Know all about Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder is a disorder that leads to repetitive behaviours induced by unwanted and excessive thoughts or ideas. People with OCD are bothered by their triggers to an extent that it goes out of their control.

“My friends usually call me a freak as I have the habit of spraying disinfectant on every surface before sitting or even touching. At my office, I spray disinfectant on my table, water bottle or anything else especially when someone touches them. Whenever I receive any parcel, I change my clothes. All these habits amplified during the time of COVID as I became more conscious”, said Palak

But what isn’t OCD?

Obsessive-Compulsive Disorder does not include the desire to collect items. Similarly, OCD is not characterised by compulsive lying, betting or other behaviours which indicate problems with impulse control.

Credit: CitySpidey

What is OCD

Compulsions are mostly time-consuming which can sometimes hinder your daily activities. Some common types of OCD are: checking on things repeatedly, obsession with certain patterns, positioning and placement in a particular way, fear of contamination, etc. An example could be someone with OCD of cleanliness and personal hygiene who’d wash their hands repeatedly until they don’t feel clean enough. The World Health Organization ranks OCD as one of the most handicapping conditions in terms of lost income and reduced quality of life. According to the International OCD Foundation, OCD is an anxiety disorder in which people are stuck in an orbit of obsession.

According to a study of the University of Waterloo, “People with OCD have generally been shown in research to have this inflated feeling of responsibility… They often feel that they are going to be responsible for something bad that will happen or that if they fail to  do something, they will be responsible for that harm too.”

Though there is no definite cure for OCD, it can get better with stress management and Cognitive Behaviour Therapy (CBT).

Credit: CitySpidey

 

Are Obsessive Thoughts a Mental Health Symptom?

Since not everyone is the same, and your symptoms could result from an underlying condition, you may want to try some of these self-care strategies and find out which works better for you.

Remember, discussing how you feel and your obsessive thoughts with a mental health professional is highly advisable for long-term improvement.

Identify the thoughts

You may find it useful to learn the difference between your usual thoughts and your obsessive thoughts through a meditation practice or a thought log. Both techniques can help you discover your triggers.

As you write your thoughts, you may identify patterns and themes that repeat or that are particularly distressing.

Counter the thoughts

“Once you identify the obsessive thought, talk back to it,” Bauer says. “Use your rational voice and tell the obsessive voice to stop. Explain to your obsessive thought that your friend is busy and will text when they are free, you already washed your hands, or the door is locked.”

You may find it helpful to remind yourself that these obsessive thoughts aren’t helpful or accurate. You are in control of your own choices and behaviors.

But if you find doing this difficult, also remind yourself this is a symptom and it’s not your fault. You’re doing the best you can to counter these thoughts.

Sit with the thoughts

If you’re living with obsessive thoughts, it may be tempting to constantly push the thoughts away, especially if they’re distressing. But, sometimes, this reaction can have the opposite effect, says Shepard.

“I think of it like the Chinese finger trap puzzle, that little woven tube that you can stick your fingers in,” she says. “Your instinct […] is to try and pull your fingers out when they start to feel stuck. But this only tightens the puzzle’s grip. Instead, you have to relax into the puzzle to free yourself.”

The same is true with obsessions, she says. Try to allow them to be there, in a nonjudgmental way, to help them dissipate.

Journal

It may also help to take out a notebook and write about what you’re feeling.

Journaling may provide emotional relief and help you accept the thoughts you’re having.

Engage in calming activities

“The more anxious we feel, the easier these thoughts invade us,” Bauer says. “It is important to understand our anxiety triggers and how to decrease and manage our anxiety.”

Several activities can promote relaxation. Some of these may work for you:

  • exercise
  • deep breathing at least once a day, or when anticipating anxiety
  • massage
  • daily meditation
  • prayer
  • progressive muscle relaxation
  • yoga

Anticipatory anxiety: Definition, symptoms, coping, and more

The following tips may help people with anticipatory anxiety to reduce their fear and cope with uncertainty about the future:

Look after basic needs

Good self-care begins with taking care of basic needs.

  • Reduce sources of stress where possible.
  • Eat a balanced diet, and limit caffeine and sugar, which can make anxiety worse.
  • Exercise regularly, as research indicates it can reduce anxiety.

Sleep is another important area for those with anxiety. Individuals should try to get enough sleep by going to bed at the same time each night and getting up at the same time each morning.

However, anticipatory anxiety causes sleep disturbance and insomnia, and a lack of sleep worsens anxiety. Breathing exercises or meditation can help people fall asleep more easily. People struggling with chronic sleep disturbance should see a doctor if mindfulness activities do not help.

Practice relaxation and grounding

Techniques to help relaxation can reduce anxiety over time. They also improve sleep quality. Useful techniques include:

  • deep breathing
  • progressive muscle relaxation
  • guided imagery
  • grounding techniques

People can learn more about these techniques from a therapist. There are also numerous apps or online videos that can help guide people through each process.

People should also note that these techniques are not a cure for anxiety. If a person uses them incorrectly, for example when they feel anxious, they can serve as avoidant coping.

Ideally, people should practice these exercises at certain scheduled times, rather than when they feel anxious. A healthcare professional can help a person mindfully incorporate relaxation techniques into cognitive behavior therapy (CBT) or exposure therapy.

Journal

Journaling may help people to reduce anxiety and explore their fears and triggers. People with avoidance disorders should do this with the guidance of a trained mental health professional, as it could lead to rumination (dwelling on negative thoughts), or a compulsion that functions as avoidant coping.

Address negative thoughts

Changing a person’s thinking can help change their moods. People can do this by considering the source of the anxiety and the negative thoughts it produces.

Then, explore how realistic these thoughts are. Often, people with anxiety imagine the worst-case scenario. If they continue to challenge negative thoughts when they arise, these thoughts should become less frequent over time.

Practice self-compassion

Self-compassion — treating oneself with kindness and care in negative situations — may reduce anticipatory anxiety.

One way individuals can practice self-compassion is to explore how they might treat a friend who was having anticipatory anxiety. Often, people are kinder to others than they are to themselves. This exercise highlights the importance of self-compassion.

Find more self-compassion exercises here.

Take charge of the situation

As anticipatory anxiety occurs when people worry about a future event or situation, it can be helpful to take charge of the situation.

For example, if someone is anxious about a job interview, it may be helpful to practice answering interview questions with a friend or family member.

There are several natural ways of reducing anxiety. Learn about them here.

OCD: What It Is and What It Isn’t Obsessive compulsive disorder is a disruptive anxiety

It’s common for anyone to experience times when something in the environment isn’t perfectly straight or color-coded or complete. It aggravates our natural need for order, so we casually say, “It’s my OCD!”

But is it really obsessive compulsive disorder? In most cases, probably not.

“OCD is an anxiety disorder that involves distinct obsessions and compulsions,” said J. Chris Nordgren, PhD, psychologist at Avera Behavioral Health Center. “An obsession is a mental impulse, or intrusive thought, that causes distress. The compulsion is an outward action the person must engage in to relieve the discomfort.”

Types of OCD, Signs and Symptoms

There are five main types of OCD:

  • Contamination – feeling overwhelmed by perceived germs, dirt or dangerous chemicals in the environment
  • Concern of causing harm to others – an excessive fear of accidentally hurting someone, or losing control and hurting someone
  • Repeating things – worrying that if an action isn’t repeated a certain number of times, something bad will happen
  • Obsession of symmetry, order and arrangement – needing things to be balanced and even
  • Hoarding – the extreme accumulation of stuff, which may include trash (sometimes classified as OCD and sometimes not)

OCD comes in pairs: the obsessive mental impulse and the compulsive behavior.

The difference between common emotional distress and true OCD is that the person with OCD will spend an excessive amount of time neutralizing the discomfort through compulsive behaviors.

“For example, if they’re worried they accidentally hit someone while driving, they might drive around the block over and over, check the car when they get home, and watch the news to see if there was a local hit and run,” said Nordgren.

OCD sufferers might spend time ensuring the hangers in their closet are evenly spaced, walk through a doorway again and again, or wash their hands repeatedly. Or, if they touch something with their left hand, they may then touch it with their right to maintain balance.

What OCD Is Not

There are other disorders sometimes mistaken for OCD. They are like OCD in that have some element of obsessive thinking or compulsive behavior; however, they are different from OCD in that they do not have the distinct presence of both obsessions and compulsions. They also all have different treatment procedures than are used for OCD.

These disorders include:

  • Obsessive compulsive personality – a personality disorder characterized by perfectionism, order and tidiness
  • Trichotillomania – a disorder characterized by the urge to pull at hair
  • Excoriation disorder – a disorder of picking at the skin
  • Tics – an involuntary physical or vocal response to a buildup of stress
  • Illness anxiety disorder – an excessive concern about physical symptoms

OCD Treatment: There Is Hope

“The best part about treating OCD is that there is solid hope for the one who is struggling,” said Nordgren. “In my practice, patients who put in moderate effort and do their homework have always seen significant improvement.”

Treatment often begins by addressing non-OCD symptoms that lower the person’s ability to fight their OCD. These might include stress, anxiety or depression. Medication or cognitive behavioral therapy may be recommended to reduce those symptoms.

Then a technique called “exposure plus response prevention” takes place. The person is introduced to moderately uncomfortable obsession triggers while, at the same time, resisting the compulsion. This treatment makes the obsessions and compulsions diminish.

“Going straight to the most stressful situation could cause a person to abandon treatment,” explained Nordgren. “Victories build confidence.”

Talk to your primary care provider if you’re experiencing thoughts or behaviors that are disruptive. Check with your insurance provider to learn if you need a referral or how specialized care is covered.

Higher Risk for Sjögren’s Linked to Obsessive-compulsive Disorder

People with obsessive-compulsive disorder, known as OCD, are at an increased risk — more than three times higher than those who don’t have the condition — of developing Sjögren’s syndrome, according to a population-based study in Taiwan.

Additionally, among the general population, women and individuals ages 65 and older are more prone to develop Sjögren’s, the study showed.

“We concluded that risk of [Sjögren’s] is significantly increased in patients with OCD compared to those without OCD,” the researchers wrote.

The study, “Increased Risk of Sjögren’s Syndrome in Patients with Obsessive-Compulsive Disorder: A Nationwide Population-Based Cohort Study,” was published in the International Journal of Environmental Research and Public Health.

Psychiatric disorders, including anxiety, cognitive deficits, and mood disorders have been reported to affect patients with Sjögren’s syndrome. These neuropsychiatric manifestations can occur at the early and later stages of the disease.

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Obsessive-compulsive disorder is characterized by uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions). Recent research suggests that the prevalence of OCD has increased in people with autoimmune diseases, becoming an extra factor of distress.

However, whether OCD is a risk factor for the development of Sjögren’s syndrome remains largely unknown.

To answer this, a group of researchers in Taiwan conducted a nationwide, population-based analysis of data from the National Health Insurance Research Database or NHIRD.

The NHIRD database contains information on insurance claims, outpatient and emergency room visits, and hospitalizations for almost all of the population — around 23 million people — in Taiwan. The researchers screened data from one million individuals in the NHIRD, with data collected in the 14 years from 1999 to 2013.

Specifically, the team looked for individuals who had been newly diagnosed with OCD, with three or more visits to the hospital or one hospitalization, and no diagnosis of Sjögren’s syndrome.

Individuals without an OCD diagnosis and who did not have Sjögren’s were included as controls. The controls were screened for matching age and gender, and for additional disorders.

The final analysis included 1,678 patients with OCD and 3,356 matched controls. The individuals with obsessive-compulsive disorder had a mean age of 35.6, and included 49.8% women, while the controls had a mean age of 36.1 and were comprised of 50% women.

The overall incidence of Sjögren’s syndrome was markedly higher among people with OCD, with 1.9 cases per 1,000 person-years, than among the controls, for whom the rate was 0.6 cases per 1,000 person-years. Of note, a person-year is a measure of a risk of the disease for a specified population during a specified period. This result was still maintained after adjusting for potential confounding factors, such as age, sex, and co-existing medical conditions (comorbidities).

The results showed that individuals with obsessive-compulsive disorder had a 3.41 times higher risk of developing Sjögren’s than did controls.

Moreover, the risk of Sjögren’s rose significantly during the two years following the OCD diagnosis.

When analyzing the whole group, the risk was the greatest — 5.04 times higher — among those ages 65 and older. Women also were at higher risk than males.

Overall, “this nationwide population-based case-control cohort study revealed that OCD was correlated with a higher risk of incidental [Sjögren’s syndrome],” the researchers wrote.

“Clinicians should be aware that autoimmune symptoms are probable in patients with OCD, especially after a 2-year follow up. Clinically assessing psychiatric stress is important in managing patients with [Sjögren’s syndrome],” the team concluded.

Feeling angry all the time? Here’s what might have triggered it

Anger is an emotion that comes naturally to almost everyone. While the cause of anger or aggression may differ in people, it will only lead to rage and aggressive expression. Although some people learn the art of staying in control and keeping their minds calm, there are certain factors that can cause anger issues which are hard to tackle.

Anger can come in varied forms


As is known, anger is not just a physical show of emotions or strength. It can have many forms and people can choose to express their aggression in different ways.

Given that anger can be demonstrated in order to fulfill different purposes, there are many forms of anger itself. While some people want to solely express themselves, others may like to assert dominance and one’s superiority. Similarly, some show anger in order to intimidate people or it may just be a response out of fear.

That said, besides being physical in nature, anger can also be verbal, mental and emotional. It can lead to physical abuse like hitting and pushing, but intimidation and verbal abuse can also be termed as anger.

What causes anger issues in people?


Everyone is prone to anger. But not everyone has the same reason for being angry. The causes may differ in each person. While for some, anger may be triggered by family problems, financial issues and/or stress-related to work or a romantic relationship, there are those who suffer with certain disorders that can lead to issues related to anger and aggression.

That said, some of the things that can cause anger in people are as follows.

Depression

Often, depression can lead to prolonged sadness and extreme mood swings, causing frustration and anger at even the smallest of instances. It can seem unreasonable to a foreign eye, but depressed people may be prone to uncontrollable emotional outbursts.

Epilepsy

Although very rare, researchers believe that epileptic seizures known as a simple partial seizure can affect your emotions and cause anger and feelings of aggression.


Obsessive compulsive disorder (OCD)


Obsessive compulsive disorder (OCD) is a type of anxiety disorder that makes a person prone to obsessive thoughts and compulsive behavior. Most often, the need to complete a particular ritual or follow a schedule and the inability to do exactly that can trigger frustration, leading to anger. Also, obsessive thoughts and compulsive behaviour may sometimes heighten the level of irritability in a person.

Bipolar disorder

Also a serious condition, bipolar disorder can cause dramatic shifts in your mood and personality. People dealing with this disorder may experience bouts of anger and rage.

Alcohol and drug abuse

According to experts, drinking too much or drug abuse can lead to excessive aggression. Alcohol consumption and taking unnecessary drugs can deprive you of your ability to think clearly and with rationality. It impairs you of the ability to take control of your impulses, leading to anger.

Signs you have anger issues

Since anger is a natural emotion, it may be difficult to find out if you have anger issues and whether you need to manage it. That said, there are some defining characteristics of a person with anger issues.

– Recurrent instances of irritability and frustration
– Feeling overwhelmed by many negative emotions at the same time
– Physical symptoms such as high blood pressure, heart palpitations and tingling sensations in the body
– Occasional verbal and physical abuse
– Sulking, being sarcastic at all times and giving silent treatments can be subtle signs of anger


How to stay calm in times of turmoil?


If you have been diagnosed with anger and or think that your anger is out of hand, you must try calming techniques that can relieve you from such aggression and frustration.

That said, here are some anger management tips to tame your temper.

– It is extremely important to think before you speak. Do not say or do anything that will worsen the situation, instead try breathing exercises to calm yourself down. Exercise can also help you manage your anger.

– Rather than reaching a conclusion, think of possible solutions.

– Join anger management classes that can provide you with various tips and tricks to tackle your anger-related problems.

Can We Help Young Brains Fight Off Anxiety? – Greater Good Science Center at UC Berkeley

Anxiety is one of the most common childhood mental disorders. About 7% of children suffer from it at any given time, with nearly 1 in 3 adolescents experiencing it sometime during their teen years. 

For an anxious child, seemingly normal activities can be hard. Worried kids have trouble adjusting to school, making friends, and learning. They can feel inhibited, avoiding challenges by running away or retreating into themselves. While parents may feel desperate to help, their approaches can backfire. For example, trying to talk kids out of their feelings or keep them away from anxiety-producing situations may inadvertently make the anxiety worse.

To help anxious kids, clinicians have developed science-based treatments, like cognitive-behavioral therapy, to alleviate symptoms. But the treatments can be cumbersome and expensive, and they don’t always work. Anxiety in kids as young as preschool-aged can be a sign of future trouble—a precursor to later disorders, like social anxiety, phobias, or obsessive-compulsive disorder. But less is known about how to stop anxiety in its tracks at very young ages, when kids may not even have the cognitive capacity to benefit from the treatment.

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What if very young kids could be inoculated against anxiety somehow, sparing them from a future of worry and inhibition? A new line of research conducted by Kate Fitzgerald, professor of Psychiatry and Obstetrics at the University of Michigan, suggests this may be possible.

Fitzgerald has been studying very young children with anxiety symptoms and making important discoveries about the brain markers for childhood anxiety. Building on this work, she and her team have created a training program for young children aimed at increasing their cognitive capacities, helping to lessen their anxiety—both immediately and, possibly, in the future.

“We hope our work will show that childhood anxiety is not inevitable, but might be prevented with the right intervention,” says Fitzgerald. “So far, it’s looking promising.”

The neuroscience of anxiety

When we face challenging or scary situations in life, our brains naturally go into action. The amygdala sends out neurochemicals (like adrenaline) to make our hearts pound and prepare our bodies to “fight, flight, or freeze” in case of danger. At the same time, the frontal lobes engage our cognition to assess the situation, draw from past experience, and problem-solve to come up with an appropriate response. In healthy people, these dual systems work in tandem—one putting on the gas and the other applying the brakes—depending on what’s needed.


In the context of this process, a little bit of anxiety can have a positive side—like when it motivates us to practice hard to master a piano piece or study for a test. But, in anxious people, that gas pedal goes to the metal every time, making them want to run or flee challenge. It can be debilitating and exhausting, too, as they often have to exert a lot of effortful control just to get through. Facing stressful situations while tamping down that fear response is key to overcoming anxiety—in adults as well as older kids.

But in young kids, Fitzgerald and her team are discovering, the brain may respond a little differently. For example, four to seven year olds have a higher-than-normal startle response in “neutral situations”—where nothing threatening is happening—but have a normal startle response in scary situations that any child might react to. That suggests that they have more to overcome when facing everyday challenges, like going to school or meeting new people.

Her team has also discovered that a part of the brain that responds when people make a mistake—the error-related negativity (or ERN)—is weaker in anxious five to seven year olds than in worried older children and adults. That’s likely because young kids don’t have well-developed cognitive capacities that could help them understand that errors happen, aren’t scary, and can often be fixed. Without more cognitive control, their startle response wins out, making them anxious, says Fitzgerald.

A young child with low cognitive control is also more likely to develop anxiety later on in childhood, while one with a higher capacity will be more resilient to stress. Raising cognitive control (which can be measured by the ERN) could both treat anxiety in young children and potentially prevent it from becoming worse over time.

“If we could just help kids gain some cognitive control when they are anxious, it could really make a difference in how they deal with stressful situations,” says Fitzgerald. “We just need to empower them.”

Preventing harmful anxiety

To test this idea, Fitzgerald and her colleagues conducted a pilot study (as yet unpublished) with anxious four to seven year olds. The children came to a “camp” the researchers designed called Kid Power for four half-day sessions over two weeks. At the camp, children played fun, ordinary childhood games, like “Simon Says” and “Red Light/Green Light,” that help strengthen cognitive control.

Counselors at the camp gradually increased the challenge within the games to help kids master the skills needed to do well—like being flexible, using their working memory, and inhibiting undesirable responses (like moving when they’re supposed to freeze). They also enjoyed the company of other kids, with whom they brainstormed ways to improve their performance. And parents participated at the end of each session, learning the games from their kids so they could practice playing together at home.

To see the effects this training had on the kids’ brains and behavior, Fitzgerald and her colleagues measured their startle response and ERN before they attended the Kid Power camp and four to six weeks after. To do that, they had kids play computer games that required cognitive control, while wearing special monitors that could capture their startle and ERN responses when they made mistakes. Additionally, the researchers gathered information from the parents and the kids themselves about anxiety symptoms before and after the camp.

After analyzing the data, the team found that the children’s ERNs increased (signifying greater cognitive control), while their startle responses went down—a pattern associated with less anxiety at that age.

“The brain signal that related to detecting an error actually increased, but in a good way,” said Fitzgerald. “Kids were getting better at doing hard things, stopping instinctual responding, including the fear response.”

This mirrored the children’s (and their parents’) own assessments. They reported fewer anxiety symptoms, including fear and avoiding challenging situations, after the training—something Fitzgerald found particularly rewarding.

“It’s exciting to link the brain to behavior, but what’s even more rewarding is the individual children we’ve seen go through the program who are experiencing less anxiety symptoms,” she says.

For example, one parent reported that her daughter, who’d had symptoms of obsessive-compulsive disorder prior to attending the Kid Power camp, had made noticeable improvement, even while the camp was still going on.

“She didn’t want to leave while she was here, and she was in a better mood during the week in between—a little less rigid and able to experience more joy,” the parent wrote in an evaluation.

Fitzgerald recalls another five-year-old camper who’d been very afraid of making mistakes in his kindergarten class, which led to bouts of crying and other disruptive behaviors, requiring daily calls home. After attending the camp, though, and learning how to calm anxiety, everything changed.

“After a week of playing those games that were part of the intervention, those calls from home stopped,” says Fitzgerald. “His mom was impressed, because earlier counseling with a trained therapist had not led to improvement. Only after Kid Power did he successfully adjust to kindergarten and begin to enjoy it.”

With encouraging results from this pilot study, Fitzgerald applied for and received a $3 million National Institutes of Health grant to expand the Kid Power program and conduct further research. She hopes future studies will help her nail down the key ingredient in the program that led to reduced anxiety and, potentially, find a way to tailor treatment to individual children—some of whom may need a stronger dose of the training or slightly different activities to improve, she says.

If her initial findings hold, her work could have broad implications, providing a template that others can follow for treating and preventing childhood anxiety disorders in the future.

“Interventions are within reach,” she says. “As we work to understand the science behind anxiety in young minds, we can use that science to develop treatments that are more effective.”

This article was originally published by AIM Youth Mental Health, a non-profit dedicated to finding and funding promising youth mental health research that can identify solutions to make a difference in young people’s lives today, which contributed to funding Kate Fitzgerald’s research. Read the original article.

Can We Help Young Brains Fight Off Anxiety?

Anxiety is one of the most common childhood mental disorders. About 7% of children suffer from it at any given time, with nearly 1 in 3 adolescents experiencing it sometime during their teen years. 

For an anxious child, seemingly normal activities can be hard. Worried kids have trouble adjusting to school, making friends, and learning. They can feel inhibited, avoiding challenges by running away or retreating into themselves. While parents may feel desperate to help, their approaches can backfire. For example, trying to talk kids out of their feelings or keep them away from anxiety-producing situations may inadvertently make the anxiety worse.

To help anxious kids, clinicians have developed science-based treatments, like cognitive-behavioral therapy, to alleviate symptoms. But the treatments can be cumbersome and expensive, and they don’t always work. Anxiety in kids as young as preschool-aged can be a sign of future trouble—a precursor to later disorders, like social anxiety, phobias, or obsessive-compulsive disorder. But less is known about how to stop anxiety in its tracks at very young ages, when kids may not even have the cognitive capacity to benefit from the treatment.

Advertisement
X



What if very young kids could be inoculated against anxiety somehow, sparing them from a future of worry and inhibition? A new line of research conducted by Kate Fitzgerald, professor of Psychiatry and Obstetrics at the University of Michigan, suggests this may be possible.

Fitzgerald has been studying very young children with anxiety symptoms and making important discoveries about the brain markers for childhood anxiety. Building on this work, she and her team have created a training program for young children aimed at increasing their cognitive capacities, helping to lessen their anxiety—both immediately and, possibly, in the future.

“We hope our work will show that childhood anxiety is not inevitable, but might be prevented with the right intervention,” says Fitzgerald. “So far, it’s looking promising.”

The neuroscience of anxiety

When we face challenging or scary situations in life, our brains naturally go into action. The amygdala sends out neurochemicals (like adrenaline) to make our hearts pound and prepare our bodies to “fight, flight, or freeze” in case of danger. At the same time, the frontal lobes engage our cognition to assess the situation, draw from past experience, and problem-solve to come up with an appropriate response. In healthy people, these dual systems work in tandem—one putting on the gas and the other applying the brakes—depending on what’s needed.


In the context of this process, a little bit of anxiety can have a positive side—like when it motivates us to practice hard to master a piano piece or study for a test. But, in anxious people, that gas pedal goes to the metal every time, making them want to run or flee challenge. It can be debilitating and exhausting, too, as they often have to exert a lot of effortful control just to get through. Facing stressful situations while tamping down that fear response is key to overcoming anxiety—in adults as well as older kids.

But in young kids, Fitzgerald and her team are discovering, the brain may respond a little differently. For example, four to seven year olds have a higher-than-normal startle response in “neutral situations”—where nothing threatening is happening—but have a normal startle response in scary situations that any child might react to. That suggests that they have more to overcome when facing everyday challenges, like going to school or meeting new people.

Her team has also discovered that a part of the brain that responds when people make a mistake—the error-related negativity (or ERN)—is weaker in anxious five to seven year olds than in worried older children and adults. That’s likely because young kids don’t have well-developed cognitive capacities that could help them understand that errors happen, aren’t scary, and can often be fixed. Without more cognitive control, their startle response wins out, making them anxious, says Fitzgerald.

A young child with low cognitive control is also more likely to develop anxiety later on in childhood, while one with a higher capacity will be more resilient to stress. Raising cognitive control (which can be measured by the ERN) could both treat anxiety in young children and potentially prevent it from becoming worse over time.

“If we could just help kids gain some cognitive control when they are anxious, it could really make a difference in how they deal with stressful situations,” says Fitzgerald. “We just need to empower them.”

Preventing harmful anxiety

To test this idea, Fitzgerald and her colleagues conducted a pilot study (as yet unpublished) with anxious four to seven year olds. The children came to a “camp” the researchers designed called Kid Power for four half-day sessions over two weeks. At the camp, children played fun, ordinary childhood games, like “Simon Says” and “Red Light/Green Light,” that help strengthen cognitive control.

Counselors at the camp gradually increased the challenge within the games to help kids master the skills needed to do well—like being flexible, using their working memory, and inhibiting undesirable responses (like moving when they’re supposed to freeze). They also enjoyed the company of other kids, with whom they brainstormed ways to improve their performance. And parents participated at the end of each session, learning the games from their kids so they could practice playing together at home.

To see the effects this training had on the kids’ brains and behavior, Fitzgerald and her colleagues measured their startle response and ERN before they attended the Kid Power camp and four to six weeks after. To do that, they had kids play computer games that required cognitive control, while wearing special monitors that could capture their startle and ERN responses when they made mistakes. Additionally, the researchers gathered information from the parents and the kids themselves about anxiety symptoms before and after the camp.

After analyzing the data, the team found that the children’s ERNs increased (signifying greater cognitive control), while their startle responses went down—a pattern associated with less anxiety at that age.

“The brain signal that related to detecting an error actually increased, but in a good way,” said Fitzgerald. “Kids were getting better at doing hard things, stopping instinctual responding, including the fear response.”

This mirrored the children’s (and their parents’) own assessments. They reported fewer anxiety symptoms, including fear and avoiding challenging situations, after the training—something Fitzgerald found particularly rewarding.

“It’s exciting to link the brain to behavior, but what’s even more rewarding is the individual children we’ve seen go through the program who are experiencing less anxiety symptoms,” she says.

For example, one parent reported that her daughter, who’d had symptoms of obsessive-compulsive disorder prior to attending the Kid Power camp, had made noticeable improvement, even while the camp was still going on.

“She didn’t want to leave while she was here, and she was in a better mood during the week in between—a little less rigid and able to experience more joy,” the parent wrote in an evaluation.

Fitzgerald recalls another five-year-old camper who’d been very afraid of making mistakes in his kindergarten class, which led to bouts of crying and other disruptive behaviors, requiring daily calls home. After attending the camp, though, and learning how to calm anxiety, everything changed.

“After a week of playing those games that were part of the intervention, those calls from home stopped,” says Fitzgerald. “His mom was impressed, because earlier counseling with a trained therapist had not led to improvement. Only after Kid Power did he successfully adjust to kindergarten and begin to enjoy it.”

With encouraging results from this pilot study, Fitzgerald applied for and received a $3 million National Institutes of Health grant to expand the Kid Power program and conduct further research. She hopes future studies will help her nail down the key ingredient in the program that led to reduced anxiety and, potentially, find a way to tailor treatment to individual children—some of whom may need a stronger dose of the training or slightly different activities to improve, she says.

If her initial findings hold, her work could have broad implications, providing a template that others can follow for treating and preventing childhood anxiety disorders in the future.

“Interventions are within reach,” she says. “As we work to understand the science behind anxiety in young minds, we can use that science to develop treatments that are more effective.”

This article was originally published by AIM Youth Mental Health, a non-profit dedicated to finding and funding promising youth mental health research that can identify solutions to make a difference in young people’s lives today, which contributed to funding Kate Fitzgerald’s research. Read the original article.

Health Anxiety Common as COVID Restrictions Loosen

July 14, 2021 — As restrictions lift and mask mandates become scarce, Americans are filling their social calendars and booking vacations. While some are rejoicing, health care professionals say others are emerging from the pandemic with more health-related fears.

COVID-19 has caused more anxiety and depression for many over the course of the pandemic. A survey from the CDC and the Census Bureau found the percentage of adults with symptoms of an anxiety or depressive disorder increased from 36.4% to 41.5% from August 2020 to February 2021.

But this phenomenon will not just disappear as COVID-19 cases decrease, says Reese Druckenmiller, a clinical social worker for the Mayo Clinic Health System.

“There are still people out there not wanting to leave home,” she says. “Some folks inherently struggle with anxiety more than others, and we know anxiety can come from different experiences and traumas. This pandemic has been traumatic for people.”

Though there is little research on the psychological effects of pandemic outbreaks, scientists are beginning to explore this. A recent review published in the International Journal of Cognitive Therapy concluded that, based on available research and the effects of previous pandemics, COVID-19 will likely have a significant effect on people’s mental health, particularly those who already have obsessive-compulsive disorder and health anxiety, along with people on the front line of health care.

According to the authors, since the virus doesn’t have symptoms among certain populations, there’s more anxiety about becoming infected and unknowingly spreading it to vulnerable people.

Not to mention the influx of anxiety-provoking news over the past year, Druckenmiller notes.

“One thing I noticed during the pandemic: The news changed. There were still regular news stories, but at the forefront of every single newscast was the numbers, how many people have died, how many people are hospitalized,” she says.

Some of Druckenmiller’s own patients who are more health-focused saw this as an added burden — another source of anxiety.

For those still uncomfortable with an abrupt reentry into public spaces, Druckenmiller recommends taking small steps. Start leaving the house every day, she suggests, even if it’s just for a walk. It is also important to be honest with loved ones about your own comfort level.

“Our brain is very flexible and fluid, but it also doesn’t just switch on a dime,” she says. “If I’ve been told over the past year this is a horrible thing that could kill me, my brain can’t adjust that fast. We need evidence through experience.”

Hypnosis for anxiety, depression, and fear: Does it work?

Besides hypnosis, other forms of therapy may help people with anxiety and other mental health conditions. These treatments have varying success among those with anxiety, depression, or extreme fear.

CBT

CBT is a form of talk therapy. It uses structured psychotherapy across a specific number of sessions and focuses on the present rather than the past.

The approach helps individuals identify what is most important to them and work towards achieving these goals, no matter the obstacle. As the name suggests, the cognitive model is the basis of CBT, meaning that the way someone views a situation is more critical than the situation itself.

CBT borrows techniques from many other forms of psychotherapy, including:

  • acceptance and commitment therapy
  • compassion-focused therapy
  • solution-focused therapy
  • mindfulness
  • positive psychology
  • motivational interviewing
  • interpersonal psychotherapy

CBT may benefit those with anxiety and depressive disorders. However, it can be more effective for some than others. For example, CBT works better than medication for panic disorder, but the reverse is true in individuals with social anxiety disorder.

Learn more about CBT.

Interpersonal therapy

Interpersonal therapy (IPT) creates a link between a person’s mood and the disturbing life events they have experienced.

IPT can often help people cope with major depressive disorder and may offer an alternative to medication. It could also help with anxiety disorders such as social phobia and post-traumatic stress disorder (PTSD).

Learn more about interpersonal therapy.

Meditation

Meditation is a form of mental training, requiring the individual to calm their mind. It allows people to increase feelings of calmness and physical relaxation, cope with illness, improve psychological balance, and enhance their overall health and well-being.

Some meditation approaches include:

  • mindfulness-based training
  • mindfulness-based intervention
  • mindfulness-based cognitive therapy
  • mindfulness-based stress reduction

Meditation is particularly effective for depression and potentially more so than other therapies. Under some circumstances, this approach is as effective as prescription medications.

However, for anxiety disorders, meditation is only moderately effective. It also works better for some forms of depressive and anxiety disorders. For example, mindfulness-based stress reduction may improve symptoms of depression and PTSD.

Learn more about meditation.

Exposure therapy

Exposure therapy is a psychological treatment that practitioners use to help people face their fears. Often, when someone is afraid of something, they avoid it. Exposure therapy works by breaking the pattern of fear and avoidance by “exposing” individuals to the things they avoid and fear in a safe environment.

Various forms of exposure therapy exist. One of them involves in vivo exposure, where the individual directly faces the feared situation, object, or activity in real life. Imaginal exposure is another variation, where an individual vividly imagines the feared situation, object, or activity. Virtual reality technology is also an option when in vivo exposure is not possible, such as for someone with a fear of heights.

Exposure therapy helps with anxiety disorders, including:

  • phobias
  • panic disorder
  • social anxiety disorder
  • obsessive-compulsive disorder
  • PTSD
  • generalized anxiety disorder

Learn more about exposure therapy