Category: Mental Health

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Is It Anxiety or OCD? 2 Psychology Experts Explain the Difference

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Photo by Joice Kelly on Unsplash

Emily Upton, UNSW Sydney; Black Dog Institute and Kayla Steele, UNSW Sydney

Anxiety itself is not a mental illness. It’s a normal, adaptive emotion that helps us respond to perceived threats.

Anxiety is the automatic reaction that makes you jump back when you think you’ve seen a snake while bushwalking – before realising it’s a stick.

It’s also (inconveniently) the sweaty palms and shaky voice you notice before a presentation or a first date, or the circling thoughts that keep you awake at 3am.

Most of us have ways to cope with anxious thoughts and feelings that can give us more of a sense of control. This could be checking and double-checking we’ve got the room right for our presentation, or seeking reassurance from someone we love.

But when might these behaviours fit a diagnosis of an anxiety disorder? And when could they actually be a sign of obsessive compulsive disorder (OCD)?

As clinical psychologists, we find these questions come up a lot, perhaps spurred by a recent surge of interest in OCD on social media. So what’s the difference between anxiety and OCD? And how are they treated?

Social media is full of content ‘diagnosing’ OCD and explaining how it’s different to anxiety. TikTok

When is anxiety something more serious?

“Normal” anxiety can become an anxiety disorder when fears or worry are persistent, intense and start interfering with everyday life.

About one in three people will experience an anxiety disorder at some point in their lifetime.

Among the most common are social anxiety disorder (fear in social situations), panic disorder (frequent panic attacks, and fears you’ll have another) and generalised anxiety disorder (persistent and excessive worry).

These disorders have slightly different symptoms. But all share excessive and persistent fear or worry that causes distress or leads people to avoid important parts of life including work, study or social activities.

So, what about OCD?

Although OCD involves anxiety, it is actually considered a separate disorder in the diagnostic manual used by mental health professionals.

It is possible to have both – around half to three-quarters of individuals with OCD also meet criteria for one or more anxiety disorders as well.

OCD involves obsessions, compulsions, or both. These cause significant distress or interfere with daily functioning.

Obsessions are intrusive, unwanted thoughts, images or urges. This could mean an intense fear your food is contaminated, suddenly visualising hurting someone, or a feeling that keeps entering your mind that you’ve made a serious mistake.

Compulsions are the repetitive behaviours (or mental rituals) people feel driven to perform to ease that distress, such as checking, repeating phrases, excessive hand-washing or seeking reassurance.

Many of us will occasionally experience unwanted thoughts or go back to check the oven is actually off. Keeping things tidy or being particular about routines can simply be habits that don’t cause distress.

But what makes OCD different is its severity and impact.

If obsessions or compulsions take up large amounts of time, cause you significant distress, or interfere with daily life, it may be a sign of OCD.

You can’t “spot” OCD from behaviour alone. OCD can also be invisible because many compulsions happen mentally, such as repeating phrases or counting. People with OCD may also try to hide their symptoms out of shame.

Are OCD and anxiety treated differently?

While anxiety disorders and OCD share some similarities, including repetitive distressing thoughts, the patterns and beliefs driving them are different. This means the way they’re treated will also differ.

Cognitive behavioural therapy (CBT) is one of the most effective treatments for both anxiety disorders and OCD.

For OCD, treatment often involves a specialised form of CBT called exposure and response prevention (ERP). It involves gradually facing situations that trigger distressing thoughts while resisting the urge to perform compulsions.

For example, someone with contamination fears might gradually reduce the number of times they wash their hands before eating. Over time, people learn the feared outcome does not occur, that they can tolerate their discomfort without the ritual, and that the anxiety passes on its own.

Treatment for anxiety disorders focuses on the specific fear. For generalised anxiety, for example, it involves understanding patterns of worry, challenging beliefs that keep worries going, and developing more helpful ways to respond to problems, such as brainstorming solutions and taking small actions.

Antidepressant medication (particularly selective serotonin re-uptake inhibitors, or SSRIs) can be an effective component of treatment for both anxiety disorders and OCD. A combined treatment approach of medication (SSRIs) and therapy (CBT) often leads to the best treatment outcomes, especially for severe OCD.

A final note

While it’s great mental health is being discussed more openly online and stigma is reducing, social media can also blur the line between personal experience and evidence-based information.

If something you’ve seen online has sparked curiosity about your mental health, the best next step is to talk with a qualified professional who can help you understand what you’re experiencing and what support might help.

For more information and resources about anxiety and OCD, visit the Black Dog Institute or Beyond Blue, and ReachOut or Headspace for young people.

There are lots of evidence-based online treatment programs for anxiety disorders and OCD you can access for free or low-cost, such as This Way Up, MyNewWay or Mindspot.

There are also online treatments for kids and teens with OCD and anxiety.

You can also ask your GP about a Mental Health Care Plan for Medicare-rebated psychology sessions.

Emily Upton, PhD Candidate in Psychology, UNSW Sydney; Black Dog Institute and Kayla Steele, Postdoctoral Research Fellow and Clinical Psychologist, UNSW Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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People with Poor Mental Health Have Worse Healthcare Experiences

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Poorer mental health was associated with worse reported care and less trust in the healthcare system

Photo by Alex Green on Pexels

People with self-reported poorer mental health also report worse quality of care and lower confidence in healthcare systems, according to a study published May 5th in the open-access journal PLOS Medicine by Margaret E. Kruk from Washington University in St. Louis, U.S., and colleagues.

Rates of depression and anxiety have increased worldwide since the COVID-19 pandemic, and more people are pursuing mental health treatment as a result. However, there is limited up-to-date data describing how these individuals seek out and receive care. Detailed, population-level information can help healthcare systems meet this growing population’s needs.

To make a start on gathering this data, Kruk and her colleagues surveyed 32 419 adults in 18 high-, low-, and medium-income countries. More than 1000 people from each country responded. Participants self-reported data via the People’s Voice Survey in 2022 and 2023.

First, survey respondents self-assessed their physical and mental health (the latter including “poor,” “fair,” “good,” “very good,” and “excellent”). Then, they quantified their overall confidence in the healthcare system, their own use of healthcare services, the typical quality of care received, and their ability to manage their own mental health (a metric called patient activation).

Mental healthcare receipt among people with poor mental health. Infographic displaying the weighted distribution of mental health status and care receipt. Each figure icon represents 2% of the population. Dark orange = respondents with poor/fair mental health who received mental healthcare in the past 12 months; light orange = those with poor/fair mental health who did not receive care; blue = those with good/very good/excellent mental health.

Image credit: Kruk ME, et al., 2026, PLOS Medicine, CC-BY 4.0 (https://creativecommons.org/licenses/by/4.0/)

Across all countries, respondents reporting poor mental health were more likely to report chronic illness, poorer overall health, lower patient activation, worse care quality and lower confidence in the healthcare system. Between 0.9% (Lao PDR) and 52.4% (UK) of these respondents reported receiving mental health care in the last year. Respondents in Nigeria reported the best overall mental health (4.7% people reported the lowest proportion of “poor” or “fair” mental health (4.7%), while respondents in China had the highest proportion (39.6%).

The researchers hope these results can help the countries in question – and individual healthcare systems – better serve the needs of those with poor mental health. While this is a descriptive study, the researchers posit patient activation as a potential target for elevating overall health and wellness.

The authors acknowledge that big-picture data doesn’t describe individuals’ specific experiences within the healthcare system. They suggest comparison across similar health systems and tracking system performance over time to continuously improve health services.

The authors add, “What stands out from this study is that poor mental health doesn’t exist in isolation. People reporting poor mental health were nearly twice as likely to have a chronic illness and far less likely to feel empowered to manage their own health. Health systems need to stop treating mental health in a silo and recognise that these patients are showing up across all areas of care – and often with more complex needs.”

Kruk adds, “As a research consortium working across very different health systems, we expected to find variation, and we did, in treatment access. But the experience gap was remarkably consistent: people with poor mental health had worse care, more unmet needs, and less trust in the system, regardless of where they lived. Health systems globally need to rethink how they serve this growing group, not just whether they can reach them.”

Provided by PLOS

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It Is Time for SA to Get Serious About the Link Between Substance Abuse and Mental Health

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Around 3.8 million people in South Africa developed depression in 2024, researchers estimate in a major modelling study. Photo from Pixabay CC0

By Gauta Mashego

Substance abuse is both a symptom and a consequence of untreated mental illness, and government needs to urgently step in to confront this dangerous overlap, argues Gauta Mashego of SECTION27.

Mental health globally has been in crisis for years. The strain on mental health was especially visible when the world stood still during the COVID-19 pandemic. The prevalence of anxiety and depression increased by 25% in the first year of the global outbreak of the SARS-CoV-2 virus, according to the World Health Organization. However, as the pandemic eased and life returned to the usual, open conversations around mental health also tapered off.

In South Africa, as in many low-and-middle income countries, people struggle with mental health disorders such as anxiety and depression. Around 3.8 million people in South Africa developed depression in 2024, estimate researchers in a major modelling study published as a preprint in March on medRxiv.

Mental health is shaped by many factors

Several studies worldwide report a high prevalence of substance use among people with mental illness compared to the general population.

Researchers have found that patients who suffer from psychotic disorders, such as schizophrenia and bipolar mood disorder, were more likely to abuse alcohol and illegal substances. Indeed, findings from a community survey highlighted a substantial burden of co-occurring mental disorders and alcohol use among men in three provinces in South Africa.

What also makes our society vulnerable to both mental health conditions and increased use of drugs and the development of substance use disorders, is our historical context of apartheid as well as socio-economic factors such as poverty, unemployment, and violence. Researchers have argued that mental health problems are related directly to poverty, while others also make the case that the poor are at greater risk than the rich to suffer from mental illness. At the same time, those living with mental illness are more likely to remain trapped in poverty due to high treatment costs, reduced productivity, and stigma around mental illness.

The kids are not alright

Underage drinking further complicates an already complex problem.

Up-to-date statistics of underage drinking in South Africa are limited, however the matter was thrust into the spotlight on Christmas day in 2025 when a disturbing video circulated on social media showing children between the ages of 6 and 12 consuming alcohol in the presence of adults.

Providing insights into the drinking behaviours of adolescents aged between 11 and 18, a 2019 Human Sciences Research Council study in townships across three provinces found that most had their first drink at the age of 13 or 14 years.

Highlighting the extent of underage drinking among Grade 8–11 learners from public schools in all nine provinces, the 2011 South African Youth Risk Behaviour Survey recorded that around 17% of 13-year-olds and 18% of 14-year-olds had engaged in drinking five or more drinks within a few hours on one or more days in the preceding month.

Mental disorders that commonly co-occur with alcohol use disorders in adolescents include antisocial disorders, mood disorders, and anxiety disorders.

Young people’s drinking habits are often linked to factors such as social norms, and the accessibility and affordability of alcohol. Added to this, since young people are often prolific consumers of media, they are frequently exposed to alcohol advertising and marketing, which encourages the consumption of alcohol.

But there is some hope.

The Liquor Amendment Bill aims to amend the Liquor Act of 2003 to prohibit the advertising, promotion or product placement of liquor in all forms of media. The Amendment Bill is at a very early stage in the legislative process, and it is likely to take time before we see any changes to the law (and longer before we see its implementation).

Other legislative changes debated include raising the legal drinking age from 18 to 21 and keeping schools alcohol-free, and more generally to place a moratorium on new liquor licences and stronger enforcement against Liquor Act violations.

South Africa also has a National Drug Master Plan 2019-2024. It was released by the Department of Social Development, and importantly, it recognises addiction as a chronic disease affecting the brain and behaviour.

However, experts say that while it is a great document, the Central Drug Authority which is tasked with implementing the plan, needs more power and resources to implement the plan’s recommendations.

South Africa also has a National Mental Health Policy Framework and Strategic Plan (2023-2030), that was introduced by the Department of Health. Similarly to its previous iteration, the latest plan envisions the integration of mental healthcare into primary healthcare. A key objective of the new plan is to ensure that mental healthcare users have access to care near their places of work. Another aim is to strengthen collaboration between government departments like education and social development to ensure that mental health is incorporated in planning and service development.

However, as it stands, many public healthcare facilities lack mental health professionals, with rural and underserved communities having little to no access to care. Only about 50% of public hospitals offering mental health services have a psychiatrist, while the country has less than one psychologist for every 100 000 people.

Shortages of mental health professionals mean patients often wait months for appointments. For an adolescent or a child who experiences anxiety, depression or suicidal thoughts, these delays can feel unbearable and it is quite possible that they may give up before receiving help. Currently, only one in ten children diagnosed with treatable mental conditions will have access to care.

While South Africa developed extensive legislative and policy frameworks to give effect to the constitutional right to healthcare, including mental healthcare, constitutional promises must make a difference in the lives of people. Unfortunately, millions of people in the country face barriers to mental healthcare, exposing the persistent gap between constitutional promises and lived reality.

When families lack access to counselling, community-based mental health services and early intervention programmes, harmful coping mechanisms continue to be passed down rather than prevented. To achieve the objectives of the Mental Health Policy Framework by 2030 and to catch up with the National Drug Master Plan that lapsed in 2024, stronger political will and meaningful action are urgently required. This is a crisis South Africa can’t evade.

*Mashego is a candidate attorney with SECTION27.

Note: Spotlight is published by SECTION27, but is editorially independent – an independence that the editors guard jealously. Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.

Republished from Spotlight under a Creative Commons licence.

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Parental Depression: How Does Timing Impact Mental Health in Adult Offspring? 

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Photo by Alina Matveycheva

A new Yale study shows how the timing of depression in mothers and fathers affects mental health in their adult children. This includes influences on depression, anxiety, and psychotic disorders.

Timing effects across development

A research team led by Kieran O’Donnell, PhD, at Yale School of Medicine (YSM) found that pregnancy is a sensitive period, and exposure to high levels of maternal depression during pregnancy alone is associated with increased risk of psychosis in adult offspring. The findings highlight the importance of adequate mental health support during pregnancy.  

The effects of maternal depression on adult symptoms of depression were detected across childhood, as well as during pregnancy, while paternal effects emerged from mid-childhood. The findings were published online in JAMA Network Open. 

Study design and methods

O’Donnell and his team used a statistical framework borrowed from econometrics to analyse the study data. They analysed the effects of parental depression, assessed from pregnancy through 21 years of age, on adult mental health outcomes in a 30-year study of more than 5 000 participants.  

“This is one of the most comprehensive studies – if not the most comprehensive – to ask if there are sensitive periods or developmental stages when exposure to parental depression has a particularly strong impact on later mental health,” says O’Donnell, an associate professor at Yale Child Study Center and in the Department of Obstetrics, Gynecology, and Reproductive Sciences at YSM.

Findings and implications for intervention

“Finding that parental mental health was important for long-term mental health outcomes in the next generation was not surprising, and is consistent with previous studies,” says O’Donnell. “What did come as a surprise was the clear difference in the patterns of associations between maternal and paternal depression and each mental health outcome we studied, as well as the distinct timing effects of mother’s versus father’s depression. These findings suggest that multiple and possibly distinct mechanisms underlie the associations between maternal and paternal depression and offspring mental health.” 

One of the study’s goals was to investigate key periods of development when parental interventions might be most effective in promoting mental health in the next generation. Study findings suggest that earlier intervention is better, and providing adequate mental health support for parents during pregnancy is important.

“Our findings also highlight the importance of checking in on parents’ mental health across childhood,” O’Donnell adds. “Doing so will benefit parents and may also have a positive benefit on the long-term mental health outcomes of their children.” 

Source: Yale University

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Simple Rituals Like Tea Drinking Help Rewire Focus

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Scientists use cutting-edge imaging to explore how Rooibos may support healthy brain cells. From left: Catherine Smit, Dr Sholto de Wet and Prof Ben Loos.

In a world of endless notifications, relentless multitasking and constant information overload, the ability to focus is slipping through our fingers. Research suggests the human attention span has shrunk dramatically over the past two decades, with a widely cited Microsoft study putting it at just eight seconds today, down from 12 seconds in 2000. That’s shorter than the attention span of a goldfish.

Meanwhile, chronic stress and cognitive overload are now recognised as major contributors to burnout, anxiety and reduced productivity.

The role of simple rituals in restoring focus

Against this backdrop, scientists are beginning to explore not only what we consume, but also how we consume it, including the role of simple rituals like tea preparation, in restoring mental clarity.

Emerging research into Rooibos, a naturally caffeine-free herbal tisane indigenous to South Africa, suggests that both its bioactive compounds and the act of drinking it may support the brain under pressure.

How stress impacts the brain

From a neuroscience perspective, chronic distraction has measurable consequences.

According to Prof Ben Loos from Stellenbosch University’s Department of Physiological Sciences, stress isn’t good for the brain and can affect how well it functions. “It can contribute to a pro-inflammatory state and neuro-inflammation.” He explains that prolonged cognitive overload increases the production of reactive oxygen species (ROS), creating a damaging cellular environment that impairs brain function.

Over time, this affects critical regions, such as the prefrontal cortex, responsible for attention and decision-making, and disrupts neuroplasticity – the brain’s ability to adapt and learn. “Individuals may feel depleted due to an overload of the prefrontal cortex,” Prof Loos notes, adding that unmanaged stress can impair memory and learning capacity.

While much of the modern response to fatigue involves stimulants like caffeine, researchers are increasingly interested in alternatives that support the nervous system without overstimulation. Naturally caffeine-free Rooibos presents one such option.

Antioxidants and cellular protection

At a molecular level, Rooibos contains potent antioxidants, notably aspalathin and quercetin, which have been studied for their neuro-protective potential.

Prof Loos explains that Rooibos works in different parts of the body to help protect cells from the kind of damage that can build up as we age. “In simple terms, the compounds in Rooibos help keep brain cells healthy, support the body’s natural energy levels and keep cells working as they should, which is important for maintaining a sharp, active mind.

“A big part of this comes down to structures in our cells called mitochondria. These are like tiny energy generators that turn the food we eat into fuel, giving both the body and brain the energy they need to function properly, grow and stay healthy,” he says. For the brain cells, this means, making new connections with other brain cells and simply aging healthier.

Research has highlighted that mitochondrial dysfunction is closely linked to cognitive decline and neurodegenerative diseases. By supporting mitochondrial health, Rooibos compounds may help create a more stable internal environment for cognitive function.

This microscopic image shows active mitochondria (in red) inside brain cells. Rooibos appears to help these energy-producing structures stay strong and adaptable, supporting overall cell health. (Image: Catherine Smit)

Supporting brain chemicals linked to learning and memory

Dr Taskeen Docrat from the Applied Microbial Health and Biotechnology Institute (AMHBI) at CPUT explains that the natural compounds in Rooibos not only help protect our cells, but might also support the brain chemicals that are important for memory and learning. These antioxidants help the body manage and reduce harmful stress that can damage cells.

Dr Taskeen Docrat, researcher from the Applied Microbial Health and Biotechnology Institute (AMHBI) at Cape Peninsula University of Technology (CPUT) explores how Rooibos antioxidants may support cognitive health.

She mentions that Aspalathin, one of the compounds in Rooibos, helps protect the brain by lowering this kind of stress. Quercetin, another compound, may boost the levels of a protein called BDNF, which plays an important role in helping the brain learn, adapt and store new information.

The science of ritual and the nervous system

But beyond biochemistry, there is growing recognition of the psychological benefits of ritual. Structured, repetitive behaviours, such as preparing and drinking tea, can activate the parasympathetic nervous system, which promotes relaxation and recovery.

Dr Docrat explains that ritualised behaviours activate the part of our nervous system that calms us down. This can lower stress hormones in our body, specifically, cortisol. When cortisol levels drop, we tend to feel less stressed, which can lead to better emotional regulation and clearer thinking.”

This aligns with broader psychological research showing that small, intentional rituals can reduce anxiety and improve focus by creating a sense of control and predictability in otherwise chaotic environments.

Importantly, Rooibos offers these benefits without the potential downsides of caffeine. While moderate caffeine intake can enhance alertness, excessive consumption – particularly in high-stress contexts – may increase heart rate, anxiety and sleep disruption.

“Opting for a caffeine-free drink like Rooibos could provide safer support for the nervous system without the crash,” Dr Docrat notes.

A holistic approach to focus and mental clarity

Although direct evidence linking Rooibos consumption to improved focus is still emerging, the underlying mechanisms are compelling. Prof Loos cautions that it’s not easy to correlate what they see on the molecular level to high-level functions, such as mental focus, but adds that improved cellular health in the brain likely supports better neuronal function overall.

In a world where distraction is the norm, the solution may not lie in pushing the brain harder, but in creating conditions that allow it to function optimally. Incorporating simple, non-caffeinated rituals like drinking Rooibos may offer a dual benefit – biochemical support for brain health and a psychological pause that resets attention.

As Prof Loos concludes, we need moments of calm, silence and focus to manage stress, sharpen the mind and support resilience and creative thinking.

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How Oestrogen in the Brain Impacts Stress and Trauma Response

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New research reveals how oestrogen levels in the brain influence vulnerability to stress-related memory problems, helping explain sex differences in PTSD risk.

Photo by Sherise Van Dyk on Unsplash

For some people, a single traumatic event like a shooting, a natural disaster or a violent assault, can leave an imprint that lingers long after the immediate danger has passed. Memories of that event may return with unusual intensity, shaping mood, behaviour, and mental health in ways that are difficult to predict. Others exposed to similar trauma recover without developing lasting memory problems or trauma-related symptoms.

Why those outcomes diverge is a central question in stress and trauma research. Clinicians have long observed that severe acute stress can permanently alter memory for some people but not others, and that women face roughly twice the lifetime risk of posttraumatic stress disorder (PTSD). Recent research from the University of Pennsylvania in collaboration with the University of California-Irvine suggests that part of the answer may lie in the brain’s biological state at the precise moment trauma occurs.

Elizabeth Heller, PhD, an associate professor of Pharmacology in the Perelman School of Medicine at the University of Pennsylvania, and her team in the Heller Lab, have now shed light on how the brain’s biological state at the time of stress, particularly its oestrogen levels, can shape vulnerability long after the acute stress has lifted. Heller helped uncover that oestrogen levels in the brain may play a surprising role in this vulnerability, and for both sexes. The study, published in Neuron, also provides new insight into why women are more likely than men to develop post-traumatic stress disorder (PTSD) and to face higher dementia risk later in life.

Unpacking oestrogen’s role in memory vulnerability

Oestrogen is widely known to support learning and memory. This study found that high levels of oestrogen in the hippocampus, a brain region critical for memory, help the brain’s cells change and adjust more easily. However, in the context of severe acute stress, this flexibility can increase vulnerability to stress-related memory problems.

Heller and the Penn team mapped how high levels of oestrogen interact with chromatin structure (the storage packaging up DNA inside cells) in the hippocampus to make some brains more susceptible to PTSD‑like memory changes.

The findings help explain why traumatic events such as natural disasters, mass violence, and assaults can cause long-term memory problems, and why women are roughly twice as likely as men to develop PTSD.

“A lot of what determines vulnerability is the state your brain is already in,” Heller explained. “If a traumatic event hits during a period when oestrogen is already unusually high, the resulting plasticity can amplify the impact in lasting ways, promoting vulnerability to stress. Even with these findings in hand, the word oestrogen can mislead readers into assuming the biology applies only to women. That assumption shaped public understanding for decades, but it doesn’t hold up against what this research, and years of foundational neuroscience, actually shows.

As Heller notes, oestrogen is a critical brain hormone in both sexes. It is produced locally in regions like the hippocampus where it helps regulate learning, mood, and responses to stress. Recognising that universality is essential to understanding what this study truly reveals.

“The striking thing is that oestrogen levels are actually high in both males and in females in some parts of the hormonal cycle. Thus, the effects of high oestrogen levels happen in both males and females,” Heller said. “We tend to treat oestrogen as a women’s health hormone, but the brain makes its own oestrogen, and it plays powerful roles in stress, memory, mood, and emotion across sexes.”

By Eric Horvath

Source: Penn Medicine

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Study Identifies Why Nightmares Persist in Children and How to Break the Cycle

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Photo by Caleb Woods on Unsplash

Recently published research from the University of Oklahoma and the University of Tulsa proposes a new model to explain why nightmares can persist over time in children and how therapy can be designed to break that cycle.

The study, published in Frontiers in Sleep, introduces the DARC-NESS model, a mnemonic for the factors that can keep a child stuck in chronic nightmares. At the centre of the model is “nightmare efficacy,” or the idea that children can learn skills to rid themselves of nightmares and restore good sleep.

“The DARC-NESS model looks at the mechanisms of what is maintaining nightmares, as well as the mechanisms that can break the cycle of nightmares,” said Lisa Cromer, PhD., a professor of psychology at the University of Tulsa and a volunteer child psychiatry faculty member at the OU School of Community Medicine in Tulsa. “It’s a child’s response to a nightmare that causes the chronic nightmares to happen, which means if we can learn to respond to nightmares differently, then we can interrupt that cycle. It’s empowering to understand that we can take steps to master our dreams.”

Rather than focusing only on the content of a nightmare, the model encourages clinicians to consider a broader set of factors, including how a child interprets the dream, worries about going to sleep, experiences anxiety at bedtime and copes after waking.

That information can help guide a personalized treatment plan instead of a one-size-fits-all approach. For some children, treatment may focus on reducing bedtime anxiety. Others may benefit from improving sleep habits or participating in exposure-based therapy, such as describing, writing about or drawing the nightmare and then working with a clinician to “rewrite” it.

“We believe we have created a way to conceptualize why nightmares persist and how we can better treat them in kids,” said OU Health child and adolescent psychiatrist Tara Buck, MD, an associate professor at the OU School of Community Medicine in Tulsa. “What’s unique about the model is that it’s customisable to what the patient needs, and it focuses on what the patient can control. We look for the potential intervention points and target those in a collaborative way with patients and their families.”

Unlike insomnia, in which people fear they won’t sleep, children with chronic nightmares are afraid they will sleep. According to Buck, helping children build confidence in their ability to address nightmares can have benefits far beyond sleep.

“Self-efficacy is at the heart of the model,” she said. “When children feel empowered to do something about the nightmares, they begin to see how things are interconnected – because they’re sleeping better, they have more energy, they go to school more consistently and their parents report improved behaviour.”

The model is designed for use by a range of clinicians, including therapists and pediatricians. For many years, health care providers either assumed that nightmares couldn’t be treated or that they would go away if an underlying trauma or mental health condition were addressed. However, that’s not always the case.

“We’ve worked with children who have been in mental health treatment for a long time and their nightmares are still persistent,” Buck said. “There is a need for a nightmare treatment model to help children when their nightmares are recurrent and distressing.”

“A nightmare is a bad dream that you wake up from,” Cromer said. “If you don’t wake up, then the brain is doing its job of resolving the fear of the dream. But if a child does wake up, they’re trying to escape the nightmare. And when a child wakes up, they’re not able to resolve the nightmare, which actually exacerbates the problem. That’s why nightmares are so important to treat.”

By April Wilkerson

Source: Oklahoma University

Categories : Mental Health NeurologyTags :

Two Major Symptoms of Schizophrenia Share a Single Explanation

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Our dopamine learning system helps us make choices, some as simple as whether to eat a green or red apple, says Arvind Kumar (pictured). He co-authored a new study showing what happens when this system breaks down, and how misalignment contributes to two symptoms of schizophrenia. (Photo: David Callahan)

Scientists have long known that dopamine helps the brain learn from rewards, but a new computational model shows how for people with schizophrenia this learning system can break down and simultaneously produce two very different symptoms – delusions and a loss of motivation.

Publishing in the Journal of Neuroscience, researchers at Stockholm’s KTH Royal Institute of Technology and University of Tokyo, Japan found that problems with motivation and the formation of delusional beliefs may both be linked to a single underlying problem: when an overactivated cortex disrupts the brain’s ability to link actions and consequences.

Arvind Kumar, associate professor in computational neuroscience at KTH, says the study offers a computational neuroscience model that attempts to unify several known roles of the brain’s dopamine system: learning from rewards, controlling motivation and building an internal picture of what’s going on.

Why a unified explanation?

A unified explanation would make it easier to study how these symptoms develop together and may guide future research into treatments, the lead author Kenji Morita says. “If the suggested root cause is validated, then mechanistically grounded therapies could be developed.”

The model in the study shows what happens when this internal cause-and-effect tracking system breaks down. The model suggests that two simultaneous learning processes in the cortico-basal ganglia-midbrain circuits need to align for a person to realize what is rewarding and why.

Deep within the brain, the striatum is a control center that enables the brain to learn which reward is which and selectively increase motivation for right one, such as food when hungry or water when thirsty.

The other dopamine alignment takes place in the cortex. This is the part that enables the brain to essentially follow what is happening. It enables the brain to assign credit correctly: for example, a smell of baked bread predicts food, or the sound of liquid predicts drink.

The researchers found that both reduced motivation and delusion‑like beliefs could arise when an overstimulated cortex disrupts alignment between these processes.

“It causes the brain’s learning system to mix up association between motivation and reward,” Kumar says, “leading to both low motivation and delusion‑like ideas, such as assigning the wrong reasons for things happening.”

“The brain needs to align motivation, reward identity and their causes together to make a suitable choice,” he says.

By David Callahan

Source: KTH Royal Institute of Technology

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Vivid Dreaming Makes Sleep Feel Deeper

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Perceived sleep depth is greater after having vivid immersive dreams

Photo by Bruce Christianson on Unsplash

Researchers led by Guilio Bernardi at the IMT School for Advanced Studies Lucca in Italy have discovered a key relationship between dreaming and the feeling of having had a good night’s sleep. Published in PLOS Biology on March 24th, the study shows that the feeling of deep sleep is not determined solely by slow-wave brain activity. Rather, immersive dreaming that comes with increases in wake-like brain activity leads to a greater feeling of deep sleep.

Why is it that sometimes we sleep 8 hours and don’t feel rested, while other times we feel like we had a great night’s sleep after only 5 hours? Research has shown that our feeling of deep sleep is related to a shift from high- to low-frequency brain waves, which is thought to drive unconsciousness. At the same time, other reports indicate that dream (REM) sleep is also perceived as deep, despite its wake-like brain waves. To better characterise the effects of dream sleep on perceived sleep depth, the researchers analysed EEG recordings from 44 adults who were repeatedly awoken during non-REM sleep over the course of 4 nights.

Analysis showed that shifts from faster to slower waves were indeed associated with a feeling of deep sleep. However, this relationship weakened when participants reported having had a dream, even if they could not remember the content. Perceived sleep depth was thus higher after dreaming even though this state is associated with wake-like brain activity. Specifically, vivid, bizarre, and emotionally intense dreams were all associated with subjectively deeper sleep, while abstract, reflective thought-like dreams with meta-awareness were related to more shallow feeling sleep.

These findings are contrary to the longstanding view that the feeling of deep sleep is governed solely by slow brain waves and the depth of unconsciousness, and suggest that perceptually immersive dreaming is what allows us to feel well rested – even if we can’t remember what we dreamed.

The authors add, “We already know that dreaming extends beyond REM sleep and occupies a large portion of the night, yet its function remains unclear. Our study suggests that dreams may help shape how we experience sleep by immersing us in an internal world that keeps us disconnected from the external environment.”

“Understanding how dreams contribute to the feeling of deep sleep opens new perspectives on sleep health and mental well-being. Alterations in dreaming – for example, a reduction in the richness or frequency of dreams – could influence how people perceive their sleep depth or duration, and may contribute to dissatisfaction with sleep quality.”

“This kind of research is extraordinarily demanding. Serial awakening studies require waking participants repeatedly across multiple nights and collecting detailed reports each time. It was only possible thanks to the dedication, resilience, and coordination of an exceptional team of researchers.”

Provided by PLOS

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GLP-1 Medications May Also Help with Symptoms of Anxiety and Depression

On By ModernMedia
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GLP-1 medications used to treat diabetes and obesity were associated with a reduced need for hospital care and sickness absence due to psychiatric reasons, a new study shows. The large register-based study was carried out in collaboration between the University of Eastern Finland, Karolinska Institutet in Stockholm and Griffith University in Australia.

Diabetes and obesity are associated with an increased risk of mental health symptoms, and similarly, individuals with mental disorders have an elevated risk of metabolic diseases such as obesity and diabetes. Researchers have long been interested in the connections between these conditions and in how pharmacological treatments may affect both metabolic and mental health disorders.

The present study, published in The Lancet Pyschiatry, included nearly 100 000 participants, over 20 000 of whom had used GLP-1 medications. Participants were followed through Swedish national registers between 2009 and 2022.

The risk of substance use was also reduced

The results showed that the use of GLP-1 medications – particularly semaglutide – was associated with a reduction in sickness absence and hospital care due to psychiatric reasons. During periods of semaglutide use, the reduction was 42% compared with periods when GLP-1 medications were not used. For depression, the risk was 44% lower, and for anxiety disorders, 38% lower. 

In addition, semaglutide use was associated with a lower risk of substance use disorders: hospital care and sickness absence related to substance use were 47% lower during periods of semaglutide use compared with periods without GLP-1 medication. The use of GLP-1 receptor agonists was also associated with a reduced risk of suicidal behaviour.

One of the study’s authors, Professor Mark Taylor from Griffith University, says such results were to be expected: “An earlier study examining Swedish registers found the use of GLP-1 medications to be associated with a reduced risk of alcohol use disorder. Alcohol-related problems often have downstream effects on mood and anxiety, so we expected the effect to be positive on these as well.”

However, the magnitude of the association surprised the researchers:
“Because this is a registry-based study, we cannot determine exactly why or how these medications affect mood symptoms, but the association was quite strong. It is possible that, in addition to factors such as reduced alcohol consumption, weight loss-related improvements in body image, or relief associated with better glycaemic control in diabetes, there may also be direct neurobiological mechanisms involved – for example, through changes in the functioning of the brain’s reward system,” says Research Director, Docent Markku Lähteenvuo from the University of Eastern Finland.

Other recent evidence on the effects of GLP-1 medications on anxiety and depressive disorders has been somewhat inconsistent, but it has been largely based on small studies.

Source: University of Finland