Category: Obessive-Compulsive Disorder

Lena Dunham's Representations of Mental Illness

00Anxiety, Asperger's Syndrome, Featured news, Health, Media, Obessive-Compulsive Disorder, OCD, Self-Esteem March, 17
Karolina Reis on Flickr

Source: Karolina Reis on Flickr

Media portrayals of mental illness are often controversial and have been criticized for inaccurate stereotypical depiction.

But more recently viewers have seen a notable shift towards more accurate representations. Writers, producers, and actors are using their own experiences to create more authentic characters and situations.

The controversial television series Girls on HBO leads the way.

Lena Dunham –actress, writer, director, and executive producer of Girls– stars as the show’s protagonist Hannah Horvath, who struggles with obsessive compulsive disorder (OCD). Through her character, Dunham conveys her own personal journey, enabling viewers to observe genuine symptoms of the illness.

Dunham was diagnosed with OCD around age 9. In an excerpt from her new book, she discusses the experience of intrusive thoughts:

“I am afraid of everything. The list of things that keep me up at night includes but is not limited to: appendicitis, typhoid, leprosy, unclean meat, foods I haven’t seen emerge from their packaging, foods my mother hasn’t tasted first so that if we die we die together, homeless people, headaches, rape, kidnapping, milk, the subway, sleep.”

As a public figure, Dunham feels a responsibility to discuss her disorder openly. She believes this approach helps people better relate to those who live with mental illness.

Researchers Joachim Kimmerle and Ulrike Cress explored this in an article published in the Journal of Community Psychology. Their study demonstrated that we can learn about mental illness from fictional shows when the information is accurately presented, highlighting how there can be many useful and creative ways to disseminate knowledge in mental health.

However, research by Nicole Mossing Caputo, a marketing and public relation specialist, and Donna Rouner, who has her PhD in mass communication, at Colorado State University found that when viewers don’t relate to the storyline or don’t form an emotional bond with a character, social stigmas tend to persist.

When a link to a storyline is successful or an emotional bond is formed, viewers become less critical and adopt the protagonists’ perspective and understand their struggle. Connections to narratives and characters like Hannah Horvath help battle misconceptions.

Another show, Parenthood, candidly explores the struggle of living with Asperger’s Syndrome (Autism Spectrum). Like Dunham, the show’s creator Jason Katims uses his own experience of raising a son with Asperger’s to connect with viewers on issues surrounding mental illness.

Dunham’s representation of OCD on television has increased public discussionaround mental health. It has increased the visibility of various mental-health communities and has helped pave the way for other shows to do the same.

In a Psychology Today article, Jeff Szymanski, Executive Director of the International OCD Foundation, speaks to this progress:

“Lena did a service not only to herself by letting the world ‘see’ what the struggle looks like, but to the entire OCD community at large by showing some of the pain, stigma, and struggle any person with mental health issues has to endure.”

And many are taking notice.

Shortly after Girls first aired, Allison Dotson—an OCD sufferer herself—wrote an articlefor the Huffington Post explaining how the depiction of Hannah on Girls has helped fight stereotypical portrayals of her disorder:

“As someone with OCD, I find it refreshing to see this often misunderstood illness portrayed in a realistic way on an acclaimed television show. Just as Hannah herself resists typical far-fetched sitcom stereotypes — she’s not model thin, she struggles with her finances and her career choices, and she often finds herself in believable awkward situations — her OCD symptoms are presented in a way that resists the low-hanging fruit of a kooky character most of us never encounter in our day-to-day routine.”

– Alyssa Carvajal, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Abusing Your Body Through Exercise

Abusing Your Body Through Exercise

00Anxiety, Body Image, Diet, Featured news, Obessive-Compulsive Disorder, Sport and Competition June, 15

Source: Flickr/Mario Lazaro Delgado Marquez

Last year, a good friend of mine became obsessed with the gym. Preoccupied by the “small” size of his muscles, he would spend hours staring at himself in the mirror. Others commented on how great his body looked, yet he didn’t believe them. Sticking to a rigid exercise and eating schedule, he stopped socializing with friends, became secretive, and dropped out of school.

A sense of hatred toward a particular body part, hiding it, or using extreme measures to change it is commonly seen in people with Muscle Dysmorphic Disorder (MDD).

MDD is most common in men, especially professional body builders or frequent gym-goers, and individuals who work or live in an environment where weight and appearance are considered important. My friend was a kinesiology student and was surrounded by an MDD-conducive environment.

MDD is listed in the DSM-5 under the spectrum of obsessive-compulsive disorders(OCD) to reflect its similarities to both process and treatment of OCD. MDD is also a subcategory of body dysmorphic disorder (BDD), a pathological preoccupation with features that are perceived as defective or grotesque, which leads to persistent stress and obsession. In MDD, the emphasis is specifically on muscularity. My friend’s particular body part was his biceps; even though he had stretch marks from over-working them, he still complained they were too small.

MDD is also distinct from eating disorders. The concern is not with striving to be thin, but rather with their perceived underdeveloped muscle mass. At times I would see my friend eat three cans of tuna and four eggs in one sitting – he felt his body needed the protein to build mass.

Statistics on MDD are limited since it is categorized under BDD. The prevalence of BDD is approximately 2.4% of the general population which makes it more prevalent than schizophrenia or bipolar disorder.

Symptoms of MDD are deceptive. The trouble with diagnosing MDD is that patients often do not consider themselves ill or in need of help. The more my friend became involved in the gym, the more I would try and talk to him about my suspicion that he was suffering from MDD, but the conversations never ended well. To add to the complexity of the disorder, some individuals with MDD tend to wear baggy clothes to hide their bodies, while others wear tight clothes to show off their muscular stature.

But getting help is important, as potential long term effects include damaged muscles, joints, cartilage and ligaments due to inadequate rest from strenuous weightlifting. They are also more likely to have a poorer quality of life, show a higher frequency of anabolic steroid abuse, and even suicide attempts.

Criteria for diagnosis include repetitive behaviours caused by preoccupations with perceived body defect(s), excessive training, following a rigid diet, avoidance of social events to maintain diet and exercise schedules, and avoiding situations that include body exposure, which may lead to extreme anxiety. The individual’s body perception causes considerable impairment in daily functioning. The diagnosis requires two of these criteria to be met.

There are analytical tools to help diagnose MDD. Most common is the Muscle Appearance Satisfaction Scale developed in 2002 by Psychologist Stephen B. Mayville, which rates levels of muscle satisfaction, substance use, and injury. Or the Muscle Dysmorphia Inventory which is a six factor scale that determines body size, exercise dependence, supplement use, dietary behaviour, physique protection, and pharmacological use.

And there are psychological treatments as well. The most common of which is Cognitive Behavioural Therapy (CBT), which teaches an individual to identify and modify distorted thoughts (e.g., I am not muscular enough), and to replace unhealthy behaviours (e.g., exercising four hours a day) with healthier ones. Treatment with selective serotonin reuptake inhibitors (SSRIs) has also been used with MDD, but the most effective treatment is a combination of CBT and medication.

Despite recent awareness and treatments, with rising interest in fitness clubs and health supplements, as well as pressure on males to be unrealistically muscular and lean, a further rise in MDD wouldn’t be surprising.

– Jenna Ulrich, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today