Mental Health

OCD

Obsessive Compulsive Disorder (OCD) affects as many as 1 out of every 100 adults. The disorder is characterized by intrusive obsessions and all-consuming compulsions, and its impact on the lives of those who have it can be devastating. Even when OCD is managed with therapy or medication, it can have far-reaching consequences on a patient’s career, social life, and personal relationships.

The essential features of adult OCD are recurrent, unwanted obsessions or compulsions that are severe enough to be time consuming; that is, they take more than one hour a day — or they cause marked distress or significant impairment in your daily life.

There are many different types of obsessions and many people with OCD will have more than 1 type of obsession. Some examples of common obsessions are:

FEAR OF CONTAMINATION
This obsession involves a fear of coming into contact with germs, getting sick or making others sick from touching “dirty” or “contaminated” items, sticky substances or chemicals. For example, “I will be contaminated by germs if I pick up this pen off the floor” or “I can be poisoned by lead if I come into contact with paint.”

THOUGHTS OF DOUBT
This obsession involves constant doubt about whether you’ve done something wrong or made a mistake. For example, “Did I turn off the stove?”; “I think I made a spelling error on the email I just sent.”; “I think I threw away something important”; or “I might not have answered that question clearly and precisely enough.”

FEAR OF ACCIDENTALLY HARMING SELF OR OTHERS
Adults with these obsessions are afraid of harming themselves or others through carelessness. For example, “If I don’t make sure that the door is locked at night, the apartment might get broken into and I might be robbed and murdered”, “If I don’t immediately change out of my work clothes and wash them with bleach, I might bring outside germs home and cause my whole family to be sick.”

NEED FOR SYMMETRY/EXACTNESS
Adults with this obsession feel a need to have objects placed in a certain order or position or tasks or events to be completed in a set way. For example, “I need to sort all my clothes by colour and have them face the same direction. Otherwise, it just does not feel right!”; “I just scratched my right arm twice and now I need to balance it out by scratching my left arm twice.”

REPUGNANT OBSESSIONS
Repugnant means disgusting. These kinds of obsessions include unwanted thoughts, images, or impulses of doing something horrible to a loved one (e.g. throwing your baby off a balcony, kicking your elderly grandmother; jumping off a bridge); sexual obsessions (e.g. thoughts of touching someone sexually against his/her will, images of molesting one’s baby, doubts about one’s sexuality); and obsessions that violate religious beliefs (e.g. swearing in temple/church, images of having sex with a priest). Repugnant obsessions can also take the form of doubts, for example; “Did I run over someone without realizing?”; “Did I become sexually aroused while bathing my baby?”; or “Did I sin but forget to repent?

These kinds of obsessions are particularly unwanted and people who experience them would never want to act on them. Having them DOES NOT mean you are crazy, dangerous or evil deep down inside.

What do “Compulsions” Look Like?

These behaviors are performed in an attempt to stop something bad from happening. However, repeated checking often makes people feel even less sure that they have successfully prevented the bad event from happening. Some examples include:

• WASHING/CLEANING COMPULSIONS
  This category of compulsion involves excessive washing and cleaning behavior. For example, you may wash your hands excessively, follow intricate rituals and rules for cleaning the bathroom or kitchen, or follow rituals with regards to grooming, tooth brushing, or showering. Rituals may including having a specific order you have to follow (e.g. washing a specific part of your body first or brushing your teeth in a particular order).
• CHECKING COMPULSIONS
  This category involves behaviors aimed at ensuring something is done properly, everyone is safe or mistakes have not been made. For example, you may repeatedly check to make sure doors are locked, stoves are turned off, or electrical outlets are unplugged. Other examples may also include checking to make sure everyone is okay and not harmed (e.g. Contacting family members repeatedly to “check” if they are safe). Checking can also include making sure that you haven’t made any mistakes (e.g. re-reading emails over and over to “check” for spelling/grammar mistakes or visually checking the environment to make sure that you have not left anything important behind).
• ORDERING/ARRANGING COMPULSIONS
  This category of compulsion involves arranging items in specific ways, such as clothes, books, shoes, etc. For example, you might line up all the clothes in the closet so that they are arranged according to colour, with all the hangers facing in the same direction. Adults with this compulsion will sometimes arrange things until it “feels right”. Some will do it to prevent bad things from happening; for example, “If I don’t arrange all the books and magazines in the house so that they face east, then someone in my family will die.”
• MENTAL RITUALS
  These are compulsions that are performed in your head. For example, you might mentally repeat a prayer whenever you have thoughts about something bad happening, or you might replace a “bad” thought (e.g. mom dying) with a “good” one (e.g. mom smiling and in good health).
• NEED TO ASK OR CONFESS
  Some adults with OCD are afraid that they have done or thought something “bad”, and therefore feel a strong urge to confess all of their thoughts to friends or family (for example, telling a loved one that “I just had a thought about pushing someone into the street”). Most people who feel the need to confess will also seek repeated reassurance that everything is okay (for example, asking a loved one, “Do you still love me even though I had a bad thought?”).
• HOARDING
  Some adults with OCD have a very hard time throwing away things that seem to others useless or of limited value. Hoarding can lead to excessive clutter in the home and interfere with daily life. For example, some people are not able to throw away any receipts, financial documents, or old newspapers.
  *Tip: Over time, OCD symptoms can change. For example, you might start off with washing your hands compulsively but later develop excessive checking behaviours and actually stop compulsive washing altogether.

People with OCD much more often than not have at least one other co-existing disorder. A trained mental health clinician can diagnose and provide appropriate treatment for these conditions as well as OCD. These disorders include:

• Anxiety Disorders
• Major Depressive Disorder
• Bipolar Disorders
• Attention-Deficit/Hyperactivity Disorder (AD/HD)
• Feeding/Eating Disorders
• Autism Spectrum Disorder (ASD)
• Tic Disorders/Tourette Syndrome (TS)

Causes
Using neuroimaging technologies in which pictures of the brain and its functioning are taken, researchers have been able to demonstrate that certain areas of the brain function differently in people with OCD compared with those who don’t. Research findings suggest that OCD symptoms may involve communication errors among different parts of the brain, including the orbitofrontal cortex, the anterior cingulate cortex (both in the front of the brain), the striatum, and the thalamus (deeper parts of the brain). Abnormalities in neurotransmitter systems – chemicals such serotonin, dopamine, glutamate (and possibly others) that send messages between brain cells – are also involved in the disorder.

Although it has been established that OCD has a neurobiological basis, research has been unable to point to any definitive cause or causes of OCD. It is believed that OCD likely is the result 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.

Treatment
Treatment will be multi faceted dependent on the root physical and emotional causes. Each patient is unique, so all factors will be taken into consideration so that a tailored plan can be out into place.

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Stress

Stress is a factor in five out of the six leading causes of death — heart disease, cancer, stroke, lower respiratory disease, and accidents. An estimated 75 percent to 90 percent of all doctor visits are for stress-related issues. The culprit behind so many of our health problems is staring us in the face. The U.N. Contacts stress the 21st century health epidemic.

Understanding the mechanics of stress gives you the advantage of being more aware of and sensitive to your own level of stress and knowing when and how to take proactive steps.

• Your body doesn’t care if it’s a big stress or a little one.

The human body doesn’t discriminate between a BIG stress or a little one. Regardless of the significance, stress affects the body in predictable ways. A typical stress reaction, which most of us experience dozens of times each day, begins with a cascade of 1,400 biochemical events in your body. If these reactions are left unchecked we age prematurely, our cognitive function is impaired, our energy is drained, and we are robbed of our effectiveness and clarity.

• Stress can make smart people do stupid things.

Stress causes what brain researchers Contact “cortical inhibition.” The phenomenon of cortical inhibition helps to explain why smart people do dumb things. Simply said, stress inhibits a small part of your brain and you can’t function at your best. When we are in coherence – a state where we are cognitively sharp, emotionally calm, and we feel and think with enhanced clarity – the brain, heart and nervous system are working in harmony. This state of coherence facilitates our cognitive functioning – we are actually operating at peak performance mentally, emotionally and physiContacty.

• People can become numb to their stress.

We can be physiologiContacty experiencing stress yet mentally numb to it because we’ve become so accustomed to it. Some have become so adapted to the daily pressures, irritations and annoyances of life that it starts to seem normal. Yet the small stresses accumulate quickly and we may not realize how much they’re impairing our mental and emotional clarity and our overall health until it shows up as a bad decision, an overreaction or an unwanted diagnosis at the doctor’s office.

• We can control how we respond to stress.

We don’t need to be victims to our own emotions, thoughts and attitudes. We can control how we respond to stress and we can become more sensitive to stressful situations and how they are affecting us before it manifests as a physical, mental or emotional complaint. There are simple, scientifiContacty validated solutions to stress that empower people to rewire their own stress response.

• The best strategy is to handle stress in the moment.

The best way to manage stress is to deal with it the very moment you feel it come up. Millions of people unsuccessfully use the binge-and-purge approach when it comes to stress. They stress out all day, believing that they can wait until later to recover when they go to an evening yoga class, go to the gym or chill out when they take the weekend off. Unfortunately, when we put off going for our own inner balance our bodies have already activated the stress response and it’s our health that suffers.

Treatment

Here at the Harley Street IBS and Auto immune Clinic, we understand the deep impact that stress has at the root of many conditions we treat. We seek to address the damage stress has caused on the body, normalising nervous system and adrenal function, whilst teaching patients how to respond differently to in the moment stress, with easy to use evidence-based tools provided by our mind-body medicine team. We also give treatment for anxiety when necessary. This dual approach has proved very successful in restoring balance to people’s health both physical and emotional/mental.

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Anxiety Treatment

Experiencing occasional anxiety is a normal part of life. When we are well and healthy we are able to switch back into feeling at ease quickly.

However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations, or about specific things. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

Whatever form of anxiety you have, treatment can help.

Symptoms

Common anxiety signs and symptoms include:

• Feeling nervous, restless or tense
• Having a sense of impending danger, panic or doom
• Having an increased heart rate
• Breathing rapidly (hyperventilation)
• Sweating
• Trembling
• Feeling weak or tired
• Trouble concentrating or thinking about anything other than the present worry
• Having trouble sleeping
• Experiencing gastrointestinal (GI) problems
• Having difficulty controlling worry
• Having the urge to avoid things that trigger anxiety

Causes

Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor, as can societal pressures and the incredibly fast pace on this digital age. Due to the gut brain connection there are also considerations of inflammation and gut health when considering anxiety.

At the Harley Street IBS & Autoimmune clinic, we will take all factors into consideration and create a tailored treatment plan for anxiety for each individual.

If you would like to book an appointment

Depression

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also Contacted major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.

More than just a bout of the blues, depression isn’t a weakness and you can’t simply “snap out” of it. Depression may require long-term treatment.

Although depression may occur only once during your life, people typiContacty have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

• Feelings of sadness, tearfulness, emptiness or hopelessness
• Angry outbursts, irritability or frustration, even over small matters
• Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
• Sleep disturbances, including insomnia or sleeping too much
• Tiredness and lack of energy, so even small tasks take extra effort
• Reduced appetite and weight loss or increased cravings for food and weight gain
• Anxiety, agitation or restlessness
• Slowed thinking, speaking or body movements
• Feelings of worthlessness or guilt, fixating on past failures or self-blame
• Trouble thinking, concentrating, making decisions and remembering things
• Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
• Unexplained physical problems, such as back pain or headaches
  For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Causes

Depression can be caused by a constellation of factors that cause chronic inflammation – inflammatory foods, medications like the birth control pill, reduced sunlight exposure, and loneliness, to name a few – and manifest differently in different people. Some of the symptoms that qualify a person for a diagnosis of depression seem downright paradoxical: increased and decreased appetite, insomnia or fatigue, motor agitation or impairment. Even in one person, different depressive symptoms can appear at different times.

A recent scientific review article entitled ‘Depression subtyping based on evolutionary psychiatry: Proximate mechanisms and ultimate functions’ attempts to re-classify depression into twelve subtypes.1 For each of these subtypes, researchers propose different causes for depressive symptoms, as well as potential reasons that these subtypes evolved and purposes they serve. In this framework, depression may be (1) an beneficial adaptation that effectively addresses a specific problem (2) an adaptation that does not solve the problem (3) a byproduct of other adaptations or (4) a general pathological state that serves no purpose and is harmful.

It is important that each person is treated as an individual to find the root causes of their symptoms of depression, so each can be gently addressed and healed.

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ADHD

ADHD stands for Attention-Deficit/Hyperactivity Disorder. Some people call it ADD, but ADHD is the correct name for it. There are 3 main types of ADHD: predominantly inattentive, predominantly hyperactive/impulsive, and combined type. Anyone can have moments of being inattentive, impulsive, or hyperactive. Adults with ADHD, however, experience these symptoms repeatedly and in a way that is severe enough to have an impact at home, at school/work, or in social situations. ADHD can be a lifelong condition yet symptoms in adults may be less noticeable than those in children (ages 6-17), though they are just as important to identify.

Symptoms of inattention

• Often makes careless mistakes and lacks attention to details
• Examples: overlooking or missing details or handing in work that is inaccurate
• Often has difficulty paying attention to tasks
• Example: difficulty remaining focused during lectures, conversations, or lengthy readings
• Often seems to not listen when spoken to directly
• Example: mind seems elsewhere, even in the absence of obvious distraction
• Often fails to follow through on instructions, chores, or duties in the workplace
• Example: starts tasks but quickly loses focus and is easily sidetracked
• Often has difficulty organizing tasks and activities
• Examples: messy, disorganized work; poor time management; fails to meet deadlines
• Often avoids, dislikes, or is reluctant to participate in tasks requiring sustained mental effort, like preparing reports, completing forms, or reviewing lengthy papers
• Often loses things like tools, wallets, keys, paperwork, eyeglasses, and mobile phones
• Often easily distracted by other things, including unrelated thoughts
• Often forgetful in daily activities, such as running errands, returning calls, paying bills, and keeping appointments

Symptoms of Hyperactivity and impulsivity

• Often fidgets with or taps hands and feet, or squirms in seat
• Often leaves seat when remaining seated is expected
• Example: leaves their place in the office or other workplace setting or in other situations that require remaining seated
• Often runs or climbs where it is inappropriate or feels restless (in adults, may be limited to feeling restless)
• Often unable to participate in leisure activities quietly
• Often acts as if “on the go” or “driven by a motor”
• Example: is unable to be or uncomfortable being still for an extended time, as in meetings or restaurants
• Often talks excessively
• Often blurts out an answer before a question has been fully asked
• Examples: completes people’s sentences; cannot wait for next turn in conversation
• Often has difficulty waiting his or her turn, for example, while waiting in line
• Often interrupts or intrudes on others
• Examples: butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; may intrude into or take over what others are doing

What Causes ADHD?

Thecauses of ADHDremain somewhat unclear. Is ADHD genetic?Research suggests that genetics and heredity play a large part in determining who gets attention deficit hyperactivity disorder. However, scientists are still investigating whether certain genes, especially ones linked to the neurotransmitter dopamine, play a defined role in developing ADHD. Additional research suggests that exposure to toxins and chemicals may increase a child’s risk of having ADHD.

Treatment

At the Harley Street IBS and Auto Immune Clinic, we will take a comprehensive medical history and look into the root causes of symptoms using cutting edge functional medicine tests. We will then create a tailored plan for each individual.

If you would like to book an appointment

Insomnia

Insomnia is a sleep disorder that is characterized by difficulty falling and/or staying asleep. People with insomnia have one or more of the following symptoms:

Symptoms

• Difficulty falling asleep
• Waking up often during the night and having trouble going back to sleep
• Waking up too early in the morning
• Feeling tired upon waking

Types of Insomnia

There are two types of insomnia: primary insomnia and secondary insomnia.

• Primary insomnia:Primary insomnia means that a person is having sleep problems that are not directly associated with any other health condition or problem.

• Secondary insomnia:Secondary insomnia means that a person is having sleep problems because of something else, such as a health condition (like asthma, depression, arthritis, cancer, or heartburn); pain; medication they are taking; or a substance they are using (like alcohol).

Acute vs. Chronic Insomnia

Insomnia also varies in how long it lasts and how often it occurs. It can be short-term (acute insomnia) or can last a long time (chronic insomnia). It can also come and go, with periods of time when a person has no sleep problems. Acute insomnia can last from one night to a few weeks. Insomnia is called chronic when a person has insomnia at least three nights a week for three months or longer.

Causes of Insomnia

• Significant life stress (job loss or change, death of a loved one, divorce, moving)
• Illness
• Emotional or physical discomfort
• Environmental factors like noise, light, or extreme temperatures (hot or cold) that interfere with sleep
• Some medications (for example those used to treat colds, allergies, depression, high blood pressure, and asthma) may interfere with sleep
• Interferences in normal sleep schedule (jet lag or switching from a day to night shift, for example)

Causes of chronic insomnia include:

• Depression and/or anxiety
• Chronic stress
• Pain or discomfort at night

Treatment for Insomnia

At the Harley Street IBS and Autoimmune Clinic we will conduct an evaluation, which may include a physical exam, a medical history, and a sleep history. You may be asked to keep a sleep diary for a week or two, keeping track of your sleep patterns and how you feel during the day. We will assess possible root causes and imbalances using functional medicine tests, and design a tailored program for each individual. It also includes treatment for any anxiety.

If you would like to book an appointment