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National Institute of Mental Health Acknowledges Dr. Romo-Nava with Highly Coveted Award

Dr. Francisco Romo-Nava, MD, PhD

Mason, OH –The National Institute of Mental Health (NIMH) awarded a K23 Career Development Award titled “The role of the circadian system in binge eating disorder” to Dr. Francisco Romo-Nava, MD, PhD, Associate Chief Research Officer at The Research Institute at Lindner Center of HOPE. This is a highly competitive award for clinician-scientists that will enable the development of the “Neuroscience of the Body Research Program” to study the role of brain-body communication in psychiatric disorders.

This K-23 award involves a study with a novel approach to investigate the circadian system function and its’ potential as a therapeutic target in binge eating disorder. During this award, Dr. Romo-Nava will receive mentoring by world renowned researchers. Dr. Susan L. McElroy, Chief Research Officer at The Research Institute at Lindner Center of HOPE, will mentor Dr. Romo-Nava during the award period. Dr. Romo-Nava will also receive mentoring by Dr. Carlos Grilo at Yale University, Dr. Frank Scheer at Harvard University, Dr. Robert McNamara and Dr. Jeffrey Welge at the University of Cincinnati. Dr. Romo-Nava will also collaborate with Dr. Helen Burgess at the University of Michigan.

This award involves an estimated budget of $810,000 during the next four years.

Lindner Center of HOPE in Mason is a comprehensive mental health center providing excellent, patient-centered, scientifically-advanced care for individuals suffering with mental illness. A state-of-the-science, mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization and partial hospitalization for individuals age 12-years-old and older, outpatient services for all ages, diagnostic services for all ages and short-term residential services for adults, outpatient services for substance abuse through HOPE Center North location and co-occurring disorders for adults and research. The Center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The Center is also affiliated with the University of Cincinnati (UC) College of Medicine.

 

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Fortunately, our culture has recently seen a gradual erosion of the stigma regarding emotional disorders, along with an increased understanding of such conditions. However, a less well-understood aspect of emotional disorders is the impact that they have on the cognitive functioning of those who are afflicted. Disorders such as Major Depression, Bipolar Disorder, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, and Schizophrenia all tend to interfere with one’s ability to access the full extent of their cognitive abilities, adding to the burden that these conditions create.

Regarding Major Depression, it is the one disorder that the DSM-V lists cognitive difficulties as one of the diagnostic criteria (diminished ability to think or concentrate, or indecisiveness, nearly every day). As a neuropsychologist, I routinely encounter patients who are all too aware that their depression impacts their ability to think clearly, to focus, and to recall everyday interactions. Part of the reason for this is that depression causes a reduction in processing speed, as well as the energy that it takes to attend to conversations and events. Difficulties with maintaining attention, and “keeping up” with things going on around them, these patients experience troubles recalling information, sometimes so profoundly that they begin to fear that they may have dementia. However, as their depression is more effectively treated, they regain full access to their cognitive skills and abilities.

Anxiety disorders also are accompanied by significant cognitive difficulties, for a couple of reasons. First, when the mind is anxious, most of the brain’s resources (blood flow, oxygen, glucose, etc.) are redirected to the emotional centers of the brain (the limbic system), and away from parts of our brain that mediate higher-level thinking and logic. Secondly, those who are anxious tend to be rather “internally-oriented” in their thinking, and so they are not as attentive to external events. In other words, because they become preoccupied with their fears and worries, the ordinary events of the external world can be largely overlooked. As a result, these ordinary events are not well-encoded into the memories of anxious patients, and therefore they cannot easily be recalled. As with depression, as anxiety becomes better managed, these cognitive issues largely resolve.

Two other diagnoses have profound implications for cognitive functioning. Bipolar disorder has a well-established pattern of cognitive difficulties, including diminished attention, verbal memory, and executive functioning abilities (planning, anticipating, problem-solving, emotional regulation, staying focused and attentive to personal goals, etc.) These difficulties, fortunately, are typically limited to times that these patients are actively experiencing a mood episode, whether it be depression or mania. Regarding those with schizophrenia, they experience similar cognitive difficulties. However, they often continue to experience such cognitive difficulties even when their symptoms of schizophrenia have been well-controlled with treatment. This is why the DSM-V lists “associated features” of schizophrenia specific to these difficulties, explaining that, “Cognitive deficits in schizophrenia are common and are strongly linked to vocational and functional impairments.”

Fortunately, over the past 20 years there have been treatments and interventions to address such cognitive difficulties. Cognitive Enhancement Therapy, or CET, has been developed and implemented for the mentally ill for whom cognitive problems are getting in the way of living independently, maintaining employment, and sustaining meaningful relationships. It has proven to be an effective means to address such difficulties, and for providing a much higher quality of life. It is anticipated that, as the benefits of CET become more evident to those working with the mentally ill, its positive impact will widen in both its breadth and depth.

Thomas A. Schweinberg, PsyD Staff Psychologist Lindner Center of HOPE

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Lindner Center of HOPE’s Comprehensive Diagnostic Assessment for Children and Adolescents Now Available Virtually

Now, perhaps more than ever, families may be concerned about the mental wellbeing of their child or adolescent. In many cases, observing children in their home environments having to manage school stress, face isolation from friends and extended family, being restricted from doing their normal activities; parents/guardians may be increasingly concerned about behaviors, mental health and functioning.

Lindner Center of HOPE offers an affordable and accessible 3.5 day intensive outpatient diagnostic program for young people age 6 to 17 (18 if still in high school), to help families reach a clear and accurate diagnosis that will provide direction for treatment. Due to ongoing COVID-19 safety recommendations, this program is available as a virtual offering for families located or staying in Ohio. (Program providers are licensed in Ohio and can serve families living or staying in Ohio during the assessment. Families residing outside of Ohio can come to the state and still participate in the virtual program.)

The virtual program incorporates everything from the previously operating, face to face program, including a full battery of neurocognitive and psychological testing, psychiatric assessment, family assessment, as well as specialty consults (ie obsessive compulsive disorder, anxiety, eating disorder, addiction, trauma or behavioral addictions). The assessment also includes genetic testing to assist in medication recommendations and lab work, completed prior to starting assessment. The entire assessment is done through video and online applications.

What’s included in the assessment?
• Comprehensive psychiatric assessment performed by skilled multidisciplinary team
• Pre-admission screening and evaluation of records
• Care coordination, psychosocial assessment and collateral interviews
• Psychiatric consultation
• Psychological evaluation and testing
• Specialty diagnostic and therapeutic consultations, as clinically indicated
• Strengths-based family assessment
• Genetic testing with results review
• Feedback session with diagnostic team
• Written report of results and recommendations
• Aftercare planning
• Follow up call with clinical social worker 6 weeks after feedback session

SCHEDULING
Our admissions team will work with the family and any existing referral sources to understand the issues and expectations to determine if the outpatient comprehensive diagnostic assessment will meet the needs.

Assessments typically begin on Mondays or Tuesdays and continue during business hours through the work week. Assessments must be planned and scheduled through admissions and the clinical social worker. Existing records should be provided in advance of arrival to prepare the team with history, goals and personalization of the assessment.

Call Admissions today to discuss scheduling an outpatient comprehensive diagnostic assessment for your child or adolescent. 513-536-0537.

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Novel Coronavirus Is Increasing Need for Mental Health Care and Substance Use Treatment

Mason, OH –Lindner Center of HOPE is expanding its mental health services patient assistance fund established in February 2020 to help first responders with costs associated with the treatment of mental illness and substance use to include Tri-State area health care workers. The increased stress and uncertainty caused by the pandemic is exacerbating symptoms of mental illness and substance use disorders. The community’s health care workers are experiencing an unprecedented set of challenges as they face COVID-19, so their mental wellness and stability is even more critical.

With the amendment to the policy for the use of the fund, health care workers would be considered “First Responders” and may be eligible to receive financial assistance for mental health services at Lindner Center of HOPE.

Lindner Center of HOPE’s eleventh annual Touchdown for HOPE Super Bowl Sunday event at the Great American Ballpark Champions Club raised $195,000 for this patient assistance fund in February 2020.

Health care workers and first responders can contact Lindner Center of HOPE for outpatient services, (including partial hospitalization programs, intensive outpatient programs, Neuromodulation services, medication assisted treatment and outpatient appointments) and residential treatment services and share their health care role. Costs outside of insurance coverage would be eligible for funds up to $5000 per six month period, as long as funds remain available. Lindnercenterofhope.org offers information regarding contacting the center for the listed services.

While funds are available, patient’s health care claims will be filed by Lindner Center of HOPE, accepting no patient co-pays. All fees may be considered for use of the funds.

Lindner Center of HOPE in Mason is a comprehensive mental health center providing excellent, patient-centered, scientifically-advanced care for individuals suffering with mental illness. A state-of-the-science, mental health center and charter member of the National Network of Depression Centers, the Center provides psychiatric hospitalization and partial hospitalization for individuals age 12-years-old and older, outpatient services for all ages, diagnostic services for all ages and short-term residential services for adults, outpatient services for substance abuse through HOPE Center North location and co-occurring disorders for adults and research. The Center is enhanced by its partnership with UC Health as its clinicians are ranked among the best providers locally, nationally and internationally. Together Lindner Center of HOPE and UC Health offer a true system of mental health care in the Greater Cincinnati area and across the country. The Center is also affiliated with the University of Cincinnati (UC) College of Medicine.

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In the United States, suicide is the 10th leading cause of death.  The rate increased 33% from 1999 through 2017 according to the Centers for Disease Control and Prevention.  The American Foundation for Suicide Prevention states that “suicide most often occurs when stressors and health issues converge to create an experience of hopelessness and despair.” For some, the COVID-19 pandemic could create this experience. The pandemic has produced a condition that has increased many of the risk factors for suicide: feelings of depression and anxiety, increased alcohol and substance use, serious physical health conditions, unemployment, financial crisis, illness or death of a loved one, isolation, and decreased access to care.

Social distancing and isolating at home have limited access to coping skills and reduced suicide protective factors. People no longer have in person contact with behavioral health providers, there is decreased connectedness to support systems, and no access to gyms, art studios, massage therapy, beauty salons, barbers, etc.  With fewer physical and creative outlets, healing therapies, and self-care that improves self-esteem, people can feel lost. They also no longer have physical access to places of worship where the social connection was as important as the message or music.  It important to remember that we need to maintain physical distancing rather than social distancing – it is necessary to maintain physical separation to not contract the virus but other ways of maintaining social connections are still very important.

Another risk factor that staying at home can bring is closer proximity to abusers. Children of abusive parents who are no longer in school are now with their abusers all day and adults with abusive partners are also with their abusers more often. Adverse childhood experiences are associated with 2 to 3 times more suicide attempts later in life and victims of intimate partner violence are twice as likely to attempt suicide.

Staying at home also increases access to lethal means so it is imperative to either remove guns from the home or ensure they are locked securely and reduce access to other lethal means (such as large amounts of extra medications, excess amounts of alcohol, ropes/cords) in the home for people who are high risk for suicide.  For homes with large amounts of prescription medications due to multiple health conditions, a medication safe is recommended.

For people with loved ones who have risk factors for suicide, it is important to know the warning signs. Warning signs include talk of: killing themselves, feeling hopeless, having no reason to live, being a burden, feeling trapped, and unbearable pain; behavior: increase use of alcohol and drugs, looking for a way to end their lives (including internet searches), withdrawing from activities, isolation from family and friends, too much or too little sleep, saying goodbye to people, giving away possessions, aggression, and fatigue; and mood: depression, anxiety, loss of interest, irritability, humiliation/shame, agitation/anger, and relief/sudden improvement.  If you notice these warning signs, it is important to ask a person directly if they are having thoughts of suicide and if they are, get them help by contacting their mental health providers, calling a crisis line, taking them to an emergency department, or calling 911. Visit take5tosavelives.org or bethe1to.com to learn how to talk to your loved ones about suicide. Due to COVID-19, people have tried to avoid emergency departments and hospitals but if someone you love is unsafe do not hesitate to get them the help they need.

What are ways to increase coping skills and protective factors in our current climate? Take advantage of telephone or video appointments offered by your mental health providers. If you do not already have mental health providers, now is a good time to seek treatment – practices are still accepting new patients and insurances are covering telephone and video appointments. To reduce worry and fear, limit media consumption about COVID-19. Stick to a routine, stay physically active, get outside with appropriate physical distancing, get enough sleep, limit alcohol, and eat healthy. If you feel you have a problem with alcohol, substances, overeating, or other addictive behaviors – there are online support groups. Connect with loved ones by phone, social media apps, video apps, or writing. Consider safe altruistic ways to connect with others – making masks, running errands for vulnerable loved ones, donations, etc.

How can you get help?  Crisis Text Line: text HOME to 741741, they can also be messaged on Facebook messenger.

National Suicide Prevention Lifeline 1-800-273-8255

YouthLine answered by trained teen peer support from 4 pm – 10 pm and by adults from NSPL during other hours 877-968-8491 or text teen2teen to 839863

Childhelp National Child Abuse Hotline text or call 1-800-422-4453

National Domestic Violence Hotline 1-800-799-7233 or text LOVEIS to 22522

Mental Health America Support Group Directory www.mhanational.org/find-support-groups

Lindner Center of HOPE 513-536-HOPE

 

Danielle J. Johnson, MD, FAPA Lindner Center of HOPE, Chief Medical Officer

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Times are uncertain. The world feels scary. Our normal day to day life has been turned upside down. Let me just start by saying this, if you are feeling anxious, scared, overwhelmed, frustrated… you are allowed to feel these emotions, it makes total sense why you feel this way, you are not alone, and you are not weak. Remember, pain in life is unavoidable, but suffering is a choice. Meaning, we are going to experience stress in our life, every person on this planet will, but it is ultimately how we respond to that stress that influences exactly how much pain we will experience. Let’s walk through some ways we can live with anxiety during times of stress.

Mindfulness of Emotions. When it comes to managing our anxiety during times of stress, an important first step that we tend to overlook is mindfulness. In order to reduce anxiety, we must first acknowledge that it is there. Allow yourself to pause and put a name on what you are feeling, notice if you feel it physically in your body, observe what thoughts are running through your mind. Try using the stem “I am aware of the emotion of ______, I am aware of the thought that _______.”  By bringing mindful awareness to our anxiety in this way, we are bravely choosing to face our discomfort while also seeing it as something that we are experiencing in that given moment, not who we are or the way things will always be.

Self-Compassion. Now that you are observing your anxious mind in action, practice some self-compassion by normalizing the experience, validating its’ presence, being “kind to your mind.” We tend to create more suffering for ourselves when we judge ourselves for our emotions, when we tell ourselves we should not be feeling that way, or try to just “suck it up.” You are an amazing human doing the best you can with some really hard human things right now!

Changing Emotional Response. While part of our goal is accepting the anxiety through mindfulness and self-compassion, we also have the ability to create change in our emotional state and our response to it. First, we need to “check the facts” and get a good look at what our mind is telling us. Our minds tend to be great storytellers, mind readers, and fortune tellers. While these seem like super powers, these are actually mind tricks and traps that create more suffering. Checking the facts is seeing if your emotion and its’ intensity actually match reality (i.e., are valid), or if you are responding to a mind trick.

Next, ask yourself if the action urge associated with the emotion you are feeling is effective? For example, is being angry with your partner because they did not clean the house then throwing a shoe at them actually helpful here??  If the emotion is invalid and/or ineffective, we want to act opposite to what the emotion is telling us to do. So instead of avoiding work responsibilities because we are stressed, make a specific schedule to complete tasks. Instead of spending hours reading the news because we are scared, watch one news program then spend the rest of the day playing with the kids or watching movies.

Acceptance. Consider what is and what is not in your control. If there is a stressor that is in your control, practice problem solving. For stressors we cannot control, accept that we cannot change that reality and focus instead on what in the here and now is in your power. Remember, rejecting reality does not change reality. Instead of dwelling on how terrible it is to be stuck at home, make plans for a game night, clean out that room you have been avoiding, soak up the springtime outdoors.

Practice Gratitude. Lastly, practice gratitude every day. Spend some time thinking about what you have that you are grateful for rather than hyper-focusing on what you don’t have or what has been taken away, which tends to just create more stress. Be specific, instead of just saying you are grateful for your family, say “I am grateful that today my kids helped clean the kitchen and cuddled with me on the couch.”

We as humans are under an incredible amount of stress right now, but remember, as humans we are also incredibly strong and resilient.  Importantly, please know you do not have to struggle with this alone. Sometimes the strongest thing we can do is ask for help. If your anxiety is persistent and intense and/or is significantly interfering with your life, please reach out to a mental health therapist. Telehealth services are being offered across the region, including at the Lindner Center of HOPE, who has a whole team of providers eager to help guide you through this.

By Allison Mecca, PsyD
Lindner Center of HOPE, Staff Psychologist, Harold C. Schott Foundation Eating Disorders Program

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Quarantine.Isolation . Lockdown.

Who could have ever predicted that these words – so often associated with scary movies or rare, brief safety emergencies – would become so commonplace in our social language? The terms, themselves, being so casually thrown around that we’ve nearly become numb to their actual magnitude? The concept of loneliness is a broad one: certainly, this can describe distance or literal, geographical separation from others; however, it is also quite possible to experience loneliness while physically surrounded by people. This often arises in response to feeling misunderstood or “different” from those around us, or through a belief that we are truly alone in our struggles and suffering.

 

When in this state of mind, it’s easy to inadvertently fall into self-destructive patterns and habits that further worsen the depth of isolation we experience. This tends to be easier to “catch” in the “normal” world – someone is missing days at work or school, not showing up to family events, skipping appointments. However, in the midst of the COVID19 pandemic, this has become more difficult to identify, both in ourselves and in family members or friends. In this strange new reality, maladaptive coping might present through symptoms of depression:

– Withdrawing from others by declining phone calls or choosing not to respond to text messages
– Staying in bed during times when you’re not sleeping or physically in need of rest
– Deferring school assignments or work deadlines in favor of binging on Netflix series for extended periods of time
– Not leaving the house for fresh air when weather permits
– Declining hygiene practices and decreased attention to nutritional needs and physical activity
– Self-medicating through alcohol or drug use

In contrast, some individuals experience severe levels of anxiety when facing loneliness or isolation. Those with pre-existing obsessive-compulsive disorder, anxiety or impulse-control disorders, eating disorders, or traits of perfectionism may attempt to cope with isolation by trying to gain a sense of control over specific aspects of their lives. This could present as:

– Excessive cleaning, organizing, list-making in the home without clear need to do so
– Catastrophic thought processes with over-indulgence in news reports and social media
– Difficulty sleeping or resting due to racing thoughts
– Flare-ups of previous OCD rituals or disordered eating patterns
– Difficulty concentrating on school assignments or work due to preoccupation with above concerns

One of my favorite, go-to methods for combating these negative impulses is an emotion regulation technique called “opposite action,” a concept originating from the skill sets taught in dialectical behavioral therapy (DBT). This technique forces us to identify our emotion and the urges or impulses that go along with it, and to assess their degree of helpfulness or harmfulness by challenging them with facts. If found to be irrational or maladaptive, then we aim to implement the opposite of our emotion-driven impulse. We actually implement opposite action frequently through our lives without necessarily naming it as such. By identifying the technique, though, we
can consciously choose to use this skill when our level of motivation to change is low. Consider this example
(modified content courtesy of PsychPoint.com):

STEP ONE: Identify the emotion you’re looking to change. You’re really anxious about leaving home to go
on vacation.
STEP TWO: Identify the urges/impulses associated with the emotion. You actively avoid booking the
vacation by burying yourself in work and household tasks to subconsciously convince yourself that you simply
do not have the time to take a vacation.
STEP THREE: Assess whether the urge or behavior fits the facts of the situation. You have plenty of unused
vacation time and recognize that your year-end productivity will not be negatively impacted by taking the break.
You’ve taken vacations before and your family has benefited from the escape each time.
STEP FOUR: If the emotion and behavior does not fit the situation, then apply the opposite action.
Create a manageable schedule / timetable to take the steps necessary to search for and secure the logistics
required for booking the trip.
STEP FIVE: Experience the opposite emotion. Experience the excitement involved with planning activities
and excursions or buying a new outfit for the occasion. Go on the trip and enjoy the time with your family while
allowing others at work to keep things running smoothly until you return.

Used consistently, opposite action can help us to change our emotional response to stressors over time. It’s
important, though, to commit to the technique so that you can experience the full benefits of taking control of
your mood and behaviors rather than allowing them to be in control of you.

For a quick video explanation of opposite action, view the following:

If you’re experiencing the above symptoms associated with loneliness and have tried methods for self-help
without benefit, or if you’ve been previously diagnosed with a psychiatric illness or substance use disorder
that has begun to flare up in the midst of these extraordinary times, please know that psychiatric treatment
providers are still open, available, and ready to help you through this – at all levels of care.

Clinicians at the Lindner Center of HOPE are seeing patients every day through Telehealth, with options for
telephone or video sessions for both therapy and medication management. Additionally, our services are open
for emergency intake assessments and inpatient hospitalization, partial hospitalization, intensive outpatient,
residential, and treatment for substance use disorders.

If you or a loved one could benefit from professional help, call the Lindner Center of HOPE at 513-536-
4673 to start the conversation and take the next steps toward healing.

Jen Milau, APRN, PMHNP-BC
Lindner Center of HOPE , Psychiatric Mental-Health Nurse Practitioner

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“Take a rest.  A field that is rested give a beautiful crop”
– Ovid, Roman Poet, circa 20 BC

 

Pockets of Rest
By Valerie Martin, Spiritual Care Team

It is not news that poor rest and sleep can have a negative effect on health.  But look at this: On the public safety side, besides falling asleep at the wheel of your car, it can cause disasters.  According to the Div. of Sleep Medicine at Harvard Medical School & WGBH Educational Foundation, it was found that sleep deprivation was a significant factor in the 1979 nuclear accident at Three Mile Island, as well as the 1986 nuclear meltdown at Chernobyl.

Then there are the personal nuclear meltdowns that can happen when we are weary.  They may present themselves in various forms: frustration, anger, being short with people, fits of crying, wanting to hit a wall (choose something softer please), withdrawing, even giving up.

We have allowed lack of rest to happen, you know.  We have allowed schedules and other people’s priorities to direct our lives, even if we do not realize it.  We do not question the flow or the huge pressure we feel to “keep up”.  We CAN and SHOULD take more control over our schedules and what we put on them.  Don’t go quitting everything!  Just be the director of your own story.  Take back a measure of control.

We have listed for you a few things that have worked for others.  Find what works for you.  Be intentional about this.  Look for pockets in your day to take a control of your need for rest.  You just might avoid going nuclear!

Finding pockets of rest in 4 main areas of your life

  • The Car
    • Turn off radio in your car
    • Turn off talk-radio in your car
    • Aromatherapy
  • At Work
    • Take your breaks
    • No work talk on your lunch hour
    • Change your position at your desk or get up and work the hall.  It’s recommended you do this every hour
    • If you are overloaded, have an honest conversation with your boss and team & call Spiritual Care Team
  • At Home
    • Stick to a bed time for the kids that is earlier than yours and stop with the to do list a couple of hours before bed.  The dust will be there tomorrow.
    • Dance while making dinner
    • Have a family dinner time ritual
      • “What’s your biggest up/down for the day”
      • Prayer
      • Tell me something funny
  • Don’t turn on your TV as soon as you get home
  • Take a hard look at all the activities your family is involved with
  • In Your Ear
    • The information we expose ourselves to daily impacts our thoughts, our stress levels, our view of life.  Be thoughtful about what these things are.
    • Classical music – especially baroque – has been proven to have calming effect on your heart rate
    • Take news breaks. TMI (Too much information) is everywhere!  It can over load us, make us feel powerless and gives us a skewed view of the world.
    • Take technology fasts – anything with a screen
    • Try silence.  A time to pray, meditate or simply be.

 

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Many who struggle with OCD are probably noticing a spike in their symptoms during these unprecedented times. Stress and uncertainty can often make OCD symptoms flare. Those who struggle with specific types of OCD may be having an even harder time: specifically those with contamination concerns and those concerned with harming others. Another symptom of OCD that may be particularly hard currently are perfectionism tendencies. While it may be harder to fight back against OCD with everything going on right now, it is more important than ever to not give in to compulsions and let them take over your life. One simple step you can take is to stay connected to your therapist, likely via telehealth at the moment. Having regular sessions during this time is key, especially as symptoms flare. Staying connected to others online or through social media options is also important, as the more you are connected to others the less stress you will notice. Another key piece is to continue to do things you enjoy and that bring you pleasure, as this will help lessen stress as well. Keeping a structured routine can be helpful and can help make things to continue to feel more normal. It can be important to try to continue with whatever routine you had going before that you are still able to do, for instance still getting at the same time in the morning and getting ready for work even if you are working from home. Adding consistent exercise into that routine will also be helpful, as this helps create endorphins and naturally lessens anxiety. Lastly, avoid reading the news all day, which will only lead to more stress and anxiety. It is important to limit access to only a couple of trusted sites and not get carried away with reading up on everything all day long.

Some specific OCD related steps you can take will vary depending on the type of OCD you have. For those who struggle with contamination concerns, get familiar with the CDC guidelines for the current pandemic and do not add other steps that are not recommended. For instance, they are recommending only washing hands for 20 seconds after being outside or in public, before eating, after going to the bathroom, and after you’ve coughed/sneezed/blown your nose. If soap and water are not available, they recommend you use hand sanitizer that contains at least 60% alcohol. They also only recommend disinfecting surfaces once per day. This should only take a few minutes per day and they suggest only focusing on the surfaces in your home that are frequently touched. It is also important to think about whether this is truly needed (for example, if you stayed home all day and had no visitors, do you really need to disinfect that doorknob?). It is also important to avoid some news sources that might not offer expert recommendations but rather their own opinions.

For those who struggle with fears of harming others, these symptoms might tackle the current pandemic and cause you to obsess about whether or not you might have infected someone or whether or not you might infect someone in the future. This might be a similar theme to past fears of contamination concerns, but it will still be helpful to alert your therapist to the new content so that new exposures can developed.

For those who struggle with perfectionism tendencies, this might be an especially trying time. The perfectionism could target all of the changes going on and adaptations people are having to make to conduct
their jobs, manage their families etc. It is important to give yourself a break and realize that it is impossible to be perfect in anything we do, but especially now during all of this change and uncertainty. Practice doing one or two things imperfectly on purpose as an exposure.

One important exercise I make sure to encourage all of my patients to do is to keep track of their victories against OCD, whether the victories are big or small. Keeping track of successes and not dwelling on everything that is going wrong is a helpful way to stay on track and to realize everything that you are doing to fight OCD, which is likely a lot. It can sometimes be hard to pick out the successes and often others only notice the failures or slips, but there are victories in there as well that deserve your attention and that can help give you confidence to fight back even harder next time

Nicole Bosse, PsyD
Lindner Center of HOPE, Staff Psychologist

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Quarterly free webcasts offer one free continuing education credit per session

Lindner Center of HOPE is hosting a webcast titled Dialectical Behavioral Therapy (DBT) vs Radically Open Dialectical Behavior Therapy (RO DBT) presented by Brett Dowdy, PsyD, Lindner Center of HOPE, Chief of Psychological Services, and Laurie Little, PsyD, Director of Therapeutic Services, Sibcy House on Tuesday, May 12, 2020.

The webcast is the second of the Center’s Free 2020 Webcast Series. The series will cover a variety of topics chosen to increase understanding of mental health and addiction diagnosis and treatment.

Following the webcast, Participants will be able to:

  1. Describe the clinical population best suited for DBT and RO DBT
  2. Discuss the core similarities between DBT and RO DBT
  3. Analyze the differences in treatment approaches and learn how to target clinical referrals.

Visit https://lindnercenterofhope.org/dbtvsrodbt-webcast/ for more information and to register.

The series is offered quarterly. Login opens at 5pm with presentation from 5:30 -6:30. Other topics for the series include:

The remaining webcasts include:

Residential Stabilization, Diagnostic Assessment and Treatment to Optimize Patient Outcomes presented by William P. Hartmann III, MD FAPA, Medical Director, Williams House at Lindner Center of HOPE – Tuesday, August 11, 2020

Visit https://lindnercenterofhope.org/residential-stabilization-webcast/ for more information and to register.

 

OCD’s 10 biggest tricks and how to defeat them presented by Charles Brady, PhD, ABPP, Lindner Center of HOPE, Clinical Director of Outpatient Services and Staff Psychologist  – Tuesday, October 6, 2020

Visit https://lindnercenterofhope.org/ocd-tricks-webcast/ for more information and to register.