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Bi-Polar Disorders

 

 

Definition

 

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

 

There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

 

  • Bipolar I Disorder— defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.

  • Bipolar II Disorder— defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.

  • Cyclothymic Disorder (also called cyclothymia)— defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

  • Other Specified and Unspecified Bipolar and Related Disorders— defined by bipolar disorder symptoms that do not match the three categories listed above.

 

Signs and Symptoms

 

People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and unusual behaviors. These distinct periods are called “mood episodes.” Mood episodes are drastically different from the moods and behaviors that are typical for the person. Extreme changes in energy, activity, and sleep go along with mood episodes.

 

People having a manic episode may:

 

  • Feel very “up,” “high,” or elated

  • Have a lot of energy

  • Have increased activity levels

  • Feel “jumpy” or “wired”

  • Have trouble sleeping

  • Become more active than usual

  • Talk really fast about a lot of different things

  • Be agitated, irritable, or “touchy”

  • Feel like their thoughts are going very fast

  • Think they can do a lot of things at once

  • Do risky things, like spend a lot of money or have reckless sex

 

People having a depressive episode may:

 

  • Feel very sad, down, empty, or hopeless

  • Have very little energy

  • Have decreased activity levels

  • Have trouble sleeping, they may sleep too little or too much

  • Feel like they can’t enjoy anything

  • Feel worried and empty

  • Have trouble concentrating

  • Forget things a lot

  • Eat too much or too little

  • Feel tired or “slowed down”

  • Think about death or suicide

 

Sometimes a mood episode includes symptoms of both manic and depressive symptoms. This is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while at the same time feeling extremely energized.

 

Bipolar disorder can be present even when mood swings are less extreme. For example, some people with bipolar disorder experience hypomania, a less severe form of mania. During a hypomanic episode, an individual may feel very good, be highly productive, and function well. The person may not feel that anything is wrong, but family and friends may recognize the mood swings and/or changes in activity levels as possible bipolar disorder. Without proper treatment, people with hypomania may develop severe mania or depression.

 

Diagnosis

 

Proper diagnosis and treatment help people with bipolar disorder lead healthy and productive lives. Talking with a doctor or other licensed mental health professional is the first step for anyone who thinks he or she may have bipolar disorder. The doctor can complete a physical exam to rule out other conditions. If the problems are not caused by other illnesses, the doctor may conduct a mental health evaluation or provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder.

 

Adapted from National Institute of Mental Health

 

 

 

The Addictive Personality

 

An addictive personality refers to a particular set of personality traits that make an individual predisposed to developing addictions. This hypothesis states that there are common elements among people with varying addictions that relates to personality traits. A person who is substance-dependent are characterized by having at least one physical or psychological dependency on a substance that negatively affects his/her quality of life. However, people with addictive personalities are also highly at risk of becoming addicted to gambling, food, pornography, exercise, and work, and are also sometimes subject to codependency. Scientists have been better able to understand addictive personalities as researchers delve further into understanding the physiological chemistry of addiction. Alan R. Lang of Florida State University, author of an addiction study prepared for the United Styates National Academy of Sciences, said, "If we can better identify the personality factors, they can help us devise better treatment and can open up new strategies to intervene and break the patterns of addiction."

 

Psychological factors

 

Alan R Lang has done much research on personality traits that play into addiction. While his research found that there is no single set of traits that is definitive of an “addictive personality", he did find several “significant personality factors.” These main factors are:

 

  • impulsivity

  • value on nonconformity combined with weak commitment to socially valued goals for achievement

  • sense of social alienation and tolerance for deviance

  • heightened stress and lack of coping skills

 

Some advocate for the existence of an “addictive belief system” that leads people towards being more likely to develop addictions. This system is rooted in cognitive distortions like “I cannot make an impact on my world” and other maladaptive attitudes like “I am not good enough.” These core beliefs, often very black and white thinking, set up the person to develop the many traits common in the addictive personality, such as depression and emotional insecurity. Cognitive and perceptual styles also have been shown to play a role in addictions. People with addictions and addictive personalities tend to have an external locus of control, and they also have an increased tendency towards field dependence. However, it is unclear whether these are causative traits or simply personality traits that tend to be found in people with addictions.

 

Environmental factors

 

Although genes factor into making someone prone to addiction, the environment has the greatest effect. Concurrent with the widely accepted  diathesis-stress model, if an individual has a predisposition towards developing addictions, this alone will not cause problems. It is encountering a stress in the environment that causes the addiction to manifest. Experience with trauma appears to make someone more prone to addictions, especially “severe childhood stress.” Examples such as physical or sexual abuse, and unpredictable expectations and behavior of parents, increase a person's risk for developing addiction.

 

Signs and symptoms

 

People who suffer from an addictive personality spend excessive time on a behavior or with an item, not as a hobby but because they feel they have to.  Addiction can be defined when the engagement in the activity or experience affects the person’s quality of life in some way. In this way, many people who maintain an addictive personality isolate themselves from social situations in order to mask their addiction.

 

People that face this issue are currently defined to have a "brain disease" as promoted by the National Institute on Drug Abuse and other authorities. People who experience addictive personality disorders typically act on impulses and cannot deal with delayed gratification. At the same time, people with this type of personality tend to believe that they do not fit into societal norms and therefore, acting on impulses, deviate from conformity to rebel. People with addictive personalities are very sensitive to emotional stress. They have trouble handling situations that they deem frustrating, even if the event is for a very short duration. The combination of low self-esteem, impulsivity, and low tolerance for stress causes these individuals to have frequentmood swings and often suffer from some sort of depression. A coping mechanism to deal with their conflicting personality becomes their addiction and the addiction acts as something that the person can control when they find it difficult to control their personality traits.

 

People with addictive personalities typically switch from one addiction to the next. These individuals may show impulsive behavior such as excessive caffeine consumption, Internet use, eating chocolate or other sugar-laden foods, television watching, or even running.

 

Extraversion, self-monitoring, and loneliness are also common characteristics found in those who suffer from addiction. Individuals who score high on self-monitoring are more prone to developing an addiction. High self-monitors are sensitive to social situations; they act how they think others expect them to act. They wish to fit in, hence they are very easily influenced by others. Likewise, those who have low self-esteem also seek peer approval; therefore, they participate in "attractive" activities such as smoking or drinking to try to fit in.

 

People with addictive personalities find it difficult to manage their stress levels. In fact, lack of stress tolerance is a telltale sign of the disorder. They find it difficult to face stressful situations and fight hard to get out of such conditions. Long-term goals prove difficult to achieve because people with addictive personalities usually focus on the stress that comes with getting through the short-term goals. Such personalities will often switch to other enjoyable activities the moment that they are deprived of enjoyment in their previous addiction.

 

Addictive individuals feel highly insecure when it comes to relationships. They may often find it difficult to make commitments in relationships or trust their beloved because of the difficulty they find in achieving long-term goals. They constantly seek approval of others and as a result, these misunderstandings may contribute to the destruction of relationships. People suffering from addictive personality disorder usually undergo depression and anxiety, managing their emotions by developing addiction to alcohol, other types of drugs, or other pleasurable activities.

 

An addict is more prone to depression, anxiety, and anger. Both the addict's environment, genetics and biological tendency contribute to their addiction. People with very severe personality disorders are more likely to become addicts. Addictive substances usually stop primary and secondary neuroses, meaning people with personality disorders like the relief from their pain.

 

Suicide

 

Introduction

 

Suicide is a major public health concern. Over 40,000 people die by suicide each year in the United States; it is the 10th leading cause of deathoverall. Suicide is complicated and tragic but it is often preventable. Knowing the warning signs for suicide and how to get help can help save lives.

 

Signs and Symptoms

 

The behaviors listed below may be signs that someone is thinking about suicide.

 

  • Talking about wanting to die or wanting to kill themselves

  • Talking about feeling empty, hopeless, or having no reason to live

  • Making a plan or looking for a way to kill themselves, such as searching online, stockpiling pills, or buying a gun

  • Talking about great guilt or shame

  • Talking about feeling trapped or feeling that there are no solutions

  • Feeling unbearable pain (emotional pain or physical pain)

  • Talking about being a burden to others

  • Using alcohol or drugs more often

  • Acting anxious or agitated

  • Withdrawing from family and friends

  • Changing eating and/or sleeping habits

  • Showing rage or talking about seeking revenge

  • Taking great risks that could lead to death, such as driving extremely fast

  • Talking or thinking about death often

  • Displaying extreme mood swings, suddenly changing from very sad to very calm or happy

  • Giving away important possessions

  • Saying goodbye to friends and family

  • Putting affairs in order, making a will

 

Risk Factors

 

Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk. Suicidal behavior is complex and there is no single cause. In fact, many different factors contribute to someone making a suicide attempt. But people most at risk tend to share certain characteristics. The main risk factors for suicide are:

 

  • Depression, other mental disorders, or substance abuse disorder

  • Certain medical conditions

  • Chronic pain

  • A prior suicide attempt

  • Family history of a mental disorder or substance abuse

  • Family history of suicide

  • Family violence, including physical or sexual abuse

  • Having guns or other firearms in the home

  • Having recently been released from prison or jail

  • Being exposed to others' suicidal behavior, such as that of family members, peers, or celebrities

 

Many people have some of these risk factors but do not attempt suicide. It is important to note that suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress, not a harmless bid for attention, and should not be ignored.

 

Often, family and friends are the first to recognize the warning signs of suicide and can be the first step toward helping an at-risk individual find treatment with someone who specializes in diagnosing and treating mental health conditions. 

 

Do gender and age affect suicide risk?

 

Men are more likely to die by suicide than women, but women are more likely to attempt suicide. Men are more likely to use deadlier methods, such as firearms or suffocation. Women are more likely than men to attempt suicide by poisoning. The most recent figures released by the CDC show that the highest rate of suicide deaths among women is found between ages 45 and 64, while the highest rate for men occurs at ages 75+. Children and young adults also are at risk for suicide. Suicide is the second leading cause of death for young people ages 15 to 34.

 

What about different racial/ethnic groups?

 

The CDC reports that among racial and ethnic groups, American Indians and Alaska Natives tend to have the highest rate of suicides, followed by non-Hispanic Whites. African Americans tend to have the lowest suicide rate, while Hispanics tend to have the second lowest rate.

 

Treatments and Therapies

 

Research has shown that there are multiple risk factors for suicide and that these factors may vary with age, gender, physical and mental well-being, and with individual experiences. Treatments and therapies for people with suicidal thoughts or actions will vary as well. NIMH has focused research on strategies that have worked well for mental health conditions related to suicide such as depression and anxiety.

 

Psychotherapies

 

Multiple types of psychosocial interventions have been found to be beneficial for individuals who have attempted suicide. These types of interventions may prevent someone from making another attempt. psychotherapy is one type of psychosocial intervention and can effectively reduce suicide risk.

 

One type of psychotherapy is called cognitive behavioral therapy (CBT). CBT can help people learn new ways of dealing with stressful experiences through training. CBT helps individuals recognize their own thought patterns and consider alternative actions when thoughts of suicide arise.

 

Another type of psychotherapy, called dialectical behavior therapy (DBT), has been shown to reduce the rate of suicide among people with borderline personality disorder, a serious mental illness characterized by unstable moods, relationships, self-image, and behavior. A therapist trained in DBT helps a person recognize when his or her feelings or actions are disruptive or unhealthy, and teaches the skills needed to deal better with upsetting situations.

 

Adapted from National Institute of Mental Health.

 

 

Older Adults and Mental Health

 

Overview

 

It’s just as important for an older person with symptoms of depression to seek treatment as it is for someone younger. The impact of depression on health in older adults can be severe: much research has reported that depression is associated with worse health in people with conditions like heart disease, diabetes, and stroke. Depression can complicate the treatment of these conditions, including making it more difficult for someone to care for him- or herself and to seek treatment when needed. In older adults, depression may be disregarded as frailty, or it may be viewed as an inevitable result of life changes, chronic illness, and disability. Recognizing the signs and seeing a health practitioner is the first step to getting treatment, which can make a real difference in someone’s quality of life.

 

Warning Signs

 

  • Noticeable changes in mood, energy level, or appetite

  • Feeling flat or having trouble feeling positive emotions

  • Difficulty sleeping or sleeping too much

  • Difficulty concentrating, feeling restless, or on edge

  • Increased worry or feeling stressed

  • Anger, irritability or aggressiveness

  • Ongoing headaches, digestive issues, or pain

  • A need for alcohol or drugs

  • Sadness or hopelessness

  • Suicidal thoughts

  • Feeling flat or having trouble feeling positive emotions

  • Engaging in high-risk activities

  • Obsessive thinking or compulsive behavior

  • Thoughts or behaviors that interfere with work, family, or social life

  • Unusual thinking or behaviors that concern other people

 

Adapted from: National Institute of Mental Health

 

Attention Deficit Hyperactivity Disorder (ADHD)

 

Definition

 

Attention-deficit/hyperactivity disorder (ADHD) is a brain disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

 

  • Inattention means a person wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.

  • Hyperactivity means a person seems to move about constantly, including in situations in which it is not appropriate; or excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with constant activity.

  • Impulsivity means a person makes hasty actions that occur in the moment without first thinking about them and that may have high potential for harm; or a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering the long-term consequences.

 

Signs and Symptoms

 

Inattention and hyperactivity/impulsivity are the key behaviors of ADHD. Some people with ADHD only have problems with one of the behaviors, while others have both inattention and hyperactivity-impulsivity.Most children have the combined type of ADHD.

 

In preschool, the most common ADHD symptom is hyperactivity.

 

It is normal to have some inattention, unfocused motor activity and impulsivity, but for people with ADHD, these behaviors:

 

  • are more severe

  • occur more often

  • interfere with or reduce the quality of how they functions socially, at school, or in a job

 

Inattention

 

People with symptoms of inattention may often:

 

  • Overlook or miss details, make careless mistakes in schoolwork, at work, or during other activities

  • Have problems sustaining attention in tasks or play, including conversations, lectures, or lengthy reading

  • Not seem to listen when spoken to directly

  • Not follow through on instructions and fail to finish schoolwork, chores, or duties in the workplace or start tasks but quickly lose focus and get easily sidetracked

  • Have problems organizing tasks and activities, such as what to do in sequence, keeping materials and belongings in order, having messy work and poor time management, and failing to meet deadlines

  • Avoid or dislike tasks that require sustained mental effort, such as schoolwork or homework, or for teens and older adults, preparing reports, completing forms or reviewing lengthy papers

  • Lose things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones

  • Be easily distracted by unrelated thoughts or stimuli

  • Be forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments

 

Hyperactivity-Impulsivity

 

People with symptoms of hyperactivity-impulsivity may often:

 

  • Fidget and squirm in their seats

  • Leave their seats in situations when staying seated is expected, such as in the classroom or in the office

  • Run or dash around or climb in situations where it is inappropriate or, in teens and adults, often feel restless

  • Be unable to play or engage in hobbies quietly

  • Be constantly in motion or “on the go,” or act as if “driven by a motor”

  • Talk nonstop

  • Blurt out an answer before a question has been completed, finish other people’s sentences, or speak without waiting for a turn in conversation

  • Have trouble waiting his or her turn

  • Interrupt or intrude on others, for example in conversations, games, or activities

 

Diagnosis of ADHD requires a comprehensive evaluation by a licensed clinician, such as a pediatrician, psychologist, or psychiatrist with expertise in ADHD. For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must be chronic or long-lasting, impair the person’s functioning, and cause the person to fall behind normal development for his or her age. The doctor will also ensure that any ADHD symptoms are not due to another medical or psychiatric condition. Most children with ADHD receive a diagnosis during the elementary school years. For an adolescent or adult to receive a diagnosis of ADHD, the symptoms need to have been present prior to age 12.

 

ADHD symptoms can appear as early as between the ages of 3 and 6 and can continue through adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in quiet, well-behaved children, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.

 

ADHD symptoms can change over time as a person ages. In young children with ADHD, hyperactivity-impulsivity is the most predominant symptom. As a child reaches elementary school, the symptom of inattention may become more prominent and cause the child to struggle academically. In adolescence, hyperactivity seems to lessen and may show more often as feelings of restlessness or fidgeting, but inattention and impulsivity may remain. Many adolescents with ADHD also struggle with relationships and antisocial behaviors. Inattention, restlessness, and impulsivity tend to persist into adulthood.

 

Risk Factors

 

Scientists are not sure what causes ADHD. Like many other illnesses, a number of factors can contribute to ADHD, such as:

 

  • Genes

  • Cigarette smoking, alcohol use, or drug use during pregnancy

  • Exposure to environmental toxins during pregnancy

  • Exposure to environmental toxins, such as high levels of lead, at a young age

  • Low birth weight

  • Brain injuries

 

ADHD is more common in males than females, and females with ADHD are more likely to have problems primarily with inattention. Other conditions, such as learning disabilities, anxiety disorder, conduct disorder, depression, and substance abuse, are common in people with ADHD.

 

Treatment and Therapies

 

While there is no cure for ADHD, currently available treatments can help reduce symptoms and improve functioning. Treatments include medication, psychotherapy, education or training, or a combination of treatments.

 

Psychotherapy

 

Adding psychotherapy to treat ADHD can help patients and their families to better cope with everyday problems.

 

Behavioral therapy is a type of psychotherapy that aims to help a person change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioral therapy also teaches a person how to:

 

  • monitor his or her own behavior

  • give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting

 

Parents, teachers, and family members also can give positive or negative feedback for certain behaviors and help establish clear rules, chore lists, and other structured routines to help a person control his or her behavior. Therapists may also teach children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing. Learning to read facial expressions and the tone of voice in others, and how to respond appropriately can also be part of social skills training.

 

Cognitive behavioral therapy can also teach a person mindfulness techniques, or meditation. A person learns how to be aware and accepting of one’s own thoughts and feelings to improve focus and concentration. The therapist also encourages the person with ADHD to adjust to the life changes that come with treatment, such as thinking before acting, or resisting the urge to take unnecessary risks.

 

Family and marital therapy can help family members and spouses find better ways to handle disruptive behaviors, to encourage behavior changes, and improve interactions with the patient.

 

Adapted from: National Institute of Mental Health

 

Women and Mental Health

 

Women and Mental Health

 

Overview

 

Mental disorders can affect women and men differently. Some disorders are more common in women such as depression and anxiety. There are also certain types of depression that are unique to women. Some women may experience symptoms of mental disorders at times of hormone change, such as perinatal depression, premenstrual dysphoric disorder, and perimenopause-related depression. When it comes to other mental disorders such as schizophrenia and bipolar disorder, research has not found differences in rates that men and women experiences these illnesses. But, women may experience these illnesses differently – certain symptoms may be more common in women than in men, and the course of the illness can be affected by the sex of the individual. Researchers are only now beginning to tease apart the various biological and psychosocial factors that may impact the mental health of both women and men.

 

Warning Signs

 

Women and men can develop most of the same mental disorders and conditions, but may experience different symptoms. Some symptoms include:

 

  • Persistent sadness or feelings of hopelessness

  • Abuse of alcohol and/or drugs

  • Dramatic changes in eating or sleeping habits

  • Appetite and/or weight changes

  • Decreased energy or fatigue

  • Excessive fear or worry

  • Seeing or hearing things that are not there

  • Extremely high and low moods

  • Aches, headaches, or digestive problems without a clear cause

  • Irritability

  • Social withdrawal

  • Thoughts of suicide

 

Mental health problems can be treated with various form of therapy which is provided by Blair Wellness Group.

 

Adapted from National Institute of Mental Health

 

Coping with Traumatic Events

 

Overview

 

A traumatic event is a shocking, scary, or dangerous experience that affects someone emotionally. These situations may be natural, like a tornado or earthquake. They can also be caused by other people, like a car accident, crime, or terror attack.

 

How individuals respond to traumatic events is an important area of research for the National Institute of Mental Health (NIMH). Researchers are exploring the factors that help people cope as well as the factors that increase their risk for problems following the event.

 

Warning Signs

 

There are many different responses to potentially traumatic events. Most people have intense responses immediately following, and often for several weeks or even months after, a traumatic event. These responses can include:

 

  • Feeling anxious, sad, or angry

  • Trouble concentrating and sleeping

  • Continually thinking about what happened

 

For most people, these are normal and expected responses and generally lessen with time. Healthy ways of coping in this time period include avoiding alcohol and other drugs, spending time with loved ones and trusted friends who are supportive, trying to maintain normal routines for meals, exercise, and sleep. In general, staying active is a good way to cope with stressful feelings.

 

However, in some cases, the stressful thoughts and feelings after a trauma continue for a long time and interfere with everyday life. For people who continue to feel the effects of the trauma, it is important to seek professional help. Some signs that an individual may need help include:

 

  • Worrying a lot or feeling very anxious, sad, or fearful

  • Crying often

  • Having trouble thinking clearly

  • Having frightening thoughts, reliving the experience

  • Feeling angry

  • Having nightmares or difficulty sleeping

  • Avoiding places or people that bring back disturbing memories and responses.

 

Physical responses to trauma may also mean that an individual needs help. Physical symptoms may include:

 

  • Headaches

  • Stomach pain and digestive issues

  • Feeling tired

  • Racing heart and sweating

  • Being very jumpy and easily startled

 

Those who already had mental health problems or who have had traumatic experiences in the past, who are faced with ongoing stress, or who lack support from friends and family may be more likely to develop stronger symptoms and need additional help. Some people turn to alcohol or other drugs to cope with their symptoms. Although substance use can temporarily cover up symptoms, it can also make life more difficult.

 

Mental health problems can be treated with various form of therapy which is provided by Blair Wellness Group.

 

Adapted from National Institute of Mental Health

 

Post-Traumatic Stress Disorder

 

Definition

 

PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.

 

It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened even when they are not in danger.

 

Signs and Symptoms

 

Not every traumatized person develops ongoing (chronic) or even short-term (acute) PTSD. Not everyone with PTSD has been through a dangerous event. Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.

 

A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD.

 

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

 

  • At least one re-experiencing symptom

  • At least one avoidance symptom

  • At least two arousal and reactivity symptoms

  • At least two cognition and mood symptoms

 

Re-experiencing symptoms include:

 

  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating

  • Bad dreams

  • Frightening thoughts

 

Re-experiencing symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms.

 

Avoidance symptoms include:

 

  • Staying away from places, events, or objects that are reminders of the traumatic experience

  • Avoiding thoughts or feelings related to the traumatic event

 

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

 

Arousal and reactivity symptoms include:

 

  • Being easily startled

  • Feeling tense or “on edge”

  • Having difficulty sleeping

  • Having angry outbursts

 

Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

 

Cognition and mood symptoms include:

 

  • Trouble remembering key features of the traumatic event

  • Negative thoughts about oneself or the world

  • Distorted feelings like guilt or blame

  • Loss of interest in enjoyable activities

 

Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members. 

 

It is natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.

 

Do children react differently than adults?

 

Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children (less than 6 years of age), these symptoms can include:

 

  • Wetting the bed after having learned to use the toilet

  • Forgetting how to or being unable to talk

  • Acting out the scary event during playtime

  • Being unusually clingy with a parent or other adult

 

Older children and teens are more likely to show symptoms similar to those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge. For additional information, visit the Learn More section below. The National Institute of Mental Health (NIMH) offers free print materials in English and Spanish. These can be read online, downloaded, or delivered to you in the mail.

 

Risk Factors

 

Anyone can develop PTSD at any age. This includes war veterans, children, and people who have been through a physical or sexual assault, abuse, accident, disaster, or many other serious events. According to the National Center for PTSD , about 7 or 8 out of every 100 people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men, and genes may make some people more likely to develop PTSD than others.

 

Not everyone with PTSD has been through a dangerous event. Some people develop PTSD after a friend or family member experiences danger or harm. The sudden, unexpected death of a loved one can also lead to PTSD.

 

Why do some people develop PTSD and other people do not?

 

It is important to remember that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder.

 

Many factors play a part in whether a person will develop PTSD. Some examples are listed below. Risk factors make a person more likely to develop PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder.

 

Risk Factors and Resilience Factors for PTSD

 

Some factors that increase risk for PTSD include:

 

  • Living through dangerous events and traumas

  • Getting hurt

  • Seeing another person hurt, or seeing a dead body

  • Childhood trauma

  • Feeling horror, helplessness, or extreme fear

  • Having little or no social support after the event

  • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home

  • Having a history of mental illness or substance abuse

 

Some resilience factors that may reduce the risk of PTSD include:

 

  • Seeking out support from other people, such as friends and family

  • Finding a support group after a traumatic event

  • Learning to feel good about one’s own actions in the face of danger

  • Having a positive coping strategy, or a way of getting through the bad event and learning from it

  • Being able to act and respond effectively despite feeling fear

 

Researchers are studying the importance of these and other risk and resilience factors, including genetics and neurobiology. With more research, someday it may be possible to predict who is likely to develop PTSD and to prevent it.

 

Treatments and Therapies

 

The main treatments for people with PTSD are medications, psychotherapy (“talk” therapy), or both. Everyone is different, and PTSD affects people differently so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD. Some people with PTSD need to try different treatments to find what works for their symptoms.

 

If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be addressed. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal.

 

Adapted from National Institute of Mental Health

 

Men and Mental Health

 

Men and Mental Health

 

Overview

 

Many mental illnesses affect both men and women however men may be less likely to talk about their feelings and seek help. Recognizing the signs that someone may have a mood or mental disorder is the first step toward getting treatment and living a better life.

 

Warning Signs

 

Men and women experience many of the same mental disorders but their willingness to talk about their feelings may be very different. This is one of the reasons that their symptoms may be very different as well. For example, some men with depression or an anxiety disorder hide their emotions and may appear to be angry or aggressive while many women will express sadness. Some men may turn to drugs or alcohol to try to cope with their emotional issues. Sometimes mental health symptoms appear to be physical issues. For example, a racing heart, tightening chest, ongoing headaches, and digestive issues can be a sign of an emotional problem.

 

Warning signs include

 

  • Anger, irritability or aggressiveness

  • Noticeable changes in mood, energy level, or appetite

  • Difficulty sleeping or sleeping too much

  • Difficulty concentrating, feeling restless, or on edge

  • Increased worry or feeling stressed

  • A need for alcohol or drugs

  • Sadness or hopelessness

  • Suicidal thoughts

  • Feeling flat or having trouble feeling positive emotions

  • Engaging in high-risk activities

  • Ongoing headaches, digestive issues, or pain

  • Obsessive thinking or compulsive behavior

  • Thoughts or behaviors that interfere with work, family, or social life

  • Unusual thinking or behaviors that concern other people

 

 

Psychological counseling can help to determine the causes of any of these behaviors and provide assistance, not only for the person suffering from them himself, but also in assisting family members in encountering, coping with, and contributing to beneficial behavioral change.

 

 

Adapted from National Institute of Mental Health

 

 

 

Anxiety Disorders

 

Anxiety Disorders

 

Definition

 

Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships. There are several different types of anxiety disorders. Examples include generalized anxiety disorder, panic disorder, and social anxiety disorder.

 

Signs and Symptoms

 

Generalized Anxiety Disorder

 

People with generalized anxiety disorder display excessive anxiety or worry for months and face several anxiety-related symptoms.

 

Generalized anxiety disorder symptoms include:

 

  • Restlessness or feeling wound-up or on edge

  • Being easily fatigued

  • Difficulty concentrating or having their minds go blank

  • Irritability

  • Muscle tension

  • Difficulty controlling the worry

  • Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)

 

Panic Disorder

 

People withpanic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom.

 

Panic disorder symptoms include:

 

  • Sudden and repeated attacks of intense fear

  • Feelings of being out of control during a panic attack

  • Intense worries about when the next attack will happen

  • Fear or avoidance of places where panic attacks have occurred in the past

 

Social Anxiety Disorder

 

People with social anxiety disorder (sometimes called “social phobia”) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others.

 

Social anxiety disorder symptoms include:

 

  • Feeling highly anxious about being with other people and having a hard time talking to them

  • Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others

  • Being very afraid that other people will judge them

  • Worrying for days or weeks before an event where other people will be

  • Staying away from places where there are other people

  • Having a hard time making friends and keeping friends

  • Blushing, sweating, or trembling around other people

  • Feeling nauseous or sick to your stomach when other people are around

 

Evaluation for an anxiety disorder often begins with a visit to a primary care provider. Some physical health conditions, such as an overactive thyroid or low blood sugar, as well as taking certain medications, can imitate or worsen an anxiety disorder. A thorough mental health evaluation is also helpful, because anxiety disorders often co-exist with other related conditions, such as depression or obsessive-compulsive disorder.

 

Risk Factors

 

Researchers are finding that genetic and environmental factors, frequently in interaction with one another, are risk factors for anxiety disorders. Specific factors include:

 

  • Shyness, or behavioral inhibition, in childhood

  • Being female

  • Having few economic resources

  • Being divorced or widowed

  • Exposure to stressful life events in childhood and adulthood

  • Anxiety disorders in close biological relatives

  • Parental history of mental disorders

  • Elevated afternoon cortisol levels in the saliva (specifically for social anxiety disorder)

 

Treatments and Therapies

 

Anxiety disorders are generally treated with psychotherapy, medication, or both.

 

Psychotherapy

 

Psychotherapy or “talk therapy” can help people with anxiety disorders. To be effective, psychotherapy must be directed at the person’s specific anxieties and tailored to his or her needs. A typical “side effect” of psychotherapy is temporary discomfort involved with thinking about confronting feared situations.

 

Cognitive Behavioral Therapy (CBT)

 

CBT is a type of psychotherapy that can help people with anxiety disorders. It teaches a person different ways of thinking, behaving, and reacting to anxiety-producing and fearful situations. CBT can also help people learn and practice social skills, which is vital for treating social anxiety disorder.

 

Two specific stand-alone components of CBT used to treat social anxiety disorder are cognitive therapy and exposure therapy. Cognitive therapy focuses on identifying, challenging, and then neutralizing unhelpful thoughts underlying anxiety disorders.

 

Exposure therapy focuses on confronting the fears underlying an anxiety disorder in order to help people engage in activities they have been avoiding. Exposure therapy is used along with relaxation exercises and/or imagery. One study, called a meta-analysis because it pulls together all of the previous studies and calculates the statistical magnitude of the combined effects, found that cognitive therapy was superior to exposure therapy for treating social anxiety disorder.

 

CBT may be conducted individually or with a group of people who have similar problems. Group therapy is particularly effective for social anxiety disorder. Often “homework” is assigned for participants to complete between sessions.

 

 

Adapted from National Institute of Mental Health

 

 

 

 
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