Our Blog: Upward Alabama

When Falling Asleep Feels Like Falling Apart: Understanding Fear of Sleep and Its Ties to Insomnia, PTSD, Anxiety, and OCD

By Courtney Worley, Ph.D., ABPP, DBSM, M.P.H.

Sleep

Anxiety OCD PTSD Insomnia

Posted: September 12, 2026

Most people who struggle with sleep are afraid of NOT sleeping. But there is a smaller, less-discussed group of people for whom the dread runs in the opposite direction. For them, the frightening moment is not the hours of wakefulness.: it is the instant sleep starts to take hold. They fight to stay awake, not because they cannot sleep, but because some part of them does not want to.

OCD or Autism? Understanding the Difference (and Why Some People Have Both)

By Courtney Worley, Ph.D., ABPP, DBSM, M.P.H.

OCD

Autism Treatment

Posted: August 20, 2026

Symptoms of OCD and autism can look a lot alike from the outside. Both can involve repetition. Both can involve routines that feel non-negotiable. Both can involve an intense focus on something specific. But underneath that surface resemblance, they work in very different ways — and understanding the difference matters, because the right kind of support looks completely different depending on which one (or both) you're dealing with.

The Pill, the Patch, and Your Sleep: What Every Woman Needs to Know About Hormonal Contraceptives and Sleep Health

By Courtney Worley, Ph.D., ABPP, DBSM, M.P.H.

Sleep

Behavioral Sleep Medicine CBT-I Insomnia

Posted: July 18, 2026

A newly published systematic review in Sleep Medicine Reviews — one of the most prestigious journals in the field — has brought into focus something that has been quietly under-researched for decades: hormonal contraceptives, one of the most widely-used medications in the world, appear to meaningfully influence how women sleep. And yet, most women have never been told this, and most healthcare providers haven’t been trained to ask. This post is about changing that conversation.

Pure O(CD)--When Your Mind Will Not Stop: A Guide to Understanding OCD and Specialized Care

By Courtney Worley, Ph.D., ABPP, DBSM, M.P.H.

OCD

Anxiety Treatment

Posted: June 14, 2026

Mental compulsions are one of the most misunderstood and under-diagnosed features of Obsessive Compulsive Disorder. Often individuals with mental rituals are misdiagnosed, undertreated, or told that what they are doing — trying to think their way out of anxiety — is actually the right approach. The skill of learning to challenge thoughts is standard practice in many therapies and is effective in many disorders. In OCD, it is not. And understanding why is the first step toward real relief.