Twin Sisters With Severe OCD Have Died In A Possible Double Suicide

“When they were toddlers, putting on their shoes or socks was a long, drawn-out process because there couldn’t be any wrinkles in their socks and their shoes had to be tied just a certain way, and that process could go on half hour, 45 minutes, an hour,” their mom, Kathy Worland, said in a 2017 interview on The Doctors. (Worland did not respond to an interview request from BuzzFeed News.)

The sisters said on the show that they began cleanliness rituals in middle school, and by their early twenties were taking showers that lasted up to 10 hours, and would use an entire bar of soap.

They began to lose friends. ”When it takes you all day to take a shower, you are never going to meet them somewhere,” Sara said in the 2017 interview.

“It’s a cold, miserable, agonizing shower,” Amanda said in an interview with 9News in 2016. “We used hydrogen peroxide and alcohol. There was one point we were using so much hydrogen peroxide on our faces, it turned our eyebrows orange.”

The rituals were painful, debilitating, and exhausting, and did not relieve their symptoms, they said. “It hurts a lot — it’s ridiculously painful,” said Sara. “And it’s just something I did, like I had no choice. The OCD is saying, ‘Do this, do this,’ and I’m like, ‘OK, OK, I’m doing it.’”

“It’s like listening to somebody who is holding you at gunpoint — you absolutely have to do what they say, ” Amanda said. “We’ve tried all the medications — we’ve been on medication since we were 12.”

The twins couldn’t work, travel, or touch other people (including each other or their mother) due to the condition.

Twins with OCD are fatally shot; found fame on ‘The Doctors’

twins
Amanda, left, and Sara Eldritch are featured in a 2016 Littleton Adventist Hospital publication. Their bodies were found Friday near the Royal Gorge Bridge and Park. (Littleton Adventist Hospital / Courtesy Photo) 

Twin sisters who gained fame after receiving a pioneering surgery for obsessive-compulsive disorder were found dead with gunshot wounds on a Colorado roadside.

Amanda and Sara Eldritch, 33, were found Friday in a vehicle parked near a rest area outside Cañon City, the Fremont County Sheriff’s Office confirmed Monday.

The sisters, who lived in the Denver suburb of Broomfield, were the first people in Colorado to receive deep brain stimulation  to treat their often-debilitating symptoms of OCD. Their story was told last year on “The Doctors,” a daytime talk show that focuses on medical issues.

The sheriff’s office said in a news release that no other information on the women’s deaths is available at this time.

The rest area where they were found is near Royal Gorge, a tourist attraction that features a high pedestrian bridge over the Arkansas River Canyon. It’s about a three-hour drive from the Eldritches’ home.

A year after the 2015 surgery at Littleton Adventist Hospital, the twins said they began to feel at peace with their existence. In a hospital publication, Sara Eldritch was quoted as saying, “I feel like I can identify my anxiety. I can actually see where it’s coming from. And I feel like I can deal with it.”

But before the surgery, the article said, “they felt at war with their own existence. And in a desperate cry for help as adolescents, they tried taking their own lives.”

For the sisters, coping with the disorder meant 10-hour showers, 20-minute hand-washings and using dozens of bottles of rubbing alcohol to disinfect everything they touched.

The deep brain stimulation was intended to inhibit overactive parts of the brain, halting anxiety and making therapy more effective. As part of the procedure, surgeon David VanSickle placed electrodes on specific areas of their brains, with electrode wires under the skin of the head, neck and shoulders.

One year after the surgery, the spring 2016 publication said, the twins began finding “hope and joy in simple things like taking a morning walk — something they hadn’t done in more than a decade.”

When they went on “The Doctors” last year, they had a rare day apart and spent  the night in separate hotels to “help them break through their codependency,” the show’s website said.

“I did kind of like the contrast of, this is what it’s like to be alone, and this is what it’s like to be back with my sister and friends,” Amanda Eldritch said at the time. “I like having two things to compare.”

 

 

Pure O – How I realised I had the lesser-known version of OCD …


How I realised I had Pure O and gradually learned to manage it
(Picture: Dave Anderson for Metro.co.uk)

You’re probably familiar with Obsessive Compulsive Disorder – a mental illness where sufferers can have obsessive thoughts and compulsive behaviours such as performing certain rituals and routines in order to ease the anxiety that comes from obsessional thinking.

Pure O stands for ‘purely obsessional’.

This means that there are fewer obvious rituals (such as checking or counting) and these often take place in the mind itself.

Up until a few years ago, I was completely unaware of Pure O and what it meant.

I had been told that, most likely, I had generalised anxiety disorder and depression.

It was only once I had read about Pure O online did I realise that I was suffering from the exact same thing.

The best way to describe it is this: You see someone crossing the road. A car is coming around the corner. A thought appears in your head and you envision the car hitting the person.

Most people are able to dismiss this as a silly, fleeting thought. A glitch in the galaxy of the mind.

I, or other sufferers, would hold onto this thought. Fixate on it. Obsess over it.

‘Why did I think that? Am I an awful person? What is wrong with me?’

Things fell apart when I was 18.

I had always been a worrier growing up, and had a habit of overthinking things and what people thought of me.

Had I upset a friend at some party two years prior? What did that person exactly mean when they said that throwaway comment about my hair? And so on.

When I started my final year of college, I envisioned the year ahead.

I’d get the grades I needed and would be at the university I wanted to attend.

Come the summer, this didn’t happen.

Things didn’t go how they were supposed to, and I found myself with a gap year I didn’t really want.

I got a job in a bookshop and the next few months trudged by.

Until, one night, I woke up with tears running down my face.

My heart was racing, and I felt the most terrified I had ever felt.

I had a nightmare that was so frightening, I couldn’t catch my breath.

Instead of calming myself down and going back to sleep, I replayed the nightmare over and over again for the rest of the night.

I had violently hurt someone I loved, and my mind wouldn’t let it go. It told me I was a bad person and that I was capable of doing bad things.

For some inexplicable reason, I believed it.

So this is how it began. One moment, one thought, one nightmare.

Obsessive Compulsive Disorder is often referred to as ‘the doubting disease’ which I think is the most accurate description.

(Picture: Liberty Antonia Sadler)

For the next few months I became stuck in a dark cycle.

A horrifying thought would come into my head, I’d spend days convincing myself that I was ‘good’ and I’d never really hurt anyone, the thought would lift, but then another would instantly appear in its place.

I couldn’t read, or sleep, or think properly. The joy was sucked out of everything.

I remember going to the cinema with a friend and not being able to watch the film in front of me because I was pinching myself so hard from worrying.

Once, I caught sight of myself in the mirror and burst into tears.

Huge dark circles had appeared under my eyes and I looked like a ghost of my former self.

I wasn’t sure whether I’d ever be able to get back to her.

I didn’t feel I could talk about it with anyone because what if they thought it was true?

What if I was a terrible person? What if they abandoned me and I was even more alone?

For those months, there was not one single waking moment where I felt peaceful and calm.

From the outside, I’m sure I seemed okay.

I kept it all inside and when I was around others I was able to make myself seem as if I didn’t have a care in the world.

On one particularly bad night I woke at 3am and went to the bathroom so I could splash some water on my face.

I locked the door and cried as quietly as I could. I found myself wondering if this would ever end.

Would I spend the rest of my life like this – locked in a cycle of fear and doubt?

I wondered how on earth I’d get through three years of university away from home.

Somehow, I did manage to carry on.

September came in a flash, and I had made the choice to move away for university.

I decided I would see a doctor as soon as I arrived and try to articulate what was happening to me.

Luckily, I saw a doctor who understood me through my tears and reassured me that things would get better and that I wasn’t losing my mind.

I saw her regularly over the following years, and I would not have gotten through university without her.

When I read about someone else’s experience with Pure O, it dawned on me that this was exactly what I had been experiencing.

Intrusive, frightening thoughts that I had no control over.

I remember Googling Pure O, reading about others’ experiences and finally feeling as if a weight had been lifted.

I wasn’t mad, I was just ill.

Seven years on, things are much better.

I still have days where I struggle and find it difficult to cope but I am better equipped to distance myself from the thoughts and obsessions.

Antidepressants have helped enormously, and I feel no shame in taking them or talking about taking them.

I had therapy which had mixed results, but I intend to give it another try.

I only wish I had gotten some help sooner.

One of the cruellest aspects of any mental illness is that no one can see how much you are suffering. The pain that you are in.

The mind can be a desolate and frightening place and it can feel as if you are living a nightmare.

The one thing I have taken away from all of this is this: please do not suffer in silence.

Please talk to someone and get some help. It will save your life.

MORE: Kicking babies and driving into traffic: We talk Pure O on our mental health podcast, Mentally Yours

MORE: Beyond the therapy room: three activities that can contribute to good mental health

MORE: I spent a week documenting my OCD on camera

Health Matters: Overcoming anxiety



Life is full of ups and downs, so it’s normal to feel anxious from time to time, but if you find yourself coping with anxiety in unhealthy ways, it’s time to seek help. Do you have trouble falling asleep or have you started waking up in the night or having nightmares?

Have you started to avoid normal activities like grocery shopping or going out with friends? Have you started using alcohol or drugs to numb your pain? These can be signs that you are suffering from an anxiety disorder.

Anxiety disorders affect 40 million American adults. Almost a fifth of adults and a quarter of adolescents (aged 13 to 18 years old) suffer from anxiety in one form or another, and sadly, only 40 percent of those with anxiety disorders receive treatment.

“Anxiety disorder” is an umbrella term that includes a broad array of symptoms, all of which involve varying levels of fear. Acute anxiety comes on quickly. Separation anxiety makes it hard to leave someone. Generalized anxiety makes you feel worried all the time. Panic disorder, social anxiety, obsessive compulsive disorder and post-traumatic stress disorder are all forms of anxiety.

Sometimes anxiety stems from an outside influence: a traumatic event, a reaction to a medication, chronic pain or a hormonal imbalance. Other times, anxiety is internally driven. Unfortunately, many people wait to seek treatment until the anxiety manifests in physical symptoms like headaches, stomachaches, back pain, shortness of breath, sleep problems or frequent urination. This is the body’s fight-or-flight response being overwhelmed.

It’s important to recognize that anxiety has many causes, often a combination of genetics, social environment, mental processes and physiological health. Understanding family history can be very helpful. Although family members may not have been diagnosed with anything specific, hearing stories about the odd behaviors of aunts or uncles or grandparents or cousins can give people a clue about genetic predispositions for an anxiety disorder.

Because of the stigma often attached to mental illness, I prefer to describe anxiety disorders as imbalances in the brain—because that’s what they are—no different than blood pressure or blood sugar. When things are in balance, you feel good. When they are out of balance, you feel bad. The pain is real. Anxiety is real. It is not your imagination.

One of the most damaging things we do to ourselves and our loved ones is to dismiss anxiety, to assume we can just snap out of it, be stronger, get over it. Can you just “get over” diabetes? Can you just “get over” high blood pressure? No. You need treatment. The same is true for anxiety disorders.

Treatments for anxiety disorders depend on a patient’s individual needs and the severity of their symptoms. For mild to moderate anxiety, many patients benefit from cognitive behavioral therapy (CBT). This involves meeting with a therapist who can help patients recognize their emotional triggers and manage their responses to them.

Some patients are prescribed medication that helps reduce their anxiety enough to allow them to focus on learning the skills they need to de-escalate their anxiety symptoms to be able to engage in therapy treatment. Once they’ve learned the coping skills, many patients stop using the medication.

For moderate to severe anxiety, selective serotonin reuptake inhibitors and other medications are almost always part of the treatment.

Mild anxiety doesn’t necessarily feel “mild,” but it rarely puts the patient at serious risk for immediate medical intervention. Moderate anxiety can drastically affect a patient’s life, making them feel overwhelmed and/or intensely irritable, but they can function in society. Severe anxiety includes things like panic attacks or other behaviors that make it hard to think or behave rationally.

The good news is that anxiety disorders are treatable. With CBT and good self-care that includes a healthy diet, regular exercise, enough sleep, a balance of work and play, and a mindfulness practice, patients can live long, happy, lower-stress lives.

Xochilt Morales de Martinez is a psychiatric nurse practitioner at MCHC Health Centers, a local, nonprofit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino counties.

Bill Gates and his daughter ‘loved’ this mystery romance novel—and he advises that you read it too

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Phoebe Adele Gates, Bill Gates, and Melinda Gates attend the Goalkeepers 2017.

Bill Gates is an avid reader and it appears that his youngest daughter Phoebe is as well.

In a recent blog post, the billionaire reveals that his latest literary favorite is a romance mystery novel. He reveals that his wife and daughter are actually mega-fans of both the book and the author John Green.

Titled “Turtles All the Way Down,” Green’s novel follows the story of Aza Holmes, a high school student in Indianapolis. Holmes and her best friend embark on a quest to find a missing billionaire in hopes of receiving a $100,000 reward for information on his whereabouts.

However, the protagonist must plow through her mental disorders (obsessive-compulsive disorder and severe anxiety), which make the mission extremely difficult and are a major obstacle in her social life.

Readers may find the “claustrophobic” description of her “mental swirl” difficult to read, writes Gates, but the author does a stellar job of showing what it’s like to live with OCD, a condition from which his daughter suffers.

Romance also makes an appearance in the book — when Holmes falls head over heels for the son of the missing billionaire. And although the plot centers around a fellow billionaire, Gates hopes that he’s nothing like him, referring to the missing character as “morally bankrupt.”

However, Gates thinks that his kids can relate to some of the billionaire’s experiences, noting that the character wants to give all of his money away to his pet lizard.



How Bill Gates helped Jeff Bezos become the richest person in the world


While Gates does not plan on leaving his vast wealth to an animal, he also will not hand over his entire fortune to his three children. Both he and his wife have repeatedly stated that they will leave a majority of their estimated $89.8 billion net worth to philanthropic causes.

In the blog post, Phoebe adds her own “mini-review” of the book and explains that the plot hit home for two reasons: She struggled with OCD for years and she sees herself in the billionaire’s son Davis.

“Never has a book been able to capture so well what it is like to live in the shadow of someone else’s legacy,” writes Phoebe. “This story shows how Davis struggled to find his own identity outside of his father’s fame and wealth.”

Phoebe also notes that she has a voracious appetite for books, much like her father. In fact, Gates reads about 50 books a year and has a tendency to share his annual favorites.

Last year, his two favorite books were “One is ‘Enlightenment Now” by Steven Pinker and “Factfulness” by Han Rosling. Gates describes both books as “amazing,” during a recent Reddit “Ask Me Anything” session. “They are both very readable and explain that the world is getting better,” he writes.

As for his newest 2018 favorite, the billionaire thinks that the book will be enjoyable for readers of all ages. “It’s a fun, moving story filled with quirky but relatable characters,” he writes.

Like this story? Like CNBC Make It on Facebook.

Don’t miss:

Self-made billionaire Bill Gates reveals 3 times in his life that he’s felt successful

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How to cope with OCD

Obsessive-compulsive disorder can be a disruptive condition to live with, but there are steps that you can take to cope with it. In this Spotlight, we take you through them.

People with OCD face daily stuggles, but there are ways to overcome it.

Obsessive-compulsive disorder (OCD) occurs when a person has recurring thoughts and behaviors that they cannot control.

Individuals with OCD feel that they must repeat these thoughts and behaviors again and again.

Around 1 percent of people in the United States have experienced OCD in the past year.

The symptoms of OCD can encroach on all aspects of a person’s life — including work, education, and relationships. OCD symptoms are generally broken down into two types: obsessions and compulsions.

People with OCD usually spend at least 1 hour every day contending with their obsessions and compulsions.

Obsessions are defined as thoughts or urges that cause anxiety (such as fear of germs), thoughts about hurting yourself or other people, or a craving to have objects in a perfectly symmetrical order. Obsessions might also take the form of persistent and unwanted mental images.

Compulsions are specific behaviors that people with OCD feel that they have to do when they have an obsessive thought. These may include washing excessively, ordering things in a certain way, or counting compulsively.

Though a person with OCD may feel instant relief from performing the rituals associated with their obsessive thoughts, they do not experience pleasure from this. Rather, such thoughts and actions contribute to a rising sense of anxiety.

OCD symptoms can either improve or worsen over time. But, if a person who has OCD is able to recognize that they are experiencing excessive unwanted thoughts or unable to control their behavior, they may be able to take steps to help themselves.

Treatments for OCD

If you think that you might have OCD, you should speak to your doctor. OCD is usually treated with medication such as selective serotonin reuptake inhibitors, psychotherapy such as cognitive behavioural therapy (CBT), or a combination of the two.

Some people with OCD find CBT helpful because this type of therapy teaches the person how to think differently about their obsessions and compulsions, helping them to overcome these unwanted thoughts and behaviors.

Last year, Medical News Today reported on a study that used functional MRI to examine how the brains of people with OCD responded to a type of CBT known as exposure and response prevention (ERP).

ERP involves exposing people who have OCD to things that trigger their symptoms and works on encouraging the person to resist following their usual urges in these situations.

The team behind that study found that the brains of people with OCD who had ERP displayed a significant increase in connectivity between eight brain networks.

The authors of that study suggest that these brain changes could represent how the participants are activating different thought patterns and learning new behaviors not based on compulsions.

Around 30–60 percent of people who receive treatment for OCD find that it does not help, however. So, finding other strategies to help manage symptoms of OCD is important.

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Talking about OCD can help

Many individuals who live with OCD find that an important first step in self-help is to be open about their condition with friends and family. If you have OCD, being able to talk about it with the people that are close to you can help you to feel more comfortable about the condition, as well as less isolated.

Spending time with other people who have OCD can also be beneficial. Joining a support group or engaging with other people who have OCD online can help people to feel accepted.

It may also empower them to talk about their experiences in an environment without worrying that they may be judged.

The International OCD Foundation’s website can help you to find an OCD support group near you. They even give advice to anyone interested in starting their own support group.

Meanwhile, The Mighty is just one example of an online OCD community — based, in this instance, around real-life stories from people with OCD.

Relaxation and minimizing stress

People with OCD often find that their symptoms get worse when they are stressed, so managing stress is a really important coping strategy. We tend to feel stressed when we are in situations wherein a lot of pressure is placed upon us and we do not feel as though we are in control.

Try relaxation techniques to remove yourself from stressful situations.

What follows are some tips that, while they may not necessarily cure your OCD, could help you to understand your triggers and minimize their effects. Recognizing when stress is likely to build up can help you to catch it before it overwhelms you.

Part of managing stress is about avoiding these situations, if at all possible. Another big part of managing stress is learning how to cope with difficult situations, or “developing emotional resilience.”

Trying different relaxation techniques could help to ease stress — for instance, deep breathing techniques can be calming.

Try breathing in through your nose and out through your mouth. Count to four as you breathe in, and again as you breathe out.

Another good way to relax can be taking a break from your devices. Try going an hour without your cell phone on. Does it help? Then why not try going the whole day?

Instead of flopping down and zoning out in front of the television or losing yourself in Facebook in the evening, try reading a book, drawing a bath, or trying out a new recipe. Taking time out from our usual routines can give us a sense of space, which many people find calming.

Creative hobbies — such as painting, sewing, and crafts — can be a great source of relaxation. And, music can really help to distract us from upsetting thoughts or feelings of anxiety.

Whether it is playing an instrument, dancing, or just putting your headphones on and cranking up the volume, losing yourself in music can be very therapeutic.

Some people think that mindfulness may help people with OCD. There has not yet been much conclusive research into whether mindfulness is effective for OCD, but it can help people to manage their mental health in general.

Mindfulness techniques involve paying deep attention to your mind, body, and surroundings and working on how you respond to changes in your mental state.

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Sleep, exercise, and diet

Many mental health problems tend to flare up as a result of not getting enough sleep, and studies have shown that OCD is no exception to this. So, making an effort to stick to a regular sleeping pattern can help a lot.

Again, try avoiding cell phones, laptops, tablets, and TV for at least an hour before bed; these can stop us from getting the sleep we need. People who are physically active are more likely to get enough nourishing sleep, so a little exercise — or even just going for a walk or doing some housework — can work wonders.

Alcohol, caffeine, and foods with lots of sugar can all disrupt sleep, so be careful to moderate your intake of these if you have OCD and problems sleeping.

That familiar quick hit of energy that comes with coffee or soda may feel necessary during the day, but as well as messing with your sleep, it can also boost anxiety and depression, thus potentially worsening OCD symptoms.

Foods that release energy slowly — such as nuts, seeds, pasta, rice, and cereals — are a preferable alternative because they help to balance blood sugar levels.

Drops in blood sugar levels can bring about depression and fatigue, which may be destabilizing to people with OCD. And, ensuring that you drink lots of water — aim for 6–8 glasses per day — will improve your concentration and help to balance mood.

Although these strategies are by no means a one-size-fits-all cure, if you have OCD, you may find that some of these techniques are helpful in avoiding or minimizing the effects of your triggers.

See what works for you, and always remember to speak to your doctor about the best way to manage your symptoms.

Understanding Compulsive Obsessive Disorder (OCD)

Most people have heard about Obsessive-compulsive disorder (OCD), and a lot of residents experience it. The symptoms usually begin gradually and vary throughout life.

To put it in easily understood terms, OCD is a type of anxiety disorder. Anxiety disorders include panic attacks, obsessive-compulsive disorder and post-traumatic stress disorder.

Symptoms include stress that’s out of proportion to the impact of the event, inability to set aside a worry, and restlessness.

OCD is characterised by unreasonable thoughts and fears (obsessions) that lead to compulsive behaviour. OCD often centres on themes such as a fear of germs or the need to arrange objects in a specific manner.

There are many obsessions people may experience, but one of the most known is repeated hand-washing. The disorder can drive people to wash their hands repeatedly to satisfy the idea in their mind that tells them maybe they have still not got rid of all those threatening germs.

But what causes OCD? There are three main sources – genetics, brain structure and environment.

The disorder can be inherited, and pass from one generation to the next – and is the result of the structure of the person’s genes.

Brain structure has been narrowed down to differences that have been found in the frontal cortex of the brains of OCD and non-OCD test subjects that might point to specific areas of the brain that are affected.

Environmental causes relate to something that one has experienced, such as physical, sexual, or emotional abuse at a young age.

Sources: http://health.facty.com/ and https://www.northpointrecovery.com/.

Do you perhaps have more information pertaining to this story? Email us at [email protected]  (please remember to include your contact details in the email) or phone us on 011 693 3671.

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Hey Khloé, Living with OCD is Nothing Like Your YouTube Series

Khloe Kardashian poses with her hands in a peace sign wearing all black and pasted onto a yellow background

(Photo: Getty Images)

It seems like every week, there’s yet another instance of the Kardashians being totally tone deaf. One of the recent Kardashian catastrophes was Khloé’s “Khloe-C-D” YouTube series—comprised of multiple videos, many of which have been viewed millions of times, about how she organizes everything from her fridge to her sunglasses drawer. Khloé calls it “the method to my madness,” but fans are now calling the series out for being making light of Obsessive Compulsive Disorder. But let’s be real, when it comes to misusing terms like OCD, Khloé isn’t the only guilty party.

I frequently hear people saying, “OMG I’m totally OCD about my desk being clean” or “I thought I lost my phone, I just had a total panic attack.” For years I would just smile and laugh, maybe add an “I know, right?” to keep the conversation moving—but I’ve finally started to correct people. I know what these terms *actually* mean, and it’s time other people should too.

I have Obsessive Compulsive Disorder and I suffer from panic attacks—two disorders that aren’t always seen together, but often go hand-in-hand. Having OCD doesn’t mean I have the lofty organizational standards of Khloé Kardashian and my attacks don’t just happen during moments of high stress. Instead, both are real, chronic mental health problems that I’ve dealt with my entire life.

I knew I was different early on

In hindsight, there were obvious and early signs that I was different from other kids. Everything I did had to be even; if I chewed something five times on one side of my mouth, I then had to chew something five times on the other side. It took me a while to get up and down stairs because I’d have to alternate which leg went first, just in case one leg muscle was inadvertently getting more of a workout. I didn’t realize these habits were odd until friends or family pointed them out, or told me to “stop being weird.” When teachers or friends noticed the particular way I laid out multiple pens on my desk every morning before class started, or when someone caught me daydreaming, I was just labelled “quirky” or “absent-minded.” What they didn’t realize was that my thoughts weren’t in the clouds, but rather obsessively looping—sometimes about something very mundane and other times something existential.

I didn’t want to be seen as ‘that weird kid,’ so I started doing things in secret by maintaining a mental log of the numbers, rituals and routines of my daily life. I kept a running tally in my head throughout the day so I could make sure everything was square before I went to bed, even if that meant delaying sleep to complete a ritual to give me temporary peace of mind.

Whether because of my obsessive personality or in spite of it, I thrived in my teens: I excelled at school, played sports and had a great social life—even though it often meant sleepless nights replaying an awkward conversation over and over in my head, or taking notes in class and then re-writing them at home because they weren’t neat enough the first time around. Going through multiple rewrites wasn’t just about wanting organized notes, it was a way to quiet my anxiety. Though this wasn’t normal behaviour for many of my peers, this was my normal. But when I went to university in 2006, everything changed.

What it’s *really* like to have a panic attack

A photo of writer Lauren Ufford from when she was in undergrad

When I started my undergrad, I was juggling working full time, overloading my course load each semester and holding myself to unattainable standards—and by the end of my first year, it became too much. The panic attacks started at night. First, I would feel hot all over. My heart would start pounding, my hands would shake, and then the nausea would roll in and I’d feel light-headed. I’d try to take deep breaths, but my mind would be moving at hyperspeed and the only thing I could think about was trying not to faint. These attacks would last about a minute or two, but when they were happening, they felt like an eternity.

For a while, I thought they would just go away on their own. Maybe I needed to increase the sleep I was getting or how much I was exercising. But the more I tried to get on with my life, the more I began to obsess over when the next attack was going to hit. Seemingly anything could set them off: a weird dream in the middle of the night, stressing about a project or exam or getting stuck on a crowded bus. Sometimes they came for no reason whatsoever. Eventually the stress of thinking about panic attacks actually gave me panic attacks.

Getting diagnosed

Finally, I sought help with a counsellor. After a few sessions talking about my anxiety, my “type A” personality and my history of compulsions, I was diagnosed with OCD and general anxiety disorder. The latter wasn’t a surprise to me, but I didn’t know much about OCD. I soon learned that the Canadian Mental Health Association defines OCD as a mental illness made up a combination of obsessions and compulsions. According to the CMHA, these obsessions are unwanted, repetitive thoughts; the compulsions are behaviours—like washing dishes or putting items in a particular order—intended to reduce anxiety. Statistics Canada estimates that two percent of all Canadians will experience OCD in their lifetime, like I have. Studies also indicate that most individuals report the onset of OCD later in their teen years or in early adulthood. So basically: check, check, check.

Looking at myself through a critical lens, I suddenly saw that the obsessive thoughts that I had experienced since childhood weren’t me being ‘high-strung’ or ‘anal.’ And while I had some compulsions to count actions, I consider myself lucky that they aren’t a huge part of what the illness looks like for me. For some people, these types of compulsions can be crippling and take up a large portion of their daily lives.

A new normal

I’ve come a long way from where I was in undergrad, but OCD is an illness that will stay with me forever. Right now, I’m coping really well, but there have definitely been highs and lows, good times and bad, especially related to the events and stressors in my life. Buying our first house, getting married and starting a new career were all bittersweet for me because the excitement and happiness was mixed in with anxiety and a noticeable increase in obsessive thinking and compulsive behaviour. I’ve tried anti-depressants, therapy, meditation and anti-anxiety medications in different combinations over the years. I know what works for me at the moment might not work for me in 10 years—and might be completely different to what works for someone else with the same diagnosis.

A photo of a young couple, the woman (Lauren Ufford) is wearing a blue cap and gown and holding flowers and the man standing with her is wearing a suit and they are both smiling at the camera

Writer Lauren Ufford and her husband Andrew at her university graduation

As comfortable as I am talking about my illness, I am also guilty of hiding my weaknesses, my thoughts and my anxiety. I project a pretty tough exterior to the rest of the world (my therapist would say this is a way of maintaining control), but my relationship with my husband, the one person who I let witness these moments, is where I find a lot of strength. He didn’t know a thing about OCD or anxiety disorders before we started dating. The first time he ever saw me having a panic attack, he wanted to take me to the hospital. Seeing me struggle to breathe while flush-faced, repeating a mantra over and over to myself, was a lot for him to absorb. Since then, he’s become the one person (aside from my dogs) who can actually calm me down when it’s really bad, because he took the time to learn about what’s really happening to me, and he’s attuned to when I need space and what to say to help snap me out of my repetitive thoughts.

I also know individuals who struggle with mental illness that don’t want to talk about it at all. And it’s with them in mind that I’ve started correcting people who say things like “Jeez, your house is so clean, must be nice to have OCD.” Because you never know who might be struggling with mental illness, and what that term really means to them.

Related:

My Life Is Wonderful, but Sometimes I Can’t Get Out of Bed
Four Women Open Up About Birth Control and Depression
Bella Hadid Opens Up About Social Anxiety + 15 Other Celebrities On Mental Health

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Seth Rich lawsuit against Fox News stands on unusual legal ground

Mary Rich and her husband, Joel Rich talk about the loss of their son in their home in Omaha, Nebraska, on January 11, 2017. (Photo by Matt Miller for The Washington Post via Getty Images)

The parents of Seth Rich, the Democratic National Committee staffer murdered in 2016, filed a lawsuit last week against Fox News. Their complaint alleges that the network conspired with Fox reporter Malia Zimmerman and guest commentator Ed Butowsky, also named as defendants, to push a “sham story” about Rich that ultimately traumatized his parents.

Jill Abramson wrote Tuesday that the suit is more important than Stormy Daniels’ legal effort to terminate her non-disclosure agreement, and media critic Erik Wemple ranked the “fraudulent story on Seth Rich” and its journey to the Fox News website “among the most baroque and shameful episodes in modern media history.” Yet the lawsuit is not a sure winner for the parents; it evokes emotional distress, historically a hard claim to win against the media.

ICYMI: A newspaper’s column about the term “racist” shocked readers

Some necessary background: Rich was fatally shot in his Washington, DC, neighborhood in the early hours of July 10, 2016. Since then, police have not identified any suspects or motives, beyond the possibility that Rich was killed during an attempted robbery. Right-wing groups began floating the conspiracy theory that Rich was the source of the DNC emails that WikiLeaks released, day by day, in the final stretch of the presidential campaign, to Donald Trump’s apparent advantage. The theory held that Rich had been killed in retaliation for leaking the emails.

Egged on by Butowsky, Zimmerman effectively laundered that theory through a wholly deficient story published on May 16, 2017, on Fox News’s website. As the story fell apart over the course of a few days, Fox hosts Sean Hannity, Steve Doocy, and Lou Dobbs—all seemingly immune to reason and professional responsibility—dished on the story on their programs. So did Fox contributor Newt Gingrich, as a guest on Fox Friends. Hannity tweeted about the story. Elsewhere, Rush Limbaugh and Alex Jones raged into the abyss about it.

A week later, Fox retracted the story, stating, “The article was not initially subjected to the high degree of editorial scrutiny we require for all our reporting. Upon appropriate review, the article was found not to meet those standards and has since been removed.” The same day, Rich’s parents, Mary and Joel, published a Washington Post op-ed in which they pleaded with “conservative news outlets and commentators” to stop politicizing their son’s death.

Now they are suing.

The complaint includes four causes of action against all defendants: intentional infliction of emotional distress; aiding and abetting intentional infliction of emotional distress; conspiracy to commit intentional infliction of emotional distress; and tortious interference with contract. The complaint also includes one cause of action against Fox News alone: negligent supervision and/or retention. Libel is not an available route because the news coverage focused on Rich, and death wipes out libel claims, so relatives can’t bring them.

(Notably, the network is already fighting a related lawsuit, filed in August by a private detective and former Fox News contributor who investigated Rich’s murder for Mary and Joel. He claims that Fox fabricated quotes attributed to him in the retracted story, in an effort to smear Seth. Mary and Joel claim in their suit that Butowsky convinced them to hire the detective to investigate their son’s murder, with the ulterior motive of advancing the smear campaign around Seth.)

Let’s focus on the primary legal theory: intentional infliction of emotional distress (IIED). It allows a plaintiff to sue where another’s conduct was “so outrageous in character, and so extreme in degree, as to go beyond all possible bounds of decency, and to be regarded as atrocious, and utterly intolerable in a civilized community.”

To that end, the complaint argues that Fox, Zimmerman, and Butowsky “intentionally exploited” Seth’s murder “through lies, misrepresentations, and half-truths—with disregard for the obvious harm that their actions would cause Joel and Mary.” The stated harm includes the inability of Seth’s parents to “com[e] to terms with his murder because they were repeatedly forced to relive it”; “symptoms consistent with a diagnosis of Post-Traumatic Stress Disorder … and [of] obsessive compulsive behavior”; “feelings of anxiety…triggered by…stories in the media and by their feeling that they never know what is going to come next”; and, for Mary, “symptoms consistent with Social Anxiety Disorder.”

ICYMI: NewYork Times columnist in hot water 

Generally, courts are reluctant to recognize media liability for emotional distress. Often, the intangible nature of the harm is not persuasive, while the First Amendment values at play are. For example, an IIED claim failed where a plaintiff sued a news outlet that disclosed the graphic details of a loved one’s death in the emergency room. And in the most famous case in this area, Hustler Magazine, Inc. v. Falwell, the US Supreme Court considered claims, one of them IIED, brought against Hustler by the Reverend Jerry Falwell, who sued because of a parody ad that portrayed him as a drunkard who had sex with his mother in a fly-infested outhouse. The court, observing that the parody was gross and offensive, cited the First Amendment to reject Falwell’s IIED claim.

Generally, courts are reluctant to recognize media liability for emotional distress.

Historically, too, courts have been suspicious of efforts by public officials and figures to evade constitutional protections for expression by recasting libel claims as other torts, such as IIED. Public officials and figures used to think of IIED as an attractive alternative to libel, because for years in IIED cases they did not have to prove the kind of fault that such libel plaintiffs did (i.e., actual malice). That made it easier for public officials/figures to win IIED claims. But that changed with Hustler, which extended the actual malice standard to IIED.

That said, courts are most likely to recognize media liability in IIED cases involving plaintiffs who are private people subjected to extraordinarily aggressive or invasive reporting practices. For example, an Orlando television station settled an IIED case after a Florida court refused to dismiss a suit over the station’s decision to broadcast images of a girl’s skull. WESH-TV had aired a close shot of a police officer lifting a skull—that of the plaintiff’s daughter, who had been abducted three years earlier—from a box. The broadcast began with a story about the memorial services held that day for the girl; her parents, not warned of the skull footage, watched in horror. In another case, CBS settled after it broadcast a video of a woman’s conversation with an intervention specialist at a woman’s home following an alleged attack by her husband. She said the CBS camera crew members misrepresented themselves, claiming to be a crew from the district attorney’s office.

Mary and Joel Rich seem to have as strong an IIED case as any, based on the coverage they were subjected to, the harm they suffered, and the overwhelming likelihood that they would be treated as private people and not public figures. But the inconsistency of the decisions in this area, and the general reluctance of courts to recognize media liability for emotional distress, makes the suit’s success less than assured. Ultimately, this would be a great libel case, but may or may not work as an IIED one.

RELATED: “I spent 45 minutes on the phone with Megyn Kelly asking her to not run that show”

Jonathan Peters is CJR’s press freedom correspondent. He is a media law professor at the University of Georgia, with posts in the Grady College of Journalism and Mass Communication and the School of Law. Peters has blogged on free expression for the Harvard Law Policy Review, and he has written for Esquire, The Atlantic, Sports Illustrated, Slate, The Nation, Wired, and PBS. Follow him on Twitter @jonathanwpeters.

5 Physical Manifestations Of Anxiety Disorders – Medical Daily

Many have experienced difficulty in trying to differentiate an anxiety disorder from general worrying habits. The American Psychiatric Association states an anxiety disorder involves “excessive fear or anxiety,” referring to “anticipation of a future concern and is more associated with muscle tension and avoidance behavior.”

The disorder is categorized into various types including Generalized Anxiety Disorder, Obsessive-Compulsive Disorder (OCD), Panic Disorder, Post-Traumatic Stress Disorder (PTSD) and Phobia and Social Anxiety Disorder.

Regarded as one of the most common mental health issues in the world, symptoms and signs of an anxiety disorder can manifest in surprisingly physical ways.  

1. Muscle tension

Pain in the body, ranging from soreness to migraines to joint aches, can be an indicator of Generalized Anxiety Disorder though research literature on this link is limited. Sufferers of anxiety are known to involuntarily clench their jaw or practice poor posture which are potential causes of muscle pain. 

2. Acne

In research studies, adult acne patients were found to experience comparatively higher levels of anxiety. The increased production of stress hormones, in turn, increases facial oil production.

“Both acne and anxiety are prevalent disorders. Dermatologists need to [be] aware of this and assess mental health status of patients presenting with acne — whether they are adolescents or adults,” says researcher Sandhya Ramrakha from the University of Otago, New Zealand.Another overlooked factor may be the habit of fidgeting and touching your face, a common symptom of anxiety and a common cause of acne.

3. Compulsive actions

An OCD is characterized by compulsive actions and intrusive thoughts that are difficult to control. One may repeatedly engage in an action until they find a sense of mental peace. Some examples of actions include obsessive lock checking, ritualistic behavior around even numbers or symmetry, and unrealistic hygiene standards. These coping mechanisms among OCD patients may stem from spontaneous uncontrollable thoughts or external physical triggers.

Some compulsive actions, as mentioned in the aforementioned point, can risk evolving into harmful conditions like trichotillomania (pulling out hair) or skin excoriation (picking at skin).

4. Sleep problems

Chronic sleep problems may represent a warning sign as statistics show a close relationship between anxiety and insomnia. Even after a night of sleep, anxiety patients may wake up with a racing mind or an inability to stay calm. 

Nightmares are a common occurrence for those suffering from Post-Traumatic Stress Disorder. They often reflect a bad memory or a worst-case scenario i.e. anxiety for the past and anxiety for the future respectively. 

5. Self-consciousness

Social anxiety is provoked by situations that may demand interaction in a slightly unpredictable setting, for instance, speaking over the phone or making conversation at a party. Those who suffer from social anxiety, involuntarily exaggerate the judgment of other people and this can show through a variety of physical signs such as blushing, increased heart rate, sweating, nausea, stuttering, or trembling hands. 

2 Out of 3 People See Depression at Work. Here’s How to Keep Your Team Well

When Arun Gupta, founder of the New York City health care company Quartet Health, couldn’t find satisfactory mental health insurance for his team, he came up with a creative solution: confidentially reimbursing employees for out-of-­pocket expenses through a third-party vendor. “A lot of times, people might have to pay cash or have high co-pays attached to getting therapy. Now they can see anybody they want to see, as often as they need,” he says. “We’re pushing the envelope here, but it’s good for business.”

That’s because roughly 18 percent of American adults suffer from some form of mental illness, according to the National Institute of Mental Health. And that makes it a particular problem for smaller businesses, where every employee plays a crucial, often nonduplicated role. In the United States, the total economic burden of major depression alone is now estimated to be $210.5 billion per year, according to the consulting firm the Analysis Group. Even if you don’t go as far as Gupta, there are many measures you can take to ensure your workers are at their best.

1. Fight the stigma.

Build employee well-being into your culture. Once a month at social-media company Buffer, “we gather online and discuss topics like self-care,” says Courtney Seiter, the company’s director of people. At those times, Seiter says, employees share their struggles with anxiety, obsessive-compulsive dis­order, and depression. Boston-based clothier Ministry of Supply matches every employee with a company veteran who can provide emotional support. Co-founder and CEO Aman Advani attributes the company’s “incredibly low voluntary exit rate” to this approach.

Even offering unpaid leave for mental health crises can help, says Lauren Steiner, president of Cleveland-based consultancy Grants Plus, which was awarded a Psychologically Healthy Workplace Award from the American Psychological Association in 2016. “We had someone struggling with a mental health issue who needed time, and that’s really hard for a small company to handle,” she says. “When she came back to work, initially it was just for a few hours per day until she was ready to come back full time. I know she was very grateful for the flexi­bility.” In addition to building employee loyalty, the company avoided the costs of hiring and training a replacement.

2. Insure wellness.

Comprehensive mental health coverage is expensive, but some employers believe it pays for itself. Lisa Hannum, CEO of St. Paul-based Beehive Strategic Communication, provides her employees a choice of insurance policies with different mental health coverage options. She says this policy has played a role in the company’s 60 percent reduction in sick days over the past two years.

“My product is people,” Hannum says. “If they’re not energized and healthy, we don’t have a product.” Carrie Espinosa, owner of Waukegan, Illinois-based insurance agency Horizon Benefit Services, encourages employers to provide a number of plans and have their workers contact her directly for advice on benefits packages. “Employees can call us and say, ‘Here’s my scenario–help me pick the best plan,’ ” she says, pointing out that federal law ensures the conversation is confidential.

3. Work the program.

One popular supplement to standard mental health coverage is an employee-assistance program. EAPs, which can be added to insurance policies or purchased singly, are pack­ages of mental health services, such as limited-duration crisis counseling. But EAPs vary widely in their cost. If you can’t afford one, get together with other businesses to purchase an EAP as a group, advises Jodi Jacobson Frey, an associate professor at the University of Maryland’s School of Social Work. Then make sure your employees know about it.

Most employers have an EAP, but not all do what they should to publicize them. I’ve always aggressively promoted the EAP, ” says Dan Mendelson of consulting firm Avalere Health. “Employees need to see the leaders of the company acknowledge the importance of engaging with mental health professionals when it’s needed.”

Know the law.

“It’s illegal under the Americans With Disabilities Act to discipline or fire employees just because they’re alcoholics. Current illegal drug use is not protected. Drug testing is regulated by state law, and the rules vary drastically. It’s a good idea to talk to a lawyer before staging an intervention.” — Sachi Barreiro, employment law editor, Nolo.com

Few Effective Treatments For Hair Picking (Trichotillomania) Or Skin …

Trichotillomania and skin-picking disorders result in repetitive self-grooming behaviors that result in damage to the body.

I feel the urge again. My fingertips run along my face, feeling for imperfections, and I slip into the bathroom to be alone. After a glance in the mirror, I stalk back out, my nails digging into my palms. Not today.

Since my adolescence, I’ve had a tumultuous relationship with my reflection. That’s because I suffered from trichotillomania, or hair pulling, and currently struggle with its cousin excoriation disorder, dermatillomania, or skin picking.

Trichotillomania and skin-picking disorder are referred to as body-focused repetitive behaviors, an umbrella term for self-grooming behaviors that result in damage to the body.

But the difference between everyday fidgeting — say, occasionally playing with a hangnail when you’re antsy — and BFRBs, is that the behaviors cause clinically significant distress or interfere with daily functioning. A day at the spa, or on the beach, for instance, would only lead me to wonder how I’d hide my scarring.

Despite attempts to stop, people can pull or pick for long periods of time and even miss school, work, or outings.

And there is no long-term cure for either disorder.

One study suggests that around 13 percent of adults in the U.S. engage in at least one BFRB. But a non-profit organization dedicated to the cause gave me more conservative figures. Per their research, an estimated 1 to 2 percent of the population has trichotillomania and about 1.4 percent has skin picking disorder.

That still makes them two of the most common BFRBs, which may affect more than 10 million people in the U.S. alone.

Since these disorders are sometimes comorbid, meaning a person can have both at the same time, figuring out how many people have them it isn’t quite as simple as adding the two statistics together, says Jennifer Raikes, executive director the TLC Foundation, the BFRB focused non-profit.

There’s also a range of severity of these disorders. “For some people, they’re relatively minor, and for some people, they’re really life-warping and potentially dangerous,” Raikes adds.

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Skin pickers can run the risk of infection. There’s also a subset of individuals who swallow pulled hairs, which can potentially cause gastrointestinal injuries from undigested hairballs that can require surgery to remove.

Some people, myself included, experience feelings of isolation and confusion. Many of us believe, falsely, that the behavior is uncommon.

Finding others

That’s why, when I first found other women who shared my afflictions, I was astounded to hear them talk about the same feelings I’ve harbored in silence since I was a teen. We aren’t using their last names to protect their privacy.

“The shame with this is excruciating,” says Mary, who is in her 50s.

“It’s not just a bad habit, something you could stop if you just tried hard enough,” she says. “I almost feel like there is some kind of electrical buzz in me that it helps discharge. And living with that buzz is intolerable.”

I, too, feel that buzz.

For others, like Nina, who is in her 40s, picking can strain relationships. “When I was younger, it really upset all the people around me,” she says. “Nobody could understand that it was not something that I had a lot of control over.”

Mary says she has felt similar pressure. “My husband is frustrated beyond belief that I can’t just stop, and constantly nags me to ‘let it heal.’ It is a source of constant tension.”

Who suffers

Though body-focused repetitive behaviors tend to begin during adolescence, they can start at any time, including childhood. It’s not entirely clear why some people develop BFRBs, though research suggests that people may have an inherited predisposition for the disorders.

Women tend to be more likely to be sufferers, though it’s possible that men under-report their afflictions.

And from an evolutionary standpoint, we’re not the only species that exhibits these problems: Mice will pull their fur out. Birds pull their feathers. Dogs lick their paws to the point of irritating them.

A number of internal and external triggers can spur BFRBs, such as anxiety, stress and boredom. Some are driven by personal beliefs, like the thought that pulling or picking may make an area smoother.

Others do it in specific circumstances, like when they’re lying in bed, driving their cars or working at a computer. Many, like myself, rely on solitude and mirrors.

The comprehensive behavioral model of treatment helps patients identify triggers and then tailor an intervention. If smooth skin is the goal, for example, a therapist may advise carrying around a smooth stone to touch to mimic the sensation. If you require a mirror, like the author does, you may be advised to cover it or keep your lights dim.

The comprehensive behavioral model of treatment helps patients identify triggers and then tailor an intervention. If smooth skin is the goal, for example, a therapist may advise carrying around a smooth stone to touch to mimic the sensation. If you require a mirror, like the author does, you may be advised to cover it or keep your lights dim.

And sometimes when sufferers pull or pick, they don’t even notice that they’re doing it. The behaviors can also become more focused and routine because of the immense satisfaction or relief that they bring.

The more I spoke to people with these disorders, the more it became apparent that it’s a different experience for everyone.

Mary tells me she didn’t leave the house without concealer. Nina tells me manicures help her picking and that her urge dissipated over time once her life settled down.

But we all have one big thing in common: Despite our best efforts, we cannot completely stop. These women tried everything from wearing hats and gloves to cognitive behavioral therapy to deter pulling and picking.

A neurological condition

“This is a neuropsychological condition, really a neuropsychiatric condition, much the same as obsessive-compulsive disorder,” says Dr. Ira Halper, psychiatrist and director of the Cognitive Therapy Center at Rush University Medical Center in Chicago.

That leads me to perhaps one of the more contentious aspects of hair pulling and skin picking: their classification in the Diagnostic and Statistical Manual of Mental Disorders, the standard reference of mental health diagnoses.

Trichotillomania and skin picking were only recently recognized under Obsessive Compulsive and Related Disorders when the American Psychiatric Association published the DSM-5 in 2013. Up until that point, trichotillomania had been considered an impulse-control disorder along with kleptomania, pathological gambling and pyromania.

“I don’t think that the classification as a related disorder is entirely off-base, but I do think it’s confusing,” Raikes says. Though trichotillomania and skin picking disorder are related to OCD, she says, that doesn’t mean that the disorders are a form of it.

“The distinction is important because if they are too closely equated, it can result in receiving ineffective treatment,” she adds, meaning people will seek help for OCD rather than BFRBs.

“I always use the analogy, it’s like a distant cousin,” says psychologist Charles Mansueto, founder and director of the Behavior Therapy Center of Greater Washington. Mansueto is also on the TLC Foundation’s scientific advisory board. “It’s not unrelated. It just is not identical with or even a close sibling of it. It has its own characteristics. It requires its own treatment.”

Could A Zap To The Brain Derail Destructive Impulses?

“In the history of psychiatry, this is nothing,” he adds. Schizophrenia, for example, has been studied for over a hundred years, whereas hair pulling and skin picking are just now being recognized, “This is so new.”

“A lot of people misdiagnose [skin picking] as OCD,” says Suzanne Mouton-Odum, a psychologist who helped create StopPicking.com, an interactive program for excoriation disorder that helps identify a sufferer’s internal and external cues and shares coping strategies. Mouton-Odum is also on the TLC Foundation scientific board.

“What’s so different about treating these behaviors is you really have to get to know the person, and you have to understand what their triggers are for the behavior and really work with that,” she says.

Treatments

Though treatments exist, they have shown to only be moderately successful.

The current treatment of choice is called cognitive behavior therapy, an approach that hones in on problematic thoughts, feelings and behaviors. Some of the most successful approaches train patients to recognize what prompts them to pull or pick and replace it with something else, like balling hands into fists.

There’s also the comprehensive behavioral model, developed by Charles Mansueto and his colleagues. The ComB model helps patients self-monitor to pinpoint triggers in five areas (sensory, cognitive, affective, motor and place) and then tailor an intervention. If smooth skin is the goal, for example, a therapist may advise carrying around a smooth stone to touch to mimic the sensation. If you require a mirror, like me, you may be advised to cover it or keep your lights dim. This model also uses barriers like medical tape and Band-Aids to make patients more conscious of when they pull or pick.

And, even though selective serotonin reuptake inhibitors are commonly prescribed to combat hair pulling and skin picking, there’s increasing interest in an amino acid called N-acetylcysteine. One study showed that NAC helped lessen urges for more than half of participants. “That’s the closest thing we have to a magic bullet,” says Mouton-Odum.

Though the fight to understand and treat these disorders feels Sisyphean, especially because little federal funds have been devoted to them, the TLC Foundation has a huge research study underway.

The BFRB Precision Medicine Initiative is being led by investigators from UCLA, the University of Chicago, and Massachusetts General Hospital. The study will investigate the clinical, biological and genetic underpinnings of body-focused repetitive behaviors and collect data that will form the basis for more effective treatments.

“To understand these problems is to understand being human and that we all are in the same boat,” says Dr. Mansueto. “Join the club of humanity.”

I step back into the bathroom, this time a little more confident in my ability to reckon with my disorder because I know that I am not alone.

Kasia Galazka is a freelance science writer who has written for BuzzFeed, Psychology Today, Pitchfork and Paste. Follow her on Twitter: @supergalaxy.