OCD and Brain Inflammation

A very interesting study was published this past week in JAMA Psychiatry stating that brain inflammation in those with obsessive-compulsive disorder is significantly elevated (by more than thirty per cent) compared to those without the disorder.

Dr. Jeffrey Meyer, senior author of the study and Head of the Neuroimaging Program in Mood & Anxiety at the Centre for Addiction and Mental Health (CAMH) Campbell Family Mental Health Research Institute, says:

“Our research showed a strong relationship between and OCD, particularly in the parts of the brain known to function differently in OCD,”…..”This finding represents one of the biggest breakthroughs in understanding the biology of OCD, and may lead to the development of new treatments.”

Another very interesting finding from the study is that researchers found a connection between resisting compulsions and brain inflammation. Those with OCD who experienced the greatest stress or anxiety when they tried to avoid acting out their compulsions also had the highest levels of inflammation in one particular brain area. This factor could prove helpful in determining who might benefit the most when and if new treatments are developed targeting inflammation.

I do think it’s worth mentioning that while this study seems to hold great promise, so much more work needs to be done. There were only twenty participants with OCD in the study, and twenty in the comparison group.

And as often happens, new findings generate more questions. Where does this inflammation come from? Where (if anywhere) does PANDAS fit into this picture? How will this information lead to better treatments for those with OCD?

I’m always excited and heartened to learn of new research and discoveries related to OCD, and this does appear to be a breakthrough of sorts. We are learning more and more about obsessive-compulsive disorder thanks to dedicated researchers who work tirelessly to unlock the mysteries of this potentially devastating disorder.

 

 

 

 

 

 

 

 

 

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ERP Therapy – An Analogy


by winnond freedigitalphotos.net

by winnond freedigitalphotos.net

 

This post first appeared on my blog in January 2012….

One of the reasons I became an advocate for OCD awareness was to spread the word that exposure and response prevention (ERP) therapy is the therapy of choice for treating obsessive-compulsive disorder. Unfortunately, I sometimes come across first-person blogs where those with OCD equate this therapy with torture, and therefore refuse to try it. Others feel it might be helpful but are just too afraid to attempt it.

On his blog, Dr. Steven Seay compares ERP therapy to an exercise program, and using this analogy, really sets the record straight as to what this therapy involves when dealing with a competent therapist:

I often think about ERP as an exercise program for your brain. Why do people exercise? Typically to improve their quality of life in some way — be it related to health, aesthetics, or the way it makes them feel. People don’t take up exercising for no reason at all–it’s always purpose-driven. This is just like ERP. Why would you do it? Because it’s going to enhance your life in some way.

The analogy can be taken a bit further, though.

Exercise is not a singular activity. It’s something that’s often based around targeting a particular muscle group or certain aspect of health. People who want big biceps do different exercises than people who want to lose weight. This is similar to ERP. People who want to be less bothered by unwanted thoughts (e.g., thoughts of hitting someone with your car) do different exposures than someone who is afraid of contracting a deadly disease. The form of the “exercise” reflects a specific therapeutic goal.

Moreover, there are multiple ways to target the same muscle group. People who want to work on their abs might consider crunches, leg lifts, push-ups, etc. In ERP, there is no one exposure that will help you get better. Instead, there is an array of options that might work for you.

There’s also the hierarchical nature of exercise. If you want to get stronger, it’s smart to start with light weights and build up to heavier weights. It would be downright dangerous to attempt a 500lb bench press without proper training. In ERP, going for that “10″ on your hierarchy is ill-advised at the beginning of treatment. Before going there, you need to lay the proper groundwork first. A gradual approach might take more time, but it will get you to the destination without subjecting you to unnecessary injuries.

Finally, the world is full of different types of trainers. Not everyone is a drill sergeant. The best trainers will listen to you, work with you, and try to understand where you’re coming from. They’ll then use their expertise to design an individualized plan for you that is based on your goals, preferences, and perspective. The best therapists I know follow this same approach to treatment.

My position is that if you’re completing an exposure under duress, you’re unlikely to benefit from it. It’s the process of choosing to face your fear (and willingly embracing the uncertainty that comes with it) that really makes the difference.

Thank you, Dr. Seay.  Here’s hoping your words inspire all those with OCD to “hit the gym!”

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Children, Rituals, and OCD

 

by teerapun, freedigitalphotos.net

by teerapun, freedigitalphotos.net

 This post originally appeared November 2011:

When my daughter was two or three years old, she had a bedtime ritual where she lined up ten of her dolls and stuffed animals on the floor. They had to be in the right order, at the right angle, touching or not touching each other in a specific way. If these “friends” were not arranged just so, she would get upset, and then have to adjust each and every one of them until she got it just right. Then she could go to sleep.

She does not have OCD.

Rituals are a normal part of childhood, and they play an important role in children’s overall development. Rituals create order for children as they grow and try to make sense of the world around them. For example, a bath, story time, and cuddles every night before bed give children structure and a sense of security. They feel safe; they know what to expect.  Everything is as it should be.

Wow. Rituals never sounded so good.  So how could something so wonderful cause so much distress?

Typically, children without obsessive-compulsive disorder will be soothed and comforted by their rituals, whereas a child with OCD will experience only a fleeting calm. Anxiety and distress will always return, and the child will feel compelled to complete the ritual again. As I discussed in this previous post on rituals, this feeling of “incompleteness” is a telltale sign of OCD.

Another thing to watch for if you think your child might have OCD is the amount of time he or she spends ritualizing, and how much it interferes with his or her life. Typically, spending an hour or more a day completing rituals should raise some red flags.

Diagnosing OCD in young children is not always easy, as there are many ways the disorder can manifest itself. And OCD is tricky. Just when I was really starting to worry about my daughter, she began to care less and less about the arrangement of her “friends.” On the other hand, my son, who has never lined up anything in his life, developed OCD.

It is known that OCD often begins in childhood. I know this is no surprise to a lot of people, as I’ve often been told, “I’ve had symptoms of OCD for as long as I can remember.” I’d love to hear from those with OCD. When did you first realize you had the disorder, or that something was wrong? What were your early symptoms? How did your families react? Chances are the more we share, the more people might see themselves or their children, and seek appropriate help.

Posted in Mental Health, OCD | Tagged , , , | 2 Comments

What Makes It So Hard to Seek Help for OCD?

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Where is Dan?

by stuart miles freedigitalphotos.net

My son Dan’s twenty-eighth birthday is in a couple of days, so I thought I’d share this post written in November 2013. He continues to do well after suffering with severe OCD almost nine years ago – and I continue to be enormously grateful…..

I have been fortunate to share the story of my son Dan’s recovery from severe OCD with so many whose lives have been touched by this horrible disorder. The fact that he is doing so well is concrete evidence that OCD, no matter how severe, is indeed treatable, and it is gratifying to know that people have found hope through our story.

When I connect with those who have either read my book or heard me speak, they often ask “How is Dan now?”

I am incredibly thankful that the answer continues to be, “He is doing very well.”

The next question is often something such as, “Where is he? Why don’t we ever see him at these conferences/meetings/other OCD events?”

In 2012 I wrote a post discussing whether “OCD advocacy” should be a responsibility of those who have recovered from severe OCD. Better than my post, I believe, are the comments from those who pointed out that advocacy comes in many ways, shapes, and forms. By continuing to do well, keeping his OCD at bay, and living his life to the fullest, Dan is giving hope to all those who suffer from obsessive-compulsive disorder.

Maybe my son’s choice to not focus on his OCD any more than he needs to is one of the reasons he has learned to cope so well. After all, OCD is something he has, not something he is. Dan has made a conscious effort to put his OCD on the back burner and focus wholeheartedly on living his life to the fullest. He fought his way back from the brink of despair, and perhaps this fact fuels his resolve to leave OCD out of his life as much as he possibly can.

Still, I’m not fooling myself. I know at some point Dan might not have a choice. While he might go years with mild obsessive-compulsive disorder, there’s still a chance it could flare up at any time with a vengeance. It could overtake him again. The bottom line is I don’t know what the future holds, and neither does Dan. Uncertainty. The word that those with OCD (and many of us without the disorder) hate. Nobody knows what will be.

For now, however, I will revel in the fact that Dan is doing well. I will continue to advocate for OCD awareness and proper treatment, and I will respect his decision to not want to make OCD a focal point of his life. Because after all, isn’t that the whole idea?

Posted in Mental Health, OCD | Tagged , , , , | 6 Comments

1 Million Steps 4 OCD Walk

by radnatt freedigitalphotos.net

From the IOCDF website:

Each year, members of the OCD community from across the country — including individuals with OCD, mental health professionals, friends, family members, coworkers, children, and even four-legged friends (dogs must be on a leash, of course) — join together at the 1 Million Steps 4 OCD Walk to raise awareness, hope, and funds to support the important programs of the International OCD Foundation and our partnering Local Affiliates.

The Walk began in 2013 with the flagship event in Boston, and has since expanded to 4 cities around the United States, as well as countless communities across the globe. See below for details about all of our walks, including how to start a walk in your hometown if there is not a walk near you.

Walks are being held in Boston, Sacramento, Atlanta, and Houston.

And yes, you can start a walk in your own hometown! Don Grothoff, a long-time reader of my blog, has organized his own virtual walk. For more details visit his site.

The walks will take place between June 3, 2017 and June 10, 2017. For more detailed information on all the walks, including how to start your own, visit the IOCDF website.

Happy Walking!

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OCD and Transitions

by sira anamwong freedigitalphotos.net

As we enter this season of college and high school graduations, I’d like to share a post I wrote in May 2012, shortly after my son Dan graduated college…

A few days ago my son Dan graduated college. My last post touched upon what this milestone means to me, and this past weekend we had a wonderful celebration with lots of relatives and friends. A well-deserved gathering to honor the graduate.

The days, weeks, and months ahead will be a time of transition for Dan. I am keenly aware that the upcoming changes, by their very nature, will be stressful. He won’t be in school anymore, or living with his three best friends. His girlfriend won’t be nearby. In fact, none of his friends will be around when he comes back home. He’ll have lots of decisions to make – decisions he has never had to make before. What types of jobs will he apply for? How will he approach his job hunt? Where will he live? What are his short-term goals? His long-term goals? Dan, like other graduates, will basically be building a new life for himself, and though that can be stressful and anxiety provoking for anyone, it is often even more so for those struggling with obsessive-compulsive disorder, the “doubting disease.” So much uncertainty!

But there are ways to make this transition easier. I think one of the most important things to do is to prioritize all of these decisions, and just take one thing at a time. Focus on what is most important, and deal with that first.

Also, making major life decisions can be difficult for those with OCD and I think it’s important for those with the disorder to make sure their decisions are based on what they really want, not on what their OCD is dictating or what they feel is the “right” thing to do. Of course, depending on the severity of the OCD, this might be easier said than done, and that’s why having a support system in place is crucial. Therapists, family, and friends should all be aware of the changes going on and be there when needed.

Eating well, exercising, and taking care of ourselves in general are always important, and even more so during times of stress and change. Yet so many of us don’t make this a priority. Carving out some time for enjoyment, even if it’s something as simple as socializing with friends for a short time, can have a positive impact.

Dan’s OCD first became severe when he was a freshman in college. This was also a time of major transition for him. Will it happen again during this time of change?  The answer, of course, is “I don’t know.” I do know he now has the insight, skills and tools to fight his OCD – all things he didn’t have back then. Still, the future is uncertain. I, and hopefully Dan, will choose to embrace this uncertainty instead of worrying about it, and live each day to the fullest, as he moves on to this exciting new chapter in his life.

Congratulations to all the graduates out there and I wish you all the very best!

Posted in Mental Health, OCD | Tagged , , , , | 13 Comments