful benefits derived by OCD patients from treatment with our innovative Deep TMS technology. We continue to work diligently to secure further coverage policy decisions from additional payors, and believe that, over time, other MACs will issue draft policies for Deep TMS coverage of OCD.”

The patient selection criteria included in Palmetto’s final LCD is closely aligned with the Clinical TMS Society’s recommended OCD coverage policy. The U.S. Food and Drug Administration (FDA) granted BrainsWay De Novo clearance in August 2018 for Deep TMS as an adjunct form of therapy for patients suffering from OCD.

About Obsessive-Compulsive Disorder
Obsessive-compulsive disorder (OCD) is a chronic and debilitating condition with a lifetime prevalence in the United States of 2.3%. Characterized by uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that the sufferer feels compelled to repeat over and over, OCD is considered by the World Health Organization (WHO) to be one of the top 10 debilitating medical conditions associated with a decreased quality of life and loss of income. Due to the complexity and heterogeneity of the condition, coupled with the high percentage of patients that are drug-resistant, many patients suffering from OCD do not respond well to first line treatment options. The economic burden on the U.S. healthcare system for OCD treatments is estimated to be over $7 billion per year.

About BrainsWay
BrainsWay is a global leader in advanced noninvasive neurostimulation treatments for mental health disorders. The Company is boldly advancing neuroscience with its proprietary Deep Transcranial Magnetic Stimulation (Deep TMS™) platform technology to improve health and transform lives. BrainsWay is the first and only TMS company to obtain three FDA-cleared indications backed by pivotal studies demonstrating clinically proven efficacy. Current indications include major depressive disorder (including reduction of anxiety symptoms, commonly referred to as anxious depression), obsessive-compulsive disorder, and smoking addiction. The Company is dedicated to leading through superior science and building on its unparalleled body of clinical evidence. Additional clinical trials of Deep TMS in various psychiatric, neurological, and addiction disorders are underway. Founded in 2003, with offices in Burlington, MA and Jerusalem, Israel, BrainsWay is committed to increasing global awareness of and broad access to Deep TMS. For the latest news and information about BrainsWay, please visit www.brainsway.com.

Forward Looking Statements
This press release contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995. Such statements may be preceded by the words “intends,” “may,” “will,” “plans,” “expects,” “anticipates,” “projects,” “predicts,” “estimates,” “aims,” “believes,” “hopes,” “potential” or similar words. These forward-looking statements and their implications are based on the current expectations of the management of the Company only and are subject to a number of factors and uncertainties that could cause actual results to differ materially from those described in the forward-looking statements. The following factors, among others, could cause actual results to differ materially from those described in the forward-looking statements: inadequacy of financial resources to meet future capital requirements; changes in technology and market requirements; delays or obstacles in launching and/or successfully completing planned studies and clinical trials; failure to obtain approvals by regulatory agencies on the Company’s anticipated timeframe, or at all; inability to retain or attract key employees whose knowledge is essential to the development of Deep TMS products; unforeseen difficulties with Deep TMS products and processes, and/or inability to develop necessary enhancements; unexpected costs related to Deep TMS products; failure to obtain and maintain adequate protection of the Company’s intellectual property, including intellectual property licensed to the Company; the potential for product liability; changes in legislation and applicable rules and regulations; unfavorable market perception and acceptance of Deep TMS technology; inadequate or delays in reimbursement from third-party payers, including insurance companies and Medicare; inability to commercialize Deep TMS, including internationally, by the Company or through third-party distributors; product development by competitors; inability to timely develop and introduce new technologies, products and applications; continuation and/or exacerbation of the global supply chain crisis and its impact on the Company’s ability to source components, meet customer demand, fill orders, maintain pricing levels and support the Company’s service needs; and the effect of the global COVID-19 health pandemic on our business and continued uncertainty and market impact relating thereto.

Any forward-looking statement in this press release speaks only as of the date of this press release. The Company undertakes no obligation to publicly update or review any forward-looking statement, whether as a result of new information, future developments or otherwise, except as may be required by any applicable securities laws. More detailed information about the risks and uncertainties affecting the Company is contained under the heading “Risk Factors” in the Company’s filings with the U.S. Securities and Exchange Commission, including the Company’s Annual Report on Form 20-F. Investors and security holders are urged to read these documents free of charge on the SEC’s web site at http://www.sec.gov.

Contacts:
BrainsWay:
Scott Areglado
SVP and Chief Financial Officer
844-386-7001
Scott.Areglado@BrainsWay.com

Investors:
Bob Yedid
LifeSci Advisors
646-597-6989
Bob@LifeSciAdvisors.com

Media Contact:
Will Johnson
201-465-8019
BrainsWay@antennagroup.com

Obsessive-Compulsive Disorder Market: High prevalence of OCD is expected to drive the market

Global Obsessive Compulsive Disorder Market: Overview

Obsessive-compulsive disorder (OCD) may be defined as an anxiety disorder that is characterized by unreasonable and uncontrollable thoughts and fears that lead an individual to perform repetitive behaviors. Obsessive-compulsive disorder compels a person to get stuck on a particular thought or fear. For example, a person afraid of contamination may wash his/her hands repetitively in an order to make sure his/her hands are clean. Likewise, a person may check a gas stove multiple times to be sure that it’s really turned off. Usually people affected with obsessive-compulsive disorder possess both obsessions as well as compulsions; however, in many cases individuals may have either obsessions or compulsions.

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Some common thoughts that usually pop up in mind of people with obsessive-compulsive disorder are fear of being contaminated by germs or dirt, excessive thinking about religious or moral ideas, superstitions, having things orderly or symmetrical, doubts that stove is turned off and thoughts of hurting oneself or others. These thoughts cause people with obsessive-compulsive disorder to perform actions like repeatedly checking of things such as locks and switches; repeatedly reciting certain words with intent to reduce anxiety, ordering or arranging things and accumulating wastes like newspaper, wine bottles or empty food containers. The exact causes of OCD are not known, however, some possible reasons may include differences in brain structure and genetic factors.

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The treatment involves psychotherapy as well as medication. Cognitive behavior therapy (CBT) is a specific type of psychotherapy that has been useful in treating people with OCD. Cognitive behavior therapy (CBT) teaches a person multiple ways of thinking, reacting and handling a particular situation. Most commonly used medications for treating OCD include antidepressants and anti-anxiety medications. A child suffering from PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) is prescribed antibiotics for treating strep infections and SSRI medicines (citalopram, escitalopram, fluoxetine, sertraline and paroxetine).

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Global Obsessive Compulsive Disorder Market: Trends

The market for obsessive-compulsive disorder (OCD) is expected to grow globally under the influence of high prevalence of OCD and life style changes causing changes in thinking processes. According to International OCD Foundation, approximately 2-3 million adults are living with OCD in the United States. The International OCD Foundation also states that nearly 500,000 American children have OCD. A large number of cases of OCD go unreported as many people are not aware that there is any such specific disease. Also, many people hide their illness in order to avoid embarrassment.

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Global Obsessive Compulsive Disorder Market: Regional Outlook

Geographically, the market for obsessive-compulsive disorder (OCD) has been segmented into North America, Europe, Asia-Pacific and Rest of the World (RoW). North America was the largest regional market in 2013, followed by Europe, Asia-Pacific and Rest of the World (RoW). One of the major factors responsible for North America’s leading position in this particular market is well established health coverage in the region and high level of awareness regarding the illness. In Asia-Pacific and Rest of the World (RoW) regions, the market is expected to grow in coming future owing rise in prevalence of people with OCD and increasing wareness regarding the disease. Japan, China, India, Australia and New Zealand are the most potential markets in the Asia-Pacific region.

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Global Obsessive Compulsive Disorder Market: Key Players

Some major companies and research institutions that are extensively engaged in the development, manufacturing and marketing of OCD drugs include Abbott Laboratories, Pfizer Ltd., Merck Co., Sanofi, Novartis AG, University of South Florida, Ortho-McNeil Janssen Scientific Affairs, LLC and Indiana University.

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Adrenocorticotropic Hormone [ACTH] Market The entire U.S. healthcare system is planning, preparing, and collaborating to manage the COVID-19 pandemic. In order to maintain continuous supply chains, manufacturers in the adrenocorticotropic hormone (ACTH) market are striving to understand care patterns of high-risk patients and those with respiratory diseases. Manufacturers are establishing robust supply chains with urgent care centers, retail clinics in pharmacies, and workplace clinics to keep economies running during the pandemic.

CAR T-cell Therapy Market The coronavirus outbreak has generated a significant repercussion on the administration of adoptive cell therapies, including chimeric antigen receptor (CAR) T-cells. Decline in people transit, closing of borders, and confinement of the population has impacted the supply chains of these life-saving medical products. This is anticipated to slowdown the growth of the CAR T-cell therapy market during the ongoing pandemic.

Direct-to-Consumer Laboratory Testing Market Even though DTC (direct-to-consumer) tests have many advantages, it is also associated with significant ethical and regulatory concerns. The FDA (Food Drug Administration) exercised its discretion not to enforce requirements for laboratories and commercial manufacturers operating without EUA (Emergency Use Authorization), as long as they provided a disclaimer that the tests are not reviewed by the FDA.

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Affirmations for anxiety: Do they work?

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Although there is little research into positive affirmations for anxiety, a 2016 study looked at excessive worry, a common symptom of anxiety disorders. The study included 102 individuals with generalized anxiety disorder.

The researchers asked them to replace their worries with positive pictures or words depicting potential good outcomes. A control group used positive images unrelated to their worries.

After 1 month, all of the participants benefited, showing decreased levels of anxiety and worry, with no differences between the groups. It appears that replacing worry with positive ideas has benefits even when these ideas are unrelated to the concern.

Individuals with anxiety issues, such as social anxiety disorder, may also have heightened sensitivity to people’s facial expressions. As a result, they may perceive negative social cues such as unhappy or disgusted facial expressions as threats.

Research shows that if an individual feels threatened, affirmations could restore their feelings of self-competence and self-worth. Therefore, using positive affirmations may help increase self-esteem and make a person feel less threatened.

Local mental health advocate warns of negative impact of cannabis use

A local mental health advocate is speaking out about what she considers the potential risks of cannabis use.

Zoey Raffay, a published author and former student at Orillia Secondary School, says she has not consumed cannabis recently, and her mind is as clear as ever.

“I find that cannabis really struck my psychosis, my depression, and anxiety,” said the 21-year-old. “It made it all skyrocket and it made my medications go up. Now that I’ve been off it, it’s been amazing. In the long-term, cannabis doesn’t help with things like depression and anxiety. I found it just made It worse.” 

Raffay, who has been diagnosed with borderline personality disorder, major depressive disorder, anxiety, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD), has been vocal about her mental health struggles. In 2018, she published a personal story about trying to commit suicide in a collection called Brainstorm Revolution: True Mental Health Stories of Love, Personal Evolution, and Cultural Revolution.

For 18 months, Raffay says she smoked up to six grams of cannabis a day. When she finally quit, she says everything improved.

“Now I can hold a knife,” she said. “I didn’t feel comfortable holding a knife before. I would see faces, and now I don’t see faces. It just really sparked my psychosis.” 

Raffay says that cannabis can be a good thing for people dealing with chronic pain. However, she believes people with mental health or addiction issues should avoid cannabis altogether.

“I never classified weed as an addictive drug, I always classified it as a dependency drug,” she said. “But as soon as I got off of it, I realized I was addicted to it. You get massive withdrawal symptoms. It’s obvious that you can get addicted to it, which I didn’t realize.”

To continue to spread awareness on the potential negative impacts of cannabis, Raffay is scheduled to appear on Dela’s Voice, an online talk show about addiction, mental health and grief. She will be on the show on Feb. 6 at 12 p.m. You can watch it here.

Not everyone shares Raffay’s opinion.

Victoria McGillis, the manager of Vivid Cannabis Co. on Progress Drive, says Raffay has much to learn about the benefits of cannabis consumption, even for those dealing with mental health issues.

“Cannabis is actually prescribed by doctors for depression and anxiety,” she said. “Cannabis can help if you have the correct cannabis. There are all kinds of cannabinoids, and if you are using the wrong one, and also depending on how you are using it, it can worsen things.”

McGillis’s husband is a sergeant with the Ontario Provincial Police who deals with PTSD. He was prescribed THC and CBD oil for his depression, anxiety, and PTSD.

“We actually have a ton of police officers, firefighters, and even nurses who are coming to us because of depression and anxiety with what’s going on in the world right now,” she said. “We have almost 50 people in our first responders’ program.” 

McGillis says it is all too common for younger people to access cannabis from the wrong sources without proper education.

“There are still black-market stores out there, and there are black-market drug dealers out there,” she said. “It’s all about education and I believe whoever is selling and whoever is buying have the exact same responsibility for education.” 

McGillis says cannabis can be like other medications. Sometimes you need to try a couple of different consumption options before you find the right thing, she explained.

She also believes that Raffay was likely consuming “way too much” cannabis, if she was smoking six grams a day.

“That is way too much, and I can see why it made things worse for her,” she said. “That is abusing it. That’s like drinking a 24 [of beer] a day. It’s a lot.” 

McGillis invites Raffay and anyone who feels uneducated about cannabis to come by Vivid to learn more.

Meredith Fryia, manager of addiction services for the Simcoe County branch of the Canadian Mental Health Association, told OrilliaMatters she is unable to provide a statement or data on the impact of cannabis on mental health. 

“While medical cannabis is prescribed for treating pain and certain other medical conditions under supervision by a healthcare provider, as far as we know the research is inconclusive about its use for treatment of mental health issues,” she said in an emailed response.

4 Tips for Dating Someone with Anxiety

Developing a relationship with someone who has anxiety may depend on approaching one another with empathy as you work through uncomfortable feelings. Compassion can help you deepen your connection.

It might take extra effort if you haven’t experienced an anxiety disorder, but every relationship worth your time will require effort, whether or not mental health conditions are involved. Here are some tips to consider:

1. Try to be curious

Alter and Drake suggest approaching the topic of anxiety with curiosity to learn more about the disorder and how it may affect your partner.

You can learn about anxiety from your partner and other reliable sources such as the American Psychological Association and the National Institute of Mental Health.

Try asking your partner questions about their experience of anxiety. Establishing a better understanding of where your partner’s anxiety comes from and the kind of situations that might trigger it can help achieve greater empathy.

“Anxiety about their boss disliking them at work is different from anxiety about their health during the pandemic, which is different from anxiety about whether or not you’re going to leave them in the middle of a disagreement,” says Alter.

2. Do your best to kick judgment to the curb

Try not to judge your partner’s anxiety as you develop a better understanding of their triggers. Even if their fears don’t sound real to you, they often feel real to your partner.

Your partner may be hesitant to share their fears with you at first due to stigma. They may have lost jobs, partners, or friends after sharing their feelings and challenges related to anxiety.

3. Consider learning their triggers

“Anxiety manifests itself in different ways for different people. Understanding things that set off or exacerbate your partner’s anxiety and the strategies that have worked for them in the past will allow you to better support them,” says Drake.

Drake warns not to try to “fix” them or “solve” your partner’s anxiety. This mindset is generally unhelpful and could potentially push your partner to feel misunderstood to the point that they stop sharing their feelings.

4. Active listening can be a powerful tool

Do your best to listen to your partner’s fears, triggers, and coping strategies. Drake offers some supportive responses for active listening:

  • I am here for you
  • you are not alone
  • your fears, worries, and triggers are not silly

Try to be honest and patient. Remember that it’s acceptable to answer, “I don’t know.” Curing your partner’s anxiety isn’t necessarily possible, but you can be supportive and help them through it.