Obsessive-Compulsive Disorder (OCD) – Everything You Need To Know

Obsessive-Compulsive Disorder commonly known as OCD is an anxiety disorder leading to obsession about something which then leads to repetitive behaviour driven out of compulsion. An individual may get obsessive or paranoid about washing hands or checking on things and more. At a heightened state the condition starts to affect day to day activities of a person thus deteriorating the quality of life. For an individua, suffering from OCD the unwanted thoughts are persistent and distressing. Many a times this also leads to OCD Depression. Although even after being aware that the obsession is unwanted and unwarranted the individual faces a hard time stopping the compulsive thoughts and actions.

About OCD Symptoms
Obsessive-compulsive disorder may involve both obsessive thought and compulsive behaviour or any one of the two. The intensity of the disorder may vary from mild to moderate to severe. The disorder may develop in teenagers and young people and then grow in severity over the years. In case of mild and even moderate intensity cases many a time even the patient is not aware or is not able to establish that he is suffering from a medical condition. The most common obsessions which are observed in OCD affected individuals are related to cleanliness, counting, checking, orderliness, security, repeated thoughts that are religious or sexual in nature and more. This in turn leads to stress, fear and obsessive behaviour such as repeated hand-washing, repeated checking of locks and switches and more.

OCD Causes
Exact cause of what causes OCD is still not completely clear but researcher believe that genetics plays a major role. 30% of all patients of OCD have a history of the disorder in the family. Other than being hereditary researchers have concluded that imbalances of chemicals in the brain especially that of serotonin causes OCD. One study has also concluded that an infection known as streptococcal infection is the culprit in many cases. Some medical professionals believe that depression can also trigger OCD whereas others believe that depression is one of the symptoms of OCD. Obsessive-compulsive disorder can also get triggered because of irregularity in brain circuits and as an effect of some past trauma.

OCD Diagnosis and Prevention
It’s rather difficult to diagnose OCD as many symptoms of the disorder can be similar to other mental disorders such as depression and schizophrenia. There are a few ways using which a medical practitioner can diagnose OCD. Mostly first the medical practitioner will eliminate the possibility of any other similar problem by using physical exams and lab tests such as blood test, test for thyroid functions and more. After which he will diagnose the disorder through a psychological evaluation. When it comes to prevention, there is no specific preventive measure that one can take to avoid OCD. But maintaining overall good physical and mental health helps. Also seeking timely treatment can help tackle the ailment effectively.

OCD Treatment and Tips
It is widely believed that OCD can’t be cured permanently but can only be managed effectively. Most patients seek medical help only after the condition reaches the severity level and becomes disabling for individuals. The two most primary methods for treating or controlling OCD are through psychotherapy and medications. Psychotherapy in form of Cognitive behavioural therapy (CBT) is used in which the patient is trained to handle, manage, react oppositely to the compulsion and gradually control the disorder. Other times medications including antidepressants are prescribed to control the disorder.

A dangerous obsession: the troubles of stereotyping OCD | Opinion …

“How can you not line your shoes up at night without your toes feeling cramped?” my grandfather asked one morning when I was a child.

At the time, my grandfather’s question and the other odd habits of his I noticed seemed strange, but I told myself it was just his way.

I never really noticed the habit of pulling my hair out when I was stressed. It didn’t seem strange. I had to go back three times to make sure my curling iron was unplugged before I could leave the house.

I never associated these traits or my grandfather’s habit with Obsessive Compulsive Disorder, because neither one of us were “clean freaks” or the other stereotypes people use to label the disorder.

It all seemed just a part of my nervous personality until I talked to someone who finally put some reasoning behind it. I have OCD tendencies in relation to my anxiety disorder.

OCD isn’t an adjective, it’s a noun. You wouldn’t joke about being “so cancer” because your hair falls out when you brush it. How we use words can affect how we think about things, especially something so personal and intangible as mental health.

The idea of OCD isn’t unfamiliar to most people, but the true face of it is. According to a Psychology Today article, “4 Myths About OCD,” there’s lingering stereotypes about what OCD actually looks like, including the common stereotype that those who suffer from the disorder are insistent about clean conditions.

The entertainment industry perpetuates this stereotype. Emma Pillsbury, the guidance counselor character on Fox’s “Glee,” is depicted as quirky, cute and, unfortunately, her OCD is seen as a characteristic of this at times. While she comes off as just an adorable “clean freak,” it isn’t shown until later in the series how debilitating her disorder can be.

The true consequences of what writers rely on to label a character-type showed through in a 2009 ABC interview with game show host Howie Mandel. Mandel went into detail about his OCD and germaphobia, which at the time was an object of curiosity surrounding his public figure. Far from just a “clean freak,” Mandel said his disorder affects his family life, his job and even his head, which he shaves in order to prevent what he perceives as the uncleanliness of hair.

Mandel isn’t afraid of germs because they’re gross, or he’s afraid of getting sick and being inconvenienced. Mandel is germaphobic because he thinks if he gets sick, he will die. Those who suffer from OCD display habits in hopes of stopping their repetitive thoughts, not because they just want to be clean.

My grandfather didn’t have to line his shoes up because he had to be organized. He had to because otherwise his toes would feel cramped once he put them on. There’s no order to this thinking.

I once dropped a noodle underneath the burner plate on my stove. My thoughts immediately jumped to the house burning down, and my roommate had to take the noodle out for me because I started having a panic attack.

The next time you want to joke about being OCD while you clean your room or straighten something, ask yourself: am I just annoyed by this, or is there a thought in my head that keeps telling me I have to do this?

OCD comes in many different forms, and not everyone is the same. If you really feel like your repetitive thoughts and urges might be something more, then talk to a professional.

Realize OCD is a real mental illness, not just a punchline or a stereotype, and maybe there will be one less person who goes undiagnosed longer than they should, like I did.

Digital editor Julie Hubbell can be reached at julie.hubbell191@topper.wku.edu.

Presentation on Treating Obsessive Compulsive Disorder

On Monday, Nov. 13, the Sussex chapter of the National Alliance on Mental Health (NAMI)  will welcome Dr. Charity Wilkinson Truong to discuss “Treating Obsessive Compulsive Disorder.”  The presentation will be held at Bridgeway, 93 Stickles Pond Rd. in Newton from 7:00-8:30 p.m. 

Charity Wilkinson Truong, Psy.D., is a licensed psychologist with training and experience in empirically supported treatments for OCD, PTSD, and anxiety disorders, including Exposure and Response Prevention for Obsessive Compulsive Disorder.  Dr. Wilkinson Truong has worked with children, adolescents and adults with OCD in a variety of settings. She is a staff psychologist and training director at Stress and Anxiety Services of New Jersey, which has offices in East Brunswick and Florham Park (website: www.StressAndAnxiety.com).

Anyone interested is welcome to attend this program free of charge, but pre-registration is requested via Eventbrite at https://namisussex1113.eventbrite.com or by emailing nami.sussex@gmail.com.

Presentation on Treating Obsessive Compulsive Disorder – Sparta …

On Monday, Nov. 13, the Sussex chapter of the National Alliance on Mental Health (NAMI)  will welcome Dr. Charity Wilkinson Truong to discuss “Treating Obsessive Compulsive Disorder.”  The presentation will be held at Bridgeway, 93 Stickles Pond Rd. in Newton from 7:00-8:30 p.m. 

Charity Wilkinson Truong, Psy.D., is a licensed psychologist with training and experience in empirically supported treatments for OCD, PTSD, and anxiety disorders, including Exposure and Response Prevention for Obsessive Compulsive Disorder.  Dr. Wilkinson Truong has worked with children, adolescents and adults with OCD in a variety of settings. She is a staff psychologist and training director at Stress and Anxiety Services of New Jersey, which has offices in East Brunswick and Florham Park (website: www.StressAndAnxiety.com).

Anyone interested is welcome to attend this program free of charge, but pre-registration is requested via Eventbrite at https://namisussex1113.eventbrite.com or by emailing nami.sussex@gmail.com.

If You’re a Vegetarian, You Could Be at Risk for These Mental Health Conditions

Salad

SaladFoxys Forest Manufacture/ShutterstockThere are myriad health benefits that come with making the decision to switch to a vegetarian diet, but there can be some complications too.

Health experts already warn that a vegetarian diet can lead to possible nutrient deficiencies, but a new study adds another concern—the potential impact of a no-meat diet on your mental health. Based on continuing research, experts are warning that a vegetarian diet may be associated with panic attacks, depression, and obsessive-compulsive disorder, Women’s Health reports.

Research into the possible mental health risks associated with vegetarianism began last year, when an Australian study discovered that participating vegetarians demonstrated a less optimistic view of the world around them as opposed to meat-eaters. According to Women’s Health, the study also reports that vegetarians are 18 percent more likely to experience depression, and 28 percent more likely to contend with panic attacks and anxiety. The findings from a previous German study show that vegetarians are 15 percent more likely to experience depressive conditions and twice as likely to experience anxiety disorders. (Here are more everyday habits that could up your risk for depression.)

Health experts have yet to pinpoint the exact science behind the link. “We don’t know if a vegetarian diet causes depression and anxiety, or if people who are predisposed to those mental conditions gravitate toward vegetarianism,” Boston psychiatrist Emily Deans, MD, told Women’s Health.

Experts believe it’s likely that people with mental illness are more likely to keep a closer eye on their plate, and in turn this causes the heightening of their symptoms. Regardless of the limited understanding of mental illness and vegetarianism, doctors agree that what you eat will impact your mental health, for better or for worse. No matter what you eat, you should know how to recognize these warning signs of an emotional breakdown.

Dr. Deans warns that many of the nutrients our brain needs are often found in meat and animal proteins. When our brain is lacking in these vitamins, the levels of glutamate in our bodies is lower, which causes an increase in feelings of depression, anxiety, and obsessive-compulsive disorder. When our brains don’t have enough zinc or iron, both of which we find in meat, then it’s expected that one can experience mood swings. Dr. Deans recalls that in the past she’s treated patients who believe they’ve had a panic attack but are really just experiencing iron deficiency. (These are the signs of a panic attack.)

These feelings can compound themselves even worse in vegetarians who are unsure what to eat and instead reach for white bread, rice, pasta, and cereal. Experts call this the “carb-itarian diet” and warn that the “resulting seesaw of blood sugar and hormone levels may lead to even more irritability, depression, and anxiety.” Check out the iron-rich foods all vegetarians should eat.

Some vegetarians will never experience adverse mental health affects as result of going meatless, but doctors still say it’s a good idea to seek out a professional medical opinion when making a drastic change to your diet. You should also consider keeping track of your food and moods as you begin a new diet, which will enable you to monitor how you’re feeling based on what you’re eating.

If you’re thinking of going meatless, here are some vegetarian dishes that will help you get the nutrients you need.

There’s new evidence of how our DNA shapes depression and other disorders like it


sad woman depressed lonely girlShutterstock

  • Scientists are uncovering promising links between
    specific parts of our DNA and a range of disorders such as
    anxiety, depression, and obsessive-compulsive
    disorder.
  • As with any disease, having certain genes or
    mutations in those genes doesn’t mean you’ll go on to develop
    the disorders, but it may play a key role.
  • The research also helps highlight the biological
    underpinnings of mental illness, something that could help with
    the development of better treatments.

 

When you fall and break a bone, an X-ray shows the crack. There’s
no equivalent diagnostic for disorders of the brain — a shortfall
that’s made it difficult for millions of people with conditions
ranging from anxiety to obsessive-compulsive disorder to get
treatment.

A spate of new research may change that. In a handful of recent
studies, scientists have identified what they believe to be some
of the most reliable genetic hallmarks of mental illness, a
discovery that would transform our current approach to treating
the disorders. If we can better understand the genes
that influence psychiatric diseases, we can design
treatments that accurately target the part of the brain that
they appear to effect.

“Beyond giving us so much data to explore, being able to show
that depression is a brain disease, that there is biology
associated with it, I think that’s really critical,” Roy
Perlis
, the director of the Center for Experimental Drugs and
Diagnostics at Massachusetts General Hospital,
told Business Insider
in 2016. “These are brain diseases,
like any other. They’re not someone’s fault.”


LifeProfile DNA Kit 2
Cheek swabs are a popular
way of obtaining DNA.

Hollis
Johnson/Business Insider


The latest research suggests that our DNA may play an
outsize role in psychiatric disease. As far as diseases go,
mental illnesses are among those that are the most likely to be
passed down from parent to child, a finding only
recently illuminated
by decades of research. 

“Genetics plays a very big role in your risk of getting these
diseases,” Elinor
Karlsson
, a geneticist at the Broad Institute of MIT and
Harvard University, told Business Insider. 

Still, looking at someone’s genome alone will probably
never be enough to determine if they’ll go on to
develop a psychiatric disease — other factors, including
environmental factors like severe stress, play a strong
role too. But scientists are discovering more and more clues that
suggest that the key to discovering new treatments for mental
illnesses will center on a deeper dive into our DNA.

“We need to go after this genetic component,” Karlsson said.

In the summer of 2016, Perlis used data from 23andMe to

pinpoint 17 genetic variants linked with major depressive
disorder
. But Perlis and 23andMe aren’t the only ones making
progress in this arena. Earlier this month, researchers at the
University of Massachusetts and the Broad Institute identified
four genes linked to obsessive-compulsive disorder (OCD), a
chronic condition characterized by uncontrollable
repetitive thoughts and behaviors. 

‘People who have OCD are more likely to have these changes in
these genes’

Hyun Ji Noh, a geneticist at the Broad Institute, has read lots
of studies showing a link between OCD and genetics. Despite all
this promising research, none of the existing papers came to any
definitive conclusions about which genes seemed to be tied to the
disorder.

So for her latest study, published earlier this month in the
journal Nature Communications, she decided to try a different
tack.

Instead of just focusing on human DNA, which in the other
studies had yielded limited results, she looked at
multiple sets of genes — and not just from humans. 

“There are a lot of naturally occurring dog diseases — especially
psychiatric diseases — that are very similar to human diseases,”
Hyun Ji Noh, a geneticist at
the Broad Institute and the lead author on the study, told
Business Insider. “So to me it was sort of natural to put
dog studies in the context of human disease.”


alone sad depressed sea
Flickr/Jane
Rahman


Noh’s paper looked at hundreds of genes that had been
implicated in psychiatric disease in dogs, mice, and people.

In humans, the researchers found 608 genes. To find out
which of these 608 genes was actually tied to OCD, Noh
compared what they looked like in hundreds of
people with and without the disorder. By the end of the analysis,
just four genes emerged that showed up repeatedly in mutated form
in people with OCD. 

In these four genes, “a lot of mutations kept showing
up for OCD patients but not in the healthy individuals,” Noh
said.

In other words, these four genes likely play a key role in
the biology of the disorder. Still, having a mutation in one of
these four genes doesn’t necessarily mean you’ll go on to develop
OCD.

“We know people who have OCD are more likely
to have these changes in these genes. But this is one
of potentially 100 things that will determine if you have OCD,”
said Karlsson, who also worked on the paper. “It’s complicated,”
she said.

Chasing ‘depression genes’

Like OCD, researchers say depression is influenced heavily by our
DNA. But unlike OCD, it’s fairly common, occurring in
an estimated 16.1 million Americans
. Current treatments
for depression haven’t changed much since the 1950s, and they
don’t work for everyone.

So, in an effort to find out more about what exactly causes the
illness, researchers published a paper in the summer of
2016 in the journal Nature Genetics in which they
pinpointed 17 genetic variations, or tweaks in particular genes,
that appear to be tied to major depressive disorder, the most
debilitating form of the disease that’s currently
the leading
cause of disability worldwide
.

The researchers got their data from personal genomics
company 23andMe. 

Using data from more than 75,600 people who told the company
that they’d been clinically diagnosed with depression and more
than 231,700 people who reported no history of depression, Perlis
and his team were able to identify 17 areas on DNA that appear to
be linked with depression. They also found some ties between
these areas and those which have been previously identified
as possibly playing a role in other psychiatric disorders,
such as schizophrenia.

Scientists have been looking for such genetic
hallmarks of depression for years
. And while some, like
a 2013
study in the journal The Lancet
and a
2015 paper in the journal Nature
, have
yielded promising clues, none have been able to spot any
precise, reliable genetic markers of the disease.

At least
not until now
.

“My group has been chasing depression genes for more than a
decade without success, so as you can imagine, we were really
thrilled with the outcome,” Perlis said.

The hope is that identifying these watermarks in our DNA — tiny
areas on genes where high amounts of variation tend to occur
among individuals — will help us better understand how
genetics and behavior interact to influence disorders like
depression.

Still, Perlis said, “this is really just the beginning. Now
the hard work is understanding what these findings tell us about
how we might better treat [these disorders].”

Genetics of mental illnesses like depression, OCD: New research …


sad woman depressed lonely girlShutterstock

  • Scientists are uncovering promising links between
    specific parts of our DNA and a range of disorders such as
    anxiety, depression, and obsessive-compulsive
    disorder.
  • As with any disease, having certain genes or
    mutations in those genes doesn’t mean you’ll go on to develop
    the disorders, but it may play a key role.
  • The research also helps highlight the biological
    underpinnings of mental illness, something that could help with
    the development of better treatments.

 

When you fall and break a bone, an X-ray shows the crack. There’s
no equivalent diagnostic for disorders of the brain — a shortfall
that’s made it difficult for millions of people with conditions
ranging from anxiety to obsessive-compulsive disorder to get
treatment.

A spate of new research may change that. In a handful of recent
studies, scientists have identified what they believe to be some
of the most reliable genetic hallmarks of mental illness, a
discovery that would transform our current approach to treating
the disorders. If we can better understand the genes
that influence psychiatric diseases, we can design
treatments that accurately target the part of the brain that
they appear to effect.

“Beyond giving us so much data to explore, being able to show
that depression is a brain disease, that there is biology
associated with it, I think that’s really critical,” Roy
Perlis
, the director of the Center for Experimental Drugs and
Diagnostics at Massachusetts General Hospital,
told Business Insider
in 2016. “These are brain diseases,
like any other. They’re not someone’s fault.”


LifeProfile DNA Kit 2
Cheek swabs are a popular
way of obtaining DNA.

Hollis
Johnson/Business Insider


The latest research suggests that our DNA may play an
outsize role in psychiatric disease. As far as diseases go,
mental illnesses are among those that are the most likely to be
passed down from parent to child, a finding only
recently illuminated
by decades of research. 

“Genetics plays a very big role in your risk of getting these
diseases,” Elinor
Karlsson
, a geneticist at the Broad Institute of MIT and
Harvard University, told Business Insider. 

Still, looking at someone’s genome alone will probably
never be enough to determine if they’ll go on to
develop a psychiatric disease — other factors, including
environmental factors like severe stress, play a strong
role too. But scientists are discovering more and more clues that
suggest that the key to discovering new treatments for mental
illnesses will center on a deeper dive into our DNA.

“We need to go after this genetic component,” Karlsson said.

In the summer of 2016, Perlis used data from 23andMe to

pinpoint 17 genetic variants linked with major depressive
disorder
. But Perlis and 23andMe aren’t the only ones making
progress in this arena. Earlier this month, researchers at the
University of Massachusetts and the Broad Institute identified
four genes linked to obsessive-compulsive disorder (OCD), a
chronic condition characterized by uncontrollable
repetitive thoughts and behaviors. 

‘People who have OCD are more likely to have these changes in
these genes’

Hyun Ji Noh, a geneticist at the Broad Institute, has read lots
of studies showing a link between OCD and genetics. Despite all
this promising research, none of the existing papers came to any
definitive conclusions about which genes seemed to be tied to the
disorder.

So for her latest study, published earlier this month in the
journal Nature Communications, she decided to try a different
tack.

Instead of just focusing on human DNA, which in the other
studies had yielded limited results, she looked at
multiple sets of genes — and not just from humans. 

“There are a lot of naturally occurring dog diseases — especially
psychiatric diseases — that are very similar to human diseases,”
Hyun Ji Noh, a geneticist at
the Broad Institute and the lead author on the study, told
Business Insider. “So to me it was sort of natural to put
dog studies in the context of human disease.”


alone sad depressed sea
Flickr/Jane
Rahman


Noh’s paper looked at hundreds of genes that had been
implicated in psychiatric disease in dogs, mice, and people.

In humans, the researchers found 608 genes. To find out
which of these 608 genes was actually tied to OCD, Noh
compared what they looked like in hundreds of
people with and without the disorder. By the end of the analysis,
just four genes emerged that showed up repeatedly in mutated form
in people with OCD. 

In these four genes, “a lot of mutations kept showing
up for OCD patients but not in the healthy individuals,” Noh
said.

In other words, these four genes likely play a key role in
the biology of the disorder. Still, having a mutation in one of
these four genes doesn’t necessarily mean you’ll go on to develop
OCD.

“We know people who have OCD are more likely
to have these changes in these genes. But this is one
of potentially 100 things that will determine if you have OCD,”
said Karlsson, who also worked on the paper. “It’s complicated,”
she said.

Chasing ‘depression genes’

Like OCD, researchers say depression is influenced heavily by our
DNA. But unlike OCD, it’s fairly common, occurring in
an estimated 16.1 million Americans
. Current treatments
for depression haven’t changed much since the 1950s, and they
don’t work for everyone.

So, in an effort to find out more about what exactly causes the
illness, researchers published a paper in the summer of
2016 in the journal Nature Genetics in which they
pinpointed 17 genetic variations, or tweaks in particular genes,
that appear to be tied to major depressive disorder, the most
debilitating form of the disease that’s currently
the leading
cause of disability worldwide
.

The researchers got their data from personal genomics
company 23andMe. 

Using data from more than 75,600 people who told the company
that they’d been clinically diagnosed with depression and more
than 231,700 people who reported no history of depression, Perlis
and his team were able to identify 17 areas on DNA that appear to
be linked with depression. They also found some ties between
these areas and those which have been previously identified
as possibly playing a role in other psychiatric disorders,
such as schizophrenia.

Scientists have been looking for such genetic
hallmarks of depression for years
. And while some, like
a 2013
study in the journal The Lancet
and a
2015 paper in the journal Nature
, have
yielded promising clues, none have been able to spot any
precise, reliable genetic markers of the disease.

At least
not until now
.

“My group has been chasing depression genes for more than a
decade without success, so as you can imagine, we were really
thrilled with the outcome,” Perlis said.

The hope is that identifying these watermarks in our DNA — tiny
areas on genes where high amounts of variation tend to occur
among individuals — will help us better understand how
genetics and behavior interact to influence disorders like
depression.

Still, Perlis said, “this is really just the beginning. Now
the hard work is understanding what these findings tell us about
how we might better treat [these disorders].”

The science of fright: Why we love to be scared

Fear may be as old as life on Earth. It is a fundamental, deeply wired reaction, evolved over the history of biology, to protect organisms against perceived threat to their integrity or existence. Fear may be as simple as a cringe of an antenna in a snail that is touched, or as complex as existential anxiety in a human.

Whether we love or hate to experience fear, it’s hard to deny that we certainly revere it – devoting an entire holiday to the celebration of fear.

Thinking about the circuitry of the brain and human psychology, some of the main chemicals that contribute to the “fight or flight” response are also involved in other positive emotional states, such as happiness and excitement. So, it makes sense that the high arousal state we experience during a scare may also be experienced in a more positive light. But what makes the difference between getting a “rush” and feeling completely terrorized?

We are psychiatrists who treat fear and study its neurobiology. Our studies and clinical interactions, as well as those of others, suggest that a major factor in how we experience fear has to do with the context. When our “thinking” brain gives feedback to our “emotional” brain and we perceive ourselves as being in a safe space, we can then quickly shift the way we experience that high arousal state, going from one of fear to one of enjoyment or excitement.

When you enter a haunted house during Halloween season, for example, anticipating a ghoul jumping out at you and knowing it isn’t really a threat, you are able to quickly relabel the experience. In contrast, if you were walking in a dark alley at night and a stranger began chasing you, both your emotional and thinking areas of the brain would be in agreement that the situation is dangerous, and it’s time to flee!

But how does your brain do this?

A woman dressed up as a character from the movie The Exorcist reacts during Halloween in La Fresneda

A woman dressed up as a character from the movie “The Exorcist” reacts during Halloween in La Fresneda, northern Spain, on Oct. 31, 2016. Photo by Eloy Alonso/Reuters

How do we experience fear?

Fear reaction starts in the brain and spreads through the body to make adjustments for the best defense, or flight reaction. The fear response starts in a region of the brain called the amygdala. This almond-shaped set of nuclei in the temporal lobe of the brain is dedicated to detecting the emotional salience of the stimuli – how much something stands out to us.

For example, the amygdala activates whenever we see a human face with an emotion. This reaction is more pronounced with anger and fear. A threat stimulus, such as the sight of a predator, triggers a fear response in the amygdala, which activates areas involved in preparation for motor functions involved in fight or flight. It also triggers release of stress hormones and sympathetic nervous system.

This leads to bodily changes that prepare us to be more efficient in a danger: The brain becomes hyperalert, pupils dilate, the bronchi dilate and breathing accelerates. Heart rate and blood pressure rise. Blood flow and stream of glucose to the skeletal muscles increase. Organs not vital in survival such as the gastrointestinal system slow down.

A part of the brain called the hippocampus is closely connected with the amygdala. The hippocampus and prefrontal cortex help the brain interpret the perceived threat. They are involved in a higher-level processing of context, which helps a person know whether a perceived threat is real.

For instance, seeing a lion in the wild can trigger a strong fear reaction, but the response to a view of the same lion at a zoo is more of curiosity and thinking that the lion is cute. This is because the hippocampus and the frontal cortex process contextual information, and inhibitory pathways dampen the amygdala fear response and its downstream results. Basically, our “thinking” circuitry of brain reassures our “emotional” areas that we are, in fact, OK.

How do we learn the difference?

Similar to other animals, we very often learn fear through personal experiences, such as being attacked by an aggressive dog, or observing other humans being attacked by an aggressive dog.

However, an evolutionarily unique and fascinating way of learning in humans is through instruction – we learn from the spoken words or written notes! If a sign says the dog is dangerous, proximity to the dog will trigger a fear response.

We learn safety in a similar fashion: experiencing a domesticated dog, observing other people safely interact with that dog or reading a sign that the dog is friendly.
Why do some people enjoy being scared?

Fear creates distraction, which can be a positive experience. When something scary happens, in that moment, we are on high alert and not preoccupied with other things that might be on our mind (getting in trouble at work, worrying about a big test the next day), which brings us to the here and now.

Furthermore, when we experience these frightening things with the people in our lives, we often find that emotions can be contagious in a positive way. We are social creatures, able to learn from one another. So, when you look over to your friend at the haunted house and she’s quickly gone from screaming to laughing, socially you’re able to pick up on her emotional state, which can positively influence your own.

While each of these factors – context, distraction, social learning – have potential to influence the way we experience fear, a common theme that connects all of them is our sense of control. When we are able to recognize what is and isn’t a real threat, relabel an experience and enjoy the thrill of that moment, we are ultimately at a place where we feel in control. That perception of control is vital to how we experience and respond to fear. When we overcome the initial “fight or flight” rush, we are often left feeling satisfied, reassured of our safety and more confident in our ability to confront the things that initially scared us.

It is important to keep in mind that everyone is different, with a unique sense of what we find scary or enjoyable. This raises yet another question: While many can enjoy a good fright, why might others downright hate it?

Why do some people not enjoy being scared?

Any imbalance between excitement caused by fear in the animal brain and the sense of control in the contextual human brain may cause too much, or not enough, excitement. If the individual perceives the experience as “too real,” an extreme fear response can overcome the sense of control over the situation.

This may happen even in those who do love scary experiences: They may enjoy Freddy Krueger movies but be too terrified by “The Exorcist,” as it feels too real, and fear response is not modulated by the cortical brain.

On the other hand, if the experience is not triggering enough to the emotional brain, or if is too unreal to the thinking cognitive brain, the experience can end up feeling boring. A biologist who cannot tune down her cognitive brain from analyzing all the bodily things that are realistically impossible in a zombie movie may not be able to enjoy “The Walking Dead” as much as another person.

So if the emotional brain is too terrified and the cognitive brain helpless, or if the emotional brain is bored and the cognitive brain is too suppressing, scary movies and experiences may not be as fun.

What are disorders of fear?

All fun aside, abnormal levels of fear and anxiety can lead to significant distress and dysfunction and limit a person’s ability for success and joy of life. Nearly one in four people experiences a form of anxiety disorder during their lives, and nearly 8 percent experience post-traumatic stress disorder (PTSD).

Disorders of anxiety and fear include phobias, social phobia, generalized anxiety disorder, separation anxiety, PTSD and obsessive compulsive disorder. These conditions usually begin at a young age, and without appropriate treatment can become chronic and debilitating and affect a person’s life trajectory. The good news is that we have effective treatments that work in a relatively short time period, in the form of psychotherapy and medications.

Arash Javanbakht is an Assistant Professor of Psychiatry at Wayne State University. Linda Saab is an Assistant Professor of Psychiatry at Wayne State University. This article was originally published on The Conversation. Read the original article.

OCD is real, and here are 3 ways you can help

Amy Osmond Cook
Amy Osmond Cook

Imagine this: You’ve lost cherished friends, your health is declining, your adult children have moved away, and you are about to leave the home where you raised your family. Welcome to the world of a senior adult. With so much change, it’s no wonder there is an increase in anxiety in older adults. “In some cases, anxiety is a normal reaction to stress. It’s our body’s way [of] coping,” says agingcare.com writer Marlo Sollitto. “But when anxiety becomes an excessive, irrational dread of everyday situations, it crosses the line to become a disabling disorder.” She added an important point: Anxiety is not a normal part of aging.

What is obsessive-compulsive disorder?

This anxiety disorder begins with an obsession that expands into a compulsion. For example, Valerie’s mother has always been particular about her bedspread. But soon after moving into an assisted-living apartment, Valerie’s mother began removing and reapplying her bedspread numerous times every morning. “We all have different rituals, but when those behaviors start taking control, it is almost impossible to live a normal life,” says Craig Clayton, administrator at Garden Park Care Center in Garden Grove.

For seniors in particular, OCD is an anxiety disorder that may be related to Alzheimer’s disease or another form of dementia. As such, health care providers take this behavior very seriously. “Fortunately, many people suffering from OCD respond well to medications or therapy, and we encourage family members and close friends to be part of the treatment process by better understanding this disorder and offering support to their loved ones,” says Clayton.

If you suspect your loved one is suffering from OCD, here are three ways to offer help.

Talk about it

Since anxiety and aging are not mutually exclusive, it’s important to discuss your loved one’s feelings. Did something happen? Is there too much change happening at once? Sometimes the very act of voicing concerns can help calm the anxiety that fuels OCD behaviors. Together, you can discuss options.

Be patient

You may be annoyed by a loved one’s fascination with numbers. Remember, though, your loved one feels powerless to this compulsion. OCD is based on unwanted, repetitive thoughts or actions. A little patience can go a long way in offering support to loved ones as they learn to take control over their compulsions.

Be respectful

Arranging her room in a certain way may not seem important to you, but it means a lot to your loved one. “Loss of independence can create tremendous frustration, feelings of uselessness, and sadness, due to a sense of loss of control in one’s life,” say experts at myageingparent.com. Challenging a loved one’s choices can contribute to feelings of anxiety. Respect boundaries and needed space while loved ones learn to better understand their behaviors.

Change is hard, even for the strongest among us. It can trigger OCD and other anxiety disorders. But with open communication, patience, and respect, this new threshold can be a positive and supportive experience.

Amy Osmond Cook is the Executive Director of the Association of Skilled Nursing Providers, a nonprofit organization dedicated to educating the public about best practices in senior care. Contact her at amy@skillednursingproviders.org.

 

Kim Kardashian Says She Has Body Dysmorphia—Here’s What That Really Means

Does the term “body dysmorphia” sound familiar?

If so, you’re likely all caught up on Keeping Up with the Kardashians. In a recent episode, Kim Kardashian West revealed that she, like many of us, experiences major anxiety when it comes to her own body image. “You take pictures and people just body-shame you,” she said, referring to then-new bikini photos of her on vacation. “It’s like literally giving me body dysmorphia.”

We’ve heard that term a lot, but what does it actually mean? To find out, we turned to Dr. Eda Gorbis, a member of the Anxiety and Depression Association of America and the director and founder of the Westwood Institute for Anxiety Disorders.

Gorbis put the definition of body dysmorphic disorder (BDD), it’s official name, in layman’s terms: “Body dysmorphic disorder is considered to be the disease of self-perceived ugliness,” she told InStyle, explaining that it affects roughly 5 million Americans, both women and men equally.

Body Dysmorphia Kim Kardashian

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Essentially, people with the disorder become obsessive about their appearance, most commonly emphasizing what they believe to be imperfections on their nose, chin, eyelids, skin, ears, penis, and breasts. “They have a disturbed, distorted self-image,” Gorbis said, explaining that these “imperfections” are typically not visible to the naked eye.

Sometimes, patients seek help from cosmetic surgeons to alter their appearances before they notice the underlying psychological issues. “I had one patient who had 100 procedures and 17 plastic surgeries, and then she was obsessed with another part of her appearance. Usually, once the surgery is done, they may be happy for a little while, and then the focal point moves to another body part or appearance,” she said.

Gorbis adds that people living with BDD may spend many hours (think 10) assessing their bodies in front of the mirrors, and others may simply avoid mirrors at all costs. Generally, patients with severe BDD obsessively turn to close family and friends for reassurance. “I had a person who was late to her 36th birthday by hours because she was stuck in the mirror finishing her makeup until it felt gorgeous to her,” Gorbis said.

But what’s the difference between waking up with a lower self-esteem and actually having BDD?

Gorbis explained that the condition—which often stems from disorders like obsessive compulsive disorder and can lead to others like anorexia nervosa—varies from mild to severe, but it boils down to whether or not an obsession with your own self-perception is affecting your ability to carry out routine daily functions.

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“More than 50 percent of the human population feels as though they would like to improve their appearance or they feel uncomfortable in the morning when they look in the mirror, but it doesn’t interfere with life,” Gorbis said, elaborating that those with the disorder enter an endless, snowball-like cycle of comparing and contrasting specific body parts to those of others.

She calls it “an internal monster that moves from one body part to another” and says the danger in not seeking professional help can result in impulse actions like suicidal thoughts or substance abuse. Others develop hermit-like social patterns, Gorbis explained and are “very, very social timid because of the disorder.”

So what should you do if you’re checking “yes” to all of these symptoms?

“It’s very important to seek out the professional help of people who specialize in body dysmorphic disorder and are treating it along with a psychiatrist who specializes in it,” she concluded.

And talking about the issue, like Kardashian West did boldly and publicly, is a great way to help people take that first step.

The truth about obsessive compulsive disorder

So you’ll understand that we get a little irked when hearing the phrase bandied around in ways that would be considered totally unacceptable for other illnesses.

Myth: Having OCD means you like things neat and tidy

OCD Action: As described earlier, OCD is characterised by obsessions and compulsions. A compulsion for someone with OCD could be the need to keep things in order or symmetrical, but this is definitely not the case for everyone with OCD, and those who carry out these compulsions most certainly do not enjoy them, rather they carry out the compulsion to get rid of extreme anxiety caused by a thought. For many with OCD, being neat and tidy most likely won’t bother them any more than someone without the condition.

Lily: The key problem with misusing the phrase OCD is that every time someone does this, a step is taken away from understanding what it really means to have it. At my secondary school, people frequently used this term to infer, mostly, that they liked things to be neat and tidy. And the gleeful tones in which the words were shrieked indicated that they found their organisational activities a source of pleasure and personal pride. If you’d asked me what OCD was, I probably would have said: ‘it’s people who like to keep their things neat.’

As a result, it came as a shock when a doctor told me that the mental torment I had no name for that was taking over me was in fact OCD. ‘No, you’ve got it wrong,’ I thought. ‘I make endless lists in my head of things I’ve possibly done wrong all day. It’s not a hobby I enjoy and it’s got nothing to do with cleaning.’

I did not know then what I now know – that to have OCD only requires that you suffer from obsessions (unwanted thoughts, fears and ideas) followed by compulsions (the action you take, whether physical or mental, in response to the obsession), and that they cause you significant distress. Obsessions and compulsions can be anything. From thinking you might have run over a child in your car and so repetitively retracing your route, to holding your mouth shut because you fear you might start shouting out swear words in public.

But most people don’t associate OCD with those sorts of things, because our casual use of the term limits any real understanding of the disorder in the public consciousness. As such, people may spend years battling in silence with a terrifying mental anguish they have no name for.

Lily’s advice on coping with OCD

OCD is a tough beast that can take over your life in the most complex and uncomfortable ways. But the good news is, with hard work and persistence, recovery is possible. If you think you’re in the grips of OCD, speak to your doctor. GPs are becoming better at recognising all OCD, and not just the stereotypical symptoms like straightening things and tidying. The appropriate course of action would then be for your GP to refer you for cognitive behavioural therapy (CBT), a special type of behaviour therapy that aims to get you better by thinking about and then changing how you respond to your thoughts.

There is an average delay of 12 years between the onset of OCD and treatment being received

Family and friends can be crucial in your recovery, but perhaps not in the way you’d expect. The instinct of those who see their loved ones in distress is to offer them reassurance that their fears are unfounded, and that they needn’t worry. The problem is, the seeking of reassurance in itself becomes a compulsion for the sufferer, and well meaning people end up feeding into and perpetuating the condition in this way. If you know someone with OCD and want to help, the important thing is to be there for them emotionally and let them know how much you care, without letting yourself become a vehicle to fulfilling their compulsions. This is harder than it sounds, but good healthcare professionals will be happy to offer advice as to how those around someone with OCD and put this into practice.

For more information about the diagnosis and treatment of Obsessive Compulsive Disorder, visit http://www.ocdaction.org.uk/

Are Treatments for Psychiatric Disorders among Children Safe and Efficient?

Psychiatric Disorders Among Children

Researchers review the antidepressants currently used for psychiatric disorders among children and their possible adverse effects.

Depressive disorders, anxiety disorders, obsessive-compulsive disorders (OCD), and posttraumatic stress disorders (PTSD) are psychiatric disorders that are often seen among children and adolescents. A recent systematic review and meta-analysis carried out in the US and published in JAMA Psychiatry have set out to examine the use of certain antidepressants for psychiatric disorders among children and adolescents.

Currently, first-line treatments for this young subgroup of patients are antidepressants called selective serotonin reuptake inhibitors, also known as SSRIs. Another group of antidepressants is called serotonin-norepinephrine reuptake inhibitors, also known as SNRIs. Due to a lack of compelling evidence, SNRIs considered second and third-line treatment options. The review investigated the efficacy and safety of these antidepressants, compared to a placebo, for psychiatric disorders in children and adolescents.

The results obtained from the review of 36 trials, including 6,778 participants, demonstrated that SSRIs and SNRIs provide better treatment than placebo for children and adolescents diagnosed with these psychiatric disorders. However, the authors of the review state that the overall difference between drug and placebo is small and differs between disorders, with a larger response seen in anxiety than depression, particularly with the SSRIs.  This variability in drug-placebo response is attributed to the fact that the response to placebo was higher in the pediatric depression groups.

The authors explain that this difference between SSRIs, SNRIs, and placebo in children and adolescents with depression could be due to the lack of clearly defined criteria for the diagnosis of depression, which is further complicated by the fact that there is a high rate of comorbidity of depression with other mental disorders such as anxiety.  In addition to this, the patients with OCD demonstrated a low response to both drug and placebo treatments when compared to both anxiety and depression.

This review found that patients receiving an antidepressant reported more adverse events and discontinuation of treatment than those receiving placebo. These results correspond to the results from other meta-analysis studies conducted in the past, in which increased suicide and suicide attempts were observed in children and adolescents receiving SSRIs and SNRIs. These results highlight the reservations surrounding the safety of antidepressants in children and adolescents.

To conclude, the authors state the main findings of this systematic review and meta-analysis are:

  • The similar response rate for depression and anxiety deserves subsequent investigation, which could lead to a change in current prescribing guidelines.
  • The difference in responses to drug treatments and placebo between OCD and anxiety/depression strongly suggests that there are major differences in the causes and development (or etiology) of the disorders. Hence, additional measures might be necessary for pediatric patients with OCD.
  • Additional research is needed in order to establish factors that may affect the efficacy of the SSRI’s and SNRI’s in children and adolescents.
  • The variability in assessing and reporting adverse events needs to be reviewed in order to establish a standardized method for reporting these adverse events.

This last finding is of paramount importance as the risk of life-threatening events in this young group of patients needs to be addressed in order to determine treatment and treatment combinations that are the most appropriate for patients. Psychiatric disorders among children and adolescents need to be thoroughly studied to improve outcomes and minimise risks.   Therefore, further research is required to minimise the risk of adverse events and to improve the clinical outcomes for these disorders.

Written by Jade Marie Evans, MPharm, Medical Writer

Reference: Cosima L et al . (2017). Efficacy and Safety of Selective Serotonin Reuptake Inhibitors, Serotonin-Norepinephrine Reuptake Inhibitors, and Placebo for Common Psychiatric Disorders Among Children and Adolescents A Systematic Revie. Available: http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2652447?resultClick=1. Last accessed 01/09/2017.