Category Archives: OCD

Why Do We Need Therapy Even When the System is Broken?

While scrolling through the endless noise of the internet, I came across a strikingly profound perspective. A user posted:

“Asians don’t need therapy because our psychological issues are, at their core, systemic and structural.”

This statement immediately took me back to an experience I had over a decade ago. I was working with a consulting firm when they posed a classic structural dilemma: “If a married couple lives apart—one in China, one in the US—how do they maintain their marriage?”

It was a profound question indeed. Can the suffering imposed by heavy societal structures really be resolved just by sitting on a therapist’s couch? Is therapy some kind of magic wand that makes structural obstacles disappear?

Of course not.

If therapy cannot alter our broader environment—if it cannot cancel the relentless exams crushing high schoolers, erase the physical distance between separated couples, or single-handedly dismantle systemic pain—then why do we still need it?

Are You Actually Sick, or Are You Just “Normally Inflamed” in an Unhealthy Construct?

Imagine if you were forced to run every day in a pair of shoes that were two sizes too small. After just a few days, your feet would inevitably start to bleed, swell, and hurt intensely.

If someone pointed at your bleeding feet at that exact moment and said, “Your feet are just too weak; you are sick,” you would find it completely absurd—maybe even infuriating. Why? Because you know the problem isn’t your feet at all. It’s the shoes.

The relentless hyper-competitiveness of modern society is exactly like that ill-fitting pair of shoes.

  • The anxiety you feel is actually your brain alerting you: “It’s unsafe here, run!”
  • The depression and lack of motivation you feel is actually your brain protecting you: “We are utterly exhausted; initiating a forced shutdown.”

So, please say this to yourself first: “I am not weak. I am simply a normal person having a normal reaction to an unhealthy structure.” Your pain isn’t a design flaw or a personal defect; it is a vital, protective warning signal sent by your own body.

The Structure Won’t Change, and Travel Won’t Cure It. What Now?

Often, when we are completely drained by life, well-meaning friends or glossy advertisements will offer a simple solution: “Go travel! Take a beach vacation, see the world, and you’ll feel better.”

So, we give it a try. We spend our hard-earned money on a getaway, lie on a beach for two weeks, and genuinely feel like we’ve come back to life. But the cruel reality hits the exact moment we step off the plane and return to our desks. That familiar, heavy sense of suffocation rushes right back.

This happens because a temporary escape cannot cure systemic pain. We simply cannot rely on a plane ticket to permanently flee a rigid and pressured reality.

Therapy is About Breathing Again in a Chaotic World

Since we cannot change society overnight, nor can we travel abroad forever, are we supposed to just sit back and let those unfit shoes grind our feet hopelessly?

Of course not. This is the true meaning of psychotherapy and psychiatry.

Mental health professionals cannot overthrow the system for you, but they can walk with you to achieve three things:

Lift the burden of self-blame: The therapy room is a safe space. Here, we can help you untangle the threads: which pains are forced upon you by the environment, and which ones you can try to let go of. The moment you stop blaming yourself, healing begins.

Teach you how to “hold an umbrella in the rain”: When it is pouring outside, we cannot command the sky to stop raining, but therapy can give you an umbrella. We will practice together: How to set boundaries in an overloaded job? How to protect yourself in toxic relationships? How to adjust your pace in a frantic environment?

Reclaim your autonomy: The world constantly dictates who you should be and how much money you need to make to be considered “successful.” But here, we care more about: “How are you feeling today? What do you want?” We help you find your own voice—the one drowned out by the frantic rhythm of life.

To Those Who Are Feeling Lost Right Now

Stepping into a therapy room or seeking psychiatric help never means you are a “failure,” nor does it mean you should be reduced to just a “patient.”

On the contrary, it means you are a perceptive, deeply awake individual. In a world where so many pretend to be fine while being numbly consumed by the system, you have chosen to honestly acknowledge the pain—and you have made the courageous decision to reach out and pull yourself up.

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The Truth About Long COVID and Recovery Strategies

by Dr. Pearl Hu @ Remede Therapy

In my practice at Remède, I’ve noticed a growing trend: high achieving professionals and parents coming in with a profound sense of “stuckness.” They describe brain fog, lingering fatigue, and a constant state of being overwhelmed. Naturally, the question they often ask is: “Do I have Long COVID?”

The Narrative vs. The Clinic

Pulitzer Prize winning journalist Ed Yong has written extensively in The Atlantic about the devastating reality of this condition, noting that for many, Long COVID isn’t just a lingering cough—it’s a “biological wreckage” that can shatter a person’s sense of self.

Yong’s reporting has been vital in giving a voice to the rare few who face permanent physiological damage. However, as we move further into 2026, we must look at the broader clinical landscape.

The Problem with Loose Definitions

The clinical definition of Long COVID remains remarkably broad, often encompassing any symptom present three months after infection. This “catch all” approach is too loose for true clinical significance. Because the criteria include non specific symptoms like general fatigue or headaches—which most of the population experiences for various reasons—it inflates the perceived scale of the “disease.”

The reality is that the vast majority of people recover fully. While a small fraction of individuals suffers from legitimate, permanent damage, these are the rare outliers. For most, the “lingering” symptoms are not a sign of a permanent viral takeover, but a nervous system that hasn’t yet found its way back to baseline.

Why the 7% Figure is a Myth

To suggest an inflated rate of 7%—roughly 18 million American adults—is simply unreasonable for any medical professional. To put that in context, consider the prevalence of diabetes. As of 2026, approximately 14.7% of the U.S. population is living with diabetes.

If “Serious Long COVID” truly affected 7% of the world, it would represent a health crisis nearly half as widespread as the entire diabetes epidemic. If a new, chronic infection of that magnitude had emerged overnight, the global medical infrastructure would have collapsed years ago. Most of these high figures are derived from survey data, which is highly prone to selection bias; those struggling with general burnout are naturally looking for a framework to explain their exhaustion.

The PANDAS Parallel: Searching for a Villain in OCD

The tendency to search for a hidden biological “glitch” to explain sudden psychological shifts isn’t unique to the COVID era. For years, we have seen a similar phenomenon in the diagnosis of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections).

The narrative suggests that a common infection—like Strep—suddenly “attacks” the brain, causing an overnight onset of OCD, tics, and anxiety. While estimated to affect approximately 1 in 200 children (0.5%), the fear of this invisible “enemy” often overshadows clinical reality.

  • The Trap of the Biological Label: When we tell a person (or a parent) that their OCD is purely a “brain infection,” we inadvertently strip them of their agency. It creates a sense of “brokenness” that can only be fixed by a miracle cure.
  • The Reality of Regulation: PANDAS often presents with much worse outcomes and higher distress than traditional OCD due to its acute nature. However, the gold standard treatment remains CBT and ERP (Exposure and Response Prevention). While immunotherapy may be used in rare, severe cases where traditional methods fail, the primary path to recovery is teaching the nervous system how to tolerate uncertainty and quiet the alarm.

The Symptoms: A Familiar List

The list of symptoms typically associated with Long COVID and post viral syndromes is extensive and varied:

  • Neurological: Brain fog, difficulty concentrating, and sleep disturbances.
  • Autonomic: Heart palpitations (POTS) and dizziness upon standing.
  • Systemic: Extreme fatigue and joint pain.
  • Psychological: Heightened anxiety, intrusive thoughts, and a feeling of being constantly “on edge.”

A Shift in Perspective: Integrating COVID into Known Medicine

Rather than viewing “Serious Long COVID” as a mysterious new disease, we are seeing that the body’s response to COVID 19 often mirrors what we have seen with other common respiratory viruses.

The encouraging news is that none of these symptoms are new to the medical field. Conditions like dysautonomia and POTS existed long before 2020. We already possess a robust toolkit to manage these responses. By viewing these through the lens of established medicine, we move away from the “unknown” and toward a clear path to recovery.

The Remedy: Regulating the “Software”

If biological “hardware” damage is that rare, why do so many people feel like they are living in a fog? The answer often lies in overflowing anxiety impacting performance. Our nervous systems are like high performance computers; sometimes the hardware is fine, but the “software” is running too many high stress programs in the background.

For those suffering, it is not the virus that impairs you; it is the inaction of what you can still do despite the symptoms. The remedy for chronic fatigue is not to withdraw from life, but to gradually regain your stamina and live a healthy life—eat, sleep, and exercise normally.

Expanding the Toolkit: Beyond Movement

While recalibrating movement is essential, regulating the nervous system requires a holistic approach. Clinical guidance in 2026 published by Patient-Led Research Collaborative emphasizes several non pharmacological interventions that help clear the fog, in addition to nutrition and sleep hygiene:

  • Pacing, Energy, and Movement: Instead of “pushing through” fatigue, utilize a pacing strategy. Identify your current window of tolerance and gradually expand it.
    • Don’t Stop Moving: Total withdrawal is not recommended.
    • Focus on Tone: Elevate your parasympathetic tone (your “rest and digest” system).
    • Start Right: Begin with yoga and gentle aerobic exercise. Avoid high intensity cardio initially to avoid overstimulating a sensitive system.
  • Hydration and Sodium Management: For those experiencing POTS like symptoms, increasing fluid intake to 2 to 3 liters daily and potentially increasing salt consumption (under medical supervision) can help maintain blood pressure and reduce dizziness.
  • Strategic Compression: Use of abdominal binders or waist high compression stockings can physically prevent blood pooling, providing immediate relief for the “lightheaded” feeling that fuels autonomic anxiety.

Moving From Fear to Performance

The danger of mislabeling chronic stress or OCD as an incurable viral condition is the Nocebo Effect. If you believe your fatigue or intrusive thoughts are a permanent mystery, your anxiety spikes, reinforcing the physical symptoms.

Software issues can be recalibrated. By shifting the focus from “treating a virus” to regulating the nervous system, we reclaim our agency. If you choose not to take action and instead continue seeking external “causes,” it will be a very frustrating journey; you are essentially wasting time on things you do not have control over.

True recovery begins when we apply this fundamental wisdom:

“May I find the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”

We move away from the fear of a “ticking time bomb” and toward proven tools that quiet the alarm, clear the fog, and restore your ability to perform at your highest level.

Reclaim Your Perspective The statistical biological norm is recovery. By confronting the uncertainty and addressing the “overflow” of anxiety, you can get unstuck and return to the high performing, poetic life you were meant to lead.

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What to do if my child has OCD?

Pediatric OCD is diagnosed in school-age children between age 7 to 12. The diagnosis of OCD in kids and teens is often overlooked and under-diagnosed. If your child struggles with the following symptoms, your child may struggle with OCD:

These obsessions are the most common among kids and teens:

  • Fear of dirt or germs
  • Fear of contamination
  • A need for symmetry, order, and precision
  • Religious obsessions
  • Preoccupation with body wastes
  • Lucky and unlucky numbers
  • Sexual or aggressive thoughts
  • Fear of illness or harm coming to oneself or relatives
  • Preoccupation with household items
  • Inrusive sounds or words

These compulsions are the most common among kids and teens:

  • Grooming rituals, including hand washing, showering, and teeth brushing
  • Repeating rituals, including going in and out of doorways, needing to move through spaces in a special way, or rereading, erasing, and rewriting
  • Checking rituals to make sure that an appliance is off or a door is locked, and repeatedly checking homework
  • Rituals to undo contact with a “contaminated” person or object
  • Touching rituals
  • Rituals to prevent harming self or others
  • Ordering or arranging objects
  • Counting rituals
  • Hoarding and collecting things of no apparent value
  • Cleaning rituals related to the house or other items

OCD is like the hiccups of the brain. It makes your child get stuck and cannot stop doing the compulsions. When you attempt to interrupt OCD, your child can have a melt down. The cause of OCD is believed to reside in the deep brain circutry that involves prefrontal cortex (orbitofrontal and anterior cingulate cortexes), basal ganglia, and thalamus. Very rarely, certain autoimmune process after streptococcus infection can trigger OCD and it is called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with Streptococcal infections).

When you suspect your child struggles with OCD, it is very important to work with professionals who specialize in cognitive behavioral therapy (CBT). Your involvement in treatment process is also very important to the treatment outcomes. Sometimes, medications can facilitate the therapeutic process of CBT for severe cases of OCD. Other alternative treatment for refractory OCD include transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS).

Please check out the following website for resources if your child struggles with OCD.

https://www.ocdkidsmovie.com/ocdresources