Scientists propose explanation for baffling form of childhood OCD

Pediatric autoimmune neuropsychiatric disorders, or PANDAS, were first proposed in the 1990s. Thought to be triggered by streptococcal infections, they account for an unknown portion of youth OCD cases. But the biology underpinning this disorder has baffled scientists.

The new Yale research, published June 16 in the American Journal of Psychiatry, identifies antibodies that bind to particular brain cells called interneurons as an explanation.

“It is really OCD plus,” said senior author Christopher Pittenger, assistant chair for translational research, associate professor of psychiatry and a researcher in the Yale Child Study Center. “These children have OCD, but they can also have severe separation anxiety, subtle motor symptoms, and show frequent need to urinate. Many refuse to eat.”

While 1% to 3% of children will be diagnosed with OCD by the age of 17, the fraction of OCD cases that can be attributed to PANDAS is unknown. Some doctors say there is not enough evidence to support PANDAS as a distinct diagnosis from OCD. Others, including many parents of children with the syndrome, argue it may account for a large subset of children with OCD.

Pittenger and his team decided to explore the biology of the disorder in a series of experiments involving 27 children who met the strictest criteria for a PANDAS diagnosis and 23 control subjects.

They found that many children with a PANDAS diagnosis possess high levels of an antibody that can attack specific interneurons — neurons that modify the signaling of other nearby cells. These antibodies are concentrated in the striatum, an area of the brain that is associated with voluntary motor control, among other functions, and is known to be involved in OCD. When the antibody binds to these neurons, it reduces their activity.

PANDAS is “real, but probably rare,” Pittenger said.

Adults with Tourette syndrome, a related syndrome characterized by vocal and motor tics, lack the same specific striatal interneurons, suggesting that problems with these cells may play a role in several conditions, Pittenger noted.

His lab aims to explore this biology in other children with OCD and Tourette syndrome to see how widespread interneuron-binding antibodies are in this group of related conditions.

Yale’s Jian Xu is the paper’s first author. The work was principally funded by the National Institute of Mental Health.

Coronavirus has exacerbated my six-year-old’s anxiety

Question: My six-year-old son has developed a phobia of getting sick which early this year started to inhibit his ability to go to friends’ houses and school normally. My wife and I tried various techniques such as giving reassurance, acknowledging his fears and offering empathy.

We tried buying him a “worry monster”, which is a teddy with a zip for a mouth. Basically the child puts the worry into the monster’s mouth, zips it closed and the monster takes the worry away. This teddy has given him some help and comfort, but his anxiety and fears have continued.

Staying Safe From The Coronavirus Without Giving In To OCD Obsessions : Shots – Health News

Cleaning skills that only the most generous would have called eccentric in pre-pandemic times are actually useful as I try to keep myself and my immunocompromised housemate — my girlfriend — safe from catching the coronavirus. But being hypervigilant is exhausting.

Cleaning skills that only the most generous would have called eccentric in pre-pandemic times are actually useful as I try to keep myself and my immunocompromised housemate — my girlfriend — safe from catching the coronavirus. But being hypervigilant is exhausting.

When I was 8 years old, just about all I could think of was how I was going to die that day.

No, I didn’t grow up in the middle of a war zone, though many others on the other side of the world were living through that kind of nightmare in 1996.

I was born and raised in a safe, small town in Idaho where murder was a rarity. It wouldn’t be a gun, a child predator, or a car accident that killed me, I figured.

Instead, because I had a significant form of anxiety that neither I nor my parents recognized at the time — obsessive compulsive disorder — I was convinced that some kind of microscopic creature would be absorbed through my hands and infect every living cell in my body. Maybe it would be bacteria, I thought, or parasites. Or a virus.

For Novelist John Green, OCD Is Like An 'Invasive Weed' Inside His Mind

That pencil I borrowed from my second-grade classmate? It had to be totally infested. The handle on the drinking fountain? Crawling with germs.

When I took out the trash or cleaned our cat’s litter box, my mind raced to strategize which hand I would use to turn on every light switch, open and close each door and carefully lift the lid on the garbage can to minimize my exposure to any kind of contamination.

I got good at using my feet, elbows and any other part of my body that lacked opposable thumbs to avoid touching what I deemed to be the life-threatening surfaces of everyday objects.

Now, 23 years later, those skills that only the most generous would have called “eccentric” in pre-pandemic times are actually useful as I try to keep myself and my immunocompromised housemate — my girlfriend — safe.

But those skills come at a cost as I try to balance the need to frequently sanitize our home with the need to keep anxiety-driven compulsion at bay.

One in 40 adults and 1 in 100 children in the United States cope with OCD on a daily basis, according to the National Institutes of Mental Health

There are different flavors of OCD with different degrees and different types of obsessions and compulsions, including what people may have seen on the AE TV show Hoarders. Those who militantly organize their surroundings also might have a touch of it.

One of my symptoms has always been an extreme and focused aversion to contamination, a characteristic I share with an estimated 40% of those who develop OCD, according to Dr. Elias Aboujaoude, a psychiatrist and director of Stanford University’s OCD clinic.

As a child, touching anything I thought was covered with germs canceled out the use of that hand until I had a chance to scour it with soap and water. Until then I would hold my hand as far as possible from my torso.

If I didn’t perfectly perform these draconian mental gymnastics, I knew — without a doubt — I was going to die. Maybe not immediately, but probably within a day or two, I thought.

Logic, which seems like it would be the panacea for irrational fears, is actually cruelly twisted back at you with OCD. No matter how much you reassure yourself that the hellscape you dreamed up in your head isn’t real, the condition amplifies your fears until you perform whatever fantastic ritual you’ve created for yourself to alleviate the anxiety.

By the time I turned 9 — with cognitive behavioral therapy, persistent practice, as well as a lot of patience and support from my parents — I learned to accept the invasive, persistent thoughts for what they were. Just thoughts. Medication also helps cut my base-level anxiety, and it limits the scope of an occasional panic attack.

Today, my OCD is classified as mild to moderate, which means I’m not crippled by anxiety, at least most of the time.

Why OCD Is 'Miserable': A Science Reporter's Obsession With Contracting HIV

I haven’t had a major contamination relapse since 2008 when I was in college. I was convinced for months back then that I needed to always keep whatever food I ate or drank within sight, because I thought it would magically be dosed with LSD. Let’s be real, no one would be that generous with their stash.

(That episode ended after I finally got the help of a new therapist after not having seen one for more than a decade).

It’s not uncommon for people with well-controlled OCD to experience a small lapse in compulsive behaviors when under great pressure or stress, psychiatrists find, though for many people, full-blown relapses are, as in my case, rare after successful treatment.

Still, the pandemic has been challenging for a lot of us.

Cases of COVID-19 began to spring up in Idaho, where I live, in mid-March. Since then, thousands more cases have appeared.

As we learned the details of how some patients died — alone, gasping for air, choking on fluid that fills their lungs like a lock system in a dam — I could feel my anxiety rise.

I’ve been lucky enough to be able to work from home. But I’m suddenly finding my cleaning regimen taking up a not-so-insignificant part of my day.

In the home I share with my girlfriend, I take every precaution I can to maintain a contamination-free zone in the house, just as CDC guidelines recommend, though sometimes I go a little overboard.

High-touch objects such as door knobs, light switches, remotes, faucets and countertops are all disinfected multiple times per day. When a package gets delivered, I handle it like a live grenade. It, too, must be zapped of any trace of this disease that could sneak into our house.

I know where every object in this house has been, whether I’ve touched it with a finger that has grazed a doorknob that was nicked by the grocery bags that were left on our doorstep, and whether I’ve recently doused that surface with rubbing alcohol to kill any possible trace of the coronavirus that might have crept in while I wasn’t paying attention.

If the gallon and a half of hand soap doesn’t run out first, the hand lotion will.

I worry that, to my girlfriend, I look like a frazzled conspiracy theorist — as though I’m tracking links and clues on a corkboard filled with pins and ribbons, meticulously tracing every step.

That’s not how she sees me, she says. But for her own mental health, she has been leaving the cleaning up to me.

It’s stressful for her, too. She knows I don’t trust her to decontaminate any delivery or package we receive (and I feel guilty admitting that’s true).

While her mind is consumed with concern over the rising global death toll and whether there’s any end in sight, my mind is also managing dozens of little internal clocks ticking down the hours, minutes and seconds until every microbe will die on the mail pile or on the cloth seat in my car.

There’s a thin line between being hypervigilant and succumbing to my deeper obsessions and compulsions — so far I’ve managed to stay on the right side of that line.

My therapist, who will tell me if I’ve crossed it, is still accessible by video call, thankfully. I’ve taken up exercising on our back porch to burn off some of my anxious energy, and that helps.

I’ve planted my garden full of lettuce, spinach, arugula, fancy purple carrots and radishes. Smelling the rich soil and seeing the vibrant colors of my vegetables transports me away from the day’s news and body count.

Heading back inside, I’ll think about how delicious all these things I’ve grown will be to eat in a month or two. But sometimes another thought breaks through, with a slight sense of dread: “Did I wash my hands?”

James Dawson is writer and reporter for Boise Public Radio.

Mental Health Awareness: OCD and…

The American Psychiatric Association describes Obsessive-Compulsive Disorder as “an anxiety disorder in which time people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.”

In the United States, about 1 in 40 adults and 1 in 100 children have OCD. And according to the World Health Organization, OCD is one of the top 20 causes of illness-related disability for individuals between 15 and 44 years of age worldwide.

The International OCD Foundation explains that “having OCD is not simply an overreaction to the stresses of life. While stressful situations can make things worse for people with OCD, they do not cause OCD. People with OCD face severe, often debilitating anxiety over any number of things, called “obsessions.” This level of extreme worry and fear can be so overwhelming that it gets in the way of their ability to function. To try to overcome this anxiety, people with OCD use “compulsions” or rituals, which are specific actions or behaviors. These compulsions are not activities a person with OCD does because they want to, but rather because they feel they have to in order to ease their fears. OCD is not about logic — it is about anxiety and trying to get relief from that anxiety.”

OCD is one of the most common mental illnesses that is frequently referred to in a casual, and incorrect, manner. People will refer to their “OCD” being “triggered” if a picture is crooked or their home isn’t to their standard of cleanliness.  This has diminished what those with OCD go through every day.

“Triggers related to cleanliness and symptoms related to washing make up only a small part of the range of OCD triggers and symptoms,” states the IOCDF. “People with OCD can have obsessions related to a wide variety of things, including losing control, hurting others, unwanted sexual thoughts, and many more. Similarly, the anxiety caused by these obsessions can be lessened by different compulsions, such as “checking” (e.g., re-checking door locks, repeatedly making sure the oven is off), “repeating” (e.g., doing the same action or ritual over and over to be sure it was done “correctly”), and “counting” (e.g., doing things in certain numbers, counting items to certain numbers).”

Obsessive-Compulsive Personality Disorder

Obsessive-Compulsive Personality Disorder (OCPD) is a personality disorder defined by a strict adherence to control, order, perfectionism, and control over one’s environment. This often is at the expense of flexibility and openness to new experiences. Those with OCPD tend to impose the same standards on others. If these standards are not met they may become extremely angry, indignant, or depressed.

It can be difficult for a person with OCPD to express their feelings, for form meaningful relationships.  Those with OCPD may withdrawal from social settings and become isolated.

Some of OCPD symptoms are:

• Excessive devotion to work that impairs social and family activities
• Excessive fixation with lists, rules, and minor details
• Perfectionism that interferes with finishing tasks
• Rigid following of moral and ethical codes
• Unwillingness to assign tasks unless others perform exactly as asked
• Lack of generosity; extreme frugality without reason
• Hoarding behaviors
(Provided by IOCDF)

OCPD affects an estimated 1 in 100 people in the United States.

OCD vs. OCPD 

Despite having similar names, OCD and OCPD are two separate and distinct mental illnesses, each with their own specific symptoms and characteristics.  The main difference between the two is that OCD is designated in the DSM within its own category called Obsessive-Compulsive and related disorders, while OCPD is considered a personality disorder.

IOCDF lists these comparisons for OCD vs OCPD:

What is the difference between OCPD and OCD?
• People with OCD have insight, meaning they are aware that their unwanted thoughts are unreasonable. People with OCPD think their way is the “right and best way” and usually feel comfortable with such self-imposed systems of rules.

• The thoughts, behaviors and feared consequences common to OCD are typically not relevant to real-life concerns; people with OCPD are fixated with following procedures to manage daily tasks.

• Often OCD interferes in several areas in the person’s life including work, social, and/or family life. OCPD usually interferes with interpersonal relationships but makes work functioning more efficient. It is not the job itself that is hurt by OCPD traits, but the
relationships with co-workers, or even employers can be strained.

• Typically, people with OCPD don’t believe they require treatment. They believe that if
everyone else conformed to their strict rules, things would be fine! The threat of losing a job or a relationship due to interpersonal conflict may be the motivator for therapy. This is in contrast to people with OCD who feel tortured by their unwanted thoughts and rituals, and are more aware of the unreasonable demands that the symptoms place on others, often feeling guilty because of this.

• Family members of people with OCPD often feel extremely criticized and controlled by people with OCPD. Similar to living with someone with OCD, being ruled under OCPD demands can be very frustrating and upsetting, often leading to conflict.

YouTube star Lele Pons reveals her battle with severe OCD in new documentary series

Lele Pons is opening up about her battle with mental illness, including Tourette syndrome, depression, ADHD, and severe obsessive-compulsive disorder that at times has left her unable to function.

The 23-year-old Venezuelan star, who has 16.4 million YouTube subscribers and 40.9 million Instagram followers, revealed her struggled with mental disorders for the first time on April 22 with a trailer for her new YouTube documentary, The Secret Life of LeLe Pons

‘People who think that I have the perfect life: Know that I don’t have a perfect life,’ she said. ‘My deepest, darkest secret is that I have OCD and that I’ve had it for most of my life.’

Candid: Lele Pons is opening up about her battle with mental illness, including Tourette syndrome, depression, ADHD, and severe obsessive-compulsive disorder

Candid: Lele Pons is opening up about her battle with mental illness, including Tourette syndrome, depression, ADHD, and severe obsessive-compulsive disorder

Famous: The 23-year-old Venezuelan star has 16.4 million YouTube subscribers and 40.9 million Instagram followers

Famous: The 23-year-old Venezuelan star has 16.4 million YouTube subscribers and 40.9 million Instagram followers

Real life: But, she recently revealed, she has been secretly battling neurological disorders for most of her life

Real life: But, she recently revealed, she has been secretly battling neurological disorders for most of her life

While Lele named several neurological disorders she suffers from, the premiere episode of the show mostly focuses on her OCD, which she has been struggling with for over a decade.

Obsessive-compulsive disorder is an anxiety disorder characterizing by having unwanted obsessive thoughts, which lead a person to repeat certain behaviors (compulsions).

Obsessions defy logic and usually involve concerns about germs or contamination, a need for symmetry, ‘intrusive thoughts’ of a sexual nature, or fears about death or harm befalling themselves or loved ones. 

This can lead the sufferer to commit repetitive behaviors to calm their thoughts. The rituals — like cleaning repeatedly or doing an action a set number of times — can become debilitating and take up much of the day, interfering with normal function.  

‘My OCD is very, very powerful thoughts that make me do stuff that I don’t want to do,’ Lele said.

Scary: In one of the earliest manifestations of the disorder began when she was a child, Lele would feel a need to put a pillow over her head and go a full minute without breathing

Scary: In one of the earliest manifestations of the disorder began when she was a child, Lele would feel a need to put a pillow over her head and go a full minute without breathing

Looking back: Her mother said that she first noticed something was wrong when she observed Lele's need to touch three times 'I just had to touch everything. Everything, everything,' Lele said. 'And if I didn't touch everything, I thought my family was gonna die'

Looking back: Her mother said that she first noticed something was wrong when she observed Lele’s need to touch three times

'When I was little, it got to a point where I could not move from the car and I stayed an hour there, doing some rituals ... and my dad had to carry me out of the car,' she said

‘When I was little, it got to a point where I could not move from the car and I stayed an hour there, doing some rituals … and my dad had to carry me out of the car,’ she said

Stepping in: Her parents realized something was wrong and took her to get professional help Her father noted that Lele can do incredibly complicated things with no effort — but might be incapable of doing something as simple as writing a check or turning off a light, because the rituals get in the way

Stepping in: Her parents realized something was wrong and took her to get professional help

In one of the earliest manifestations of the disorder began when she was a child, Lele would feel a need to put a pillow over her head and go a full minute without breathing.

‘If I made it, I was gonna be happy,’ she explained.

‘When I was little, it got to a point where I could not move from the car and I stayed an hour there, doing some rituals and touching things. And my dad had to carry me out of the car,’ she recalled.

Her mother said that she first noticed something was wrong when she observed Lele’s need to touch three times. 

‘I began to know that she had something wrong when she began to touch three times the door of my room, and I [asked] her, why you do that?’ recalled her mom. Lele told her it was one touch for her, one for her father, and one for her mother.

‘I just had to touch everything. Everything, everything,’ Lele said. ‘And if I didn’t touch everything, I thought my family was gonna die.’

She grew afraid to walk through doors and developed several other compulsions, like turning a faucet on and off three times.

'My OCD is very, very powerful thoughts that make me do stuff that I don't want to do,' Lele said in the documentary

‘My OCD is very, very powerful thoughts that make me do stuff that I don’t want to do,’ Lele said in the documentary

Opening up: She gives a surprising look at her struggles in her new docu-series

Opening up: She gives a surprising look at her struggles in her new docu-series

Diagnosis: Obsessive-compulsive disorder is an anxiety disorder characterizing by having unwanted obsessive thoughts, which lead a person to repeat certain behaviors (compulsions)

Diagnosis: Obsessive-compulsive disorder is an anxiety disorder characterizing by having unwanted obsessive thoughts, which lead a person to repeat certain behaviors (compulsions)

She had learning disabilities, too. Because she wouldn’t talk a lot, she would draw pictures to communicate with her parents. For example, a drawing of a girl eating pizza meant she wanted to eat pizza.

All of these difficulties disrupted her life, and Lele said she ‘barely had any friends’ beyond her family, and would mostly play with her cousins. She was ‘really lonely.’ 

Eventually, she started seeing Dr. Katia Moritz, a clinical psychologist.

‘When I first met Lele, she came in as an emergency situation,’ Dr. Mortiz said. ‘She couldn’t really function and they were struggling to get her to school, eat, sleep, do any of the basic activities that she needed to do.’ 

OCD sufferers benefit from medication and cognitive behavioral therapy, in which the patient learns to cope with negative thoughts and emotions in a more productive way. 

One thing that helped Lele was joining Vine in high school.   

‘Doing funny videos was a distraction to OCD, to what was going on,’ she said.

Serious: At her worst, Lele has been unable to function properly due to the disorder

Serious: At her worst, Lele has been unable to function properly due to the disorder 

How it works: Obsessions defy logic and usually involve concerns about contamination or germs, a need for symmetry, 'intrusive thoughts' of a sexual nature, or fears about death or harm befalling themselves or loved ones

How it works: Obsessions defy logic and usually involve concerns about contamination or germs, a need for symmetry, ‘intrusive thoughts’ of a sexual nature, or fears about death or harm befalling themselves or loved ones

In a video she shared, her therapist talks her through an episode as she sobs and clenches her body, overcome with emotion

In a video she shared, her therapist talks her through an episode as she sobs and clenches her body, overcome with emotion

Can't help it: She insists that she needs to perform her compulsion one more time to make it three times total

Can’t help it: She insists that she needs to perform her compulsion one more time to make it three times total

Raw: She shared several candid looks at what it looks like when she is overcome and fighting a compulsion

Raw: She shared several candid looks at what it looks like when she is overcome and fighting a compulsion

She had initially joined the video-sharing app to make friends, and it soon helped her find them not just online but in school, where her classmates took notice. 

Though her online presence has helped her in some ways, she still struggles with OCD today. 

‘In times that I’m sad, in times that I’m going through stuff, OCD is there. It’s just really hard because there’s triggers, and in OCD if you are triggered to do something, you have to do it,’ she said.

‘When you have a condition that controls you most of the time, you wish you didn’t have that.’

Lele still needs to turn the faucet off three times after she takes a shower — a compulsion that’s shown on camera during the episode.   

The cameras also capture a particularly rough moment with her therapist, in which she is seen sobbing while fighting off a compulsion. 

Some help: Eventually, she started seeing Dr. Katia Moritz, a clinical psychologist, who appears in the documentary

Some help: Eventually, she started seeing Dr. Katia Moritz, a clinical psychologist, who appears in the documentary

Stilling doing it: One compulsion she still performs is turning off the faucet three times after showering

Stilling doing it: One compulsion she still performs is turning off the faucet three times after showering

Fun: Lele first started on Vine as a distraction from her OCD and as a way to make friends

Fun: Lele first started on Vine as a distraction from her OCD and as a way to make friends

She tells Dr. Moritz that she needs to do the compulsive action one more time, because she has only done it twice and it needs to be three times. Dr. Moritz speaks to her calmly, holding her hand and reminding her that she doesn’t need to do it.

She walks her through relaxing her body, unclenching her hands and uncurling her toes in order to push through the moment.     

Dr. Moritz explained that people suffering from OCD turn to compulsions to stop the bad feelings and thoughts creeping in their heads, because doing the ritual quiets it. But the job of therapy is to make the feeling pass without doing the ritual.

Lele also said that she gets help from medication, explaining: ‘If I didn’t take medication, I wouldn’t be where I am.’

Her father, Luis Pons, noted that Lele can do incredibly complicated things with no effort — but might be incapable of doing something as simple as writing a check or turning off a light, because the rituals get in the way.

‘All she has been trying to do all her life is to find a balance between the things that are expected in the world in which she lives and her mind. It’s a struggle that is 24 hours a day,’ he said.  

Busy: She has had an incredible amount of success, but says it wouldn't be possible if she wasn't on medication

Busy: She has had an incredible amount of success, but says it wouldn’t be possible if she wasn’t on medication

Surprise: She said that she has gone into treatment for a month at a time on several occasions and fans don't notice she is gone because she has content saved up that can be posted

Surprise: She said that she has gone into treatment for a month at a time on several occasions and fans don’t notice she is gone because she has content saved up that can be posted

What is obsessive compulsive disorder?

Obsessive compulsive disorder, usually known as OCD, is a common mental health condition which makes people obsess over thoughts and develop behaviour they struggle to control.

It can affect anyone at any age but normally develops during young adulthood.

It can cause people to have repetitive unwanted or unpleasant thoughts.

People may also develop compulsive behaviour – a physical action or something mental – which they do over and over to try to relieve the obsessive thoughts.

The condition can be controlled and treatment usually involves psychological therapy or medication.  

It is not known why OCD occurs but risk factors include a family history of the condition, certain differences in brain chemicals, or big life events like childbirth or bereavement. 

People who are naturally tidy, methodical or anxious are also more likely to develop it.

Source: NHS 

Adding to her struggle, Lele is the subject of hatred and bullying on the internet, as many public figures and social media stars are. 

‘People are making hating me cool,’ she says through tears. ‘Sometimes I block out, I just want to end it.’ 

She also finds herself comparing herself to other people all the time, and that has made the prospect of being vulnerable and talking about her mental illness especially scary

‘Am I scared to tell people? Yes. Am I scared of what they might say? But am I embarrassed? No.’  

As the episode debuted on YouTube, Lele spoke to Entertainment Tonight about the sensitive subject matter, explaining that she chose to open up ‘now that I’m not ashamed and embarrassed about having OCD.’

‘When I was little I couldn’t move, I was stuck in one place. I couldn’t move and my dad had to carry me around places,’ she said. ‘There are things that you don’t want to do, but your brain and your thoughts are telling you to do them.

‘I do a lot of touching, a lot of checking, I touch things, everything.’ she went on. ‘I talk to someone but I repeat myself three times and they don’t notice. I touch something three times. Sometimes I even get nervous when I say [or] do something two times and I’m like, I need to go back… 

‘Everything is so calculated, it’s insane. When it comes to thoughts, I have fear of, “If I don’t do this three times, something bad is going to happen.” And you really, really, truly believe it. It’s not normal, you know? Because I know for a fact that nothing bad’s going to happen, but the feeling is so there that you actually believe it, it’s just hard.”‘

She said that she has gone into treatment for a month at a time on several occasions and fans don’t even notice she is gone because she has content saved up that can be posted while she is away.      

Anxiety Help Los Angeles County Mental Health Guide – Pasadena Weekendr

Individuals and families in Pasadena who may be suffering from mental illness or substance use, or anyone struggling with or in need of information about available mental health services in Pasadena, can click through a map on the Los Angeles County Department of Mental Health website to find mental healthcare providers in the city and nearby locations.

At these centers, trained specialists can help people deal with anxiety and its effects and help find the right mental health care.

The map shows more than 30 mental healthcare providers in Pasadena, two in Altadena, and four in South Pasadena.

These centers are staffed by psychotherapists and psychologists, and are often able to expand services by supervising licensed and experienced professionals.

Psychologists offer a variety of services, including counseling, mental health education, psychotherapy, and behavioral counseling. They are also trained to treat anxiety, depression, bipolar disorder, post-traumatic stress disorder, and other mental illnesses.

Those who may already have an anxiety diagnosis or who simply want to stop worrying or feeling anxious can avail of services at the Downtown Los Angeles Mental Health Center, at 529 Maple Ave. in Los Angeles, according to a Patch report.

Anxiety-related conditions can include generalized anxiety disorder, obsessive-compulsive disorder (OCD), panic attacks, and depression.

Anxiety disorders are one of the most common mental illnesses in the United States, affecting over 40 million adults each year.

Treatment of OCD patients can also be used in patients with health anxiety, as the disease is included in the group of OCD disorders, according to the American Psychiatric Association. It is a form of psychotherapy and focuses on the cognitive component of therapy, the purpose of which is to help you recognize and understand the false and disturbing beliefs that activate anxiety, the report said.

Your therapist may advise you to use Cognitive Behavioural Therapy (CBT) to explore and focus on the areas of anxiety that fall under the umbrella of depression, post-traumatic stress disorder (PTSD), anxiety disorder, and depression.

In Pasadena, Sync Counseling Center, at 482 N. Rosemead Ave. Suite 207, provides you with a safe space to talk to a therapist and other mental health professionals, and explore your thoughts, feelings, and challenges. This will help you develop problem-solving skills to actively reduce your work stress.

Among people who are affected by an anxiety disorder, only about 37 percent receive medication for their symptoms, the Patch reports quotes an American Psychiatric Association statement. About half of all people diagnosed with anxiety disorders are also diagnosed with depression.

To manage anxiety, therapy, medication, or a combination of both can be particularly effective, the report added. Professional treatment for anxiety is one of the most useful things anyone can do, especially when dealing with other mental health problems such as depression, bipolar disorder, or post-traumatic stress disorder.

Without treatment, people with an anxiety disorder are often so preoccupied with anxiety that they are unable to fully exercise their personal, professional, and social lives.

Seeing a licensed therapist in Pasadena can help you find the best treatment for your specific symptoms. The first step is to make an appointment with a mental health specialist, such as a psychiatrist, psychologist, or chief psychiatrist.

To find a mental healthcare provider in Pasadena, visit www.locator.lacounty.gov/dmh and enter your address into the search box on the front page.

Camila Cabello gets candid about her mental health struggles: ‘I was embarrassed and ashamed’

Camila Cabello is getting candid about her struggles with mental health.

In an essay published in WSJ magazine Thursday, the singer, 23, discussed not wanting to come forward about her obsessive-compulsive disorder (OCD) symptoms. According to the National Institute of Mental Health, OCD is when someone “has uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that he or she feels the urge to repeat over and over.”

“I didn’t want to tell you what was going on for the same reason a lot of us don’t want to talk about what it feels like to be at war in our minds and in our bodies. I was embarrassed and ashamed,” Cabello wrote. “That same little voice also told me maybe I was being ungrateful for all the good in my life – and that hiding the open wound I’d been avoiding the last few years was the easiest and fastest solution.” 

But, she said that was “not the truth.”

“There was something hurting inside me, and I didn’t have the skill to heal it or handle it. In order to heal it, I had to talk about it,” she said. “Denying my suffering and berating myself didn’t help things. I needed to say those three revolutionary words: ‘I need help.'”

What it’s like to have an anxiety disorder during the pandemic

Living through a global pandemic can spark anxiety in just about anyone. But for people who have an anxiety disorder, it can be crippling.

“It’s important to think about people with obsessive-compulsive disorder and other anxiety disorders because often our illnesses are invisible or not taken seriously,” Megan Williams, a rising senior at the University of Pittsburgh who has obsessive-compulsive disorder (OCD), tells Yahoo Life. 

Williams, who writes about mental health for The Pitt News, was sexually assaulted when she was 15, and developed OCD afterward. OCD is a mental health condition that happens when a person gets caught in a cycle of obsessions (unwanted and intrusive thoughts, images, or urges that trigger upsetting feelings) and compulsions (behaviors to try to relieve the stress), according to the International OCD Foundation.

Williams says her OCD is largely focused around safety—she will lock a door and have “crippling panic” that she didn’t “lock it enough” and will feel the need to check three times to make sure she turned off a gas burner. But Williams says her compulsions have changed slightly with the COVID-19 pandemic.

“For over two months, I didn’t go anywhere,” she says. “I went home and washed my hands until they were cracked and bleeding. The feeling with OCD is that you are out of control, and you do your compulsions to regain that control, even if they are irrational.”

Williams says she’s also struggled with news reports interfering with her mental health. “It seems now that my compulsions aren’t obsessive, but that they’re logical,” she says. Case in point: She obsessively checked her feet for “coronavirus toes” after news broke that they can be a symptom of the virus. “I mean, you can’t look at feet longer than I looked at my own feet,” she says. “Check again, check again, because something can change.”

Williams says she’s especially nervous about states re-opening. “One of the No.1 things that’s frustrating about having OCD during coronavirus is I can’t control what other people do, no matter how much my OCD is screaming at me to control what other people do,” she says. 

Williams isn’t the only person struggling right now. There are several mental health disorders that fall under the category of anxiety disorders, including general anxiety disorder, panic disorder, and social anxiety disorder, and many are negatively impacted by the pandemic, psychologist Alicia Clark, author of Hack Your Anxiety, tells Yahoo Life. “This is common in the sense that the disorder has more to do with the process than with the content of the obsessions,” she says. “In a pandemic or any cultural situation like this, where there are directives for certain behaviors and a call to be extra vigilant, it can hit somebody with an anxiety disorder pretty hard.” 

Factors like unstructured time, stress of quarantining, having young children constantly at home, and self-isolation can all feed into the symptoms of anxiety disorders, says psychologist Lily Brown, director of research at the Center for the Treatment and Study of Anxiety at the University of Pennsylvania Perelman School of Medicine, tells Yahoo Life. “These are all huge risk factors for anxiety,” she says.  

What, exactly, that looks like, and the particular challenges people with an anxiety disorder can face vary. But, Brown says, there are certain issues that are unique to each disorder under the pandemic.

People who have been in treatment for contamination OCD (a common form of OCD in which a person has irrational fears or compulsions around hygiene) may have found that habits they once sought treatment for—compulsively wearing gloves, avoiding public bathrooms, using hand sanitizer all the time, and wearing masks in public—are now considered normal, Brown says. “Before the crisis, people with contamination-related OCD would engage in unnecessary decontamination processes,” she says. “Now, they’re being told they’re healthy. It can be confusing.” And, as is the case with Williams, people with other forms of OCD may suddenly find their obsessive habits and compulsions have changed to reflect what’s happening in the world.

A big challenge for people with contamination OCD will be to try to alleviate their obsessions and compulsions after the pandemic is over, Brown says. “For many of us who don’t have OCD, we’re going to go back to doing what we did before,” she says. “For someone with OCD, it’s going to be challenging to try return to the public’s definition of baseline.”

People who suffer from panic disorder, a condition marked by panic attacks, or sudden feelings of terror when there is no real danger, can struggle with the lack of activities available right now, psychologist John Mayer, author of Family Fit: Find Your Balance in Life, tells Yahoo Life. “People who suffer from panic disorder need to have a wide variety of diversions that take their minds away from ruminating about the pandemic, restrictions, and control it places on their lives,” he says. “Panic makes one feel closed-in with no way out. Diversity in diversions helps ease the closed-in feelings that make panic worse.” 

Patients with generalized anxiety disorder (GAD), a condition that causes extreme feelings of worry or nervousness about everyday things, can find themselves struggling with procrastination right now, Brown says. “It seems counterintuitive—you might think someone who is anxious all the time would want to be productive all the time— tend to struggle with perfectionism and feel like the circumstances need to be just so,” Brown says. “That makes it hard to get started on whatever kind of project they might need to do.” With all of the unstructured time many people are facing, “it’s extraordinarily challenging for people with GAD to fight through it and do the basic things that need to be done,” Brown says. People with GAD are especially prone right now to “trick themselves into thinking they’re problem-solving when they’re actually just sitting and worrying,” Brown says.

Those who have social anxiety disorder, an intense, persistent fear of being watched and judged by others, may feel more comfortable than the general public with social distancing recommendations, Brown says. “They can feel like it’s somewhat of a gift for them,” she says. “The problem is, whenever things feel normal again, people with social anxiety disorder are going to experience a major uptick in distress.”

The fallout from all of this can be massive. “In regard to people with anxiety before the pandemic, their levels of anxiety have at a minimum doubled and, in many cases, this additional source of anxiety has resulted in them becoming disabled, and not being able to work, care for their children, or care for themselves,” Mayer says.

If you struggle with an anxiety disorder or notice your anxiety is interfering with your quality of life, Brown says it’s time to seek help. She recommends searching the Association for Cognitive and Behavioral Therapies’ therapist database to find a mental health professional near you. Keep in mind that you may not need to go anywhere to get help. “We’ve expanded a lot of telehealth options in ways we’ve never been able to before,” Brown says. “It’s possible to quickly and easily get help from home.”

To enhance the understanding around just how vast and prevalent mental illness is in the United States, we’ve created an augmented reality experience that uses color-coded sections to help visualize the lifetime prevalence for anxiety and mood disorders among adult Americans.

Place the image in front of you and walk around it to see the data sourced from the National Institute of Mental Health on adult Americans suffering from anxiety disorders, mood disorders and different parts of the mental health continuum.

For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides. 

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