Living with Generalised anxiety disorder: ‘My mind whirrs continually …

Generalised Anxiety Disorde 300x225 Living with Generalised anxiety disorder: My mind whirrs continually   negative thoughts compete for space

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“Nothing is to be feared but fear [itself].” Sir Francis Bacon knows nothing of the importance of his words to my life – this year alone, I’ve stated iterations of his quote (to myself) more than I’ve used any other words in the dictionary.

My problems began in summer 2011. After three months of blood tests, scans and invasive procedures, I was diagnosed with a rare, incurable cancer. The summer passed in a blur of shock, denial and fear. It quickly became apparent that I had two major problems to tackle – the cancer with accompanying treatments and the severe anxiety that would run alongside it, eventually becoming the more malicious of the two evils.

I’ve suffered bouts of ‘normal’ anxiety throughout life – who hasn’t? However, after my cancer diagnosis I began to experience a heightened state of fear almost constantly – it just wouldn’t leave me alone. After an intolerable amount of panic attacks and the realisation that I was becoming a recluse, I began cognitive behavioural therapy. Mid-way through, the psychologist diagnosed me with Generalised anxiety disorder (GAD) with obsessive compulsive tendencies, post-traumatic stress and panic disorder. And I thought the cancer was complicated! Labelling them didn’t matter to me as they all contributed to each other, feeding the anxious beast in my mind.

Perhaps I should have expected this but at the time I was otherwise consumed with all the fun and games of cancer treatment, and it didn’t really occur to me that my feelings were escalating out of control.

Fast forward through many panic stricken days to May 2012 when I was deemed a medical miracle – although not cured of cancer, the doctors hadn’t expected me to respond so well to treatment. My life was to become my own again, allegedly. I should have been euphoric, singing from every rooftop in London. I just felt awful – I may have won a battle but the war was just beginning.

Currently a typical day begins with strong feelings of dread and doom on a spectrum ranging from mild to horrendous, characterised by the feeling that ‘today is my last’. I’ll spend (a lot) of time wondering whether I’ll choke on my breakfast; trip over the cat and break my neck; whether my partner will be hit by a car and other such niceties.

The physical symptoms are always there – the crushing feeling in my chest, the difficulty swallowing, the hyperventilation and the dizziness. My mind whirrs continually – negative thoughts compete for space in the dusty loft of my memory lobe. Panic releases adrenaline into my body – I’m always in ‘fight’ mode. Unfortunately when the fight is against an antagonist that is unseen to all and extremely unpredictable, it’s very difficult to win even one round.

GAD is a difficult thing to explain rationally, especially when you’ve been a fully functioning member of society. I try to keep my sense of humour when explaining to loved ones that I am sometimes controlled by a ‘beast’ and that, yes, weirdly, I have degrees of both agoraphobia and claustrophobia.

I fear most forms of transport, being alone in my house, being outside in a crowd, choking to death/drowning/being murdered and the impact of this leads me to feel there is no purpose to my life. GAD is an illness of peaks and troughs – one day I can feel fabulous, the next dreadful. The continual not knowing is a very difficult thing to accept and however hopeful I am one day, GAD quickly slams me back down to earth the next.

I would be so very grateful to wake up without the doom-filled prophecies, leave my house with a jaunty whistle, hop on the train, go to work, sit in a meeting with my colleagues without feeling like the walls are collapsing in on me, walk down the street without clinging to a person/fence/bollard, have lunch without wine to calm the nerves, not jump out of my skin when I hear any loud noises. All the things I used to do without even thinking.

I’ve tried various anti-anxiety drugs and alternative therapies with some degree of success. Positive mantras used to be an alien subject to me but are now a daily habit. Music rates highly on my list of things to make me feel better. Crying is unfortunately a regular occurrence but it’s a good way to release tension. I’m currently undergoing treatment called Eye Movement Desensitisation and Reprocessing which I am hoping will make a difference in the long term.

It’s interesting that although one in 20 people have GAD, I’ve yet to meet anyone (outside of anxiety forums) who really talks about it – I think anxiety is still a taboo subject. I am really appreciative that Anxiety UK is trying to rectify this by raising awareness with this video (below). I hope it helps people talk about anxiety a bit more, so that we can try to beat this malevolent enemy.

For more information about anxiety visit www.anxietyuk.org.uk

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Is autism a link to violence





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Investigators are still working to learn more about the Connecticut killer, 20-year-old Adam Lanza.

According to a mediator who worked with Lanza’s parents during their divorce, the young man had an autism-related disorder called “Aspergers.”

Mental health experts say there is no connection between the disorder and violence.

Aspergers is a mild form of autism often characterized by social awkwardness.

According to Julie Miller, an autism specialist, people with autism do have a higher rate of aggressive behavior, outbursts, shoving or pushing or angry shouting.
However Miller says it’s not the type of planned and intentional violence we saw in Newtown.

“There’s something else that happened that caused such an unspeakable act, ” says Julie Miller, Director of the Autism Center in San Luis Obispo. “But typically individuals on the autism spectrum are the victims of crimes, they don’t perpetrate crimes.”

She added that people with autism are all unique and cannot be lumped into a single category.

Mental health professionals also say those with autism and related disorders are sometimes diagnosed with other mental health conditions such as depression, anxiety, or obsessive compulsive disorder.

Leading many to believe what happened in Connecticut may have more to do with other mental health issues Adam Lanza was experiencing.

According to the Centers for Disease Control and Prevention, autism now effects one in 88 American children every year.

7NEWS – Experts: No link between Asperger’s, violence – News Story

NEW YORK – While an official has said that the 20-year-old gunman in the Connecticut school shooting had Asperger’s syndrome, experts say there is no connection between the disorder and violence.

Asperger’s is a mild form of autism often characterized by social awkwardness.

“There really is no clear association between Asperger’s and violent behavior,” said psychologist Elizabeth Laugeson, an assistant clinical professor at the University of California, Los Angeles.

Little is known about Adam Lanza, identified by police as the shooter in the Friday massacre at a Newtown, Conn., elementary school. He fatally shot his mother before going to the school and killing 20 young children, six adults and himself, authorities said.

A law enforcement official, speaking on condition of anonymity because the person was not authorized to discuss the unfolding investigation, said Lanza had been diagnosed with Asperger’s.

High school classmates and others have described him as bright but painfully shy, anxious and a loner. Those kinds of symptoms are consistent with Asperger’s, said psychologist Eric Butter of Nationwide Children’s Hospital in Columbus, Ohio, who treats autism, including Asperger’s, but has no knowledge of Lanza’s case.

Research suggests people with autism do have a higher rate of aggressive behavior — outbursts, shoving or pushing or angry shouting — than the general population, he said.

“But we are not talking about the kind of planned and intentional type of violence we have seen at Newtown,” he said in an email.

“These types of tragedies have occurred at the hands of individuals with many different types of personalities and psychological profiles,” he added.

Autism is a developmental disorder that can range from mild to severe. Asperger’s generally is thought of as a mild form. Both autism and Asperger’s can be characterized by poor social skills, repetitive behavior or interests and problems communicating. Unlike classic autism, Asperger’s does not typically involve delays in mental development or speech.

Experts say those with autism and related disorders are sometimes diagnosed with other mental health problems, such as depression, anxiety, bipolar disorder or obsessive-compulsive disorder.

“I think it’s far more likely that what happened may have more to do with some other kind of mental health condition like depression or anxiety rather than Asperger’s,” Laugeson said.

She said those with Asperger’s tend to focus on rules and be very law-abiding.

“There’s something more to this,” she said. “We just don’t know what that is yet.”

After much debate, the term Asperger’s is being dropped from the diagnostic manual used by the nation’s psychiatrists. In changes approved earlier this month, Asperger’s will be incorporated under the umbrella term “autism spectrum disorder” for all the ranges of autism.

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AP Writer Matt Apuzzo contributed to this report.

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Online:

Asperger’s information: http://1.usa.gov/3tGSp5

Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Experts: No link between Asperger’s, violence

What is obsessive compulsive disorder?

Anyone who’s seen As Good As It Gets has a basic idea about what an Obsessive Compulsive Disorder is, broadly.

“My son keeps on and on washing his hands in the bathroom,” said a confused father to Dr Kersi Chavda at the P. D. Hinduja Hospital MRC, Mumbai. The father came to consult the doctor for his 12 year-old-son. “He has to wash in a particular way, and has to count the number of times he soaps himself. He refuses to open doors holding door handles, unless he has a tissue in his hand, he thinks the handle is always dirty. Again, after locking the doors at night, he locks and unlocks them seven times, and then comes and repeats the entire process to his mother verbally; the parents were literally going crazy.” Dr Kersi’s diagnosis confirms the problem to be Obsessive Compulsive disorder.

Obsessive Compulsive Disorder (OCD) is the second most common psychological disorder nowadays. Part of the spectrum of anxiety disorders, it can drive people to anger and despair, wreck marriages, and be a source of sadness to the care-giver as well.

Dr Kersi explains Obsessive Compulsive Disorder: “An obsession is a recurrent thought, idea or image which causes anxiety, for example ‘My hands are dirty’, this anxiety causes the person to do whatever he can to alleviate the feeling and often in the process of reducing his anxiety, he finds that he has done a particular recurrent action which has helped. This recurrent action then becomes the “compulsion”, and almost invariably is ritualistic, i.e. it has to be performed in a particular manner. Thus ‘I have to wash my finger tips, then the palms, then up to the wrist and then my arms’ becomes a compulsion every time the patient head to the tap. One would continue the action until he/she is convinced that they have done it their way.”

The commonest Obsessive Compulsive Disorder involves cleanliness, checking or counting and religion and often the tenor of these images themselves can be very frightening to the person concerned. “No one enjoys having this problem. Often one is aware that the thoughts and actions do not make sense, but there is still tremendous resistance to change and control of the ritualistic actions,” adds Dr Kersi.

Obsessive Compulsive Disorder Treatment includes relaxation techniques, delayed gratification, supportive therapy and the use of specific medication which break the Obsessive Compulsive Disorder cycle. In severe intractable cases, psycho-surgery is performed.

Read more Personal Health, Diet Fitness stories on www.healthmeup.com

Tara Fass: Why Is Therapy Like a Toxic Dump?

What is therapy? As a therapist in Los Angeles, I’m asked this a lot. One patient likened therapy to “emotional vomiting.” Another likened it to cleaning out her “junk drawer,” another to “connecting the dots” on his life and yet another to a “dress rehearsal.”

Kidding aside, may I also suggest that therapy is a place to unload a “toxic dump” in the office and, by doing so, clear your path in the real world? Therapy is not to be confused with mere complaining. What you can more safely experience in the office (that which feels broken and unsafe outside) and leave it between us, therapy then becomes a safe place and a bridge to new ways about thinking and feeling, instead of just reacting.

Whatever rift was created in your relationships must be repaired through tolerable interactions with another human too, in this case your therapist. That’s why in-person therapy is by far the best mode of contact, though other modes of communication such as the telephone, texts, email, etc. are also handy. There is a quality of being “all in” by meeting in person for therapy sessions, which is not to be underestimated.

Weeping, breaking down and muddling through your complaints in the presence of a third-party trained to help you pull it together again can be highly rejuvenating and refreshing. Yet finding the right one can be challenging. When reaching out to therapists you may want to work with keep in mind a few practical considerations in addition to their theoretical perspective and training: Do you want to commence therapy with a man or a woman? What age range do you want your therapist to be?

You may have some rather unconscious criteria too that may sound outlandish stated out loud, such as: Are you afraid of or looking to feel you’re with an idealized version of your mother or father? Is there a desire, perhaps, to fall in love with your therapist? Does a therapist’s voice or photo repulse, thrill or scare you? These are emotions and questions that might come up in you to pay attention to.

Maybe you want to choose a therapist who might be tempting in these or other ways. In any case, to keep it interesting (and if your therapist doesn’t pick up on it first and address it) see to it that you bring all of this into the treatment room as soon as possible. The experience of therapy will be compromised if what feels forbidden or poisonous is avoided and suppressed. Remember, thinking and talking about what is awful is okay in a way that acting out in shameful ways is unacceptable.

How fast should a therapist call back after you make the initial call? It’s simple: the sooner probably the better, even with a second call-back in round two of telephone tag. You want a therapist who is flexible and responsive, and one who also holds strong boundaries.

Think about how the professional makes you feel personally. Rarely does anyone reach out to a therapist expecting a day at the country club. You are likely up to your armpits in deep suffering. Previous attempts at figuring out your issues have not been working, even though you may be meditating, going to yoga, reading all sorts of self-help books, and talking endlessly with close friends and family. You’re still a hot, melting-down mess, longing for resolution and somewhere safe to unload a toxic dump.

Is there a real person — a therapist — who you can make a connection with and who is trained to help you squeeze through what feels like a dark and narrow passage? Though this entire blog post may sound like advice, good therapists strive to steer clear of giving advice. They help you sit with discomfort and contain your symptoms long enough — whether it is anxiety, depression or obsessions and compulsions — to make it possible to feel and think rationally so that you can sort out what is going on, heal and self-correct.

The benefits of therapy are nice “work” if you can get it. The effort to figure out your conflicts and motivations on a comfortable couch in a nicely-decorated office with one other person, rather than unloading on your loved ones and friends, may be well worth the effort.

For more by Tara Fass, click here.

For more on mental health, click here.

NAMIBC registering for family education classes

Tuesday December 11, 2012

PITTSFIELD — National Alliance on Mental Illness Berkshire County is now registering participants for Family-to-Family Education classes starting in January.

Family-to-Family is a free 12-week course about illnesses of the brain such as post-traumatic stress disorder, depression, bi-polar disorder, obsessive-compulsive disorder and anxiety disorders.

It is designed primarily for family members, friends and caregivers of individuals with these illnesses.

Up-to-date information about diagnosis, medications, treatment options, crisis planning, accessing services, self-care, coping skills and the power of advocacy will be covered by trained volunteers.

All instruction and course materials are provided without cost to participants.

To sign up or find out more, contact Susan Kerr, executive director at the NAMIBC office, 413-443-1666 or email namibc@namibc.org.

Why are People so Interested in the DSM-5?

There is a lot of internet buzz about the approval by the American Psychiatric Association’s (APA) board of trustees of its fifth edition of  the Diagnostic and Statistical Manual of Mental Disorders (DSM-5.)

The APA press release notes “the trustees’ action marks the end of the manual’s comprehensive revision process, which has spanned over a decade and included contributions from more than 1,500 experts in psychiatry, psychology, social work, psychiatric nursing, pediatrics, neurology, and other related fields from 39 countries.”

The approval was announced on Saturday, December 1 (was the APA trying to keep it quiet?) with publication of the DSM-5 scheduled spring 2013.  For a book that has no plot or characters, its pending publication has caused great excitement.  True, it is a sequel, but it is not the latest installment of Harry Potter or the Twilight Saga.

Though the DSMs have not reached the volume of sales of a Harry Potter (so far),  the paperback edition of the last version of the DSM had a sales rank of 261 on Amazon.com.  This is remarkable for a book that is over 900 pages in length and written for professionals.

Besides being bestsellers, the DSMs have inspired games and even music awards. DSM-IV the Game is available for free online.  It is described as “beautiful way to engage and learn about yourself, family, and friends and as an ice breaker at your next holiday gathering.”

Several years ago, Dr. Jill Squyres, a clinical psychologist in San Antonio, created the DSM-IV Music Awards for her professional society’s fall social.  The  DSM-IV Music Awards are modeled on the Academy Awards. She chooses categories based on a DSM diagnosis and then nominates songs that are reflective of disorders such as Major Depression (Jagged Little Pill by Alanis Morisette,  King of Pain by the Police), Mania (Wake Me Up Before You Go Go by Wham, Life in the Fast Lane by the Eagles), Obsessive-Compulsive Disorder (I’m In Love With My Car by Queen, Pinball Wizard by the Who), and Borderline Personality Disorder (Isn’t life Strange by Jim Morrison, Addicted to Love by Robert Palmer).

How does a medical book about psychiatric disorders inspire games and awards let alone become a bestseller? There are not enough medical professionals or people with vested interests, such as the pharmaceutical or insurance industries, to account for these sales figures. What is behind the fascination with the DSM among the general public?   I believe it is because our mental state goes to the core of who we are as human beings and our fascination with the link between mental illness and creativity.

Mental illness went “public” long before cancer and AIDS. Although mental illness is still considered a stigma by the general public, writers and artists have been talking publicly about their bouts of depression and struggles with alcohol and drugs for hundreds of years.  Ernest Hemingway, Virginia Woolf, Sylvia Path and Vincent van Gogh committed suicide. The poets T.S. Eliot and Ezra Pound were committed to mental institutions. The 27 club is comprised of  musicians who died at age 27; Janis Joplin, Jimi Hendrix, Brian Jones, Kurt Cobain, and Amy Winehouse.  The public breakdowns and rants of Mel Gibson, Alec Baldwin, Lindsay Lohan, Charlie Sheen and Mel Gibson have been televised and viewed by millions on YouTube.

The style and language of the DSM is another reason for its popularity. Unlike most medical textbooks , there is relatively little medical terminology and diagnoses are described in terms that are easily understandable to the nonmedical reader. Each diagnosis includes a list of symptoms, referred to as criteria, that typify the disorder. The list of symptoms is exhaustive, but not all symptoms necessarily occur in the disorder. The format and clear non-technical language invite the reader to examine and apply this new knowledge to themselves and others. A parent who worries that his child might have Attention Deficit Hyperactivity Disorder (ADHD) or a spouse concerned that their loved one is displaying symptoms of Alzheimer’s disease can easily look up these disorders and review the symptom check list.

Psychiatric disorders consist of behaviors that are extreme. The same behaviors occur with less intensity or frequency in everyday living. A key symptom of Major Depression Disorder is anhedonia, a failure to find pleasure in everyday life. Anhedonia was the working title of Woody Allen’s movie Annie Hall, which won four Academy Awards including Best Picture. In mild or moderate degrees, most of us have experienced “mild anhedonia” (a.k.a being in a funk) at some point in our lives.

Obsessive-compulsive disorder (OCD)  is an anxiety disorder marked by obsessions, which consist of unwanted and repeated thoughts, or behaviors, and compulsions that make those with OCD feel compelled to perform a behavior to lessen their anxiety. Although most of us are not paralyzed by OCD, we all have some traits. We go back and check to see if we locked our doors or left the tea kettle on. And although we might wish to have the detective skills of Adrian Monk or the writing skills of Jack Nicholson in As Good As It Gets , these fictional characters inability to cope with OCD causes them great anguish and the inability to have significant relationships.

I believe that today’s films and TV shows that portray mental illness are popular because they present characters we can relate to, unlike earlier films such as Psycho, a film that scared people so much they stopped taking showers. We laugh at the neurotic mother-son relationships portrayed in Everyone Loves Raymond and Seinfeld because we can relate to them. And we worry about our children. Are we pushing them so hard that they will end up like Natalie Portman’s crazed ballerina in the Black Swan?

Brain scans have shown that that creativity and “madness” light up similar pathways in the brain. However, the overwhelming majority of mentally ill people are not artists and most artists are not mentally ill.  Edgar Allen Poe, Vincent Van Gogh and Ernest Hemingway were gifted artists who happened to be mentally ill. Their mental illness did not make them artists. In fact, mental illness interferes with the artistic process.  William Styron was not able to write in the throes of his depression. The mathematician John Nash did his greatest work before he was diagnosed with schizophrenia.

I have no doubt that some gifted people are able to function by “throwing themselves into their art.” However, their legacy is their work, not their mental illness. People may fantasize about being able to play guitar like Jimi Hendrix, write like Hemingway, and sing and dance like Michael Jackson. But they don’t fantasize about being clinically depressed, overdosing on drugs, being homeless, or being institutionalized.

To answer to my question of why we are so fascinated by the DSM, I believe it is because it presents and explains extremes of behavior, related to and connected with the more normal levels of behavior we experience. We read the DSM to find ourselves in its pages.

Images: Vincent Van Gogh; Janis Joplin; MONK cover by author.

Chicago Expert Says ‘Anxiety’ Is A Major Challenge Facing New Moms

/PRNewswire/ — Postpartum depression has long been seen as a problem, but mental health providers say anxiety – not just depression – seems to be a major challenge facing new mothers today.  Mental health experts in Chicago are identifying an increasing number of patients who are experiencing severe anxiety and obsessive compulsive symptoms after childbirth.

“We’re seeing moms with disabling anxiety, not just depression after giving birth,” says Vesna Pirec, M.D., Ph.D., the chief medical director of Insight Behavioral Health Centers and a leading expert in the field of women’s mental Health.  “The presentation of anxiety symptoms varies from overwhelming thoughts and images of something bad happening to the baby, to fears that they could somehow harm their newborn. These thoughts can lead to a full blown anxiety attack and a decline in normal functioning,” says Dr. Pirec.

According to recent studies, 16% of postpartum mothers experienced pure anxiety symptoms, while only 6% had pure depression; 4% of the sample had comorbid anxiety and depression. Many experts in the mental health field feel more research is needed. 

Pregnant and postpartum women are often not adequately screened for anxiety even though they are considered an at-risk population for developing new anxiety disorders, or exacerbation of preexisting anxiety symptoms.

“We need improved awareness for perinatal anxiety among both the general public and health care providers,” says Dr. Pirec.  “In some cases, symptoms can start in pregnancy and continue in postpartum, which could affect either fetal or child development.”

Symptoms of perinatal anxiety can include:

  • Excessive worrying –  A persistent focus of a specific anxiety, such as excessive fear of sudden infant death, or a developmental issue which may or may not be objective.  These fears can lead to hyper-vigilance by the mom.
  • Severe insomnia – Most new moms lack sleep, but this would involve the inability of the woman to fall asleep or stay asleep even when the baby is resting.
  • Obsessions during pregnancy – The patient could be plagued by thoughts and images that something bad will happen to the baby, such as worrying about the baby falling or being contaminated by food or medication.
  • Obsessive compulsive symptoms in postpartum period – Examples include obsessively worrying about harming the baby, possibly to the point that the mom would avoid the baby.  Rituals could be created in the caring of the baby and could result in a decline in overall functioning.

Treatment of these issues is often adequately served with intensive out-patient services that would include individualized and group treatment, as well as medication management when appropriate.

Insight Behavioral Health Centers recently launched a comprehensive program tailored specifically towards mood and anxiety disorders in peripartum women.  The program includes individual and group therapy, with more than ten treatment groups for women covering a wide range of issues and experiences.  It focuses on assessment and treatment that is tailored to the patient’s specific needs.

“If left untreated, perinatal anxiety can progress into more severe forms of mental health illness,” says Dr. Pirec.  “If family members and health care providers can identify the signs early, we can take steps to ensure better health for mom and baby.”

About Insight Behavioral Health Centers In addition to its newly added women’s mental health program, Insight Behavioral Health Centers specialize in treatment for adolescents and adults dealing with mood and anxiety disorders and eating disorders including anorexia, bulimia, and binge eating.  Insight is accredited by the Joint Commission and a teaching affiliate of the McGaw Medical Center of Northwestern University. Insight currently has four locations including Northbrook, Evanston, Willowbrook and downtown Chicago.  For more information, visit www.insightbhc.com, or call 312-540-9955. For media inquiries, please contact Debra Baum at 847/767-1206 or at debra_baum@comcast.net.

SOURCE Insight Behavioral Health Centers

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New TLC special profiles obsessive cleaners in ‘Neat Freaks’

Neat Freaks on TFLNeat Freaks on TFL

This woman spends all day, every day cleaning as it is described on the coming TLC special, ‘Neat Freaks.’

Do you clean too often, and sometimes feel a little embarrassed about it? Just as watching reality shows often improves one’s mood through the schadenfreude of peering into lives that are more disordered, TLC has a new special airing soon that will make you feel comparatively normal. Neat Freaks, a one hour special airing on Wednesday December 5 at 10 p.m. features people who literally spend their entire lives scrubbing their homes.

Meet one African-American character named Alfreta. She is so compulsive in her disinfection regime that she not only scrubs her own bathroom with bleach daily, she also cleans the bathrooms in homes she visits — and public restrooms.

The show follows her as Alfreta does her daily routine of detailing her home from top to bottom. As she explains it, “I clean once a day, but once a day is all day.”

Neat Freaks will also introduce audiences to a man named Caleb, who sprays himself and dates down with hydrogen peroxide before sex, and Christy, who hates having guests over because they might sully her sterile interior.

In keeping with similar hits like Hoarders that profile the mentally ill, Neat Freaks might be a smash if this special is picked up and airs as a series. Yet, while we are shaking our heads at these crazy antics, we must remember that we are watching people caught in the grip of a tormenting condition.

According to the trusted medical resource WebMD, engaging in repetitive rituals such as cleaning as a means of fighting a fear of germs is a symptom of OCD or Obsessive-Compulsive Disorder.

“Obsessive-compulsive disorder (OCD), a type of anxiety disorder, is a potentially disabling illness that traps people in endless cycles of repetitive thoughts and behaviors,” the outlet states. “People with OCD are plagued by recurring and distressing thoughts, fears, or images (obsessions) they cannot control. The anxiety (nervousness) produced by these thoughts leads to an urgent need to perform certain rituals or routines (compulsions).”

In the case of the Neat Freaks cast, cleaning might allay each person’s fear of germs, as the repetition of certain acts becomes a calming activity similar to the predictable nature of a church service. Yet, for OCD sufferers, the respite from anxiety is only momentary.

RELATED: Eating disorders quietly plague black communities

“Although the ritual may temporarily alleviate anxiety, the person must perform the ritual again when the obsessive thoughts return,” the WebMD outline on OCD states. This means that people such as Alfreta and Christy remain trapped repeating acts that keep them from living normal lives.

You may think Alfreta is a rarity among African-Americans with this problem, but, unfortunately there is very little data about the prevalence of the issue among blacks. Many think of the popular main character of the beloved show Monk when germphobia comes to mind, and may balk at the idea that OCD also plagues African-Americans — but people like Alfreta are not an anomaly.

It may be found that OCD affects blacks at the same rates as other groups when sufficient information is collected about this demographic. What is known is that when blacks do suffer from the disorder, they are less likely to seek treatment.

“OCD among African Americans and Caribbean blacks is very persistent, often accompanied by other psychiatric disorders, and is associated with high overall mental illness severity and functional impairment,” relates an abstract from a paper on the subject published by the US National Library of MedicineNational Institutes of Health. “It is also likely that very few blacks in the United States with OCD are receiving evidence-based treatment and thus considerable effort is needed to bring treatment to these groups.”

I am not diagnosing Alfreta with OCD, and watching her scrub her bathroom fixtures with a toothbrush might indeed make for “can’t look away” television. But, a show such as Neat Freaks can’t help but remind us of the symptoms of OCD, which is a serious disease — one that research shows not enough African-Americans receive help with it. Hopefully, this show will be a gateway for more blacks to become aware of its symptoms and lessen the cultural stigma against psychiatric treatment that pervades our community as it entertains.

Follow Alexis Garrett Stodghill on Twitter at @lexisb.

(This piece has been edited for clarity.)

Care trumps pills for peace of mind

CHENNAI: Government employee Sudheer Ramakrishnan, 37, was a stickler in many ways. He would step out of his house with a box containing precisely nine betel leaves and one painkiller. Those, he believed, relieved him of his frequent migraines.

One day, on his way to work, he was shocked to find that he had only seven leaves in the box. He asked the bus driver to stop the vehicle but when the driver refused, he turned violent. “Seven leaves instead of nine,” he shouted.

A psychiatrist diagnosed Ramakrishnan’s problem as obsessive compulsive disorder (OCD) and put him on medication which left him drowsy and weak. But Ramakrishnan recently discovered cognitive behaviour therapy (CBT) when he visited a new psychiatrist. The doctor found that his frequent headaches were linked to panic attacks he had as a child in the dark.

The psychiatrist put him through a series of goal-oriented and systematic procedures that rid Ramakrishnan of the connection with the ‘dark’ memory from his childhood. Ramakrishnan now goes to work without the betel leaves and painkiller.

Welcome the new shrink, who does not prescribe medicines. A growing number of psychiatrists in the city are using CBT instead of drugs to cure psychological problems.

Experts say the development will benefit mental healthcare because psychiatrists in the country have all but abandoned talk therapy, the form popularised by Sigmund Freud, and embraced multiple drug treatment. The drugs they prescribe include sedatives, antipsychotics and inhibitors of dopamine, a chemical that acts as the brain’s neurotransmitter. The doctor spends much less time with each patient, and the medicines only stupify patients.

On the other hand, say psychiatrists, CBT is a psychotherapeutic approach that addresses emotional stress and maladaptive behaviour without the ill-effects of drugs. “It helps tone down aggressiveness, fight fears and depression,” says Dr B S Virudhagiri Nathan, director of CARE Institute of Behavioral Sciences, Chennai.

The therapy has been found to be effective for mood swings, psychotic disorders, phobias and attention deficit hyperactivity. “Through conversation and interactive audio-visual tools, CBT specialists help patients think positively,” says Dr Nathan, who runs a CBT training programme in the city in collaboration with University of Manchester.

Psychologists say teachers, doctors and parents should be trained in CBT, which evolved since the 70s. “The training helps when dealing with children who may have fears,” says Dr Deborah McNally, acting director of Salford cognitive therapy training centre, University of Manchester.

However, the city has few CBT specialists. “Our focus should be to teach CBT to counsellors and psychologists, teachers and parents,” says Dr S Karunanidhi, head of the department of psychology, Madras University.

Nearly 7% of India’s population suffers from some form of mental disorder, and doctors estimate more than 7 lakh people in Tamil Nadu require periodic psychiatric care.

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What is CBT?

Cognitive behaviour therapy focuses on SUBHEAD changing HERE illogical thought patterns that trigger mental disorder

Symptoms of OCD

Obsessive compulsive disorder is an anxiety disorder characterised by unwanted thoughts and repetitive behaviors, which are often irrational. For example, repeatedly washing of hands fearing contamination, repeatedly checking if the doors are locked and being obsessed with order and symmetry

What does the therapy entail?

The therapist follows the ‘ABC’ pattern – activating event, beliefs about the event and consequences. The therapist traces the event that triggered the disorder and the client’s immediate interpretation of the event, which can be rational or irrational. The train of thoughts and the behavioural disorder triggered by the event is also assessed by the therapist, who then strives to help the client challenge their thought patterns and beliefs through intensive counselling

Symptoms of behavioural disorders among children

Lack of concentration, fear of going to school, temper tantrums, hyperactivity, irrational fears, frequent defiance, low self-esteem

Symptoms of depression

Mood swings, irritability, loss of appetite, loss of weight, fatigue, absent-mindedness, lack of libido, sleeplessness, frustration, suicidal thoughts and magnifying vague physical pains