Carolina Behavioral Therapy Offers Virtual Therapy Services in Columbia SC

Columbia, Sept. 27, 2022 (GLOBE NEWSWIRE) — Columbia, South Carolina –

Carolina Behavioral Therapy wants to inform everyone that they are offering virtual evidence-based therapy services to individuals in Columbia, SC and surrounding areas. This virtual outpatient mental health clinic offers therapy for obsessive-compulsive disorder (OCD), trauma, post-traumatic stress disorder (PTSD), self-harm, anxiety disorders, suicide, substance use disorders, and depression. They specialize in Linehan style Dialectical Behavior Therapy Programs (DBT), Exposure and Response Prevention (EX/RP) for OCD, and Prolonged Exposure Therapy (PE) for PTSD for adults and adolescents. All of their therapy services are provided virtually via telehealth to residents of South Carolina and North Carolina.

While everyone experiences emotions such as anger, anxiety, fear or shame, for some people, these emotions can overwhelm their daily life and cause extreme behaviors, relationship challenges and unmanagable thought patterns. DBT is assists people struggling to manage their emotions, and helps them develop alternative behaviors and tools to function and maintain a meaningful life. In addition to DBT, Carolina Behavioral Therapy also offers targeted therapy treatment programs for PTSD and OCD.

therapist Columbia SC

Symptoms of PTSD include: difficulty in sleeping or concentrating; being easily startled or feeling jumpy or edgy; inability to experience pleasure; reduced interest in the things they previously enjoyed; changes in the ability to cope and in how they think about themselves and how dangerous the world is; avoidance of places, objects, and conversations that remind them of the event; flashbacks and the feeling that the event is still in progress; physiological reactions to places, odors, objects, and people that remind about the event; and dreams of the traumatic events and presence of involuntary memories.

Dr. Scott Fairweather, therapist at Carolina Behavioral Therapy, says, “If you’ve been exposed to a traumatic event, PTSD symptoms are signs that the trauma is unfinished business, and the individual is struggling to process what has happened to them. This means either your, or your loved one’s brain has not been able to make sense of the traumatic event as it would other situations. PE can help an individual to gradually approach situations and memories related to the trauma that are causing distress and problems in life. By approaching trauma related images and situations you process the memory and begin to heal. You will never forget what has happened to you but after the brain is able to process the experience there will be fewer triggers, and memories, and you can start living your life again.”

Meanwhile, OCD is a condition experienced by millions of people all over the world, both children and adults. It includes obsessive thoughts and also compulsive habits or avoidance behaviors when reacting to certain cues in the environment. These cues tend to increase the anxiety in the person such that they feel uncomfortable. People with OCD tend to counter the anxiety and increase their comfort through compulsions that are often time consuming and can disrupt their daily life significantly. While they may be aware that their obsessions and compulsions don’t actually make sense, they are unable to avoid the anxiety if they stop.

Typical obsessions include: concern about getting contaminated; aggressive obsessions such as fear of harming self or others; saving or hoarding; somatic obsessions; sexual obsessions; religious obsessions; and symmetry and exactness. Typical compulsive habits include: cleaning or washing compulsions; checking compulsions such as checking locks and appliances; repeating rituals; and mental rituals.

EX-RP therapy may help in treating the symptoms of OCD. This kind of therapy works by altering the person’s reaction to the feelings that are associated with the OCD habits. Taking control of one’s obsessive behaviors may require a lot of work but it is possible with the appropriate treatment. Studies have revealed that about 70 percent of patients who undergo EX-RP therapy experienced significant improvement in their OCD.

Dr. Scott Fairweather, LISW-CP/LCSW, LAC, AADC, serves as therapist for Carolina Behavioral Therapy. He is a Certified Prolonged Exposure Therapist (PE) and a Linehan Board of Certification – Certified Dialectical Behavior Therapy (DBT) Clinician. He specializes in the implementation of evidence-based treatments for OCD, suicide / self-harm behaviors, PTSD, mood disorders, and substance use disorders. He is also certified in Exposure and Response Prevention for OCD through the CTSA. He is ready to provide virtual counseling using proven cognitive behavioral therapies to individuals who may be struggling with stress, anxiety, depression, and other issues.

Those who are interested in knowing more about the virtual counseling services offered by Carolina Behavioral Therapy can visit their website or contact them on the phone or through email. CBT’s services are available to residents of North and South Carolina.

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For more information about Carolina Behavioral Therapy, contact the company here:

Carolina Behavioral Therapy
Scott Fairweather
(803) 393-5420
carolinabehavioraltherapy@gmail.com
Carolina Behavioral Therapy
Columbia, SC 29250

Deep brain stimulation as obsessive-compulsive disorder treatment – News

In a recent study published in the Journal of Neurology, Neurosurgery Psychiatry, researchers investigated the effectiveness of deep brain stimulation (DBS) against treatment-resistant obsessive-compulsive disorder (OCD).

OCD is characterized by intrusive, enduring obsessive thoughts and dysfunctional, ritualized behaviors. The illness typically manifests during a crucial developmental stage, such as puberty, early adulthood, or childhood. Ablative lesioning techniques like anterior cingulotomy and anterior capsulotomy are well-known surgical approaches to treat symptoms of treatment-resistant OCD (TROCD). More extensive knowledge of treatment efficacy across studies with various methodological methods is necessary for the developing field of DBS for TROCD.

Review: Efficacy of deep brain stimulation for treatment-resistant obsessive-compulsive disorder: systematic review and meta-analysis. Image Credit: Ralwell / ShutterstockReview: Efficacy of deep brain stimulation for treatment-resistant obsessive-compulsive disorder: systematic review and meta-analysis. Image Credit: Ralwell / Shutterstock

About the study

In the present study, researchers evaluated the effectiveness of DBS in reducing OCD and concomitant depressive symptoms across patients with TROCD by employing a systematic review and meta-analysis.

The Systematic Reviews and Meta-Analyses (PRISMA) standards were followed to produce a systematic review. Studies were investigated if they satisfied the following requirements: (1) the subjects were adults aged above 18 years with a primary OCD diagnosis as per the International Classification of Diseases criteria or the Diagnostic and Statistical Manual of Mental Disorders Fourth or Fifth edition (DSM-IV or DSM-V), (2)  used the Yale-Brown Obsessive Compulsive Scale (Y-­BOCS) to measure the outcome (3) DBS was the primary intervention, (4) primary outcome was the improvement in OCD symptoms post-DBS treatment, (5) treatment response defined as 35% or higher reduction in Y-BOCS score, and (6) published in peer-reviewed journals in the English language.

Using the R statistical computing package, a meta-analysis was conducted. The primary outcomes included Y-BOCS mean difference at the most recent follow-up compared to baseline, treatment effect or Y-BOCS percent decrease at the most recent follow-up, and responder rate at the most recent follow-up. Two secondary objectives were the depression scale responder rate and the standardized mean difference (SMD) in depression scale scores.

Results

A total of 3,023 records, spanning the years 1986 to 2021, were found using the search strategy. Thirty-four studies from 2005 to 2021 were chosen for the systematic review and meta-analysis, including nine randomized controlled trials (RCTs). All 352 individuals were adults with severe to extreme OCD at the beginning of the study. The studies had had three first-line pharmacotherapy trials, one supplemental medication trial, and at least 20 hours of expert exposure and response prevention (ERP) without a persistent response to treatment. Additionally, patients in 67% of the studies had to have an unremitted disease of five years or more before being considered for surgery. Among the 11 studies remaining, only one required over ten years of disease duration and two years or more of unremitted disease; another required one year of unremitted disease, while five did not specify.

The team noted that the disease lasted an average of 24.3 years. According to 23 studies, major depressive disorder affected about 55% of patients, anxiety disorders affected 10% of people, and personality disorders affected 9.5% of people. RCTs had a median of 10 participants, compared to seven in non-RCTs. The two stimulation targets that were most frequently discussed were ventral capsule/ventral striatum (VC/VS) and nucleus accumbens (NAc), followed by anterior limb of the internal capsule (ALIC), bed nucleus of stria terminalis (BNST), and ALIC/BNST.

Using the Hamilton depression scale was utilized in 14 investigations. To evaluate depression before and after surgery, seven studies used the Beck Depression Inventory (BDI), five studies used the Montgomery-Åsberg Depression Rating Scale (MADRS), and one study used the Depression Anxiety Stress Scale-Depression (DASS-D). A Hamilton anxiety scale was employed in 11 of the 16 studies that provided anxiety ratings, the STAI-X1/2 in four of 16, and the DASS-A in 1.46 of 16.  Seven of the seventeen studies that provided GAF ratings did so exclusively with baseline data.

About 70% of studies provided comprehensive information on serious adverse events (SAEs), including but not limited to hardware issues, infections, seizures, suicide attempts, intracranial hemorrhage (ICH), and the emergence of de novo obsessions linked to stimulation. Overall, 31% of patients reported having at least one SAE. There were 8% or fewer device-related problems, such as lead damage or misposition. There were nine postoperative seizures and 11 occurrences of postoperative infection, of which six needed the removal and/or replacement of a pulse generator. One patient had a generalized tonic-clonic seizure, an intracranial infection, shock, and a drug-induced coma, among other SAEs.

Furthermore, there were six instances of attempted suicide and one suicide that was successful. Studies documented five postoperative ICH occurrences, two of which led to protracted finger palsy and prolonged dysarthria. In two instances, DBS therapy itself resulted in a new obsession (such as checking the settings and battery life), which aggravated OCD.

The meta-analytical Y-BOCS mean difference (MD) among 345 patients pooled from 31 trials was 14.28 points at the most recent follow-up. The meta-analytical treatment effect (TE) was discovered to be a 47% decrease in Y-BOCS scores at the last follow-up across 249 patients from 28 studies where precision estimates could be acquired or measured using the pre-disambiguated and post-disambiguated data that was available.

Conclusion

The study findings showed that DBS is a successful treatment for TROCD, and the typical patient will get a 50% reduction in OCD symptoms. With further follow-up, two-thirds of patients will experience at least a complete response to DBS therapy. In addition, the researchers believe that current limbic and non-limbic targets can be stimulated to reduce comorbid depressive symptoms in TROCD significantly.

New Adolescent Obsessive-Compulsive Disorder Program Addresses an Increased Need for Specialized Exposure

Compass Health Center is launching an Adolescent OCD and Complex Anxiety Disorder Program at its Oak Brook location

Newswire.com

In response to the growing need for targeted clinical services to treat Obsessive Compulsive Disorder (OCD) and other anxiety disorders in adolescents, Compass Health Center is launching its Adolescent OCD and Complex Anxiety Disorder Partial Hospitalization and Intensive Outpatient (PHP/IOP) program at its Oak Brook location on Sept. 6, 2022. The goal of this new program is to provide specialized, evidence-based treatment for OCD and anxiety disorders among adolescents ages 13-18 in the Western Suburbs.  

“Since settling into the community over the past year, we’ve seen more and more adolescents and their families in need of specialized services to treat OCD anxiety disorders including but not limited to social anxiety, school anxiety and school refusal,” said Katrina Shannon, LMFT, Director of Adolescent Program, Compass Health Center – Oak Brook. “We have seen the positive impact and outcomes of our adolescent OCD programming at both our Northbrook and Chicago locations and are eager to provide this effective and engaging treatment in Oak Brook.” 

OCD is a mental health diagnosis in which people experience recurring thoughts, ideas, and sensations (obsessions) that make them feel a strong urge to repeat specific actions or behaviors (compulsions). If not properly managed, these actions and behaviors can significantly interfere with an individual’s ability to function in their daily life. Complex Anxiety refers to those conditions/disorders that research shows best respond to Exposure and Response Prevention (ERP) as a treatment modality. These conditions include OCD, Social Anxiety, Panic Disorder, Separation Anxiety Disorders, Phobias and Illness Anxiety Disorder. 

OCD and anxiety disorders cause problems, not because they make people feel anxious, but because of how we as humans tend to respond to anxiety, by avoiding what causes the anxiety. This avoidance ends up causing more problems than it solves and results in deteriorating relationships, skipping school, academic difficulties, and family conflict. ERP systematically decreases the avoidance triggered by anxiety and prompts the patients to build more meaning and purpose into their lives, even if it requires them to feel anxious in the process. 

For those with OCD and anxiety disorders, the effects of the pandemic worsened symptoms, Time Magazine reports. “New research shows that OCD symptoms have gotten more severe for many people during the pandemic, and new diagnoses have increased.” In addition, a BMC Psychiatry study in 2020 found that nearly 45% of young people ages 7 to 21 experienced a worsening of overall OCD symptoms within the first pandemic year. 

“With the loss of their routines and their social lives, many adolescents expectedly struggled with their mental health during the pandemic. For teens with OCD or anxiety diagnoses, specialized treatment including an exposure plan is key to positive treatment outcomes,” said Meg Hoffman, LCSW, Associate Director of Adolescent OCD and Complex Anxiety Program, Compass Health Center – Northbrook. “Adolescents in our OCD Complex Anxiety Program learn evidence-based coping skills, participate in exposure and process groups, and engage in individual exposure therapy. Each patient works with a treatment team, including a psychiatrist or psychiatric nurse practitioner, an individual therapist, a family therapist and, during the school year, an education specialist toward their unique and mutually-established treatment plan goals.” 

Compass’s Adolescent OCD Complex Anxiety Program (PHP/IOP) provides therapy modalities rooted in daily ERP as well as Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and habit reversal training. Adolescents attend group therapy sessions and meet daily with an exposure therapist to address symptoms and triggers leading to avoidance and compulsions. Through these evidence-based therapies, adolescents learn to tolerate distressing thoughts and physical sensations so that they can more fully and meaningfully engage in their daily lives. Programming is now available at all Compass onsite locations. Visit Compass Health Center’s website or call now for an intake.  




Newswire.com


New Adolescent Obsessive-Compulsive Disorder Program Addresses an Increased Need for Specialized Exposure and Response Prevention Therapy in Chicago Suburbs

What to Know About Health Anxiety | Time

Is that sniffle a sign of seasonal allergies or COVID-19? It’s a question you’ve likely asked yourself at least once—and perhaps lots of times—over the last few years.

Especially during a pandemic, it’s normal to analyze your health. But for some people, those thoughts can cross a line into more problematic territory. At least 4% of the U.S. population lives with what’s known as health anxiety, or an excessive preoccupation with health and illness—and symptoms of the condition may have emerged or worsened for certain people during these virus-dominated recent years, experts say.

“Health anxiety, to a certain extent, is normal during the pandemic,” says Michelle Patriquin, director of research at the Menninger Clinic, a mental health treatment center in Texas.

In 2013, the Diagnostic and Statistical Manual of Mental Disorders retired the term “hypochondriasis,” which many people found belittling and inadequate. Since then, health anxiety has been formally known as “illness anxiety disorder” and is characterized by excessive worry about having or developing a serious disease, often even if tests don’t show anything wrong. People with this condition frequently become fixated on mild or routine physical sensations—fearing that a headache could be an early sign of a brain tumor, for example.

Health anxiety overlaps with obsessive-compulsive disorder (OCD) and panic disorder, explains Paul Salkovskis, a clinical psychologist in the U.K. who has studied health anxiety for decades. People with both health anxiety and OCD may engage in behaviors like frequent hand-washing or temperature-taking. And, similar to panic attacks, health anxiety can manifest physically through symptoms like shortness of breath, dizziness, and elevated heart rate. People with health anxiety often misinterpret these sensations as a sign that something is physically wrong, in the future if not in the moment. They may believe a racing heart is the first sign of developing cardiovascular disease.

Everyone worries about their health from time to time. But when that worry interferes with daily life or spirals into behaviors like obsessively researching symptoms online (what some researchers call “cyberchondria”), it could be health anxiety.

The pandemic has understandably added fuel to the fire, Patriquin says. Due to valid fears of catching and spreading COVID-19, isolation, political unrest, and upticks in substance use, it’s no surprise that many people have experienced psychological distress over the past few years, she says. Rates of anxiety and depression have increased worldwide since the pandemic began, and Menninger Clinic research shows that symptoms worsened for many people with preexisting mental health issues.

For some, the COVID-19 pandemic may have prompted or exacerbated symptoms of health anxiety due to legitimate fears of illness and 24/7 news coverage about health and disease, among other factors, according to a 2021 study published in the International Journal of Cognitive Therapy. The fact that the virus is highly transmissible and can be spread even by people without symptoms can also fuel anxiety, the paper adds.

To learn more about health anxiety in the general population, another team of researchers turned to Reddit. In January 2020, even before many countries began responding to the threat of COVID-19, they saw that activity in Reddit’s health anxiety forum began to spike—and as time went on, the language used in other mental health-related forums began to mirror that used in the health anxiety thread, with many posts using words like “virus,” “respirator,” and “vaccine,” they found.

Salkovskis, however, noticed something interesting in his practice: some people with contamination fears temporarily saw their symptoms improve early in the pandemic, because lots of people were taking disease precautions. “However, that’s kind of a holiday rather than a cure,” he says.

Indeed, by the spring of 2021, rates of psychological distress—including health anxiety—were elevated in high-income countries including the U.S., U.K., and Italy, according to research that has not yet been published in a peer-reviewed journal and was led by Marcantonio Spada, a professor of addictive behaviors and mental health at London South Bank University. Health anxiety was more common in countries, including the U.S., that took aggressive pandemic-management tactics like lockdowns, as compared to countries, including Sweden, that took more relaxed approaches, Spada says.

“You ask people to avoid situations, to mask, to monitor a threat,” Spada says. “Then you’re left with a collection of thinking patterns and behaviors that make you vulnerable next time there’s uncertainty.” Spada’s research also suggests that people who score highly on measures of neuroticism have been more likely to develop health anxiety during the pandemic, which is in turn correlated with the development of generalized anxiety and depression.

Three years of fear and rumination about COVID-19, however understandable, has caused an uptick in obsessive behaviors, like methodically wiping down groceries, as well as generalized anxiety, Salkovskis says. But not everyone with these symptoms meets the diagnostic criteria for illness anxiety disorder, he says. People with health anxiety believe they are ill and hold onto that belief for a long period of time, he says. Someone could think for years that they’re in the early stages of developing cancer or heart disease, and it’s hard to definitively prove them wrong. But it becomes clear fairly quickly whether or not someone has COVID-19, Salkovskis says.

It can be difficult to tell if your health concerns are normal in the COVID-19 era, when it’s natural to be on high alert about disease. Behaviors that otherwise might be red flags for health anxiety, like frequent hand-washing or mask-wearing, have become normal and recommended over the past few years. But Patriquin says there are still signs to look for. If you feel compelled to take virus precautions in very low-risk situations—such as wearing a mask when you’re at home, around only those you live with—or if your relationships and work are suffering as a result of your routine, speaking to a mental-health professional may be worthwhile.

Cognitive behavioral therapy (CBT) is the only treatment for health anxiety with strong evidence behind it, Salkovskis says. According to the Mayo Clinic, CBT can help people with health anxiety acknowledge and adjust their fears related to illness and physical sensations and develop coping strategies. Two-thirds of people with health anxiety saw a reduction in symptoms after being treated with CBT, and about half went into complete remission, according to a research review published in 2019.

Lifestyle remedies can also be useful for managing anxiety disorders, Patriquin says. Getting enough sleep can make a significant difference in symptoms, as can seeking social support, she says. Even socializing online can help buffer the negative consequences of health anxiety, one study published in 2021 found—so if you’re struggling with this condition, reaching out to both a mental-health professional and your loved ones is a good place to start.

Write to Jamie Ducharme at jamie.ducharme@time.com.

What to Know About Health Anxiety

Is that sniffle a sign of seasonal allergies or COVID-19? It’s a question you’ve likely asked yourself at least once—and perhaps lots of times—over the last few years.

Especially during a pandemic, it’s normal to analyze your health. But for some people, those thoughts can cross a line into more problematic territory. At least 4% of the U.S. population lives with what’s known as health anxiety, or an excessive preoccupation with health and illness—and symptoms of the condition may have emerged or worsened for certain people during these virus-dominated recent years, experts say.

“Health anxiety, to a certain extent, is normal during the pandemic,” says Michelle Patriquin, director of research at the Menninger Clinic, a mental health treatment center in Texas.

In 2013, the Diagnostic and Statistical Manual of Mental Disorders retired the term “hypochondriasis,” which many people found belittling and inadequate. Since then, health anxiety has been formally known as “illness anxiety disorder” and is characterized by excessive worry about having or developing a serious disease, often even if tests don’t show anything wrong. People with this condition frequently become fixated on mild or routine physical sensations—fearing that a headache could be an early sign of a brain tumor, for example.

Health anxiety overlaps with obsessive-compulsive disorder (OCD) and panic disorder, explains Paul Salkovskis, a clinical psychologist in the U.K. who has studied health anxiety for decades. People with both health anxiety and OCD may engage in behaviors like frequent hand-washing or temperature-taking. And, similar to panic attacks, health anxiety can manifest physically through symptoms like shortness of breath, dizziness, and elevated heart rate. People with health anxiety often misinterpret these sensations as a sign that something is physically wrong, in the future if not in the moment. They may believe a racing heart is the first sign of developing cardiovascular disease.

Everyone worries about their health from time to time. But when that worry interferes with daily life or spirals into behaviors like obsessively researching symptoms online (what some researchers call “cyberchondria”), it could be health anxiety.

The pandemic has understandably added fuel to the fire, Patriquin says. Due to valid fears of catching and spreading COVID-19, isolation, political unrest, and upticks in substance use, it’s no surprise that many people have experienced psychological distress over the past few years, she says. Rates of anxiety and depression have increased worldwide since the pandemic began, and Menninger Clinic research shows that symptoms worsened for many people with preexisting mental health issues.

For some, the COVID-19 pandemic may have prompted or exacerbated symptoms of health anxiety due to legitimate fears of illness and 24/7 news coverage about health and disease, among other factors, according to a 2021 study published in the International Journal of Cognitive Therapy. The fact that the virus is highly transmissible and can be spread even by people without symptoms can also fuel anxiety, the paper adds.

To learn more about health anxiety in the general population, another team of researchers turned to Reddit. In January 2020, even before many countries began responding to the threat of COVID-19, they saw that activity in Reddit’s health anxiety forum began to spike—and as time went on, the language used in other mental health-related forums began to mirror that used in the health anxiety thread, with many posts using words like “virus,” “respirator,” and “vaccine,” they found.

Salkovskis, however, noticed something interesting in his practice: some people with contamination fears temporarily saw their symptoms improve early in the pandemic, because lots of people were taking disease precautions. “However, that’s kind of a holiday rather than a cure,” he says.

Indeed, by the spring of 2021, rates of psychological distress—including health anxiety—were elevated in high-income countries including the U.S., U.K., and Italy, according to research that has not yet been published in a peer-reviewed journal and was led by Marcantonio Spada, a professor of addictive behaviors and mental health at London South Bank University. Health anxiety was more common in countries, including the U.S., that took aggressive pandemic-management tactics like lockdowns, as compared to countries, including Sweden, that took more relaxed approaches, Spada says.

“You ask people to avoid situations, to mask, to monitor a threat,” Spada says. “Then you’re left with a collection of thinking patterns and behaviors that make you vulnerable next time there’s uncertainty.” Spada’s research also suggests that people who score highly on measures of neuroticism have been more likely to develop health anxiety during the pandemic, which is in turn correlated with the development of generalized anxiety and depression.

Three years of fear and rumination about COVID-19, however understandable, has caused an uptick in obsessive behaviors, like methodically wiping down groceries, as well as generalized anxiety, Salkovskis says. But not everyone with these symptoms meets the diagnostic criteria for illness anxiety disorder, he says. People with health anxiety believe they are ill and hold onto that belief for a long period of time, he says. Someone could think for years that they’re in the early stages of developing cancer or heart disease, and it’s hard to definitively prove them wrong. But it becomes clear fairly quickly whether or not someone has COVID-19, Salkovskis says.

It can be difficult to tell if your health concerns are normal in the COVID-19 era, when it’s natural to be on high alert about disease. Behaviors that otherwise might be red flags for health anxiety, like frequent hand-washing or mask-wearing, have become normal and recommended over the past few years. But Patriquin says there are still signs to look for. If you feel compelled to take virus precautions in very low-risk situations—such as wearing a mask when you’re at home, around only those you live with—or if your relationships and work are suffering as a result of your routine, speaking to a mental-health professional may be worthwhile.

Cognitive behavioral therapy (CBT) is the only treatment for health anxiety with strong evidence behind it, Salkovskis says. According to the Mayo Clinic, CBT can help people with health anxiety acknowledge and adjust their fears related to illness and physical sensations and develop coping strategies. Two-thirds of people with health anxiety saw a reduction in symptoms after being treated with CBT, and about half went into complete remission, according to a research review published in 2019.

Lifestyle remedies can also be useful for managing anxiety disorders, Patriquin says. Getting enough sleep can make a significant difference in symptoms, as can seeking social support, she says. Even socializing online can help buffer the negative consequences of health anxiety, one study published in 2021 found—so if you’re struggling with this condition, reaching out to both a mental-health professional and your loved ones is a good place to start.

Write to Jamie Ducharme at jamie.ducharme@time.com.

Why Your Mental Health History Matters to the Dentist

With anxiety disorders like obsessive-compulsive disorder, it is possible to overdo it with the toothbrushing.

Ever wondered why you’re asked to answer detailed questions about your mental health history when you’re at a routine teeth cleaning? It can be tempting to skip those uncomfortable questions in all that paperwork at the dentist’s office. What many people don’t know, though, is that their oral health really does affect their mental health, and vice versa. Here are some of the ways that psychiatric issues can negatively impact your teeth and oral health.

Anxiety Disorders

With anxiety disorders like obsessive-compulsive disorder, it is possible to overdo it with the toothbrushing. Brushing too hard and too long can harm a person’s gums and scrape away at the enamel on their teeth. This can lead to a gradual decay and premature loss of teeth.

“Bruxism,” better known as grinding one’s teeth, is also not uncommon in those with anxiety issues. It can happen as a stress response, whether consciously or unconsciously. Sometimes it can occur during one’s sleep. Bruxism can wear away at tooth enamel and increase susceptibility to cavities and pain.

Mood disorders like major depressive disorder and bipolar disorder are associated with higher rates of tooth decay, for various reasons, according to a 2016 study in the Canadian Journal of Psychiatry. Those with untreated depression are more likely to engage in “self-soothing” behaviors like smoking and drinking, which can cause reflux and in turn erosion of the teeth. Teeth grinding also occurs more often in people with depression.

Meanwhile, psychotropic medications for these conditions—lithium and some antidepressants, for example—can also contribute to conditions like “xerostomia” or dry mouth. When left unaddressed, dry mouth can contribute to tooth decay in the long run.

Severe Mental Illness

“People with severe mental illness have 2.8 times the likelihood of losing all their teeth, compared with the general population,” an article from Cleveland Clinic reported. It was citing a 2015 meta-analysis of 25 studies that found those with schizophrenia and other serious mental health issues experienced significantly higher rates of gum disease and decay.

What might explain this disparity? A severe mental illness can make it harder to stay regular with teeth cleanings and daily dental care. The side effects of antipsychotics and other psychotropic medications, which can cause various issues that affect oral health, can be another contributor. Still other research has found a link between mouth bacteria and bacterial infections that lead to gum disease and decay in people with schizophrenia.

These are just some of the ways that mind, mood, and related behavioral choices are closely related to oral health. They help to explain why your mental health history matters to your dentist. In the end they’re not just being nosy—they’re doing their job.

Press Release Distributed by The Express Wire

To view the original version on The Express Wire visit Why Your Mental Health History Matters to the Dentist

Pulling Out Eyelashes: Symptoms, Causes, and Treatment

Pulling out your eyelashes can be a symptom of various conditions, including anxiety, obsessive-compulsive disorder (OCD), or trichotillomania. You may find the urge to pull out your hair overwhelming, and once the hair is pulled out, you feel relief. In this sense, it’s a compulsion.

Your eyelashes help keep dirt and dust out of your eyes, so not having eyelashes makes the eye vulnerable to possible complications. Pulling out the eyelashes can also lead to irritation and infection, so getting help is important.

This article will review the symptom of pulling out eyelashes and the causes and treatment options.

Person using tweezers and mirror

Person using tweezers and mirror

rarrarorro / Getty Images


Characteristics of Pulling Out Eyelashes

Your eyelash-pulling behavior may become noticeable by others when you lack lashes. A healthcare provider may also make this observation during an exam.

You may have an uncontrollable urge to pull out your eyelashes or do it without thinking about it. You may feel a sense of relief after pulling the eyelashes out. Or, you may have increased tension when trying to avoid pulling out the hair.

The hair-pulling may be ritualistic behavior, for instance, you pull it out in a specific way or search for a certain kind of hair. Attempts to hide the lack of eyelashes might also be made, like wearing false eyelashes.

Causes of Pulling Out Eyelashes

Trichotillomania is a common cause of pulling out eyelashes. This is a body-focused repetitive behavior in which a person pulls out their hair. It is an impulse control disorder and is sometimes classified as a type of obsessive-compulsive disorder (OCD).

If a person denies intentionally pullout out their eyelashes but they have no lashes left, they may have a disorder that causes hair to fall out. This includes alopecia areata (an immune system disorder leading to hair loss), as well as other forms of alopecia (hair loss). Alopecia does not involve pulling the eyelashes out on purpose.

Pulling out hair or eyelashes can also be brought on by severe stress or anxiety. A person may not have the coping mechanisms to handle these feelings, so they may turn to hair-pulling.

How to Treat Pulling Out Eyelashes

To treat someone who pulls out their eyelashes, an evaluation would need to be made by a mental health provider or other healthcare provider familiar with the condition. This evaluation will determine the correct underlying cause.

Having trichotillomania is often the reason for pulling out hair, but screening for other conditions is important to determine treatment. If trichotillomania is the cause, behavioral therapy is often effective.

Behavioral therapy involves becoming aware of triggers that set off the behavior and then changing the behavior. Habit-reversal training is particularly effective for pulling out hair. Interpersonal therapy to work on self-esteem and daily functioning might also help.

Medications such as selective serotonin reuptake inhibitors (SSRIs) can be beneficial. If medication is decided upon, it should be supervised by a psychiatrist with expertise in OCD and related disorders.

SSRIs can take up to six weeks at a therapeutic dose to become effective. If the medication does not help at all, it should be discontinued.

SSRI medications used can include:

Other medications that might be used include:

Complications Associated With Pulling Out Eyelashes

Eyelashes protect the eyes from dust, dirt, and sun. Without that natural protection, the eyes are more vulnerable to elements or debris.

Complications of pulling out one’s eyelashes can include:

  • Skin infections or irritation where the hair is pulled out
  • Eye problems due to the lack of protection from dust, sun, or debris

Are There Tests to Diagnose Pulling Out Eyelashes?

Pulling out eyelashes is not a condition in and of itself. It is a symptom of something else. A mental health provider will do a clinical interview with the person, take a medical and family history, and perform a physical examination. Other diagnoses will be ruled out, and an appropriate diagnosis can be made.

When to See a Healthcare Provider

Talk with a healthcare provider if you are pulling out your eyelashes or any other hair. They can refer you to a mental health provider who specializes in OCD spectrum disorders or anxiety disorders. Without treatment, the behavior is likely to continue.

Summary

Pulling out eyelashes can signal an underlying anxiety or obsessive-compulsive disorder. It can cause eye problems or complications. Pulling out eyelashes can be a symptom of trichotillomania but can also be brought on by stress.

Without treatment, the behavior will likely continue. It is treatable with behavioral therapies. Sometimes, medication also is prescribed.

A Word From Verywell

If you (or your child) has been pulling out eyelashes, know that you don’t have to deal with this alone. The condition causing hair-pulling is treatable, and you can learn to manage it.

Eyelashes help protect the eyes from dust, debris, and the sun. Talk with your provider or an eye care specialist about ways you can protect your eyes if you are pulling out your eyelashes. They may offer helpful advice while your eyelashes grow back.

New Adolescent Obsessive-Compulsive Disorder Program Addresses an Increased Need for Specialized Exposure and Response Prevention Therapy in Chicago Suburbs

In response to the growing need for targeted clinical services to treat Obsessive Compulsive Disorder (OCD) and other anxiety disorders in adolescents, Compass Health Center is launching its Adolescent OCD and Complex Anxiety Disorder Partial Hospitalization and Intensive Outpatient (PHP/IOP) program at its Oak Brook location on Sept. 6, 2022. The goal of this new program is to provide specialized, evidence-based treatment for OCD and anxiety disorders among adolescents ages 13-18 in the Western Suburbs.  

“Since settling into the community over the past year, we’ve seen more and more adolescents and their families in need of specialized services to treat OCD anxiety disorders including but not limited to social anxiety, school anxiety, and school refusal,” said Katrina Shannon, LMFT, Director of Adolescent Program, Compass Health Center – Oak Brook. “We have seen the positive impact and outcomes of our adolescent OCD programming at both our Northbrook and Chicago locations and are eager to provide this effective and engaging treatment in Oak Brook.” 

OCD is a mental health diagnosis in which people experience recurring thoughts, ideas, and sensations (obsessions) that make them feel a strong urge to repeat specific actions or behaviors (compulsions). If not properly managed, these actions and behaviors can significantly interfere with an individual’s ability to function in their daily life. Complex Anxiety refers to those conditions/disorders that research shows best respond to Exposure and Response Prevention (ERP) as a treatment modality. These conditions include OCD, Social Anxiety, Panic Disorder, Separation Anxiety Disorders, Phobias, and Illness Anxiety Disorder. 

OCD and anxiety disorders cause problems, not because they make people feel anxious, but because of how we as humans tend to respond to anxiety, by avoiding what causes the anxiety. This avoidance ends up causing more problems than it solves and results in deteriorating relationships, skipping school, academic difficulties, and family conflict. ERP systematically decreases the avoidance triggered by anxiety and prompts the patients to build more meaning and purpose in their lives, even if it requires them to feel anxious in the process. 

For those with OCD and anxiety disorders, the effects of the pandemic worsened symptoms, Time Magazine reports. “New research shows that OCD symptoms have gotten more severe for many people during the pandemic, and new diagnoses have increased.” In addition, a BMC Psychiatry study in 2020 found that nearly 45% of young people ages 7 to 21 experienced a worsening of overall OCD symptoms within the first pandemic year. 

“With the loss of their routines and their social lives, many adolescents expectedly struggled with their mental health during the pandemic. For teens with OCD or anxiety diagnoses, specialized treatment including an exposure plan is key to positive treatment outcomes,” said Meg Hoffman, LCSW, Associate Director of Adolescent OCD and Complex Anxiety Program, Compass Health Center – Northbrook. “Adolescents in our OCD Complex Anxiety Program learn evidence-based coping skills, participate in exposure and process groups, and engage in individual exposure therapy. Each patient works with a treatment team, including a psychiatrist or psychiatric nurse practitioner, an individual therapist, a family therapist, and, during the school year, an education specialist toward their unique and mutually-established treatment plan goals.” 

Compass’s Adolescent OCD Complex Anxiety Program (PHP/IOP) provides therapy modalities rooted in daily ERP as well as Acceptance and Commitment Therapy (ACT), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and habit reversal training. Adolescents attend group therapy sessions and meet daily with an exposure therapist to address symptoms and triggers leading to avoidance and compulsions. Through these evidence-based therapies, adolescents learn to tolerate distressing thoughts and physical sensations so that they can more fully and meaningfully engage in their daily lives. Programming is now available at all Compass onsite locations. Visit Compass Health Center’s website or call now for an intake.  

Source: Compass Health Center

Easing back-to-school anxiety – Sault Ste. Marie News

As the new school year begins, the uncertainty of new social experiences, coupled with the pressure of academics can be daunting for young learners. For many children and teens, peer pressure and interpersonal conflict may also trigger excessive anxiety.

Tiffany Caicco, owner of The Soul Compass in Sault Ste. Marie, is a registered psychotherapist, art therapist, and play therapist.

Tiffany, who specializes in counselling and coaching kids, teens, and couples, works with individuals of all ages. Based on her experience, Tiffany sees anxiety as the most pressing problem for kids. She said, “In the past few years, I’ve experienced an increase in calls from parents looking for therapeutic services to help their children and teens manage anxiety caused by interpersonal conflict, peer pressure, and bullying/cyberbullying.”

SOUL COMPASS  Photo 1
The Soul Compass newsletter, The Windrose

Stress easing strategies

Tiffany’s go-to therapy for anxiety is Cognitive Behavioral Therapy (CBT). Depending on the child, she also incorporates strategies that promote healthy and safe boundary setting, becoming more assertive, communications skills, and relaxation methods to calm the mind and body. “The key is to offer evidence-based coping strategies that meet their developmental needs,” she said.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy is a practical, short-term form of psychotherapy designed to help people to develop skills and strategies for becoming and staying healthy. Tiffany said, “CBT is the golden standard for treatment of anxiety, and I have tremendous success with my CBT program.”

CBT focuses on day-to-day life problems. Given that moderate to severe anxiety, loneliness and depression are increasing in children, teens, and young adults, effective coping strategies become life-long skills. Tiffany said, “Not all anxiety is the same. In the past year alone, I’ve encountered more children with severe types of anxiety and even phobias.”

Helping individuals overcome debilitating fears

Phobias can cause paralyzing fears, but they can be managed and overcome with proper strategies. Tiffany said, “I specialize in anxiety disorders, including a variety of common and more unusual phobias which include:

  • Ombrophobia: The fear of rain
  • Arachibutyrophobia: The fear of peanut butter on the roof of your mouth
  • Hypnophobia:  The irrational fear of falling asleep
  • Ablutophobia: The overwhelming fear of bathing or washing

Tiffany said, “I’ve also worked with children and teens who’ve experienced generalized anxiety disorder/chronic worry, trichotillomania, social anxiety, chronic pain, functional illness, obsessive compulsive disorder, selective mutism, Tourette’s Syndrome and tic disorders.”

Depending on her client, the strategies might include exposure therapy, CBT, yoga movement, mindfulness, relaxation breathwork and usually art and play.

“Play” at times is the best therapy

For children, the integration of creative therapies with CBT is a must, as it improves the therapeutic outcome. New to Tiffany’s therapy room is a playhouse that she calls “The House.” Tiffany’s art and play space also include a sand tray, puppet theatre, and art centre. She said, “When I combine CBT therapy with the creative aspect, children are more relaxed and engaged, and they integrate the learnings in a way that’s meaningful to them.”

Children will use play to work through their fears and anger. Tiffany said, “Art and play therapy is such an effective treatment option when combined with CBT.”

Her teenage clients aren’t as keen on the playroom. Still, they do appreciate the art space and Tiffany said, “They thrive with Dialectical Behavioral Therapy (DBT), a form of cognitive therapy. Tiffany recently completed a certification in DBT.

DBT, a mindfulness-based cognitive therapy, encourages living in the moment and paying attention to what is happening around you. It helps teens (and adults) slow down, stay calm, tolerate distress, and focus on healthy coping skills. Tiffany said, “DBT can be effective in helping teens manage intense emotions, and urges, and is one of the best therapies to change unhelpful ways of thinking.”

MAPs + MBSR-teens

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This October, Tiffany is running a mindfulness program for kids ages 6-12 called MAPs and a Mindfulness-Based Stress Reduction program for teens, (MBSR-t).

For more information you can read Tiffany’s newsletter The Windrose.

To register for courses, please visit The Soul Compass online. Ask Tiffany how your insurance might cover the cost.

Studying the OCD cycle

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image: Memory trace imbalance in reinforcement and punishment systems can reinforce implicit choices leading to obsessive-compulsive behavior.
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Credit: Saori C. Tanaka

Ikoma, Japan – Scientists from the Nara Institute of Science and Technology (NAIST), Advanced Telecommunications Research Institute international, and Tamagawa University have demonstrated that obsessive-compulsive disorder (OCD) can be understood as a result of imbalanced learning between reinforcement and punishment. On the basis of empirical tests of their theoretical model, they showed that asymmetries in brain calculations that link current results to past actions can lead to disordered behavior. Specifically, this can happen when the memory trace signal for past actions decays differently for good and bad outcomes. In this case, “good” means the result was better than expected, and “bad” means that it was worse than expected. This work helps to explain how OCD develops.

OCD is a mental illness involving anxiety, characterized by intrusive and repetitious thoughts, called obsessions, coupled with certain repeated actions, known as compulsions. Patients with OCD often feel unable to change behavior even when they know that the obsessions or compulsions are not reasonable. In severe cases, these may render the person incapable of leading a normal life. Compulsive behaviors, such as washing hands excessively or repeatedly checking whether doors are locked before leaving the house, are attempts to temporarily relieve anxiety caused by obsessions. However, hitherto, the means by which the cycle of obsessions and compulsions becomes strengthened was not well understood.

Now, a team led by researchers at NAIST has used reinforcement learning theory to model the disordered cycle associated with OCD. In this framework, an outcome that is better than predicted becomes more likely (positive prediction error), while a result that is worse than expected is suppressed (negative prediction error). In implementation of reinforcement learning, it is also important to consider delays, as well as positive/negative prediction errors. In general, the outcome of a certain choice is available after a certain delay. Therefore, reinforcement and punishment should be assigned to recent choices within a certain time frame. This is called credit assignment, which is implemented as a memory trace in reinforcement learning theory. Ideally, memory trace signals for past actions decay at equal speed for both positive and negative prediction errors. However, this cannot be completely realized in discrete neural systems. Using simulations, NAIST scientists found that agents implicitly learn obsessive-compulsive behavior when the trace decay factor for memory traces of past actions related to negative prediction errors (𝜈) is much smaller than that related to positive prediction errors (𝜈+). This means that, from the opposite perspective, the view of past actions is much narrower for negative prediction errors than for positive prediction errors. “Our model, with imbalanced trace decay factors (𝜈+ 𝜈) successfully represents the vicious circle of obsession and compulsion characteristic of OCD”, say co-first authors Yuki Sakai and Yutaka Sakai.

To test this prediction, the researchers had 45 patients with OCD and 168 healthy control subjects play a computer-based game with monetary rewards and penalties. Patients with OCD showed much smaller 𝜈 compared with 𝜈+, as predicted by computational characteristics of OCD. In addition, this imbalanced setting of trace decay factors (𝜈+ 𝜈) was normalized by serotonin enhancers, which are first-line medications for treatment of OCD. “Although we think that we always make rational decisions, our computational model proves that we sometimes implicitly reinforce maladaptive behaviors,” says corresponding author, Saori C. Tanaka.

Although it is currently difficult to identify treatment-resistant patients based upon their clinical symptoms, this computational model suggests that patients with highly imbalanced trace decay factors may not respond to behavioral therapy alone. These findings may one day be used to determine which patients are likely to be resistant to behavioral therapy before commencement of treatment.

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Resource

Title: Memory trace imbalance in reinforcement and punishment systems can reinforce implicit choices leading to obsessive-compulsive behavior

Authors: Yuki Sakai*, Yutaka Sakai*, Yoshinari Abe, Jin Narumoto Saori C. Tanaka (*co-first authors)

Journal: Cell Reports

Information about the Computational Behavioral Neuroscience Laboratory can be found at the following website: http://isw3.naist.jp/Research/ai-cbn-en.html


Journal

Cell Reports

DOI

10.1016/j.celrep.2022.111275

Article Title

Memory trace imbalance in reinforcement and punishment systems can reinforce implicit choices leading to obsessive-compulsive behavior

Obsessive-Compulsive Disorder is a treatable disorder, not a punchline

Obsessive-Compulsive Disorder is too often used as a punchline in society, and many of us don’t truly understand what it is. People who live with OCD spend a minimum of one hour each day obsessing on recurrent and persistent thoughts, or acting out compulsions related to those thoughts. Both behaviors need not exist for a diagnosis of OCD, but if the obsessions or compulsions impair your ability to function at work or in social situations, you may be among the 2-3% of Wichitans living with this illness.

The mental health community does not fully understand what causes OCD, though brain abnormalities stemming from genetics and the environment are thought to play a role. Symptoms often manifest in the late teen years, lending credence to the belief that the groundwork begins to be laid while our brains are still forming. The result is living your life unable to control your own thoughts or actions, for fear that one wrong step will result in disaster, or that you might act on your own thoughts of harm or violence against yourself or those you love.

Fortunately, OCD – as one in the family of anxiety disorders – is generally considered highly treatable through the proper combination of medications and therapy, including exposure therapy conducted in a controlled environment. But most importantly, we need to remember that lining up your food in a certain way in the grocery cart, or needing the volume on your television to be at a certain number, does not equate to OCD. Like many anxiety and depressive disorders, diagnosis hinges on how or if the symptoms genuinely interfere with your ability to function on a day-to-day basis.