Mental Health Archives - Pressed http://pressed.blog/category/mental-health/ Mental Health • Self Care • Purpose Mon, 22 Mar 2021 01:37:46 +0000 en-US hourly 1 https://wordpress.org/?v=6.1.6 https://i0.wp.com/pressed.blog/wp-content/uploads/2020/01/pressed_logo.png?fit=32%2C32 Mental Health Archives - Pressed http://pressed.blog/category/mental-health/ 32 32 194860002 Mental Health Series: Obsessive-Compulsive Disorder (OCD) http://pressed.blog/mental-health-series-ocd/?utm_source=rss&utm_medium=rss&utm_campaign=mental-health-series-ocd Sat, 20 Jun 2020 00:27:23 +0000 http://pressed.blog/?p=628   ..quiet. quiet. Quiet. Quiet. QUIET. LEAVE ME ALONE! This is a common sentiment with Obsessive- Compulsive Disorder, or O C D.   Much like anxiety, OCD is a term that gets thrown around nonchalantly. People often say “ I’m so OCD” when they fixate on details, or need things organized a certain way. As someone […]

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..quiet. quiet. Quiet. Quiet. QUIET. LEAVE ME ALONE! This is a common sentiment with Obsessive- Compulsive Disorder, or O C D. 

 Much like anxiety, OCD is a term that gets thrown around nonchalantly. People often say “ I’m so OCD” when they fixate on details, or need things organized a certain way. As someone that actually has OCD, I WISH those were my only problems. There is so much more involved with OCD than meets the eye. 

From my experience, OCD is widely misunderstood, yet simultaneously, rarely discussed, especially in the mental health field. Approximately 2.3% of the U.S population is affected by OCD. However, because of the taboo nature of OCD, those who are afflicted by it often suffer in silence, feeling as though it isn’t something they can talk about. Growing up, I definitely experienced this, and honestly, still do. But the rare, few times I read about OCD or heard someone’s testimony who had it, it helped me to understand that I’m not, in fact, crazy, and I’m definitely not alone. So, if I can offer that same help and hope to someone else, I would be more than happy to do so. 

Similar to my blog post on Anxiety, I will give an overview of OCD, categorized by the following sections: 

Honestly, writing this blog post gives me anxiety. So, I hope whoever reads this will extend grace and sympathy, especially if you can’t completely understand what I have to share. I hope that is extended to everyone who struggles with any kind of mental health conditions or disorders. Thank you in advance <3

Without further ado- this is OCD

 

Defining OCD

OCD is a neurologically based disorder, characterized by unwanted, recurrent thoughts (i.e. obsessions) in which an individual engages in specific repetitive behaviors (i.e. compulsions), in an effort to avoid or eliminate the thoughts. In order to truly understand OCD, it is important to understand what “obsessions” are, and what “compulsions” are.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), obsessions are defined as:

1) “Recurrent and persistent thoughts, urges, or images, that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.”

2) “The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).”

Additionally, compulsions are defined as:

1) “Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.”

2) “The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive. Young children may not be able to articulate the aims of these behaviors or mental acts.” 

In addition to the presence of obsessions and compulsions, they are either time consuming, lasting more than an hour a day (not necessarily consecutively) and/or significantly interfere with an individual’s daily functioning. Furthermore, These OCD symptoms are deemed not the result of drugs, substances, or medications, and are not the result of another medical or mental health condition.
 
Below is one example of an OCD cycle:
 

1) An individual who struggles with a contamination type of OCD, for example, may fear germs. 

2) This individual gets their hands dirty with an unidentified sticky substance from a surface. While the average person with a typically functioning brain may perceive this as disgusting, they are usually able to wash or sanitize their hands and move on from the situation. However, an individual with an OCD wired brain may run through a gamut of thoughts: “What was that? Could I contract a virus/ disease from it? How about if I am now carrying a disease and never know it? What if I die from this? Or worse, how about if I touch someone and infect them with this unknown disease? What if I am the cause of their illness and they die? Oh my gosh it would all be my fault, all because I touched this sticky substance!

3) The individual then washes their hands once, but the obsessive thoughts are still taunting them, and anxiety, fear, and dread still lingers. So, the individual washes their hands 10 more times, for 20 seconds- 1 minute each time, deeply scrubbing every crevice of their hands. The obsessive thoughts have now subsided, and the individual feels relief that they took care of the issue and are no longer a threat to themselves or society. Phew, that was a close one!

4) Going forward, this individual has conditioned themselves to always wash their hands at least 10 times following the same exact regimen, to alleviate obsessive thinking, continuing the cycle of compulsions.

5) When this compulsion no longer satisfies, this individual adapts and may add on an additional 10 hand washing cycles, until things feel “just right” and they experience relief. Or relief until the next cycle of obsessive thinking occurs.

See how this cycle could impede on someone’s daily functioning? Can you imagine going through this cycle multiple times a day while at work, school, or at home? How about while at a social event? See, a normal behavior like “hand washing” could be another person’s nightmare.

 

What OCD is Not

OCD is not the same as anxiety. According to the DSM-5 it does not fall under the umbrella of anxiety disorders and is in it’s own separate category, labeled “Obsessive-Compulsive and Related Disorders.” You can experience anxiety as a symptom, as a result of the OCD, but because OCD also includes the presence of obsessions and compulsion, it is set apart from anxiety disorders. I often find myself telling people that I struggle with anxiety instead of OCD, because this seems to be terminology that most people are familiar with. Although, like I explained in my Anxiety blog post, anxiety is very complex as well. However, what I experience is definitely different, and harder to explain in a general conversation with someone. Thus, why I am laying it all out here lol. 

Everyone has random and obscure thoughts from time to time. The difference with OCD is that the thoughts become obsessive, and the individual strongly feels the urge to engage in compulsions to offset the obsessive thoughts. Additionally, OCD causes significant impairment in daily functioning. 

Going back to my previous statement, I often hear people cavalierly indicate that they are “so OCD” because they have perfectionist tendencies, need to have things in a particular order/organized in a specific way, or are germaphobes and need to have things clean. We especially see these types of behaviors in a comedic light with characters on T.V. shows, such as Sheldon Cooper from “The Big Bang Theory.” I can’t speak for all people who have OCD, but I will say that this is so annoying to hear. Trust me, if your so-called “OCD” tendencies aren’t falling under the above categories 👆🏼👆🏼👆🏼, uh, then you don’t have OCD! So please, kindly stop using that statement of “oh I’m so OCD today!” Yeah, I wish my OCD only lasted a day and not the last 2 plus decades of my life! Lol
 
In all seriousness, please just choose your words more carefully if you happen to be one of those people that throw that term around; I know it’s not meant to be said in a demeaning or dismissive way. However, it is similar to when people say “ I’m so ADD, I’m so distracted today.” I’ve heard people who truly have ADD/ADHD, say that they get very irritated when they hear this phrase. Just like I wrote in my previous blog post, Anxiety, these terms become so normalized that they’re devalued, reducing these actual symptoms and disorders to something that is viewed as “not a big deal.” Well, I hope you can begin to see based on the definition of obsessions and compulsions above- that this is a very big deal.
 

For Your Consideration 

Key terms associated with OCD include:

  • “Sticky thoughts” or “stuck”- this describes how obsessions linger in ones mind, despite efforts to get rid of them
  • “Just right” feeling- typically describes how a compulsion needs to be completed “correctly” in order to alleviate the distress of the obsessive thought. This can only be determined by the individual and their specific compulsion regimen. 
  • “Boomerang affect”- resisting, avoiding, or fixing obsessive thoughts, especially by way of engaging in compulsive behavior, typically makes the unwanted thoughts come back tenfold. Same dynamic as a person reacting to a bully- it gives the bully satisfaction, which leads them to continue the bullying behavior.

Which is fitting. 

Because OCD is a giant BULLY. 

 

The Causes of OCD

It is estimated that about 1 in 40 adults and 1 in 100 children are affected by OCD. However, this is based on what is reported. I believe the number could be higher, but due to fear and misunderstanding of what OCD is and the many ways it may present itself,  many individuals, particularly children, may have a difficult time self-reporting symptoms. 

How does OCD occur? What contributes to it? Although there does not appear to be a specific or clear cause of OCD, experts believe that it is “the result of of a combination of neurobiological, genetic, behavioral, cognitive, and environmental factors that trigger the disorder in a specific individual at a particular point in time,” (BeyondOCD.org). Below are some of the possible causes of OCD.

 

Neurobiological

Please see OCD’s Affect On The Brain and Body section

 

Genetics

Similarly to anxiety disorders and other mental health conditions, OCD can be the result of a genetic predisposition to the disorder, either in the maternal and/or paternal sides of the family. Age of onset may vary between males and females; however, it is suggested that OCD may manifest in males at an earlier age than females. Average age of onset is 19 years old, however it is suggested that children as young as 5 years old can begin to experience OCD. Research suggests that genetics account for about 45-65% of the onset of OCD, with 25% of individuals with OCD having an immediate family member who also has OCD disorder.

 

Behavioral and Cognitive Components

Some cognitive theorists suggests that OCD sufferers misinterpret their random thoughts, causing the thoughts to have more of a profound meaning or seriousness, than is actually true. Theorists believe that this gross misinterpretation of thoughts, is what’s responsible for obsessions and inevitably compulsions. This type of thinking may be caused by a neurobiological impairment in the brain, when compared to a typically- functioning brain.

In other words, everyone gets random, fleeting, unexplainable thoughts, in which the average person is able to think “huh, that was weird” and move on with their lives. However, someone with an OCD wired brain, may perseverate on the thought (i.e. why did I have that thought? Is there a deeper meaning there? Am I a horrible person? Oh gosh, I’m a monster). Thus the thought is grossly exaggerated, creating the opportunity for obsessive thinking. In my personal life, I find when I compare thoughts with my husband, who I would categorize as an individual with a typically functioning brain when compared to my OCD wired brain, he reassures me that my thoughts are not abnormal and he has had similar random thoughts, but he is able to brush them off, where as I obsess over them, which causes me great distress. 

Furthermore, other theorists believe that “behavioral conditioning” is the culprit for compulsive behavior. Basically, at some point an OCD sufferer realized that when they engage in a compulsion it relieves their distress from an obsessive thought. Even if the relief from the obsession was temporary, an OCD sufferer is more inclined to repeat the compulsive behavior, in order to achieve that relief. This continued behavior can become the equivalent of an addiction, and often when the previous compulsion no longer as affective, the OCD sufferer may feel the need to add additional rituals (i.e. specific series of actions) to the compulsion, or complete an entirely new compulsion, in order to achieve that same relief again. This compulsive behavior can become addictive, leading to impaired functioning in an individual’s daily life.

According to BeyondOCD.org here is a list of other false beliefs OCD sufferers struggle with:

  • Total control of thoughts- believing that this not only possible but required.
  • Inflated responsibility- believing that thoughts can directly cause harm, and it is the individual’s responsibility to prevent harm from occurring (i.e. the role of compulsive behavior is typically perceived as a way to prevent a negative outcome). 
  • Perfectionism- believing that it’s not okay to make mistakes and a need to have things completed perfectly. 
  • Overimportance of thoughts- believing that having a negative thought increases the likelihood of harm occurring and/or that having a negative thought is “morally equivalent” to acting on it.
  • Intolerance of uncertainty- believing that there is no room for unknowns, and it is possible and important to ensure negatives outcomes won’t occur. 
  • Overestimation of a threat- believing that negative outcomes are more likely to occur than not, and the consequences will be severe. 

 

Environmental Factors 

There are a multitude of environmental factors that have been linked to the onset of OCD. It is suggested that most environmental factors do not cause OCD, but rather may triggers symptoms in individuals, especially during childhood, who have a predisposition to the disorder. These factors include:

  • Inconsistent parenting styles- this can create a sense of instability, heightening anxiety and stress.
  • Trauma, abuse or distressing events- this may include exposure to inappropriate material/images at a young age. Trauma/abuse/distressing events can create lingering “sticky” thoughts (i.e. obsessive thoughts) about the events, and are unwanted and disturbing to the individual. This may be especially true if the event(s) occurred during childhood, in which the experience is confusing and the child is unable to process the event(s). 
  • PANDAS- It is suggested that children may experience the onset of OCD or OCD symptoms as a result of severe viral or bacterial infections. This type of OCD onset has specifically been linked to streptococcal infections, which is known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (a.k.a. PANDAS). 

 

Types of OCD

There are several subtypes of OCD, each with their own unique set of symptoms. Many of these symptoms are very complex, which makes it difficult for those who suffer from OCD to be able to express and explain their  symptoms; many of these symptoms can cause fear, guilt and shame. For these reasons many of those with OCD may suffer in silence if they are unable to understand their symptoms, and also may fear how others, even trained mental health professionals, could perceive them. 

Below I will summarize the main subtypes of OCD and give examples of some  of the symptoms of each subtype. The most important thing to remember while reading these subtypes and their symptoms, is that these symptoms are experienced as intrusive, disturbing, and unwanted to the OCD sufferer. 

 

Contamination (Cleaning) OCD

Contamination OCD essentially is excessive fear of uncleanliness or germs that could lead to contaminating oneself or others, which could lead to severe consequences (e.g. contracting a illness, disease, or even death). The individual with contamination OCD feels it is their responsibility to prevent these consequences from occurring. 

Examples of obsessions for Contamination OCD include fearful thoughts of:

  • Public items, such as transportation and door knobs
  • Bodily fluids, such as blood, urine, saliva, sweat, semen
  • Illness- related associations, such as viruses, diseases, sick people, hospitals, homelessness

Examples of compulsions include:

  • Cleaning and washing rituals (e.g. a strict regimen of washing hands a specific number of times, for a specific duration of time)
  • Mental checking/reviewing if came in contact with contaminants and if cleaning rituals were completed correctly
  • Avoiding contaminants or avoiding clean items or people when feeling contaminated
  • Constant reassurance from others that they have not contracted a illness, virus or disease from a contaminant and/ or have not exposed others to these consequences as a result of coming into contact with a contaminant

I’ve heard people with OCD, myself included, say that the current Covid-19 pandemic exposed them to a real-life contamination OCD scenario. It was basically like watching people go into mad hysterics and act as “crazy” on the outside, as some or most of us OCD sufferers feel on the inside lol.  So, for people with anxiety and/or OCD, their mental health conditions either prepared them to deal with the pandemic, or their symptoms were heightened due to it. So, if you ever want to have an idea of what a person with contamination OCD might experience on a daily basis- just think back to what you felt or how you saw people react at the beginning of this pandemic 👍

 

Checking/Responsibility OCD

Checking/Responsibility OCD is experiencing excessive fear that if one acts irresponsibility, whether purposefully or not, their actions could lead to a catastrophic consequence. For example, I often check and touch the stove knobs multiple times before I leave the house, to ensure that the house wouldn’t burn down, especially if I’m leaving my husband and son behind in the house. I rationalize it by telling myself, “If I don’t ‘properly‘ check the stove, and it was left on, and the house burned down with my family inside, their deaths would be my responsibility- all because I didn’t take the time to check the stove.” See the inflated sense of responsibility in that line of thinking? Beginning to understand how this type of thinking could impair someone’s daily functioning? Good. Let’s continue!

 Aside from this personal example, below are additional examples of obsessions and compulsions for Checking/Responsibility OCD.

Obsessions include excessive fear of:

  • Leaving doors/other things unlocked
  • Leaving appliances on
  • Safety items not working correctly, such as car brakes

Compulsions include:

  • Repeatedly touching/tapping items to make sure they are off or closed (e.g. the stove, refrigerator)
  • Returning to home/location to make sure items are properly off or closed
  • Needing constant reassurance that items were checked correctly and off/closed.

 

Symmetry and Ordering OCD (a.k.a Organizational, Perfectionism, or “Just Right” OCD)

Symmetry and Ordering OCD has to do with excessive fear that particular things are not as precise as desired.

Obsessions include:

  • Feeling uneasy about an item not being in the correct location 
  • Sensitivity about the symmetry of behaviors or objects in relation to other behaviors/objects
  • Continuously feeling uneasy after finishing a routine

Compulsions include:

  • The urge to even out a behavior on both sides of an object (e.g. tapping both side of arms or legs the same amount)
  • Positioning objects so they appear “just right” (e.g. making sure items are aligned in a row)
  • Repeating an activity or behavior until it feels “just right”  (e.g. repeatedly walking in a circle, opening and closing a door or drawer)

 

Harm OCD (a.k.a “Forbidden Thoughts”, or Taboo OCD)

This subtype of OCD includes unwanted and intrusive thoughts about harming oneself or others. Some of these thoughts may be violent, sexual or religious in nature. Again, for this subtype I think it is very important to highlight that the individual does not experience a desire to harm themselves or others; these thoughts are truly distressing and unwanted by the OCD sufferer, so much so that they will go to great lengths to prevent any possibilities of harm happening (i.e. going back to that false sense of total control and inflated responsibility discussed in the behavior and cognitive components of OCD.

Obsessions include excessive fear of:

  • Harming a person, especially a vulnerable person or loved one, such as one’s child 
  • Not “taking care” of violent thoughts correctly (i.e. through correctly completing compulsions/rituals “just right” to alleviate the thoughts) 
  • Unconsciously harming someone without any recollection (e.g. doing so in sleep/sleeping walking)
  • Past trauma or exposure to inappropriate material during childhood, predetermining you to be an abuser
  • Sudden shift in personality causing one to enjoy harmful thoughts 
  • Specific fear of causing an accidental hit and run, and being unaware of it until you are tracked down by law enforcement

Oh yeah, that last one- weirdly specific and real! Here is a personal example: one time I was driving home late at night, and I ran over a curb accidentally. A pretty common experience that the average person would shrug off.  Well, as I continued driving I had a random thought pop in my head- “ what if that wasn’t actually a bump? What if I just ran over a person??” That thought consumed my mind; I instantly thought about how I potentially killed a person, could get prison time for a hit and run, and my life would be over- all because I wasn’t more careful while driving. I scrutinized myself to no end. So naturally I had to circle back to that same spot to make absolutely sure that I did not hit a person and it actually was just a curb (i.e. the compulsion). However, after I checked, I questioned myself relentlessly- “ Did I check the area thoroughly? Am I sure I didn’t see a person? It’s dark, what if I missed the person, had an opportunity to save them and unknowingly left them for dead?? It was as if I couldn’t believe my own eyes and needed constant reassurance. The only problem was there was no one there with me, so the responsibility to reassure myself was on me. Let’s just say I couldn’t fall asleep that night…

I eventually was able to calm down, reorient myself with reality, and truly realize that I simply ran over a curb accidentally, a common experience, and did not harm anyone. I eventually was able to come to terms with this being another wretched OCD episode. 

That takes us to compulsions. Some compulsions include:

  • Mentally checking/reviewing thoughts to make sure they are all appropriate, especially as it relates to people/loved ones.
  • “Thought neutralization“- If there is even a hint of “inappropriateness” in thoughts, the individual may feel the impulse to immediately replace the thought with an irrefutable positive thought
  • Avoidance of media/information, people, activities, places that may trigger the unwanted harmful thoughts 
  • Mentally checking/reviewing memories and thoughts to ensure that you did not accidentally harm someone and reassure yourself that you would not harm someone purposefully.
  • ”Compulsive flooding”- Forcing oneself to think about violent thoughts/images, in order to reassure self and prove that they are disgusted by these acts and would never do them
  • Needing constant reassurance from others/self that one would never harm themselves or others 

I chose to elaborate on this specific OCD subtype, because I feel like it is more likely to be misunderstood. Additionally, any individual who struggles with this type of OCD may feel especially shameful, confused, and imprisoned by their thoughts, to a degree that they feel they could never disclose these thoughts, for fear of being misjudged. I think contamination or symmetry OCD are less challenging for the average person to understand, and are the common forms of OCD that come to mind when one thinks about OCD. So it is very important to shine a light on harm OCD, to provide deeper understanding and strongly emphasize that these thoughts are nothing more than symptoms- not any more than a cough is to a cold.

It is important that those who struggle with harm OCD, and for those who don’t, to understand that these thoughts are truly unwanted, and these individuals do not have a desire to harm anyone; honestly they would go to greater lengths than the average person to ensure the safety and wellbeing of those around them because they so strongly disagree with their OCD thoughts. So, if you are an individual who struggles with harm OCD, I want to reassure you of this: you are not crazy, you are not a bad person, and there is help out there for you, so you don’t have to struggle in silence. 

 

Scrupulosity OCD (a.k.a. Religious OCD)

Scrupulosity OCD has to do with putting extreme importance on morals, religion, or philosophy, and excessive fear of not upholding these values.

Obsessions include excessive fear of: 

  • Judgement and condemnation for not upholding ones religion perfectly
  • Negative, or perceived negative thoughts about religion icons (i.e. God, Jesus, Satan, etc.)
  • Misinterpreting religious text
  • Specific words, numbers, or events signifying condemnation (e.g. the number 666)
  • Uncertainty if behavior is always ethical, and needing it to be perfect at all times
  • Being An innately bad person

Compulsions include:

  • Mental checking/reviewing of religious thoughts and practices 
  • Prayers that are ritualistic and repetitive 
  • Replacing/correcting religious thoughts that are negative or perceived as negative in nature (i.e. thought neutralizing) 
  • Avoiding or oversensitivity religious triggers (i.e. materials or symbols associated with cruxifixction or Satan)

 

Hyperawareness OCD

Hyperawareness OCD has to do with being acutely aware of normal things that passively occur, such as feelings and sensations in the body, which causes extreme distress.  

Obsessions include acute awareness of:

  • Blinking, swallowing, breathing, heart beating, or other bodily sensations
  • Positioning of body parts in relation to other parts of the body, or to the environment (e.g. how one is seated; how leg or arm is positioned)
  • Normal or disturbing memories or images ( which can include things seen on television, movies, etc.)
  • One’s process of thinking (thinking about thinking relentlessly which causes distress)

Compulsions include:

  • Avoiding triggering situations where hyperawareness may occur (e.g. social activities)
  • Reviewing/checking triggering behaviors (i.e. breathing and other bodily sensations
  • Needing reassurance that hyperawareness is not the result of a different condition and will subside within a certain duration of time. 

 

Tic- related OCD

Behavioral tics are believed to alleviate the distress associated with obsessions; ironically, these tics can become apart of compulsive behaviors. It is especially common for children to experience Tic-related OCD, however because children tend to exhibit behavior that is perceived as silly or corky, this may not be obvious to the child or surrounding adults. 

Behavioral tics include:

  • Blinking
  • Clearing the throat
  • Sudden vocal noise (e.g. screeching)
  • Twitching
  • Shrugging 
  • Clenching (muscle tightening, appearance of bracing self or holding breath)

 

For Your Consideration

It is possible for individuals to experience multiple subtypes of OCD. Symptoms may look different among children and adults as well. Typically resistance of these OCD symptoms- thoughts, sensations, or images-  unfortunately make the symptoms come back stronger. So, although compulsions typically provide some temporary relief, they ultimately perpetuate the OCD cycle. This is why, if deemed appropriate, it is so important to reach out and get professional help from a trained mental health professional, if you are finding that your symptoms are impairing your daily functioning. Please see possible treatment options and coping strategies below. 

There are additional OCD subtypes alongside the subtypes listed above , which include Sexual Orientation OCD, Relationship OCD, and Hoarding-related OCD. For more information about the above listed OCD subtypes or the additional subtypes, please refer to The Mindfulness Workbook for OCD, and Healthline and NIH websites, listed below in references.

Remember, everyone has crazy, weird, and obscure thoughts from time to time- the only difference is that these thoughts cause greater distress and are perceived as more profound to the OCD-wired person, making it much harder for the person to let those thoughts go. 

 

OCD’s Affect On The Brain and Body 

It is suggested that the parts of the brain most affected by OCD are the orbitofrontal cortex and the anterior cingulate cortex (refer to diagram 1 below) as well as the thalamus and striatum (refer to diagram 2 below). It is also suggested that there is a malfunction in the transmission of certain neurotransmitters- i.e. chemicals such as dopamine, serotonin, norepinephrine, and glutamate which send messages between brain cells. These are some of the same chemicals that are affected in regards to  anxiety symptoms/disorders. Additionally, according to BeyondOCD.org, a research study revealed that those who struggle with OCD and related disorders may have a “mutation” in the human serotonin transporter gene (a.k.a. hSERT).

Diagram 1

Source - https://iocdf.org/
Source – https://iocdf.org/

Diagram 2

Source - https://www.mybraintest.org/
Source – https://www.mybraintest.org/

Many times OCD symptoms can lead to chest pain, panic attacks, shakiness, and increased heart rate, much like anxiety disorders. Additionally, there may be other physical symptoms OCD sufferers demonstrate:

  • Individuals may appear dazed, with a blank expression on their face if engaging in an internal compulsion (e.g. mentally saying a prayer to ward off the distress of a religious OCD obsession).  
  • Those who externalize compulsions, may:
    • Be found mumbling (e.g. if saying a ritualistic prayer)
    • Have body positioned in a way that appears particular or awkward (e.g. making sure hands aren’t placed on counter top for fear of contamination;  sitting on leg while on floor, to separate them from association with hell/Satan).  
    •  Demonstrate behavioral tics (see Tic-related OCD) to either disguise or relieve the distress of the obsessions.

Thus, in a similar fashion to anxiety disorders, those who struggle with OCD symptoms may kick into that survival “fight, flight, or freeze” mode, when faced with persistent obsessions. This contributes to the perceived need to engage in compulsions, in order to alleviate stress, anxiety, and fear associated with obsessions. For more on “fight, flight and freeze” defense mechanism, refer to Anxiety’s Affect on the Brain and Body, in my previous blog post, Anxiety

Diagram 1

Source - https://iocdf.org/
Source – https://iocdf.org/

Diagram 2

Source - https://www.mybraintest.org/
Source – https://www.mybraintest.org/

Many times OCD symptoms can lead to chest pain, panic attacks, shakiness, and increased heart rate, much like anxiety disorders. Additionally, there may be other physical symptoms OCD sufferers demonstrate:

  • Individuals may appear dazed, with a blank expression on their face if engaging in an internal compulsion (e.g. mentally saying a prayer to ward off the distress of a religious OCD obsession).  
  • Those who externalize compulsions, may:
    • Be found mumbling (e.g. if saying a ritualistic prayer)
    • Have body positioned in a way that appears particular or awkward (e.g. making sure hands aren’t placed on counter top for fear of contamination;  sitting on leg while on floor, to separate them from association with hell/Satan).  
    •  Demonstrate behavioral tics (see Tic-related OCD) to either disguise or relieve the distress of the obsessions. 

Thus, in a similar fashion to anxiety disorders, those who struggle with OCD symptoms may kick into that survival “fight, flight, or freeze” mode, when faced with persistent obsessions. This contributes to the perceived need to engage in compulsions, in order to alleviate stress, anxiety, and fear associated with obsessions.

 

Experiencing OCD

“Hold up my balloons and cover up my face
I can feel them weighing on me every day
I should let ’em go and watch ’em float away
But I’m scared if I do, then I’ll be more afraid
Tell them how I feel, but they don’t want to change
Tell them how I feel, but they remain the same
Loosen up my grip, they say that’s not okay
Quiet, quiet, quiet, quiet, quiet, ay, leave me alone!”

My first experience with OCD occurred between the ages of 7 and 8, although at the time I had no idea what it was. All I knew was that I was having some strange and scary thoughts that would pop into my head. As I got older the urge to engage in other behaviors to make the thoughts and uncomfortable feelings going away (i.e. compulsions) became more prevalent; when I was young this looked a lot like mumbling to myself or praying, sitting a particular way, organizing and putting things away in a particular way as well. As I got older the thoughts worsened and spurred on the need for more and stronger compulsive behavior; everything had to be done perfectly, following a rigid ritual/regimen, otherwise I had to start all over again until it felt just right.

When I was about 12 years old I reached out for help from family because I couldn’t handle it anymore; That took about 5 years to do because I didn’t know how to explain what I was experiencing, because I really didn’t know myself. For this reason I lived in fear that anyone I told would just think I was crazy and I would be locked away in a psychiatric facility. Therefore for a while, I wrestled back and forth with suicidal thoughts, because the weight of whatever this was, was too much to bear. 

So, throughout my teen years I was in and out of therapy, ran through the gamut of medications. A lot of my symptoms mirrored high anxiety and bipolar disorder, which can be commorbid (i.e. combined) with OCD, so looking back it was understandable why I was treated for those conditions. It wasn’t until I was in grad school at the University of Michigan, that things clicked. I was taking a mental health diagnostics class and studying the newly published DSM-5 manual. One particular class was about OCD, and literally everything discussed about the disorder- from the obscure thoughts to specific compulsions- I had experienced! It was such a relief to finally be able to put a name on what I was experiencing. I started crying uncontrollably, and immediately met with my professor after class to discuss next steps. 

I was 24 years old when I was officially diagnosed with OCD. Even though I had found relief in finally having the correct diagnosis, it was really difficult to share what I was experiencing; it was still hard for me to explain and honestly I wasn’t sure how much I could trust my therapist. Through building a relationship with my therapist, and undergoing a combination of cognitive behavioral therapy (CBT) and exposure and response prevention therapy (ERP), I was definitely able to make progress; I wasn’t just able to feel comfortable sharing about my obsessions and compulsions, but also became better able to manage symptoms on a daily basis. 

Since I was 7 years old through the present, I have experienced a multitude of OCD subtypes and symptoms to some degree. The most prevalent subtype I have experienced is the Scrupulosity/Religious OCD. For me, I have a genetic predisposition to OCD. This combined with misunderstandings about God and religion growing up, innately feeling a strong need to care for and protect people, and other environmental factors, have made me a prime target for OCD. 

I had my friend, Adam Sally, create the above banner image. In the image, I am resisting and trying to pull away from the shadow figure, as it’s holding me down, forcing me to watch something that I don’t want to. That’s how I experience OCD- a bully holding me down, creating this cycle of constant chaos, resistance, and fighting with it. 

Just like the song by NF, specifically the lyrics I quoted at the top of this section, there is that constant push-pull of wanting to let go of the “balloons” (compulsions) because I know deep down they’re making the problem worse. But I feel like if I do, then I will have no defense when the obsessive thoughts come back. So I cling to those balloons- although I know it’s false security. If I had to guess, I’m sure a lot of people with diagnosed and undiagnosed OCD feel the same. 

 

Treatment Options

There are multiple treatment options used to treat OCD. These include Cognitive Behavioral Therapy (CBT), Exposure and Response (Ritual) Prevention (ERP), and in some cases EMDR. I will summarize these treatment models below, as well as include some common medications that can be used to treat OCD. 

 

Cognitive Behavioral Therapy (CBT)

CBT is a treatment model commonly used to treat a variety of mental health conditions, which includes OCD.  Just as I wrote in my previous blog post, Anxiety, the most common treatment is Cognitive-Behavioral Therapy (CBT). CBT is a form of psychotherapy (i.e. talk therapy) that helps an individual identify negative behavior and thought patterns. The idea is to help the individual learn problem-solving skills to challenge, reframe and redirect fears and worries that impair daily functioning. CBT is used widely across a range of mental health conditions. Professionally, CBT is a treatment that I am most familiar with, and used often to treat clients who struggled with anxiety, PTSD, and OCD. Personally, I have been treated with the CBT model, which has helped me manage OCD symptoms. 

 

Exposure and Response Ritual Prevention (ERP)

ERP is a treatment model that includes aspects of CBT along with exposure therapy. This treatment helps the individual to manage/minimize obsessions  and compulsions by confronting OCD triggers, while also providing skills to not engage in compulsive behaviors (i.e. mental rituals, external behaviors to offset the discomfort of compulsions. The idea is to help the individual face the discomfort of the obsessions without avoidance of triggers or habitually engaging in other compulsive behavior; the compulsions increase the intensity and recurrence of the obsessions, perpetuating the OCD cycle. Thus, this treatment helps the individual realize that obsessive thoughts are not actually a threat, and therefore compulsions are unnecessary because the consequences they fear will not occur.  

ERP achieves these goals by:

  • Helping the individual identify OCD triggers, obsessions, and compulsions
  • Monitor and rate symptoms from most distressing to least
  • In vivo exposure- Primarily targets the obsessions.  In vivo is real life exposure to external OCD triggers, such as media, images, wording, other external stimuli that causes the individual distress; the idea is to gradually and repeatedly expose the individual to these triggers so that the trigger will lose its significance. 
  • Imaginal exposure- Primarily targets the compulsions. It’s aim is to have the individual imagine the consequences they fear, if they were not to engage in compulsive behavior when confronted with an obsession,  or didn’t avoid OCD triggers. Again, the goal is to decrease the urge to engage compulsive behavior, helping the individual see that compulsions are unnecessary.

 

Eye Movement Desensitization and Reprocessing (EMDR)

As I explained in my previous blog post, Anxiety, Eye Movement Desensitization and Reprocessing, or EMDR, is a therapy technique that helps individuals process disturbing thoughts and information in a less intense, more adaptive manner. EMDR accomplishes this through strategic eye movements, similar to eye movements that occur during the REM (i.e rapid eye movement) sleep cycle. EMDR has been suggested to have some success with OCD, especially with OCD that is commorbid with PTSD, or where trauma/distressing past events are known to have contributed to the OCD. This appears to be because EMDR primarily addresses an individual’s distressing or traumatic experiences; however EMDR has appeared to show success in targeting feelings of uncertainty as well. 

 

Medication Options

Serotonin antidepressants are generally used to help treat OCD. Some of these serotonin antidepressants include Zoloft (sertraline), Prozac (fluoxetine), and Paxil (paroxetine). 

 

For Your Consideration 

The above mentioned treatment options and medications are a selection of options that can be used to treat OCD. As with most mental health conditions, mental health professionals suggest a combination of treatment and medication help individuals find success. However, it is up to the individual if they would like to participate in treatment and/or medication. Since each person is wired differently, what works for one person may not necessarily work for another person. I personally have found great success with the CBT and ERP treatment models. However, I am not diagnosing or suggesting that anyone needs to engage in treatment or take medication. As always, do your own research as well, and definitely reach out either to your physician or a trained mental health professional to develop a plan that will best meet your needs. If you do decide to receive treatment, please be patient with yourself- it can take time to comfortably share about your OCD symptoms, as well as build trust with your clinician. 

 

Coping Strategies 

Although treatments and medication each have their benefits, it is also important to have some practical coping strategies in your back pocket, for day to day use. Just as with anxiety, a multitude of cognitive and mindfulness techniques can be used to cope with OCD. Some common coping strategies include grounding techniques (e.g. deep breathing, muscle relaxation, mental exercises), symptom tracking, cognitive reframing and thought postponement. Although beneficial, symptom tracking and thought postponement may be techniques that are best conducted under the guidance of a mental health professional, as these techniques can invoke initial distress. 

 

Grounding techniques

Grounding essential is another term for centering yourself, and refocusing yourself on the present moment. I referred to this technique as “reorienting yourself with the present” in my previous blog post, Anxiety. Grounding helps you to take the focus off of your distressing thoughts and feelings, and refocus on your environment or your body. This can be done by:

  • Deep breathing- Taking  a few deep inhales, holding breath for a moment or two; then exhaling. Complete this cycle 3-5 times, or more and preferred 🙂
  • Muscle relaxation- Gradually tightening and releasing each part of the body, beginning from head to toe, or vice versa 
  • Other mental exercises- Focus your senses of sight, taste, sound and hearing to observe and describe your environment (e.g. the taste and sound of chewing gum, the colors outside of your window, etc.) 

 

Symptom Tracking 

This is typically a technique discussed during treatment. Essentially, this is an opportunity for an individual to track their OCD cycle, by listing:

  • The situation that triggered the OCD cycle
  • Rating your emotions
  • Brief description of the obsessions 
  • Brief description of the compulsive behavior 
  • If the individual was able to refrain from engaging in a compulsion
  • Duration of the cycle
  • Emotions afterward

Symptom tracking can help the OCD sufferer better understand their specific OCD cycle, which is the first step toward symptom alleviation and management. 

 

Cognitive Reframing 

Cognitive reframing is a technique often used and taught within therapy. Essentially, it is a way to redirect negative thoughts, by either challenging if the thought is realistic, true, or beneficial, or by replacing it with a positive thought. This is an opportunity for OCD sufferers to “call out”  their obsessive thoughts, by saying:

  • This isn’t me; this is the OCD
  • You’re not real
  • You have no power over me
  • Go away!
  • or other comfortable phrasing

This is an opportunity to put OCD in it’s place, allowing you to separate yourself from the OCD, and letting it know that it’s not welcome in your mind! Show it who’s boss!

 

Thought Postponement

Again, another strategy discussed during treatment. Initially, this strategy may be more difficult for an individual to do on their own, and may require practice. The idea is that when an individual is triggered and feels an obsessive thought coming into mind, to immediately “postpone” or redirect focus to the present moment. Practicing grounding techniques is definitely key to successfully using this technique. The difficulty is, refusing the urge to engage in a compulsion, as not “attending” to the obsessive thought will cause distress. Personally, I have found success with thought postponement by:

  • Saying the word “postpone”- I either say the word “postpone” aloud or mentally. Similarly to cognitive reframing, I am “calling out” the thought and acknowledging it’s existence, however I am disempowering it by not allowing myself to fixate on it.
  • Postponing  for a few minutes at a time- When first using this technique it may feel impossible to completely postpone your thoughts. So I’ve found that gradually working up to full postponement can be helpful. Thus, when an obsessive thought comes into mind, tell yourself, “I will postpone this thought for 1 minute.” See how that time frame feels, and if possible continue adding time to the postponement. As you continue to practice this technique over time, you may find that you are able to “postpone” your OCD thoughts indefinitely, without the urge to engage in a compulsion. Now, this may not happen every time, but again takes practice. I have had some success with this, and it is definitely a work in progress 🙂

For additional mindfulness and other coping strategies, please see my previous blog post, Anxiety.

 

Faith-Based Perspective

Just as I wrote in my previous blog post, Anxiety, there are articles and studies suggesting that an individual’s belief in God can help them cope with mental health conditions. It is suggested that faith that advocates for compassion, forgiveness, and trust in God’s plan, helps the brain build patterns of positive thinking, which minimizes stress hormones and anxiety. These beliefs can help individuals make meaning and purpose out of negative circumstances in life. 

On the flip side, however, I do understand how religious beliefs can contribute to anxiety too, especially if they believe that God has abandoned them or is punishing them, loved ones or others. Sometimes this thinking can add to anxiety and stress. I can firsthand attest to this as well. As I mentioned in the experiencing OCD section, one component of the OCD I experience has to do with religious obsessions; these obsessions typically have to do with fear that God is going to condemn me. However although it is difficult, I am able to distinguish between an OCD led thought vs. what I know to be true from my experiential knowledge of God, and what lines up in the Bible. Therefore, I am still able to turn to God and Jesus for support and alleviation of OCD symptoms.

There is a difference between religiosity/legalism, vs. theology and faith. As a Christian, I believe in Jesus. Jesus said the following:

“do not worry about your life, what you will eat or drink; or about your body, what you will wear… look at the birds of the air; they do not sow or reap or stow away in barns, and yet your Heavenly Father feeds them. Are you not much more valuable than they? Can any one of you by worrying add a single hour to your life?” – Matthew 6:25-27

There are examples throughout the Bible of people experiencing hardship- persecution, oppression, captivity, to name a few. Jesus wasn’t immune to this hardship either, because he wanted to show people that he understood what we go through in this world. However, time and time again God showed his care for his people, by providing them with what they needed. With that being said, I understand that there’s a lot of hardships in each of our lives and in the world. Although God may not swoop in to take away every concern, every evil, every anxiety in the world, I do believe that he is not the cause of these hardships.

I do believe, and have experienced and witnessed, that God does care for us and wants to be the answer to our needs. I also believe that he has called each of us to be the answer, by serving others and meeting the needs of our families, friends, communities, and truly, the world. 

My friend kindly reminded me of this bible verse- “Cast all your anxiety on him, because he cares for you.” – 1 Peter 5:7 

Another reminder that I often have to lean on is this: [Jesus speaking] “I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.” – John 16:33

When I am struggling under the weight of stress, anxiety, and my struggles with OCD, these verses, along with many others, bring me peace and help me to cope. <3

 

Conclusion

OCD is a very complex disorder, with different subtypes and symptoms. Due to the complex and confusing nature of OCD, it can leave people feeling alienated and helpless. The good news is, it doesn’t have to be that way! As an individual with OCD who suffered with the disorder for about 17 years before properly being diagnosed and treated for it, I can attest that there is help out there, and this can be managed! If you or someone you know struggles with OCD/OCD-like symptoms, I would encourage you to get help, coping can be less challenging with a support system!

For those who know someone who struggles with OCD- I know it can be a struggle to understand what the OCD sufferer is going through and how to best be of help; I also know it can be a struggle to be patient with that person, with all of their specific symptoms and behaviors. However, I hope this blog evoked some sympathy and understanding. Thank you for your support, and please continue to give grace to that individual, I’m sure they appreciate it more than you know 🙂

Please remember, I am simply providing information from my professional and personal experience, as well as references and resources that I have researched. I am in no way diagnosing anyone with OCD, or suggesting that anyone needs to receive treatment and/or medication. If you feel you may have OCD, please consider seeking help from a medical or mental health professional. Additionally, please do your own research to better understand and explore all treatment options and available resources. For more resources, please see references at the bottom of this page, and refer to my resource page.

Hang in there- there is help and you are not alone! Please feel free to reach out to me via my contact page with any questions or concerns.

 

Keep pressing on!

-Amanda 

 

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Artwork Credit:

Adam Sally, Oxford, Michigan. Adam is the creator of the banner image for this blog post. Through the use of photoshop, Adam created a life like image of my experience with OCD- a constant resistance and wrestling with this shadow figure, or “bully.” I have so much appreciation and gratitude for my awesome friend, and his obvious talent!

Adam is a man of many trades! Along with his art skills, Adam is talented at graphic design, logo design, social media content creation, real estate videography, wedding/event videography, and video marketing. If you need services that exceptionally represent your visions and businesses, Adam is your guy! Check him out on Facebook and Instagram

 

References

 
 
Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition- American Psychiatric Association 
 
Life Application Study Bible, New International Version (NIV)
 
 
Psychopharmacology: Straight Talk on Mental Health Medications- Joe Wiegmann, RPh, LCSW
 
 
The Mindfulness Workbook for OCD: A Guide to Overcoming Obsessions and Compulsions Using Mindfulness and Cognitive Behavioral Therapy- Jon Hershfield, MFT, Tom Cowboy, MFT
 
Treating Your OCD with Exposure and Response (Ritual) Prevention, Second Edition- Elna Yadin, Edna B. Foa, Tracey K. Lichner 
 
 
Other OCD Resources:
 
Can Christianity Cure Obsessive-Compulsive Disorder? A Psychiatrist Explores the Role of Faith in Treatment- Ian Osborn, MD
 
OCD- Be Still and Know: A Christian Guide to Overcoming Obsessive Compulsive Disorder- P.A. Kennan
 

 

 

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]]> 628 Mental Health Series: Anxiety http://pressed.blog/mental-health-series-anxiety/?utm_source=rss&utm_medium=rss&utm_campaign=mental-health-series-anxiety Sun, 17 May 2020 18:59:22 +0000 http://pressed.blog/?p=497 A N X I E T Y. Most people don’t even bat an eye when they hear this term- its become so mainstream and normalized. Although many people experience some form of anxiety- whether it be with a looming work deadline or trying to pay bills on time- there is more to anxiety than meets […]

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A N X I E T Y. Most people don’t even bat an eye when they hear this term- its become so mainstream and normalized. Although many people experience some form of anxiety- whether it be with a looming work deadline or trying to pay bills on time- there is more to anxiety than meets the eye.

Below, I will give an overview of anxiety, categorized by the following sections:

 

Causes of Anxiety: An Etiology 

According to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (a.k.a the DSM-5), which is the most up to date diagnostic manual used widely by qualified mental health professionals, anxiety is defined as “the anticipation of future threat,” whereas fear is  defined as, “ the emotional response to real or perceived imminent threat.” Therefore, anxiety disorders are the result of behavioral responses to anxiety and pervasive fear, which typically leads to impaired functioning. 

Anxiety can be caused by a multitude of factors. Below I have categorized examples of possible causes of anxiety, organized, from what I consider to be, lower in severity to higher in severity:

  • Personality-  Shyer or more reserved temperament, originating in childhood; perfectionism, whether innate or influenced by environmental factors (e.g. through child rearing) 
  • Diet- Foods filled with high amounts of sugar, additives, caffeine, and gluten (more so if an individual has a gluten sensitivity) have been suggested to contribute to anxiety symptoms. See also A Holistic Perspective, within the Anxiety’s Affect on the Brain and Body section 
  • Daily Life Stressors- This may include work or school performance, finances, relationship difficulties, concerns for the health and wellbeing of self and loved ones, external/environmental factors (e.g. living conditions); these typically are primary life stressors 
  • Genetics- predisposition to anxiety or other mental health conditions, from maternal or/ and paternal sides of the family
  • Family dynamics- if there is an insecure attachment (i.e. weak or inconsistent bond) between child and attachment figures (i.e. parents, caregivers). See Attachment theory in the References section for more information
  • Medical conditions-  Specifically with the thyroid or heart arrhythmias,  or side effects of medications or drugs/substances, such as high amounts of  caffeine. Because these conditions can cause or imitate symptoms of anxiety/ other mental health conditions, they are typically ruled out when trying to determine if an individual is suffering from a specific mental health condition. 
  • Distressing/Traumatic events- events that negatively impacted an individual, whether in childhood or/and adulthood. 

Some anxiety may be experienced as temporary or ongoing; however what sets anxiety disorders apart from merely experiencing anxiety, is the severity by which anxiety is experienced, paired with the duration of time. If anxiety is impairing one’s daily functioning to the degree that they are not able to participate in certain activities or complete ordinary tasks, and lasts for a long duration of time, the anxiety may fall into the disorder category (duration typically lasts between 1 to 6 months at minimum, depending on the anxiety disorder and age of onset.)

 

Types of Anxiety Disorders

There are 7 main types of anxiety disorders: Separation Anxiety Disorder, Selective Mutism, Specific Phobia, Agoraphobia, Social Anxiety Disorder, Panic Disorder, and Generalized Anxiety Disorder. The DSM-5 also lists additional anxiety disorders, such as Substance/ Medication- Induced Anxiety Disorder, Anxiety Disorder Due to Another Medical Condition, Other Specified Anxiety Disorder, and Unspecified Anxiety Disorder; these anxiety disorders are typically explored as a possible diagnosis, if an individual does not meet all of the criteria for the main types of anxiety disorders listed above. However, for the purposes of this blog, I will focus on the 7 main types of anxiety disorders. I will give a brief overview of the characteristics of each type of disorder, as well as the duration of time symptoms must occur, in order to be diagnosed.

Separation Anxiety Disorder

The DSM-5 characterizes this disorder as being “ fearful or anxious about separation from attachment figures to a degree that is developmentally inappropriate.” An individual is plagued by fear and anxiety that harm could happen to them or attachment figures (e.g. parents, caregivers, loved ones), causing the individual to be separated from attachment figures, whether temporarily, a long duration of time, or indefinitely (e.g. removal from the home, death).  Some symptoms include continually refusing to go out in the community (e.g. to school or work), refusal to be alone, persistent physical symptoms (stomachaches, headaches, etc.), and persistent nightmares. This disorder typicallly afflicts children, but can be found in adults as well. Symptoms must last at least 4 weeks in children and teens, and 6 months in adults, in order for Separation Anxiety Disorder to be diagnosed.

Selective Mutism

The DSM-5 characterizes selective mutism as “a consistent failure to speak in social situations in which there is an expectation to speak (e.g. school) even though the individual speaks in other situations.”  This typically impairs an individual’s work or school performance, as well as social interactions. Typically found in children, symptoms must occur for at least 1 month in order to be diagnosed, and is not found to be the result of a different communication or neurological disorder ( such as a speech and language impairment, or autism spectrum disorder). 

Specific Phobia

The DSM-5 characterizes specific phobia as being “ fearful or anxious about or avoidant of circumscribed [restricting; limiting] objects or situations. The fear, anxiety, or avoidance is almost always immeasurably induced by the phobic situation, to a degree that is persistent and out of proportion to the actual risk posed.” Some of the phobias or phobic situations include flying, heights, injections or seeing blood, and animals. Symptoms include avoidance of a specific situation or object, immediately acting out in fear or anxiety when faced with the specific situation or object, and impaired functioning due to excessive fear or anxiety of the specific situation or object. Symptoms must occur for at least 6 months in order to be diagnosed.

Agoraphobia

The DSM-5 characterizes agoraphobia as being “fearful and anxious about two or more of the following situations: using public transportation; being in open spaces; being in enclosed spaces; standing in line or being in a crowd; or being outside of the home alone in other situations.” The fear and anxiety is produced if the individual believes that there would be no escape,  or help available if they were to develop panic symptoms, or other similar symptoms. In addition to the above described symptoms, other symptoms include avoidance of agoraphobic situations; fear and anxiety being excessively disproportionate to the actual risk of harm caused by the situation and; impaired functioning due to excessive fear or anxiety of the agoraphobic  situation. Symptoms must occur for at least 6 months, in order to be diagnosed. 

I think it is important to note that the difference between agoraphobia and specific phobia, is the individual must demonstrate excessive fear/anxiety specifically in two or more situations in the agoraphobic category (i.e. standing in a line or a crowd, public transportation, going outside of the home alone, enclosed spaces, open spaces), in order to be diagnosed with agoraphobia. 

Social Anxiety Disorder 

The DSM-5 characterizes social anxiety disorder, also known as social phobia, as being “fearful or anxious about or avoidant of social interactions and situations that involve the possibility of being scrutinized. The cognitive ideation is of being negatively evaluated by others, by being embarrassed, humiliated, or rejected, or offending others.” Other symptoms include pervasive avoidance of social situations, and impaired functioning due to excessive fear or anxiety of social situations. If symptoms are not attributable to another disorder (i.e. autism spectrum disorder, panic disorder, or body dysmorphic disorder), and lasts for at least 6 months, then social anxiety disorder may be diagnosed. 

Panic Disorder

The DSM-5 characterizes panic disorders as an individual who experiences  “recurrent unexpected panic attacks and is persistently concerned or worried about having more panic attacks or changes his or her behavior in maladaptive ways because of the panic attacks (e.g. avoidance of exercise or of unfamiliar locations).” It is also important to add that the DSM-5 defines panic attacks as “abrupt surges of intense fear or intense discomfort that reach a peak within minutes, accompanied by physical and/or cognitive symptoms.” Panic attacks can happen while the individual is calm or anxious. There are many possible symptoms of panic disorder; however some of those symptoms include trembling/shaking, chest pain, dizziness/lightheadedness,  feeling like one  is choking, shortness of breath, and fear of dying. In addition to these symptoms, one (or more) of the experienced panic attacks are accompanied by at least one month of the following:

  • Excessive worry about ongoing panic attacks or/and; 
  • Avoidance behaviors that interfere with functioning, in an effort to prevent the potential for panic attacks 

If symptoms are not the result of a medical condition, substance/drug or medication, or another mental health disorder (e.g. a response to social situations from social phobia, or obsessions with regard to Obsessive- Compulsive Disorder), then Panic Disorder may be an appropriate diagnosis. 

Generalized Anxiety Disorder

The DSM-5 characterizes generalized anxiety disorder as “persistent and excessive anxiety and worry about various domains, including work and school performance, that the individual finds difficult to control.”  Symptoms include difficulty concentrating, restlessness, fatigue, sleep difficulties, muscle tension, and irritability. A diagnosis may be appropriate if:

  • At least 3 of  the 6 listed symptoms are present in adults (1 present in children), with a few ongoing for at least 6 months
  • Impaired functioning due to excessive worry or anxiety
  • Symptoms are not the result of a medical condition, substance/drug or medication, or another mental health disorder 
For Your Consideration

Phew! We got through all of that info!

As you can see there are many types of anxiety disorders, and variances within each disorder type. Again, Anxiety isn’t a blanket statement, and there is a lot involved within that 7 letter term. 

As mentioned previously in the Overview post, I am merely providing information, based on my professional experience and resources. I am in no way diagnosing anyone, nor am I suggesting that you diagnose yourself based the provided information. If you or a loved one are exhibiting the above symptoms and suspect that you or they are experiencing an anxiety disorder, please seek professional help from your physician (who may be able to provide a referral for a psychiatrist/psychologist), or from a trained mental health professional (i.e. psychiatrist, psychologist, counselor).

Additionally, as a social worker who previously worked in trauma, I would like to note that some symptoms characteristic of these anxiety disorders could also be characteristic of individuals (especially children and teens) who have experienced trauma- specifically physical or sexual abuse. I am not adding this to cause fear, but only to keep in consideration if you find that your child, teen, a loved one, or even yourself, are exhibiting these symptoms. My professional and personal opinion is to explore all options, because it is better to error on the side of caution in this situation. If you believe this could be a possibility, please have a discussion with the child/teen, asking if anyone has hurt them- it’s definitely not an easy conversation to have, but an important one. If you yourself have experienced a trauma, please seek professional help from your physician or trained mental health professional, and if appropriate report to the proper authorities. You are not alone and there is help out there!

 

Anxiety’s Affect on the Brain and Body 

Alright, now for a mini biology lesson on the brain!

The primary areas of the brain that are most affected by anxiety are the amygdala (i.e. the red almond-like structure in the diagram) and the hippocampus (i.e. the green caterpillar like structure in the diagram.) The amygdala is basically the emotion center of the brain that triggers emotional responses if a threat is perceived, whether the threat is real or imagined. So, when you think of the fight, flight, freeze responses, the amygdala  is the part of the brain that is responsible. The hippocampus is the part of the brain responsible for encoding sensory information (i.e. our experiences/events) and all emotional responses attached to it, into memories (i.e. the memory warehouse). So when the amygdala perceives a threat to the system, it will signal the release of adrenaline and hormones, such as cortisol (a.k.a the stress hormone) into the body, which causes that fight, flight, and freeze response.

Here is a scenario below, to get a sense of what this all may look like:

1) A child gets separated from their parent at the grocery store

2) After a few moments stress may set in; the amygdala will alert the brain that this situation is a threat, signaling the release of cortisol and other hormones, creating the survival mode “fight, flight, freeze” response

3) The hippocampus will record the separation event as a fearful memory. If this situation was particularly distressing or traumatic for the child, this may cause the child to experience high anxiety or fear if they are separated again from parents in the future, or at the thought about being separated from parents in the future. 

Anxiety and Brain - https://directindia.org/resources/anxiety-and-the-brain/
Anxiety and Brain – https://directindia.org/resources/anxiety-and-the-brain/

Some people may process an event as a distressing experience, and be able to continue functioning normally. However, depending on how greatly impacted an individual is by a particular event or how frequently they are exposed to other causes of anxiety,  it may lead to the development of an anxiety disorder.

Please see the diagram for a more comprehensive view of anxiety’s affect on the brain and body.

A Holistic Perspective

From a holistic perspective, foods high in sugar, caffeine, and gluten (more so, if you have an existing gluten sensitivity), have been suggested to contribute to anxiety symptoms in the brain and body. It is suggested that in high amounts, sugar and caffeine can cause physical changes/reactions (e.g. racing heart, shakiness) that the brain may interpret as a threat to system, causing a heightened anxious state. Additionally, it is suggested that for those with gluten sensitivities, gluten can cause inflammation in brain, through what is called the “gut-brain axis”, which is defined as the “bidirectional communication system between the enteric nervous system in the gut and the central nervous system in the brain and spinal cord,” (kresserinstitute.com). Although gluten has been linked to mental health conditions, I would strongly encourage everyone to do additional research on this subject. 

 

Experiencing Anxiety

There are all kinds of causes of anxiety, and everyone experiences symptoms of anxiety differently. As I have mentioned in previous blog posts, I have a diagnosis of obsessive-compulsive disorder (OCD), which makes me prone to high anxiety often. I had my awesome artist friend, Adam, create artwork for this blog series. I really wanted him to illustrate how I and many others may experience anxiety: tightness in the chest- as if someone or something is pressing down on you; feelings of relentless panic that you can’t escape- like impending doom. Some of us wake up with that feeling and go to bed with it. 

California Pediatrician, Nadine Burke Harris, famously known for her TED talk on Adverse Childhood Experiences (ACEs) shared a wonderful analogy about how we handle stress. She essentially stated that if you were in a forest and came across a bear, your fight or flight response (discussed in the anxiety’s affect on the brain and body section) would kick into gear, which is a good thing because that’s what your brain and body are biologically designed to do in an actual threatening situation. However, for some people the “bear” is always with them, and that fight or flight response is consistently being triggered, changing from a life saving defense mechanism, into a health impairing response. 

Illustrated by Adam’s artwork are the many shadow figures, or  “monsters” that anxiety can disguise as. The monster  can look different  for everyone- financial issues, dysfunction in the home setting, crowds, spiders, separation from loved ones, a medical condition, a traumatic event- you name it. Anxiety is not one size fits all, it can be caused by a multitude of factors and experienced differently across all individuals. With that being said,

It is extremely important that we do not dismiss how someone experiences anxiety, because we do not truly know what is going on in someone’s mind and body. 

 

Treatment Options

There are various treatment options used to treat anxiety symptoms/ anxiety disorders. Below I will summarize some possible treatment options, possible medications, as well as food and diet suggestions that could help manage or/and treat anxiety symptoms and disorders.

Cognitive-Behavioral Therapy (CBT)

The most common treatment is Cognitive-Behavioral Therapy (CBT). CBT is a form of psychotherapy (i.e. talk therapy) that helps an individual identify negative behavior and thought patterns. The idea is to help the individual learn problem-solving skills to challenge, reframe ad redirect fears and worries that impair daily functioning. CBT is used widely across a range of mental health conditions. Professionally, CBT is a treatment that I am most familiar with, and used often to treat clients who struggled with anxiety, PTSD, and OCD. Personally, I have been treated with the CBT model, which has helped me manage OCD symptoms. 

Dialectical Behavioral Therapy (DBT)

Another type of treatment that can be used to treat anxiety disorders is Dialectical Behavioral Therapy (DBT). DBT is a therapy technique that combines acceptance and mindfulness. It helps individuals develop skills to better regulate, process and accept negative emotions and situations as they are, so that they won’t be in fear/feel powerless to the negative emotions and situations. 

Exposure Therapy

When treating phobias, exposure therapy can be beneficial. Exposure therapy helps individuals become desensitized to their phobias through gradually exposing the individual to the feared objects/situations. From personal experience, exposure therapy has helped tremendously in reducing and helping me manage OCD symptoms. 

Eye Movement Desensitization and Reprocessing (EMDR)

Similarly, Eye Movement Desensitization and Reprocessing (EMDR), is a therapy technique that helps individuals process disturbing thoughts and information in a less intense, more adaptive manner. EMDR accomplishes this through strategic eye movements, similar to eye movements that occur during the REM (i.e rapid eye movement) sleep cycle. Just as exposure therapy, EMDR has been reportedly effective in treating phobias, as well as panic attacks, PTSD, and OCD. 

Anti-anxiety Medications

There are a variety of anti-anxiety medications that are used to treat anxiety disorders; however, the type of medication may be dependent upon the individual and the type of anxiety disorder. Common medications used to treat anxiety disorders include Xanax (alprazolam), Valium (diazepam), Lunesta (eszopiclone), and Klonopin (clonazepam). 

Food and Diet Suggestions

In addition to treatments and medications, limiting/eliminating certain foods from your diet while increasing other healthier foods, can reportedly help reduce symptoms of anxiety. Foods that have been found to be helpful include fish, vegetables, fruits, and foods with whole grains and fiber. Foods suggested to limit or eliminate include anything with high amounts of caffeine, refined sugars, additives, gluten (more so if you have a gluten sensitivity), and alcohol. 

For Your Consideration

The treatment options and diet suggestions listed above are only a selection  of possible techniques, to treat and reduce anxiety symptoms. Each individual is wired differently, and therefore what works for one person may not work for another. It is not guaranteed that these options will work for each individual. For this reason, if you are interested in any of the treatments, medications, or diet suggestions above, I highly recommend that you do further research on it, as well as work with a qualified mental health or/ and medical professional, to develop a plan that will best meet your needs. 

 

Coping Strategies

Although treatments, healthy diets, and medication each have their benefits, it is also important to have some practical coping strategies in your back pocket, for day to day use. Some common coping strategies most clinician recommend include cognitive reframing, deep breathing exercises, muscle relaxation, and other mindfulness techniques.  Additionally, an uncommon  strategy, but a personal favorite of mine, is ASMR.

Cognitive Reframing 

Cognitive reframing is a technique often used and taught within therapy. Essentially, it is a way to redirect negative thoughts, by either challenging if the thought is realistic, true, or beneficial, or by replacing it with a positive thought. 

Deep Breathing Exercises

As I mentioned in my previous blog post, Lose Control, practicing deep breathing is extremely beneficial. Deep breathing slows your heart rate down, reduces stress, lowers your blood pressure, and can improve sleep. The reason is because deep breathing causes the brain to release endorphins, which naturally provides a calming/ rejuvenating effect. The key is to actively slow your breathing down by taking a deep inhale, holding for a few moments; then slowly exhaling. Repeat as many times as you would like :).

Muscle Relaxation

Muscle relaxation is another wonderful and recommended technique. The idea is that you redirect your focus from stresses and worries, to a focus on your body. Slowly, focus on one body part at a time, gradually tighten that body part and hold for a few moments, and then release it. Continue to do this until you have reached every part of your body. You can practice this technique lying down or sitting up, and can choose to begin from the top of your body to the bottom, or vice versa. I recommend getting comfortable and lying down while practicing muscle relaxation :).

Other Mindfulness Techniques

Other mindfulness techniques include reorienting yourself with the present, which is a fancy way to say focus on your immediate environment. For example, I am currently up late working on this blog post lol so if I am beginning to feel anxiety about trying finish this within a reasonable time frame, I may try to reduce those feelings of anxiety by refocusing on the things right in front of me- the sound of the sink water running upstairs as my husband kindly finishes up dishes; the color of my keyboard; the light humming of the dryer running in the background. This is a technique that can alleviate stress and anxiety by grounding yourself in the present moment. I personally practice this technique often! 

Alongside yoga, guided meditations or guided imagery are other beneficial mindfulness techniques; you can find an array of these on YouTube, or by downloading free or low cost mindfulness Apps in your phone’s App stores. 

Autonomous Sensory Meridian Response (ASMR)

As I mentioned above, an uncommon relaxation strategy I personally enjoy is called Autonomous Sensory Meridian Response, also known as ASMR. ASMR is that tingly sensation you typically experience on your scalp or along your back and spine, typically caused by a specific experience or stimuli. Most common sources of ASMR are delicate movements of the hands (e.g. when someone plays with your hair), whispering, clicking/tapping (typically of a keyboard), or page turning/paper tearing. Much like other mindfulness techniques, ASMR can help individuals redirect their focus from stresses and anxiety, to relaxing in the present moment. ASMR has been known to help people relax into sleep- I can personally attest to this! If you search ASMR on YouTube, you will find a plethora of videos. 

Faith, Science and Coping 

 There are various articles and studies that show how anxiety affects the brain and body, as well as treatments and practical coping strategies to manage symptoms of anxiety. However, there are also articles and studies suggesting that an individual’s belief in God can help them cope with anxiety, as well as other mental health conditions. It is suggested that faith that advocates for compassion, forgiveness, and trust in God’s plan, helps the brain build patterns of positive thinking, which minimizes stress hormones and anxiety. These beliefs can help individuals make meaning and purpose out of negative circumstances in life. 

On the flip side, however, I do understand how religious beliefs can contribute to anxiety too, especially if they believe that God has abandoned them or is punishing them, loved ones or others. Sometimes this thinking can add to anxiety and stress. I can firsthand attest to this as well. One component of the OCD I experience (which I will discuss further in a future blog all about OCD, stay tuned) has to do with religious obsessions; these obsessions typically have to do with fear that God is going to condemn me. However although it is difficult, I am able to distinguish between an OCD led thought vs. what I know to be true from my experiential knowledge of God, and with what lines up in the Bible. Therefore, I am still able to turn to God and Jesus for support and alleviation of anxiety symptoms that stem from my OCD.

There is a difference between religiosity/legalism, vs. theology and faith. I believe in Jesus. Jesus said the following:

“do not worry about your life, what you will eat or drink; or about your body, what you will wear… look at the birds of the air; they do not sow or reap or stow away in barns, and yet your Heavenly Father feeds them. Are you not much more valuable than they? Can any one of you by worrying add a single hour to your life?” – Matthew 6:25-27

There are examples throughout the Bible of people experiencing hardship- persecution, oppression, captivity, to name a few. Jesus wasn’t immune to this hardship either, because he wanted to show people that he understood what we go through in this world. However, time and time again God showed his care for his people, by providing them with what they needed. With that being said, I understand that there’s a lot of hardships in each of our lives and in the world. Although God may not swoop in to take away every concern, every evil, every anxiety in the world, I do believe that he is not the cause of these hardships.

I do believe, have experienced, and have witnessed, that God does care for us and wants to be the answer to our needs. I also believe that he has called each of us to be the answer, by serving others and meeting the needs of our families, friends, communities, and truly, the world. 

My friend kindly reminded me of this bible verse- “Cast all your anxiety on him, because he cares for you.” – 1 Peter 5:7 

Another reminder that I often have to lean on is this: [Jesus speaking] “I have told you these things, so that in me you may have peace. In this world you will have trouble. But take heart! I have overcome the world.” – John 16:33

When I am struggling under the weight of stress, anxiety, and my struggles with OCD, these verses, along with many others, bring me peace and help me to cope. <3

 

Conclusion

There are many factors that cause and contribute to anxiety and anxiety disorders. For this reason, anxiety is experienced differently by each individual, and no one should be judged for how they cope with their anxiety. I cannot stress that last sentence enough. I hope this post provided helpful insights, to help each of us be more sympathetic to the needs of others. 

Once again, I would like to highlight that I am merely providing information based on my research, professional and personal experiences. I am in no way diagnosing anyone, or indicating that they should receive treatment or/and medication. If you struggle with anxiety, or think that you may have an anxiety disorder, and would like to receive further help, please seek out help from a medical or mental health professional. Please do your own research to better understand and explore all treatment options and available resources. For more resources, please refer to my resource page.

Hang in there- there is help and you are not alone! Please feel free to reach out to me via my contact page with any questions or concerns.

 

Keep pressing on!

-Amanda 

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Artwork credit: Adam Sally, Oxford, Michigan. Adam is the creator of the banner image for this blog post. Sketching first in pen and then ultimately finalizing his work through photoshop, Adam created an extremely life like image of me wrestling with the many monsters/shadow figures- or forms of anxiety- that people take on. Through creative collaboration, Adam and I discussed how anxiety can be experienced physically. Through his own creativity, Adam perfectly illustrated this physical experience, by drawing the shadow figures tugging at my neck, chest, and whole body. Adam perfected my original vision into something I couldn’t have dreamt up or created myself! I have so much appreciation and gratitude for my awesome friend, and his obvious talent!

Adam is a man of many trades! Along with his art skills, Adam is talented at graphic design, logo design, social media content creation, real estate videography, wedding/event videography, and video marketing. If you need services that exceptionally represent your visions and businesses, Adam is your guy! Check him out on Facebook and Instagram

References:

 
 
 

Anxiety and Brain

 
 
 
 
Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition- American Psychiatric Association 
 
Evidence That Demands A Verdict: Life-Changing Truth For A Skeptical World- Josh McDowell & Sean McDowell, PhD
 
Foods That Harm, Foods That Heal- Reader’s Digest
 
 
 
Life Application Study Bible, New International Version (NIV)
 
 
Psychopharmacology: Straight Talk on Mental Health Medications- Joe Wiegmann, RPh, LCSW
 
 
 

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]]> 497 Mental Health Series: An Overview http://pressed.blog/mental-health-series-overview/?utm_source=rss&utm_medium=rss&utm_campaign=mental-health-series-overview Sun, 17 May 2020 17:07:50 +0000 http://pressed.blog/?p=491 All of my blogs up until this point, have touched on the vast subject of mental health in some capacity. However, I am launching a series focusing on a few specific mental health disorders/conditions, giving a more in depth look at what each entail. This series is very important to me because sometimes mental health […]

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All of my blogs up until this point, have touched on the vast subject of mental health in some capacity. However, I am launching a series focusing on a few specific mental health disorders/conditions, giving a more in depth look at what each entail. This series is very important to me because sometimes mental health disorders gets lumped in altogether, becoming devalued and misunderstood. When this happens, many people are inclined to say “oh yeah, everyone gets depressed (or anxious, etc.) it’s not a big deal. Just suck it up like the rest of us.” Uh…. no lol.

There are differences within each disorder category. For example, in the area of Anxiety there are multiple anxiety disorders that fall under that specific category. Although many people do experience anxiety, depression, trauma, and other mental health conditions, there is a difference between experiencing symptoms, and having a disorder. Not to mention, everyone experiences symptoms differently and for different durations of time; mental health is a spectrum, it is not one size fits all.

 

Mental health is a spectrum; it is not one size fits all.

 

In this series, I will be discussing the mental health disorders and conditions that I have had professional and / or personal experience with: Anxiety, Obsessive- Compulsive Disorder (OCD), Depression, and Posttraumatic Stress Disorder (PTSD). My goal is:

  • To provide information about the causes of these disorders/conditions
  • Show the parts of the brain that are affected by these disorders/ conditions
  • Discuss symptoms, and the difference between experiencing symptoms vs. having a disorder (i.e. the reason why I keep differentiating between mental health disorder and mental health conditions)
  • Possible treatment options 
  • Coping strategies 

Lastly, I will discuss the sensitive subject of suicide, and what may cause some people to succumb to it. 

I would like to provide a disclaimer- what I write is not the end all be all answer. Meaning, although I am a LMSW (Licensed Master Social Worker), I am only providing you with information from my professional experiences, resources that I am familiar with, and with some personal insights where applicable. I am in no way diagnosing or stating that anyone should or shouldn’t pursue certain treatments or medication. Even with reading what I have to offer, I would still encourage you to do research on your own for additional information and, if needed, for professional help. 

So, without further ado, lets get started with the first mental health topic: Anxiety

Continue to Mental Health Series: Anxiety
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Artwork credit: Adam Sally, Oxford, Michigan. Adam is the creator of the banner image for this blog post. Sketching first in pen and then ultimately finalizing his work through photoshop, Adam created an extremely life like image of me wrestling with the many monsters/shadow figures- or forms of anxiety- that people take on. Through creative collaboration, Adam and I discussed how anxiety can be experienced physically. Through his own creativity, Adam perfectly illustrated this physical experience, by drawing the shadow figures tugging at my neck, chest, and whole body. Adam perfected my original vision into something I couldn’t have dreamt up or created myself! I have so much appreciation and gratitude for my awesome friend, and his obvious talent!

Adam is a man of many trades! Along with his art skills, Adam is talented at graphic design, logo design, social media content creation, real estate videography, wedding/event videography, and video marketing. If you need services that exceptionally represent your visions and businesses, Adam is your guy! Check him out on Facebook and Instagram

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]]> 491 The Exception http://pressed.blog/the-exception/?utm_source=rss&utm_medium=rss&utm_campaign=the-exception Fri, 08 May 2020 00:35:24 +0000 http://pressed.blog/?p=436   Today I wake up,  Is it going to be me? Will I be the one on your t.v. screen?   Sickness, death or harm, Is all I think about when you’re in my arms. The anxiety is crippling, But it’s better than vulnerability, It’s got to be.    Laughing, smiles; pure joy, I wish […]

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Today I wake up, 

Is it going to be me?

Will I be the one on your t.v. screen?

 

Sickness, death or harm,

Is all I think about when you’re in my arms.

The anxiety is crippling,

But it’s better than vulnerability,

It’s got to be. 

 

Laughing, smiles; pure joy,

I wish time would move slow,

This must be the climax,

and now I’m waiting for the blow.

 

Maybe I focus too much on what’s wrong,

Instead of what’s right,

But I know I’m not immune to hardship,

And that keeps me up at night. 

 

I just don’t want to fall into the deception,

That I could never be the exception.

 

The problem is,

This isn’t how I’m called to live, 

I was given life to live to the full, 

I can’t let anxiety and fear rule.

 

The truth is, control is an illusion; I can’t protect you,

 I’ll do my best, and trust that God will see you through.

If you don’t believe that’s true, I really don’t blame you,

And I hope you find a path that leads to peace and truth.

 

Today, I let off the brakes, 

And I’m more willing to embrace,

A life of joy, and of weeping,

In my wake, and in my sleeping.

 

So today,

I can accept wherever this life leads me,

Whether I’m the exception, or keeping on breathing.

<3

 

This poem was the culmination of conversations with family and friends, about the anxieties of life. We shared similar feelings of trying to live life fully against the uncertainty of loved ones or ourselves succumbing to illness, concerns of social re-engagement from the Covid-19 pandemic, and other kinds of hardships. From friends giving birth to their babies during this trying time, stories of people who experienced loss of loved ones, to my husband coming close to being furloughed, anxiety and stress definitely has been running high. I would wake up most mornings with a heavy weight in my chest. After exploring it further, I realized I was worrying if this would be the day that I or a loved one would experience harm or hardship- be the exception. 

For those who battle anxiety and OCD, it can be difficult to find that balance between living like everything is a threat in order to preserve your life, vs. living like nothing’s a threat in order to live your life; we tend to lean more toward the former. However, I came to the realization that living every day in fear of something bad happening, is not how I am called to live. The truth is, no day is guaranteed, and this has always been the case. That being said, I am trying to be grateful for what each day brings, whether positive or negative; however trying to view the negative as an opportunity to practice endurance and growth. This isn’t a blanket statement, and it will not be easy to practice a positive perspective toward all hardships. There are some hardships that are flat out unfair or unjust, leaving us barely keeping our heads above water. But sometimes, all we can do is try. For me, these are the times that I rely heavily on my faith, as well as the support of family and friends. 

 

During this time of quarantine, I have found that Telehealth counseling (i.e. confidential virtual therapy services) has been extremely beneficial. If you or someone you know struggles with any sort of mental health disorder/challenges, especially during this unprecedented time, I would highly recommend this service. Here are some options for Telehealth mental health services:

*These services appear to be secure and HIPAA compliant

 

Additionally, please review these mental health resources for more support:

  • Nationally 
  • Metro-Detroit/ surrounding areas, Michigan 

* During this time of the Covid-19 pandemic, I am unsure what services are provided through these organizations. However, I still encourage individuals who live near these organizations to contact them. 

  •  Online/ App Store: 
    • Headspace, a mindfulness and meditation App
    • Mindfulness Coach App
    • One Minute Pause App
    • Soul time Christian Meditation App
    • Meditation Oasis App bundle- includes Simply Being, Breathe & Relax, iSleep Easy, Walking Meditations, and more in this bundle. Also each of these Apps can be purchased separately. 

 

These and other resources can be found on the Pressed resource page. These resources are just a selection.  I would encourage everyone to do research and look up other mental services and resources, especially community resources closer to where you live. For any Telehealth mental health services, I encourage you to make sure that the service is confidential and HIPAA compliant (legally they all should be, but it is always best to do your due diligence). 

 

As always, keep pressing on,

-Amanda 

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]]> 436 Lose Control http://pressed.blog/lose-control/?utm_source=rss&utm_medium=rss&utm_campaign=lose-control Wed, 08 Apr 2020 00:08:43 +0000 http://pressed.blog/?p=394 The post Lose Control appeared first on Pressed.

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I hit a wall this week. I did my best to stay positive with everything going on in the world right now; but inevitably, I hit that wall I so desperately was trying to steer away from. I didn’t handle that well- AT ALL. Every scream of my child was like nails on the chalkboard. I was either completely shutting Chris (my husband) out or lashing out at him; the only other adult in my household to lean on for in person support right now, and I was either shutting him out or shutting him down. I must admit, my reactions to things out of my control are not good. Ironic isn’t it? A social worker by trade, and a blogger writing about the merits of coping, self-care, and “pressing on”, not practicing what she preaches?
 
My attempts to keep my anxiety at bay and OCD symptoms in check were slowly slipping from my tightly gripped hands. I could start to feel the tightening in my chest, the tears well up in my eyes, and the shakiness of my voice whenever I would try to lie and tell Chris “I’m okay,” when he knew that I wasn’t. Some people are really good at suppressing their feelings; I am not one of them, friend.
 
That’s what anxiety, OCD, and just flat out fear does. It gets its hooks in your brain and clings to it. All my OCD rituals, coping skills, deep breathing got away from me and I completely lost control. However, I wasn’t ready to accept that I had lost control- I was too controlling to admit I had lost a battle to control (if that makes sense). So, instead I continued to micromanage myself. I obsessed on every detail about my parenting and skills my son needed to work on for his age development, promoting my blog, getting more likes on Instagram and Facebook, trying to fix each and everyone one of my OCD thoughts until it “felt right” (OCD sufferers will understand that one). Inevitably though, I became angry when my actions didn’t yield the results I wanted.
 
Anxiety. Control. Crying. Anger. Control again. Falling apart. Put that cycle on repeat, and you have yourself a recipe for disaster.
 
I realized that my faith foundation was crumbling. As a person who believes in Jesus, I have learned through reading the Bible and talking to others with spiritual wisdom, that God ultimately is the one in control. He doesn’t expect us to be in control and have all the answers. However, He does hope that we will lean on him for support, grace, and answers. I realized that I needed to lose my control and rely on His control.
 
 

You don’t have to react to everything that bothers you

 
Now, if you don’t believe in God or Jesus, or anything I just said, I can understand that. It can be hard to believe in tangible, visible things around us- let alone an invisible almighty being. I believe what I wrote in the last paragraph is as true for you as it is for me, and I really hope that you will get to a place of believing that too. However alongside that, this is also true at its core: don’t let your emotions drive your actions. Emotions are really strong, I think we can all agree with that! They can lead us to do things we swore we would never do, or never do again. For me, I default to anger when I’m losing control- yelling, being snarky, swearing, slamming doors and drawers, not receiving anything you have to offer me but simultaneously expecting you to accept every word I say. It’s not pretty and I’m not proud. But I am human. So are you.
 
So as hard as it may be, try to practice not letting your emotions drive your actions. Yes, pick and choose your battles; there are things that are important to speak out about in an appropriate and respectful way. However at the same time, we don’t need to react to everything that bothers us. This is a truth that I am working on implementing… slowly lol
 
As always, here are some of my suggestions:
 
  • Check-in with yourself: Be honest with yourself about how you’re doing. You won’t be able to be honest with anyone else until you do.
  • *Breathe: Slow. Your. Breathing. Down. Can’t stress this enough. One of the first things most counselors will preach about is the importance of deep breathing. Deep breathing slows your heart rate down, reduces stress, lowers your blood pressure, and can improve sleep. The reason is because deep breathing causes the brain to release endorphins, which naturally calms you down. Therefore, take 5 minutes daily, while your washing the dishes, or using the bathroom, to actively practice deep breathing.
    • Count to 5 slowly as you inhale; hold for a second or two. Then slowly exhale for a second or two longer than your inhale. Good job 🙂
  • Reach out: When you find that you are losing control, reach out to at least one person- one confidant. It’s so important to express your feelings. If you don’t have that one person to talk to, reach out to me. Yes I clearly have my issues (lol), but I can set them a side for a moment, to listen to yours. That’s why I’m writing to you: to let you know that you are not alone, your feelings are validated, and I care for you.
I pray that as we all endure this season, with Covid-19 and other burdens that we’re carrying, that we can give ourselves grace when we lose control. I pray that we won’t be too proud to go to God with our problems, and will go to each other as well.    💕
 
 
Keep pressing on,
 
-Amanda
 
 
 
*For more information on the benefits of deep breathing and its effects on the brain check out:
 
  • neurocorecenters.com
  • Download Mindfulness Coach in your App Store [I highly recommend this tool for all individuals, especially for social workers/counselors to use with their clients :)]
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]]> 394 “I’m [NOT] Fine” http://pressed.blog/im-not-fine/?utm_source=rss&utm_medium=rss&utm_campaign=im-not-fine Sun, 01 Mar 2020 02:14:00 +0000 http://pressed.blog/?p=105 The post “I’m [NOT] Fine” appeared first on Pressed.

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“How are you?”

“I’m fine.”

This interaction is as natural as breathing. How often do we lie to ourselves and others by saying “we’re fine,” when we know that we are the opposite? A more accurate statement, or sometimes exclamation, would be “I’m NOT fine!” However, sometimes people can pick up the “not” in the tone of our voices, even if we we’re not saying it out loud. Why then, do we often feel the need to mask our feelings when we’re not, in fact, fine?

 I think there are multiple answers to this question. Many of us may feel when asked how we’re doing, that people are either being polite or making conversation, and don’t expect a whole novel about our lives. Another possibility is that we feel it takes more time and energy then it’s worth to explain what we’re going through; Or by the time we talk to someone face to face about how we’re doing so much time has passed, and we’re either over the issue, or possibly just numb to it. Sometimes we don’t want to feel what we feel, and definitely don’t want to work through it- much easier to sweep it under the rug, right? Other times we may simply feel that people just couldn’t understand, since they live in a perfect world according to their pictures on social media.

There are times, however, when the reasoning may be more serious: What if people judge me? What if they think I’m crazy? What if I am crazy and there’s no one who can actually help me? What if they don’t believe me? Or, what could happen as a result of what I share?  Personally, I have struggled with all of the above possibilities. As I mentioned previously, I live with Obsessive-Compulsive Disorder (a.k.a. OCD), which, in a nutshell, is like anxiety on speed. So, fear and trust plays an important role in why I  hesitate to share how I’m actually doing. 

Regardless of the reasons why we may hesitate to share how we are actually doing- we need to start sharing how we are actually doing. Stuffing our feelings down inevitably will make things worse. The stress may cause us to lash out at others, not be able to sleep at night or focus at work, or may make us physically sick. Even just talking to one person, (a friend, parent, co-worker, counselor, etc.), could make a world of difference. The person doesn’t have to be an expert in what you’re going through to lend a listening ear and provide support. Often times we find that we’re not the only ones struggling with relationship issues, comparison, work issues, mental health, grief, trauma, honestly, whatever the problem may be.

On the flip side, we need to create an environment where sharing feelings is welcomed. I do appreciate that society is changing and becoming more conscious of emotional and mental health needs, but we could still do better. Also, we need to not shy away when we suspect someone isn’t as “fine” as they claim they are. Yes, this does take time and energy out of you to sit and listen, but if the roles were reversed, isn’t that what you would want? Although it isn’t our job to fix people and be mind readers, we can still be aware of the big silent [NOT] in the middle of that “I’m fine” statement. How?

1) Pick up on voice tone and body language- if someone is verbalizing that they’re fine or okay, but their tone of voice sounds sad or their appearance is stressed, worn out or angry, that is an indicator that something may be wrong.

2) If it turns out that they are not so “fine”- (surprise, surprise), then take the time to listen. Again you don’t have to be an expert to say “I’m sorry you are going through that,” or “What can I do to help?”, or if appropriate, give that person a pat on the shoulder or a hug.

Remember no one expects (or shouldn’t expect) you to have all of the answers and fix their problems. Honestly, sometimes we are offering advice and solutions too much when we need to just be quiet and listen. Sometimes all someone may need is silence, and just a person willing to sit in the moment with them. 

Don’t down play your feelings. There are times when venting to a confidant is not enough and we may need additional help. Like I wrote at the bottom of my home page- don’t be a “hero”- you don’t have to go through what you’re going through alone. Please research and reach out to your local mental health services. As someone who has both participated in therapy and been a therapist, I can honestly say that it can change your life. 

Keep pressing on,

-Amanda 

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]]> 105 Intro to Pressed http://pressed.blog/intro-to-pressed/?utm_source=rss&utm_medium=rss&utm_campaign=intro-to-pressed Sun, 01 Mar 2020 01:37:00 +0000 http://pressed.blog/?p=94 Purpose… this is an important word, we all want to know what- is our purpose… Let me introduce myself, and share a little bit about me and the purpose of starting this blog. My name is Amanda, and I am newly 30 years old; I have enjoyed the last three decades of my life with […]

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Purpose… this is an important word, we all want to know what- is our purpose…

Let me introduce myself, and share a little bit about me and the purpose of starting this blog.

My name is Amanda, and I am newly 30 years old; I have enjoyed the last three decades of my life with a lot of highs and lows. I am married to my hubby of almost six years and we have one son- these are the main men in my life <3. I am an LMSW (Licensed Master Social Worker). I went to Oakland University in Rochester, Michigan, for my bachelor’s degree and then to the University of Michigan for my master’s degree. Within the last ten years of my life I practiced as a School Social Worker, working primarily in urban areas with at-risk youth and families, and shortly after I began working as a trauma therapist with children and adolescent victims of sexual abuse.

Before you read my next point and exit, hear me out: I follow Jesus. I know some Christians can present themselves in a, hmmm, not so “Godly” fashion; Judgmental, pretentious, exclusive, and closed minded are some of the words that come to mind. Basically, things that ironically Christ taught against. This is why I don’t call myself a Christian, but a follower of Jesus. I may not be the best example of Christ at all times, (as a matter of fact, I know I’m not), but I hope I do not present myself in the ways mentioned above. If I do, then I need to check myself. I do, however, try to consistently practice Christ’s golden rule, “Love your neighbor as yourself,” (Mark 12:31). The emphasis is on both NEIGHBOR and SELF because they are equally important, which I will dive into as this blog goes on. So, if you’re not a Christian I’m not here to force Christianity down your throat, that’s not what this blog is about. Yes, I believe in God and Jesus, and I do like to talk about my faith because it is central to my life; However, I’m aware that not everyone feels this way. Cool, stick around- Welcome!

I have Obsessive-Compulsive Disorder, aka, OCD. Yeahhh, not fun. Any other OCD sufferers out there know this well. As a matter of fact anyone with any sort of mental health issues, I know you’re the real MVPs, because not only do you have to function in your external world, but you have to simultaneously battle your internal world. Brothers and sisters, I am here for you the most. Living with OCD was one of my main motivations for beginning this blog. I want to reach out to those who struggle with OCD or other mental health conditions as well; you are not alone and there is help out there!

So Why Pressed?
When I was thinking of naming this blog, the word “pressed” stuck out in my mind. I had an awesome friend highlight how the word “press” is found within the word depression, and that stuck with me. Press. Pressed. Then I thought, if we feel pressed in too much, it gets really hard to press on. I’m assuming this is true no matter where you are in life, or how young or old you are. However, I want you to know that there’s a light at the end of the tunnel; At times we may feel hard pressed, but we’re not crushed and we don’t have to stay defeated*.

Now back to that word purpose: I hope I’ve started to paint a picture of what the purpose of this blog is- to continue shining light on mental health, self-care, and figuring out your purpose in life. In my opinion, these three things go hand in hand especially when we are comparing our accomplishments (or lack there of) to our peers, or flat out feel like we’re fading into the background. I think we’ve all been there, and I’m no exception.

Lastly, I would like to highlight that I have listed some mental health resources on the bottom of my home page, for your reference. I may list additional resources as this blog progresses. Please, don’t be a hero; You don’t need to go through what you’re going through alone. Get the help you need, it’s only one click away.

So friend- let’s keep pressing on,

-Amanda

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Footnotes:

*2 Corinthians 4:8- We are hard pressed on every side, but not crushed; perplexed, but not in despair;

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