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The Prevalence of Body Dysmorphia Disorder |

By Madeleine Latimer

Have you ever heard of Body Dysmorphia Disorder? Body Dysmorphia Disorder, also called BDD, is an extremely common disorder, even more so than Obsessive Compulsive Disorder (OCD), anorexia, and schizophrenia, developing often in adolescence. BDD is most easily described as a body-image disorder. Sure, everyone has parts of themselves that they don’t like; but people with BDD spend the majority of their time obsessing over their imperfections. BDD is not curable. It can last for someone’s entire lifetime. It can also lead to suicide.

For people with BDD, they spend almost all of their time obsessing over their body. Most of the time, these thoughts that people have about their body and the things they are obsessing over are delusions or complete exaggerations of their imperfections or flaws. Most people would barely recognize these things a person with BDD might obsess over and think are highly noticeable. Common behaviors of BDD may be obsessively checking oneself in the mirror, excessive self-grooming (such as compulsive hair styling, hair cutting, shaving, plucking eyebrows, plucking body hair), extreme makeup application, constantly asking other people if they look okay, skin picking, frequent changing of clothes, tanning to cover freckles or pale skin, and shopping for beauty products and clothing items constantly. Most people with BDD attempt to hide the things they hate about themselves by doing things like wearing a hat all the time, wearing sunglasses, wearing bulky clothes that cover their body, wearing very heavy makeup, or by holding their body in certain positions, like turning the perceived “bad side” of their face away from other people. These thoughts they have can cause extreme emotional stress and interfere with their day-to-day functions. BDD is not simply hating your smile or the way your thighs look. It is a disorder that is much more pervasive and self-destructive, needing to be diagnosed by a doctor and addressed with treatment. BDD in its extreme can even result in suicide.

About 1 in 50 people is affected by Body Dysmorphia Disorder. It affects about 2.4% of the population and is almost equally distributed amongst women and men. According to Katherine A. Phillips’ article “Suicidality in Body Dysmorphic Disorder,” 80% of people who suffer with BDD have had suicidal thoughts and 28% of them have attempted suicide. The suicide rate for those diagnosed with BDD is very high. The suicide attempt rates are estimated to be 6–23 times higher than what is reported for the US population. It is within the range reported for depressed outpatients, and it is higher than that reported for generalized anxiety disorder, panic disorder or agoraphobia. People with BDD tend to isolate themselves in social situations because they feel they are unacceptable in the eyes of others because of perceived flaws or inadequacies. BDD can be a lead in to additional disorders such as bulimia, anorexia and binge-eating. It can also bring other disorders, such as Major Depressive Disorder, Social Anxiety Disorder, and Obsessive-Compulsive Disorder. A significantly higher amount of people with BDD, compared to people with OCD, have reported suicidal thoughts. One study found that lifetime suicide attempts, with the leading cause being their disorder of either BDD or OCD, had a higher rate among people with BDD than those subjects with OCD. People with BDD are at 22% compared to people with OCD at 8%. Another study found a higher lifetime rate of suicide attempts, being at 40% among people with combined diagnosis of both BDD and OCD, compared to those with only a single diagnosis of either BDD or OCD. BDD is not curable and there are no medications that can treat it, since the disorder is purely psychological. Therapy is the primary treatment which can help change the way that a person processes information and copes with their BDD, but just like depression and anxiety, it can never fully be cured so the goal is management.

BDD is not widely known. More awareness for the disorder needs to be spread through community education at all age levels, throughout the medical specialties and within the educational institutional ranks. Often times, it goes unrecognized due to people not knowing or fully understanding what this disorder is and the signs which give rise to a possible affliction with BDD. Often people may be too ashamed to tell their doctor during check-ups they are having these feelings, even further, the questions are not being asked by physicians. There are depression and anxiety surveys that most doctors ask teens to complete during these annual check-ups, but not for Body Dysmorphia Disorder. Those practicing in this area of specialty agree that mental health check-ups should be at least a bi-annual expectation for all patients.

When it comes to types of treatments, those most commonly used are serotonin reuptake inhibitors (SRIs) and cognitive-behavioral therapy (CBT) both of which appear to be effective for a majority of patients. Cosmetic treatments, such as surgery and dermatologic treatment, are typically ineffective for BDD as this fails to address the underlying psychological issue resulting in the disorder.

Social media and media in general, has a strong effect on today’s youth. It is causing an increase in the prevalence of Body Dysmorphia Disorder. Television, social media, and peer competition have their own influences on how one looks at themselves and their body. Many believe that a simple fix to this problem is to simply put down your phone. This is not in itself an effective solution. The media is everywhere and almost impossible to avoid. Tom Quinn, an eating disorder specialist says that “teaching emotional intelligence and embedding coping mechanisms into the school curriculum can ensure that young people grow up not only aware of their emotional needs but also able them to support themselves.” The school curriculum could benefit from an overhaul to health education and the issues facing teens and young adults today. Outside of social media, even advertisements are at fault for encouraging people to feel bad about their bodies. A 2014 Victoria Secret ad campaign had ten women, all of which were tall and slender, and only featuring three women of color. It was called “The Perfect Body” and received much backlash due to its lack of variety in body types, shapes and sizes.

Body Dysmorphia Disorder is not exclusive to young adults. BDD is something that will affect a person their entire life. Michael Jackson and Andy Warhol both suffered from BDD. Michael Jackson’s tell was his extreme plastic surgery, which even though he denied, was quite obvious to everyone else. Andy Warhol obsessed over the redness of his nose. He was very obsessed with his image and the way he looked. A few other famous people known to struggle with BDD include Franz Kafka, Sylvia Plath and Shirley Manson. There are most likely more famous people with BDD, but since the topic is not widely talked about, people are less likely to bring it up. It is not similar to the discussion surrounding depression. Depression is talked about on a global scale. Many famous people and influencers will bring it up to influence others to go get help with their depression or call the suicide hotline. BDD does not have that.

Body Dysmorphia Disorder is not well known, and although it only effects 2.8% of the population, it is a rapidly growing disorder due to the effects of social media. It is also going on without treatment because it is less known than the other psychological disorders. There should be more knowledge of BDD. The BDD suicide rates are so much greater than they should be. Education and recognition of this disorder is critical to improving the outcome of this segment of the population. The proper diagnosis and treatment for those suffering from BDD is the only way to slow the growth of this public health problem and improve the mental health and body images of our next generation. If people become educated about BDD and a global conversation, it could lower the rates of suicide caused by BDD and open up resources for people get the help they need to become more comfortable dealing with their BDD on a day to day basis.

Header photo from psycom.net


Adkins, Alyce. “How Social Media Contributes to Body Dysmorphic Behavior.” The Lexington Line, The Lexington Line, 9 May 2018, www.thelexingtonline.com/blog/2018/5/7/how-social-media-contributes-to-body-dysmorphic-behaviors.

“Famous People with BDD.” BDD, Body Dysmorphic Disorder Foundation, bddfoundation.org/resources/famous-people-with-bdd/.

Phillips, Katharine A. “Suicidality in Body Dysmorphic Disorder.” Primary Psychiatry, U.S. National Library of Medicine, Dec. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC2361388/.

“Body Dysmorphic Disorder (BDD).” Anxiety and Depression Association of America, ADAA, Anxiety and Depression Association of America, adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd.

With diagnosis and treatment lacking, nonprofit strives to raise awareness of OCD in Japan

A peer-inspired dieting competition triggered the unhealthy lifestyle, but it wasn’t only an eating disorder that haunted Sayaka Hashiba’s late sister.

Hashiba, a 34-year-old Tokyo office worker, said her younger sister’s behavior became visibly erratic when she was around 12 years old.

An athletic, upbeat girl with good grades, she nevertheless began adopting peculiar eating habits, including broccoli-only meals that quickly shredded her weight from 40 kilograms or so to around half of that in a matter of months. She started repeating routine activities, such as climbing up and down staircases and recounting each thing she had done since waking up in the morning.

Meanwhile, the excessive fasting deteriorated her health, and she was hospitalized and diagnosed with anorexia nervosa. Her condition kept her away from school, and her weight remained unstable, bouncing up and down. Her family didn’t know what to make of her odd habits, Hashiba recalled.

Still, her sister was able to maintain a semblance of normality as a young adult, working at izakaya pubs, although her colleagues occasionally complained of her overuse of alcohol disinfectant sprays and oshibori (wet hand towels).

Several years ago, she reached out to Hashiba, telling her via instant messenger that she may have obsessive-compulsive disorder. But Hashiba said she didn’t take her sister’s claim seriously at the time, something she regrets to this day. In September, she died at home from heart failure — nearly two decades of a dangerously unbalanced diet and low caloric intake had taken a toll on her fragile body. She was 31.

Sayaka Hashiba's sister, who suffered from OCD, passed away last year. Hashiba, 34, now volunteers for OCD Japan to raise awareness of the anxiety disorder. | ALEX MARTIN
Sayaka Hashiba’s sister, who suffered from OCD, passed away last year. Hashiba, 34, now volunteers for OCD Japan to raise awareness of the anxiety disorder. | ALEX MARTIN

“The World Health Organization says OCD is nonfatal, but it’s a mental disorder that tortures people for the longest time,” Hashiba said. “And despite the hell my sister must have been going through, none of us in the family figured out what was wrong with her. We left her struggling alone.”

Compared to countries such as the United States, where a growing understanding and acceptance of OCD has led some celebrities to open up about their battle with the anxiety disorder, there is a general lack of awareness regarding the illness in Japan, preventing patients and their families from seeking necessary help and leaving them suffering in silence.

In fact, according to studies, it takes an average of 90 months before those with OCD visit a medical institution in Japan — enough time to complicate symptoms and delay treatment. In Hashiba’s sister’s case, she was diagnosed with OCD only nine days before her death.

“My sister used to say she wanted to do something, anything, that could help others,” said Hashiba, who now volunteers for OCD Japan, a nonprofit led by experts offering advice on how to tackle the disorder. “I know it’s too late now and that nothing I can do will bring her back. Still, I want to believe she would be happy if I worked to raise awareness of the illness that took her life.”

OCD was once ranked by the WHO among the top 10 most disabling illnesses in terms of lost income and decreased quality of life. The organization also lists anxiety disorders, including OCD, as the sixth largest contributor to nonfatal health loss globally.

Despite the extreme distress the disorder can provoke, the condition is often misunderstood and is even used as an adjective for being meticulous or organized.

In Japan, the word keppekishō is used as a blanket term to describe people who are over-particular about cleanliness, obscuring and downplaying what may be far more serious than mere fastidiousness.

The U.S.-based National Institute of Mental Health, the largest research organization in the world specializing in mental illness, defines OCD as a common, chronic and long-lasting disorder in which a person has uncontrollable, recurring thoughts and behaviors that he or she feels the urge to repeat over and over. These include obsessions, such as fear of germs or contamination and having things symmetrical or in perfect order, as well as compulsions including excessive cleaning, hand washing, compulsive counting and repeatedly checking on things — all symptoms Hashiba’s sister checked off at one point or another.

And while no comprehensive figures are available, around 1 in 50 to 1 in 100 people, or roughly over 1 million nationwide, are thought to have OCD, said Ayako Kanie, a psychiatrist at the National Center for Cognitive Behavior Therapy and Research and a member of OCD Japan.

Symptoms typically begin during adolescence, and there appears to be a genetic component involved as well as psychological factors. “People with OCD may also be diagnosed with other disorders including depression and anorexia,” Kanie said. “Some OCD patients also exhibit a strong aversion toward eating certain foodstuffs, such as products using chemicals, which can lead to excessive weight loss.”

According to the International OCD Foundation, the most effective treatments for the condition are cognitive behavioral therapy, with or without medication. More specifically, the organization says a type of CBT called exposure and response prevention has the strongest evidence supporting its use in the treatment of the disorder, while a class of medications called serotonin re-uptake inhibitors are effective.

“The Exposure in ERP refers to exposing yourself to the thoughts, images, objects and situations that make you anxious and/or start your obsessions,” the International OCD Foundation says on its website. “While the Response Prevention part of ERP refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been ‘triggered.’”

Kanie said that such heightened anxiety typically recedes in 30 minutes or so, a period that, once successfully overcome, gives patients confidence over time.

“For example, the treatment will involve patients with an aversion to germs being asked to touch something dirty and then restraining themselves from washing their hands.”

However, the process requires the supervision of trained professionals and the cooperation of family members and others close to patients, Kanie said, options that may not be available for all depending on personal circumstances.

While the method is thought to alleviate symptoms in around 70 percent of cases, there are not enough trained therapists, said Noriko Nakayama, a clinical psychologist and a member of OCD Japan.

“While patients can be diagnosed with OCD at psychiatry clinics and be prescribed with antidepressants, whether they provide CBT depends,” she said. That is one reason her organization is educating medical professionals on how to conduct the therapy.

On June 2, Hashiba and members of OCD Japan organized their first OCD Walk, an International OCD Foundation-backed awareness and advocacy event that originated in 2013 and now takes place in many cities across the U.S. The event gathered around 70 participants, who marched through the bustling shopping district of Shibuya toward Yoyogi Park as they played music from speakers and held up banners and flags.

Participants of the OCD Walk march down the streets of Tokyo on June 2. | ALEX MARTIN
Participants of the OCD Walk march down the streets of Tokyo on June 2. | ALEX MARTIN

A 52-year-old reporter at a major newspaper covering the event, who asked to remain anonymous, said he suffered from OCD.

“It started in middle school when I began excessively double-checking if doors were closed,” he said. The symptoms receded for some time but resurfaced a couple of years after he began working. He would worry about being contaminated by germs in toilets, and his condition worsened after he was transferred to Tokyo, where the overcrowded city caused him to become a social recluse, or hikikomori.

“When it was really bad, I would spend an hour washing my hands and two hours in the bathtub,” he said.

His wife recommended he receive professional counseling and accompanied him to therapy sessions. Coupled with medication, his condition gradually improved to the point he could go back to work.

“I still stay away from public bathrooms in train stations and fret over whether I stepped on someone’s spit,” he said. “But I’ve learned to live and deal with these situations.”

For Hashiba, the walk was just the start in what she considers to be her mission to spread the word about OCD.

She’s often flooded with countless memories of her little sister, about how she was an expert skier as a child or how she would be the first to comfort Hashiba when she was feeling down.

“She was a strong, cheerful woman who never let her struggles take the best of her,” she said, while showing photographs of her sister stored on her smartphone.

“Discussing mental health is often taboo in Japan, but that needs to change for the sake of those who are suffering.”

A woman prays at the site of a mass stabbing on June 4, a week after the incident in which a knife-wielding man killed two and injured more than 15 people near a bus stop in Kawasaki.Image Not AvailableDoing things by the book: Outlets offering elementary legal advice are available in Japan but, at ¥5,000 per half hour, they're not cheap.

Postpartum OCD Is Real. This Is What You Need to Know About It

After her second child was born, Britney Asbell, 29, became obsessed with the thought that someone might break into their home or their house might catch on fire. At the time, she also fixated on the safe where the family’s gun was kept. “I would just sit and spend probably the first hour or two of my day repeating the code [to the safe],” she said. “That was my compulsive behavior then. I had to know. What if something happened and I needed to protect my children?”

Among the mental health disorders that affect new mothers, postpartum obsessive-compulsive disorder just might be the most misunderstood, if it’s even recognized at all. Postpartum OCD is believed to affect between 2 and 3 percent of people who have recently given birth, while affecting only 1.08 percent of the general population, according to research published in the Journal of Clinical Psychology. The jury’s still out as to why.

Postpartum OCD is much different from postpartum depression. It’s important to differentiate between the two so that mothers can receive the treatment they need, allowing them to be healthy and happy in their new role. PPD is characterized by intense sadness, loss of interest in things once enjoyed, guilt, worthlessness, and lack of motivation, said Margaret Howard, professor of psychiatry, human behavior and medicine at Brown University.

Obsessive-Compulsive Disorder, however, is characterized by unwanted and relentless thoughts that cause significant distress,” Howard explained. Postpartum OCD also varies from postpartum psychosis, which is characterized by delusions, hallucinations, or extreme feelings of elation. The minimal but developing research on postpartum OCD shows that people managing it do not want to harm their child. Instead they can become consumed with the fear of causing intentional harm to their child, or of something bad accidentally happening to them.

For Asbell, a mom of three in Macon, Georgia, these thoughts play on repeat in her head. One thought, ‘What if I drop baby down my stairs?’ could easily result in hours spent working through that what if question, mentally playing out each potential scenario that could have followed.

The symptoms of postpartum OCD are very specific. Intrusive thoughts are a normal part of the new mom experience, with the vast majority (between 70 and 100 percent) of people who recently gave birth reporting at least some thoughts related to harming their baby unintentionally. As pointed out by BMC Psychiatry, maternal OCD is different than the typical experience, though, because the onset often takes place immediately after birth, because of how frequent and distressing those intrusive thoughts become, and the manner in which people cope with them. The sheer volume of terrifying thoughts is what transforms run-of-the-mill new parent nerves into unmanageable anxiety for people with postpartum OCD.

Stephanie Saunders, a 28-year-old mother of one living in British Columbia, said that her intrusive thoughts became more pronounced and debilitating around five months after she delivered her child. “I was petrified that if I stood on the balcony with her that she would somehow fall off the railing and die, and that I wouldn’t be able to protect her,” she said. Fear of missing a red light and getting into a gruesome car accident made it difficult for her to leave the house. She began avoiding social outings, worried that when her daughter began to cry, the other mothers would assume she was an incapable mother.


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“The response to these distressing thoughts is to engage in behaviors or even mental rituals such as counting or saying certain words over and over, that are believed to ‘neutralize’ the obsessive thoughts,” Howard said. Sometimes, the behaviors individuals turn to for comfort from these obsessive thoughts are obvious—excessive washing and sanitizing in the house to deal with fear of germs, for example. Other times, behaviors may be disguised as “normal” new mom things, like checking their baby’s breathing. Avoiding situations that cause anxiety, like bathtime or leaving the house, is also a common compulsive behavior.

Compulsions may even arise in subtle ways such as thought monitoring, according to Jenny Yip, clinical psychologist and a member of the International-Obsessive Compulsive Disorder Foundation, or IOCDF. Thought monitoring is what’s known as a covert compulsion, which can involve repeated reviewing of thoughts to determine if they’re “right” or “good.” As a mother of twins with a childhood history of OCD, Yip began to experience obsessive thinking after their birth surrounding the fear that she might love one more than the other. She fell into a habit of compulsively checking her thoughts about her babies to manage her anxiety.

According to Howard, screening for postpartum OCD is the first step if I doctor feels their patient could be at risk—that should be followed by a clinical interview that confirms the diagnosis. If diagnosed, a proven method of treatment for it is exposure and response prevention therapy, Yip said. This specialized therapy is recommended to the majority of people with OCD by the IOCDF and works on identifying triggers for obsessive thinking. Then, in a therapeutic setting, individuals are taught to trigger these thought processes and intentionally chose not to engage in compulsive behaviors, which reduces behaviors and anxiety over time.

Unfortunately, people with postpartum OCD often fall through the cracks, Yip said. This is often the result of inadequate screening—regular screening for anxiety disorders like OCD is performed by as little as 20 percent of care providers. And, with so little accurate information about postpartum OCD readily available to new moms, their fear of judgment, or worse, holds them back from seeking help.

“The whole point of the initial postpartum period is bonding,” Yip said. “It’s supposed to be bliss. Instead, you’re going through this really rough period of having the intrusive, horrific images and that interferes with the bonding period.”

This was the case for Asbell, who struggled after the births of all three of her children but didn’t report her intrusive thoughts until her third postpartum period. After her second child, she reached out to her physician at eight weeks postpartum after experiencing what she calls a bought of rage, throwing a toy across the foyer in her home to release pent up, overwhelming emotions. It was hard for her to speak up. She was afraid they might see her act of anger, although it wasn’t directed at her children, as a reason to take her children. Because she felt being honest about her feelings and actions was already “pushing the envelope,” she kept quiet about her obsessive thoughts.

She doesn’t recall being screened formally at all, but was treated for postpartum depression with a prescription. She found her symptoms getting worse. After a panic attack at four months postpartum, she was accepted into an outpatient partial program for PPD. This was the first time it crossed her mind that she might have obsessive-compulsive tendencies. She remained in therapy throughout her third pregnancy and continued on after the birth of her child. It was at this point that she finally felt comfortable voicing her intrusive thoughts and eventually received a postpartum OCD diagnosis.

Many people in her position may fear that they’ll be hospitalized which, unfortunately, isn’t a baseless fear, according to Yip, who explained that there are still physicians who haven’t been educated on postpartum OCD and very well may suggest hospitalization or a 72-hour-hold for psychiatric evaluation. For new moms who want nothing more than to care for their new child, this can be a terrifying thought.

She doesn’t want people to be afraid to speak up. Instead, she suggests that parents who believe they’re experiencing these symptoms should begin by doing their own research to prepare themselves for their follow-up appointment. “If you’re going to your doctor for the purpose of getting help, I would highly suggest you [seek out] information about postpartum OCD,” she says. “Take it to your doctor and tell them, ‘Hey, these are my symptoms and this is what I believe I’m experiencing.’”

Self-advocacy is difficult during a vulnerable time in your life, but it’s often necessary. Lindsey Aerts, a 36-year-old from Salt Lake City, who experienced postpartum OCD after the birth of her first child, doesn’t recall being screened at her six-week check-up and found herself googling “Does having scary thoughts mean I’ll act on them?” before reaching out to her care provider again at three months postpartum. Now, along with Asbell and Saunders, she’s taken to social media to spread awareness about the disorder using the hashtag #PPOCD.

“Luckily, I feel like I got the treatment I needed but I know so many moms who are not in the same situation,” Aerts says of her experience after being referred to a psychiatrist and diagnosed with postpartum OCD.

Ultimately, it seems that OCD is pretty misunderstood in general. Yip points to the media, which focuses largely on quirky behaviors like counting or handwashing, without giving the public a view of the disturbing, obsessive thoughts that may be driving these comforting, compulsive behaviors. The hope is that, with experts like Yip and Howard spreading awareness among professionals caring for new parents, and more people sharing their own stories online, fewer will suffer in silence.

“Once I started sharing, I had friends and even strangers saying, ‘Because you shared your experience, I felt less alone in mine,’” Asbell said. “It made me think that if more women opened up, more women might get the help they need.”

Could cannabinoids help treat obsessive-compulsive disorder?

obsessive-compulsive disorder

US experts reviewed research into the possible causes of OCD and the potential for using cannabinoids in treating the condition.

Obsessive-compulsive disorder (OCD) is a mental illness in which the sufferer has unwanted intrusive obsessive thoughts that make them extremely anxious and distressed. These thoughts are combined with repetitive compulsive behaviors that they act out in an attempt to relieve obsessive thoughts. For example, a common obsession in OCD is anxiety about contamination or dirt. This is often combined with compulsive hand-washing and cleaning behaviors.

Current treatments for OCD are not effective in some patients

OCD goes far beyond the normal anxious thoughts and behaviors that most people experience to some degree. It is a disabling mental illness that interferes with normal daily life. OCD is estimated to affect around 2-3% of people worldwide over the course of their lifetime. Certain antidepressant and antipsychotic medications can relieve OCD symptoms. However, these drugs are not effective in some patients and may have unpleasant side effects, so new therapies are needed.

The underlying causes of OCD are not fully understood but may be linked to disruptions in pathways and signaling systems in the central nervous system (CNS). Experts in New York, USA, reviewed research into the neurological causes of OCD and the potential use of cannabinoids in treating the condition. They recently published their review in Cannabis and Cannabinoid Research.

Disruption of the Endocannabinoid System (ECS) may underlie OCD

Growing evidence from animal experiments and neuroimaging studies in humans suggests that disruption of Endocannabinoid System (ECS) in the brain could have a role in anxiety, fear, and repetitive behaviors. The ECS is widely distributed in the CNS and is made up of multiple nerve pathways, endogenous (produced in the body) cannabinoid neurotransmitters (eCBs), eCB receptors, and enzymes that make and breakdown eCBs. Broadly speaking, the ECS prevents excessive nerve activation, appearing to “act as a brake mechanism” and support the brain’s ability to “relax, sleep, forget, and protect”.

Cannabinoids or agents targeting the ECS could provide new OCD treatments

Exogenous (present in the environment) cannabinoids include “phytocannabinoid” compounds found in the cannabis plant and synthetic cannabinoids made in the laboratory. Animal experiments have found that exogenous cannabinoids can relieve OCD-like symptoms. Furthermore, some OCD patients who smoke cannabis have anecdotally reported relief from their OCD symptoms. Preliminary clinical studies with cannabinoids in OCD patients have supported this observation.

These findings suggest that developing new medications that target the ECS could be useful in treating OCD. The reviewers point out that careful consideration should be given to the selection of test cannabinoid agents, since eCB receptors are found widely in the CNS, so there is potential for unwanted side effects. Agents targeting other ECS components, such as eCB enzymes, could provide other test treatment options. “Only further exploration of this topic will determine whether cannabinoids pass the most important test: Helping more patients with OCD to achieve wellness,” concluded Dr. Reilly Kayser, the lead author of the review.

Written by Julie McShane, MA MB BS

 

References

  1. Kayser RR, Snorrason I, Haney M, et al. The endocannabinoid system: a new treatment target for obsessive compulsive disorder? Cannabis and Cannabinoid Research 2019;4(2):1-11).
  2. Mary Ann Liebert Inc.(Publishers), Press release 31 May 2019. “Can cannabinoids help treat ovsessive compulsive disorder?” https://www.eurekalert.org/pub_releases/2019-05/mali-cch053119.php

"Climb Out of the Darkness" in Winslow to support moms with postpartum mental health issues

WINSLOW, Maine (WABI) – Women who’ve survived some of the darkest moments of motherhood are coming together in Winslow soon.

Photo courtesy: MGN

They want other women and families who’ve faced postpartum mental health issues to join them.

Women of every culture, age, income level and race can develop perinatal mood and anxiety disorders. Symptoms can appear any time during pregnancy and the first 12 months after childbirth.

It’s not just depression. Other types of mood disorders pregnant and postpartum moms can experience are anxiety, obsessive compulsive disorder (OCD), bipolar, Rage, PTSD, and psychosis. Support groups have been proven to be just as effective as one-on-one therapy in helping families recovery from these disorders.

Climb Out of the Darkness, the world’s largest event raising awareness of pregnancy and postpartum mental health disorders, will hold a Climb in Winslow on June 21 at 5pm. Women and men who are survivors will walk, stroll or climb together at Rotary Centennial Trail to symbolize their collective rise out of the darkness.

Money raised by the Climb will support Postpartum Support International’s goals to provide funds to local groups and organizations, provide low-cost training in perinatal mood disorders for providers, train law enforcement and legal experts, mentor peer supporters and group leaders, and train primary healthcare providers in Maine.

Postpartum Support International offers help and a variety of resources at www.postpartum.net. A PSI helpline can also be accessed by call 1-800-944-4PPD.

The Facebook page Hope for Maine Moms and Families offers support, too, and provides information about local support groups. More information about the Climb Out of the Darkness can also be found there.Amanda Brown, the PSI coordinator for Maine can be reached at (857)203-0482 or amandabrownpsi@gmail.com.

Support Groups

The Tree of HOPE (Bangor)
When: Every Tuesday 10:00am-12:00pm
Where: 489 State Street Bangor at Northern Light EMMC Penobscot Pavilion Level 8 Conference Room
No sign up necessary, Free to the public

The Tree of HOPE (Waterville)
When: Every Tuesday 10:00am-12:00pm
Where: 180 Kennedy Memorial Drive in Waterville located in the Medical Arts Building of Inland Hospital
No sign up necessary, Free to the public

Waldo County Hospital (Belfast)
When: Second and Fourth Thursdays of the Month @ 11:00 am – 12:30 pm
Where: Waldo Country General Hospital at 119 Northport Avenue, Biscone Building, First floor- Community Room
No sign up necessary, Free to the public

Pen Bay Medical Center (Rockport)
When: First and Third Thursdays of the Month @ 11:00 am – 12:30 pm
Where: Pen Bay Medical Center at 6 Glen Cove Drive, Rockport
No sign up necessary, Free to the public

Pregnancy and Postpartum Support Group (Southwest Harbor)
When: 1st and 3rd Sundays of the month from 10:00am-11:30am
Where: 54 Herrick Integrative Medicine, Southwest Harbor

Maternal Health Alliance of Maine (Portland and Falmouth) Check the website for more information – www.mhame.org. They also offer an online support group.

Do I Have OCD? What Is OCD (Obsessive Compulsive Disorder), Signs, Symptoms, & Causes | Sandra E. Cohen, PhD

OCD makes you feel out of control. Here’s how to stop it.

If you suspect you have OCD or “Obsessive Compulsive Disorder,” then you’ve likely been dealing with OCD symptoms for some time. But what is OCD, and what causes OCD to happen?

Obsessive Compulsive Disorder is categorized, like its name suggests, by a series of obsessive thoughts and compulsions to complete certain behaviors or tasks. Leaving these behaviors undone — or doing them “wrong” — can lead to anxiety, stress, or overwhelm.

Oftentimes, people with OCD develop these specific needs for rituals due to trauma. There are various types of OCD, but the causes of OCD are frequently trauma-based, whether it comes from childhood or an early stress-event.

RELATED: How To Stop Overthinking Ease Anxiety By Chanting Ancient Healing Mantras

People with OCD have “obsessions” or out of control thoughts, and compulsions, which are actions they feel like they must do.

The Search for Novel Treatment Targets for Obsessive Compulsive Disorder – A Free Webinar from the Brain & Behavior Research Foundation

New York, June 04, 2019 (GLOBE NEWSWIRE) —

The Brain Behavior Research Foundationis hosting a free interactive webinar on “The Search for Novel Treatment Targets for Obsessive Compulsive Disorder”on Tuesday, June 11, 2019, from 2pm to 3pm ET.Susanne E. Ahmari, M.D., Ph.D., Assistant Professor of Psychiatry at the University of Pittsburgh School of Medicine,will discuss how her translational OCD research program seeks to identify the molecular, cellular, and circuit-level changes that underlie the onset and persistence of abnormal repetitive and compulsive behaviors. During this webinar, Dr. Ahmari will explain how her lab’s recent findings could ultimately pave the way to new treatment approaches for this mental illness that affects 2% to 3% of people worldwide. Jeffrey Borenstein, M.D., President and CEO of the Brain Behavior Research Foundation and host of the public television show “Healthy Minds,” will be the moderator. Join by phone or on the web at bbrf.org/junewebinar.

This webinar is part of a series of free monthly “Meet the Scientist” webinars on the latest developments in psychiatry offered bythe Brain Behavior Research Foundation. 

BBRF awards research grants to develop improved treatments, cures, and methods of prevention for mental illness. These illnesses include addiction, ADHD, anxiety, autism, bipolar disorder, borderline personality disorder, depression, eating disorders, OCD, PTSD, and schizophrenia. Since 1987, the Foundation has awarded more than $394 million to fund more than 4,700 leading scientists around the world, which has led to over $3.9 billion in additional funding. 100% of every dollar donated for research is invested in our research grants. The Foundation’s operating expenses are covered by separate foundation grants. 

Source:            Brain Behavior Research Foundation

 

Myrna Manners
Brain  Behavior Research Foundation
(718) 986-7255
mmanners@mannersdotson.com

Can OCD Symptom Alleviation in the Early Postpartum Period Be Predicted?

Women with obsessive compulsive disorder (OCD) who exhibited a decrease in symptoms following a previous childbirth may experience symptom alleviation in the next postpartum period, according to study data published in the Journal of Affective Disorders.

Women with OCD who delivered their babies at the Obstetric Inpatient Clinic of a University Hospital in Konya, Turkey, were eligible for inclusion. Participants were approached for first psychiatric evaluation within the first day after delivery. Follow-up assessments were conducted between 6 and 8 weeks after delivery. Patients were administered the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to capture OCD symptoms and severity. Coping strategies and levels of social support among participants were also assessed, along with a temperament evaluation using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire. Logistic regression was performed to identify factors associated with treatment response, defined as at least a 35% reduction in Y-BOCS score between assessments.

The final cohort comprised 27 participants of mean (standard deviation [SD]) age 27.54 (6.28) years. The average (SD) number of children was 2.03 (0.76). Mean (SD) illness duration was 50.11 (39.82) months, and 21.6% (n=8) of women with OCD had a comorbid depressive or anxiety disorder. The mean (SD) scores on the Y-BOCS-obsession, Y-BOCS-compulsion, and Y-BOCS-total at the first evaluation were 12.95 (1.71), 12.01 (2.34) and 24.95 (3.77), respectively. At second evaluation, performed at a mean postpartum week of 6.59±0.83, these same scores were 9.41 (4.01), 8.49 (4.81), and 17.89 (8.69). The differences between scores at baseline and follow-up were significant (P =.000 for all). Treatment response was achieved in 16 (43.2%) patients at 6 to 8 weeks postnatally. Patients who reported a decrease in symptom severity following a previous childbirth were much more likely to experience a decrease in symptom severity for the present birth compared with those who did not (86.7% vs 16.7%; P =.000). Additionally, among the subscale scores of Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire, “hyperthymic” was significantly greater in the decreased group compared with the non-decreased group (P =.004). Logistic regression showed that a decrease in symptom severity during the previous postpartum period (P =.001) and the existence of hyperthymic affective temperament (P =.033) were independent predictors of symptom severity decrease.

The study was limited by its size. Its scope was limited to one university-affiliated hospital, and OCD symptomology was retrospectively self-reported.

These data suggest that OCD symptoms may be naturally alleviated during the postpartum period without therapeutic intervention. Specifically, women with hyperthymic affective temperament and a prior decrease in symptoms may require less frequent pharmacologic treatment during the early postpartum period.

“Further studies also should examine the impacts of other factors such as stressful life events, functional impairment and detailed individual history of the disorder (eg, treatment response and hospitalization) on course of OCD during this period,” researchers concluded.

Reference

Yakut E, Uguz F, Aydogan S, Bayman MG, Gezginc K. The course and clinical correlates of obsessive-compulsive disorder during the postpartum period: a naturalistic observational study. J Affect Disord. 2019;254:69-73.

What Is Postpartum OCD?

After her second child was born, Britney Asbell, 29, became obsessed with the thought that someone might break into their home or their house might catch on fire. At the time, she also fixated on the safe where the family’s gun was kept. “I would just sit and spend probably the first hour or two of my day repeating the code [to the safe],” she said. “That was my compulsive behavior then. I had to know. What if something happened and I needed to protect my children?”

Among the mental health disorders that affect new mothers, postpartum obsessive-compulsive disorder just might be the most misunderstood, if it’s even recognized at all. Postpartum OCD is believed to affect between 2 and 3 percent of people who have recently given birth, while affecting only 1.08 percent of the general population, according to research published in the Journal of Clinical Psychology. The jury’s still out as to why.

Postpartum OCD is much different from postpartum depression. It’s important to differentiate between the two so that mothers can receive the treatment they need, allowing them to be healthy and happy in their new role. PPD is characterized by intense sadness, loss of interest in things once enjoyed, guilt, worthlessness, and lack of motivation, said Margaret Howard, professor of psychiatry, human behavior and medicine at Brown University.

Obsessive-Compulsive Disorder, however, is characterized by unwanted and relentless thoughts that cause significant distress,” Howard explained. Postpartum OCD also varies from postpartum psychosis, which is characterized by delusions, hallucinations, or extreme feelings of elation. The minimal but developing research on postpartum OCD shows that people managing it do not want to harm their child. Instead they can become consumed with the fear of causing intentional harm to their child, or of something bad accidentally happening to them.

For Asbell, a mom of three in Macon, Georgia, these thoughts play on repeat in her head. One thought, ‘What if I drop baby down my stairs?’ could easily result in hours spent working through that what if question, mentally playing out each potential scenario that could have followed.

The symptoms of postpartum OCD are very specific. Intrusive thoughts are a normal part of the new mom experience, with the vast majority (between 70 and 100 percent) of people who recently gave birth reporting at least some thoughts related to harming their baby unintentionally. As pointed out by BMC Psychiatry, maternal OCD is different than the typical experience, though, because the onset often takes place immediately after birth, because of how frequent and distressing those intrusive thoughts become, and the manner in which people cope with them. The sheer volume of terrifying thoughts is what transforms run-of-the-mill new parent nerves into unmanageable anxiety for people with postpartum OCD.

Stephanie Saunders, a 28-year-old mother of one living in British Columbia, said that her intrusive thoughts became more pronounced and debilitating around five months after she delivered her child. “I was petrified that if I stood on the balcony with her that she would somehow fall off the railing and die, and that I wouldn’t be able to protect her,” she said. Fear of missing a red light and getting into a gruesome car accident made it difficult for her to leave the house. She began avoiding social outings, worried that when her daughter began to cry, the other mothers would assume she was an incapable mother.


“The response to these distressing thoughts is to engage in behaviors or even mental rituals such as counting or saying certain words over and over, that are believed to ‘neutralize’ the obsessive thoughts,” Howard said. Sometimes, the behaviors individuals turn to for comfort from these obsessive thoughts are obvious—excessive washing and sanitizing in the house to deal with fear of germs, for example. Other times, behaviors may be disguised as “normal” new mom things, like checking their baby’s breathing. Avoiding situations that cause anxiety, like bathtime or leaving the house, is also a common compulsive behavior.

Compulsions may even arise in subtle ways such as thought monitoring, according to Jenny Yip, clinical psychologist and a member of the International-Obsessive Compulsive Disorder Foundation, or IOCDF. Thought monitoring is what’s known as a covert compulsion, which can involve repeated reviewing of thoughts to determine if they’re “right” or “good.” As a mother of twins with a childhood history of OCD, Yip began to experience obsessive thinking after their birth surrounding the fear that she might love one more than the other. She fell into a habit of compulsively checking her thoughts about her babies to manage her anxiety.

According to Howard, screening for postpartum OCD is the first step if I doctor feels their patient could be at risk—that should be followed by a clinical interview that confirms the diagnosis. If diagnosed, a proven method of treatment for it is exposure and response prevention therapy, Yip said. This specialized therapy is recommended to the majority of people with OCD by the IOCDF and works on identifying triggers for obsessive thinking. Then, in a therapeutic setting, individuals are taught to trigger these thought processes and intentionally chose not to engage in compulsive behaviors, which reduces behaviors and anxiety over time.

Unfortunately, people with postpartum OCD often fall through the cracks, Yip said. This is often the result of inadequate screening—regular screening for anxiety disorders like OCD is performed by as little as 20 percent of care providers. And, with so little accurate information about postpartum OCD readily available to new moms, their fear of judgment, or worse, holds them back from seeking help.

“The whole point of the initial postpartum period is bonding,” Yip said. “It’s supposed to be bliss. Instead, you’re going through this really rough period of having the intrusive, horrific images and that interferes with the bonding period.”

This was the case for Asbell, who struggled after the births of all three of her children but didn’t report her intrusive thoughts until her third postpartum period. After her second child, she reached out to her physician at eight weeks postpartum after experiencing what she calls a bought of rage, throwing a toy across the foyer in her home to release pent up, overwhelming emotions. It was hard for her to speak up. She was afraid they might see her act of anger, although it wasn’t directed at her children, as a reason to take her children. Because she felt being honest about her feelings and actions was already “pushing the envelope,” she kept quiet about her obsessive thoughts.

She doesn’t recall being screened formally at all, but was treated for postpartum depression with a prescription. She found her symptoms getting worse. After a panic attack at four months postpartum, she was accepted into an outpatient partial program for PPD. This was the first time it crossed her mind that she might have obsessive-compulsive tendencies. She remained in therapy throughout her third pregnancy and continued on after the birth of her child. It was at this point that she finally felt comfortable voicing her intrusive thoughts and eventually received a postpartum OCD diagnosis.

Many people in her position may fear that they’ll be hospitalized which, unfortunately, isn’t a baseless fear, according to Yip, who explained that there are still physicians who haven’t been educated on postpartum OCD and very well may suggest hospitalization or a 72-hour-hold for psychiatric evaluation. For new moms who want nothing more than to care for their new child, this can be a terrifying thought.

She doesn’t want people to be afraid to speak up. Instead, she suggests that parents who believe they’re experiencing these symptoms should begin by doing their own research to prepare themselves for their follow-up appointment. “If you’re going to your doctor for the purpose of getting help, I would highly suggest you [seek out] information about postpartum OCD,” she says. “Take it to your doctor and tell them, ‘Hey, these are my symptoms and this is what I believe I’m experiencing.’”

Self-advocacy is difficult during a vulnerable time in your life, but it’s often necessary. Lindsey Aerts, a 36-year-old from Salt Lake City, who experienced postpartum OCD after the birth of her first child, doesn’t recall being screened at her six-week check-up and found herself googling “Does having scary thoughts mean I’ll act on them?” before reaching out to her care provider again at three months postpartum. Now, along with Asbell and Saunders, she’s taken to social media to spread awareness about the disorder using the hashtag #PPOCD.

“Luckily, I feel like I got the treatment I needed but I know so many moms who are not in the same situation,” Aerts says of her experience after being referred to a psychiatrist and diagnosed with postpartum OCD.

Ultimately, it seems that OCD is pretty misunderstood in general. Yip points to the media, which focuses largely on quirky behaviors like counting or handwashing, without giving the public a view of the disturbing, obsessive thoughts that may be driving these comforting, compulsive behaviors. The hope is that, with experts like Yip and Howard spreading awareness among professionals caring for new parents, and more people sharing their own stories online, fewer will suffer in silence.

“Once I started sharing, I had friends and even strangers saying, ‘Because you shared your experience, I felt less alone in mine,’” Asbell said. “It made me think that if more women opened up, more women might get the help they need.”

This article originally appeared on VICE US.

Can cannabinoids help treat obsessive-compulsive disorder?

IMAGE: Cannabis and Cannabinoid Research is the premier journal dedicated to the scientific, medical, and psychosocial exploration of clinical cannabis, cannabinoids, and the biochemical mechanisms of endocannabinoids. For more information, visit…
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Credit: ©2012, Mary Ann Liebert, Inc., publishers

New Rochelle, NY, May 30, 2019–The body’s endocannabinoid system, due to the critical role it plays in regulating neurotransmitter signaling, is an enticing target for drug development against disorders associated with anxiety, stress, and repetitive behaviors, such as obsessive-compulsive disorder (OCD). A comprehensive new review article that provides an overview of this complex system, endogenous and exogenous cannabinoids, results of animal studies and human trials to date, and recommendations for future directions is published in Cannabis and Cannabinoid Research, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. Click here to read the full-text article free on the Cannabis and Cannabinoid Research website through June 30, 2019.

The article entitled “The Endocannabinoid System: A New Treatment Target for Obsessive Compulsive Disorder?” was coauthored by Reilly Kayser, MD, Ivar Snorrasson, PhD, Margaret Haney, PhD, and H. Blair Simpson, MD, PhD, Columbia University Vagelos College of Physicians and Surgeons, and Francis Lee, MD, PhD, Weill Cornell Medical College, (New York, NY). The researchers present the evidence that links the endocannabinoid system to the pathology underlying OCD. They also explore the potential for targeting this system to relieve symptoms of OCD and related disorders such as anxiety, tic, and impulse control disorders. The review includes and extensive overview of cannabinoids made by the body, and exogenous cannabinoids, including phytocannabinoids found in the marijuana plant and purified and synthetic cannabinoids.

Based on both animal study data showing anti-anxiety and anti-compulsive effects of cannabinoid agents and on preliminary human clinical trial data, the authors suggest that continued pharmaceutical development is warranted. Which cannabinoid agents to test and how to measure their effects will be among the important questions to consider in designing future studies.

“Is there a place for cannabinoid-based medicines in psychiatry? Evidence from animal and human studies points to the endocannabinoid system as an important regulator of emotionality, but how can we exploit this knowledge for therapy? This review article offers a critical assessment of the evidence, focused on obsessive compulsive disorder, and clues to future research,” says Editor-in-Chief Daniele Piomelli, PhD, University of California-Irvine, School of Medicine.

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About the Journal

Cannabis and Cannabinoid Research is the only peer-reviewed journal dedicated to the scientific, medical, and psychosocial exploration of clinical cannabis, cannabinoids, and the biochemical mechanisms of endocannabinoids. Published quarterly in print and online and led by Editor-in-Chief Daniele Piomelli, PhD, the Journal publishes a broad range of human and animal studies including basic and translational research; clinical studies; behavioral, social, and epidemiological issues; and ethical, legal, and regulatory controversies. Complete tables of content and a sample issue is available on the Cannabis and Cannabinoid Research website.

About the Publisher

Mary Ann Liebert, Inc., publishers is a privately held, fully integrated media company known for establishing authoritative peer-reviewed journals in many promising areas of science and biomedical research, including Journal of Palliative Medicine, The Journal of Alternative and Complementary Medicine, and Journal of Child and Adolescent Psychopharmacology. Its biotechnology trade magazine, GEN (Genetic Engineering Biotechnology News), was the first in its field and is today the industry’s most widely read publication worldwide. A complete list of the firm’s 80 journals, books, and newsmagazines is available on the Mary Ann Liebert, Inc., publishers website.

Obsessive-compulsive disorder research needs more focus on the patient, a new study asserts

For people living with obsessive-compulsive disorder (OCD), scientific research into their condition is not an abstract concept; it can have profound real-life implications.

Cognitive science has been instrumental in furthering our understanding of mental health problems. The interdisciplinary study of the mind and its processes embraces elements of psychology, philosophy, artificial intelligence, neuroscience and others topics. The field is rife with areas of exploration for researchers, and it has contributed enormously to the study of serious problems like OCD.

But Adam Radomsky, a professor in the department of psychology and the Concordia University Research Chair in Anxiety and Related Disorders, worries that for all its fascinating studies, cognitive science is becoming further and further removed from the people those studies are supposed to help: OCD patients and the therapists who treat them.

Radomsky and two of his former PhD students, Allison Ouimet and Andrea Ashbaugh, both now associate professors at the University of Ottawa, published a new paper in the journal Clinical Psychology Review. In it they reviewed recent OCD research and found that, as interesting as it was, it did not necessarily translate into real benefits for treatment.

Start with memories

As Radomsky explains it, there are two hallmark symptoms of OCD.

“Obsessions are horrible intrusive thoughts people have over and over in their minds,” he explains. “Compulsions are things people do over and over again, like checking you’ve completed a task, or washing and cleaning.”

A commonly held belief among researchers posited that memory had something to do with OCD behaviour.

“People are not sure if something is safe or clean or locked,” he says. An old theory was that the problem may have been cognitive in nature, or perhaps neurological.

Over the years, researchers have conducted countless tests on people living with the disorder. However, after reviewing the literature, he says the overall results are equivocal.

“Research into memory, neurobiological and attention deficits probably have not helped therapists or clinicians and probably have not improved therapy,” he says.

The research did prove fruitful in another area though, that of the individual’s beliefs in their own cognitive functioning.

“It’s not that people with OCD have a memory deficit. It’s that they believe they have a memory deficit. It is not their ability to pay attention that is the problem; it is that they do not believe they can focus,” he says. “In the clinic, we can work with what people believe.”

From clinic to lab

As both an academic researcher and practicing psychologist, Radomsky says he hopes his review will be of help to colleagues inside and outside the lab.

“We think the review will help therapists focus on areas that will be of use, and hopefully help cognitive scientists look at domains that could be useful to clinicians,” he says.

Radomsky would like to see cognitive scientists and practitioners working closer together with the goal of providing better treatment for people living with OCD.

“We learn a lot from the science that researchers are doing, but we also learn a lot from clients and patients,” he says. “In fact, in some ways, patients are the better instructors because they are living with these problems. I suspect we are going to increasingly follow their lead, because when they voice a particular concern or doubt in themselves, those are often the best ideas to take into the lab.”

Read the cited paper: “Hoping for more: How cognitive science has and hasn’t been helpful to the OCD clinician.”

Listen to Adam Radomsky discuss OCD in this podcast from the conversation series Thinking out Loud, or in this video from The Walrus Talks.

 

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