Psychologist hopes the pandemic can help reduce the stigma against OCD

TORONTO —
Many people have experienced anxiety and excessive cleaning during the pandemic, but for individuals who struggle with obsessive compulsive disorder (OCD), this isn’t anything new.

Many individuals who struggle with this anxiety disorder often have rituals or specific ways of completing a task, usually involving an excessive amount of cleanliness. 

The pandemic has heightened these concerns to the extreme, Karen Rowa, a psychologist and associate professor at McMaster University, told CTV News Channel. 

“For some of these individuals who are suffering (with OCD) they may have taken the recommendations for isolation and quarantine to an extreme, so their anxiety and OCD concerns may have pushed some of those rules where they feel like they don’t even want to go out anymore or touch anything,” she said.

Rowa said common OCD tendencies include extra hand-washing, additional precautions when going outside and lots of sanitizing. 

According to CAMH, one in 40 adult Canadians are diagnosed with OCD, though many Canadians may relate to frequent sanitizing during the pandemic. 

Rowa said it’s unlikely for a person to develop the disorder as a direct result from the pandemic, since it’s often caused by a combination of psychological, biological and genetic factors.

“We’re all at risk for having a lot of anxiety and exhibiting those types of behaviours, but certainly we wouldn’t expect that people would develop OCD simply from the pandemic,” she said. “People who are doing a lot of extra washing and being careful if the pandemic were over, I think they could go back to their normal lives whereas somebody with OCD would continue to struggle.”

While the pandemic has greatly affected some of those living with the disorder, Rowa said some of her clients have found it to be slightly comforting to see others relating to their struggles. 

“I’ve had a number of my clients tell me they feel a small relief that other people in the general population now have to go through significant behaviours that they normally have to go through,” she said. “In some ways, hopefully, this is reducing the stigma in helping people understand what it might feel like to have OCD or significant anxiety at most times.”

Rowa said Canadians need to be more supportive than ever to those who struggle with their mental health. 

“If we want to be extra supportive of individuals whose anxiety and OCD symptoms have skyrocketed, it’s really important to encourage that if they are in therapy or taking medication to continue that and if they’re not, to potentially seek some professional help if the symptoms have gotten to the point where they’re really interfering,” she said.

Rowa is also recommending family and friends to be understanding and encourage individuals not to go overboard with health measures. 

“We always say in therapy support the person, not the OCD, so have a lot of empathy and a lot of patience but also try to encourage the person to only follow the guidelines and not go beyond them, so for example (hand) washing for 20 seconds is very reasonable but washing multiple times for 20 seconds is unnecessary,” Rowa said. 

CBD Oil for Anxiety: Can it Help You to Become a Better Artist?

In recent years, CBD has become quite popular among people dealing with various health conditions. Its therapeutic qualities are such that problems like anxiety, depression, insomnia, and chronic pain, amongst other disorders, disappear within a few days of starting a CBD course.

In this article, however, we will put our whole focus on anxiety and how people are healing from this common health condition. If you or someone you know, suffers from anxiety, then perhaps CBD might come in handy for you. Do give this article a read and who knows, your anxiety would leave you alone once and forever.

CBD, an acronym for cannabidiol,  a naturally-occurring compound, is found in the cannabis plant, and legalized in all 50 states in the US (under the 2018 Farm Bill). The good thing about CBD is that it is completely non-psychoactive in nature because it contains nil or very little amount of tetrahydrocannabinol or THC, which is another cannabis compound primarily responsible for producing high in your body.

Another thing to know about this miraculous product is that it is known to have the potential to relieve people from countless health conditions. One of these health problems is anxiety, which, in today’s world of stress and pressure, has become quite common in people. As common as it sounds, there is a lot more problem than what one sees on the surface.

Anxiety is the most common type of illness in the US. It affects more than 18% of the country’s population (as per Anxiety and Depression Association of India). This disorder is backed by feelings that led to racing thoughts and mental as well as emotional discomfort. When a person feels imminent danger from someone or something, it kicks off his or her anxiety. It is quite a difficult place to be in.

So, how anxiety occurs? The biggest reason for anxiety disorder is the daily stress that results in chronic stress and anxiety. Another reason is the genetics of the person. When cortisol, the stress hormones overtake serotonin and other blissful neurotransmitters, then stress and anxiety take place. In most cases, we worry for nothing. Most of the problems come with a solution and if there is no solution, then why worry about the same. However, in case of anxiety, this doesn’t seem easy. This is why there are various medical treatments, including cognitive behavioural therapy (CGT), psychotherapy, and other medicines that therapists recommend.

However, in recent years, it has been discovered via limited research and unlimited anecdotes that anxiety can indeed help people in feeling better, and in some cases, completely relieved.

Cannabidiol has many therapeutic qualities. According to Thecannabisradar.com Research has claimed that CBD targets more than 65 points in the human body to provide therapy to. CBD helps in dealing with anxiety by stimulating neurotransmitter systems and neural regeneration.

Typically, CBD releases its cannabinoids in the endocannabinoid system of the body, which attach themselves with the CB1 and CB2 receptors, found in the brain and peripheral nervous system of the body. These receptors are known for producing cannabinoids naturally, which help in bringing the body into complete balance. This state of balance is known as homeostasis, and the body, when it achieves this balance heals itself from almost all the mental, physical, and emotional problems. This must also include anxiety disorders of all kinds.

Even though research on the same is quite limited, here is some evidence that supports the above argument.

A study done in 2010 found out that CBD can, in fact, help in putting people with social anxiety at ease. The study also revealed that participants didn’t only feel better but also changed the way they responded to anxiety.

In another study done in 2014, it was revealed that CBD oil has anti-anxiety as well as anti-depressant effects on animals.

In 2015, a report was published by Neurotherapeutics, where it was reckoned by the scientists that CBD does have a potential to relieve people suffering from conditions like generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and PTSD.

In this case study done in 2016, it was revealed that cannabidiol can reduce the symptoms of post-traumatic stress disorder (PTSD). The study was done on a child who suffered from trauma and after CBD in-take, she fell asleep better and her anxiety was reduced.

In a 2018 study, published in Cannabis and Cannabinoid Research, it was revealed that more than 60% of people reported that they use CBD oil from awesome brands like Fab CBD for treatment of pain, anxiety, and depression.

Even though the research is still in fancy, there is hope and many success stories shared by people from across the world, where they get proper relief from anxiety and other health conditions. Thus, it is so important to keep the hope alive and know that CBD can certainly be used as an alternative medical treatment for anxiety.

The best way to take CBD oil for anxiety is between the doses of 300 mg to 600 mg. All you have to do is drop a few drops under your tongue and hold the same for at least 30 seconds before swallowing it down.  You can also take CBD in other formulations, including capsules, teas, edibles, candies, vapor, etc.

Unfortunately, there is no regulated dosing system of CBD oil and other formulations in the market. Thus, it solely depends on your body and features like weight, height, and tolerance of individuals to decide on the dosage of the same. Thus, it is recommended to consult your doctor about the dosage and anyway, start with the minimum dosage. You can then increase the dosage every day and once you start feeling better, monitor your body. Soon, you will reach your ideal dosage.

Also, it is important to mention that CBD does not come with any side-effects for it is completely natural. However, one may experience fatigue, insomnia, decreased appetite, change in weight, etc as side-effects which usually go away in a few hours. If they don’t, then by all means, consult a doctor immediately. However, there haven’t been any cases of side-effects resulting from the in-take of CBD oil.

This also suggests that CBD does not develop a tolerance in people. In fact, many people have reported to develop a reverse-tolerance after a few months of taking CBD. For those who don’t know, reverse-tolerance happens when even after stopping the dosage of CBD or any other supplement, the disorder doesn’t occur or come back. The brain develops the habit of being in a state of balance or being without anxiety or any other problem.

The final verdict is that CBD oil has quite a potential to not only deal with anxiety issues but other health problems as well. So, it is for the best to talk to your doctor, especially if you are on traditional medication before starting your CBD course. Nonetheless, there shouldn’t be a problem taking CBD oil since it is absolutely natural and affordable. However, it should be your responsibility to purchase the CBD oil from a reputed company and check whether the level of THC is less than 0.3%. Also, the products should be third-party tested to ensure that they are of high-quality. Rest assured, you will definitely find a solution to anxiety via CBD oil.

 

 

My OCD Doesn’t Mean I’m Equipped For a Pandemic

In this op-ed, Gloria Oladipo explains why assuming people with OCD are obsessed with cleanliness is a harmful stereotype.

Since the COVID-19 pandemic started, some have suggested that those of us with obsessive compulsive disorder have a leg up in staying healthy. Let me clear something up: OCD is not a gift, and my obsessions around germaphobia and cleaning compulsions certainly haven’t given me an advantage when dealing with COVID-19. Like others, I am still learning information about how to prevent the spread of the disease. I still had to re-learn the proper way to use a mask and how to clean surfaces so germs don’t spread. I’ve still paid attention to news reports and updates on how the virus is progressing and what new steps I can take to protect myself. And yet, people assume that my OCD makes me more prepared to face this global pandemic.

According to the Mayo Clinic, Obsessive Compulsive Disorder (OCD) is a mental health condition characterized by an ongoing cycle of unwanted thoughts that lead to repetitive behaviors, and for people like me, it can be devastating. It affects a variety of people from different backgrounds, ethnicities, genders, sexualities, and other demographics. Obsessions can be about a variety of topics: cleanliness, harm coming to yourself or others, religion, perfectionism, and other subjects. Similarly, compulsions can be any range of repetitive behaviors from checking to make sure you’ve locked the door, to picking one’s skin, to arranging things in a particular order. While everyone experiences unwanted anxiety at one point or another, and people can be perfectionists or pay attention to detail, OCD is different than these everyday occurrences. The difference is that obsessions and compulsions affect your daily life in a significant way. 

At my worst, OCD left me completely immobilized. During my sophomore year of college, my OCD exploded. At first, it started out as small, tiny quirks here and there. I would have unwanted thoughts — “you’re going to fail this final,” for example — and knock on wood for extra assurance. I liked to keep my room tidy. On occasion, I would avoid foods in the dining hall that looked “off.” My OCD grew from there, and obsessions and compulsions began to dominate my life. I had dozens and dozens of intrusive thoughts a day: “Your parents will die,” “your university will be shot up.” I adopted an arsenal of complicated compulsions to manage the anxiety: Knocking on wood, hoarding “lucky” objects, throwing away “contaminated” food, and more. I went from being an extroverted, curious student to an anxious shadow of my past self, confined to my room — the only place I felt safe.

Even though I was experiencing clear signs of OCD, I didn’t recognize the symptoms in myself due to the condition’s misrepresentation in our culture. Most people seemingly understand OCD through a set of outdated stereotypes. Colloquially, OCD is often thought of as an obsession with cleaning or an extreme germaphobia. People often make flip comments like “I’m so OCD” because they have a preference that things remain organized and clean. In TV shows and movies, characters with OCD are defined as being extremely organized or obsessed with cleanliness. While germaphobia or organization can be an obsession-compulsion that a person struggles with, this isn’t the only way that OCD manifests. OCD encompasses a wide variety of obsessions and compulsions, many that have nothing to do with cleanliness, organization, or germaphobia at all.

Like those who think I have a leg up on COVID-19 because of OCD, another stereotype is that OCD is a heightened ability. When I disclose my OCD to someone, there’s a good chance I’ll be met with a response like “Wow, you must be so clean,” or “I wish I were more organized!” Congratulating someone on their OCD is the equivalent of congratulating someone with an eating disorder for losing weight. Like any disorder, OCD causes a great deal of distress and pain; OCD comes with debilitating anxiety that can completely take over one’s life. For example, during the height of my OCD, while my room was tidier and I was more organized, it was only because of the continuous irrational and intrusive thoughts I was having — complimenting me on my tidiness reinforced my OCD, and wasn’t in fact a compliment at all. My OCD didn’t serve me. My obsessions and compulsions only kept me more isolated, more depressed, and more anxious. Nothing about it was useful.

Misrepresenting OCD as a limited range of symptoms or as lucky only further stigmatizes those who suffer from it, and that includes the misguided comments about OCD and COVID-19. Reinforcing these stigmas and stereotypes prevents people from reaching out for help, particularly if they present symptoms other than those commonly associated with the disorder. This disproportionately hurts people of color, specifically Black people, who are already underrepresented in OCD research. In the case of this pandemic, celebrating OCD as a “useful trait” undermines the ways that OCD patients can suffer. It prevents people from speaking out about the ways in which OCD has complicated their lives because society says they should be grateful.

Most of all, misrepresenting OCD enables ableism, allowing people to call themselves OCD in jest if they clean or organize a lot. When we only understand OCD as a “quirk” or as a shorthand for being extremely tidy, it allows people to use OCD as a joke, rather than reserving it for when discussing the illness. In short, misrepresenting OCD stops people from getting the treatment they need.

OCD is extremely serious and has stolen years of my life. Instead of pursuing my goals in college, I was confined to my home, afraid of any level of uncertainty. Thankfully, through a combination of medication and therapy, my OCD has quieted, making my life more manageable. Unfortunately, for many people, misinformation prevents them from understanding their symptoms and getting the necessary help. Our society must progress beyond our one-dimensional understandings of OCD. Only through spreading factual information and combating ableist falsehoods can we help those suffering in silence from this horrible disorder.

Kid gloves required to sort out cold marriage issues

Dear Miss Lonelyhearts: My wife has become all-consumed with our kids and it’s like I’m just an accessory in her life now. She treats me poorly, is short with me and isn’t turned on the least bit.

It feels like after we had kids she just stopped liking me for some reason. I try to help where I can, but I guess I could do more. I don’t know.

I just wish we could go back to how it was before the kids, but still have the kids. You know what I mean? What should I do? — Her Unhappy Sperm Donor, St. James

Dear Unhappy: Don’t blame it on the kids! They are innocents and deserve nothing less than full love from their mom and dad.

Do start a fearless conversation with your wife focusing on everything you loved about each other in the beginning, when things began to turn, and how everything seems to be going wrong now.

Here are the rules: Don’t do this where the children can hear it, like when they’re in their bedrooms and supposedly going to sleep. Similarly, don’t do it outside on deck chairs under a bedroom window. No raised voices, either, and don’t talk about it every night, as it’s exhausting for both of you.

If you can afford a relationship counsellor — even by phone — do that as well. They have heard all these problems before and have helped work out solutions for many couples.

The kids would have to be out of the house at the grandparents’ home or at a babysitter’s place, if you already have a “bubble” with them.

It is damaging as a child to hear your parents talk about adult problems, as kids wrongly tend to assume the blame. In your case, this is likely happen because, frankly, you seem to be blaming their existence, to a degree, for your marriage problems. Not that you want to get rid of them, really, but that’s how it comes across — so be careful what you say!

 

Dear Miss Lonelyhearts: I’m the wife of a man with serious hoarding issues. He’ll save literally everything, except for stinky, wet garbage, and he has mountains of recyclables in the garage.

We don’t live under stacks of newspapers with a bunch of cats running around like on TV, but we have rooms that are becoming unusable, and every time I confront him, he just gives me a bunch of excuses and becomes annoyed.

At 56, he’s a man with many hobbies. He’s into high-level crafting and likes to build new things out of old things. But now, there’s even stuff piled in our bedroom! That’s the limit, and I told him that as I threw those things out into the hallway.

I’m losing my interest in sex, because I feel like he’s becoming a defensive slob, and that’s unattractive to me. I literally feel pushed out of our bedroom by his crap, and I am worried it will only get worse. Please help! —The Hoarder’s Wife, Charleswood

Dear Hoarder’s Wife: As you know, you can’t just storm through the house and throw his “stuff” out for him. That won’t work. He needs to work through this obsessive-compulsive disorder with a psychologist or psychiatrist to enable him to let go of things.

The message you want to get through at this juncture is “stop now” and the message he is sending back through his actions and defensiveness, is “I can’t.”

Since his hoarding has now gotten into the bedroom, it’s no wonder you aren’t feeling sexual.

He loves his stuff and feels anxiety about letting go of anything. To him, everything has special value now, or he thinks he may really need that very thing later.

Getting mad at him isn’t going to work. He’s panicked about letting go of things. He will also be panicking about the possibility of you leaving him, and hanging onto things even tighter.

Stay informed

The latest updates on the novel coronavirus and COVID-19.

Hoarding is a part of Obsessive Compulsive Disorders (OCD), and there’s help available at the Anxiety Disorders Association of Manitoba.

ADAM is open during the summer, and they offer help and meetings for many anxiety disorders. Most days they are available by phone or drop-in from 10 a.m. to 4 pm. They are a kind and welcoming group.

For more information about hoarding, you can also check out the International OCD Foundation.

 

Please send your questions and comments to lovecoach@hotmail.com or Miss Lonelyhearts c/o the Winnipeg Free Press, 1355 Mountain Ave., Winnipeg, MB, R2X 3B6.

 

Miss Lonelyhearts

Miss Lonelyhearts
Advice Columnist

Each year, the Free Press publishes more than 1,000 letters to Miss Lonelyhearts and her responses to the life and relationship questions that come her way.

Read full biography

Reproductive Psychology Program Focuses on Mother and Family Wellness

Newswise — LOS ANGELES (July 13, 2020) – While many expecting and new mothers experience emotions of joy and happiness, others suffer from a range of mental health conditions like depression, anxiety and obsessive-compulsive disorder. But a new Cedars-Sinai program is dedicated to helping women fight the stigma often associated with maternal-related mental health disorders before, during and after pregnancy.

“More than just postpartum depression, one in five mothers experience Perinatal Mood and Anxiety Disorders, known as PMADs,” said Eynav Accortt, PhD, director of the new Reproductive Psychology Program. “These can encompass a range of mental health disorders including major depressive disorder, generalized anxiety disorder, obsessive- compulsive disorder, panic disorder and post-traumatic stress disorder that occur during pregnancy or up to one year postpartum,” said Accortt. 

To support women experiencing PMADs, the Reproductive Psychology Program focuses on four core principles, including universal screening for maternal depression and anxiety, connection to support services, early psychological intervention and treatment, and hospital community education.

As Accortt explains, the effects of PMADs aren’t only on the mother herself. Symptoms can affect the mother’s relationship with her infant, other children and spouse, and can interfere with her ability to lead a healthy life. 

“Maternal drug-related death and suicide are in the same class as bleeding and high blood pressure as a leading cause of death during pregnancy and first-year postpartum,” said Accortt. “Our program is timely and critically important.”

Through the program’s screening protocol, in effect since 2017, the conversation shifts away from depression to focus instead on family wellness. 

“By changing the conversation, we can fight the stigma of depression and allow new moms to honestly endorse symptoms, get educated and get connected to empirically validated treatments that work,” said Sarah Kilpatrick, MD, PhD, chair of Cedars-Sinai’s Department of Obstetrics and Gynecology.

Kilpatrick says recent research suggests that postpartum maternal depression rates double when the mother already has preexisting depression, making the need for education within the hospital system critically important. The research also underscores the need to intervene when a mother shows a main red flag, which Kilpatrick describes as symptoms that are causing interference in functioning. 

In addition to an existing inpatient social work team providing support while women are in the hospital, the program now offers inpatient virtual support groups and a dedicated outpatient social worker who follows up with every woman who scores above a certain cutoff on the inpatient screening tool. The social worker re-screens the individual and provides support as needed. 

“This type of case management and patient navigation is highly critical at this time of a woman’s life,” said Accortt. 

The Cedars-Sinai Reproductive Psychology Clinic offers individual psychotherapy, as well as group psychotherapy, which includes IVF/fertility, miscarriage, stillbirth and termination support groups, and new moms’ therapy.

“We offer a range of interventions based on the mother’s unique needs, but all programs aim to minimize distressing symptoms and reduce their interference in functioning,” said Accortt. 

Interested women can learn more, including insurance eligibility, and schedule an appointment by calling the Prenatal Diagnostic Center (310) 423-9999 and asking for the Reproductive Psychology Clinic.

Anxiety in the time of the pandemic – News

As a clinical psychologist in Massachusetts, I have seen symptoms related to anxiety disorders worsening due to the pandemic. Worries about jobs, health, and our own and others’ safety and well-being have shot up. It is normal to have some anxiety at a time like this because it helps us behave in a way that keeps us safe. Anxiety is a natural, hard-wired emotion that helps us anticipate something going wrong in the future and to plan for it.

However, too little and too much anxiety can be unproductive and harmful. For instance, too little anxiety about contracting the novel coronavirus may lead you to be lax and not take appropriate measures to protect yourself. Too much anxiety can hamper other areas of your life and create undue stress. It is important to recognize worsening of symptoms or onset of new ones so you can cope or seek help.

Contamination fears of Obsessive-Compulsive Disorder (OCD) are exacerbated right now because it is harder to distinguish between necessary and excessive cleaning behaviors as the world feels more unsafe and unpredictable.

Persons diagnosed with agoraphobia worry about or avoid places where they feel anxious, especially if it may be difficult to leave or to get help. Social isolation can feel like a relief at times like this but may also cause more anxiety because individuals are feeling trapped at home.

The fear of having a serious medical condition, or the preoccupation with physical symptoms is causing much anxiety. This fits right in with normal worries that a pandemic would elicit. And, those with social anxiety are experiencing more unease about maintaining communication with colleagues and friends. It is harder to reach out, to go out of one’s way, to email or call.

There are some common thinking patterns underlying all of these anxiety disorders.

Mental filter is the tendency to focus solely on negative information that confirms our fears while ignoring opposing information leading to a skewed perception of danger. It is important to look for information to the contrary. For instance, a fever may make you believe you have contracted coronavirus and you worry about worse outcomes. However, you may not be paying attention to information that indicates that you don’t have the virus.

Intolerance of uncertainty is the need to have firm answers, such as when things will return to normal or whether we will be able to control the virus. This leads to impatience, restlessness, and need for resolution. However, focusing on things we can control will help, along with becoming more comfortable with the uncertainty.

Other thinking patterns common to anxiety are jumping to conclusions and catastrophizing. We predict that things will go wrong and it will be catastrophic –“I will lose my job and never be able to find another good one again.” It is helpful to ask yourself “can I be 100% sure that this will happen? And, if it does, will it be the end of the world?” (“I will survive even if I don’t get a good job again”).

Black-or-white thinking involves extreme scenarios – everything will either be fine or be doomed (“either I will not contract the virus, or if I do, I will die”). This ignores other possible outcomes like having mild symptoms, or needing hospitalization but not dying. The problem here is that when small things go wrong, we perceive an immediate shift from safety to certain doom. It also leads to the need for perfection – should thinking – which leads to high expectations from oneself and others.

With the pandemic, you may feel stressed trying to follow all rules perfectly and be intolerant of mistakes by yourself and others. Here, it is helpful to say, “I wish I didn’t make this mistake, but it is o.k. that I did”, or “It would be great if I could keep everything sanitized all the time, but I am trying my best and that is enough.” Identifying and changing these thought patterns takes some time and practice, but can lead to more rational thinking and reduced anxiety over time.

So, to maintain your well-being during this crisis, work on your emotional health. The mind and body are intricately linked, so practicing meditation, yoga, deep breathing, muscle relaxation, or regular exercise can help de-stress. Remember the basics of healthy eating, adequate sleep, and maintaining a routine, which will help with regulating emotions and feeling in control.

If you still continue to feel overwhelmed and experience difficulty functioning in some areas of your life, seek help from professionals. Contact your community mental health professionals, ask for a list of providers from your insurance company, or look up resources on findtreatment.gov. A majority of mental health professionals are now offering intakes and continuing services via telehealth visits, so you may have more access and options. The most important step is to acknowledge difficulties and take care of your mental health.

Pooja Saraff is a clinical psychologist at UMass Memorial Medical Center and assistant professor at the University of Massachusetts Medical School.

The reality of OCD during the COVID-19 pandemic

Once in every 20 minutes, like clockwork, Sivakumar Bharati* washes his hands and checks if the window are shut. “I have not ‘relaxed’ in three months aside from my REM sleep,” he says. “There is the prevalent fear of germs and contamination which is why the pandemic has been particularly stressful.”

This is the reality of OCD or obsessive compulsive disorder.

“You don’t really take notice of it until someone else points it out — and a lot of people did,” says 59-year-old retiree Sivakumar . “And back in the 70s, mental health was not taken seriously. People back then just thought I was militant about being neat, some poked fun at it.”

Sivakumar’s home in Hyderabad is evident of his obsessive compulsive disorder: to want everything symmetrical, no clutter, even the presence of muted tones. There are moments of anger and frustration where if things are not lined up, there would be a meltdown, curable only by the correct positioning and considerable time to cool off.

Prof. Dr. Gauthamadas U., Specialist in Neuro Behavioural Medicine, ChennaiProf. Dr. Gauthamadas U., Specialist in Neuro Behavioural Medicine, Chennai

Chennai-based Professor Dr Gauthamadas Udipi, specialist in neuro-behavioural medicine, who has worked with people with OCD for almost many years explains, “OCD may only be the behavioural marker of a more extensive systemic disorder. “After all, the mind is only an expression of the functioning of the brain, and the brain is only a part of the body. At one end of the OC spectrum is ‘normal’ obsessive thinking and ordered behaviour in daily life, which does not interfere significantly with daily functioning. At the other end is severe obsessive rumination and compulsive behaviour that does not allow daily function.”

Essentially, the underlying pathology is in the Salience Network (SalNet) or ‘worry-loop’ of the brain, which sees a person having uncontrollable, reoccurring thoughts and/or behaviours that they feel the urge to repeat over and over; it can be especially harrowing now, owing to the COVID-19 pandemic which invites uncertainty, rising tensions and innumerable risk factors. Often caused by severe psychological stresses, OCD manifests in different forms, from ritualistic obsessions to suicidal compulsions. Sivakumar is on the lower end of this spectrum, and it took a long time for him to realise what he had.

‘I’m OCD about that’

Sivakumar, during the late 2010s, was finally formally diagnosed by a neurologist in South Africa, who stated that OCD is a legitimate condition — and not one about which to be ashamed. “I remember him mentioning how popular culture had not even normalised but trivialised OCD. The parameters of what was ‘deemed’ OCD had shifted in a big way; people thought being tidy was OCD,” recalls Sivakumar.

And things have not been easy as the pandemic trudges on.

Dr Udipi affirms that the pandemic can be a heightener, explaining, it could “result in triggering underlying OC spectrum disorders in a genetically prone person, tilt the balance from ‘normal’ obsessions to a pathological OC pattern, or worsen an already existing OC disorder.”

The International OCD Foundation, Boston, sees the unique challenges for the OCD-afflicted and has offered numerous online resources, which are free-to-use and which help people run through their OCD anxiety with some ease while maintaining physical distancing. These options include WHO-approved tips on how to deal with contamination fears, video teletherapy, which helps those with OCD find a licensed teletherapy provider while retaining physical distancing, and printable coping cards. These cards, not a replacement for help from a medical professional, are written reminders and questions for the self to be mindful, breathe easy, take back control and understand that progress is better than perfection.

Dr Udipi adds that empathy from close friends and family is helpful. “[They] must understand that this is a disorder originating in brain circuits over which the person has little control, and advising the person that ‘it is all in the mind’, and ‘learn to control it’ is of no use, and that yoga, meditation, and other ‘self-therapies’ will not work in the case of a ‘pure obsessive thinking’ (which occurs in a very small percentage of people with SalNet disorder), as the person cannot bring the mind to focus on them due to pure circuit overdrive.” He emphasises that early identification and proper treatment by a qualified psychiatrist and team is the key.

Sivakumar agrees, concluding, “There are times you may not feel worthy because you feel like you are adding stress to home life or work life. But when you start humanising yourself with the help of a mindful and informed healthcare professional, it helps tremendously. It also helped that my family and I could find common ground with patience. But for other OCD folks out there, you have to want to accept it as a condition and not as an extension of the self. It’s emotionally taxing to go through it because your mind is telling you that this obsessive order of things is paramount.”

* Name changed to protect identity

Going back to basics can help OCD sufferers when it comes to COVID-19

The worldwide COVID-19 pandemic is having an impact on some people with obsessive-compulsive disorder. Some of it is negative, but some of it is positive, experts say.

Del Camp, chief clinical officer with Ozark Center in Joplin, said anecdotal information is showing while some OCD sufferers, blindsided by the sudden eruption of the pandemic back in March, are dealing with heightened anxiety and repetitive behaviors — such as hand-washing and checking the news for the latest pandemic news — others have been able to take the sudden uncertainty in stride. Mostly because the people around them are adopting the behaviors they’d incorporated in their lives for years.

“Part of the issues with having OCD,” Camp said, “is that you feel different. You feel like your behavior is noticeably different from others, and that drives its own anxiety level.”

The growth of COVID-19 over the last three months into nearly every aspect of a person’s life has in some ways evened the playing field for some OCD sufferers.

“For some, it’s been a relief because everyone is now doing some of what they’d been doing all along,” Camp said. “Everybody is now worried about whether somebody is sick or not; everybody is worried about touching doorknobs; everybody is worried about touching the pen at the restaurant to sign their name.”

This connection with the public has made their repetitive behavior less noticeable or feeling less awkward than before.

“The more (they) feel connected to others, and the safer (they) feel in relationships, the better (they) are likely to feel,” Camp said. “For some people, whose symptoms were largely manageable, they can talk to someone or have their medications adjusted … and (they’ll) be right back on track.

“I’ve heard people say they feel better about their symptoms,” he said, “but that doesn’t necessarily mean their symptoms are better.”

For other, however, the chaotic and uncertain nature of the pandemic — centered on hypervigilance, deadly germs and contamination — has been enough to throw them significantly off track.

“The things that they used to do in order to effectively manage their condition,” Camp said, “are no longer effective.”

For example, the real possibility of illness may cause people with OCD to take extreme measures to keep themselves and their families safe, such as repetitive hand-washing, cleaning or being afraid to leave the home out of fear of harming others through contamination. Their fears may also lead to hoarding items, such as medications, alcohol-based hand sanitizers and toilet paper.

“One of the problems is with a pandemic, your world shrinks dramatically. You don’t get to go out and do things you normally would, or options are now curtailed or modified to a level where you’re constantly reminded that there is a risk (out there).”

To help overcome heightened OCD fears, Camp said, sufferers should go back to the basics by “stepping outside yourself” to see if responses to the pandemic and its risk are reasonable.

“If I’m willing to starve myself rather than going out and getting food, then the chances are that that’s an overreaction to what’s happening,” Camp said. “Remember, that’s the OCD talking, not COVID talking. There are plenty of social distancing and (masking) and things like that that you can do, and still be OK in those circumstances.

“It’s about understanding that even at its worst, you will survive (the anxiety),” Camp said. And by not engaging in compulsive behaviors, the more the anxiety levels will subside.

“If you fear something,” he continued, “and you run away from it, it gets bigger every step you take. So, if you just simply turn around and deal with it, then there’s a part of your mind that says, ‘It can’t be that scary because I’m facing it.'”

Expecting spike

Based on the numbers Del Camp has seen, there has been a rise in numbers of those suffering from depression, substance abuse and anxiety, in which obsessive-compulsive disorder is an anxiety disorder.

“If you think about it, we haven’t really been at this long enough to see a big spike on the mental health side,” Camp said. “That will be the real second wave, which is mental health issues, that are coming up. But I suspect we will see a significant spike in anxiety in the coming months, and for OCD I would not be surprised to see at least a moderately level surge, because it really has thrown off a lot of individuals who had coping mechanisms in place.”

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Ask The Doctors | Advice

When it comes to helping someone with a hoarding disorder, persuasion, logic or arguments don’t work. Neither does force. Instead, experts recommend beginning by clearly stating your concerns for the person’s health and safety. Most hoarders know that something is wrong, and that their living situations are both peculiar and dangerous. Then, provide avenues of assistance. Some people find help with cognitive behavioral therapy, in which the individual is guided to identify and understand their thinking patterns, and then focus on gradual change. Individual therapy with a specialist in hoarding disorders can be helpful, as can group therapy, which allows the person to see they are not alone. You can find more information and resources at the Anxiety and Depression Association of America’s website, at adaa.org.

New study provides evidence for “healthy immigrant effect” suggesting immigrants are less likely to ha …

A Canadian study found that immigrants had 30% lower odds of being diagnosed with an anxiety disorder than Canadian-born adults. The study was published in the International Journal of Environmental Research and Public Health.

Anxiety disorders are among the most commonly diagnosed disabilities around the globe. Previous research suggests that the risk for anxiety disorders varies according to demographic, socio-economic, and health-related factors. Interestingly, despite the fact that immigrants face certain hardships and unique disadvantages compared to nonimmigrants, new research has found that immigrants show lower rates of anxiety.

“Our research team is interested in analyzing Canadian Longitudinal Study on Aging data to examine factors which affect mental health,” said Karen Davison, North American Primary Care Research Group Fellow and Health Science Program Chair at Kwantlen Polytechnic University in Surrey, who led the study.

“Given that anxiety disorders have such a high global burden related to disability, we were particularly interested in examining various social, economic, health, and nutrition-related factors and their relationships with the condition. This information could help to improve health practices, programs, and policies for adults.”

Davison and her team conducted a study to explore the relationship between immigrant status and anxiety disorders with a focus on older adults. They further explored nutritional and health-related factors that might mitigate the risk for anxiety disorders among all Canadians.

The researchers analyzed baseline data from the ongoing Canadian Longitudinal Study on Aging, resulting in a sample of 26,991 Canadian residents between the ages of 45-85. The survey measured self-reported lifetime anxiety disorder with the question, “Has a doctor ever told you that you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?” The study also included various demographic, economic, health, and nutritional measures.

Across the sample, 8.5% of respondents reported being diagnosed with an anxiety disorder at some point in their lifetime. Interestingly, while 9% of Canadian-born respondents reported an anxiety diagnosis, only 6% of immigrants did. When accounting for age and sex, this represented 30% lower odds of being diagnosed with anxiety for immigrants.

The authors offered several explanations for what researchers call the “healthy immigrant effect.” Canada uses a points-based immigration system, which classifies a person’s eligibility to immigrate to Canada according to their skills and qualifications. Those accepted to immigrate generally have a higher education and better work experience, qualities that may lessen their susceptibility to anxiety disorders.

“Another potential explanation … is that potential immigrants with anxiety disorders would find the challenges of relocation too anxiety inducing and would therefore not choose to immigrate,” the authors wrote.

Certain health factors impacted the likelihood of an anxiety disorder diagnosis. Having at least one existing health condition, experiencing chronic pain, being categorized as underweight, having a higher percentage of body fat, or smoking 100 or more cigarettes over one’s lifetime were each associated with increased odds of being diagnosed with anxiety.

Nutritional factors also impacted reports of anxiety. Across the sample, those who consumed two or more fiber sources a day or one or more pastries a day were more likely to be diagnosed with an anxiety disorder. Alternatively, those who consumed 0.5 to 2 sources of pulses and nuts per day or three or more sources of fruit and vegetables per day were less likely to have anxiety. This may be because fruits, vegetables, and nuts contain high levels of zinc, magnesium, and vitamin B, which have been associated with reduced anxiety.

“We believe the main message of this study is that after accounting for many social, economic, health, and nutrition-related factors, a significant relationship was found between fruit and vegetable intakes and having been diagnosed with an anxiety disorder. It is well established that fruit and vegetable intakes are associated with physical health. This study lends to the increasing evidence that shows there are also links with mental health,” Davison told PsyPost.

“In this study we found that lower intakes of calcium rich foods with high vitamin D content are associated with lower odds of anxiety disorders. However, as the number of sources consumed increased, the trends in the odds ratios showed what seemed to be a positive or dose-response type relationship. For future studies we would like to examine supplement sources of calcium and vitamin D which are commonly taken by older adults and their relationship with anxiety disorders. In addition, for future work we plan to examine biomarkers and genomic markers related to calcium and vitamin D which may help us to better understand these relationships.”

“Another finding we would like to highlight is the associations we found with higher percent body fat and anxiety. This relationship may be due to mechanisms related to immune-inflammatory activation. Previous research has shown that individuals with high body fat and mental ill health have increased inflammatory markers, such as C-reactive protein, interleukin-6, and tumour necrosis factor-alpha. The activation of certain immune system cells in response to ongoing chronic inflammation, has been linked with poor mental health. Certainly more research is needed to better understand the possible links between body composition and anxiety,” Davison added.

The authors concluded that their findings offer insight into nutritional, health-rated, and social factors associated with anxiety disorder diagnoses among immigrants and Canadian-born residents of Canada. These insights could help inform treatment for middle age and older adults with anxiety.

The study, “Nutritional Factors, Physical Health and Immigrant Status Are Associated with Anxiety Disorders among Middle-Aged and Older Adults: Findings from Baseline Data of The Canadian Longitudinal Study on Aging (CLSA)”, was authored by Karen M. Davison, Shen (Lamson) Lin, Hongmei Tong, Karen M. Kobayashi, Jose G. Mora-Almanza, and Esme Fuller-Thomson.

Having Disturbing Thoughts as a New Parent? Here’s How to Cope

While intrusive thoughts can be terrifying, the problem lies in how we interpret them, Dr. Abramowitz said. Labeling such notions as “negative” causes the brain to give them more weight, which is why parents who judge their invasive thoughts often struggle to let them go.

Dr. Abramowitz and his colleague, Nichole Fairbrother, Ph.D., a psychologist and researcher at the University of British Columbia, said intrusive thoughts pop up in new parenthood for a reason. In their research, the psychologists found that the immense responsibility parents feel for keeping their newborns alive can bring on disturbing thoughts about harm striking their babies, especially during the first six months of their children’s lives.

Dr. Fairbrother said: “I remember gazing at my baby’s delicate hands and thinking, ‘I could just cut those right off with the garden clippers,’ but because I’m an anxiety researcher, I wasn’t upset by it.”

Even though intrusive thoughts might seem puzzling, Dr. Fairbrother said, they’re often adaptive. “If a mother worries about the stroller rolling into traffic, she’s going to grip the handle more tightly,” she explained.

For parents bothered by their intrusive thoughts, certain exercises and steps can reduce the anxiety they create. A few suggestions:

One way to disarm intrusive thoughts is to recognize that they don’t define who you are. Repeating the bothersome thought in a singsong voice or saying it aloud, over and over again can help, said Stefan Hofmann, Ph.D., a clinical psychologist and anxiety researcher at Boston University. This behavioral technique, known as distancing, can unhook thoughts from emotions, helping the mind to change direction. No longer seeing the thoughts as a threat, parents begin to realize that “thoughts are nothing more than just thoughts,” Dr. Hofmann explained.

“A mother may think about pushing the stroller down the stairs, but that doesn’t mean she’ll act on it,” he said.

Trying to ignore intrusive thoughts and upsetting feelings only makes them louder. Carla Naumburg, Ph.D., a clinical social worker and parent coach, said acknowledge intrusive thoughts by practicing a mindfulness exercise called noticing, which is paying attention, without judgment to our thoughts and feelings as they arise.

When COVID-19 health measures and obsessive-compulsive disorder collide during pandemic

While we all need to continue practising public-health recommendations as the COVID-19 pandemic continues, those very actions—hand washing, avoiding touching things in public, sanitizing and cleaning surfaces—may appear similar to those performed by people with obsessive-compulsive disorder (OCD).

There are, however, significant differences between the two activities.

In a phone interview, psychologist Maureen Whittal, who cofounded Vancouver-based Anxiety Canada in 1999 and is an expert in cognitive behavioural therapy, explained the difference between someone being vigilant and someone with OCD.

According to Anxiety Canada, people with OCD may experience obsessive thoughts about self-doubt or harming others that create anxiety or distress, or they may have compulsions to engage in deliberate actions—including repeated checking of things like switches and plugs, arranging objects in specific orders, or unnecessary hoarding—to prevent something terrible from happening.

Where hygienic behaviour crosses the line depends on the reason or intent behind the behaviour, Whittal explained, particularly when people rely heavily upon “internal cues of anxiety to guide behaviour” instead of because of being advised to do so. In other words, people with OCD tend to base their actions upon emotion or what feels right instead of facts and objective logic.

For instance, Whittal said, they may be saying to themselves: “if I feel anxious, something must be dangerous, so I’ve got to do something to keep myself safe.” They may even repeat the hand washing, say, if they didn’t feel it was thorough enough.

So the actions of people with OCD are attempts to prevent a feared consequence. But underlying the fear, Whittal explained, is a specific negative belief about themselves, such as “I’m not good enough” or “I’m an awful person” if they make a mistake. If the “bad thing” doesn’t happen, she said, they may feel that their actions were successful and their behaviour may become reinforced.

Interestingly, Whittal said, most of those with OCD are aware that what they’re doing doesn’t make sense, but they will often have an ongoing feeling of doubt and “a mixing up of knowing and certainty”. A person with OCD who is asked, for example, if they locked their door after leaving home would have to be 100-percent certain to answer “yes”.

OCD occurs in about one to two percent of the population, and Whittal said she has seen heightened severity of the disorder during the pandemic due to increased stress.

She said she began speaking about COVID-19 to people with OCD in February, and many of them became more anxious in March due to future uncertainty. The lockdown, she said, was actually easier for them because the rules were clear, but when restrictions were loosened and public-health officials began saying “use your judgment”, Whittal said, “that’s a tough place for someone with OCD”.

Whittal tells people with OCD that public-health messages aren’t meant for people who are already responsible like themselves but are “meant for people who need that reminder”.

“It’s not uncommon for folks with OCD to have incredible amounts of responsibility and feeling like, ‘It’s my job to protect other people,’ and, of course, that’s what public health has been telling us,” she said.

She also advises people with OCD to reduce searches for COVID-19 information and to limit such data to those from primary or reputable sources—such as the B.C. Centre for Disease Control or Health Canada—while avoiding blogs or unestablished sources. Those seeking more information about OCD can visit the Anxiety Canada website, which has a specific section on anxiety during the pandemic.

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