All Posts Tagged: ocd

What is Self Harm?

Self harm or self-injury is the intentional wounding of one’s own body. Most commonly, a person who self harms will cut themselves with a sharp object.

Self harm can also include:

  • burning or branding (using cigarettes, lit matches or lighters, or other hot objects)
  • severely scratching
  • hair pulling (trichotillomania)
  • biting themselves
  • excessively picking at their skin (dermatillomania) or wounds
  • punching or hitting themselves
  • head banging
  • carving words or patterns into their skin
  • excessive skin-piercing or tattooing, which may also be indicators of self harm

Generally, a person who self-harms does so in private. They often follow a ritual. For example, they may use a favorite object to cut themselves or play certain music while they self injure.

Any area of the body may be targeted, however the arms, legs, or front of the torso are the most commonly selected. These areas are easy to reach and easy to cover up so the person can hide their wounds away from judgmental eyes.

In addition, self harming can also include actions that don’t seem so obvious. Behaviors like binge drinking or excessive substance abuse, having unsafe sex, or driving recklessly can be signs of self harm.

Self Harm Causes

There isn’t a simple answer for what causes people to self-injure. Although this extreme behavior may seem like a suicide attempt on the surface, it’s really an unhealthy coping mechanism.

People cut or hurt themselves to release intolerable mental distress or to distract themselves from painful emotions. Often, the self-mutilator may have difficulty expressing or understanding their emotions. People who self harm report feelings of loneliness or isolation, worthlessness and rejection, self-hatred, guilt, and anger.

When they attack themselves, they are looking for:

  • a sense of control over their feelings, their body, or their lives
  • a physical diversion from emotional pain or emotional “numbness”
  • relief from anxiety and distress
  • punishment of supposed faults

People who self harm often describe an intense yearning to injure themselves. Completing the act of mutilation and feeling the resulting pain releases their distress and anxiety. This is only temporary, however, until their guilt, shame, and emotional pain triggers them to injure themselves again.

Who is At Risk for Self Injury?

Self harm occurs in all walks of life. It is not restricted to a certain age group, nor to a particular race, educational, or socioeconomic background.

It does occur more often in:

  • people with a background of childhood trauma, such as verbal, physical, or sexual abuse
  • those without a strong social support network or, conversely, in those who have friends who self harm
  • those who have difficulty expressing their emotions
  • people who also have eating disorders, post traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), borderline personality disorder, or those who engage in substance abuse

Although anyone may self harm, the behavior happens most frequently in teens and young adults. Females tend to engage in cutting and other forms of self-mutilation at an earlier age than males, but adolescent boys have the highest incidence of non-suicidal self injury.

Self-Harming Symptoms

Physical signs of self harm may include:

  • unexplained scars, often on wrists, arms, chest, or thighs
  • fresh bruises, scratches or cuts
  • covering up arms or legs with long pants or long-sleeved shirts, even in very hot weather
  • telling others they are clumsy and have frequent “accidents” as a way to explain their injuries
  • keeping sharp objects (knives, razors, needles) either on their person or nearby
  • blood stains on tissues, towels, or bed sheets

Emotional signs of self harm may include:

  • isolation and withdrawal
  • making statements of feeling hopeless, worthless, or helpless
  • impulsivity
  • emotional unpredictability
  • problems with personal relationships

Help for Self Harm

The first step in getting help for self harm is to tell someone that you are injuring yourself. Make sure the person is someone you trust, like a parent, your significant other, or a close friend. If you feel uncomfortable telling someone close to you, seek out a teacher, counselor, religious or spiritual advisor, or a mental health professional.

 Professional treatment for self injury depends on your specific case and whether or not there are any related mental health concerns. For example, if you are self harming but also have depression, the underlying mood disorder will need to be addressed as well.

Most commonly, self harm is treated with a psychotherapy modality, such as:

  • Cognitive behavioral therapy (CBT), which helps you identify negative beliefs and inaccurate thoughts, so you can challenge them and learn to react more positively.
  • Psychodynamic psychotherapy, which helps identify the issues that trigger your self-harming impulses. This therapy will help you develop skills to better manage stress and regulate your emotions.
  • Dialectical behavior therapy (DBT), which helps you learn better ways to tolerate distress. You’ll learn coping skills so you can control your urges to self harm.
  • Mindfulness-based therapies, which can help you develop skills to effectively cope with the myriad of issues that cause distress on a regular basis.

Treatment for self injury may include group therapy or family therapy in addition to individual therapy.

 Self care for self-harming includes:

  • Asking for help from someone whom you can call immediately if you feel the need to self injure.
  • Following your treatment plan by keeping your therapy appointments.
  • Taking any prescribed medicines as directed, for underlying mental health conditions.
  • Identifying the feelings or situations that trigger your need to self harm. When you feel an urge, document what happened before it started. What were you doing? Who was with you? What was said? How did you feel? After a while, you’ll see a pattern, which will help you avoid the trigger. This also allows you to make a plan for ways to soothe or distract yourself when it comes up.
  • Being kind to yourself – eat healthy foods, learn relaxation techniques, and become more physically active.
  • Avoiding websites that idealize self harm.

 If your loved one self-injures:

  • Offer support and don’t criticize or judge. Yelling and arguments may increase the risk that they will self harm.
  • Praise their efforts as they work toward healthier emotional expression.
  • Learn more about self-injuring so you can understand the behavior and be compassionate towards your loved one.
  • Know the plan that the person and their therapist made for preventing relapse, then help them follow these coping strategies if they encounter a trigger.
  • Find support for yourself by joining a local or online support group for those affected by self-injuring behaviors.
  • Let the person know they’re not alone and that you care.

Need More Information?

Are you engaging in self harm or is your loved one self injuring? Don’t wait to seek help – speak to one of our caring, compassionate mental health professionals today. Contact the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida for more information or call us at 561-496-1094.

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Signs You May be a Hypochondriac

A hypochondriac is someone who lives with the fear that they have a serious, but undiagnosed medical condition, even though diagnostic tests show there is nothing wrong with them. Hypochondriacs experience extreme anxiety from the bodily responses most people take for granted. For example, they may be convinced that something as simple as a sneeze is the sign they have a horrible disease.

Hypochondria accounts for about five percent of outpatient medical care annually. More than 200,000 people are diagnosed with health anxiety (also known as illness anxiety disorder) each year.

Hypochondriac Symptoms

Hypochondria is a mental health disorder. It usually starts in early adulthood and may show up after the person or someone they know has gone through an illness or after they’ve lost someone to a serious medical condition. About two-thirds of hypochondriacs have a co-existing psychiatric disorder, such as panic disorder, obsessive compulsive disorder (OCD), or major depression. Hypochondria symptoms can vary, depending on factors such as stress, age, and whether the person is already an extreme worrier.

Hypochondriac symptoms may include:

·         Regularly checking themselves for any sign of illness

·         Fearing that anything from a runny nose to a gurgle in their gut is the sign of a serious illness

·         Making frequent visits to their doctor

·         Conversely, avoiding the doctor due to fear that the doctor will find they have a dreaded disease or serious illness

·         Talking excessively about their health

·         Spending a lot of time online, researching their symptoms

·         May focus on just one thing: a certain disease (example: cancer) or a certain body part (example: the lungs if they cough). Or, they may fear any disease or might become focused on a trending disease (example: during flu season, they may be convinced that a sniffle means they’re coming down with the flu)

·         Are unconvinced that their negative medical tests are correct, then worry that they have something undiagnosed and that no one will be able to find it and cure them

·         Avoiding people or places they fear may cause them to get sick

Health anxiety can actually have its own symptoms because it’s possible for the person to have stomachaches, dizziness, or pain as a result of their overwhelming anxiety. In fact, illness anxiety can take over a hypochondriac’s life to the point that worrying and living in fear are so stressful, the person can become debilitated.

You may be wondering what triggers hypochondria. Although there really isn’t an exact cause, we do know that people with illness anxiety are more likely to have a family member who is also a hypochondriac. The person with health anxiety may have gone through a serious illness and fear that their bad experience may be repeated. They may be going through major life stress or have had a serious illness during childhood. Or, they may already be suffering from a mental health condition and their hypochondria may be part of it.

Hypochondriac Treatment

Often, when a person repeatedly runs to their doctor at the first sign of a minor symptom, their doctor doesn’t take them seriously and may consider them to be a “difficult patient,” rather than a person who is honestly concerned about their health. Worse, some doctors will take advantage of the person’s fears and may run unnecessary tests just to appease the patient. In fact, it’s been estimated that more than $20 billion is spent annually on unnecessary procedures and examinations.

Self-help for hypochondria can include:

  • Learning stress management and relaxation techniques
  • Avoiding online searches for the possible meanings behind your symptoms
  • Focusing on outside activities such as a hobby you enjoy or volunteer work you feel passionate about
  • Avoiding alcohol and recreational drugs, which can increase anxiety
  • Working to recognize that the physical signs you experience are not a symptom of something ominous, but are actually normal bodily sensations
  • Setting up a schedule for regular appointments with your primary care doctor to discuss your health concerns. Work with them to set a realistic limit on medical tests and specialist referrals.

Professional treatments for hypochondria include:

  • Cognitive Behavioral Therapy (CBT), which is very helpful for reducing patient fears. In this type of therapy, the person learns to recognize and understand the false beliefs that set off their anxiety. Research has shown that CBT successfully teaches hypochondriacs to identify what triggers their behavior and gives them coping skills to help them manage it.
  • Behavioral stress management or exposure therapy may be helpful
  • Psychotropic medications, such as anti-depressants, are sometimes used to treat health anxiety disorder

It is worth noting that many sufferers are unwilling to acknowledge the role anxiety plays in their symptoms. This makes them less likely to seek help from a mental health professional. Often, hypochondriacs are so resistant to the idea that they have anxiety that it takes intervention from loved ones to help them understand that they need assistance.

Get Help for Health Anxiety Disorder

Being a hypochondriac and experiencing health anxiety can be debilitating. It can severely affect the lives of the people who suffer from it.  The mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida are experienced in helping those with illness anxiety. For more information, contact us or call us today at 561-496-1094.

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Children’s Mental Health – Psychiatric Help for Children

While we tend to think of childhood as a carefree time of life, the fact is that many children suffer from mental conditions and disorders, just the same as adults. Among other things, children’s mental health concerns can include emotional, behavioral, and mental disorders such as eating disorders, learning and developmental disabilities, Attention Deficit Hyperactive Disorder (ADHA), and autism. And, similar to adults, children can be impacted by conditions like anxiety, depression, Obsessive Compulsive Disorder (OCD) and Post-traumatic Stress Disorder (PTSD). Additionally, as children grow and mature into young adults, they can develop other problems associated with adolescence, such as underage drinking and substance abuse.

Left untreated, any of these conditions or disorders can result in difficulties with making friends, and behavior issues in school and at home. What is most troubling, however, is that research has shown that a majority of adult mental disorders start early in life. This makes it critical that children’s mental health conditions be caught promptly and treated appropriately.

Symptoms of Child Psychological Disorders

Child psychological disorders and conditions can affect any ethnic group, and income level, and those living in any region of the country. In fact, the Centers for Disease Control (CDC) cites a study from a National Research Council and Institute for Medicine report that estimates about 1 in 5 children across the United States will experience a mental disorder in any given year.

Symptoms often change as a child grows and matures, so the signs of a problem may be difficult to spot in the early stages. Often, parents are the first to recognize that there is an issue with their children’s emotions or behavior, however problems may also be brought to your attention by your child’s educators or another adult who knows your child well. Some general signs to look for include:

  • Marked decline in school performance
  • Strong worries or anxiety that causes problems at home or at school
  • Random, frequent physical aches and pains, such as headaches or an upset stomach
  • Difficulty sleeping, nightmares
  • Marked changes in eating habits
  • Feeling hopeless
  • Having low or no energy
  • Aggressive behavior, disobedience, and/or confrontations with or defiance of authority figures
  • Temper tantrums or outbursts of anger
  • Thoughts of suicide or thoughts of harming themselves or others

Psychiatric Help for Children

  • Please get immediate assistance if you think your child may be in danger of harming themselves or someone else.  Call a crisis line or the National Suicide Prevention Line at 1.800.273.TALK (8255).

Getting psychiatric help for children, in the form of early diagnosis and receiving the correct treatment, is essential for your child’s well being, both now and throughout their life.

If your child’s problems persist across a variety of settings (for example: home, school, and with peers), some of the steps to get help include:

  • Talk to your child about how they are feeling. Find out if they would like to discuss a problem with you or another adult. Actively listen to their responses and concerns.
  • Talk to your child’s pediatrician, school counselor or school nurse, or a mental health professional if you see behaviors or problems in your child or teen that worry you.
  • Seek evaluation from a specialist who deals with children’s mental health concerns.
  • Ask the specialist if they have experience with treating the problem or behavior you see in your child.
  • Don’t delay in seeking help – early treatment generally gives better results.

Children can be treated in a variety of settings that range from one-on-one (or with a parent) sessions with a mental health professional to a group setting with a therapist and the child’s peers. Talk therapy can help change behaviors and may be used in combination with other treatments. Cognitive Behavioral Therapy (CBT) has been shown to be very effective in helping children learn coping strategies so they can change unhealthy behavior patterns and distorted thinking. Additionally, medications may be recommended for disorders such as ADHD or may be given for other types of severe or difficult cases.

Need More Information on Children’s Mental Health?

If you have questions or need more information about psychiatric help for children, we can help. The professionals at our child-focused department, The Children’s Center, specialize in child psychiatry and psychology, and other services related to children’s mental health. For more information, contact The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida or call us today at 561-496-1094.

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Hoarding and OCD

We all know someone who has a collection of some items that has special meaning to them. You probably have a friend who loves turtles, for example, and has a shelf full of whimsical turtle statues. Often, men will have sports-related memorabilia tucked into several corners of their home or hunting trophies hanging in their den. While these collections are generally harmless, there are people who compulsively collect “stuff” and have accumulated so much that their possessions have literally taken over their home or yard. When a person’s life begins to be so affected by their items that they can no longer safely live in their home or they aren’t able to give up even a tiny portion of their collection, they’ve crossed over into the realm of hoarding.

Hoard Definition

A hoarder is defined by the American Psychiatric Association as a person who “excessively saves items that others may view as worthless and has persistent difficulty getting rid of or parting with possessions, leading to clutter that disrupts their ability to use their living or work spaces.” This isn’t to say that someone is a hoarder simply because they have an assortment of specific items like model cars: collectors focus on something specific and will often display them or organize them somehow. When people hoard items, however, they generally save random, unrelated items and store them haphazardly.

In most cases, a hoarder saves things that they feel:

  • they may need in the future
  • are/will be valuable
  • have sentimental value
  • make them feel safer when they are surrounded by the things they save

The APA says those with the condition – and their families – suffer negative social, emotional and physical effects to the point where there is a disruption of normal life. People who hoard, however, often don’t see the problem: many will live in unsafe and unsanitary conditions in order to maintain and add to their collection of items.

Hoarding Symptoms

Hoarding symptoms may include some or all of the following:

  • A persistent inability to part with any possession, regardless of its value or ability to be used
  • Feeling excessive discomfort if others touch or borrow items or distress at the idea of losing an item or getting rid of it
  • Inability to use an area of the home for its intended purpose (for example, being unable to cook in the kitchen or use the bathroom to bathe)
  • Keeping stacks of newspapers, magazines or junk mail
  • Allowing trash or food to build up to unusually excessive, unsanitary levels
  • Limited or no social interaction
  • Difficulty organizing items, sometimes losing important items in the clutter
  • Difficulty managing daily activities because of procrastination and trouble making decisions
  • Moving items from one pile to another, without discarding anything
  • Shame or embarrassment

Are Hoarding and OCD Related?

Hoarding has long been thought to be a form of OCD or Obsessive Compulsive Disorder because of the victim’s fixation on their items. Often, it can be traumatic for them to discard even one or two items because of their strong need to save things.

Recently, however, some researchers have come to believe that hoarding disorder isn’t the same for all people: they think hoarding may be related to ADHD and/or dementia in certain people.

Hoarding Therapy

Treatment of hoarding disorder can be challenging because many people either don’t recognize the negative impact that hoarding has on their lives or they don’t believe they need treatment. When they do seek out a therapist, hoarding therapy generally follows a similar path as treatment for OCD. Often, the most effective means is a combination of medication and therapy.

Cognitive Behavior Therapy is used to help the person become aware of their thoughts, emotions, and beliefs about their hoarding and help them identify and challenge inaccurate thinking. Certain anti-depressants have been found to be effective in treating the disorder. Frequently, family or group therapy is encouraged. Over time, the need to hoard can be overcome and learning to take small steps can lead to big changes.

We Can Help!

If you or a loved one has symptoms of hoarding disorder, talk with a doctor or mental health provider as soon as possible. Additionally, some communities have agencies that help with hoarding problems. Check with your local or county government for resources in your area.

For more information or to talk to a mental health professional about hoarding, contact Dr. Rosen or call The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094.

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What is Religious OCD?

Obsessive compulsive disorder (OCD) is characterized by unwanted, intrusive thoughts and anxiety (obsessions) about something and the behaviors (compulsions) that people who suffer from the condition use to relieve the anxiety. This particular anxiety disorder represents a very serious condition that often grips the victim’s mind with fear and, in a very real way, controls their lives.

OCD is a broad disorder that encompasses many subgroups: in the case of religious OCD (also known as scrupulosity), the person is fixated on obsessions that are based in religion and/or religious beliefs, or around beliefs concerning morality. People who experience this form of OCD suffer from obsessive religious doubts and fears, unwanted blasphemous thoughts and images, as well as compulsive religious rituals, reassurance seeking, and avoidance.

People with religious OCD strongly believe in and fear punishment from a divine being or deity. Experts estimate that anywhere between 5% and 33% of people with OCD may experience scrupulosity and the number likely rises to between 50% and 60% in OCD sufferers who come from within very strict religious cultures. Even people who are not particularly religious can suffer from scrupulosity because they worry about being morally compromised or unintentionally offending others. A common thread throughout the spectrum is the linking of thoughts and actions: people with scrupulosity believe their thoughts are the same as actions, so they worry not just about what they have done, but also about what they have thought.

Examples of Religious OCD

Religious OCD can take many forms. A CNN news article tells the story of a Jewish woman who was so consumed with obsessions surrounding exposure to pork that she spent a large amount of time each day washing her hands and cleaning items that could even have remotely had the potential to come into contact with pork. An ABC News report discusses the problems of one Catholic woman who was faced with saying hundreds of prayers a day to obtain forgiveness for her self-perceived wrongdoings. The same article recounts a story about a man who eventually stopped eating and speaking in an attempt to please God by making sacrifices similar to those made by certain biblical figures. Even pillars of religious faiths may have been victims of scrupulosity: it has been suggested that both Martin Luther and St. Ignatius of Loyola may have exhibited religious obsessions.

Symptoms of Religious OCD

Scrupulosity rituals can include such behaviors as:

  • Compulsively praying, which can involve restarting the prayer if you get distracted while saying it and/or repeating it if you didn’t feel you were concentrating properly on the prayer or on the meaning of the prayer
  • Asking others if you are behaving correctly or if you “did the right thing”or analyzing your behavior throughout the day to be sure you are acting “appropriately”
  • Reading or studying religious writings, books, and texts excessively
  • Questioning your motives in numerous situations
  • Excessively apologizing to a deity (God, Allah, etc) and seeking forgiveness for your behavior

Treatment for Religious OCD

As with other forms of obsessive compulsive disorder, treatment for religious OCD involves cognitive behavior therapy. In some cases, medicines are combined with this type of exposure and response therapy. A patient will not be asked to give up his religion when undergoing therapy, instead he are given ways to face his triggers and live within his faith and religious traditions. Additionally, those patients who may not be able to travel to a therapists’office may be able to receive treatment over the phone or on a computer-based application such as Skype or FaceTime.

Have Questions? Need Help?

To get more information and help for scrupulosity and religious OCD, please contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida at 561-496-1094 or email Dr. Rosen and The Center today.

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Obsessive and Intrusive Thoughts Often Increase After Shooting Tragedies Says South Florida Mental Health Expert

In recent weeks, we have all heard about the terrible shootings happening across America; first, the movie theater massacre in Aurora, Colorado, and then the Sikh temple shooting near Milwaukee. These incidents affect everyone substantially but they can have a severe impact on people who suffer from obsessive and intrusive thoughts as a result of an anxiety disorder.
           
Obsessive intrusive thoughts are one of the most common symptoms of anxiety disorders, and they can be increased dramatically by these types of stories. They are recurring scary, invasive notions and/or images that can be paralyzing and unrelenting. The more they occur, the more the person thinks about them, which further cements them into their psyche.
           
There are three types of obsessive intrusive thoughts:

  • Blasphemous religious thoughts revolve around concepts that are considered particularly sinful to the person thinking them
  • Inappropriate sexual thoughts or images can involve intimate actions with strangers, family, friends, or any number of other people
  • Catastrophic thoughts or violent obsessions involve visions/thoughts about harming others or oneself

It is the last of these that can easily be stirred up when a violent act such as a mass shooting occurs and is widely broadcast over the news channels. With 24/7 news stations continuously relating stories about the killer’s state of mind both before and after the event, it’s easy for victims of catastrophic intrusive thoughts to wonder if they could follow that same path. Each time the thought occurs, they may believe themselves more and more likely to follow the compulsion. These thoughts can be so powerful that the person may eventually cut themselves off from friends and family out of a fear for their loved one’s safety.

The good news is that there is help available to stop these intrusive thoughts, and for all anxiety disorders, in general. Your mental health professional may suggest exposure therapy, cognitive behavioral therapy, or in some cases, medication. If you or someone you know is suffering from catastrophic intrusive thoughts, please seek help and get on the path of returning to a normal life.

For more information about obsessive and intrusive thoughts, obsessive compulsive disorder (OCD), or about anxiety disorders, contact Dr. Andrew Rosen and The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. They can be reached by calling 561-496-1094 or by emailing Dr. Rosen and The Center today.

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