Obsessive-compulsive disorder is often a matter of degree

Dear Doctor K: The term OCD is used so casually these days. How can you identify someone who truly has obsessive-compulsive disorder?

Dear Reader: The two defining symptoms of OCD are obsessive thoughts and compulsive rituals.

Obsessions are persistent, repeated, anxiety-provoking or distressing thoughts. They intrude into a person’s consciousness. Here are some common ones: fear of contamination; fears related to accidents or acts of violence; and fears concerning disorder or asymmetry.

Compulsive rituals are persistent, excessive, repetitive behaviors. The goal of the ritual is to reduce the anxiety caused by obsessive thoughts. Examples include repeated washing or bathing; refusal to shake hands or touch doorknobs; repeated checking of locks or stoves; compulsive counting of objects; over-organizing work or household items; and repeating specific words or prayers.

In OCD, the obsessions and compulsions are excessive and distressing. They are time-consuming. They may interfere with personal relationships, and performance at work or school.

The most effective treatment for OCD is a combination of psychotherapy and medication. Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat OCD. They include sertraline (Zoloft) and citalopram (Celexa). Tricyclic antidepressants also may be effective, particularly clomipramine (Anafranil).

A number of psychotherapy techniques may be helpful. Cognitive behavioral therapy (CBT) can help a person with OCD recognize the unreasonableness of fearful, obsessive thinking. The therapist sometimes teaches specialized techniques that can help extinguish the compulsions.

So OCD is a matter of degree. If your obsessive thoughts or compulsive behaviors occur throughout the day, and interfere with life at home or at work, you’ve got a problem – and several possible solutions.

Write Dr. K at www.AskDoctorK.com or c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106

Nail-biting an obsessive compulsive disorder in new psychiatric classification

As a child, Larry Sargent remembers biting his nails until they bled.

“It wasn’t just the nails. Sometimes it would be the skin,” says Sargent. “I think it was likely a reaction to stress. There was a release because it took your mind away from what your problems were.”

Biting your nails isn’t just a bad habit. It’s now being reclassified as a full-blown psychiatric disorder.

A proposed move by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) is expected to include nail-biting as a form of obsessive compulsive disorder (OCD) when it is revised for 2013.

Nail-biting joins hair pulling and other pathological grooming habits in the OCD classification. Previously, the DSM put nail-biting in the “not otherwise classified” section of disorders.

The manual is considered the bible of the trade, a classification of mental disorders used by mental health professionals that contains a listing of diagnostic criteria for every psychiatric disorder recognized by the U.S. health-care system.

“I think when it becomes problematic, it takes so much time that it takes away from and starts to impact your life,” says Sargent, who is a volunteer for Obsessive Compulsive Anonymous, a Toronto based self-help group that meets at the Centre For Addiction and Mental Health once a week.

Sargent says he eventually outgrew nail-biting, but that led to other compulsions, including constant ritualistic checking and eventually hoarding.

OCD is one of the top 10 mental disorders globally. Traits of OCD include common compulsions such as washing, checking, repeating words, hoards, tapping or touching. Obsessions might include superstitious or magical thinking, contamination fears, a worry about throwing things away or thoughts of doing harm to oneself or others, according to the Ontario Obsessive Compulsive Disorder Network.

“There is a wide spectrum from an occasional nail-bite to something that can be considered an illness,” says Debbie Sookman, director of the Obsessive Compulsive Disorder Clinic at McGill University Health Centre. “You have to look at among other things, how much of a compulsion it is, how much time in the day it takes away from that individual, and the impact on health.”

In general, if the compulsion takes more than an hour out of the day or “causes significant distress,” then it is considered more serious. Sookman says the DSM is the “gold standard” for classifying illness.

“When we look at treatment, we also look not only at the act of nail biting but the person in general to see how they deal with their inner experience and any stressful external events,” says Sookman, who is also president of The Canadian Institute for Obsessive Compulsive Disorders.

Psychiatrists have over the years been building a case for nail biting, also known as onychophagia, as a genuine disorder.

In a 2009 study by the departments of psychiatry and dermatology at Wroclaw Medical University in Poland, the authors concluded that “nail-biting is an under-recognized problem.”

Nail-biters were frequently referred to dermatologists, but the authors said in severe cases they should be referred to psychiatrists.

“Psychiatric evaluation of co-occurring psychopathological symptoms in these patients, especially those with chronic, severe or complicated onychophagia may be helpful in making a choice of individual therapy.”

Habitual nail-biting is a common behaviour of children and young adults and normally diminishes by the age of 18, according to the study. It has been associated with high anxiety and low self-esteem.

One patient evaluated in the study had “destroyed” both her thumb nails from biting.

Her symptoms were alleviated with drug treatment and painting her nails with lacquer. She also put false nails over her own nails as a deterrent.

Sookman says a variety of treatment options, ranging from the pharmaceutical to psychological, are possible.

One issue she says is getting accurate diagnosis and access to best practices treatment for patients across Canada.

“This is a very specialized field and the sooner patients get treatment, the better the results.”


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Royce White, confronting anxiety disorder and fear of flying, joins Rockets at …

He was happy to just be back on the court after the swell of national media attention sparked by his request to the team.

“Trying to get back in the swing of things,” White said. “It went as good as it could go.”

Houston held its first week of practice in McAllen, home of its developmental league affiliate. The Rockets were back at the Toyota Center on Monday, and coach Kevin McHale said White was noticeably behind in his conditioning and his familiarity with Houston’s plays.

“He’s got to catch up on what we’re doing,” McHale said. “It’s always hard when you’re a young guy and you miss early camp practice, when you’re trying to establish your principles and what you’re doing. But he’ll be fine.”

White’s off-the-court issues were no secret. NBA teams still wanted to talk to him after his one spectacular season at Iowa State. White was the only Division I player to lead his team in scoring (13.4 points per game), rebounds (9.3 per game), assists (five per game), steals (1.2 per game) and blocks (0.9 per game) and led the Cyclones to their first NCAA tournament appearance in seven years.

The Rockets decided he was too good to pass up. And over the summer, White flew with the team to Las Vegas and to the rookie orientation in New York City, suggesting that he had a handle on his aerophobia.

As training camp approached, though, White felt apprehensive about starting his first NBA season without a plan to cope with his disorder. He contacted the Rockets through his agent and the two sides negotiated their arrangement.

“I’m excited,” White said. “It’s a different plan than I’ve ever had going into a season. I’m happy that the Rockets are willing to work with me, and I’m excited to see what I can do under new circumstances.”

McHale, who played 13 seasons in a Hall of Fame career with the Boston Celtics, acknowledged concern for how White was going to navigate through the travel demands of the league schedule.

“Royce is going to have a little bit of a different path in the NBA,” McHale said. “If your choice is to have a 10-hour bus ride, or an hour flight, everyone would want to take an hour flight. He’s just going to have to work his way through all that stuff.

“We’re here to help him and support him as much as we can,” McHale said, “but he eventually has to be responsible to your team and your teammates. That’s the biggest thing.”

On Monday, White easily answered questions in front of a throng of media. If anything, White said going public with his personal struggle has been cathartic.

“In a lot of areas, we’re actors,” White said with a smile. “The camera doesn’t frighten me. Planes do.”

He hopes the attention his situation has generated creates more awareness for mental-health issues and treatment.

“It helps for me, just to be honest,” he said. “One of the things that comes with anxiety is trying to hide from what you’re scared of and oftentimes, that is the spotlight. Being honest and having good feedback obviously helps me out.”

His teammates seemed happy to have White back, greeting him with high-fives and encouragement when practice began. If White can blossom, the Rockets think he can provide a strong — and much-needed — inside presence.

“He has a unique skill set,” point guard Jeremy Lin said. “We don’t really have anybody who can do what he can do. More importantly, we’re thankful that he’s healthy and with the team. He learned a lot today. He didn’t look like he missed too much.”

White seems willing to do whatever is necessary to get up to speed on the court.

“I just stay goal-oriented,” White said. “I want to be a good teammate, and I want to be a part of this organization. I have other goals and aspirations and I just stick to those, focus on those. I’m just ready to do whatever they ask me to do.”

Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Houston Rockets And Royce White Agree On Bus Deal

Jayne Kamin-Oncea-US PRESSWIRE

Royce White will rejoin the Houston Rockets for practice on Monday in Houston. White and the Rockets have agreed on a deal that will allow him to travel by bus for a huge part of the season to manage his mental illness.

White has suffered from an anxiety disorder as well as panic attacks and obsessive compulsive tendencies for years. He has spoken out about mental health and wants to raise awareness for kids who have it. He doesn’t want to hide from the truth and has been very honest with the Rockets organization and their fans from day one.

Royce will supply the bus that he will ride in for much of the season. He said he wants to make the bus his home away from home to feel comfortable traveling and so that he can focus on the task at hand. He will have to travel overnight on most days but said that its’ “no problem at all.”

“We’ll go forward in a good faith deal between me and Rockets, and I’m totally comfortable with that. We can find a way to get it into writing at some point. We do have a letter between us. It’s an agreement, not in contract form, but those are technicalities.”

“What the Rockets are doing is astronomically appreciated by me and should be by the mental health community.”

“One of the things that I know is this is my responsibility. I had a letdown. In my defense, these things are unprecedented. To travel by way of bus or doing some of the things I did at Iowa State to head off anxiety, it was indicated to me through the draft process, sometimes in a joking way, that most teams wouldn’t allow that.”

“My health is actually great right now. I want to keep it that way. The unknown of the season or the schedule can decrease that health. We don’t need something negative to happen. A lot of guys don’t have a stance to attack mental illness on the front end. Some don’t know they have it until something happens. The negative consequences can come. It’s just too risky.”

“It was at that point the decision was made, I just have to ask,” White said. “That’s why you see Tweets that I had to stop hiding. It’s one thing to talk about my situation. It is another to ask for what I need.”

“I don’t want to make excuses, but it has shown itself a number of times that the perception of mental illness is not friendly. You see it now with people saying ‘he gets special privileges,’ like this is something I’m doing for myself. It’s a disability. Its disability qualified. You’re starting the race behind.”

“I just reached the point I said, ‘The hell with it. I have to ask.”

It’s good to see that White and the Rockets are working together with this difficult situation. The illness that White has is very serious and should always be taken seriously. It’s something that he has to work through and manage on his own. The Rockets standing by him speaks volumes of how great they are with their players. Many teams passed on White specifically to avoid situations like this. The Rockets knew that White was too talented to pass on and have embraced who he is as a person. White now has all the tools he needs to succeed.

Tags: Houston Rockets, NBA, Royce White

What inspired Rowling’s new lead character

“These are things I know from the inside… When I was in my teens I had issues with OCD,” she said.

Describing how the condition manifested itself she said that she became increasingly irrational.

She said that as a teenager she constantly made lists and could not stop “checking, double checking, triple checking” things.

OCD, Anxiety, and Resistance

Stacey Kuhl Wochner, LCSW, of the OCD Center of Los Angeles discusses resistance and certainty-seeking in OCD and related anxiety based conditions. Part one of a two-part series.

Resisting our unwanted thoughts, feelings, and sensations is a futile task that is doomed to fail.

When treating clients with Obsessive-Compulsive Disorder (OCD) and other anxiety based conditions, two of the most important topics we discuss are “resistance” and “certainty-seeking”.  People suffering with these conditions often have unpleasant and unwanted thoughts, feelings, and bodily sensations, and resistance to these experiences is a normal, natural reaction.  Simply put, when faced with something uncomfortable or painful, we humans instinctively resist it, and quickly look for ways to reduce our discomfort through avoidance.  But unfortunately, while resistance may internally feel like the correct response to our uncomfortable thoughts, feelings and sensations, it actually serves to inflame them.

For most people, it seems counterintuitive to reduce resistance and allow uncertainty to remain in the face of these uncomfortable internal experiences.  Many are likely to think something along the lines of “I must find a way to keep this thought, feeling, or bodily sensation from happening again.”  But this philosophy of resistance in regards to our unwanted internal experiences will actually cause them to become more powerful.  As illogical as it may seem, oftentimes the best solution is to lower our resistance, surrender, and accept what is being offered.

If you encountered a mountain lion while on a hike, what would you do?  Your natural, instinctual inclination would be to respond to the message that your body is sending you.  Your sympathetic nervous system would respond and your body would begin to release hormones including adrenaline, to prepare you to perform optimally if you need to fight or flee.  You would experience physiological reactions such as shortness of breath, rapid heart rate and trembling associated with these changes.  Every cell in your body would be screaming for you to turn and run to safety.

But responding to these physiological messages could actually get you killed. The Mountain Lion Foundation of California explains that you should make direct eye contact with the animal, stand up as tall as you can, wave your arms, speak slowly and firmly, and throw rocks or branches at it.  Under no circumstances should you turn your back to it and run or crouch down.  If you become panicked and respond with fear, it will trigger the animal’s natural instinct to chase you.  You will become prey and the mountain lion the predator.

In order to make the decision to respond in a different and more effective way than your body is telling you to, you must use meta-cognition.  The simplest definition of meta-cognition is “thinking about thinking.”  We have thoughts, and we have thoughts about our thoughts.  Meta-cognition is the process that is at work when we are using Mindfulness Based Cognitive Behavioral Therapy.  It allows you to notice the space that exists between receiving information (“OMG, there is a mountain lion!”) and responding to that information (“Do I want to listen my body and run, or should I stand my ground and throw my water bottle at this wild, vicious creature?”).  You can then make the decision to maintain your composure and do the illogical action, because you understand that it will save your life.

When dealing with the unwanted thoughts, feelings and sensations experienced in OCD and related anxiety conditions, resistance to your situation is not the answer.  Mindful acceptance is almost always a better way to respond to these uncomfortable internal experiences.  There are many other examples that I use with clients that reiterate this theme.  Imagine you are driving in a car and the traffic suddenly stops in front of you.  You glance in your rear-view mirror and realize that the person behind you is not paying attention and is about to slam into you.  In this situation, it is wise to allow your body to roll with the impact and avoid tensing your muscles to brace for it.  It has been said that the reason that drunk drivers are the ones who survive car accidents is that they are more relaxed and do not anticipate the collision.

This is also what the expression, “roll with the punches” means – accepting the punch that is being presented to you as a means of diffusing it.  The phrase was derived from the boxing technique where one would lean back or to the side when being hit by an opponent in order to better absorb the punch and avoid receiving the full force of the blow.

If you were in a body of water and didn’t know how to swim, to avoid drowning your natural tendency would be to wave your arms, yell for help, and perhaps splash around in the water.  But it is actually the depletion of oxygen and energy that cause people to drown, and these intuitive activities would get you there sooner.  A better idea is to fill your lungs with air and to lay face down in the water so that you can create buoyancy.  The best way to survive is to completely surrender to the situation rather than resisting and struggling.

All of these analogies illustrate how resistance may seem like the correct response, but ends up making the situation worse.  If you choose to simply allow your thoughts, feelings and bodily sensations to run their natural course, they will rise and fall on their own.  When it comes to OCD and anxiety, you can draw upon the imagery of these analogies to encourage yourself to be courageous in making a counterintuitive decision.  Feel free to comment below with your own analogies for resistance, as it would be great to hear more examples that have helped people.

I understand that you may be in doubt about whether your thoughts, feelings, and bodily sensations are real or OCD.  You may be saying, “If I only knew for certain that they were just thoughts, then I would be willing to stop resisting.”  Part two of this series will discuss “certainty-seeking”, which is the other main strategy that is crucial to discontinue when learning to better manage OCD and anxiety.

•Stacey Kuhl-Wochner, LCSW, is a Licensed Clinical Social Worker 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 stacey@ocdla.com.

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Study: Psychologists Placing Nail-Biting In ‘Obsessive Compulsive’ Category

WASHINGTON (CBS WASHINGTON) – New psychological testing places nail biting in the pathological grooming category of, “obsessive compulsive disorder.”

The American Psychiatric Association, in a new study published in the Diagnostic and Statistical Manual of Mental Disorders, is rethinking how “pathological groomers” – aka nail biters – should feel about themselves.

In testimony from an afflicted nail-biter, National Public Radio spells out some of the personal anxieties that one nail-biter felt during their 30 years of the habit.

“I can tell you the exact moment I became a nail biter. I was 6 years old, watching my mom get dressed for work,” Amy Standen told NPR. My reaction: How cool! How grown-up! I think I’ll try it.”

Recently, something happened that made me finally quit biting my nails. I’ll get to that in a bit. But I was feeling quite pleased with myself when I showed them to Carol Mathews, a psychiatrist at the University of California, San Francisco. “Your cuticles are pushed back. It’s not bad. Looks like you’re a recovered nail biter is what I’d say,” she pointed out.

Until recently, the DSM treated pathological grooming a bit like an afterthought and put it in a catch-all category called “not otherwise classified.” But the new DSM proposes to lump together pathological groomers and those with mental disorders like OCD. That includes people who wash their hands compulsively or have to line up their shoes a certain way.

The behaviors have much in common. In both cases, it’s taking a behavior that’s normal and healthy and putting it into overdrive, doing it to the point of being excessive. But in at least one way, OCD and pathological grooming are also very different.

But from her pathological grooming patients, Mathews hears a very different story: They enjoy it. “It’s rewarding. It feels good. When you get the right nail, it feels good. It’s kind of a funny sense of reward, but it’s a reward,” she told NPR.

There are some genetic mutations that seem to crop up in people with OCD and in people who groom pathologically. But just because you have the mutation doesn’t mean the behavior is inevitable.

“With OCD, it’s more likely you won’t, says Mathews. “As genetically determined as OCD is, the risk to a family member for someone who has OCD is only 20 percent. So it’s 80 percent chance of not getting it,” she says.

 Study: Psychologists Placing Nail Biting In Obsessive Compulsive Category

Nail Biting May Be a Sign of Obsessive Compulsive Disorder

For many, biting your nails may seem like just an ugly habit. Recently, psychiatrists are changing the way we will view nail biters. By next year the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) will classify nail biting as an obsessive compulsive disorder (OCD).

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A harmless habit such as nail biting can become hazardous to one’s health. According to the Mayo Clinic, nail biting is not only bad hygiene, but also can contribute to skin infections, increase the risks of colds and other infections as well as spread germs from the nails and fingers.

Obsessive compulsive disorder is a variety of anxiety disorder. OCD traps individuals in an endless cycle of repetitive thoughts and behavior. Many who suffer from OCD are plagued by habitual, stressful thoughts and fears that are hard to control. This then forces a need to perform certain rituals or routines as a means to maintain one’s calm over the situation.

For an obsessive nail biter, the behavior is triggered by not the nail itself but outside factors such as driving or feeling stressed out.

In previous yearsm the DSM categorized nail biting as “not otherwise classified.”

However that will change starting next year. Individuals, who habitually bite their nails, compulsively wash their hands or line their shoes up a particular way, will be informed they may suffer from OCD.

The Mayo Clinic suggests if you’re concerned about nail biting; consult your doctor or a mental health provider. To stop you from nail biting, you might try:

  • Avoiding factors that trigger nail biting, such as boredom
  • Finding healthy ways to manage stress and anxiety
  • Keeping your nails neatly trimmed or manicured
  • Occupying your hands or mouth with alternate activities, such as playing a musical instrument or chewing gum


For more serious cases, behavior therapy may be necessary.

Published by Medicaldaily.com




Medication now used to treat pet’s behavioral disorders

by Tori Hamby

With so many behavioral treatments for pets – from dog whisperers to medication and expensive training programs – exasperated owners might have difficulty sifting through their options.

Like humans, pets can suffer from a variety of mental disorders that cause behavioral problems, veterinarians say. These disorders – including obsessive compulsive and anxiety disorders, and even Alzheimer’s disease – can show themselves in a pet’s predilection to tear up the house when left alone, tendency to urinate when panicked, aggression or other destructive behaviors.

“Pretty much anything you see in human behavior, we have on the animal side as well,” said Mike Heinen, owner of Lake Norman Animal Hospital in Mooresville.

Alycen Adams, a veterinarian at Carolinas Veterinary Care Clinic in Huntersville, said symptoms of OCD in pets include walking in circles to the point where paws become bloody and, in cats, excessive grooming. OCD is also common in birds, which pick at their feathers as a result.

Dogs that have traditionally been bred to perform jobs – such as Golden Shepherds and Border Collies – often have an overabundance of energy, which can manifest itself as anxiety, Adams said. When left home alone that anxiety can trigger destructive behavior.

“It’s like a high energy person with nothing to do,” Adams said. “They are going to cause mischief.”

Separation anxiety is also especially pronounced in dogs, Adams said, who have poor concepts of time. The sound of an owner’s key jingling at the door, for instance, can trick a dog into thinking their owners will be gone forever.

Medication options

The most effective behavior modification regimens, he said, combine medication and behavioral therapy. Pets can use medication to improve their coping skills, increasing the chances that non-medical treatment – such as reinforcing positive behavior through treats or attention – will stick.

“We can use medicine to break the pattern and help the animal realize ‘hey, I can cope with this; it isn’t so bad,’” Heinen said. “Then we get them over that small phobia.”

“A cat who has had a urinary tract infection can develop a fear of its litter box because of the pain it associates with it,” Adams said. “(Medicine) can ease that aversion.”

There are also drug treatments available for short-term anxiety-induced behaviors caused by thunderstorms or loud noises. Alprazolam and diazepam, known to humans as Xanax and Valium, can be administered temporarily.

Owners can give their pets a dose of these drugs about 24 hours before a thunderstorm is predicted to hit or Fourth of July fireworks go off in the pet’s surrounding neighborhood.

“These pet aren’t lying in the corner drooling like a vegetable when they are on these medications,” Adams said.

Other alternatives

Just as a number of natural treatments are available to humans for stress, anxiety or depression, pets may also benefit from these remedies. The scent of lavender, a flower known for its calming affects on humans, can sooth an anxious pet, Heinen said.

Facial pheromones are available for cats in sprays or plug-in diffuser devices. These chemicals are synthetic versions of naturally occurring familiarization pheromones used to mark objects in its surroundings as familiar.

“They make animals feel like they have their own little baby blankets,” Heinen said.

To prepare dogs for thunderstorms, owners can play sounds of thunder, wind and rain at low volumes to acclimate pets to startling noises, Adams said. Owners can gradually turn the volume up until the dog no longer becomes anxious during storms.

Owners can also buy a Thundershirt online at www.thundershirt.com. The gentle pressure of the snug fitting doggie jacket provides dogs with a sense of security.

“We have some owners who swear by it, and others who say it doesn’t really make a difference,” Adams said. “A dogs reaction to things like the Thundershirt and pheromones really depends on the sensitivity of the dog and the severity of the problem.”

A warning

While pet variations of some behavioral medicines, such as Prozac, Xanax or Valium are identical to the medications a human night take, Heinen said owners should never give their pets medicine prescribed to humans. Dosage amounts and idiosyncratic properties of different drugs could have adverse affects on pets.

“A pinch of Tylenol will kill a cat,” Heinen said. “You need the right drug and the right diagnosis.”

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Is anorexia a cultural disease?

From the outside, my eating disorder looked a lot like vanity run amok. It looked like a diet or an obsession with the size of my thighs. I spewed self- and body-hatred to friends and family for well over a decade. Anorexia may have looked like a disorder brought about by the fashion industry, by a desire to be thin and model-perfect that got out of hand.

Except that it wasn’t. I wasn’t being vain when I craned my neck trying to check out my butt in the mirror — I truly had no idea what size I was anymore. I was so afraid of calories that I refused to use lip balm and, at one point, was unable to drink water. I was terrified of gaining weight, but I couldn’t explain why.

As I lay in yet another hospital bed hooked up to yet another set of IVs and heart monitors, the idea of eating disorders as a cultural disorder struck me as utterly ludicrous. I didn’t read fashion magazines, and altering my appearance wasn’t what drove me to start restricting my food intake. I just wanted to feel better; I thought cutting out snacks might be a good way to make that happen. The more I read, the more I came to understand that culture is only a small part of an eating disorder. Much of my eating disorder, I learned, was driven by my own history of anxiety and depression, by my tendency to focus on the details at the expense of the big picture, and by hunger circuits gone awry.

The overwhelming amount of misinformation about eating disorders — what they are and what causes them — drove me to write my latest book, “Decoding Anorexia: How Breakthroughs in Science Offer Hope for Eating Disorders.”

Efforts to fight eating disorders still target cultural phenomena, especially images of overly thin, digitally altered models. Last month, the Academy for Eating Disorders and the Binge Eating Disorders Association issued a press release condemning the high-end department store Barneys for giving beloved Disney characters a makeover. Minnie Mouse and Daisy Duck were stretched like taffy to appear emaciated in honor of Barneys’ holiday ad campaign. The eating disorders groups wrote:

Viewership of such images is associated with low self-esteem and body dissatisfaction in young girls and women, placing them at risk for development of body image disturbances and eating disorders. These conditions can have devastating psychological as well as medical consequences. This campaign runs counter to efforts across the globe to improve both the health of runway models and the representation of body image by the fashion industry.

All of which is technically true. But when you look at the research literature, several studies indicate that environmental factors such as emaciated models are actually a minor factor in what puts people at risk of an eating disorder. A 2000 study published in the American Journal of Psychiatry found that about 60 percent (and up to 85 percent) of a person’s risk for developing anorexia was due to genetics. A 2006 follow-up study in the Archives of General Psychiatry found that only 5 percent of a person’s risk of developing anorexia came from shared environmental factors like models and magazine culture. A far greater environmental risk (which the study estimated constituted 35 percent of someone’s risk of anorexia) came from what researchers call non-shared environmental factors, which are unique to each individual, such as being bullied on the playground or being infected with a bacterium like Streptococcus. (Several very small studies have linked the sudden onset of anorexia and obsessive-compulsive symptoms to an autoimmune reaction to strep infections.)

Eating disorders existed long before the advent of supermodels. Researchers believe the “starving saints” of the Middle Ages, like Catherine of Siena, had anorexia. Reports from ancient history indicate that wealthy Romans would force themselves to vomit during feasts, to make room in their stomachs for yet another course. In modern times, anorexia has been reported in rural Africa and in Amish and Mennonite communities, none of which are inundated with images of overly thin women. Nor does culture explain the fact that all Americans are bombarded with these images but only a very tiny portion ever develop a clinical eating disorder.

Frankly, I think the Barney’s creation of Skinny Minnie and her newly svelte compatriots is ridiculous. They look absurd and freakish. I think we should be aware of and speak out against the thin body ideal, the sexualization of children, and the use of digitally altered images in advertising. I think we should do this regardless of the link to eating disorders. My objection to the AED and BEDA’s response is that it reinforces an “I wanna look like a model” model for how we think of eating disorders. It implies that eating disorders are seen as issues for white, upper-class women, which means that these life-threatening disorders often go undetected and untreated in men, the poor, and minorities.

How sufferers, their families, and our culture at large think about eating disorders sets the agenda for treatment, research and funding. Until a 2008 lawsuit in New Jersey established that anorexia and bulimia were biologically based mental illnesses, it was legal for insurance companies to deny necessary and lifesaving care. The message to sufferers? You’re not that bad off. You’re just making this up. Get over it.

Too many people can’t. Eating disorders have the highest mortality rate of all psychiatric illnesses. Up to 1 in 5 chronic anorexia sufferers will die as a direct result of their illness. Recovery from anorexia is typically thought of as the rule of thirds: One-third of sufferers get better, one-third have periods of recovery interrupted by relapse, and one-third remain chronically ill or die.

Although research into eating disorders is improving, it is still dramatically underfunded compared to other neuropsychiatric conditions. The National Institute of Mental Health estimates that 4.4 percent of the U.S. population, or about 13 million Americans, currently suffers from an eating disorder, and eating disorders receive about $27 million in research funding from the government. That’s about $2 per affected person, for a disease that costs the economy billions of dollars in treatment costs and loss of productivity. Schizophrenia, in comparison, receives $110 per affected person in research funding.

The lack of research funding means that it’s been difficult to develop new treatments for eating disorders and test them in clinical trials. Several types of psychotherapy have been found effective in the treatment of bulimia and binge-eating disorder, although many sufferers have difficulty maintaining recovery even with state-of-the-art treatment. Thus far, no therapies have been clinically proven for adults with anorexia. Because many of those with anorexia are scared of the idea of eating more and gaining weight, they tend to be reluctant to show up for treatment and follow through with a clinical trial. Researchers have found a type of treatment known as family-based treatment, which uses the family as an ally in fighting their child’s eating disorder, to be effective in children, teens and young adults with anorexia or bulimia.

The message from AED and BEDA is technically correct: More and more children are dieting, whether in response to thin models, obesity prevention efforts or both. Dieting is potentially dangerous because food restriction can set off a chain of events in a vulnerable person’s brain and body. For most people, diets end after a modest weight loss (and are, more often than not, followed by a regain of the lost weight, plus a few “bonus” pounds as a reward for playing). For the 1 percent to 5 percent of the population that has a genetic vulnerability to an eating disorder, that innocent attempt at weight loss, “healthy eating,” or other situation that results in fewer calories being eaten than necessary, can trigger a life-threatening eating disorder.

However, focusing on purported cultural “causes” of eating disorders leaves out the much bigger, more multifaceted picture of what these disorders are. Eating disorders result from a complex interplay between genes and environment; it’s not just culture. Yet most media coverage of eating disorders focuses on these types of cultural factors. Well over half of the eating disorder stories I see are about celebrities. Celebrities suffer from eating disorders, too, but they are a small fraction of the total number of sufferers out there. Eating disorders aren’t solely about wanting to be thin. They aren’t about celebrity culture or the supermodel du jour. They are real illnesses that ruin lives.

Arnold is a freelance science writer living outside Norfolk, Va. She has just published her third book on eating disorders, “Decoding Anorexia: How Breakthroughs in Science Offer Hope for Eating Disorders.”

© 2012, Slate

Manage Stress Effectively And Lead A Happy Life

in Health / Mental Health    (submitted 2012-09-27)

Stress and highlight have certainly turn a partial and parcel of a bland life. A small volume of it creates us feel some-more obliged and keeps us active in a differently unchanging life. When such issues surpass their limits, it becomes a matter of regard and it takes a fee on a health and good being. If we are a plant of highlight due to family tensions or work pressures, take some time for yourself and try to combine on a factors behind such highlight and anxieties.

Often people do not comprehend that sleeplessness, addictions, low appetite, brief tempers, miss of energy, depletion and some-more are symptoms of augmenting stress. If we too are confronting identical issues, do not rubbish your time, rather consider of evident measures to conduct highlight and lead a healthy life. In sequence to get absolved of highlight and tensions associated to your family or work place, we should try to adopt self assistance procedures such as meditation, yoga, unchanging practice regime, offset diet and amicable communication with friends and family. This can unequivocally infer to be a highlight buster and assistance we in progressing a healthy life style. If we feel that instead of perplexing anything on your own, it is improved to attend classes wherein professionals can beam we in battling stress, we can certainly proceed their counseling.

Stress if not managed on time can get worse with flitting time. Besides following a procedures to manage stress levels in an fit manner, we can also opt for spending some convenience time in enjoying your passion or hobby. Hobbies like- painting, examination favorite movies, enjoying light music, reading good books etc also assistance in traffic with your daily stress. You can also devise for a ideal getaway amidst scenic locales. In sequence to spend some friendly time with friends and family, we can also select to spend weekends or vacations in circuitously mountain stations. The cold climate, pleasing landscapes and stay divided from a dispatch discord of bustling city life can infer to be an ideal choice to assistance conduct stress. The mountain stations with pleasing stay options classify journey sports and movement facilities. Such recreational activities can assistance a lot in lovely your mind and physique besides assisting we to conduct highlight levels.

If we are among those who do not wish to leave homes during weekends rather spend it with friends and family during home can devise some weekend parties during home. This will assistance we in interacting with your dear ones, who can boost we adult with romantic support. In fact, healthy conversations and fun filled time spent with family acts as a good highlight buster and relaxes your mind and physique from all arrange of tensions or stress. It is really essential to manage highlight and tensions relating to work as it can lay a disastrous impact on your health and opening and infer to be a jump in your career achievements. Hence, kick all your highlight currently and live a some-more prolific life.

About a Author

Writer is a competent Experienced and Professional therapist as Calmconfidentme of Stress Management; Reduce Work Stress and How to Build Self Confidence. He is Provides lot of technique for Stress government Techniques, How to Build Confidence, determining highlight and tragedy and More.