Behavioral and fMRI studies of cognition: A Chance to Participate in OCD Research before January 10, 2014

I posted information about this previously.  Mt. Sinai is closing their study by January 10, 2014, and still needs 2-3 more patients before then.

Behavioral and fMRI studies of cognition in healthy individuals and patients with anxiety

Study Description The current study is a neuroimaging study involving fMRI.  Specifically, we seek to examine the neural mechanisms underlying switching attention between internal thought, such as imagination,  and external stimuli.   

For OCD patients, participation consists of 2-3 sessions totaling 5-7 hours, and participants are reimbursed at $25 an hour.  The first session involves a clinical assessment and paperwork to confirm the patient's eligibility (~3 hours total), and the second session involves completing computer tasks while in the scanner (~2.5 hours total).  Payment is given to participants in cash upon completion of their participation.

Link http://icahn.mssm.edu/research/clinical-trials/11-1344

Doctors Can be Anxious Too

Doctors can be anxious too.  I have assumed that I am always the anxious one, and most other people are calm.  A month ago I went to see my family doctor about some body pain, and she gave me some medicine and told me to call her the next week to check in.  When I did, and I wasn't 100% better, she said to make a specialist appointment just in case it still wasn't gone the next week.  When I checked in again, and told her that my specialist appointment was October 21, she freaked out and said that was completely unacceptable, and I needed to be seen in the next 2 weeks.  This in turn ratcheted up my anxiety!  She also ordered a test for an ailment that would manifest pain in a different location, "just in case I had an atypical presentation."

My husband said, "Your doctor is anxious.  I don't know if that is good for you."  What we decided to do was have him do a search for treatment guidelines, rather than have me search, which is my primary compulsion with health anxiety.  I felt blessed to have someone who would help me get more information, but who would stop long before I would ever feel "done" if I was searching myself.

I got an earlier appointment with the specialist, who said the medicine hadn't had enough time to work, and that we could set aside the test for the unlikely ailment.  She did schedule a different test for October, but it was one my husband had found as the next step in the diagnosis process.

It's been a long week, with a dental appointment and a gynecology annual exam.  Preventive healthcare is important, but my OCD gets all stirred up.  Not to mention that I still don't feel good.  The challenge is to keep doing things important to me, even if I don't feel 100% or know what's wrong with 100% certainty.  Maybe my family doctor is right, and I have something unusual going on.  Maybe it's just that I live in a malpractice prone part of the country.  Maybe she lost someone to a disease and she never wants to lose someone again.

OC87: A Movie About Courage and Living Your Life in the Midst of OCD

My husband was away, and I was feeling anxious.  I've come a long way since the time I walked 7 miles around a lake in order to ward off the anxiety of being alone for a week, but I'd been having physical aches and pains in the weeks leading up to his leaving, and my OCD was stirring.

Feeling achy and anxious, I started searching for movies on Netflix.  This was my way of avoiding searching for the meaning of my symptoms, but still, compulsive and exhausting.  Working my way through the alphabet and the numbers, using the arrow keys to navigate to one letter at a time.

Then OC87: The Obessive Compulsive Major Depression Bipolar Aspberger's Movie came up.  I remembered hearing about it when it came out a couple years ago, but I hadn't seen it.  It was already midnight, but I started watching.

Bud Clayman majored in film in college, but thoughts that scared him, and depression infiltrated his life.   OC87 refers to 1987 when he built his life around attempting to control the world around him, and the thoughts within him.

I was moved by Bud Clayman's persistence in making this film about his life now, after 30 years of OCD, depression and Asperger's, which involved dealing with people, dealing with his intrusive thoughts, indecision, anger and grief.  I particularly liked the scene he wrote where he played both "Good Buddy" and "Bad Buddy" in a riff on a scene from Lost in Space.  Part of this is in the trailer for the movie, the Bad Buddy telling the Good Buddy that he isn't capable of living without him, but Bud Clayman is capable of living his dream, even with the spectre of OC87, in the midst of the imperfections.

What this film reminded me was that to spend the week trying to figure out if my symptoms were a physical problem, or whether it was OCD, and freezing myself into a block of worry was a manifestation of my illness, and not what I want in my life.  

In one scene, Bud asks a woman what films she likes, and she asks him the same question, and his answer is that Ordinary People is the best movie ever made.  He describes how OC87 evolved out of a desire to describe how therapy had helped him, how it was a safe place, and how Ordinary People resonated with him, in its depiction of therapy.

Ordinary People is one of my favorite films, and I hadn't expected it to come up in Bud Clayman's film. I saw it when I was 12 or 13, several times, mesmerized.  Netflix had it, and I watched it next.  I'll write more about that.

Have you seen OC87?

Google Doesn't Have the Answer for Every OCD Fear

This photo is called Uncertainty by Rieke Photography.  From the time I had access, over 20 years ago, I was searching on the internet for answers to my uncertainty.  I know the feeling of the keys under my fingers, the gentle give of each key when I depress it, the hope that I will get THE answer for my fears.

For a long time, I was glad I had dial-up because at least I was thwarted in compulsive web searching at home, even though I still had it at work.  The fact that I have high-speed internet at home now, and do not spend all my time searching, is quite amazing to me.  

In the thick of my OCD, before I got any treatment, I couldn't imagine stopping my searches.  If I had a health symptom, I searched for answers.  If I was trying to figure out an unanswerable question, I searched for answers.  I remember when Google first appeared.  I was a librarian, and word spread fast that there was this new search engine with a magical algorithm that worked exceedingly well.

But even Google couldn't solve my OCD, because the reassurance I was seeking was a mythical oasis that vanished as soon as I got close.  I will grant though that it was through Google that I found the International OCD Foundation.  I joined, and started receiving their newsletter.  The irony is that I subscribed to the newsletter for 5 years, all the while compulsively searching about OCD, instead of seeking treatment.

Eventually, when I reached my lowest point in 2006, I finally put it together that Exposure Therapy might work for my mental obsessions and health anxiety, and found an Exposure Therapist.

Part of my Exposure Therapy involved stopping a search before I felt "done" and staying with the wave of anxiety until it ebbed.  There are still days when I am feeling stressed, and search Google as a way to dull the anxiety, but it is not my default position, hands poised on the keyboard.

OCD is in the Realm of Human Experience: The Painfulness of Uncertainty

Recently, a dear friend of mine had a call-back at her annual mammogram screening.  We were having lunch and she told me how anxious she was.  The appointment was the next day, and her mind was spiraling into "what ifs."  She hadn't been sleeping.

I shared my experience with OCD, and some of what my exposure therapist had taught me, about the painfulness of uncertainty for humans, about how the present moment is the only functional moment, and that if something was wrong, she would deal with it when it happened.

I told her the story a friend had told me about a woman who had breast cancer, and then during a big storm a tree had fallen on her and killed her.

Then I felt bad for telling that story.  It's not very reassuring.  But it does get at the conundrum of being human, the inability to tell the future, the uncertainty even within the narrative of having breast cancer, where something else entirely can take you out.  And my friend understood this.  She knew I didn't want anything to happen to her, but that I did want her to be able to live her life.

I had a call-back after a mammogram several years ago, and the anxiety sucked.  The more I was able to bring myself back to the moment, the more I was able to cope.  Uncertainty is painful for humans, and the desire to race ahead and resolve things is strong.

There are times when what I am obsessing about coincides with fears of people around me, and they will reassure me that I "should" be worried, that it only makes sense.  But worry isn't protective, and can erode the very life we love and are afraid of losing.

My friend was fortunate to be at a mammogram center where the radiologist reads it while you wait, and it was fine.  This is compassionate care, mitigating what uncertainty can be mitigated.

OCD Treatment Study: For those Taking Medication but Still Having Symptoms in Philadelphia and New York

This is a study for people who are taking medication for Obsessive Compsulvise Disorder (OCD) but still have trouble with OCD symptoms. The study provides a type of Cognitive Behavioral Therapy for OCD to see whether this therapy can help people become well and then stop taking their medication.

Medication and OCD

The most commonly used treatment for obsessive compulsive disorder (OCD) is a group of medications called serotonin reuptake inhibitors (SRIs). Despite research showing that these medications help many OCD patients, a substantial number who take such medications remain symptomatic. In fact, on average patients taking SRIs experience only a 30% reduction in their OCD symptoms and most have side effects that impact their quality of life.

Another Treatment Option

Another treatment for OCD is a type of cognitive-behavioral therapy called Exposure and Response Prevention (EX/RP). EX/RP has been found effective as a stand-alone treatment for OCD and it can also further reduce OCD symptoms in patients who take medication and continue to experience OCD related distress. Not only is EX/RP effective in reducing symptoms, many patients are able to maintain their gains after therapy has stopped.

Our OCD Treatment Study

The goal of this study is to identify who benefits from adding Exposure and Response Prevention to SRI medication and to find out whether they can discontinue their SRI. Participants in the study will receive up to 25 twice-weekly sessions of EX/RP. Participants who experience a significant reduction of OCD symptoms from EX/RP will be randomly selected to either: 1) gradually discontinue their medication and begin taking a placebo (sugar) pill instead or, 2) to continue taking their medication. Participants will not know if they are taking placebo or medication. All participants will be monitored by the study psychiatrist for an additional 6 months and will receive monthly therapy sessions to help them maintain the gains made from EX/RP.

This study is being conducted in Philadelphia at the University of Pennsylvania and inNew York at Columbia University. To participate in this research, you must be able and willing to travel to either Philadelphia or New York for all study visits.

Click here to find out more about eligibility for our OCD treatment study.

Warning:People with OCD should never try to stop taking their medication without supervision by their prescribing doctor.

Center for the Treatment
and Study of Anxiety
University of Pennsylvania
3535 Market St, 6th Floor
Philadelphia, PA 19104
215-746-3327

EDITED 12/18/14
The contact info for the New York Site has changed:  (646) 774-8062 and the new email is mschwar@nyspi.columbia.edu

Participants Wanted for Mt. Sinai Hospital on Learning How Cognition Works in OCD

Behavioral and fMRI studies of cognition in healthy individuals and patients with anxiety

ID Number 11-1344

Principal Investigator(s) 
Emily Stern 

Department(s) or Division(s) 
Psychiatry 

Description 

The current research study is designed to learn more about how cognition works in individuals with anxiety disorders, specifically Obsessive-Compulsive Disorder (OCD).  This study uses neuroimaging techniques (fMRI) to examine the neural mechanisms underlying switching attention in individuals with a diagnosis of OCD.  

Potential participants may qualify to take part in this research study if they are between the ages of 18 and 50 without a history of serious problems with their health (such as a heart attack), emotions (such as depression) or nervous system (such as seizures), have received a diagnosis of Obsessive-Compulsive Disorder, and are interested in participating in psychological research.

Contact Information 
Alexandra Muratore
(212) 824-8995
sinaibrainlab@mssm.edu 

Recruiting Patients: Yes 

Link http://icahn.mssm.edu/research/clinical-trials/11-1344

Dealing with OCD Health Anxiety and Preventive Screenings

I had a week in January with my annual screening mammogram, followed by my diagnostic colonoscopy for chronic anemia. I am proud of myself for getting through it all in spite of anxiety.

The mammogram center had moved to a new office and actually had a radiologist there to read the results while I waited, and the results were normal. My mind did its usual "what ifs" but I did feel a flash of relief.

The colonoscopy prep was not how I would like to spend a day, but it also wasn't awful, and it is encouraging that I can deal with something uncomfortable. There was a small benign polyp but not the cause of my anemia. I am in that borderland of being old enough that the gastroenterologist wanted to "make sure" even as he reassured me that nothing was probably wrong at the initial consult in November.

Medical screening and testing stirs up my health anxiety, and I am learning to accept that, and keep going. I did not do any web research. I did see my therapist when my anxiety was high in September, as I wrote about in a previous post. I am learning to expect the surge in anxiety and not launch int ruminating about why it is back, why the OCD anxiety shows up. This defuses my panic, and my "oh no!" response.