Reward learning may offer novel therapeutic target in OCD

Using a sensory preconditioning paradigm to determine the extent to which individuals were using past experiences to guide their behavior, researchers found that those with obsessive-compulsive disorder were less likely to generalize from rewards than those with social anxiety disorder and healthy controls.

“It has been speculated that the cycle of obsessions and compulsions in OCD may in a sense hijack the dopaminergic reward system, leading to insensitivity to external rewards and incentives, and preventing the adaptive pursuit of rewards in the environment,” Nina Rouhani, graduate student at the Princeton University Neuroscience Institute, and colleagues wrote. “These findings strongly suggest that individuals with OCD might generalize differentially from reward and losses. [Social anxiety disorder] has also been associated with deficient goal-directed learning of reward, although loss learning was not assessed.”

Researchers examined whether 57 individuals with OCD, social anxiety disorder and healthy comparisons generalized differently from rewards vs. losses. Including participants with social anxiety disorder allowed the investigators to see if differential performance on this task compared to healthy controls was specific to OCD or transdiagnostic across patients with anxiety.

Participants completed a sensory preconditioning paradigm that evaluated stimulus-response learning and generalization from monetary rewards, losses and neutral outcomes. The task consisted of three phases: an association phase, where participants learned to link pairs of images through repeated exposure to the pairs (ie, the generalized stimulus and conditioned stimulus); a reward phase, where the conditioned stimuli were paired with reward, loss or a neutral outcome; and a final decision phase, where they chose between pairs of the stimuli without any reinforcement.

Rouhani and colleagues observed no differences between individuals with OCD, generalized anxiety disorder and healthy comparisons in the direct learning of stimuli with their outcomes.

During the task, all participants demonstrated intact stimulus-response learning by choosing rewarding options and avoiding negative ones; however, participants with OCD were less likely to generalize from rewards than those with social anxiety disorder or healthy comparisons. The researchers did not observe this impairment for losses.

In addition, the results showed that greater deficits in reward generalization were associated with severity of threat estimation measured via a subscale of the Obsessive Beliefs Questionnaire within OCD and across all groups.

“Our findings together with prior studies describing deficits in reward processing in OCD suggest reward learning as a novel therapeutic target in OCD,” the investigators wrote. “Our findings also suggest that the interplay among reward processing, threat estimation, and habit-like behavior is complex and warrants careful study in both healthy control and clinical populations using validated paradigms that can tap all three domains in the same subjects.” – by Savannah Demko

Disclosure: Rouhani reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

Fashion seller under fire for ‘Obsessive Christmas Disorder’ pajamas: ‘OCD ruins lives’

Most of us would admit to occasionally dropping a light-hearted reference about being a little OCD, even if we don’t actually suffer from the mental health condition. However, having Obsessive Compulsive Disorder is not a joke. And now an online retailer has been slammed for using the term to describe someone who really loves Christmas.

Boohoo.com has come under fire for its festive PJs, which have OCD written on the top, and “obsessive Christmas disorder” underneath. And Twitter is not best pleased about them.

OCD-UK contacted Boohoo after the backlash and say it was advised that the retailer would review whether or not to remove it from sale, according to Metro UK. A spokesperson for the company said it was never the retailer’s “intention to cause offense”.

“We have spoken with the charity, OCD-UK, that first raised the issue of OCD misuse. It was never Boohoo’s intention to cause offense,” the spokesperson told Yahoo UK. “We are taking steps to educate the teams on this illness and raise awareness within the business to ensure that this does not happen again.”

Just last week, TK Maxx revealed that it would be removing a range of Christmas-themed home goods from stores after customers accused the store of “mocking” mental disorders.

The products, including a selection of cookie jars and plates, were emblazoned with the words: “I have OCD … Obsessive Christmas Disorder,” which many people felt trivializes the illness. To be fair to Boohoo and TK Maxx, it is likely that neither meant to mock people who have a mental illness, but their choice to sell such products is symptomatic of how dismissively society views the condition.

According to BeyondOCD.org, OCD affects one in 40 people in the United States. But while they may be aware of Obsessive Compulsive Disorder (OCD), many people do not know what a serious effect it can have on someone’s life.

What is OCD?

“Obsessive Compulsive Disorder (OCD) is an anxiety-related mental health condition which, when severe, can be disabling,” explains Abie Taylor-Spencer, TMS technician at the mental health clinic Smart TMS. “OCD affects men and women equally, and although it typically tends to occur during late adolescence or early adulthood, it can begin at any age.”

What are the main symptoms of OCD?

According to Taylor-Spencer, the main symptoms of OCD can be categorized into two significant areas: obsessions and compulsions. “[Obsessions] are uncontrollable thoughts, images, worries or urges which someone experiences recurrently and can trigger intense distress,” she says. “The intrusive thoughts can be difficult to ignore and occur frequently, causing extreme anxiety and preoccupation, which prevents the individual from regular day-to-day functioning.”

Taylor-Spencer says that common obsessions in OCD include: causing or failing to prevent harm, perfectionism, scrupulosity (concern with religious issues such as morality and blasphemy) and the fear of contamination and illness.

“The compulsions are repetitive and time-consuming behaviors which an individual performs in an attempt to relieve the anxiety caused by the obsessive thoughts,” she explains. “These can be physical actions or rituals, such as washing or cleaning excessively, arranging things in a specific way, checking that appliances are turned off and that doors are locked.”

Taylor-Spencer says that many compulsions involve numbers; for example, compulsions may involve activities (such as turning on a light switch) that must be repeated a specific number of times without the ritual being interrupted.

“Some compulsions are purely mental; for instance, an individual may pray to prevent harm to others, or count whilst carrying out a task to end on a specific number. “Other common compulsions include seeking reassurance, hoarding and actively avoiding circumstances which may trigger an obsession,” she adds. “Individuals often engage in such behaviors because they feel driven to do so in order to neutralize, counteract or dissipate their obsessions.”

Can different people have worse symptoms than others?

Symptoms vary considerably between individuals. “For example, those with severe OCD may find their symptoms disabling, whereas those with mild OCD will not experience an impact on their lives to the same extent,” Taylor-Spencer explains. “People who find their OCD to be relatively low may find that their symptoms improve without treatment; however, this is unlikely to occur in those with moderate to severe OCD.”

What are the causes of OCD?

According to Taylor-Spencer, different factors contribute to the development of OCD. “The condition may be triggered by a combination of genetic, neurological, behavioral, cognitive, and environmental factors,” she explains. “Imbalances in neurotransmitters such as serotonin and glutate have been recognized as potential factors in the development of this disorder.”

And having relatives with OCD can significantly increase the likelihood of an individual developing OCD. If you need help: a series of guides published by Beyond OCD offer further information.

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Obsessive Compulsive Disorder in MS Patients May Be Trigged by Inflammatory Th17 Cells, Study Suggests

The pro-inflammatory Th17 cells that characterize multiple sclerosis (MS) may also underlie symptoms of obsessive-compulsive disorder (OCD), results of a mouse study show.

The study, “Auto-Reactive Th17-Cells Trigger Obsessive-Compulsive-Disorder Like Behavior in Mice With Experimental Autoimmune Encephalomyelitis,” was published in the journal Frontiers in Immunology.

“For the first time, we are reporting a likely link between OCD and an important arm of cell-mediated immunity,” Avadhesha Surolia, the study’s senior author, and an honorary professor at the Indian Institute of Science in Bengaluru, India, said in a press release.

“Until now, we have looked at neuropsychiatric diseases as purely a neurological problem, ignoring rather completely the immunologic contribution,” Surolia added.

Patients with autoimmune diseases like multiple sclerosis can develop OCD, an anxiety disorder. But central mechanisms linking these disorders remain elusive.

Researchers at the institute used the chronic experimental autoimmune encephalomyelitis (EAE) model, an established MS mouse model, to characterize the psychological abnormalities associated with MS.

Ten days after the induction of MS-like symptoms, they saw that mice developed a repetitive behavior similar to OCD — the animals spent an excessive amount of time, 60 to 70 percent more than a healthy control group of mice, grooming themselves Excessive behavior was also seen in compulsive nestlet shredding and marble burying.

Researchers then focused on a group of cells, called Th17 lymphocytes, known for their pro-inflammatory properties. Th17 cells play a key role in the destruction of the nerve cells’ protective myelin layer, a hallmark of MS.

To determine the relative contribution of Th17 cells to the OCD-like symptoms, they infused Th17 cells into the EAE mice. They also infused mice with Th1 cells, another group of autoreactive immune cells also linked with MS.

Although both groups of animals developed signs of MS, only mice given Th17 cells showed a significant increase in grooming activity, as well as marble burying and nestlet shredding behavior.

“We observed unexpectedly high grooming activities in diseased mice which in some cases manifested as hair-less patches and/or injuries,” the researchers wrote. “The repetitive behavior was noted to be quite similar to OCD in human subjects … firstly, diseased mice devoted unusually greater time in grooming themselves which can be viewed as over-grooming; second, the grooming behavior was rigid in pattern and rigidity is a characteristic feature of OCD; thirdly, the behavior had a[n] anxiety component.”

Brain analysis of Th17-infused mice with excessive grooming behavior showed that these cells lodged primarily in two brain areas known to regulate grooming in mice — the brainstem (the region that connects the cerebrum with the spinal cord) and the brain cortex.

EAE mice treated with digoxin, a selective inhibitor (blocker) of Th17 differentiation, reduced by half the animals’ grooming activity.

Neurotransmitters, like serotonin, were previously linked with OCD, and researchers saw a considerable reduction in serotonin levels in the brain stem and cortex of the EAE mice. Mice treated with an antidepressant that boosts the uptake of serotonin, like fluoxetine (sold as Prozac), reduced their obsessive grooming behavior.

These results suggest that the infiltrating Th17 cells eventually may disrupt serotonin signaling, triggering the OCD-like symptoms. Additional neurotransmitters, like glutamate, may also play a role in the compulsive behavior — perturbed glutamate signaling is known to underly several neuropsychiatric disorders, including OCD.

“[I]t could be proposed that autoimmunity due to Th17-cells or any condition leading to a persistent increase in this particular repertoire of immune cells is a risk factor for neuropsychiatric illnesses,” the study concluded.

Its researchers suggest that therapies targeting the pro-inflammatory Th17 cells may help to halt the development of OCD in people with MS and possibly other autoimmune diseases.

“In this way we will be able to treat the root cause of the malady rather than targeting its manifestation and the symptoms,” Surolia said.

Now Boohoo are under fire for ‘Obsessive Compulsive Christmas’ PJs, but what are the signs of OCD?

Most of us would admit to occasionally dropping a light-hearted reference about being a little OCD, even if we don’t actually suffer from the mental health condition. 

But the fact is that having Obsessive Compulsive Disorder is not a joke. Not should it be used as an abbreviation to describe someone who really loves Christmas.

Just last week TK Maxx revealed they would be removing a range of Christmas-themed home goods from stories after upset customers accused the store of “mocking” mental disorders.

The products, a selection of cookie jars and plates, were emblazoned with the words: “I have OCD… Obsessive Christmas Disorder,” which many people felt trivialises the illness.

And now Boohoo has come under fire for their festive PJs which have a similar message.

The pyjama set, on sale for £17, have OCD written on the top with ‘obsessive Christmas disorder’ underneath.

And Twitter is not best pleased about them.

According to Metro, OCD-UK contacted Boohoo following the backlash and say they were advised the retailer would review whether or not to remove it from sale.

Yahoo UK also contacted Boohoo and a spokesperson responded: “We have spoken with the charity, OCD-UK, that first raised the issue of OCD misuse. It was never boohoo’s intention to cause offence. We are taking steps to educate the teams on this illness and raise awareness within the business to ensure that this does not happen again.”

To be fair to Boohoo and TK Maxx, it is likely neither meant to mock people who have a mental illness, but the move is symptomatic of how society views the condition.

According to the mental health charity Mind, OCD affects an estimated 1.2 per cent of the population in the UK.

But while Obsessive Compulsive Disorder (OCD) is something that many of us are aware of, what is not widely known is just how vast OCD can be and the full effect it can have on someone’s life.

What is OCD?

“Obsessive Compulsive Disorder (OCD) is an anxiety-related mental health condition which, when severe, can be disabling,” explains Abie Taylor-Spencer, TMS Technician at mental health clinic Smart TMS

“OCD affects men and women equally and although it typically tends to occur during late adolescence or early adulthood, it can begin at any age.”

What are the main symptoms of OCD?

According to Abie Taylor-Spencer the main symptoms of OCD can be categorised into two significant areas; obsessions and compulsions.

Obsessions: “These are uncontrollable thoughts, images, worries or urges which someone experiences recurrently and can trigger intense distress,” she says.

“The intrusive thoughts can be difficult to ignore and occur frequently, causing extreme anxiety and preoccupation which prevents the individual from regular day to day functioning.

Abie says that common obsessions in OCD include; causing or failing to prevent harm, perfectionism, scrupulosity (concern with religious issues such as morality and blasphemy) and the fear of contamination and illness.

Compulsions: “The compulsions are repetitive and time-consuming behaviours which an individual performs in an attempt to relieve the anxiety caused by the obsessive thoughts,” she explains.

“These can be physical actions or rituals, such as washing or cleaning excessively, arranging things in a specific way, checking that appliances are turned off and that doors are locked.

Abie says that many compulsions involve numbers; for example, compulsions may involve activities (such as turning on a light switch) having to be repeated a specific number of times without the ritual being interrupted.

“Some compulsions are purely mental; for instance, an individual may pray to prevent harm to others, or count whilst carrying out a task to end on a specific number.

“Other common compulsions include seeking reassurance, hoarding and actively avoiding circumstances which may trigger an obsession,” she adds.

“Individuals often engage in such behaviours because they feel driven to do so in order to neutralise, counteract or dissipate their obsessions.”

Can different people have worse symptoms than others?

Symptoms vary considerably between individuals.

“For example, those with severe OCD may find their symptoms disabling, whereas those with mild OCD will not experience an impact on their lives to the same extent,” Abie explains.

“People who find their OCD to be relatively low may find that their symptoms improve without treatment, however, this is unlikely to occur in those with moderate to severe OCD.”

What are the causes of OCD?

According to Abie there are different factors which may contribute to the development of OCD.

“The condition may be triggered by a combination of genetic, neurological, behavioural, cognitive, and environmental factors,” she explains.

“Imbalances in neurotransmitters such as serotonin and glutate have been recognised as potential factors in the development of this disorder.”

And having relatives with OCD can significantly increase the likelihood of an individual developing OCD.

What are the treatment options for OCD?

There are currently a few different treatment options that are available for people who are suffering from OCD.

  • Psychological treatments which include cognitive behavioural therapy (CBT) and exposure and response prevention (ERP). This involves exposure to the unwanted thought or situation to achieve habituation, which is where the compulsive response can be prevented over time.
  • Medications are available to treat OCD, which are typically used when an individual does not respond to psychological treatment. Commonly, selective serotonin reuptake inhibitors (SSRIs) such as citalopram and sertraline are used to alter the balance of chemicals in the brain. A tricyclic antidepressant such as clomipramine may be prescribed. But around 40% of individuals with OCD do not respond to medication.
  • Transcranial magnetic stimulation (TMS) can also be used to treat OCD. Research has found that OCD is linked to increased activity in the supplementary motor area (SMA), and reducing activity in this area can lead to improvement in OCD symptoms.

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Microblading Helped Me Stop Obsessively Pulling Out My Eyebrows

Fortunately, we live in a time when sharing your struggle with mental health is more than OK—it’s encouraged. I’ve sat in yoga classes, meditation circles, and even all-hands work meetings where stress, overwhelm, and mindfulness were discussed and dissected. My social media feed is peppered with influencers who share the daily ups and downs of depression. And earlier this year, Iconery’s delicate nameplate necklace featuring the word “anxiety”—meant to be worn proudly in order to normalize mental illness—sold out within hours.

But join in the mental health conversation by saying, “I obsessively pick my eyebrow hairs out, one by one, until my brows are bald?” That’ll still earn you some side-eyed glances.

Trichotillomania (aka, trich) is my personal struggle. A form of obsessive compulsive disorder defined by the uncontrollable urge to pull out one’s hair, trich is sometimes referred to as “hair-pulling disorder,” according to the Mayo Clinic. Those with trich could be compelled to pull out any hair on the body, but the most commonly affected areas are the scalp, eyelids, and brows. Consider it next-level nail biting or tooth grinding; an almost involuntary habit that’s difficult, if not impossible, to break.

Somewhere in the middle of my secret 15-year battle with hair pulling, I Googled it. I discovered the term trich, I found out that approximately 1 percent of the U.S. population has the same condition, and I learned that there’s no known cure (although different forms of talk therapy have been shown to help, according to the Mayo Clinic).

I picked my way through high school, college, career changes, dating, and even my wedding. The more stress I felt at any given time, the stronger my urge to pick. And as a woman who regularly falters under the pressure of society’s unattainable beauty standards, the feeling of shame and ugliness that stemmed from having my disorder emblazoned on my forehead—especially in the era of Cara Delevingne and Lily Collins–esque arches—was stressful enough to trigger a fresh episode.

The cycle was vicious.

True, I was always able to cover up “problem areas” with one of the million brow products on the market; but the process of applying, checking, and touching up my drawn-on eyebrows throughout the day only added another layer of obsessive to my obsessive compulsive disorder.

Then I stumbled upon microblading, “a form of tattoo artistry where pigment is implanted under your skin and hairlike strokes are drawn to mimic natural hairs in your brow,” according to Courtney Casgraux, the CEO and founder of Los Angeles’s GBY Beauty. And that’s when I found hope for a life that wasn’t consumed by trich.

“We have experience with clients that have had trich, alopecia, and even chemo,” Casgraux tells SELF. “The hairlike strokes look natural, and as long as you have medical clearance from your doctor, we are able to build you beautiful brows that last years.”

Of course, you don’t have to have a major health issue to partake in brow tattooing. “It’s a time saver,” Casgraux says. “Women who are constantly on the go love this since it’s one less thing they have to worry about.” Prices vary; in most areas, the initial microblading application can run between $500 and $650, but Casgraux notes it can reach up to $800 in places like New York City and San Francisco.

Personally, I didn’t take the decision to go “under the blade” lightly; I worried that my microblading technician might craft a pair of fake brows that were uneven or oddly placed; which, really, I might hate even more than being bald. But the potential to eradicate the trich-induced anxiety I felt on a daily basis was too compelling to pass up. Plus, microblading differs from tattooing in one major way: The results are semipermanent and only last one to three years.

At my appointment, the aesthetician and I discussed the look I was going for (natural and low-key) and she stenciled an outline over my brows for approval. Then came a numbing cream to dull the pain of the blade. And then, finally, there was the “carving” of short, hairlike strokes into the brow bone. Finally, pigment was applied to the area; it took about 30 minutes to sink into the skin. For best results, I was advised to avoid getting the area wet—from washing my face, sweating, or otherwise—for the next week.

I’m still brimming with happy tears over the result. My new brows look unbelievably natural and require no day-to-day upkeep at all. (Although Casgraux notes, “At GBY, we recommend that the client comes in once a year for a minor touch up to keep brows looking fresh.”) But the result I’m referring to is more than just physical.

Microblading has had an immeasurable impact on my mental health.

It’s freed me from the fear of being outed by my noticeable bald patches, and it alleviated some of the all-encompassing anxiety I felt around my appearance. In the year since my session, my picking episodes are fewer and farther between.

Trich isn’t curable—and microblading certainly isn’t an official treatment method—so I do still struggle with the urge to pull. But thanks to microblading, it’s mostly been replaced by a new obsession: Every time I pass a reflective surface, I can’t help but admire my full, fake, beautiful brows.

Related:

People with OCD get stuck in ‘loop of wrongness’

A study of hundreds of brain scans sheds light on abnormalities common to people with obsessive-compulsive disorder.

People with OCD may wash and re-wash their hands or check—and re-check, then check again—that the stove is off. But because the reasons for the behaviors are unclear, about half of patients don’t have effective treatment options.

Now, new research pinpoints the specific brain areas and processes linked to the repetitive behaviors common to patients with OCD. Put simply, patients get stuck in a loop of wrongness and can’t stop behaviors—even if they know they should.

Researchers gathered the largest-ever pool of task-based functional brain scans and other data from OCD studies around the world, and combined them for a new meta-analysis, which appears in the journal Biological Psychiatry.

Can’t stop

“These results show that, in OCD, the brain responds too much to errors, and too little to stop signals, abnormalities that researchers had suspected to play a crucial role in OCD, but that had not been conclusively shown due to small numbers of participants in the individual studies,” says lead author Luke Norman, a postdoctoral research fellow in the University of Michigan psychiatry department.

“It’s like their foot is on the brake telling them to stop, but the brake isn’t attached to the part of the wheel that can actually stop them.”

“By combining data from 10 studies, and nearly 500 patients and healthy volunteers, we could see how brain circuits long hypothesized to be crucial to OCD are indeed involved in the disorder,” he says.

The analysis “sets the stage for therapy targets in OCD, because it shows that error processing and inhibitory control are both important processes that are altered in people with the condition,” says Kate Fitzgerald, a faulty member in psychiatry.

“We know that patients often have insight into their behaviors, and can detect that they’re doing something that doesn’t need to be done. But these results show that the error signal probably isn’t reaching the brain network that needs to be engaged in order for them to stop doing it.”

Error monitor

Researchers focused on the cingulo-opercular network—a collection of brain areas linked by “highways” of nerve connections deep in the center of the brain. The area normally acts as a monitor for errors or the potential need to stop an action, and gets the decision-making areas at the front of the brain involved when it senses something is “off.”

Researchers collected the pooled brain scan data when people with and without OCD performed certain tasks while lying in functional MRI scanner. The analysis includes scans and data from 484 children and adults, both medicated and not.

It’s the first time a large-scale analysis has included data about brain scans performed when participants with OCD had to respond to errors during a brain scan, and when they had to stop themselves from taking an action.

A consistent pattern emerged from the combined data: Compared with healthy volunteers, people with OCD had far more activity in the specific brain areas involved in recognizing that they were making an error, but less activity in the areas that could help them stop.

More to the story

These differences aren’t the full story, the researchers say, and they can’t tell from the available data if the differences in activity are the cause, or the result, of having OCD.

But the findings suggest that OCD patients may have an “inefficient” linkage between the brain system that links their ability to recognize errors and the system that governs their ability to do something about those errors.

“It’s like their foot is on the brake telling them to stop, but the brake isn’t attached to the part of the wheel that can actually stop them,” Fitzgerald says.

“In cognitive behavioral therapy sessions for OCD, we work to help patients identify, confront, and resist their compulsions, to increase communication between the ‘brake’ and the wheels, until the wheels actually stop. But it only works in about half of patients. Through findings like these, we hope we can make CBT more effective, or guide new treatments.”

Not an anxiety disorder

Patients are often anxious about their behavior—but OCD is not an anxiety disorder, researchers say.

The researchers plan to test techniques aimed at taming that drive, and preventing anxiety, in a new clinical trial. In the meantime, the researchers hope that people who currently have OCD, and parents of children with signs of the condition, will take heart from the new findings.

“We know that OCD is a brain-based disorder, and we are gaining a better understanding of the potential brain mechanisms that underlie symptoms, and that cause patients to struggle to control their compulsive behaviors,” Norman says.

Adds Fitzgerald, “This is not some deep dark problem of behavior—OCD is a medical problem, and not anyone’s fault. With brain imaging we can study it just like heart specialists study EKGs of their patients—and we can use that information to improve care and the lives of people with OCD.”

The National Institutes of Health funded the work.

Source: University of Michigan

9 CBD Products that Help With Anxiety

YOUR HAPPY PLACE–Whether it’s the endless flow of stressful headlines, or the onset of the holidays (which some people actually dread), or you’re one of 40 million American adults that suffer from anxiety, hemp- (and cannabis-) derived CBD products are an emerging, alternative option for potentially finding relief.

In fact, there’s a lot of preliminary data that indicates cannabidiol, aka CBD, could be effective for a whole assortment of physical and mental conditions, though U.S. researchers are limited in their ability to conduct clinical trials that would yield more definitive data. This MedicalNewsToday.com article cites studies going back to 2010 that showed CBD’s potential efficacy for disorders including seasonal affective disorder (SAD), depression, as well as “social anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), generalized anxiety disorder, and post-traumatic stress disorder (PTSD).”

Advertisementintegra-products.com

Consumer trends also seem to be trending toward products and experiences that encourage wellness, self-care, and concepts like “gratitude” or the Danish term “hygge,” which translates to “cozy, charming, or special.” Traditional holiday customs are gradually evolving away from stressful activities and gravitating toward purchasing and gifting items that promote well-being.

Especially during this holiday season, the term “chill” takes on dimensions beyond just the weather. Growing interest in self-care and anxiety relief is a reflection, of course, of consumers’ increased recognition of chronic stress as a serious issue that can lead to more health problems over time.

CBD is the latest “it” ingredient in many supplements, cosmeceuticals, edibles, and more. Hemp oil is typically what manufacturers add to products that can be shipped throughout the U.S. (since hemp oil contains CBD only, and less than .03 percent THC, the psychoactive ingredient in cannabis). Though the American hemp industry is in its infancy, the U.S. is the largest global importer of hemp products from countries like France, the Netherlands, and China.

Always refer to the product manufacturer/vendor for any questions about product–they should be easy to contact and available to answer your questions. Some manufacturers will be able to offer seed-to-sale quality test results (if they grow their own hemp), but any CBD product manufacturer should be able to offer information for where they source their CBD oil, and other details like whether it’s also organic, if products are Vegan- or no animal testing-friendly, as well as recommended usages.

Here’s nine CBD products that target stress, so you can just chill and relax (aka chillax)–because if you don’t take care of yourself, you can’t take care of anyone or everyone else:

CBD_Living-water_mgretailerCBD Living Water–Made with 100 percent organic, natural hemp CBD extracts. Cutting-edge nanotechnology is used to infuse CBD extract in approximately 9+pH water. At MayoClinic.com’s Connect Blog, volunteer mentor Gail (@lalyfa) offered her opinion on CBD Living Water, which she used to manage anxiety after eliminating prescription drug Tramadol, under doctor’s care. “The CBD Living Water was my favorite as it just was like drinking bottled water and was immediately available in my system. Within a few minutes of drinking one serving, my anxiety began reducing,” she wrote. For more about CBD Living Water, visit CBDLiving.com.

Green_Roads_cbd_oil_mgretailerGreen Roads CBD Oil–Like other product manufacturers, Green Roads offers a dozen different CBD products in various applications for humans and pets. For the CBD oil purist or patients looking for higher dose formulas, this line of CBD oils has several options. Sleep blog Tuck.com recently declared Green Roads CBD Oil their pick for “Highest Quality” CBD Oil, in their roundup of CBD oils for insomnia, pain, and anxiety. The company described its oil manufacturing process and said, “Our industrial hemp goes through a supercritical CO2 extraction process to obtain the best possible CBD solution. This solution is then formulated by our board-certified pharmacists into finished products and sent out for third party testing.” More, at GreenRoadsWorld.com.

ignite_cbdpen_bubblegum_mgretailerIgnite CBD Flavored Disposable Vape Pens–For many, the ritual of smoking or vaping is a calming exercise. Especially for those who are trying to eliminate cigarette smoking from their routine, vaping is an option, and also a discreet choice for those who’d like to indulge in CBD on-the-go. Colorado-based Ignite CBD offers their Calm formula vape pen in Bubble Gum and Lavender flavors, and described effects as “release and relaxation in moments of stress, and takes the edge off of a chaotic day.” Each pen contains natural essences, fractionated coconut oil, and natural, hemp-derived CBD oil that’s tested throughout production to guarantee no pesticides, herbicides, microbials, or other contaminants. At IgniteCBD.co.

Isodiol_nanomist-mgretailerIsodiol Bioactive™ CBD line–For folks that want an all-inclusive line of products to bring CBD into their wellness routine, Isodiol’s Bioactive line offers balm, lotion, a pain relief patch, three tinctures, three oil capsule formulations, and even a nano-mister that delivers oral doses of their ISO99™ CBD extract, terpenes, and adaptogens. Heneplex™ nanotechnology encourages rapid absorption. The unique formulation may help to promote “relief from temporary discomfort, maintenance of nuro-agility” and “natural calmness.” Isodiol’s Calm Nanomist comes in grape flavor. From Isodiol.com.

Kushed_LavenderKush_mgretailerKushed Candles–Technically, these candles only smell like cannabis and actually contain no THC or CBD; however, aromatherapy is becoming more recognized for scents’ ability to stimulate feelings of wellness, happiness, calm, and even libido. If you perk up around a puff of cannabis or like to indulge in natural, earthy, floral smells, the LavenderKush Candle sounds soothing–scented with lavender, Clary sage, cannabis, and hints of peony, fern, and violet. Other scents include LemonDrop, CaramelCream, CaliforniaDream blends, among others, as well as the QueenGreen all-cannabis scent, which is infused with hemp-derived essential oil. More at Kushedcandles.com.

MarysNutritional-Massage-Oil_mgretailerMary’s Nutritionals Hemp Massage Oil–What’s more relaxing than a massage? This unscented, no-nut blend contains full-spectrum hemp oil, as well as sunflower seed, grape seed, and rice bran oils. CBD oil used in this blend is sourced from hemp grown by Loveland, CO-based Elite Botanicals, and is free of chemicals, solvents, heavy metals, and pesticides. In-house chemists oversee the production of all Mary’s Nutritional products, which also go through in-house testing procedures to guarantee consistency and quality. Enjoy a massage with a friend, or use simply as a part of your all-over skincare regime. For more, visit MarysNutritionals.com.

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Obsessive Compulsive Disorder Brains Stuck In A Loop Of Error Processing

inner speech

The brains of obsessive-compulsive disorder patients get stuck in a loop of “wrongness”, that patients can’t stop even if they know they should, new research suggests.

This new analysis of brain scans from hundreds of people with OCD, and people without the condition, was larger than any previous study. It pinpoints the specific brain areas and processes linked to those repetitive behaviors.

No one knows exactly what drives people with obsessive-compulsive disorder to do what they do, even when they’re fully aware that they shouldn’t do it, and when it interferes with their ability to live a normal life. That lack of scientific understanding means about half of them can’t find an effective treatment.

Overactive Error Response

Researchers from the University of Michigan gathered together the largest-ever pool of task-based functional brain scans and other data from OCD studies around the world, and combined them for a new meta-analysis .

“These results show that, in OCD, the brain responds too much to errors, and too little to stop signals, abnormalities that researchers had suspected to play a crucial role in OCD, but that had not been conclusively shown due to small numbers of participants in the individual studies.

By combining data from ten studies, and nearly 500 patients and healthy volunteers, we could see how brain circuits long hypothesized to be crucial to OCD are indeed involved in the disorder. This shows the power of doing this kind of research more collaboratively,”

says Luke Norman, Ph.D., lead author of the new study and a postdoctoral research fellow in the U-M Department of Psychiatry.

Targeted Therapy Trial

Norman works with U-M psychiatry faculty members Kate Fitzgerald, M.D., M.S., and Stephan Taylor, M.D. Fitzgerald co-directs the Pediatric Anxiety Program at Michigan Medicine, U-M’s academic medical center and leads a clinical trial that is currently seeking teens and adults with OCD to test the ability of targeted therapy sessions to treat OCD symptoms.

“This analysis sets the stage for therapy targets in OCD, because it shows that error processing and inhibitory control are both important processes that are altered in people with the condition.

We know that patients often have insight into their behaviors, and can detect that they’re doing something that doesn’t need to be done. But these results show that the error signal probably isn’t reaching the brain network that needs to be engaged in order for them to stop doing it,”

says Fitzgerald.

Brain Differences

In their paper, the researchers focus on the cingulo-opercular network.

That is a collection of brain areas linked by highways of nerve connections deep in the center of the brain. It normally acts as a monitor for errors or the potential need to stop an action, and gets the decision-making areas at the front of the brain involved when it senses something is “off.”

The pooled brain scan data used in the new paper was collected when OCD patients and healthy people were asked to perform certain tasks while lying in a powerful functional MRI scanner. In all, the new analysis included scans and data from 484 children and adults, both medicated and not.

Norman led the combining of the data in a carefully controlled way that allowed for the inclusion of brain scan data from studies conducted as far apart as the Netherlands, the United States and Australia.

cingulo-opercular network in OCD

The regions of the cingulo-opercular network where those differences were greatest.
Credit: University of Michigan

It’s the first time a large-scale analysis has included data about brain scans performed when participants with OCD had to respond to errors during a brain scan, and when they had to stop themselves from taking an action.

A consistent pattern emerged from the combined data: Compared with healthy volunteers, people with OCD had far more activity in the specific brain areas involved in recognizing that they were making an error, but less activity in the areas that could help them stop.

Faulty Brakes

The researchers recognize that these differences alone aren’t the full story — and they can’t tell from the available data if the differences in activity are the cause, or the result, of having OCD.

But they suggest that OCD patients may have an “inefficient” linkage between the brain system that links their ability to recognize errors and the system that governs their ability to do something about those errors. That could lead their over-reaction to errors to overwhelm their under-powered ability to tell themselves to stop.

“It’s like their foot is on the brake telling them to stop, but the brake isn’t attached to the part of the wheel that can actually stop them. In cognitive behavioral therapy sessions for OCD, we work to help patients identify, confront and resist their compulsions, to increase communication between the ‘brake’ and the wheels, until the wheels actually stop. But it only works in about half of patients. Through findings like these, we hope we can make CBT more effective, or guide new treatments,”

Fitzgerald says.

Clinical Translation

While OCD was once classified as an anxiety disorder, and patients are often anxious about their behavior, it’s now seen as a separate mental illness.

The anxiety that many OCD patients experience is now thought to be a secondary effect of their condition, brought on by recognizing that their repetitive behaviors are not needed but being unable to control the drive to do them.

The U-M team will test techniques aimed at taming that drive, and preventing anxiety, in its clinical trial of CBT for OCD. The study is currently seeking teens and adults up to age 45 who have OCD, and healthy teens and adults who do not. It involves two brain scans at U-M’s research fMRI facility, and 12 weeks of free therapy between the first and last scan.

Fitzgerald notes that rTMS (repetitive transcranial magnetic stimulation) which was recently approved by the FDA to treat OCD, targets some of the circuits that the U-M team has been working to identify.

rTMS focuses magnetic fields on certain areas of the brain from outside the skull.

“If we know how brain regions interact together to start and stop OCD symptoms, then we know where to target rTMS,”

she says.

For severe cases of OCD, brain surgery techniques have emerged in the last decade as an option — and the new results are consistent with their effects. In such cases, neurosurgeons either disconnecting certain brain areas from one another with tiny burst of energy or cuts, or insert a permanent probe that can stimulate activity in a particular area.

The authors of the new paper call for neurosurgeons to consider the new findings about the role of the brain areas involved in the cingulo-opercular network in both inhibitory control and error processing when deciding whether and where to intervene.

Bottom Line For Patients

The researchers also call for studies that use genetic tests and repeated fMRI brain imaging of the same OCD patients over time, in what’s called a longitudinal study. That could help researchers piece apart the “chicken and egg” issue of whether the problems with error processing and inhibitory control lie at the heart of OCD, or whether they’re the effects of the symptoms of OCD.

In the meantime, Norman, Fitzgerald and Taylor hope that people who currently have OCD, and parents of children with signs of the condition, will take heart from the new findings.

“We know that OCD is a brain-based disorder, and we are gaining a better understanding of the potential brain mechanisms that underlie symptoms, and that cause patients to struggle to control their compulsive behaviors,”

says Norman.

“This is not some deep dark problem of behavior — OCD is a medical problem, and not anyone’s fault. With brain imaging we can study it just like heart specialists study EKGs of their patients—and we can use that information to improve care and the lives of people with OCD,”

adds Fitzgerald.

Norman, Luke J. et al.
Error-processing and inhibitory control in obsessive-compulsive disorder: a meta-analysis using statistical parametric maps
Biological Psychiatry DOI: https://doi.org/10.1016/j.biopsych.2018.11.010

Stuck in a loop of wrongness: Brain study shows roots of OCD …

No one knows exactly what drives people with obsessive-compulsive disorder to do what they do, even when they’re fully aware that they shouldn’t do it, and when it interferes with their ability to live a normal life.

That lack of scientific understanding means about half of them can’t find an effective treatment.

But a new analysis of brain scans from hundreds of people with OCD, and people without the condition, may help. Larger than any previous study, it pinpoints the specific brain areas and processes linked to those repetitive behaviors.

Put simply, the study suggests that the brains of OCD patients get stuck in a loop of “wrongness,” that patients can’t stop even if they know they should.

Errors and stop signals

Researchers from the University of Michigan gathered together the largest-ever pool of task-based functional brain scans and other data from OCD studies around the world, and combined them for a new meta-analysis published in Biological Psychiatry.

“These results show that, in OCD, the brain responds too much to errors, and too little to stop signals, abnormalities that researchers had suspected to play a crucial role in OCD, but that had not been conclusively shown due to small numbers of participants in the individual studies,” says Luke Norman, Ph.D., lead author of the new study and a postdoctoral research fellow in the U-M Department of Psychiatry.

“By combining data from ten studies, and nearly 500 patients and healthy volunteers, we could see how brain circuits long hypothesized to be crucial to OCD are indeed involved in the disorder,” he says. “This shows the power of doing this kind of research more collaboratively.”

New targets for therapy

Norman works with U-M psychiatry faculty members Kate Fitzgerald, M.D., M.S., and Stephan Taylor, M.D. Fitzgerald co-directs the Pediatric Anxiety Program at Michigan Medicine, U-M’s academic medical center and leads a clinical trial that is currently seeking teens and adults with OCD to test the ability of targeted therapy sessions to treat OCD symptoms.

“This analysis sets the stage for therapy targets in OCD, because it shows that error processing and inhibitory control are both important processes that are altered in people with the condition,” says Fitzgerald.

“We know that patients often have insight into their behaviors, and can detect that they’re doing something that doesn’t need to be done,” she adds. “But these results show that the error signal probably isn’t reaching the brain network that needs to be engaged in order for them to stop doing it.”

Zeroing in on brain differences

In their paper, the researchers focus on the cingulo-opercular network. That’s a collection of brain areas linked by highways of nerve connections deep in the center of the brain. It normally acts as a monitor for errors or the potential need to stop an action, and gets the decision-making areas at the front of the brain involved when it senses something is “off.”

The pooled brain scan data used in the new paper was collected when OCD patients and healthy people were asked to perform certain tasks while lying in a powerful functional MRI scanner. In all, the new analysis included scans and data from 484 children and adults, both medicated and not.

Norman led the combining of the data in a carefully controlled way that allowed for the inclusion of brain scan data from studies conducted as far apart as the Netherlands, the United States and Australia.

It’s the first time a large-scale analysis has included data about brain scans performed when participants with OCD had to respond to errors during a brain scan, and when they had to stop themselves from taking an action.

A consistent pattern emerged from the combined data: Compared with healthy volunteers, people with OCD had far more activity in the specific brain areas involved in recognizing that they were making an error, but less activity in the areas that could help them stop.

Disconnected brakes

The researchers recognize that these differences alone aren’t the full story — and they can’t tell from the available data if the differences in activity are the cause, or the result, of having OCD.

But they suggest that OCD patients may have an “inefficient” linkage between the brain system that links their ability to recognize errors and the system that governs their ability to do something about those errors. That could lead their over-reaction to errors to overwhelm their under-powered ability to tell themselves to stop.

“It’s like their foot is on the brake telling them to stop, but the brake isn’t attached to the part of the wheel that can actually stop them,” Fitzgerald says. “In cognitive behavioral therapy sessions for OCD, we work to help patients identify, confront and resist their compulsions, to increase communication between the ‘brake’ and the wheels, until the wheels actually stop. But it only works in about half of patients. Through findings like these, we hope we can make CBT more effective, or guide new treatments.”

Translating the findings to clinical care

While OCD was once classified as an anxiety disorder, and patients are often anxious about their behavior, it’s now seen as a separate mental illness.

The anxiety that many OCD patients experience is now thought to be a secondary effect of their condition, brought on by recognizing that their repetitive behaviors are not needed but being unable to control the drive to do them.

The U-M team will test techniques aimed at taming that drive, and preventing anxiety, in its clinical trial of CBT for OCD. The study is currently seeking teens and adults up to age 45 who have OCD, and healthy teens and adults who do not. It involves two brain scans at U-M’s research fMRI facility, and 12 weeks of free therapy between the first and last scan.

Fitzgerald notes that rTMS (repetitive transcranial magnetic stimulation) which was recently approved by the FDA to treat OCD, targets some of the circuits that the U-M team has been working to identify.

rTMS focuses magnetic fields on certain areas of the brain from outside the skull. “If we know how brain regions interact together to start and stop OCD symptoms, then we know where to target rTMS,” she says.

For severe cases of OCD, brain surgery techniques have emerged in the last decade as an option — and the new results are consistent with their effects. In such cases, neurosurgeons either disconnecting certain brain areas from one another with tiny burst of energy or cuts, or insert a permanent probe that can stimulate activity in a particular area.

The authors of the new paper call for neurosurgeons to consider the new findings about the role of the brain areas involved in the cingulo-opercular network in both inhibitory control and error processing when deciding whether and where to intervene.

The bottom line for patients

The researchers also call for studies that use genetic tests and repeated fMRI brain imaging of the same OCD patients over time, in what’s called a longitudinal study. That could help researchers piece apart the “chicken and egg” issue of whether the problems with error processing and inhibitory control lie at the heart of OCD, or whether they’re the effects of the symptoms of OCD.

In the meantime, Norman, Fitzgerald and Taylor hope that people who currently have OCD, and parents of children with signs of the condition, will take heart from the new findings.

“We know that OCD is a brain-based disorder, and we are gaining a better understanding of the potential brain mechanisms that underlie symptoms, and that cause patients to struggle to control their compulsive behaviors,” says Norman.

Adds Fitzgerald, “This is not some deep dark problem of behavior — OCD is a medical problem, and not anyone’s fault. With brain imaging we can study it just like heart specialists study EKGs of their patients — and we can use that information to improve care and the lives of people with OCD.”

The study was funded by the National Institutes of Health (MH102242).

TK Maxx scraps ‘obsessive Christmas disorder’ range over complaints it trivialised mental illness

“The glamorisation of mental illness really bothers me because in reality there is nothing fun, quirky or cool about it.

“At some point, it became socially acceptable and trendy to use OCD as an adjective.

Another sufferer, who saw the products for sale in the St Helen’s branch, said.

Laura, 40, who has lived with the illness for 30 years, said: “It’s making light of something that I feel is not a light thing.”

7 Little Things You Do In Private That Could Be A Sign Of OCD

While Obsessive-Compulsive Disorder (OCD) presents some very particular symptoms, it is still quite possible for people with the disorder to go undiagnosed. The symptoms of OCD are not always as obvious as pop culture suggests, and your private thought patterns and rituals could be less common than you may think.

While OCD can be quite upsetting, there are a variety of factors that may make it so that someone with the disorder doesn’t receive a diagnosis. “Usually, the thoughts and behaviors lead to significant distress and anxiety,” Dr. Kashmira Rustomji, a psychiatrist at the Mount Sinai Adolescent Health Center, tells Bustle. “However, sometimes it can be a pattern that feels so normal to someone that they miss the signs they have the illness. Furthermore, stigma plays a large role in seeking help and may prevent people from doing so.” Your own misconceptions about what OCD is, plus the ingrained nature of the symptoms themselves, may mean the disorder is not something you’ve given much thought towards.

OCD may also go undiagnosed the symptoms are similar to other mental health issues. “Co-occurring mental health issues, like anxiety, depression, or bipolar disorder can complicate diagnosis because symptoms will often overlap,” licensed psychologist, Dr. Sal Raichbach PsyD, of Ambrosia Treatment Center, tells Bustle. “From the outside, worrying associated with OCD might look like generalized anxiety disorder, especially to someone who isn’t familiar with the differences.” This confusion is another reason it’s particularly important to pay attention to your symptoms.

Of course, a mental health professional is required to make a diagnosis, but examining your own thoughts can still be a very helpful process.

Here are seven little things you do in private that could be a sign of OCD, according to experts.

1You Do Every Task To Perfection

Ashley Batz/Bustle

If, even when you’re in private, you struggle finishing a task until it’s perfect, you may be experiencing a symptom of OCD.

“We think of these individuals as high achievers, […] however the obsession to ‘do it right’ and the compulsion to keep going until it is right — no matter how good the work actually is — can be a sign of OCD,” Joshua Klapow, Ph.D. Clinical Psychologist and Host of The Kurre and Klapow Show, tells Bustle. If you feel bound by the need to get things done perfectly, you may benefit from seeing a professional.

2You Write Lots Of Lists And Reminders

Ashley Batz/Bustle

If your private time is filled with list-making and note taking, particularly if it’s because you’re afraid of forgetting things, then you may be experiencing OCD symptoms.

“We look at this as organized, on top of things, and being sure and safe to get work done,” Dr. Klapow says. “But the obsession around the thought of possibly forgetting, and the compulsion to write it down so as not to forget, can turn itself into a vicious cycle were more time is spent making lists and reminders than actually doing the tasks on the lists and reminders.” If you feel like you absolutely can’t function without making lists, it may be worth checking with a professional to see if you have OCD.

3You Clean Your Space Often

VGstockstudio/Shutterstock

Obsessive compulsive disorder means that not only do you feel like you need to do an activity, but you also fear what happens if you can’t finish the task. So if you clean your home not for a love of making it clean, but for a fear of having it messy, then it may be a sign of OCD.

“The obsessional fear of having a messy home, or a space that is not predictable, leads to the compulsion of constantly reorganizing furniture, clothes, anything in the house so that everything looks nice and serves a purpose,” Dr. Klapow says. If, when you’re alone, you’re constantly organizing and reorganizing, it may be a good idea to ask your doctor or therapist about this tendency.

4You Check Everything Twice

Checking is a common symptom of OCD that not everyone might realize they have. If your alone time is marked by always double and triple-checking that you’ve done what you need to do, in preparation for a worst-case scenario, then it may be a symptom.

“A common compulsion for those with obsessive-compulsive disorder is the need to repeatedly check things before they leave their house, believing that it will somehow cause them harm,” Dr. Raichbach says. “It’s normal to verify that the doors are locked before leaving for the day, but feeling the need to check and re-check multiple times might be an indicator of Obsessive-Compulsive Disorder.” If you feel that you always need to prepare for the worst by checking, then you may want to speak to a professional about this.

5You Make Sure Things Are Symmetrical

Ashley Batz/Bustle

A symmetrical living space is quite aesthetically pleasing. But if you’re spending your time in private making sure things are symmetrical, even in other people’s houses, it may be a sign of OCD.

“Someone with this [kind] of OCD may have difficulty leaving their home in the morning if the pillows on their sofa are not perfectly arranged or their bed is not made up to the point that it feels ‘right,'” psychologist Dr. Heidi McKenzie, tells Bustle. “They may spend extra time on this before leaving the house, even to the point of risking being late to work because they will feel too unsettled if they don’t arrange things just so.” While tilting a painting so it’s symmetrical is not necessarily a sign of any disorder, feeling unable to function until things are “just right” may be an issue worth addressing.

6You Can’t Stop Rethinking A Situation

Ashley Batz/Bustle

Everyone overthinks things from time to time. If, however, your alone time is spent being overcome by rethinking one specific situation or memory in your head, you may be experiencing OCD.

“[People with OCD] may sit alone rethinking a particular situation, conversation or other interaction, or, they may rehearse an upcoming one and go through it over and over again,” psychiatrist Prakash Masand M.D, founder of the Centers of Psychiatric Excellence, tells Bustle. Not all OCD involves outward habits. So regardless of whether you end up with a diagnosis of OCD, if your overthinking is making it hard to participate in daily life, it’s important to check in with a professional.

7You Text All Your Friends For Reassurance

Racing thoughts are a common symptom of OCD. If, even when you’re alone or in private, you can’t turn off your troubling thoughts to the point of needing constant reassurance, you may be experiencing a symptom of OCD.

“A person [with OCD] may ask endless questions about the possibility of them having a serious disorder or a possibility of having unknowingly done something that may be morally wrong,” Anna Prudovski, psychologist and clinical director of Turning Point Psychological Services, tells Bustle. “This constant reassurance-seeking is actually a compulsion. A person is using it to reduce their anxiety caused by an intrusive thought.” If you feel that you cannot deal with your anxieties without texting a bunch of friends for reassurance, then you may want to bring that up with a professional.

Not all private habits of people with OCD are immediately noticeable. It’s important to understand that, like other mental health disorders, OCD is as much about the thoughts as it is about the actions. “Much of this illness is lived in the intrusive thoughts that people have — fears, intrusive and disturbing thoughts that lead to anxiety — and that can impact the ability to work or attend school or live comfortably because they can be so distressing,” Dr. Rustomji says. While not everyone with these symptoms will have OCD, it is still important to know that you don’t need to live with distressing thoughts — and that treatment is possible.