Facing the Monster: My Journey Living with OCD and Finding Hope

by David Kedeme

I remember the day my white high top Puma sneakers my parents gifted me for Christmas became the exact opposite of the color they came boxed in. It was a post rainy day in middle school, on a mulch covered, semi grassy area we considered our soccer field with two benches representing goals. After enjoying an intense match, what I did not enjoy but assumingly brushed off was the fact of how dirty my shoes were. Fast forward to later that day, I spent hours cleaning the shoes, trying to restore them to their original look.

Something felt different than other times I cleaned.

Every speck had to be clean. The more time I spent, the more visible other “not as clean” areas of the shoes became, requiring their own dedicated time of cleaning. Slowly, this cascaded into many other aspects of life such as my bedroom and closet needing to be organized a certain way, a tornado of relentless doubts concerning my relationships, with this dark monster in my head controlling what I can do, think, and feel. It felt like an eternity but at the same time as if no time passed from when I first touched to clean those shoes to when I could not sleep in my own bedroom and instead slept downstairs due to not wanting to mess the space up and not being able to enter and exit my closet as easily, so needing to rewear clothes days on end. I thought that doing what the monster or voice or whatever it was wanted would lead me to peace, as the relief from the sky high anxiety and gloom that came from performing what I know now as compulsions came only to have what I learned were obsessions come back, if not stronger, reinforcing this vicious cycle. My parents noticed my change in behavior, from avoiding my room at most costs to being late to dinner by up to an hour or two at times. I had only vaguely heard of obsessive compulsive disorder, OCD, and brought the idea up to my parents. The landscape we were dealing with was completely new and I felt even more alone due to this in addition to the isolation the condition induces you to be in. But we began to look for therapists, where I started talk therapy, with the therapist trying their best but the therapy modality was not the right one for me. Next up was a hypnotherapist, which also did not work for me. I needed some action to be okay with the high emotion filled state I was in when the bouts came on, in other words, exposure and response prevention therapy. After doing some research, I landed upon NOCD, an OCD teletherapy and advocacy organization.

I could not believe what I was hearing through the basement, not my room, laptop screen about actually going into my room, and that was not even the worst part. I just had to open my closet, take clothes out, move items in my room, and not do anything. “Maybe it is, maybe it is not” was a phrase that my therapist told me throughout therapy. With the significant support of my family, therapist, and friends, I was able to be okay with not being okay. Exposure and response prevention therapy makes you face the monster, making you enter the state in which you experience high anxiety. The therapy makes you look the monster in the face and realize it was not that big, not talking or engaging with you, making you sit in the discomfort and not do anything you so desperately want to do. With this methodology and rigor, I was able to coexist with the beast, and slowly it shrank, still existing though. But that is okay. That happens.

OCD belongs to a category of disorders called Obsessive Compulsive and Related Disorders within the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition, a manual that influences not only how patients receive care but also research funding and medical training. Although not officially recognized in the manual, there are many discussed subtypes of OCD depending on the obsessions and or compulsions one experiences. Some people, like me, had symptoms that ebbed and flowed in terms of severity and percolated from subtype to subtype. My symptoms throughout my experience with the condition range from having to keep most of the items in my room a certain way, doubting whether I want to be with my partner, questioning my morals, wondering whether something happened in the past pertaining to people in my life even though it did not, and more. Throughout typing this, thoughts flood my head, similar to ones I experienced, say, six years ago.

I hope to be able to perform research in the condition as well as treat people who were and are in my shoes. With up to 242 million people worldwide meeting clinical diagnostic criteria for OCD, about 40 to 60 percent experiencing treatment resistant OCD, more than two thirds of the general public not being able to accurately identify OCD, and mental health still being stigmatized today, there is more needed to be done from all fronts. When one type of online treatment is sought, about two thirds of patients achieve a clinically significant outcome, but on average, it takes greater than seven years for someone to receive a diagnosis of OCD and it can take up to seventeen years for an individual diagnosed with OCD to receive treatment. This is a multifaceted problem that requires a multifaceted approach which requires a banding of people worldwide to come together to promote awareness of the condition and a safe space for people throughout who have OCD.

Today, as I am typing this, I still am experiencing many of the symptoms I have before. The condition does not just go away, but it does become more manageable. If you are struggling, there is hope, there is a way, no matter how impossible it feels. I felt as if there was none, no light at the end of the tunnel, spending many hours crying out asking why to a source I was not even aware of, answered only by my own repetitive thoughts. But as someone who has been there, you will be okay. Even if multiple therapeutic modalities do not work, you feel like you want to give up because a current exposure seems impossible to do, you feel more anxiety at times, you feel like you are letting people down if you do not improve, you feel like the monster you were once fighting off keeps going, keep going. Seek help in many ways, rely on your community, and for those who have a hard time finding one, we are here for you, the International OCD Foundation community, and I most certainly am as well. Thank you for reading this and I am sending you hope and luck wherever you are. You are never alone.

The post Facing the Monster: My Journey Living with OCD and Finding Hope appeared first on International OCD Foundation.

Asking for help: the development of a simulation-based mental health application to enhance depression literacy, mental health communication, and help-seeking among Black autistic youth

Black autistic youth experience disproportionately high rates of depression and face intersecting barriers such as racial discrimination, stigma, and limited access to care, yet few interventions address their needs. This study introduces Asking for Help (A4H), a culturally responsive, simulation-based intervention designed to improve depression literacy and help-seeking skills through an e-learning module and interactive conversation practice. Guided by mental health literacy theory, the Theory of Help-Seeking Behavior, the Theory of Planned Behavior, and Disability Critical Theory, A4H was developed using community-engaged and user-centered design principles. Usability testing employed a mixed-methods design with 32 participants (12 youth, 10 caregivers, 8 specialists) using the System Usability Scale (SUS), Patient Health Questionnaire-9 (PHQ-9), and semi-structured interviews. Black autistic youth reported moderate depressive symptoms (mean PHQ-9 = 14.7) and rated usability slightly below benchmark (mean SUS = 66.2), while caregivers and specialists scored higher (73.5 and 71.0). Qualitative feedback highlighted cultural relevance and immediate feedback as strengths, with recommendations for simplified language, improved navigation, and multimodal supports; emotional safety and trust were critical for engagement. No short-term symptom change was observed, consistent with the formative design. Findings indicate A4H is feasible and culturally responsive but requires refinements before efficacy testing to assess impacts on literacy, help-seeking intentions, and communication skills.

Commercial or industrial use of mental health data for research: primer and best-practice guidelines from the DATAMIND patient/public Lived Experience Advisory Group

BackgroundRoutinely collected health data, such as that held by United Kingdom (UK) national health services (NHS), has important research uses. However, its use requires public trust and transparency. Access by commercial/industrial organisations is especially sensitive for the public, as is mental health (MH) data. Although existing MH data science guidelines emphasise patient/public involvement (PPI), they do not cover commercial uses specifically.ObjectivesTo develop patient- and public-led guidelines for the commercial and industrial use of MH data for research. Though UK-focused, their principles may apply internationally.MethodsA PPI Lived Experience Advisory Group (LEAG) was created within DATAMIND, a UK data hub for MH informatics. Initial discussion yielded a requirement for definitions and explanations of concepts relating to MH data research, developed iteratively. Subsequently, the LEAG developed guidelines via a qualitative quasi-Delphi approach. The agreed scope excluded data provided for research with informed consent, data processing arrangements (e.g. companies hosting electronic systems on the instruction of health services), and compliance with legal minimum requirements. The scope included the use of routinely collected MH data for research by commercial/industrial organisations without explicit consent, and aspects of industry-led MH data collection conducted with consent.ResultsAlongside the primer in MH data research concepts, the LEAG provide best-practice guidelines relating to commercial/industrial research use of MH data, for organisations controlling MH data (such as NHS bodies) and for commercial applicants seeking access. Core principles include transparency, patient rights, meaningful PPI, stringent governance, and statistical disclosure control. The guidelines recommend a risk–benefit approach to assessing data access applications, within limits that include avoiding the export of unconsented patient-level data outside NHS-controlled secure data environments, and not providing commercial applicants with access to unconsented free-text MH data. Further recommendations for NHS executive and regulatory bodies relate to public choice and transparency, clarity of guidance to research-active NHS organisations, and support for de-identification.ConclusionsMH data research requires patient/public involvement and understanding. These guidelines reflect the views of people with personal or family experience of mental ill health. We hope they are useful to the MH research community and increase public transparency and trust.

Synergies in psychedelic-assisted therapy: a qualitative interview study of psychotherapeutic processes

Research on the therapeutic effects of psychedelics in psychiatry, commonly referred to as Psychedelic-Assisted Therapy (PAT), has expanded substantially in recent years. The context-dependent nature of psychedelics has sparked discussion about the importance of the psychotherapeutic environment in achieving beneficial outcomes. This study explores the contribution of psychotherapeutic factors on PAT in Switzerland, where psychedelic treatments can be implemented within long-term clinical frameworks. Seven semi-structured interviews were conducted with Swiss therapists to explore how they frame psychedelic treatments and the role of the psychotherapeutic setting in facilitating therapeutic outcomes. Thereby, individual experiences of the patients as reported by the therapists, were particularly considered. Thematic analysis identified two main themes, each with several sub-themes. The first theme revealed that while psychotherapeutic techniques are adapted to PAT, they retain similarities to non-psychedelic psychotherapy practices, supporting patients in having meaningful therapeutic experiences. The second theme describes a synergistic relationship between psychedelics and psychotherapy, amplifying underlying general psychotherapeutic factors such as trust, a sense of profundity, and the emergence of therapeutic experiences. The interviewed therapists agreed that psychedelics work as unspecific catalysts for psychotherapeutic processes, while still acknowledging the potential for psychopharmacological effects or the interaction between psychedelics and psychotherapy to create unique psychotherapeutic processes. Findings from our sample suggest that, for specific indications, incorporating psychedelics into long-term psychotherapeutic treatment may strengthen therapeutic processes. Future research could investigate the efficacy of PAT within the framework of specific psychotherapeutic modalities or in different settings, including prospective quantitative assessments of outcomes. Ultimately, clarifying mechanisms of action of PAT may help to enhance its efficacy and potentially to integrate psychedelic treatments into mainstream mental health care.

Internet addiction in adolescents with suicidal ideation: the role of self-esteem and school connectedness

BackgroundInternet addiction (IA) has become a growing concern, particularly among adolescents, due to its adverse effects on mental health, physical well-being, and future development. Adolescents with suicidal ideation (SI) are particularly vulnerable to IA, which may be associated with a higher risk of engaging in suicidal behaviors. However, the relationship and underlying mechanisms between SI and IA remain unclear. This study, grounded in the cognitive-behavioral model of pathological internet use, investigates the relationship and explores the roles of self-esteem (mediator) and school connectedness (moderator) in this association.MethodsIn this cross-sectional study, 462 Chinese adolescents with SI (79.0% female) were recruited from psychiatric outpatient clinics between June 2024 and September 2025. Validated instruments measured SI, self-esteem, school connectedness, and IA. Structural equation modeling with bootstrapping procedures was used to test the mediation effect of self-esteem on the relationship between SI and IA. The moderating role of school connectedness was examined using PROCESS Model 8.ResultsSI was positively associated with IA (β = 0.224, p < 0.001). SI was negatively associated with self-esteem (β = -0.464, p < 0.001), and self-esteem was further negatively associated with IA (β = -0.448, p < 0.001). Self-esteem partially mediated the relationship between SI and IA, with an indirect effect of 0.208 (95% CI: 0.154-0.271). School connectedness significantly moderated the direct association between SI and IA (β = -0.005, p = 0.001), but did not moderate the association between SI and the mediator, self-esteem (β = 0.004, p = 0.202).ConclusionThis study identifies a significant positive association between SI and IA among adolescents with SI, with self-esteem partially mediating this link. Furthermore, school connectedness showed a very weak buffering effect on the direct association between SI and IA, and it does not moderate the association between SI and self-esteem. These findings enhance our understanding of the mechanisms underlying IA in this vulnerable population and suggest potential targets for interventions.

The Role of Disulfide Bonds in the GluN1 Subunit in the Early Trafficking and Functional Properties of GluN1/GluN2 and GluN1/GluN3 NMDA Receptors

N-Methyl-d-aspartate receptors (NMDARs) are ionotropic glutamate receptors essential for excitatory neurotransmission. Previous studies proposed the existence of four disulfide bonds in the GluN1 subunit; however, their role in NMDAR trafficking remains unclear. Our study first confirmed the existence of four disulfide bonds in the GluN1 subunit using biochemistry in human embryonic kidney 293T (HEK293T) cells. Disrupting the individual disulfide bonds by serine replacements produced the following surface expression trend for GluN1/GluN2A, GluN1/GluN2B, and GluN1/GluN3A receptors: wild-type (WT) > GluN1-C744S-C798S > GluN1-C79S-C308S > GluN1-C420S-C454S > GluN1-C436S-C455S subunits. Electrophysiology revealed altered functional properties of NMDARs with disrupted disulfide bonds, specifically an increased probability of opening (Po) at the GluN1-C744S-C798S/GluN2 receptors. Synchronized release from the endoplasmic reticulum confirmed that disruption of disulfide bonds impaired early trafficking of NMDARs in HEK293T cells and primary hippocampal neurons prepared from Wistar rats of both sexes (Embryonic Day 18). The pathogenic GluN1-C744Y variant, associated with neurodevelopmental disorder and seizures, caused reduced surface expression and increased Po at GluN1/GluN2 receptors, consistent with findings for the GluN1-C744S-C798S subunit. The FDA-approved memantine inhibited GluN1-C744Y/GluN2 receptors more potently and with distinct kinetics compared with WT GluN1/GluN2 receptors. We also observed enhanced NMDA-induced excitotoxicity in hippocampal neurons expressing the GluN1-C744Y subunit, which memantine reduced more effectively compared with the WT GluN1 subunit. Lastly, we demonstrated that the presence of the hGluN1-1a-C744Y subunit counteracted the effect of the hGluN3A subunit on decreasing dendritic spine maturation, consistent with the reduced surface delivery of the NMDARs carrying this variant.

Closing the Gap in Autism Genetics: Population-Specific Variants and the Imperative for Global Inclusion

Autism spectrum disorder (ASD) is a highly heritable neurodevelopmental condition with an exceptionally complex and heterogeneous genetic architecture, encompassing both polygenic common variants and rare, high-impact variants. Over the past decade, large-scale sequencing studies in Europe and North America have identified hundreds of ASD risk genes and substantially advanced biological insight. However, the global distribution of ASD genomic research remains profoundly imbalanced, with most non-European ancestry populations severely underrepresented.

Canada Gets its First National Guidance on AI for Mental and Substance Use Health

Ottawa (ONTARIO) – In a first-of-its-kind initiative, national guidance for using artificial intelligence (AI) in the mental and substance use health field is being developed through a partnership between the Canadian Centre on Substance Use and Addiction (CCSA) and the Mental Health Commission of Canada.

AI is increasingly being used for healthcare triage, service navigation, service delivery, and communication, but developers and users have no guidelines specific to mental or substance use health to support its effective and safe use. The recently published E-Mental Health Strategy for Canada highlights the need for safety in this field.

The new National Guidance for Artificial Intelligence Use in Mental Health and Substance Use Health Care will provide guidance, tools, and resources  to help practitioners, organizations, and health leaders in efficiently evaluating and implementing AI-enabled mental health and substance use health care services and solutions. It will also support people with lived or living experience of mental health or substance use health concerns in making informed choices about these technologies, while helping technology companies design and improve such solutions to meet the needs of those who use them.

“People are excited about what AI can bring, but the saying ‘break it then fix it’ can take on new dangers when what is at risk is people’s lives. This guidance will allow innovators to move fast while working to ensure it’s done safely and in a way that increases impact and access,” says CCSA CEO Dr. Alexander Caudarella.

The Mental Health Commission of Canada President and CEO Lili-Anna Pereša adds, “Technology can be a powerful ally in transforming mental health care, but innovation must be matched with responsibility. Communities are the best problem-solvers. By working together with developers, providers, and people with lived experience, we’re creating guidance that ensures AI enhances care safely and meaningfully.”

The National Guidance team will share its early findings at several upcoming conferences, including the World Psychiatric Association’s World Congress of Psychiatry, the Canadian Centre on Substance Use and Addiction’s Issues of Substance conference, and the eMental Health International Collaborative (eMHIC) Congress.

In Canada, mental health and substance use health needs are highly common, yet many people continue to face significant barriers to care, including limited access, stigma, financial costs, and lack of tailored treatment options.

 
The National Guidance for Artificial Intelligence Use with Mental Health and Substance Use Health is expected to launch in 2026/2027.

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About CCSA:

CCSA was created by Parliament to provide national leadership to address substance use in Canada. A trusted counsel, we provide national guidance to decision makers by harnessing the power of research, curating knowledge and bringing together diverse perspectives. CCSA activities and products are made possible through a financial contribution from Health Canada. The views of CCSA do not necessarily represent the views of Health Canada.

About The Mental Health Commission of Canada:

The Commission leads the development and dissemination of innovative programs and tools to support the mental health and wellness of people in Canada. Through its unique mandate from the Government of Canada, the Commission supports federal, provincial, and territorial governments as well as organizations in the implementation of sound public policy. The Commission’s current mandate aims to deliver on priority areas identified in the Mental Health Strategy for Canada in alignment with the delivery of its strategic plan. 

Media contacts:

Canadian Centre on Substance Use and Addiction
Christine LeBlanc, Senior Strategic Communications Advisor
613-898-6343 | cleblanc@ccsa.ca

Mental Health Commission of Canada
media@mentalhealthcommission.ca

The post Canada Gets its First National Guidance on AI for Mental and Substance Use Health appeared first on Mental Health Commission of Canada.

Help-Seeking in the Age of AI: Cross-Sectional Survey of the Use and Perceptions of AI-Based Mental Health Support Among US Adults

<strong>Background:</strong> Anecdotal evidence suggests that an increasing number of people are turning to generative artificial intelligence (GenAI) tools or artificial intelligence (AI)-assisted chatbots to discuss and manage mental health concerns. However, systematic data on the use and perception of such tools remain scarce. <strong>Objective:</strong> This study aimed to examine how young and middle-aged adults in the United States use GenAI and AI-assisted mental health chatbots as mental health resources and assess their preferences for these tools relative to human mental health professionals. <strong>Methods:</strong> An anonymous online survey was conducted in October 2025 among US adults in a commercial online panel sample of US adults aged 18-49 years (N=1805). Respondents were asked about the sources they typically turn to when facing mental health concerns, their frequency of using GenAI tools or chatbots for mental health support, and whether the frequency of seeing human mental health professionals had changed since they started using AI tools for mental health support. Attitudes toward AI-based mental health support were assessed and compared with attitudes toward human mental health professionals. <strong>Results:</strong> In this sample, of the 1805 respondents, 638 (35.2%) reported using AI tools at least once a week in a typical week for mental health support, and 99 (5.5%) were classified as “heavy users” who reported regularly spending hours discussing their mental health concerns through AI. However, nearly 60% of respondents reported that they would turn first to family (1078/1805) and friends (1046/1805) when facing mental health concerns. Respondents who screened positive for moderate to severe depressive or anxiety symptoms were more likely to use AI-based mental health support compared to those without these symptoms (adjusted odds ratio 1.71, 95% CI 1.36-2.15) and those with suicidal ideation were more likely to be heavy AI users (adjusted odds ratio 2.42, 95% CI 1.49-3.95). Among those who had ever seen a human mental health professional (n=511), 28.4% (145/511) reported a perceived decline in visit frequency to human mental health professionals since they started using AI tools for the same purpose. Participants expressed more favorable attitudes toward human mental health professionals than toward AI-based tools. However, among heavy AI users, perceptions of AI-based mental health support and human counseling were nearly equivalent in positivity. <strong>Conclusions:</strong> AI appears to be an important component of the mental health help-seeking landscape among respondents in this sample. Although most respondents still preferred human professionals, a subset reported relying on AI tools for comparable support. Ongoing monitoring and ethical guidelines are needed to ensure that AI technologies expand access to care while being safely and effectively integrated into the broader continuum of mental health services.

Mass Media Narratives of Psychiatric Adverse Events Associated With Generative AI Chatbots: Rapid Scoping Review

<strong>Background:</strong> Generative artificial intelligence (AI) chatbots have rapidly entered public use, including in contexts involving emotional support and mental health–related interactions. Although these systems are increasingly accessible, concerns have emerged regarding potential adverse psychiatric outcomes reported in public discourse, including psychosis, suicidal ideation, self-harm, and suicide. However, these reports largely originate from journalistic accounts rather than systematically verified clinical data. <strong>Objective:</strong> This rapid scoping review aimed to systematically map and characterize mass media narratives describing alleged adverse psychiatric outcomes temporally associated with generative AI chatbot interactions. <strong>Methods:</strong> A rapid scoping review methodology was applied to publicly accessible news articles identified primarily through Google News searches. Articles published from November 2022 onward were screened for eligibility if they described a specific case in which psychiatric deterioration or crisis was temporally linked to generative AI use. Data were extracted using a structured coding template capturing article characteristics, demographic information, AI platform features, interaction intensity, outcome type and severity, type of evidence reported, and causal attribution language. Descriptive statistics and cross-tabulations were performed. <strong>Results:</strong> A total of 71 news articles representing 36 unique cases were included. Suicide death was the most frequently reported outcome (35/61, 57.4% cases with complete severity coding), followed by psychiatric hospitalization (12/61, 19.7%). Fatal outcomes were disproportionately represented among minors (19/21, 90.5%) compared with adults (17/35, 48.6%). ChatGPT was the most frequently cited platform (51/71, 71.8%), followed by Character AI (10/71, 14.1%). Causal attribution most commonly referenced AI system behavior (45/61, 73.8%), and the term “alleged” was the predominant causal descriptor (33/61, 54.1%). Evidence sources were primarily chat logs or screenshots (34/61, 55.7%), while police or medical documentation was rare (1/61, 1.6%). Regulatory calls were present in 51 of 60 (85%) articles with nonmissing data. <strong>Conclusions:</strong> Mass media reporting of generative AI–related psychiatric harms is concentrated around severe outcomes, particularly suicide deaths among youth, and is frequently framed within regulatory and corporate accountability narratives. While causality cannot be established from media reports, consistent patterns of high-intensity interactions, user vulnerability, and limited safeguard reporting highlight the need for structured safety surveillance, transparent AI risk auditing, and clearer governance frameworks. As generative AI becomes increasingly integrated into everyday psychosocial contexts, systematic research and formal safety monitoring will be necessary to determine whether media-reported harms correspond to verifiable clinical risk patterns.