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Archive for What is ?

Post traumatic stress disorder (PTSD)

PTSD can develop after a critical incident or stressor .Also among witnesses to a critical incident. Post-traumatic stress disorder is a type of anxiety disorder. It can occur after you've seen or experienced a traumatic event that involved the threat of injury or death. Although there are numerous situations that can cause PTSD to develop the cause is unknown. There is a wide range of factors including psychological , genetic , physical  and social . With PTSD the bodies response to stress is altered . It affects the stress hormones and chemical that carry messages between the nerves. PTSD can affect anyone although it is widely believed that having a traumatic event in your history can increase the risk .

In PTSD, symptoms are present for at least 30 days.

At risk groups for PTSD

Emergency services personal

Survivors of road traffic accidents

Survivors or rape, sexual abuse  etc

Those diagnosed with a serious or life threatening illness

Been taken hostage

Serving troops who experience violence

Torture

Signs and Symptoms of PTSD

Reoccurring or obtrusive thoughts about the incident

Avoiding reminders of the incident –

Flashbacks

Inability to relax or sleep

Nightmares

Emotional Numbness and Isolation from others

Loss of interest in activities that where once seen as enjoyable

Only seeing the negative

Hypersensitivity

Irritability , tension

Physical signs and symptoms

Aches and pains

Diarrhoea

Irregular heartbeat

Headaches

Feeling of panic

Depression

Excessive use of alcohol or other drugs

 

There are three distinct categories to PTSD symptoms

Relieving the event to an extent that it disturbs regular day to day activity.

  • Upsetting memories , flashbacks , nightmares and strong uncomfortable reminders

Avoidance – Been emotionally numb or feeling of not caring, feeling detached, been unable to remember important parts of the traumatic event , having a lack of interest in activities that where once pleasurable , hiding moods , avoiding places and things , feeling a sense of lack of future .

Arousal – There can be difficulty concentrating, been startled easily, been hyper vigilant , feeling irritable or anger , having sleep difficulty or insomnia

Guilt is another emotion that can be experienced in particular in the event of a death (survivors guilt)

Symptoms of survivors guilt are anxiety, stress , tension , agitation or excitability , dizziness , fainting , feeling of palpitations , headaches ,

 Treatment of PTSD

Trying to get back into the usual routine

Talk with someone you trust

Relaxation exercises

Healthy diet and activity

Spend time with family and friends

Returning to the site of the incident

Be gentle on yourself

Psychotherapy

Cognitive behavioral therapy

Group therapy

Medication

Eye movement desensitization and reprocessing ( EMDR)

 

PTSD is a normal reaction to an abnormal reaction.

 

Borderline Personality Disorder (BPD)

What is Borderline personality disorder?

BPD is a personality disorder referred to as a disturbance or dysfunction in the personality of a person. It is general found in over 18 although many adolescents have also been diagnosed with bpd . Characteristics of bpd include the depth and variability of moods. A personality disorder is a type of mental illness and to be diagnosed particular criteria must be met. With personality disorders, the symptoms have usually been present for a long time. These symptoms have an overall negative effect on the sufferer’s life.

 Signs and Symptoms of borderline personality disorder

Proneness to impulsive behaviour – This impulsiveness can manifest itself in negative ways – Self harm , angry out bursts and the possibility of criminality as a result of impulsive urges.

Affective lability- This means that sufferers have trouble stabilising moods and as a result, mood changes can become erratic.

Reality distortion,

Tendency to see things in ‘black and white’ terms,

Excessive behaviour such as gambling or sexual promiscuity,

Proneness to depression.

 Other symptoms can co-exist with BPD including anziety disorders , eating disorders , OCD and bipolar disorder

BPD manifests itself in idealization and devaluation episodes as well as chaotic and unstable relationships with others, there can also be chaos and instability in self image , identity and behaviour as well as a disturbance in the sense of self .There are cases identified where disassociation can present .

 If left untreated, symptoms may worsen and indeed suicide attempts are a very real possibility.

 From the above symptoms ,they can make it difficult for a person with BPD to maintain healthy relationships as their behavior and action can be hard and difficult to live with . This is where education is key , education can allow the other party in a relationship the opportunity to become more tolerant and empathise with the person with BPD . BPD is not usually diagnosed pre adolescence

Schizophrenia

What is Schizophrenia?

A psychiatric disease characterized by a distorted interpretation of reality resulting in hallucinations, delusions, and disordered thinking and behavior. Contrary to belief it does not mean a split personality. Untreated, the disease can cause severe emotional, behavioral, health, and legal and financial problems. Lifelong treatment is needed, and can enable many patients to live normal productive lives. This is a serious mental disorder with about 10% of patients committing suicide. The disease usually first appears in the teenage years.

 

What are the Symptoms?

Symptoms typically begin gradually and worsen with time and include: trouble sleeping, trouble concentrating, withdrawing from family and friends, bizarre motor behavior in which there is less reaction to the environment (catatonic behavior), false beliefs or thoughts (delusions), hearing voices, seeing things (hallucinations), thoughts race between unrelated topics (disordered thinking).

 

How it can be treated?

Treatment depends on the severity of symptoms but may include: antipsychotic medications (haloperidol/Haldol, clozapine/Clozaril, risperidone/Risperdal, olanzapine/Zyprexa, quetiapine/Seroquel, ziprasidone/Geodon, aripiprazole/Abilify, paliperidone/Invega), psychiatric and psychologic counseling, and/or hospitalizations.

 

Reference: Harvard Medical School.

What are panic attacks?

Panic attacks may be symptoms of an anxiety disorder. Panic symptoms are strikingly different from other types of anxiety; panic attacks are so very sudden and often unexpected, appear to be unprovoked, and are often disabling.

Once someone has had a panic attack, for example, while driving, shopping in a crowded store, or riding in an elevator, he or she may develop irrational fears, called phobias, about these situations and begin to avoid them.

Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point at which the mere idea of doing things that preceded the first panic attack triggers future panic attacks, resulting in the individual with panic disorder being unable to drive or even step out of the house.

At this stage, the person is said to have panic disorder with agoraphobia. Thus, there are two types of panic disorder, panic disorder with or without agoraphobia.

Like other illnesses, panic disorder can have a serious impact on a person's daily life unless the individual receives effective treatment.

Panic attacks in children may result in the child's grades declining, avoiding school and other separations from parents, as well as substance abuse, depression, and suicidal thoughts, plans, and/or actions.

What is Bipolar?

The distinguishing characteristic of Bipolar Disorder, as compared to other mood disorders, is the presence of at least one manic episode. Additionally, it is presumed to be a chronic condition because the vast majority of individuals who have one manic episode have additional episodes in the future. The statistics suggest that four episodes in ten years is an average, without preventative treatment. Every individual with bipolar disorder has a unique pattern of mood cycles, combining depression and manic episodes, that is specific to that individual, but predictable once the pattern is identified. Research studies suggest a strong genetic influence in bipolar disorder.

Bipolar disorder typically begins in adolescence or early adulthood and continues throughout life. It is often not recognized as a psychological problem, because it is episodic. Consequently, those who have it may suffer needlessly for years without treatment.

Effective treatment is available for bipolar disorder. Without treatment, marital breakups, job loss, alcohol and drug abuse, and suicide may result from the chronic, episodic mood swings. The most significant treatment issue is noncompliance with treatment. Most individuals with bipolar disorder do not perceive their manic episodes as needing treatment, and they resist entering treatment. In fact, most people report feeling very good during the beginning of a manic episode, and don't want it to stop. This is a serious judgment problem. As the manic episode progresses, concentration becomes difficult, thinking becomes more grandiose, and problems develop.  Unfortunately, the risk taking behavior usually results in significant painful consequences such as loss of a job or a relationship, running up excessive debts, or getting into legal difficulties. Many individuals with bipolar disorder abuse drugs or alcohol during manic episodes, and some of these develop secondary substance abuse problems.

HOW DO I GET A DIAGNOSIS?

 

The first step to getting appropriate treatment, for depression or any emotional problem, is a complete psychological evaluation to determine whether you have a depressive illness, and if so, what type of depression. Consultation with a psychologist will include a review of your physical health history. Some medications as well as some medical conditions can cause symptoms of depression, so your psychologist will ask your family physician to rule out these possibilities if other physical symptoms are evident.

However, physicians often focus only on the physical aspects of depression, and may prescribe medication without referring you for psychological treatment or evaluation. If you experience the symptoms of depression, as described on this website, you should talk to a psychologist, to assess whether psychological treatment is indicated, even if it not suggested by your physician. As a general rule, you should never take antidepressant medication alone, without also beginning psychotherapy, or at least seeing a psychologist for an evaluation.

A good psychological diagnostic evaluation will include a complete history of your symptoms, i.e., when they started, how long they have lasted, how severe they are, whether you've had them before and, if so, whether you were treated and what treatment you received. Your psychologist should ask you about alcohol and drug use, and if you have had thoughts about death or suicide. Further, a history should include questions about whether other family members have had depression and if treated, what treatments they may have received and which were effective.

Lastly, the psychological diagnostic evaluation will include a mental status examination to assess the full range of psychological symptoms and problems. This will help identify any other psychological problems that might be present, and will help determine the most appropriate treatment for you.

Treatment choice will depend on the outcome of the evaluation. Most people do well with psychotherapy, but some require treatment with antidepressants in addition to psychotherapy. Medication can allow you to to gain relatively quick symptom relief, if you are experiencing severe and disabling symptoms. However, medication does not "cure" the depression, it only treats the symptoms. If you are depressed, you need psychotherapy to help you to learn more effective ways to deal with life's problems, and to change the negative thoughts and attitudes that have caused you to develop depression.