What is health anxiety – and how can you combat it?

Health anxiety is a condition we don’t generally hear much about – but it’s something many people in the UK suffer with.

You may often hear health anxiety referred to as hypochondria, and it’s when you spend so much time worrying about your health and wellbeing, that it begins to take over your life. Health anxiety comes under the Obsessive Compulsive Disorder (OCD) spectrum of anxiety disorders – so it’s a behaviour that can easily feel uncontrollable.

If you find yourself worrying about every little ache or pain in your body, or growing anxious about every change you see in yourself on an obsessive level – you may be suffering from health anxiety.

In fact, it’s something that even celebrities find themselves dealing with.

Recently, Loose Women panellist Stacey Solomon confessed that she often finds herself overly concerned about her health.

On the show, she confessed, “I have more checks than usual… I have health induced anxiety… I have tests done so I know what to look out for and what to be aware of.

“It’s not something I think is normal, it’s just me and my own anxieties… People MOT their car every year, why not your body? I’d rather have no car and be healthy. That’s all that matters.”

So what are the symptoms of health anxiety?

According to the NHS, constantly worrying about your health is the first symptom.

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Checking your body too often for potential signs of illness, such as a lump or rash.

Always seeking reassurance, from family or medical professionals, that you are healthy

Obsessively checking your symptoms on the internet or in the media

health anxiety

Worrying that your doctor or tests may have missed something.

Avoiding anything that discusses serious illness – such as a TV documentary.

Health anxiety can also manifest itself in some real, physical symptoms too, which could in turn make your anxiety worse.

Physical symptoms of health anxiety

Stomach pain

Headache

Racing heartbeat

Feelings of nausea

Health anxiety is real and debilitating – and it’s important not to disregard it because you think you’re being ‘paranoid’ or ‘crazy’.

So how can you attempt to combat it?

Treatment for health anxiety

The NHS recommends keeping a diary of every time these kind of intrusive thoughts cross your mind – such as when you feel the need to Google a symptom, or book a doctors appointment for something you’ve already addressed with a medical professional.

By taking note, you can deduce how much a problem your anxiety is becoming – and therefore whether or not you need to seek professional help.

Another interesting tactic is distracting yourself every time you feel like you’re beginning to overthink about your health.

health anxiety

For example, whenever you get the urge to check your body for an ailment, distract yourself by meeting up with a friend, or heading to the gym instead.

Some people may however need to seek professional help to deal with their anxiety.

If you feel that your health anxiety has become overwhelming, and is affecting your day-to-day life, book an appointment with your GP, who can offer help and advice.

Many medical professionals advise a course of cognitive behavioural therapy (CBD), which can help to change your thought process over time.

MORE: Coleen Nolan uncovers huge health concern

The Anxiety Association of America has explained the concept.

They said, “The main concept behind CBT is that our thoughts about a situation (such as the fear of AIDS) affect how we feel (afraid and anxious).

We tend to assign meaning to specific situations (lightheadedness means we have brain cancer). It’s not the actual situation causing your anxiety, but the meaning, whether accurate or not. And when you have anxiety, you give your thoughts a lot of meaning, and thus a lot of power.

“CBT aims to help you overcome fears by correcting irrational thoughts and changing problematic behaviours.”

Doctors may also prescribe medicine for anxiety, which can help to ease your nervous thoughts.

Anxiety UK also has a range of self-help groups around the country, where you can go to seek support for your issue. Find the full list here.

But most importantly, it’s key to remember that there is always help out there if you’re suffering from anxiety – and that asking for it is the first step towards feeling better.

Living with obsessive compulsive disorder

Growing up, Tina’s son Matt always seemed like a normal kid.

He was happy, outgoing, and was a little ball of energy that couldn’t sit still.

But certain things bothered him – he never wore jeans because he didn’t like the feeling of them on his skin, and didn’t like going to the beach because he hated the dusty feeling of sand on his hands.

As Matt, a Vancouver Island resident whose name was changed to protect his identity, got older, he was diagnosed with anxiety and attention deficit hyperactivity disorder. But it wasn’t until he turned 12 when things changed – and quickly.

Matt started over-worrying about things and then his focus turned to contamination. Matt would wash his hands several times in a row, and if he washed his hands and went to do another task, would wash them again. He worried about touching his game controller, in fear he would contaminate that and would be forced to wash his controller. He only used a towel once and as soon as it hit the floor Matt thought it would be dirty and would contaminate the floor.

Shortly after, Matt was diagnosed with obsessive compulsive disorder (OCD). According to the International OCD Foundation, OCD is a mental health disorder that occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings.

RELATED: Addictions to online games can destroy real lives

The Canadian Psychological Association reports between one and two per cent of Canadians will have an episode of OCD. It describes the condition like this:

“Obsessions are recurrent and persistent intrusive thoughts, images or impulses that are unwanted, personally unacceptable and cause significant distress. Even though a person tries very hard to suppress the obsession or cancel out its negative effects, it continues to reoccur in an uncontrollable fashion.

“Obsessions usually involve upsetting themes that are not simply excessive worries about real-life problems but instead are irrational concerns that the person often recognizes as highly unlikely, even nonsensical.”

According to the CPA, OCD can be chronic — waxing and waning with life’s stresses. It seldom disappears without treatment, and can have a profound negative impact on functioning — interfering with jobs, schooling, social interactions and relationships.

“It exploded on us, it came out of nowhere. It was very confusing for him as well,” said Tina, who is calling for more mental health services on the Island.

“It [contamination] was transferable almost. Say I touched the car door that he thought was contaminated, then I touched something else, then that would be contaminated. It’s just that snowball effect.”

After the diagnosis things became more severe. His fears of contamination escalated to the point where Matt would use his sleeves to open car doors. If he thought a part of the car was contaminated he would move to another seat, and then another, until he would finally ask his mother to wash the whole car.

The disorder began to affect his relationships as well. If he was hanging out with friends and his clothes got dirty he would have to go and change his clothes a bunch of times or they would want to go for a bike ride and he felt he couldn’t do it. As a result, he lost some friends in the process.

Tina said watching the disorder take over his life was difficult.

“Watching him and how debilitating it was for him and how much it was hurting him emotionally, that’s the worst part,” she said.

Shortly after, Matt received treatment at the Ledger House at Queen Alexandra Centre for Children’s Health, where he received therapy for seven weeks.He went on to participate in the OCD program through the B.C. Children’s Hospital in Vancouver for another six weeks.

RELATED: A day to tackle the stigma surrounding mental health

According to the BC Children’s Hospital website, treatment for OCD typically consists of psychological and psychiatric assessments, after which the assessing team meets with the family to discuss its findings and implement a treatment plan.

The evaluation includes a look at the patient’s medical, developmental, family and school history and his or her mental state, with attention to the potential presence of other psychiatric disorders.

First-line treatment for mild and moderate cases typically consists of cognitive behavioural therapy — basically, getting a better understanding of, and control of, the issues through talking.

“The aim of CBT is not about learning not to have these thoughts in the first place, because in essence…intrusive thoughts cannot be avoided. Instead it is about helping a person with OCD to identify and modify their patterns of thought that cause the anxiety, distress and compulsive behaviours,” reads a statement by the OCD-UK, a British charity dedicated to those affected by OCD.

“What therapy will teach the person with OCD is that it’s not the thoughts themselves that are the problem; it’s what the person makes of those thoughts, and how they respond to them, that is the key to recovery from OCD.”

For more serious cases, where the patient distress is severe, or ability to function significantly impaired, or where there is resistance to CBT, drug treatment is also recommended.

“Poor insight into the irrational nature of the obsession and/or compulsion can lead to resistance to CBT,” the Children’s Hospital practice parameter document states. “The need for close family involvement will make successful implementation of CBT more difficult in chaotic or non- intact families.”

RELATED: Centre for youth seeking mental health and addictions support opens in Victoria

Tina said Matt, now 17, has good and bad days. While school had been put on the back-burner, Matt is busy with a job and hangs out with his co-workers.

Despite the fact that her son was able to get treatment, Tina said there aren’t enough mental health services on the Island.

“We don’t have any of those programs here,” Tina said. “There’s a big lack of services.”

— with files from Black Press


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kendra.wong@goldstreamgazette.com

Europe Obsessive Compulsive Disorder Market 2018-2026 …

DUBLIN–(BUSINESS WIRE)–The “Europe
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2018”
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The research provides insights into Obsessive Compulsive Disorder
epidemiology, Obsessive Compulsive Disorder diagnosed patients, and
Obsessive Compulsive Disorder treatment rate for EU5 countries. The
research measures key indicators including prevalence of Obsessive
Compulsive Disorder derived from epidemiological analysis, patients
diagnosed with Obsessive Compulsive Disorder, and patients treated with
a drug therapy.

The research study helps executives estimate Obsessive Compulsive
Disorder market potential, assess unmet need, develop drug forecasting
models, and build population-based health management frameworks. The
information presented in this study is used to evaluate market
opportunities, effectively identify target patient population, and align
marketing decisions.

The research provides estimates and forecasts of Obsessive Compulsive
Disorder prevalence, Obsessive Compulsive Disorder diagnosis rate, and
Obsessive Compulsive Disorder treatment rate for the period 2017-2026.
The information is presented by EU5 countries including Germany, France,
Spain, Italy, and UK.

Key Topics Covered

1. Obsessive Compulsive Disorder: Disease Definition

2. Obsessive Compulsive Disorder Patient Flow in Europe

2A. Obsessive Compulsive Disorder Prevalence in Europe

2B. Obsessive Compulsive Disorder Diagnosed Patients in Europe

2C. Obsessive Compulsive Disorder Treated Patients in Europe

3. Obsessive Compulsive Disorder Patient Flow in Germany

3A. Obsessive Compulsive Disorder Prevalence in Germany

3B. Obsessive Compulsive Disorder Diagnosed Patients in Germany

3C. Obsessive Compulsive Disorder Treated Patients in Germany

4. Obsessive Compulsive Disorder Patient Flow in France

4A. Obsessive Compulsive Disorder Prevalence in France

4B. Obsessive Compulsive Disorder Diagnosed Patients in France

4C. Obsessive Compulsive Disorder Treated Patients in France

5. Obsessive Compulsive Disorder Patient Flow in Spain

5A. Obsessive Compulsive Disorder Prevalence in Spain

5B. Obsessive Compulsive Disorder Diagnosed Patients in Spain

5C. Obsessive Compulsive Disorder Treated Patients in Spain

6. Obsessive Compulsive Disorder Patient Flow in Italy

6A. Obsessive Compulsive Disorder Prevalence in Italy

6B. Obsessive Compulsive Disorder Diagnosed Patients in Italy

6C. Obsessive Compulsive Disorder Treated Patients in Italy

7. Obsessive Compulsive Disorder Patient Flow in UK

7A. Obsessive Compulsive Disorder Prevalence in UK

7B. Obsessive Compulsive Disorder Diagnosed Patients in UK

7C. Obsessive Compulsive Disorder Treated Patients in UK

8. Research Methodology

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Medical marijuana approved for eleven new medical conditions in Michigan

WASHINGTON, July 11 (Xinhua) — Eleven new medical conditions are added to the list of debilitating medical conditions qualified for medical marijuana treatment, the Michigan government said on its website on Monday.

Patients diagnosed with arthritis, autism, chronic pain, colitis, inflammatory bowel disease, obsessive compulsive disorder, Parkinson’s, rheumatoid arthritis, spinal cord injury, Tourette’s Syndrome, and ulcerative colitis are now approved to take medical marijuana for treatment.

“With the changes in state law to include marijuana-infused products, and the advancement of marijuana research, and upon the recommendation of the panel members, I’ve added these eleven conditions to the approved list.” said Shelly Edgerton, director of the Department of Licensing and Regulatory Affairs.

Meanwhile, 11 medical conditions are rejected, including anxiety, asthma, brain injury, depression, diabetes, gastric ulcer, non-serve and non-chronic pain, organ transplant, panic attacks, schizophrenia, and social anxiety disorder.

To use medical marijuana legitimately, patients should possess diagnosis of proper disease as well as registry identification cards.

Currently, 30 U.S. states and Washington D.C. allow medical marijuana with different approaches, while the federal government still doesn’t recognize marijuana’s medical potential.

State expands list of conditions medical pot can treat

LANSING, Mich. — Michigan regulators have significantly expanded the list of conditions approved for treatment by medical marijuana by approving 11 medical conditions. The decision also came with the denial of 11 other medical conditions.

The Department of Licensing and Regulatory Affairs (LARA) on Monday added 11 medical conditions deemed debilitating by the Michigan Medical Marihuana Act of 2008. They are: arthritis, autism, chronic pain, colitis, inflammatory bowel disease, obsessive compulsive disorder, Parkinson’s disease, rheumatoid arthritis, spinal cord injury, Tourette’s syndrome and ulcerative colitis.

Denied conditions are: anxiety, asthma, brain injury, panic attacks, depression, diabetes, gastric ulcer, non-severe and non-chronic pain, organ transplant, panic attacks, schizophrenia and social anxiety disorder.

Existing entries on the list include post-traumatic stress disorder, cancer, glaucoma, HIV, AIDS, Crohn’s disease, Alzheimer’s disease, and severe and chronic pain.

In a press release, LARA issued the following quote from Director Shelly Edgerton:

“With the changes in state law to include marihuana-infused products, and the advancement of marihuana research, and upon the recommendation of the panel members, I’ve added these eleven conditions to the approved list,” said Edgerton. “I’d like to thank the members of the review panel for their hard work in discussing these petitions and making their recommendations.”

Officials say they received public comments related to petitions to add conditions to the list. They add the final decisions reflect changes in state law to include marijuana-infused products and advancing research.

The list of denied medical conditions worries cannabis consultant Jay Flemming.

“They’re trying to be as restrictive as possible, I think,” Flemming tells FOX 17.

Flemming is also a former medical marijuana patient and thinks the decision to deny some of the above mentioned conditions, like brain injuries, makes no sense.

“That’s one that I find very confusing,” Flemming says. “There is significant research to show that marijuana is very effective at lowering the inflammation in the brain.”

According to a study at UCLA, THC was found to decrease the mortality rate of people with a traumatic brain injury.

When it comes to other disorders, Flemming doesn’t agree with the move to approve obsessive compulsive disorder and deny anxiety.

“The difference between OCD and anxiety, OCD, there is significant research that shows that that is very helpful,” Flemming says.

Flemming says he knows firsthand how hard it can be for a patient who feels they need to use medical marijuana but can’t. He tells FOX 17 he suffered from fibromyalgia but at the time, medical marijuana wasn’t legal so he couldn’t use it like he felt he needed to.

“During the periods I quit, I saw my own condition deteriorate,” Flemming says. “It took a toll on my relationships, it made it harder to work.”

Flemming says the process of implementing expansions to the Michigan Medical Marijuana Act of 2008 has been challenging for patients and the he believes it stems from one thing: stigma.

“For my patients, I see significant improvement in their day-to-day lives and for some of them it saved their lives,” Flemming says.

For a full look at the approvals and denials of medical conditions, click here.

The Associated Press contributed to this story.

Obsessional intrusive thoughts: Scary secrets of the mind

Obsessional intrusive thoughts are unwanted disturbing thoughts that flash into the mind, repeating over and over again throughout the day – every day. Similar to a song that gets stuck in your head, they infiltrate the brain and latch on.

Intrusive thoughts are symptomatic of anxiety and obsessive compulsive disorder. It is estimated that 50 per cent of people diagnosed with OCD experience sexual or religious intrusive thoughts. Mothers also can be impacted with post-natal OCD, and may become preoccupied with harm to their new-born.

Many people experience disturbing thoughts but can pass them off and let them go. With intrusive thoughts, the individual feels shocked and horrified by their content and mistakenly believes them to be true. It is this response that intensifies their effect, maintaining a cycle which becomes habitual. Your brain and system then automatically reacts to such thoughts or images as threats, triggering an automatic stress or anxiety response. These tormentous thoughts attach to what is important to the person, such as core values or people.

Thoughts like these can become mental secrets, making them even more sinister to their host. It is often a lonely and hidden experience as it is a mental-health issue not often talked about, impeding disclosure because the person feels embarrassed or ashamed. Like most conditions, onset is multifaceted, with biological, social and psychological factors interplaying.

So how does this mental plague feature?

For some, their intrusive thoughts manifest in relation to sexual orientation. Others may involve thoughts of a sexual nature that are repugnant to the person and linked to inappropriate people. Avoidance, rituals, attempts to neutralise and seeking reassurance are part of this cycle.

Intense fear

Another type of obsessional intrusive thought revolves around harm to oneself or others. There is an intense fear of hurting someone, even though there is no past evidence of this and no grounding in reality. Liz (not her real name) was referred to me following the birth of her baby. She felt out of sorts and had initially passed it off as exhaustion. Her mood was low, anxiety high and she was diagnosed with post-natal depression by her GP. Liz had been too afraid to disclose the harming intrusive thoughts and these persisted. She feared social services being involved or losing her mind. Being alone with her baby triggered panic attacks and many tasks were passed on to others. In therapy, she found the courage to open up and learned they were just symptoms and experienced by others too. Her reaction to them eased and she acquired skills to lower their volume.

Treatment for obsessional intrusive thoughts needs to commence with a thorough assessment of the individual. If the person’s daily functioning is severely impaired, medication may be necessary. With evidence-based therapy such as CBT (cognitive behavioural therapy) and acceptance and commitment therapy, the thoughts can diminish and lose their terrifying grip. As with all psychological disturbances, empathy, non-judgment and positive support helps.

Psychoeducation teaches the person to understand that these thoughts are symptoms with no meaning and that their content is opposite to who the person is. For example, violent thoughts may intrude on a very gentle-natured individual. Focusing on the evidence and lessening the belief in the thoughts weaken their power. Instead of analysing their content, it is necessary to see them as meaningless.

Distraction techniques

Developing healthy distraction techniques to get out of the head can clear out this excess mental clutter. Retraining the brain takes regular rigorous practice, but reaps its rewards. Mindfulness moulds the capacity to engage with all thoughts in a healthier way and creates a gap between the thinker and thoughts. Knowing that just because you think the thoughts are true does not mean they are. Shifting the response from being shocked by these thoughts to just noticing them is part of recovery. Accepting that thoughts are not facts, and perceiving accurately what is and what is not reality based, can be freeing.

You cannot suppress your thoughts, as researchers at Harvard University found. Participants were asked to think about anything other than a white bear. People kept checking to see if they were not thinking of the white bear, and the white bear continued to pop up in their heads. However, it is possible to shift thoughts, move them around and focus on what is real. When the individual reaches a phase of wellness, the work needs to continue to prevent such thoughts attacking again. A healthy lifestyle, a regular exercise programme, pleasant interactions and ways to keep the mind clear are all part of relapse prevention.

Obsessional intrusive thoughts are exacerbated by increased anxiety and stress levels, so monitoring and managing these is essential. Self-help resources include the Headspace app and books such as Overcoming Obsessive Thoughts by David A Clark, Overcoming Unwanted Intrusive Thoughts by Winston and Seif and Brain Lock by Dr Jeffrey Schwartz.

If you or someone you know is struggling with such thoughts, remember:

1. Label them as intrusive thoughts. Name them, reveal them and get help.
2. Understand that they are only symptoms.
3. Know that they have no meaning.
4. Drop avoidant and ritualistic behaviours, at a pace.
5. Engage in healthy distractions.
6. Be reassured that they are treatable.

You are more than your thoughts. Let us move the mental-health conversation forward and support those whose minds are in turmoil.

Niamh Delmar is a counselling psychologist and mental health educator

People with “Maladaptive Daydreaming” spend an average of four hours a day lost in their imagination

First, have a read of this: 

“I have been lost in a daydream for as long as I can remember….These daydreams tend to be stories…for which I feel real emotion, usually happiness or sadness, which have the ability to make me laugh and cry…They’re as important a part of my life as anything else; I can spend hours alone with my daydreams….I am careful to control my actions in public so it is not evident that my mind is constantly spinning these stories and I am constantly lost in them.”

The 20-year-old woman who emailed these reflections to Eli Somer at the University of Haifa, Israel, diagnosed herself with Maladaptive Daydreaming, sometimes known as Daydreaming Disorder. While Maladaptive Daydreaming is not included in standard mental health diagnostic manuals, there are cyber-communities dedicated to it, and “in recent years it has gradually become evident that daydreaming can evolve into an extreme and maladaptive behaviour, up to the point where it turns into a clinically significant condition,” write Somer and Nirit Soffer-Dudek at Ben-Gurion University of the Negev, in a new paper on the disorder, published in Frontiers in Psychiatry. 

 This study is, they say, the first to explore the mental health factors that accompany Maladaptive Daydreaming (MD) over time – and it provides insights into not only what might cause these intense, vivid, extended bouts of daydreaming but also hints at how to prevent them, or how to stop them in their tracks. Because while many people who experience MD report enjoying their daydreams at the time, MD can also negatively affect their relationships with others, their day-to-day lives, and their overall emotional well-being.

Earlier work led researchers to suggest that MD might be either a dissociative disorder, a disturbance of attention, a behavioral addiction or an obsessive-compulsive spectrum disorder. 

For the new online study, Somer and Soffer-Dudek recruited 77 self-diagnosed sufferers of MD, from 26 different countries, ranging in age from 18-60. Just over 80 percent were women (possibly because women seem to be more affected by MD than men, the researchers write).

The participants first provided details about any mental health diagnoses (21 had been diagnosed with depression, 14 with anxiety disorders and 5 with OCD, among other disorders). Then, each evening before bed, for 14 days, they completed a series of questionnaires that asked about their experiences that day. These scales assessed levels of dissociation, obsessive-compulsive symptoms, depression, general anxiety, social anxiety, and emotion – and also maladaptive daydreaming. (Participants were asked to report on the extent to which statements such as “I felt the need or urge to continue a daydream that was interrupted by a real-world event at a later point” had applied to them that day.) 

On average, participants reported spending four hours a day daydreaming. On days on which their MD was more intense and time-consuming, they also experienced higher levels of obsessive-compulsive symptoms, dissociation and negative emotion, and both types of anxiety. But only obsessive-compulsive symptoms consistently predicted the intensity and duration of maladaptive daydreaming on the next day, regardless of the levels of obsessive-compulsive symptoms on that following day. 

Despite these findings, the researchers note that only five of the participants had actually been diagnosed with OCD –  “This discrepancy suggests that obsessive-compulsive symptoms and MD share common mechanisms and interact with each other…but MD does not seem to be merely a subtype of OCD.” However, they added that many people with MD describe being consistently drawn to their daydreaming in a compulsive way. “The finding that a surge in obsessive-compulsive symptoms precedes MD [also] points to a key role of this construct as a contributing mechanism,” Somer and Soffer-Dudek argue.

Compulsions to daydream, or to carry on daydreaming even after many hours have passed, might be addressed using cognitive behavioral approaches developed to address other compulsions, the researchers suggest. They also speculate that low levels of the neurotransmitter serotonin may play a role in MD, as in OCD. If future work confirms this, drugs that modify serotonin levels may possibly be used in treatment. 

 There were some limitations of the study – in particular, that it was based entirely on self-reports. But as research on MD is scarce, and this is thought to be the first longitudinal exploration of the disorder, the results should at least help to inform future work in this area. Though it’s also possible that not all people with MD will want treatment. As the woman with MD who emailed Somer also wrote: “I am torn between the love of my daydreams and the desire to be normal.”

Emma Young (@EmmaELYoung) is Staff Writer at BPS Research Digest

 

This article was originally published on BPS Research Digest. Read the original article.

Anxiety disorders – what are they and how can they be overcome …

Anxiety disorders are a common mental illness in South Africa. Approximately 1 in 5 South Africans are affected each year, according to the South African Depression and Anxiety Group (SADAG). Characterised by overwhelming worry and fear, anxiety disorders can keep you from functioning in your normal life and can be disabling.

They include panic disorder, social anxiety disorder, specific phobias, and generalised anxiety disorder (GAD). Obsessive compulsive disorder (OCD) as well as post-traumatic stress disorder (PTSD) are also closely related to anxiety disorders.

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“GAD includes symptoms such as excessive worry and self-doubt that interferes with daily life and lasts for more than six months,” says Felicity Pienaar, occupational therapist at Akeso Clinic in Nelspruit. “Physical symptoms include trouble falling or staying asleep, muscle tension (clenching the jaw, balling your fists and tightening of muscles throughout the body), chronic indigestion and self-doubt.”

Pienaar explains that some people experience specific phobias, such as irrational fear of a situation or thing, like crowds, flying, or animals that are overwhelming, disruptive and out of proportion to the actual risk involved.

Others spend a lot of time thinking and worrying about being at a specific event where they will be in the spotlight or amongst a lot of people, and dwelling on it when it is over. They may experience self-consciousness, blushing, trembling, nausea, and difficulty talking and sweating when having to interact with others, even a small number of people.

People with OCD suffer from obsessive behaviour and may have anxiety about making mistakes or falling short of standards. They develop compulsive behaviour that may be cognitive (for example, needing to repeatedly tell yourself ‘it will be ok’) or physical (for example, repeated hand washing or straightening objects). This becomes a disorder when these ‘rituals’ drive their life.

Pixabay

PTSD is a debilitating condition that follows a traumatic event. People are often plagued by frightening memories of the event, which trigger the condition. People struggling with PTSD may experience flashbacks, nightmares, numbing of emotions, depression and feeling angry, irritability or feeling distracted and being easily startled.

A panic disorder is characterised by sudden attacks of panic and fear, and attacks are usually triggered by fear-producing events or thoughts, such as taking a lift or driving. Panic disorder results in physical symptoms, which include rapid heartbeat, strange chest sensations, and shortness of breath, dizziness, tingling, and anxiousness.

Panic disorders typically start in young adulthood, but children and older people are not immune. Women are twice as likely to suffer from a panic disorder. People from all races and social classes experience panic disorders, although different cultures tend to express symptoms differently.

“These issues can have a serious effect on all areas of a person’s life, resulting in them becoming unable to function in their day-to-day lives,” says Pienaar. “In serious cases, anxiety left untreated can derail careers, destroy relationships and may even drive a person to suicide.”

Photo: Pixabay

What causes anxiety?

Anxiety disorders are caused by a number of different factors. No single situation or condition will cause it. Physical and mental triggers combine to create a certain anxiety disorder.

“Experts believe that anxiety can sometimes be a learned behaviour that can be unlearned with the correct help,” says Pienaar. “Heredity plays a role, as does altered brain chemistry – indicated by the fact that symptoms respond to medication. The condition may also be exacerbated by personality and certain life experiences.”

Overcoming avoidance behaviours

It is important to recognise that avoidance doesn’t work, Pienaar says. Trying to avoid certain situations, thoughts or feelings often results in experiencing more of the thing you are trying to avoid, as the patient ends up constantly focusing on that one thing. Instead, she advises the following:

  • Recognise the cost of avoidance. Take note of the time and mental energy spent trying to avoid something. Ask yourself how it has affected your relationships and your view of yourself.
  • Start learning to tolerate uncomfortable thoughts and feelings about situations. The more you are willing to expose yourself to thoughts and feelings that make you anxious, the more quickly they will pass naturally. Thoughts and feelings are temporary, and you need to learn to “ride them out”. Consciously relaxing your muscles and doing breathing exercise can help you to think more clearly.
  • Use distraction techniques (cognitive distraction such as counting backwards in 3s or 7s, singing your favourite song or reciting your favourite poem), and mindfulness or progressive muscle relaxation.
  • Aerobic exercise, in particular, releases endorphins (chemicals in the brain) that help you to feel more healthy and vital. They act as natural pain killers and improve our ability to sleep, which is very important to reduce stress.
  • Avoid stimulants. Substances such as caffeine and nicotine make one feel jittery and tense, and can worsen existing anxiety. We believe that it will calm our nerves, but the physical effect on our body is the opposite.
  • Eat a balanced diet. Avoiding processed and high-sugar food can help manage your anxiety, as these foods cause fluctuations in blood sugar, which affects mood. This is followed by a “crash”, which can cause shaking and tension. These worsen anxiety.
  • Getting enough sleep allows your body to regenerate and recharges your mind. After a good night’s sleep, coping with our problems becomes more manageable.

File Photo

How friends and family can help

  • Educate yourself on the type of anxiety with which your loved one is struggling.
  • Encourage them to seek professional help, be open to listening to them, but do not try to be their therapist.
  • Let them know they can be open with you, and help them to acknowledge and accept their anxiety by assuring them that you do not see it as a weakness or a flaw.
  • Don’t fall into the reassurance-seeking trap. If a loved one repeatedly asks for reassurance about what it is they fear (‘Are you sure it’s not cancer? ‘Are you sure you aren’t cross with me?) they probably need help from a psychotherapist.
  • Help them to face some of the things they are avoiding or putting off altogether due to anxiety. Help them to talk through the steps they need to take in order to do that which they are avoiding, and encourage them to take the first step.
  • Encourage exercise, as well as doing meditation/mindfulness and breathing exercises together. Avoid activities that involve alcohol, as this can cause a setback in treatment.

Don’t give up hope – it will take a while for treatment to take effect, but anxiety is treatable if your loved one is willing to put in the work.

Seek professional help

In most cases of cases of anxiety disorder, a combination of medication, prescribed by a psychiatrist, and ‘talk’ therapy with a psychologist, is the most successful treatment, according to Pienaar.

“Medication alone often does not get the job done,” she says. “A good response to medication often makes you more amenable to look for the causes of your distress, and to try to change your behaviour. Anxiety disorders can persist for an extended period of time, and the severity may fluctuate, but regular treatment can help a person manage this.”

Joining a support group may also help. Contact SADAG to find a group in your area on 011 262 6396, or visit www.sadag.org.

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What are anxiety disorders?

Anxiety disorders are a common mental illness, affecting one in every five South Africans.

Characterised by overwhelming worry and fear, anxiety disorders can keep you from functioning in your normal life.

They include panic disorder, social anxiety disorder, specific phobias and generalised anxiety disorder (GAD).

Obsessive compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are also closely related to anxiety disorders.

‘GAD includes symptoms interfering with daily life and lasts for more than six months,’ says Felicity Pienaar, occupational therapist at Akeso Clinic in Nelspruit.

People with OCD suffer from obsessive behaviour and may have anxiety about making mistakes or falling short of standards.

They develop compulsive behaviour that may be cognitive (for example needing to repeatedly tell yourself ‘it will be ok’) or physical (for example, repeated hand washing or straightening objects). This becomes a disorder when these ‘rituals’ drive their lives.

PTSD is a debilitating condition that follows a traumatic event.

People struggling with PTSD may experience flashbacks, nightmares, numbing of emotions, depression and feeling angry, irritability or feeling distracted and being easily startled.

A panic disorder is characterised by sudden attacks of panic and fear, and attacks are usually triggered by fear-producing events or thoughts.

Panic disorder results in physical symptoms such as rapid heartbeat, strange chest sensations, shortness of breath, dizziness, tingling and anxiousness.

Overcoming avoidance behaviours

Trying to avoid certain situations, thoughts or feelings often results in experiencing more of the thing you are trying to avoid, as the patient ends up constantly focusing on that one thing.

Instead, Pienaar advises the following:

1. Recognise the cost of avoidance. Take note of the time and mental energy spent trying to avoid something.

2. Learn to tolerate uncomfortable thoughts and feelings about situations.

3. Use distraction techniques (cognitive distraction such as counting backwards in threes or sevens, singing your favourite song or reciting your favourite poem) or progressive muscle relaxation.

4. Aerobic exercise releases happy hormones called endorphins. They act as natural pain killers and improve our ability to sleep, which is very important to reduce stress.

5. Avoid stimulants such caffeine and nicotine. We believe that it will calm our nerves, but the physical effect on our body is the opposite.

6. Eat a balanced diet. Avoid processed and high-sugar foods, as these foods cause fluctuations in blood sugar, which affects mood. This is followed by a ‘crash’, which can cause shaking and tension that worsen anxiety.

7. Get enough sleep. After a good night’s sleep, coping with our problems becomes more manageable.

How friends and family can help

Educate yourself on the type of anxiety with which your loved one is struggling.

Encourage them to seek professional help, be open to listening to them, but do not try to be their therapist.

Accept their anxiety by assuring them that you do not see it as a weakness or a flaw.

Don’t fall into the reassurance-seeking trap. If a loved one repeatedly asks for reassurance about what it is they fear (‘Are you sure it’s not cancer? ‘Are you sure you aren’t cross with me?), they probably need help from a psychotherapist.

Help them to face some of the things they are avoiding or putting off altogether owing to anxiety.

Encourage exercise, meditation/mindfulness and breathing exercises. Avoid activities that involve alcohol.

Don’t give up hope – anxiety is treatable if your loved one is willing to put in the work.


Seek professional help

A combination of medication, prescribed by a psychiatrist, and ‘talk’ therapy with a psychologist, is often the most successful treatment, according to Pienaar.

Join a support group.

Contact www.akeso.co.za or the South African Depression and Anxiety Group (SADAG) to find a group in your area on 011 262 6396, or visit www.sadag.org.

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Preschool-onset obsessive-compulsive disorder with complete remission

Back to Journals » Neuropsychiatric Disease and Treatment » Volume 14

Authors Miyawaki D, Goto A, Iwakura Y, Hirai K, Miki Y, Asada N, Terakawa H, Inoue K

Received 31 March 2018

Accepted for publication 14 May 2018

Published 3 July 2018
Volume 2018:14
Pages 1747—1753

DOI https://doi.org/10.2147/NDT.S169797

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication:
Dr Taro Kishi

Dai Miyawaki,1 Ayako Goto,1 Yoshihiro Iwakura,1,2 Kaoru Hirai,1 Yusuke Miki,1 Naomi Asada,1,2 Hiroki Terakawa,1 Koki Inoue1

1Department of Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan; 2Department of Child and Adolescent Psychiatry, Osaka City General Hospital, Osaka, Japan

Abstract: Early-onset obsessive-compulsive disorder (OCD) is more severe than later-onset OCD. There are no reports of any early-onset OCD patients being cured, especially with respect to preschoolers. In this case report, we describe the successful treatment and cure of a 6-year-old preschool girl with severe OCD since the age of 3. At the age of 3, the patient began to fear contamination and danger to herself and her family, leading to excessive hand-washing, and several months later, ritualized checking. The OCD symptoms waxed and waned for about 3 years and thereafter worsened gradually over a few weeks, culminating in a refusal to eat and dress. At the age of 6, after a week of inpatient pediatric treatment with no improvement, the patient was transferred to Osaka City University Hospital to seek psychiatric treatment. The patient fully recovered from OCD following family-based cognitive-behavioral therapy (CBT) and short-term use of low-dose fluvoxamine in an inpatient setting. After treatment, the OCD symptoms disappeared with complete remission for over 3 years. Now, aged 9, the patient has good global functioning and is well adjusted in her daily life with no need for any treatment. To the best of our knowledge, this is the first report of preschool-onset OCD with long-term complete remission with inpatient treatment in a preschooler with severe OCD. Some preschoolers with very early-onset OCD may have good prognosis without continuous pharmacotherapy, although the symptoms with the onset are severe enough to require hospitalization. Preschool-onset OCD is likely to be misdiagnosed as separation anxiety disorder. Our findings suggest that family-based CBT, which is the treatment of choice for preschool-onset OCD, can be applicable to inpatient treatment. Early detection and intensive intervention of OCD in preschoolers may improve the chance of remission.

Keywords: very early-onset OCD, differential diagnosis, family-based cognitive-behavioral therapy, inpatient treatment

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License.

By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

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For Many Kids, Anxiety Persists Into Adulthood Even With Treatment

New research suggests an expanded review of pediatric anxiety disorders is necessary as successful treatment of anxiety issues in childhood may not extend to young adulthood.

Pediatric anxiety disorders are common psychiatric illnesses, affecting approximately 10 percent of children. Past research discovered that 12 weeks of sertraline (brand name Zoloft) and/or cognitive behavioral therapy (CBT) were effective in reducing anxiety and improving functioning.

Now, in a new follow-up study, researchers re-contacted these youths an average of six years later and then re-assessed them annually for up to four additional years.

The investigators discovered that 22 percent of youth who received 12 weeks of treatment for an anxiety disorder stayed in remission over the long term; meaning they did not meet diagnostic criteria for any anxiety disorder (defined as any DSM-IV TR anxiety disorder, including post-traumatic stress disorder and obsessive-compulsive disorder).

Thirty percent of youth who had received treatment remained chronically ill, meeting diagnostic criteria for an anxiety disorder during each year of follow-up, and 48 percent relapsed, meaning they met diagnostic criteria for an anxiety disorder at some, but not all follow-ups.

The study appears in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP).

“When you see so few kids stay non-symptomatic after receiving the best treatments we have, that’s discouraging,” said one of the study’s principal investigators, Dr. Golda Ginsburg, Professor of Psychiatry at the University of Connecticut School of Medicine.

“However, we found no difference in outcomes by treatment type. Children were just as likely to stay in remission after treatment with medication as they were after treatment with CBT,” Ginsburg added.

From 2011 through 2015, the study followed 319 young people aged 10 to 25 who had been diagnosed with separation, social, or general anxiety disorders at sites in California, North Carolina, Maryland and Pennsylvania.

The researchers conducted annual evaluations that assessed, among other factors, diagnoses, school and social functioning, and service use. Findings indicated that at each follow-up year, approximately half of the youth remained in remission.

When examined across all years of the follow-up, that number dropped to 22 percent, while 30 percent continued to meet criteria for an anxiety disorder at every annual evaluation.

The researchers found several factors that predicted which anxious kids were most likely to stay well over the follow-up period.

These subjects tended to be:

  • those who showed clinical improvement after 12 weeks of treatment;
  • males;
  • youth without a social phobia diagnosis;
  • youth who had better family functioning;
  • and those who experienced fewer negative life events.

The researchers concluded that while it may be optimistic to expect that 12 weeks of treatment resulted in long-term remission, it is now clear that more needs to be done to help anxious youth. They recommend including treatments that are more durable, and using a better mental health wellness model that includes regular check-ups to prevent relapse and improve outcomes over time.

Source: Elsevier

9 Little Morning Habits That Are Actually Signs Of High-Functioning Anxiety

We all have habits — generally, some good, some that you maybe wish you could get rid of. Maybe you’re great at fixing healthy lunches that keep you going during the work day, and you chew your nails. Or maybe you’ve taught yourself to reach out when you need support for your mental health, and you tend to stay up way too late scrolling social media. And no habits are more ingrained than the ones we do each morning; half-asleep, we brush our teeth, shower, grab a breakfast bar, and head out the door without so much as a second thought (or some variation on the above). But some seemingly small morning habits can actually be signs of high-functioning anxiety, which is why it’s so important to actually pay attention to them.

Dr. Gin Love Thompson, a psychotherapist, recently told another Bustler that high-functioning anxiety is a “pop-psychology term used by people who experience more than moderate levels of anxiety symptoms, but have either not attempted to seek treatment or have not been properly diagnosed by a mental health professional as having a diagnosable anxiety disorder.” Thompson also said that, “The danger here is that just because you are ‘functioning,’ even with a high level of success, while experiencing moderate to high levels of anxiety does not mean it is a healthy state of living. And beyond potentially endangering your health, it is most probably reducing the quality of your daily life, work and relationships.”

If you have habits related to high-functioning anxiety, you may be totally unaware you even have anxiety at all. Like with many other mental illnesses, anxiety can present itself differently in each person, but the habits below are some common signs that anxiety may be more involved in your daily life than you think.

1Waking Up Before Your Alarm

Wordley Calvo Stock/Fotolia

We all do this occasionally (and experience that joyous moment when we realize we still have a while left to sleep), but your body and brain rousing you before your alarm on the regular may indicate you’re anxious about your everyday life. According to Harvard Women’s Health Watch, this consistent early awakening is called sleep-maintenance insomnia, and though it can strike people who simply naturally need less sleep, it can also indicate “times of psychological stress” when “life events are distressing you,” Harvard reports.

This particular habit also applies to you if you consistently get up much, much earlier than needed to for something in the morning. Say your bus is coming at 9 a.m., and you find yourself wanting to get up at 5 or 6 a.m. just to be sure you won’t miss it — that’s a sign of anxiety, too.

2Thinking About What You Need To Get Done That Day

Andrew Zaeh for Bustle

I have generalized anxiety disorder, and this is one of the habits I noticed in myself when I was in high school and college. If you wake up with a to-do list practically written on the backs of your eyes, and you’re constantly watching the clock as you’re getting ready, parsing out how much time your tasks are going to take, it’s a sign that you’re not only not relaxed in the morning, but that you were probably fixated on your to-do list at night, as well. If you experience this, try making each day’s to-do list in the middle of the previous day rather than at night or in the morning, and make sure you’re treating yourself as you check off completed items.

3Not Paying Attention To Your Family

Andrew Zaeh for Bustle

Even if you’re a morning grump, you probably hang out a little with your family in the morning. (This also includes roommates and pets!) If you find yourself laser-focusing on your morning routine and shutting out those around you, it could be a sign you’re experiencing anxiety. Consider giving yourself an extra 15 minutes in the morning so you can refresh yourself with family time before heading out for your day.

4Having An Unbreakable Ritual

Andrew Zaeh for Bustle

Bad mornings happen to us all. Breaking a coffee mug, running out of deodorant, bringing the wrong set of keys to work… these things happen, and it’s totally normal to be in a bad mood when they do. But if you have an ironclad morning ritual from which you absolutely cannot deviate, or you risk ruining your mood for the entire day, that can be a sign of anxiety. To help ease out of that ritual, purposefully change things up, starting on days when you don’t have to go to work or school, so you can take some time for yourself if changing your routine puts you in a funk.

5Eating The Same Breakfast Every Morning

sonyakamoz/Fotolia

As someone with a spouse who does this and is not anxious, I want to say that for some people, this is completely normal. Rituals can be comforting, especially if you’re on a time crunch in the morning and a granola bar and juice is a familiar go-to that helps you get your day off right. But if you’re purposefully constricting yourself to a certain breakfast and get nervous at the idea of switching it up, even (especially) if you don’t really enjoy your breakfast anymore, that’s a sign you’re stressing in the a.m.

Check out some quick, easy breakfast recipes, and if the idea of eating new foods is really upsetting to you, try starting with breakfasts related to what you currently eat. If you eat a granola bar, try granola with yogurt and fruit; if you eat a boiled egg, try a morning wrap with scrambled eggs and cheese.

6Checking Things Multiple Times

Ashley Batz/Bustle

Re-checking things may be a habit many people associate with obsessive-compulsive disorder, but those of us who have anxiety do it, too. Whether you’re triple-checking your locks or unpacking and repacking your work bag because you’re just not sure your lunch is in there, these repeated steps show you could have anxiety that interferes with your daily life.

7Needing To Talk To Someone

Ashley Batz/Bustle

Again, like many of these habits, talking to people in the morning is normal. It’s when you absolutely need to talk to someone, particularly if you find yourself chattering away and recognizing that you literally can’t make yourself disengage from conversation, that this becomes concerning. If you’re noticing this, try free-writing in the morning to let all those anxious thoughts out of your head — having them on paper may help you see what your brain is getting fixated on.

8Not Noticing Time Passing

Ashley Batz/Bustle

This habit also involves hyperfixation. I have a bad habit of getting completely wrapped up in doing my hair, making sure it’s perfect from every angle. In college, I was consistently late to class because after walking from my dorm to my classroom building, I had to go to the bathroom to check that my hair hadn’t gotten out of place, and spent just as long fixing it when it inevitably had. Fixating on your morning routine and not noticing that big chunks of time have passed indicate you’re channeling anxiety in getting ready — and chances are you experience even more anxiety upon realizing you’re late.

9Going Back Home

https://us.fotolia.com/id/182409386#/Fotolia

This habit may also sound like it’s caused by obsessive-compulsive disorder, and there is an element of compulsion to it as well: If you’re consistently ending up in situations where you have to go home and double-check whether your dog’s crate is properly locked, your stove or hair straightener is off, or your fridge is closed, you’re experiencing anxiety.

The key to figuring out if this is forgetfulness versus anxiety is the brain spiral. If you think, “I might have left my fridge open,” but are able to shrug it off, chances are you’re forgetful. But if you think about your fridge being open and your brain starts to spiral toward the worst possibilities, like your pets getting into it and getting sick, or mold growing, that fixation can be a sign of anxiety.

If you have any of these morning habits and are concerned you might have high-functioning anxiety, the best course of action is to speak to a mental health professional who can diagnose and treat you, and help you keep your mornings bright.