Back to School with an OCD Checklist

by stuart miles freedigitalphotos.net

by stuart miles freedigitalphotos.net

As we approach “that time of year,” I thought I’d once again share this post as I think it could benefit a lot of people:

Dr. Aureen Pinto Wagner has compiled a checklist of ways obsessive-compulsive disorder might affect kids at school, or in relation to school. While the article is geared directly toward kids, and suggests that children share their checklist with their parents, I also think it can work the other way. Parents who know their children have OCD, or suspect they might, can work through the checklist with their child to help pinpoint potential problem areas in school. This information can then be shared with their child’s therapist (and teachers) who can work with the student on his or her issues.

One great thing about this list is that it’s appropriate for all ages, from kindergartners to high school students. For those young people who find it difficult to verbalize their feelings or talk about their OCD, this checklist could be a godsend. Thank you Aureen!

The start of a new school year can be stressful. Add OCD into the mix and major problems can arise. We should expect our children to get the support they deserve – in classrooms where, ideally, teachers have at least a basic understanding of OCD.

Here’s to a happy and successful school year for all students and parents!

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Therapists with Obsessive-Compulsive Disorder

by stuart miles freedigitalphotos.net

by stuart miles freedigitalphotos.net

When I first became involved in OCD advocacy about six years ago, I would occasionally come across articles or books written by therapists whose bios revealed that they had OCD themselves. I always found this information comforting, because at the time it was hard for me to believe my son would ever again be able to function in the outside world. If someone with OCD can come so far – from struggling with a devastating disorder to helping people with this same illness, then maybe there was hope for my son as well.

Lately, I seem to be coming across more and more therapists and other health-care professionals who specialize in treating obsessive-compulsive disorder and have OCD themselves. It could be that people in general are more comfortable disclosing their mental health issues, or it could be that more people who have overcome OCD are choosing  careers where they can help others do the same.

How great is that!

I have written before about how those with OCD are often hesitant to seek help as they are aware of how irrational their obsessions and compulsions are. They are embarrassed to discuss their OCD in detail. But if their therapist also has OCD, they just might be more willing. After all, who can understand what you’re going through and how you are feeling better than someone who has had similar experiences?

Perhaps the greatest benefit of having so many practicing therapists with obsessive-compulsive disorder goes back to a word in the first paragraph of this post: HOPE. Here are people who have not only overcome a potentially devastating disorder, they have no doubt worked very hard to achieve their dream of helping others. They have chosen a difficult path and have succeeded. How could there be any better role models for those who are wondering if they might ever be able to live the lives they want?

One of the main reasons I blog is to spread the word that OCD, no matter how severe, is treatable, and I often refer to my son’s story as proof. But to have that proof – that hope -sitting in the same room as you? I don’t think it can get any better than that.

 

 

 

 

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OCD and Exciting Research

by renjith krishnan freedigitalphotos.net

by renjith krishnan freedigitalphotos.net

Ever hear of mGluR5? Sapap3?

I surely hadn’t until this past week when some results from research conducted at Duke University were revealed.

I’m no scientist, so in the most basic of layman’s terms, this is how I understand it:

Sapap3 is a protein that helps to establish  connections between neurons so that cells can communicate. In 2007, researchers at Duke University created a new mouse model for obsessive-compulsive disorder by deleting a gene that codes for Sapap3. This Sapap3-lacking mouse exhibits OCD-like behaviors, grooming itself excessively and showing signs of anxiety.

In the more recent study, researchers honed in on a neuroreceptor called mGluR5 (metabotropic glutamate receptor 5), which is a protein the helps regulate the brain’s response to outside stimuli. When activity of mGluR5 was intentionally blocked, the OCD-like behaviors in the laboratory mice mentioned above quickly disappeared.

When I say quickly, I mean quickly:

“The reversibility of the symptoms was immediate – on a minute time frame,” said senior investigator Nicole Calakos.

Conversely, by giving laboratory mice a drug that boosted mGluR5 activity, the researchers found they could instantaneously recreate the same OCD-like behaviors and anxiety they saw in the mice who lacked Sapap3. Without a properly functioning Sapap3 protein, the mGluR5 receptor is always “on,” making the brain regions involved in compulsions overactive.

So could there be a cure for OCD on the horizon?

Who knows? While I find this new research incredibly exciting, there is still so much more work to be done and so many more questions to be answered.

While we are fortunate to have dedicated researchers who are committed to finding these answers, we don’t have to sit around and wait for them to finish their work. Those with OCD do not have to suffer – there is good treatment available.  And while everyone’s “OCD Toolbox” might look a little different, exposure and response prevention (ERP) therapy, is a must.

If you’re interested, you can read about the above study in more detail here.

 

 

 

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OCD, Medication, and Attitude

by david castillo dominici freedigitalphotos.net

by david castillo dominici freedigitalphotos.net

I’ve previously written about how complicated the topic of OCD and medication can be. I’ve talked about stigma and the process of “trial & error.” I’ve discussed how there are those who feel weak for deciding to take medication, and still others who feel empowered by this decision. I’ve talked about how there is not one specific drug for obsessive-compulsive disorder, and what works for one person might not work for another. Some people find medication to be helpful, and others never derive any benefits from them, no matter how many meds they try. There are those who are plagued by intolerable, and often dangerous, side-effects, and  others who say medication saved their lives.

To say the subject of medication and OCD is an individual thing is an understatement.

There is one aspect of medication in relation to OCD that I have yet to touch upon, and that is attitude.  Specifically, does one’s beliefs about medication influence its effectiveness?

Apparently so.

In this wonderful post, Dr. Kelly Brogan shares study after study that all arrive at the same conclusion: Mind-set matters.

Most of us are familiar with the placebo effect, which in the case of medication, involves beneficial effects produced by the patient’s beliefs in the “drug” (typically nothing more than starch and sugar) they are taking. Not as well known, but equally powerful, is the nocebo effect, which is associated with harmful effects due to the person’s negative beliefs about the “drug” they are taking.

Dr. Brogan quotes from the New England Journal of Medicine:

Placebo effects rely on complex neurobiologic mechanisms involving neurotransmitters (e.g., endorphins, cannabinoids, and dopamine) and activation of specific, quantifiable, and relevant areas of the brain (e.g., prefrontal cortex, anterior insula, rostral anterior cingulate cortex, and amygdala in placebo analgesia).

In other words, the placebo and nocebo effects are real, and have been recognized as such by the medical community.

It is interesting to note that the placebo and nocebo effects are not limited to medication. As an example, Dr. Brogan highlights a study which produced data that focused on outcomes of belief. She says:

…One of my favorite studies took 84 hotel attendants with cleaning responsibilities and told half of them that their daily work satisfied the Surgeon General’s recommendations for an active lifestyle as exercise. They told the other half nothing.

As a result, compared with the control group, they showed a decrease in weight, blood pressure, body fat, waist-to-hip ratio, and body mass index. These results support the hypothesis that exercise affects health in part or in whole via the placebo effect.

So interesting! But what does all this mean for those with OCD? I’m no expert, but I’d guess that if someone is forced to take medication for their OCD when they really don’t want to, and when they believe it won’t help, there is a good chance it won’t benefit them. Conversely, if someone is gung-ho about meds and can’t wait to take them because they’re convinced they’ll quell their OCD, chances are they’ll experience at least some relief.

Of course, there is more to these medications than just believing or not believing they will work. But attitude is a piece of the complicated OCD puzzle. Also, it’s not difficult to see how attitude and beliefs are likely to affect exposure and response prevention (ERP) therapy as well. Hmm, sounds like a good topic for another post!

 

 

 

 

 

 

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OCD and Crime

by c. guoy freedigitalphotos.net

by c. guoy freedigitalphotos.net

Man arrested after Jo Cox shooting is ‘obsessive compulsive who rubbed own skin with Brillo pads’ relative claims.

The above statement is a  recent headline from the Daily Mirror, a British newspaper. The story goes on to discuss the eccentricities of the man arrested for the recent horrific killing of Jo Cox, a Member of Parliament.

Talk about misleading. While it certainly is possible this man has obsessive-compulsive disorder (untreated), those with OCD are no more likely to commit crimes than the general population.

The headline might just have well have said, “Killer has brown eyes.” It’s just not relevant to the crime. Those with OCD who have obsessions of harming others live with the torment of these thoughts because they are so repulsed and frightened by them. Compulsions are created as a way to make sure these acts are not carried out. Those with OCD who have obsessions about hurting others with a knife, for example, will hide all the knives in their home or not go near the kitchen. They do not act on their obsessions. They WILL NOT take a knife and hurt someone, at least not because they have OCD.

This Washington Post article, which I think is well worth reading, discusses the fact that most killers do not suffer from what we typically consider mental illness, but rather  are considered sociopaths. Dr. Michael Stone, a forensic psychiatrist at the Columbia College of Physicians and Surgeons, breaks mental illness into two categories:

In the first category are those with schizophrenia, delusions and other psychoses that separate them from reality and who are suffering from serious mental illness and could be helped with medical treatment. In the second are those with personality, antisocial or sociopathic disorders who may exhibit paranoia, callousness or a severe lack of empathy but know exactly what they are doing.

Dr. Stone published a paper in 2015, and the Washington Post article summarizes its conclusions:

Stone found that just about 2 out of 10 mass killers were suffering from serious mental illness. The rest had personality or antisocial disorders or were disgruntled, jilted, humiliated or full of intense rage. They were unlikely to be identified or helped by the mental-health system, reformed or not.

Some of the commenters on this article argue that  sociopaths are indeed mentally ill, and this whole topic is just a matter of semantics. In this blog post, I discuss the use of the phrase “the mentally ill” and experts weigh in on who that includes and how this phrase  perpetuates stigma.

Blaming violent crimes on “the mentally ill” is an easy thing to do but the truth is it’s a complicated issue. One thing is perfectly clear, however. People with OCD are no more likely than anyone else to resort to violence.

 

Posted in Mental Health, OCD | Tagged , , , , , , | 5 Comments

You’re Beating OCD – Now What?

by stuart miles freedigitalphotos.net

by stuart miles freedigitalphotos.net

For many people, the journey through obsessive-compulsive disorder and back to good health is a long one. Getting a correct diagnosis, or even just recognizing you have OCD, often takes years. Then comes the search for appropriate treatment, followed by a long-term commitment to therapy and hard work. We know recovery is possible, but it is rarely a “quick fix.”

I try to imagine what it must feel like, after being controlled by OCD for so long, to finally have your life back. Relief. Gratitude. Excitement!

Yes, but for many, also add trepidation and confusion, with a helping of uncertainty.

What do I do NOW?

For many people, living with a good-sized case of obsessive-compulsive disorder is a full- time job. Obsessions, compulsions, more compulsions, getting stuck, avoidance, more compulsions, planning your next move, more compulsions – it can literally take up all your time. When my son Dan’s OCD was severe, OCD is all he “did,” day in and day out. It truly steals your life.

So when you finally get your life back, it can be disorienting and scary. What do you do with all this free time that no longer belongs to OCD? How can you be sure to live that happy, productive life you’ve worked so hard to reclaim?

I have heard from quite a few people who have had this issue, and it’s not unusual for OCD to try to worm its way back into their lives at this time. All the uncertainty about what’s to come lends itself to a ripe breeding ground for OCD. In addition, the person with OCD might start to obsess about how he or she thinks she is supposed to feel, or maybe even wonder if they ever really had OCD to begin with?

Hopefully, those who have made it this far in their battle will recognize OCD if it rears its ugly head and see it for what it is – a big bully trying to regain control. Of course, the way to keep it at bay is by continuing to use exposure and response prevention (ERP) therapy.

Back to the question of “What do I do NOW?” the answer is clear. You live your life the way YOU want to, not the way OCD wants you to. You identify your goals and work toward them within the framework of your values. What do you want out of life? While to some people the answers are obvious, others might need some guidance to help figure out their path. A good therapist can be invaluable.

Let’s get back to those feelings of Relief. Gratitude. Excitement! Because for all those whose lives are now unencumbered by OCD, anything is possible. Your hopes and dreams really can come true!

 

 


 

 

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

OCD and Alcohol

by pong freedigitalphotos.net

by pong freedigitalphotos.net

As many of us already know, obsessive-compulsive disorder is a disease of doubt, fueled by uncertainty. But in some ways, certain aspects of OCD can also be viewed as an addiction. In this post, I talk about Jon Hershfield’s description of reassurance-seeking behaviors:

If reassurance were a substance, it would be considered right up there with crack cocaine. One is never enough, a few makes you want more, tolerance is constantly on the rise, and withdrawal hurts. In other words, people with OCD and related conditions who compulsively seek reassurance get a quick fix, but actually worsen their discomfort in the long-term.

So are those with OCD more prone to addictions? Are they more likely to become dependent on alcohol, or illegal drugs, than those without the disorder?

I thought it was an interesting question, so I decided to research it a bit, focusing mainly on alcohol addiction. I found a lot of articles stating that yes, those with OCD are more prone to becoming alcoholics than the general population. Statistics varied, hovering around the twenty-five percent mark. These articles were full off anecdotal evidence, but I didn’t come across any scientific research on the subject. So who knows?

It is not surprising that people who are suffering greatly in general might resort to alcohol to dull the pain. Many of us know people who “self-medicate” or we might even take part in this ourselves. For those with OCD who self-medicate, alcohol can indeed take the edge off the anxiety they’re feeling and even help free them from obsessive thoughts.

But….once the alcohol has worn off, anxiety as well as obsessions are likely to return with a vengeance, leaving the previously “self-medicated” person with not only worsening OCD, but an alcohol problem as well. Another thing to consider is that many people with OCD take medication for the disorder, and alcohol is known to interact with these medications, including SSRIs.

I’m fortunate that my son Dan never resorted to self-medicating. In fact, he went in the totally opposite direction. He does not drink alcohol at all. When I once asked him about it, he told me that when his OCD was severe, and he was overly medicated as well, he felt totally out of control of his life. It was a horrible feeling, and he hated it. Why would he drink and willingly put himself in that position again? He said he realized there were a lot of things in his life that were out of his control, but he was going to do his best to control the things he could. Ah, good ‘ol Serenity Prayer.

Makes sense to me.

 

 

 

 

 

 

Posted in Mental Health, OCD | Tagged , , , , , , | 10 Comments