OCD has ‘bullied her brain’ since she was 3. Now she’s using cycling to raise awareness.

Functional MRIs have shown that people with the disorder have greater activity in the orbitofrontal cortex, cingulate cortex, and caudate nucleus, along with other structures that affect how the brain learns, makes decisions, and processes emotion. These areas don’t respond to serotonin — a chemical that affects mood and helps different brain parts communicate — in the same way a brain without OCD does, researchers say. The structures also become less active after patients undergo therapy.

Generalized Anxiety Disorder Symptoms

Generalized Anxiety Disorder Symptoms

Generalized Anxiety Disorder SymptomsGeneralized anxiety disorder (GAD) is more than the normal anxiety people experience day to day. It’s chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint.

Simply the thought of getting through the day provokes anxiety.

People with GAD can’t seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants — that it’s irrational. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, twitching, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Or they might feel as though they have a lump in the throat.

Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too.

Usually the impairment associated with GAD is mild and people with the disorder don’t feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don’t characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities.

GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It’s more common in women than in men and often occurs in relatives of affected persons. It’s diagnosed when someone spends at least 6 months worried excessively about a number of everyday problems.

Specific Symptoms of Generalized Anxiety Disorder

Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).

The person finds it difficult to control the worry.

The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months; children do not need to meet as many criteria–only 1 is needed).

  • Restlessness or feeling keyed up or on edge
  • Being easily fatigued
  • Difficulty concentrating or mind going blank
  • Irritability
  • Muscle tension
  • Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

Additionally, the anxiety or worry is not specifically about having a panic attack (though panic attacks can occur within a person with GAD), being embarrassed in public (as in social phobia), being contaminated (as in obsessive-compulsive disorder), being away from home or close relatives (as in separation anxiety disorder), gaining weight (as in anorexia nervosa), having multiple physical complaints (as in somatization disorder), or having a serious illness (as in hypochondriasis), and the anxiety and worry do not occur exclusively during posttraumatic stress disorder (PTSD).

The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism) and does not occur exclusively during a mood disorder, a psychotic disorder, or a pervasive developmental disorder.

  • General Treatment of Generalized Anxiety Disorder


This criteria has been updated for the current DSM-5 (2013); diagnostic code 300.02.


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

National Institute of Mental Health. (2019). Anxiety. Retrieved from https://www.nimh.nih.gov/health/publications/anxiety/index.shtml on March 1, 2019.

Combined CBT, SSRI Treatment May Be More Effective for OCD

Cognitive behavioral therapy (CBT) combined with selective serotonin reuptake inhibitor (SSRI) treatment may alleviate clinical symptoms associated with obsessive-compulsive disorder (OCD), and do so more effectively than medication alone, according to results from a multicenter randomized controlled trial published in the Journal of Affective Disorders.

The study included 167 patients (aged 16-65 years) with OCD, recruited from outpatient clinics at 3 tertiary psychiatric hospitals and 1 general hospital in China from April 2010 to August 2013. Investigators compared 2 groups of patients: those receiving CBT combined with medication (n=92) and those receiving medication alone (n=75). Patients in the medication group received sertraline (100-200 mg/day), fluvoxamine (150-300 mg/day), or paroxetine (40-60 mg/day). Investigators assessed patients’ symptoms and social functioning at baseline and at 4, 8, 12, and 24 weeks.

After 24 weeks, more patients receiving combined therapy (82.6%) achieved response than those receiving medication only (52.0%). Response was defined as a decrease in symptom severity of at least 35%, based on a patient’s total score on the Yale-Brown Obsessive-Compulsive Scale. In both groups, Clinical Global Impression Scale for Severity and Global Assessment of Functioning scores decreased. However, there were no significant differences in total reduction of symptoms, as measured by the Hamilton Anxiety Rating Scale.

The study was limited by the lack of consideration of medication types and dosages and the absence of a CBT-only group. In addition, the study integrated Chinese culture into the practice of CBT, which might have affected outcomes.

“CBT combined with medication may be effective in alleviating symptoms and social functioning impairment associated with OCD, and is more effective than medication alone in China, particularly for the treatment of compulsive behaviours,” researchers concluded.


Meng FQ, Han HY, Luo J, et al. Efficacy of cognitive behavioural therapy with medication for patients with obsessive-compulsive disorder: a multicentre randomised controlled trial in China [published online April 22, 2019]. J Affect Disord. doi:10.1016/j.jad.2019.04.090

How to treat OCD, as well as symptoms and causes

What happens at a mental health support group
Therapy can help (Picture: Dave Anderson for Metro.co.uk)

One of the most common and enduring misconceptions about OCD (obsessive compulsive disorder) is that it’s simply about cleaning or counting.

In reality, the condition affects people in myriad ways – although it can include those things – to the point it may take many people a long time to be officially diagnosed.

It can also be a mental illness with people find shameful, leading them to hold off on seeking help, or not disclose the extent of their problems when they.

This then can lead to isolation, but it’s vital that if you think you have OCD that you get the necessary treatment. Here’s a rundown of signs you might have it, as well as how to treat it.

OCD symptoms

OCD is characterised by obsessions and compulsions, but these manifest in different ways.

Obsessions typically come in the form of urges or thoughts that make you feel anxious or cause you discomfort, while compulsions can include (but are not limited to) the following):

  • Checking (for example, making sure over and over that taps or switches are off at night)
  • Cleaning
  • Washing the body
  • Repetitive acts (such as tapping a certain point a number of times)
  • Repetitive sayings (saying or thinking the same word over and over)
  • Ordering items in the home or at work
  • Hoarding
  • Collecting items
  • Counting items

Mental health illustration
You’re not alone (Picture: Ella Byworth/ Metro.co.uk)

Sometimes compulsions are observable to others, and sometimes they remain under the surface. In most cases, though they exist as a way for the person to feel some sort of relief from their obsessions, with their mind telling them that the compulsion will ‘make things better’ if they perform it in the right way.

A small number of people also find that they experience something called Pure O, which is the obsessions without the outward compulsions (although the specifics of this are debated). Others experience things such as false memories, too.

OCD causes

There is no known cause for OCD, although it’s thought that it’s a combination of genetics, chemicals in the brain, and whether someone has had any traumatic events.

Those who are already anxious – as well as those with neat and methodical personalities – are also more likely to develop OCD.

OCD treatment

According to Shane FitzGerald, of the London OCD Clinic, the best treatment for OCD is a combination of Cognitive Behavioural Therapy and medication.

He told Metro.co.uk: ‘Although people with mild to moderate OCD can often get great results with CBT alone, people with very severe OCD might struggle to get the maximum benefits without also utilising medication.

‘It is also important to note that not all therapies are equal in treating OCD, with CBT being seen as the gold standard psychological therapy for this complex problem. Research shows that.other forms of therapy are unlikely to be of significant benefit’.

Essentially, your treatment will be determined by your health professionals (and will be worked out for you based on your specific symptoms) but it will more often than not have a two-pronged approach.

For many, the hardest part of receiving treatment is seeing it, with Shane saying, ‘Quite often clients admit to having never told anyone else the real details of their OCD, making it a particularly lonely and isolating condition’.

Going to an experienced therapist (starting with your GP if you need guidance or a diagnosis) will help you reduce this feeling of loneliness and manage your symptoms.

Support for mental health illustration
Reaching out can help (Picture: Ella Byworth for Metro.co.uk)

OCD techniques to use at home

Although Shane recommends seeking professional help first and foremost, he does assert that there are a few things you can do at home to help OCD.

Challenge avoidance

Although Shane states that this might be particularly difficult without an expert, he says you can make a start by doing this: ‘Make a list of activities that you might find challenging. Give these activities a mark out of 10 for difficulty, and then move up through the list trying to gently push yourself as much as you can…

‘With intrusive thought OCD the tasks might involve listening to certain challenging messages on a loop tape or writing down certain things that make us feel uncomfortable. This process is called Exposure and Response Prevention, the most important treatment comment for any type of OCD’.

Practice mindfulness

Meditation at a similar time each day can be a good thing to do to help, but it’s important not to use this as an avoidance tactic.

Be careful with substances

Shane says, ‘Recreational drugs and binge drinking are usually a bad combination with OCD or any anxiety disorder as the hangovers will usually provide a significant spike in symptoms for a couple of days. Drinking excessive amount of caffeine such as multiple coffees can also exaggerate symptoms in some people’.


As with many mental health problems, taking regular exercise can alleviate symptoms.

MORE: Single people believe mental health issues ‘makes it harder to find a relationship’

MORE: Long-term illness and mental health problems are intertwined – why are they treated separately?

SDH Promotes Maternal Mental Health and Awareness of Maternal Mood Disorders

In recognition of Maternal Mental Health Awareness Month, the Oklahoma State Department of Health (OSDH) has produced the first video in a series, which shines a light on resilient women in Oklahoma who have experienced a diagnosis of postpartum depression and/or postpartum anxiety. The series presents their stories of courage and strength, and how they navigated what can be a difficult struggle to overcome. 

Maternal mood disorders is the umbrella term for mood and anxiety disorders, which occur during pregnancy or up to one year after a mother gives birth. The stigma around mental health also surrounds maternal mental health and has resulted in fewer discussions around diagnoses such as postpartum depression, postpartum anxiety, postpartum obsessive-compulsive disorder, and postpartum psychosis. 

Postpartum depression is the number one complication in pregnancy throughout the United States.  In Oklahoma, 15 percent of new mothers in Oklahoma report symptoms such as irritability, insomnia, change in appetite, sadness, mood swings, less energy, increased crying, or persistent anger.

Many of these symptoms are mirrored in the “baby blues,” however, baby blues differs in severity and onset.  Baby blues should not last longer than two to three weeks after delivery; and will impact many more mothers. Postpartum depression will be more intense, and most importantly will result in significantly impaired functioning with symptoms such as crying more often or crying all day for multiple days, and unwanted thoughts of harming oneself or the baby.

The OSDH urges all pregnant mothers and fathers to talk with their doctor about screening for risk of postpartum depression and anxiety. Creating a postpartum plan with scheduled calls and visits from the mother’s support system, regular walks outside for increasing vitamin D and lowering stress levels, hydration, scheduled rest when possible and adequate nutrition sets the new mom up for success. 

The first video of the series highlights Dyanna Hicks, a former police officer who is currently a nursing student and mother.

James Craig, OSDH public health social work coordinator, said Hicks’ story illustrates that as a mother, former police officer, and future nurse she is an example of how this is an issue impacting our sisters, best friends, mothers, and fathers in Oklahoma. 

“I wanted to participate in the project because after having been through one of the hardest moments in my life, I will do anything in the world to make sure another woman never has to feel the way I did,” said Hicks. “Speaking out about this is not easy, but I wanted to share my own story in hopes it will inspire others to reach out, get help and not feel so alone.” 

Hicks tells the story of her journey shortly after birth, realizing that the emerging symptoms she felt were distancing her further from feeling like herself, and feeling increasingly intense anxiety and depressive symptoms. She discusses the harmful thoughts she began to find entering her mind, losing more and more sleep to her anxiety over her daughter’s sleep safety, to finding herself wondering if her daughter would be better off without her as a mother. Her story continues with finding help with a support group of other women who express similar symptoms, a supportive and caring husband who was there beside her at every turn, and a therapist who has been appropriately trained in working with women with this struggle who worked alongside her to give her tools to combat these symptoms. 

For help and support call the Postpartum Support International (PSI) Helpline at 1-800-944-4773. For more local information, please visit www.health.ok.gov using the keyword “mood” or email jamescc@health.ok.gov.  

Obsessive Compulsive Disorder: This Is What It’s Like to Be Obsessed With Perfection

Eighteen months ago I was in the throes of some of the darkest moments of my life—but on paper it didn’t look like that. I had just finished a national tour for my first book, The Crowdsourceress, and positive coverage had started rolling in. My company, which launched crowd-funding campaigns for stellar creators worldwide, had raised a combined $20 million to help bring their creative projects to life. Journalists were calling me a wunderkind and a guru; my name was even added to Forbes’ 30 Under 30 list. By the looks of things, I was killing it.

But alone one day soon after the tour ended, I couldn’t leave my bed. Sobbing on the phone to my mother like a terrified child, I was deep in a spiral of repetitive, fearful thoughts. My skin was crawling with anxiety.

This wasn’t my first total meltdown. I had suffered from these obsessive thoughts of uncertainty for almost two decades of my life.

I grew up a happy kid—spunky, opinionated, and incredibly curious. But something happened in my preadolescent years: I became painfully afraid of bad things happening to me. From what I remember, it started when I was around 10. After watching a nineties horror film, I became wildly obsessed with the idea of being abducted by aliens. I would lie in bed every night, imagining all the ways I could be abducted, and then rush into my parents room, begging to sleep near them for protection.

Young woman and her daughter at class party.

The author, pictured here as a kid with her mom, has always been spunky and curious.

Courtesy of Meg Daly

I didn’t have these terrorizing thoughts just at night though. On some idle weekends I would find myself pacing back and forth indoors, thinking about the various ways I could be tortured by the aliens that would eventually abduct me. I remember so clearly one Saturday morning my dad pointing to a painting and saying, “This painting exists. Aliens don’t. You have a higher probability of being abducted by this painting!” I laughed, relieved, but still uncertain.

When I eventually let go of my alien obsession, I moved on to another fixation: perfection.

I was finishing fifth grade and applying to a prestigious middle school. I told myself that I had to get in—in my mind, if I failed, it would irreparably derail my entire life. Fixated, I would complete all my homework, organize it neatly in my sparkly folders, and get into bed early. But I couldn’t go to sleep: Instead I would pray relentlessly, pleading for straight A’s. Fearful that my homework could suddenly disappear into thin air while I slept, I’d anxiously jump out of bed to check that it was still there. I would do this about 20 times a night.

By the time I turned 12, my obsessions shifted again, this time to a subject on many a preteen mind: sex. But I wasn’t fantasizing about a new crush or exploring pleasure as my body went through puberty. Rather, I was terrified of anything related to sex—it got to a point that I didn’t want to be touched, fearing any unpredictable sensation in my body. My obsession became so paralyzing that I would retrace the most innocent of past interactions, analyzing them for the slightest improprieties and confessing whenever I felt something could have been perceived as wrong. Whenever I did have a sexual thought—all of which felt weird and deviant—I would fixate for hours on end about what it meant about my identity as a person, rocking back and forth into what seemed like a hole of darkness.

At first, as with my other moments of catastrophic crises, I implored my parents for reassurance, describing my graphic fears in detail. But I realized that this new obsession felt different—it was too taboo. I stopped sharing and began internalizing my rituals, while another obsessive idea set in: I really believed that if my parents knew my thoughts, even though they had been my biggest supporters so far, they would disown me forever.

When I started high school, I became really good at hiding my internal battles—so began my years of trying to cope on my own. I would power through episodes of distress by throwing myself into piles of work as a necessary distraction, or avoid situations that triggered the anxiety. The intense dedication to my work helped me excel, but it masked the obsessive thoughts playing on loop in my mind. In college I had two majors, a minor, and an honors thesis, but I remember thinking I could have—should have—done so much more.

‘It’s just something you deal with’: Erika Gilsdorf, creator…

Erika Gilsdorf used to go out of her way to avoid stepping on cracks when she was a little girl, after hearing the old superstition, “Don’t step on a crack or you’ll break your mama’s back.”

She lived with a constant fear of making some small misstep that would lead to something bad happening. She’d worry about the “What ifs?” — “What if I step on a crack and my mom gets hurt?”

She knew how “silly” that thought was, she says, but her anxiety over it was unstoppable. To ease her distress, she exerted the only control over the situation that she felt she had, which in this case was to stay away from those cracks. And then in other cases, as she got older, to check again and again that the door was locked so robbers couldn’t get in, or that her curling iron was turned off so it didn’t start a fire.

“As a young person, when I was little, I thought I was losing my mind,” the 52-year-old Detroit Lakes woman recalls today. “I didn’t know what was going on. I was completely consumed with my anxiety and my checking behaviors, and worried so much about so many things.”

Erika’s parents kept her involved in sports and other activities to try and aim her focus elsewhere, but through her adolescence and teen years, her anxiety slowly snowballed. By the time she was in college, it was impacting her performance in school, and her parents told her she should see a psychologist. She was mortified.

“I was completely upset,” she says. “I thought, ‘This is it, everybody thinks I’m crazy.’”

Mental health wasn’t talked about then like it is now, and Erika had no idea why she thought and behaved the way she did. She felt completely alone in her experience. She didn’t know anything about anxiety, and had never even heard of Obsessive-Compulsive Disorder, or OCD, which is what she ended up being diagnosed with.

When her doctor handed her a pamphlet about OCD, and told her how common it was, she felt a surge of relief. She had gone to that appointment fearing the worst, almost certain she would be institutionalized, she says, but instead, “I found out it’s just OCD, and that there are ways you can learn to manage it, and help it, and ease it.”

“Immediately, I was relieved that I wasn’t alone and that there was information and books on it, and the doctor wasn’t shocked (by my symptoms),” she says. “That was a good way of realizing that it’s not the end of the world, that there’s help.”

In the decades since then, Erika has learned a lot about her OCD and how to manage it. It’s not something a person can ever be cured of, but she’s got tools at her disposal now to help her cope. If her anxiety starts building up again, she knows she can go back to the doctor to get some fresh perspective, and can dip into that toolbox to build a healthier way forward.

“It’s a good feeling” to get help, she says. “I spent my younger years being afraid of it, afraid of getting really anxious… But it’s not something you have to be afraid of. It’s just something you have to learn to handle, and there are professionals who teach you the tools to handle it.”

She’s gotten a lot of questions over the years from curious friends, family members and acquaintances who want to learn more about OCD, and she’s also heard negative judgements, stereotypes and stigmas about the disorder. Casual jokes about OCD are common — such as someone saying, “Sorry, must be the OCD in me” as they straighten a picture on the wall — but she says those jokes belittle the struggles of those who truly have the disorder.

It was Erika’s own personal experiences that inspired her to create the “Inside Out” community campaign, and to tell her story as a part of it. She wanted to show people what it’s really like to live with a mental illness, in an effort to spread information, understanding and awareness of how common mental illnesses are.

A producer at Leighton Broadcasting, Erika decided to use her talents and resources to create a video series about mental health. She partnered with Karen Pifher, of Becker County Energize, who was immediately on board about the idea, and from there the video series evolved into a community-wide campaign that included a Video Premiere and Panel kickoff event at M-State as well as a series of stories in this newspaper and exposure on local radio stations.

The 8-part series has examined eight different mental illnesses, including depression, anxiety, PTSD, schizophrenia and others. Each video and accompanying newspaper article have included information and advice from area mental health professionals, and have put a local face to each illness, with people from the Detroit Lakes area stepping forward to talk about their personal experiences.

“I really commend everybody for telling their stories in this series, because it is hard to tell people your most vulnerable side of yourself, that you don’t want people to see,” says Erika.

She admits that it hasn’t been easy for her to share her story of OCD. Though she’s had the disorder her whole life, she’s still uncomfortable with the idea of it being so public. She’s afraid people will look at her differently once they find out she has a mental illness, she says, or they’ll wrongly assume that she’s less capable than she really is — which is all part of the stigma that the “Inside Out” series is trying to erase.

She chose to put herself out there for “Inside Out,” she says, in hopes of helping someone else with a mental illness feel less alone, and to inspire those who are struggling — or know someone else who might be struggling — to seek help.

“I see so many people suffering, and with kids suffering, and they won’t get help,” she says. “I don’t understand that, because don’t you want to get happy and get back on track? There are very nice people out there who want to help…”

“Facing it and accepting it — that you’re struggling — is not a sign of weakness,” she adds. “It’s a sign of strength that you are taking care of yourself. It’s a sign of commitment to yourself that you want to have a good life… At my age now, I just don’t understand why people wait to start the healing process.”

Erika’s mother believes her OCD has made her a stronger person, Erika says, because her treatments have forced her to face her fears, to conquer them instead of running away from them.

“The more you face it, the more it diminishes,” Erika says of anxiety and OCD. “The more you avoid it, the more powerful it gets. So it makes you a stronger person, because you don’t let it have power over you.”

When she does find herself feeling anxious, Erika spends time outdoors, which calms her. She also finds that walking or other forms of exercise help, as does time with friends or, if things have been hectic, quiet time alone.

“It’s just something you deal with,” she says. “You learn to handle it, and you learn to manage it, and to live successfully and happily with it. I’ve had OCD since I was little, since before I even knew what it was… It’s one of the challenges you learn to live with.”

Erika has been a resident of Detroit Lakes since 1990, after spending her childhood summers here at her family’s lake cottage. She went to college in Arizona, Duluth and Moorhead before returning to town and co-running Lakeside Tavern for about 15 years. She started her own video company in 2008, called South Shore Productions, for which she travels internationally to make short environmental documentaries, public service announcements and commercials for organizations including National Geographic and Royal Caribbean. She still runs that company today, and also joined up with Leighton Broadcasting in 2016.


What is it?

A long-lasting mental health disorder in which a person has uncontrollable, recurring thoughts (obsessions), and behaviors (compulsions) that he or she feels the urge to repeat over and over in response to those obsessive thoughts. The obsessions create feelings of anxiety, or intense distress, and the compulsions are an attempt to decrease that distress. In order for a diagnosis of OCD to be made, the cycle of obsessions and compulsions must be so extreme that it consumes a lot of time and gets in the way of life.

“It creates a (high) level of distress and it impairs function,” explains Dr. Samantha Beauchman, a psychologist at Sanford Health, in the “Inside Out” video about OCD. “True OCD will create a lot of anxiety. (It will be) very distressing for someone who can’t engage in that compulsion or mental activity that alleviates the anxiety. So they may struggle to go on through their day, might have a full-blown panic attack…”

How common is it?

It affects about 2% of the adult population in the U.S., and can also affect children and adolescents. Most people are diagnosed before turning 20, though onset after age 35 does happen. There’s a higher prevalence of the disorder in women than men.

What are the signs and symptoms?

People with OCD may have symptoms of obsessions, compulsions, or both. They generally know their thoughts or behaviors are excessive or irrational, but can’t control them. They typically spend at least one hour a day on those thoughts or behaviors. Some individuals with OCD also have a tic disorder, such as eye blinking, shoulder shrugging or vocal tics like repetitive throat clearing or sniffing. Symptoms may come and go, ease over time, or worsen.

Common obsessions include: fear of germs; fear of losing control; fear of being responsible for something bad happening, like a fire or burglary, or fear of harming others because of not being careful enough; concern about evenness or exactness; fear of losing or forgetting things; concern about offending God or excessive concern about right and wrong; unwanted sexual thoughts; and others.

Compulsions include: excessive cleaning and/or handwashing; ordering and arranging things in a particular, precise way; compulsive counting; repeatedly checking on things, such as checking to see if the door is locked or the oven is off; excessive praying; repeating body movements, such as tapping or blinking; repeating routine activities, such as going in and out of doors, sometimes a specific number of times every time; and others.

What causes it?

Research suggests that differences in the brain and genes of those affected may play a role. OCD does run in families, but genes appear to be only partly responsible for causing the disorder. No one really knows what other factors might be involved.

Can it be treated?

“OCD is a very treatable disorder,” says Beauchman in the video. “It has a high success rate of treatment and treatment sustaining itself over a period of time… So there’s a lot of hope with this disorder, and a lot of success.”

Treatment typically involves a mix of therapy (usually a type of Cognitive Behavior Therapy) and medication.

*Compiled from the “Inside Out” video on OCD, the National Institute of Mental Health, and the International OCD Foundation


DO talk to them about it, in a supportive and understanding way. Encourage them to get help, if they haven’t already. Erika says it’s helpful when her friends notice she’s struggling and remind her of the tools she has to help control her symptoms. She appreciates it when people ask her if she’s okay, or if she needs space or wants to talk about it.

“It’s okay to talk about it,” she says. “As long as you talk with kindness, you don’t have to worry that what you say is right or wrong. People tend to be afraid of what to say… Just say whatever comes to you that feels good at the time, that feels kind.”

DON’T demean or taunt people with OCD, or make jokes about their symptoms. Don’t diminish their experience by trying to equivocate your occasional, mildly OCD-like behaviors with their experience.

“It’s derogatory when people joke about being OCD when they’re not,” says Erika.

For people who are diagnosed with OCD, the anxiety can be severe and their fears “are a real threat to them,” says Beauchman. “Even though it might not make sense to you, might not sound reasonable, or might seem silly, in a way, it’s very important to be very understanding for this person that is struggling with the disorder. It’s very real to them.”


“Inside Out: A Step Inside Mental Illness” has been a Detroit Lakes area project to raise awareness of mental illness and erase the stigmas surrounding it. A community partnership between local media and regional healthcare and crisis organizations, the campaign consisted of a series of online videos, newspaper articles and radio discussions that shed light on some common mental health disorders, putting local faces to those disorders. Topics covered include depression, PTSD, anxiety, ADHD, suicide and others.

Videos have been released once a week for eight weeks (the campaign started the week of Feb. 25), and are available to watch free on Becker County Energize’s website, beckercountyenergize.com. There has also been a program each week on lakestv3.com. Newspaper articles have been published in the Wednesday print editions of the Detroit Lakes Tribune over the same time span, as well as on the newspaper’s website, www.dl-online.com. Participating radio stations included Leighton Broadcasting’s local stations, Wave 104.1 FM, KDLM 1340 AM and 93.1 FM, and KRCQ 102.3 FM.

CLICK THE LINKS TO READ THE REST OF THE STORIES IN THE ‘INSIDE OUT’ SERIES: Depression, PTSD, Anxiety, Suicide Part I, Suicide Part II, ADHD, Addiction, Schizophrenia

If storms give you anxiety after Hurricane Harvey, therapy is available online

HOUSTON — Because of Harvey, a lot of people still feel anxiety every time it rains.

But you don’t have to bottle it in.

There’s a free app called “Onto Better Health” that allows people to get confidential cognitive behavioral therapy at home.

UTHealth offers the app, thanks to funding from the Hurricane Harvey Relief Fund.

The programs are designed to help people dealing with anxiety disorders, moderate depression, chronic pain, obsessive-compulsive disorder, substance use, and sleep difficulties.

Summer Danner, program coordinator of the psychiatry behavioral sciences department at the McGovern Medical School at UTHealth, says rain, thunder, lightning, and watching flood coverage on the news can trigger panic attacks for people whose homes flooded before.

One of the programs, called FearFighter, takes participants through video breathing exercises designed to calm heart rates.

“The different apps have been validated by 12 clinical trials, so they do work,” said Danner. “Historically, there have been some pretty stressful and traumatic events with flooding and weather. It’s a natural response to that stress. There’s no reason to feel ashamed to reach out for help.”

Click here to learn more about the app.


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School attendance and mental health disorders

Mental health disorders are a significant cause of student absence from school, particularly in the secondary school years, according to a new study published in the Australian Journal of Education.

The study, Impact of Mental Disorders on Attendance at School, found mental disorders are among the most common and disabling conditions affecting children and adolescents.

Lead author of the report, Professor David Lawrence from the University of Western Australia, says oftentimes absence from school is associated either with physical health problems or truancy.

‘I don’t know that we’ve really had too much information in the past about what is the impact of mental disorders on attendance,’ he tells Teacher. ‘So we were able to identify that mental disorders associate with significant absence and particularly so in secondary school.’

The paper, part of a study called Young Minds Matter, examined data from the 2013-2014 Australian Child and Adolescent Survey of Mental Health and Wellbeing, and included a random sample of 6310 families with children aged four to 17 years from around Australia.

In the 12 months examined, one in seven Australian school students were found to have a mental disorder, with attention-deficit/hyperactivity disorder (ADHD), and anxiety being the two most common.

The report notes that seven disorders were assessed in the survey. These included four anxiety disorders (social phobia, separation anxiety disorder, generalised anxiety disorder and obsessive-compulsive disorder), major depressive disorder, ADHD and conduct disorder.

For each of the mental disorders considered in the survey, students with a disorder were more frequently absent than students without a disorder.

This was particularly noticeable in the secondary school years, where over 16 per cent of all absences from school were attributed to symptoms of mental disorders.

For adolescents in Years 11 and 12 with a disorder, the average number of school days missed was 25.9 — more than five weeks — compared with an average of 12 days for students in the same grades who did not have a mental disorder.

In Years 7-10, the comparison was 23 days versus 10.6 days, on average. For primary school children, there was a difference of 11.8 versus 8.2 days, on average.

It was previously considered, the study reported, that students who are absent infrequently can readily ‘catch-up’ on missed schoolwork on return to school while chronic absenteeism might substantially disrupt students’ education.

‘However, more recent evidence suggests that school performance declines consistently with increasing rates of absence with no evidence of a threshold effect,’ the report reads.

Mental health literacy for teachers

According to parents who were surveyed as part of this study, the person who first identified that a child may have a mental health problem was a teacher, principal, or someone in the school leadership team.

Given this, Lawrence says having a basic level of mental health literacy is really important for teachers and people working in schools.

‘Early identification and appropriate management of mental disorders may help improve school attendance. We don’t expect teachers to be clinicians. They are not expected to diagnose and treat mental health problems,’ he says.

‘But I do think because they [mental disorders] are such common problems  … they’re going to have a significant impact on kids’ learning so at least being aware of them and aware of what sorts of things you might be able to do is really important.’

Lawrence advocates that teachers be supported by mental health first-aid training.

‘It’s just about knowing if there is a problem, who inside the school or outside the school [to contact], what sort of thing you might say to parents, or when it’s appropriate to raise an issue with the school leadership.’

Lawrence’s article reports that health promotion and mental ill-health prevention strategies may help build resilience and advance students’ knowledge and development of strategies for managing and improving their mental health.

‘It’s also helpful for young people, themselves, to know what’s the typical sorts of things that kids are going to experience as they’re growing up and then, when something might indicate that maybe there is a bit of an issue, that they should speak to someone about that,’ Lawrence says.

‘That’s part of breaking down the stigma that’s traditionally been associated with mental health.’

In your own school setting, what supports are in place for students who are absent from school for many days? How do you work with parents or carers to ensure students are supported when they are unable to attend school?

As a school leader, do your staff feel confident they have a sufficient level of mental health literacy? Do you have any programs in place to support teachers in this area?

Biohaven Pharmaceuticals Reports First Quarter 2019 Financial Results And Advancements In Neuroinnovation Platforms

RD Expenses: Research and development (RD) expenses were $41.0 million for the three months ended March 31, 2019, compared to $75.6 million for the three months ended March 31, 2018. The decrease of $34.6 million was primarily due to the upfront payment to BMS in the three months ended March 31, 2018 of $50.0 million, partially offset by increases in direct costs of $6.3 million for the BHV-3500 program, $3.4 million in personnel costs, including non-cash share-based compensation, $3.4 million in direct costs for the troriluzole program, and $2.0 million in direct costs for the rimegepant program. The increases in direct costs for the BHV-3500 and troriluzole programs were primarily due to an increase in the number of clinical trials, and the cost of operating later-stage trials, for the three months ended March 31, 2019 as compared to the same period in 2018. The increase in personnel-related costs, including non-cash share-based compensation, was a result of hiring additional research and development personnel. Headcount in RD increased to 43 as of March 31, 2019, compared to 29 as of March 31, 2018.  Non-cash share-based compensation expense, included in personnel-related costs, was $3.7 million for the three months ended March 31, 2019, an increase of $2.3 million as compared to the same period in 2018. 

GA Expenses: General and administrative (GA) expenses were $13.5 million for the three months ended March 31, 2019, compared to $7.9 million for the three months ended March 31, 2018. The increase of $5.6 million was primarily due to increases in personnel-related costs, including non-cash share-based compensation, due to the hiring of additional personnel in GA functions, preparation for commercialization activities, professional fees supporting ongoing business operations, and additional fees to comply with being a public company. Headcount, outside of RD, increased to 30 as of March 31, 2019, compared to 20 as of March 31, 2018.  Non-cash share-based compensation expense, included in personnel-related costs, was $3.6 million for the three months ended March 31, 2019, an increase of $2.0 million as compared to the same period in 2018.

Net Loss: The Company reported a net loss attributable to common shareholders of $62.3 million or $1.41 per share for the three months ended March 31, 2019, compared to $85.5 million, or $2.32 per share, for the three months ended March 31, 2018.

About Biohaven
Biohaven is a clinical-stage biopharmaceutical company with a portfolio of innovative, late-stage product candidates targeting neurological diseases, including rare disorders. Biohaven has combined internal development and research with intellectual property licensed from companies and institutions including Bristol-Myers Squibb Company, AstraZeneca AB, Yale University, Catalent, ALS Biopharma LLC and Massachusetts General Hospital. Currently, Biohaven’s lead development programs include multiple compounds across its CGRP receptor antagonist and glutamate modulator platforms. The Company’s common shares are listed on the New York Stock Exchange and traded under the ticker symbol BHVN. More information about Biohaven is available at www.biohavenpharma.com.

About Catalent
Catalent is the leading global provider of advanced delivery technologies and development solutions for drugs, biologics and consumer health products. With over 85 years serving the industry, Catalent has proven expertise in bringing more customer products to market faster, enhancing product performance and ensuring reliable clinical and commercial product supply. Catalent employs over 11,000 people, including over 1,800 scientists, at more than 30 facilities across five continents, and in fiscal 2018 generated approximately $2.5 billion in annual revenue. Zydis® is a registered trademark of Catalent. Catalent is headquartered in Somerset, New Jersey. For more information, visit www.catalent.com.

Forward-Looking Statements
This news release includes forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements involve substantial risks and uncertainties, including statements that are based on the current expectations and assumptions of the Company’s management. All statements, other than statements of historical facts, included in this press release regarding the Company’s business and product candidate plans and objectives are forward-looking statements. Forward-looking statements include those related to: the expected commencement and completion of clinical trials, the anticipated timing of availability of data from those trials, the timing of expected regulatory submissions and approvals, the efficacy and safety profiles of the Company’s product candidates and their expected benefits compared to other treatment options, and other statements regarding the Company’s plans and objectives, expectations and assumptions of management. The use of certain words, including the words “expect,” “anticipate,” “will,” “potential,” “plan,” “might” and similar expressions are intended to identify forward-looking statements. The Company may not actually achieve the plans, intentions or expectations disclosed in the forward-looking statements and you should not place undue reliance on the Company’s forward-looking statements. Various important factors could cause actual results or events to differ materially from those that may be expressed or implied by the forward-looking statements including risks and uncertainties related to the timing of initiating, enrolling and completing clinical trials; the commencement or completion of enrollment in any clinical trial does not guarantee the continuation or successful outcome of the trial, or the acceptance by the FDA of a regulatory package for the drug candidate being tested; the submission of an IND does not guarantee that the FDA will permit clinical trials to begin; and those factors described in the “Risk Factors” section of the Company’s Annual Report on Form 10-K filed with the Securities and Exchange Commission on February 28, 2019 and the Company’s other filings with the Securities and Exchange Commission. The forward-looking statements are made as of this date and the Company does not undertake any obligation to update any forward-looking statements, whether as a result of new information, future events or otherwise, except as required by law.








For further information, contact Dr. Vlad Coric, Chief Executive Officer, at Vlad.Coric@biohavenpharma.com


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Many adolescents have mental disorders at the time of transition into adulthood

A Danish nationwide birth cohort study showed that the incidence rates of any mental disorder, substance use disorders, depression and anxiety disorders increased substantially by adolescence.

By the end of adolescence, 11 in 100 individuals in the cohort had received a mental disorder diagnosis, according to the findings published in Journal of Clinical Psychiatry.

“There is converging evidence from prevalence estimation studies showing that a sizeable proportion of young people suffer from mental disorders,” Hans-Christoph Steinhausen, MD, PhD, DMSc, of Capital Region Psychiatry, Copenhagen, Denmark, and department of child and adolescent psychiatry, University of Southern Denmark, and Helle Jakobsen, MS, of Aalborg University Hospital, Denmark, wrote.

In a cohort of children born in 1995 and followed up to the end of 2013, the researchers analyzed incidence and cumulative incidence rates of diagnosed mental disorders across the entire period of childhood and adolescence using data from nationwide Danish registries.

They calculated rates for any first-time diagnosis of a mental disorder and 10 categories of mental disorders — substance use disorders, schizophrenia, depression, anxiety disorders, obsessive-compulsive disorder, eating disorders, autism spectrum disorder, ADHD, conduct disorder and tic disorder — for 68,982 individuals. They also examined whether age, sex and further child- and family-related risk factors effected mental disorders.

The results showed that in the cohort, the overall incidence rates of any mental disorder, substance use disorders, depression, and anxiety disorders increased after age 13 years; however, the rates for ASD, ADHD, conduct disorder and tic disorder increased until age 13 then decreased. The investigators found that male youth had higher risk for any mental disorders, substance use disorders, ASD, ADHD, conduct disorder and tic disorder, while female youth had higher risks for depressive, anxiety, OCD and eating disorders.

At age 18 years, the cumulative incidence rate was 11.02% for any mental disorder, with the highest rate for an individual disorder for ADHD (2.51%) followed by depression (1.84%), ASD (1.79%), conduct disorder (1.32%) and substance use disorders (1.02%).

Some risk factors for being diagnosed with a mental disorder in the cohort were perinatal risks, divorce of parents, parental mental illness prior to offspring’s diagnosis, social position as youth and paternal death, according to the results.

“These findings of the diverse developmental patterns of various mental disorders throughout childhood and adolescence and the sizable number of disorders at the time of transition into adulthood underscore the fact that childhood and adolescence are highly vulnerable periods for the development of mental disorders,” Steinhausen and Jakobsen wrote. “The findings are relevant for mental health planning activities, as the approach used in the present study provides a very solid basis for calculating the needs in youth.” – by Savannah Demko

Disclosures: Steinhausen reports speaking for Medice and receiving book royalties from Cambridge University Press, Elsevier, Hogrefe, Huber, Klett and Kohlhammer publishers. Jakobsen reports no relevant financial disclosures.