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Cannabis Article

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Author: Keeley Joyce

WHAT IS CANNABIS

Cannabis is a psychoactive drug that is used for recreational and medicinal purposes. The plant can be used for its psychoactive and therapeutic effects. The drug can come in many forms, dried flowers, oils, and edibles such as baked goods or candies. The main psychoactive component is THC (Detla-9-tetrahydrocannabinol) what is responsible for producing the “high” people associate with cannabis. An additional cannabinoid in cannabis is CBD (cannabidiol). This component of the drug produces no psychoactive effects.  

The endocannabinoid system (ECS) is a cell signalling system in the brain that plays a role in the regulation of sleep, mood, memory, appetite as well as anxiety, fear, and stress. ECS is used by the body regardless of whether cannabis is introduced or not. When cannabis is used it enters the blood stream, makes its way to the brain, and attaches itself to cannabinoid receptors.   

Cannabis can produce several effects such as:  

  • relaxation   
  • euphoria   
  • changes perceiving colour, taste, sounds   
  • increased appetite   
  • laughter or giggling   
  • creativity  
  • amusement   

How can cannabis help with Psychiatric Disorder?

Anxiety   

Although research in medical marijuana and psychiatric disorders is still premature and very complex, research has found that THC may decrease anxiety at lower dosage levels. Additionally, CBD has appeared to decrease feelings of anxiety at all doses. Specifically for social anxiety, research has revealed that treatment with CBD significantly reduced feelings of anxiety, cognitive impairment and discomfort, speech performance as well as decreased hyper-alertness.   

Sleep Disorders   

Some research has discovered that CBD may help with trouble sleeping in many disorders such as posttraumatic stress disorder (PTSD) and insomnia. Individuals may benefit by being able to fall asleep faster and staying asleep. Moreover, patients with PTSD report having less nightmares when using CBD. People with insomnia often have high levels of the stress hormone cortisol at night, rather than in the morning when cortisol usually peaks. A study on CBD found that when participants took CBD oil, lower levels of cortisol followed.   

Eating disorders   

Some research has also yielded results showing that CBD may help with eating disorders.  Studies support the idea that if brain networks that regulate appetite are disturbed by stress and anxiety could contribute or promote eating disorder as well as obesity. As CBD may reduce anxiety levels, this can help improve mood and in turn promote healthier eating habits.  

Depression   

The effect of CBD has been investigated for having anti-depressant effects. Most anti-depressants increase serotonin in the brain, CBD may instead affect how the brain responds to the serotonin that is already in the brain.   

Possible side effects

While most studies show cannabis may help relieve possible psychological disorder symptoms, it is still premature in research. There are still some possible side effects to consider. Studies reveal some individuals who use cannabis report  

  

  • heightened anxiety  
  • mood change   
  • appetite changes  
  • nausea   
  • dizziness  
  • drowsiness  
  • paranoia/psychosis  

  

The use of cannabis also has some long-term effects and risks. If cannabis is being used through inhalation via smoking or vaping lung irritation and breathing problems as well as cancer are a potential risk. Using cannabis may also increase risks of dependence and addition. First time use of marijuana has also been linked to depersonalization. 

Depersonalization- derealization disorder occurs when an individual regularly feels as they are observing themselves from outside their body. Depersonalization may feel as things around are not real and feel like they are a dream. Cannabis induced depersonalization symptoms usually only last while the person is intoxicated and will wear off within 120 minutes after the exposure of the drug. Although, in rare cases depersonalization symptoms can last weeks to years even while not using cannabis.  

There are a few risk factors associated with cannabis -included depersonalization-derealization. Majority of the effected individuals have history of anxiety disorder, such as panic disorder or social phobia. As well as males and adolescences may have a higher chance of experiencing the symptoms. The risk for cannabis-induced symptoms may also increase when cannabis is being used during periods of distress or after exposure to trauma. Additionally, risk factors may include sudden withdrawal from regular cannabis use or severe intoxication. Research has also found a link between the use of marijuana and onset of schizophrenia. The THC component of cannabis can cause psychosis and schizophrenia in the at-risk population. Additionally, THC can exacerbate symptoms and cause an unfavorable prognosis is individuals who are already diagnosed.   

Administration & Dosage

There are many different delivery methods for cannabis some include:  

  

Smoking: people may smoke raw cannabis in many different Forms, rolled cigarettes, pipes, bongs, vapes  

  

Sublingual Delivery: The sublingual (under the tongue) or mucosal (in the oral cavity)   

  

Oral Ingestion: taking cannabis by the mouth in pill form or liquid   

  

Topical application: topical ointments, lotions  

  

There are different stains of cannabis, the two main ones are sativa and indica. The Sativa strains are known to have “a high” that gives an energizing effect. Whereas Indica stains release a deep relaxation high. There are also hybrid stains which have a certain percentage of each indica and sativa.     

 

The dosages used for CBD vary in research and there is not one set dosage on how much to take every person may react differently to dosages. Based on current evidence most research finds that for CBD 200-800mg per day has been beneficial for people who suffer from common disorders such as anxiety and depression. Lower dosages of THC (7.5mg) also appears to decrease anxiety, and higher dosages (12.5 mg) produced slight increases in anxiety and negative mood.   

References   

  

CBD for eating disorder – February 2022. CBD Clinicals. (2020, August 27). Retrieved February 13, 2022, from https://cbdclinicals.com/cbd-for-eating-disorder/   

Effects of marijuana on Mental Health: Anxiety Disorders. (n.d.). Retrieved February 13, 2022, from https://adai.uw.edu/pubs/pdf/2017mjanxiety.pdf   

Holland, K. (2019, July 29). CBD for depression: What are the benefits?Healthline. Retrieved February 13, 2022, from https://www.healthline.com/health/cbd-for-depression   

Holland, K. (2021, March 22). Beginner’s Guide to cannabis plants and strains. Healthline. Retrieved February 19, 2022, from https://www.healthline.com/health/sativa-vs-indica#how-to-choose  

Madden, S. P., & Einhorn, P. M. (2018). Cannabis-induced depersonalization-derealization disorder. American Journal of Psychiatry Residents’ Journal, 13(2), 3–6. https://doi.org/10.1176/appi.ajp-rj.2018.130202  

https://www.mayoclinic.org/diseases-conditions/depersonalization-derealization-disorder/symptoms-causes/syc-20352911

MediLexicon International. (n.d.). CBD and sleep: Does CBD work as a sleep aid?Medical News Today. Retrieved February 13, 2022, from https://www.medicalnewstoday.com/articles/cbd-and-sleep   

MediLexicon International. (n.d.). Marijuana high: Strains, smoking, vaping, and edibles. Medical News Today. Retrieved February 13, 2022, from https://www.medicalnewstoday.com/articles/327270   

Patel, S. J., Khan, S., M, S., & Hamid, P. (2020). The association between Cannabis use and schizophrenia: Causative or curative? A systematic review. Cureus. https://doi.org/10.7759/cureus.9309  

Raypole, C. (2019, December 16). Marijuana and anxiety: A good or bad match?Healthline. Retrieved February 13, 2022, from https://www.healthline.com/health/marijuana-and-anxiety#tips   

Sales, A. J., Crestani, C. C., Guimarães, F. S., & Joca, S. R. L. (2018). Antidepressant-like effect induced by cannabidiol is dependent on brain serotonin levels. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 86, 255–261. https://doi.org/10.1016/j.pnpbp.2018.06.002   

Sarris, J., Sinclair, J., Karamacoska, D., Davidson, M., & Firth, J. (2020). Medicinal cannabis for psychiatric disorders: A clinically-focused systematic review. BMC Psychiatry, 20(1). https://doi.org/10.1186/s12888-019-2409-8   

  

T, B. (2020, April 3). The many different ways that marijuana is used. Verywell Health. Retrieved February 19, 2022, from https://www.verywellhealth.com/how-is-marijuana-used-63522  

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PTSD ARTICLE

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Author: Keeley Joyce
 

What is PTSD?

Post- Traumatic stress disorder (PTSD) is a disorder that an individual may develop after experiencing or witnessing terrifying, shocking, or dangerous events.  

These events could be  

  • natural disasters  
  • military combat  
  • physical or sexual assault  
  • serious accidents  

 This is not an exhaustive list and trauma can look different for everyone.  

People who have PTSD have a heightened sense of fear. The body has natural stress response called fight-flight-freeze reaction when exposed to danger to help respond to the situation. The body uses these physiological changes to act quickly to avoid harm. In individuals who have PTSD fight-flight-freeze mode is enhanced even in safe situations evoking feelings of stress and anxiety.  

Signs and symptoms of PTSD? 

Most commonly post-traumatic stress disorder symptoms begin to surface after one month of the event, although in some cases symptoms may not arise until years later. PTSD symptoms can affect daily functioning, they interfere with social and work situations as well as relationships.  

PTSD Symptoms are grouped into five categories: Intrusions, avoidance, arousal and reactivity, as well as change in cognition and mood. 

Intrusions 

These symptoms are intrusive memories that pop up regardless of if the individual is actively trying to recall the event or not. These memories can be experienced during sleep as nightmares or during the day as vivid memories or flashbacks. The thought of these memories can induce feelings of anxiety, fear, or even guilt. Alongside the emotional component, these memories can cause physical symptoms such as chills, shaking, heart palpitations, etc. 

Avoidance 

An individual with PTSD tries their best to avoid everything that may trigger the memories of the traumatic event. This could be escaping people or situations that evoke the memory.  

Avoidance also can manifest into steering clear from other people as a whole.  

Arousal and Reactivity  

Arousal and reactivity symptoms include  

  • being easily startled  
  • constant feelings of being on edge  
  • difficulties with concentration  
  • difficulties falling or staying asleep  
  • feelings of irritability or aggression 
  • participating in reckless or destructive behavior  

Cognition and Mood  

 People with PTSD often have trouble recalling parts of the traumatic event. They often have distorted or negative views about themselves and/or the world. They experience ongoing negative emotions such as fear, anger, guilt. People who develop PTSD often lose interest in activities they previously enjoyed. They often have feelings of isolation and have trouble attaining happy thoughts.  

 

How is PTSD diagnosed

Many people will most likely go through a dangerous or traumatic event in their lifetime, although not everyone goes on to develop PTSD.  

Risk factors that may increase developing PTSD 

  • exposure to dangerous events or traumas  
  • childhood trauma  
  • lack of social support  
  • additional stress after the event (i.e., lost loved one, injury, loss of home)  
  • personal or family history of substance abuse 

High-risk professions for PTSD 

  • Military  
  • Police officers  
  • Firefighters  
  • Paramedics  
  • Healthcare workers 

Factors that may reduce developing PTSD 

  • social support  
  • coping strategies  
  • physical exercise  
  • early detection and treatment  

To determine a diagnosis, a psychological evaluation will be done to discuss signs and symptoms and the events that may have caused them. The use of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) will be used to compare symptoms and see if the individual meets the criteria.  

How is PTSD treated

Different types of psychotherapy may be used to treat PTSD this may include cognitive therapy, exposure therapy, and eye movement desensitization and reprocessing.  

Cognitive therapy 

This approach is a talk therapy that aims to restructure thinking patterns into a more positive outlook. For individuals with PTSD, it will help alter the negative views of oneself, or the world as well as negative beliefs of the traumatic event reoccurring 

Exposure therapy 

This therapy will allow an individual to safely face the memories or experiences that caused the trauma in an attempt to learn effective coping skills for facing the fear.  

Eye movement Desensitization and reprocessing (EMDR)  

this included a combination of exposure therapy with a series of instructed eye movements that attempts to allow the individuals to actively process the traumatic event that was experienced. 

Medication:  

In addition to therapy for severe cases, medication can be provided to decrease symptoms of PTSD.  

SSRIS  

Selective serotonin reuptake inhibitors are prescribed to help symptoms of anxiety and depression. These medications also can also help with sleeping difficulties and nightmares associated with PTSD. 

  • Sertraline (Zoloft) 
  • Paroxetine (Paxil) 
  • Fluoxetine (Prozac) 

SNRI  

Serotonin-norepinephrine reuptake inhibitors are also an effective treatment for PTSD. SNRIs and SSRIS both increase serotonin although SNRIS prevent the reuptake norepinephrine. Norepinephrine is a hormone and neurotransmitter play crucial role in how the body reacts to stress. SNRI’s can help the intense fight-flight- freeze response individuals with PTSD experience. They also can aid with feelings anxiety, mood, and panic attacks. 

  • venlafaxine (Effexor) 

Related Conditions

Acute Stress Disorder 

Like PTSD this is a disorder that occurs after a traumatic event. The symptoms are the same as PTSD, such as flashbacks, nightmares, etc.., although these symptoms arise three days to one month after the event. These symptoms can go away while in some cases can go on and develop into PTSD.  

Adjustment Disorder  

This disorder can develop after an individual experience’s stressful life events. Similarly, individuals with PTSD may experience feelings of sadness, hopelessness, feeling tense, detachment from others as well as physical symptoms such as headaches, palpitations. These symptoms usually start in the first three months after an event and last no longer than 6 months after the event has finished.  

Complex PTSD  

Complex PTSD, also referred to as c-PTSD is caused by chronic or prolonged trauma, whereas PTSD usually is related to one event or a series of events in a short period of time, complex PTSD is caused from a series of events that occurred time and time again over a long period.

 People with c-PTSD often have some symptoms of PTSD but not all of them. Additional symptoms of complex PTSD may include  

  • Problems with self-esteem  
  • Emotional dysfunction  
  • Relationship problems 

Risk factors: 

Adverse childhood experiences  

  • Abuse, neglect, violence, parental separation, parental substance abuse  

Trauma  

  • Multiple traumas  
  • Long term trauma  
  • Abuse  
  • Domestic violence  
  • Incarceration  
  • Witness to repeated acts of violence  

References  

Agaibi, C. E., & Wilson, J. P. (2005). Trauma, PTSD, and resilience. Trauma, Violence, & Abuse, 6(3), 195–216. https://doi.org/10.1177/1524838005277438  

Bisson, J. I. (2020). Acute stress disorder, adjustment disorders, and post-traumatic stress disorder. Oxford Textbook of Medicine, 6506–6509. https://doi.org/10.1093/med/9780198746690.003.0635  

Contributors, W. M. D. E. (n.d.). What is complex PTSD? the symptoms caused by chronic trauma. WebMD. Retrieved February 5, 2022, from https://www.webmd.com/mental-health/what-to-know-complex-ptsd-symptoms

Donohue, M. (2019, November 12). Post-traumatic stress disorder (PTSD). Healthline. Retrieved January 29, 2022, from https://www.healthline.com/health/post-traumatic-stress-disorder#symptoms  

  Kobayashi, Patel, M., & Lotito, M. (2015). Pharmacotherapy for posttraumatic stress disorder at a Veterans Affairs facility. American Journal of Health-System Pharmacy, 72(11 Suppl 1), S11–S15. https://doi.org/10.2146/ajhp150095

Mayo Foundation for Medical Education and Research. (2018, July 6). Post-traumatic stress disorder (PTSD). Mayo Clinic. Retrieved January 29, 2022, from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/diagnosis-treatment/drc-20355973  

Romney, D. M. (2003). Risk and resiliency factors in posttraumatic stress disorder. Annals of General Hospital Psychiatry, 2(1), 4. https://doi.org/10.1186/1475-2832-2-4  

U.S. Department of Health and Human Services. (n.d.). Post-traumatic stress disorder. National Institute of Mental Health. Retrieved January 29, 2022, from  

https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd

What is posttraumatic stress disorder?What Is PTSD? (n.d.). Retrieved January 29, 2022, from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd  

Borderline Personality Disorder

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Author: Keeley Joyce

WHAT IS BORDERLINE PERSONALITY DISORDER

Borderline Personality Disorder (BPD) is a condition in which individuals experience difficulties regulating emotions. Emotions in people with BPD are often felt intensely and for long periods of time. In addition, it takes longer to get back down to a regulated baseline of emotions after being emotionally triggered.  

Due to difficulties with emotional regulation BPD often causes, unstable relationships, impulsivity, negative self-image and intense responses to stresses that may result in dangerous behaviours such as self-harm. 

SIGNS AND SYMPTOMS

Borderline Personality Disorder affects how the person may feel about themselves, how they feel about other people as well as how they behave. People with BPD have a severe fear of abandonment and desperately attempt to avoid real or imagined rejection.  In individuals with BPD, they often have recurrent unstable relationships. Commonly switching from looking up to someone and adoring them to suddenly having negative feelings towards the person. Individuals with BPD often have frequent shifts in self-image, which may include negative feelings about oneself and feelings of worthlessness. Risky behaviour and impulsivity can also be noticed as a symptom of BPD, such behaviours may include, spending excessive amounts of money, drug use, reckless driving, self-sabotaging (may include quitting their job or cutting ties with someone who has a positive impact in their life). Individuals with BPD may have regular attempts at self-harm, suicide attempts, or threatening to do harmful things to themselves. Mood swings are often noticed in people who experience BPD. These mood swings can consist of extreme happiness to feelings of sadness, irritability, or shame, these polar extremes can last from a few hours to a few days.  An additional symptom of BPD is persistent feelings of emptiness. Individuals with BPD may also experience frequent intense anger in which they have trouble controlling.  Individuals with BPD may also experience short periods of psychotic symptoms or disassociations in the presence of stressors. These cognitive symptoms may look like paranoid thoughts or auditory hallucinations. Furthermore, additional cognitive symptoms are depersonalization (i.e., the individual or the person’s body feels unreal or altered) and derealization (i.e., feelings that the world around them is unreal).  

Causes

The cause of Borderline Personality Disorder are not fully understood, although research does indicate some evidence that genetic factors, adverse childhood experiences as well as brain abnormalities may be linked to BPD. Studies on twins and families have been done and suggest that genetics and heritability may influence the developments of BPD. A common history of adverse childhood events particularly, neglect and abuse are reported in BPD patients. Another important childhood factor that may be linked to BPD, is the inability to find stable attachments during childhood. Some research has also proposed the idea that there are changes in areas of the brain that are responsible for the regulation of emotions, impulsivity, and aggression.  Additionally, chemicals in the brain that are responsible for mood regulation such as serotonin may have an imbalances.  

Assessment & Diagnosis

Sometimes the diagnosis of OCD can be challenging because symptoms that are experienced often are noticed in other disorders such as anxiety disorder, depression, or other mental health disorders. The process of diagnosis starts off with a psychological evaluation which includes determining the individual’s thoughts, feelings, and behaviours to identify if the symptoms have interference with daily functioning. Criteria in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) published by the American Psychiatric Association may also be used for diagnosis. In addition, a physical exam can also be done to rule out any other problems or other complications that could be causing OCD like symptoms (i.e., neurological problems, traumatic brain injuries). 

Common Misdiagnosis

Individuals with BPD usually also meet the criteria for multiple diagnosis including:  

  • depression 
  • anxiety 
  • substance use disorders 
  • eating disorders 

Two conditions that commonly get misdiagnosed with BPD are, bipolar and complex PTSD. Bipolar Disorder and Borderline Personality disorder both present symptoms of, impulsive behaviour, intensive emotions, as well as suicidal thoughts. 

The similarity in presentation in complex PTSD and BPD can lead to misdiagnosis. Complex PTSD is a subset of PTSD and is a disorder deriving from the exposure of long-term trauma usually in childhood. cPTSD and BPD often get confused because they share similar behaviours and emotional patterns such as emotional distress, suicidal thoughts, anxiety, depression and disassociations. Although there are a few main differences in both BPD and cPTSD there is a noticed theme of fear of relationships. however, People with cptsd or BPD both have abandonment issue, but with BPD, this is more prevalent. People with cPTSD may choose to avoid intimate relationships while someone with BPD may have difficulties being alone and use an intimate relationship to prevent feelings of abandonment.  Individuals with BPD and cPTSD both struggle with emotional regulation. Although, individuals with BPD express more outbursts of anger such as crying or tantrum like behaviour more often, while irregulated emotions in cPTSD are typically presented as numbness, emptiness and detaching from emotions

Treatment 

While many individuals with BPD benefit from psychotropic medications, the gold standard treatment is treated through a form of psychotherapy, called Dialectical Behaviour Therapy (DBT). 

Dialectical Behaviour Therapy is a form of cognitive behavioural therapy (CBT). CBT tries to recognize and transform negative thinking patterns into positive behavioral changes. Additionally, DBT focuses on reassuring the patients and aiming to get them to be acceptant of the experience.  

A standard comprehensive DBT treatment includes five parts: 

  1. BT skills training Group 
  • mindfulness, distress tolerance, interpersonal effectiveness, emotion regulation 
  1. Individual therapy 
  • helps individuals apply the skills they have learnt to specific situations and discuss individual goals.  
  1. In-the-moment coaching  
  • telephone coaching in case the patient is in a crisis  
  1. Case management strategies 
  • teach the patients how to be autonomous and how to be their own case manager, take control of their own lives and care 
  1. DBT consultation team  
  • focuses on supporting those who are providing the DBT to ensure the best treatment possible is being provided to the patient 

DBT is completed in stages  

Stage 1: focuses on treating self-destructive behaviour i.e., suicide attempts, self-harm  

Stage 2: teaching quality of life skills: emotional regulation, distress tolerance & interpersonal effectiveness  

Stage 3: narrows in on improving relationships and self-esteem 

Stage 4: fosters additional joy and relationship connections 

Another effective treatment for BPD is Dr. Jeffrey Young’s schema therapy.  Schema-focused therapy helps an individual with BPD recognize any needs that have not been met which may be leading to negative patterns in life. This therapy focuses on allowing for all needs to be met promoting positive life patterns.  

Medications  

Although there are no medication treatments for borderline personality disorder, there are medications that can help with symptoms found within BPD such as anxiety, depression, aggression, and anxiety. 

These medications may be: 

  •  antidepressants (Celexa, Lexapro, Proxac ,Zoloft, Paxil) 
  • antipsychotics (Abilify, Cplyta, Geodon)  
  • mood stabilizing drugs (Tegretol, Lamictal, Trileptal)  

ADHD ARTICLE

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Author: Keeley Joyce

What is ADHD? 

Attention-Deficit/Hyperactivity Disorder frequently referred to as ADHD, is most commonly found in children. ADHD is a neurodevelopment disorder that generally gets detected in childhood although can sometimes go undetected until adulthood. Children usually display high energy and impatience, although if a child can never sit still, has extreme trouble paying attention, often demonstrates inappropriate behaviors they could be experiencing ADHD. A child with ADHD may frequently daydream, forget or lose things, squirm, or fidget. They often exhibit a hard time resisting temptations or getting along with peers.  

Adults who experience ADHD regularly have trouble being on time, are unable to stay organized and are forgetful. These difficulties can interfere with many areas in a person’s life from relationships through to career. Too often a person can have undetected ADHD. As a child, they may have been deemed as a “troublemaker” “class goof” or even “lazy.” As an adult, the symptoms now result in difficulty dealing with adult responsibilities such as bills, jobs, children, etc. Adults with undiagnosed ADHD may even have recurring incidents of accidents and reckless driving. Often undiagnosed ADHD can cause listening problems and inability to pay close attention to detail which can have an effect on relationships and success at work. Most people experience these symptoms with or without ADHD, but the severity of the symptoms is what differentiates the two.  

Types of ADHD 

There are three types of ADHD, whichever type of symptoms an individual exhibits or experiences more frequently determines which type they fall under.  

Predominantly inattentive presentation:  

The individual can become bored very easily and lose focus easily. They often find themselves getting sidetracked from what they intended to be doing. Individuals may have a hard time with task organization or the completion of tasks. lack of attention to details and instruction following or conversations can be noticed. Individuals with this presentation may even avoid tasks that involve mental effort. An example may be children not wanting to do homework or adults not wanting to fill out papers or other responsibilities. This individual may struggle with time management and losing items frequently.  

 Predominantly Hyperactive-Impulsive Presentation:   

Someone who finds it hard to sit still for long periods of time. For example, this person may not be able to sit in a classroom or at work without feeling agitated or wanting to fidget and get up. In children, this may appear by the child constantly jumping or climbing. In adults, this may look like the inability to wait in a grocery store line without extreme feelings of irritability. Impulsivity is noticed and frequent interruptions of others during inappropriate times. They may talk a lot and have trouble participating in activities that involve being quiet. Often due to impulsiveness this person may be prone to accidents and injuries, this type may act impulsively without thinking of consequences.  

Combined presentation:  

Both symptoms of the two above categories are equally present.  

What causes ADHD? 

Currently, there are no known causes of ADHD, although there is some research that provides to risk factors, 

which may include: 

Genetics: blood relatives who have ADHD 

Environmental Toxins (environmental lead) 

Maternal drug, alcohol, or smoking during pregnancy  

premature birth 

A popular assumption is that sugar can be attributed to the cause of ADHD although there is no evidence of this being proven.  

How is ADHD diagnosed?  

Professionals use Guidelines from the American Psychiatric Association Diagnostic and Statistical Manual, Fifth Edition (DSM-5) to help diagnose ADHD. The DSM-5 provides a standard that is used in comparison to the individual to identify a correct diagnosis and treatment plan. Due to ADHD having effects on executive functioning cognitive tests may also be done to determine any deficits. Treatments Treatments

Treatment:  

Therapy

Cognitive Behavioral Therapy (CBT) is one way that can help manage ADHD symptoms. CBT is a common type of talk therapy that aids in controlling thoughts and behaviors and presenting healthier thinking patterns. Studies have shown that CBT can help reduce hyperactivity, inattention, and impulsivity and improve daily functioning. Therapy for an individual with ADHD will involve creating a treatment plan that will implement strategies and techniques to help decrease struggle in daily tasks of concern.  

Medication

Stimulants are the most common medication prescribed for people with ADHD. These may include Ritalin, Adderall, and Dexedrine. Stimulants work by increasing a neurotransmitter in the brain (dopamine) responsible for motivation, pleasure, attention, and movement. These types of medications help people with ADHD with concentration levels while decreasing hyperactive and impulse.

OCD ARTICLE

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Author: Keeley Joyce

WHAT IS OCD?

Obsessive-Compulsive Disorder (OCD) is a disorder in which a person experience’s intrusive and uncontrollable thoughts referred to as obsessions and/or an urge to partake in a repetitive behaviour referred to as compulsions. People without OCD often have distressing thoughts or engage in repetitive behaviours, although for people with OCD these thoughts and behaviours disrupt daily functioning. OCD can center around certain themes, for example, an individual’s fear of being contaminated by germs (i.e., an obsession), and to decrease the stress and fear of this idea, they constantly participate in behaviours that they believe will prevent the fear, such as washing their hands excessively (i.e., a compulsion). OCD usually begins in teenage or young adult years and can change in severity throughout life, although it can start in childhood. The type of obsessions and/or compulsions one experiences can change over time. OCD Symptoms tend to get worse when an individual is experiencing large amounts of stress. 

SYMPTOMS

OCD usually contains both obsessions and compulsions simultaneously, although some individuals may only experience one of them. 

Obsession Symptoms: 

Obsessions are unwanted thoughts and fears that are loud persistent and repetitive. These thoughts are intrusive or disturbing images that evoke stress and anxiety. 

 Examples for Obsession symptoms: 

  • Fear of contamination: touching objects others have touched 
  • Doubting and trouble accepting uncertainty: questioning if the door has been locked or stove turned off
  • Extreme concern with order, symmetry, or precision: severe stress when objects are not in order or in a particular format 
  • Disturbing thoughts or images about hurting oneself or others 

Compulsion symptoms

Compulsions are behaviours an individual may feel necessary to perform to combat the obsessions. These compulsions are done in an effort to ease anxiety surrounding obsessive thoughts. 

Symptoms may include: 

  • excessive hand washing
  • cleaning household items 
  • arranging or rearranging objects in a specific order 
  • constantly checking locks or appliances 
  • silently repeating numbers, phrases, or words

People with OCD often have extensive rituals for them to cope with obsessions and attempt to move on thinking about something else. For example, someone with OCD may not be able to sleep or have trouble relaxing because they cannot stop wondering if the door is locked even though they have already checked it, so they have a routine to check the door 5 times every night to ensure that it is locked.

Related conditions  

Some other conditions closely related to OCD include Body Dysmorphia Disorder (BDD) and Trichotillomania (hair-pulling disorder). BBD often can be misdiagnosed as OCD. Similar to OCD, people with BDD experience recurring obsessions that are distressing and uncontrollable. These obsessions are about perceived flaws in their appearance.  BDD also involves behaviours that resemble compulsions such as constantly looking in the mirror to monitor their self-image. Although similar, the difference between OCD and BDD is that symptoms of BDD are specific to one’s body image or appearance rather than the common themes noticed in OCD (contamination, symmetry, violence, etc.) 

People with OCD may also have other disorders such as Hair pulling disorder (trichotillomania). A disorder that involves recurrent urges to pull out hair from the scalp, eyebrows, or other areas. Individuals may use hair pulling to cope with negative or uncomfortable feelings. Hair pulling can give individuals a sense of relief and satisfaction when dealing with intrusive or disabling thoughts. 

how is OCD diagnosed?

Sometimes the diagnosis of OCD can be challenging because symptoms that are experienced often are noticed in other disorders such as anxiety disorder, depression, or other mental health disorders. The process of diagnosis starts off with a psychological evaluation which includes determining the individual’s thoughts, feelings, and behaviours to identify if the symptoms have interference with daily functioning. Criteria in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5) published by the American Psychiatric Association may also be used for diagnosis. In addition, a physical exam can also be done to rule out any other problems or other complications that could be causing OCD like symptoms (i.e., neurological problems, traumatic brain injuries). 

Treatment 

Therapy

Exposure and Response Prevention (ERP), a type of Cognitive behavioral therapy (CBT) is an effective treatment method for OCD.  During a typical session, the individual will be exposed to the feared thoughts or images that they obsess over and are guided to not partake in their usual compulsions that decrease their anxiety. By experiencing what they fear without the result of anything bad happing, the individual gradually learns that the intrusive thoughts will not result in the fear happening in the absence of compulsions. 

Medication

Depending on the severity, medications can be prescribed to help with obsessions and compulsions.

Research shows the most effective medication for higher severity OCD are Serotonin reuptake inhibitors (SRI), which also can be prescribed as an anti-depressant. 

  • Fluvoxamine
  • Sertraline
  • Paroxetine
  • Clomipramine