Download mental illness

MENTAL ILLNESS:
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Anxiety disorders
Childhood disorders like ( ADD/HD)
Bi-polar ( manic depression)
Obsessive compulsive disorder ((OCD)
Schizophrenia
Oppositional defiance disorder (ODD)
Conduct disorders (CD)—see separate file
IN-Depth descriptions
Anxiety Disorder
Anxiety disorder is the most common of all mental illnesses. The combined prevalence of the
group of anxiety disorders is higher than that of all other mental disorders in childhood and
adolescence. Anxiety disorder leaves you unable to cope with daily life due to abnormal fears of
life. Anxiety in moderation is a perfectly normal response – it is a healthy response preparing you
for any action that may even be threatening. Anxiety disorders cause overwhelming fear and an
inability to cope with any daily chore. Anxiety disorders can completely paralyze and disable the
victim.
Anxiety disorder is the most treatable of all mental illnesses. Anxiety disorder produces unrealistic
fears, excessive worry, flashbacks from past trauma leading to easy startling, changes in sleep
patterns, intense tension and ritualistic behavior. Anxiety disorder also results in a slew of related
physical symptoms such as shaking, sweating, racing heart, dizziness, nausea, vomiting etc.
A wide range of effective therapies and treatments of anxiety disorder are available. Usually
anxiety disorder requires medication and cognitive-behavioral therapies in combination. Most
patients of anxiety disorder respond well to treatment and there is a high success rate of treating
anxiety disorder resulting in the return to productive and fulfilling daily lives. Unfortunately, most
victims of anxiety disorder do not seek treatment.
Generalized Anxiety Disorder
Generalized Anxiety Disorder (GAD) refers to constant yet unrealistic worry about many areas of
one’s daily life. Examples of generalized anxiety disorder are the safety about family members or
persistent worries about financial security in spite of repeated assurances to the contrary. People
with generalized anxiety disorder feel anxious, irritable, sleep deprived and physically stressed. In
generalized anxiety disorder these symptoms are at a level that interferes with daily functions of
life. Children with generalized anxiety disorder have excessive worries about all upcoming events
and worry unduly about academic performance, sports activities, punctuality and even natural
disasters. Generalized anxiety disorder persists even though they are not being judged and the
performance has attained good results. Generalized anxiety disorder creates children who are
perfectionistic, overly conforming and insecure and who need constant reassurance on all levels.
Most adults seeking generalized anxiety disorder treatment report the onset in childhood or
adolescence.
According to the NIMH (National Institute for Mental Health) generalized anxiety disorder is
characterized by extended symptoms of unfounded chronic, exaggerated worry and tension,
much more intense than normal anxiety experiences. People with generalized anxiety disorder
expect the worst and worry incessantly about money, health, family and the workplace even
though there are no visible signs to suggest a need to worry.
Generalized anxiety disorder sufferers are unable to relax and suffer insomnia and have many
physical symptoms such as fatigue; trembling; muscle tension; headaches, irritability and hot
flashes. Fortunately effective treatments for GAD have been developed and funded through
industry and research supported through the NIMH.
Generalized anxiety disorder happens more in women. In half of the cases general anxiety
disorder begins in childhood or adolescence. Generalized anxiety disorder has a fluctuating
nature and symptoms exacerbate according to life’s stresses and difficulties.
In generalized anxiety disorder excessive worry and anxiety as well as apprehensive expectation
occurs more often than not for more than a 6 month period. Controlling worry is difficult with
general anxiety disorder. The worry of generalized anxiety disorder is not confined to specialized
areas as in having panic attacks; the embarrassment of social phobia or being away from home
in separation anxiety disorder. Rather in generalized anxiety disorder the worry, anxiety and
physical symptoms cause impairment of social, occupational or other functional areas of life.
Generalized anxiety disorder usually strikes in childhood and adolescence but can also begin in
adulthood, and seems to affect more women than men. NIMH research indicates that generalized
anxiety disorder is genetic and grows worse during stressful times. Symptoms of generalized
anxiety disorder manifest more slowly than in other anxiety disorders. The generalized anxiety
disorder treatment includes simultaneous medication and cognitive-behavioral therapy. NIMH
also reports that generalized anxiety disorder coexists with depression, substance abuse and/or
other anxiety disorders. Irritable bowel syndrome, another stress related condition, can also
accompany generalized anxiety disorder.
Social Anxiety Disorder
Social anxiety disorder causes people to feel dread at the possibility of being humiliated during
any social exposure. Social anxiety disorder involves a preoccupation of embarrassment and
ridicule with tasks as diverse as eating a meal to delivering a speech. The social anxiety disorder
emanates from the expectation of negative evaluation by others. A severe form of social anxiety
disorder causes fear that even precludes contact with others. Social anxiety disorder is generally
associated with significant anticipatory anxiety for a long time before the event in question. Social
anxiety disorder produces symptoms that create even more tension for the sufferer in case others
detect these symptoms. Social anxiety disorder symptoms tend to be found more in females.
Society anxiety disorder includes symptoms such as trembling, sweating/blushing, stuttering,
fainting, losing bladder control or having a mind that goes blank. The severity of social anxiety
disorder symptoms and impairments fluctuates normally in relation to vocational demands and
social stability within the circle of family and friends.
Children with social anxiety disorder suffer consistent embarrassment during public performance
or class presentations. These anxious feelings in social anxiety disorder produce physical
reactions such as palpitations, tremors, sweating, diarrhea, blushing, muscle tension etc. Social
anxiety disorder can result in full-blown panic attacks. Adults with social anxiety disorder are able
to recognize the behavior as excessive, but are not able to prevent or control the fear. Children
with social anxiety disorder are not able to recognize their excessive reactions but notice others'
reactions to their anxiety. Children with social anxiety disorder do not function well in age
appropriate social situations, fall behind and in more severe cases, avoid school completely.
Social anxiety disorder is long lasting and interferes with daily routine, social situations and job
and school venues.
Panic Anxiety Disorder
Panic anxiety disorder involves sudden and unexpected attacks of extreme terror. The terror of
panic anxiety disorder is intense. The symptoms of panic anxiety disorder can include shortness
of breath, palpitations of the heart, chest pain, choking, trembling and faintness. Any or all of
these symptoms of panic anxiety disorder can occur at any time. The distinguishing features of
panic anxiety disorder are different from natural reactions to real danger. Anxiety panic disorder is
potentially disabling but can be treatable although the symptoms of anxiety panic disorder were
once dismissed as nerves or stress. Your predisposition to anxiety panic disorder increases if a
close family member suffers from the disorder. Anxiety panic disorder can be destructive and
debilitating.
Panic anxiety disorder is diagnosed when two unexpected panic attacks have been experienced.
Additionally, panic anxiety disorder is marked by the development of persistent concern regarding
further attacks and the change to behavior to avoid or minimize these attacks. Panic anxiety
disorder is often complicated by a major depressive disorder. Panic anxiety disorder is also
exacerbated by alcoholism and substance abuse disorders. Panic anxiety disorder co-occurs with
other specific anxiety disorders such as social phobia, generalized anxiety disorder, specific
phobia and obsessive-compulsive disorder.
Women are about twice as susceptible to panic anxiety disorder than men, and the disorder
appears more commonly between late adolescence and mid-adult life. Panic anxiety disorder is
genetic and is distinguishable form depressive conditions.
Anxiety panic disorder interferes with a child’s normal development and disrupts the school
situation and social life. In extreme forms of anxiety panic disorder children may not leave the
house and even avoid going to school to prevent fearful situations. Anxiety panic disorder
increases the risk of depression, suicide and alcohol and drug abuse.
Treatment for anxiety panic disorder is effective and involves antidepressant or anxiety-relieving
medications. Cognitive behavior therapy is another form of treatment anxiety panic disorder. The
best treatment results for anxiety panic disorder are a combination of both treatments. Coping
strategies in the form of relaxation techniques, leisure and recreation activities help to reduce the
factors that exacerbate the condition of anxiety panic disorder.
Common Medications For Anxiety and Depression
New meds for anxiety disorder and depression results from research that indicates the
engagement of a wide range of neuro-circuits. Two key regulatory centers, called hippocampus
and amygdala govern memory storage and emotions amongst others. Benzodiazepines,
antidepressants and buspirone are typically used to treat anxiety disorder and depression.
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Benzodiazepines are medications with anti-anxiety and sedative- hypnotic effects.
Antidepressant medications have substantial anti-anxiety and anti-panic effects.
Monoamine oxidate inhibitors (MAOIs) are new meds for anxiety disorder and depression
that have significant antiobsessional, antipanic and anxiolytic effects, however they are
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seldom used unless simpler medication strategies have failed. The five drugs within the
SSRI class, are new meds for anxiety disorder and depression and are the preferred type
of antidepressant for treatment of anxiety disorders.
Buspirone, one of the new meds for anxiety disorder and depression is not habit forming
and has no abuse potential. It is comparable to the SSRIs and is better tolerated than the
TCAs. It is more useful in the treatment of generalized anxiety disorder.
Anxiety and depression frequently coexist, so that patients that exhibit both conditions are the
rule rather than the exception. Many of the new meds for anxiety disorder and depression
medications can be used in isolation or concurrently for both disorders.
New meds for anxiety disorder and depression involves medications such as Paxil, Toffranil or
Norpramine and are effective in preventing future attacks. Other new meds for anxiety disorder
and depression such as Ativan or Xanax may be given alone or in combination with other
medications.
Cognitive behavior therapy enables the understanding of the condition, how to deal with the
problem and finally the coping techniques for the disorder. A combination of medicine and
cognitive behavior techniques work best to manage the condition.
Treatments
Mental health professionals offer a wide range of effective therapies and treatments for anxiety
disorders, drawing on significant advances in procedures and technologies. Anxiety disorders
usually require a combination of medication and cognitive-behavioral therapies.
Today, a variety of medications are available for anxiety disorders. If one is ineffective, there are
usually others to try. Patients generally start with low doses and gradually increase as needed.
Like others, medications for anxiety disorders have side effects, but they usually become
tolerable or diminish with time.
Behavioral therapies are also effective in treating anxiety disorders. They focus on changing
specific actions and use several techniques to stop negative behavior. One technique - exposure
therapy - involves exposing the patient to the feared object or situation on a gradual basis until
the fear is reduced or eliminated. In cognitive-behavioral therapy, a related therapy, patients learn
to react differently to the triggers of anxiety attacks. They also learn to understand how their
thinking patterns contribute to their symptoms and how to change their thoughts to reduce or
prevent the symptoms.
Most patients respond well to treatment, and the success rates among those who receive
treatment are usually very high, allowing patients to return to productive, fulfilling lives.
Bi-polar disorder
Signs and Symptoms
People who suffer from manic-depressive disorder will likely display one or
more of the following behaviors during the manic phase:
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Excessively euphoric or expansive mood
Irritability and anger that is inconsistent with the situation
Hyperactivity
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Grandiose ideas or delusions; extreme optimism
Lack of good judgment
Flights of ideas or racing thoughts; talking in a rush and changing from
topic to topic; disorganized thoughts
Decreased need for sleep
Sudden rage, irritability or paranoia
The depressive phase has the same symptoms of major, or "unipolar,"
depression:
Feelings of worthlessness, hopelessness, helplessness, total
indifference and/or extreme guilt
Prolonged sadness; unexplained crying spells
Jumpiness or irritability; withdrawal from formerly enjoyable activities or
relationships
Inability to concentrate or remember details
Loss of appetite or great increase in appetite; constant fatigue,
insomnia
Physical ailments that cannot be explained otherwise
Thoughts of death or suicide attempts
Treatments
While manic depression is a serious mental illness, it is treatable. Anyone who
may suffer from manic-depressive disorder should seek a complete medical
evaluation to rule out any other mental or physical disorders that could mimic
manic-depression. Treatments should stabilize the manic-depressive cycle and
focus on the mood being experienced.
Medication Therapy
Lithium carbonate, the most common medication for manic-depression, can
reduce the number and intensity of manic episodes or prevent them altogether.
For patients who do not respond well to lithium, physicians have had success
with other medications like carbamazepine and valproate.
Like many others, these medications can have negative side effects when not
used properly. However, under careful physician guidance, lithium and similar
medications can return patients to normal, productive lives.
Living with Manic-Depressive Disorder
Living with manic-depression can be a terrifying ordeal. Like many other mental
illnesses, manic-depression can destroy lives if left untreated. It can complicate
relationships, especially with close family and friends. A victim's employment
and financial standing are also at great risk. It can even result in suicide. The
personal and social consequences of manic-depressive disorder may be helped
by psychotherapy in addition to medication. Because of the intense nature of
manic-depressive disorder, family members may benefit from counseling as
well. Not only can they find emotional support, education and understanding,
but they may learn to participate in the patient's treatment.
Types of Childhood Disorders
Recognizing and understanding some of the disorders common in children is the first step.
Mood Disorders
Major depression, manic depressive disorder (also called bipolar disorder) and mania are
disorders which cause change in a child's mood. Depression is considered to be the most
common mental disorder. It is often mistaken for "the blues" and therefore goes untreated.
Depression is caused by a number of factors, from chemical imbalances to environmental
influences to genetics.
Major depression causes people to feel hopeless, exhausted and useless. More than changes in
mood, major depression can cause problems with sleep, appetite, self-esteem, daily activities and
physical health.
Manic depressive disorder (bipolar disorder) causes swings from deep depression to abnormal
elation or "highs." Hyperactivity, scattered ideas, easy distraction, irritability and recklessness
also occur in bipolar disorder during manic episodes.
Anxiety Disorders
Certain fears are common in children. But when they don't go away with time, they may be a sign
of anxiety disorders. Anxiety disorders come in many forms and may be experienced differently in
each person. However, their common factor is a feeling of constant terror, dread or worry beyond
one's normal reactions to danger.
Phobias are irrational fears of objects or situations which cannot be overcome with reasonable
explanations or actions. Not to be confused with simple childhood fears that go away with time,
like a fear of the dark, phobias are so extreme that they cause major disruption to the victim's life.
Specific phobias are typically fears of particular objects or situations. The most common are fears
of animals, fears of heights, fears of enclosed spaces and fears of flying.
Social phobias cause people to dread being watched or humiliated while doing something of a
social nature, such as eating a meal or giving a speech, due to expectation of negative
evaluation. Some people with social phobias fear and avoid any contact with others.
People with agoraphobia often have panic attacks and fear being in situations in which they
cannot get help or escape. Often, this paralyzing fear causes its sufferers to remain isolated in
their homes.
Separation anxiety disorder is marked by intense anxiety or panic when separated from parents
or other loved ones. This disorder can be so extreme that it disrupts normal activities. Often
children with separation anxiety disorder will cling to their parents or stay close wherever they go.
They may refuse to play outside, spend the night with a friend, or even go on errands. This
disorder is also characterized by physical ailments, such as headaches, nausea and vomiting,
and even heart palpitations and dizziness. Separation anxiety can explain why many children
refuse to attend school.
Conduct disorders are thought to be the single largest group of psychiatric illnesses in young
people. Often beginning before teen years, the symptoms of these problems are frequently
mistaken for juvenile delinquency or the turmoil of growing up. Some common behaviors include
stealing, consistent lying, cruelty, deliberate destruction of property, fighting with or without
weapons, or even rape.
There are many studies into the biological, psychological and sociological causes of conduct
disorders, but like many other disorders, conduct disorders are probably caused by a number of
factors. Conduct disorders will not go away with age, and therefore treatment is critical.
Attention-Deficit Disorder
Attention-deficit disorder (ADD) affects a child's ability to concentrate, learn and maintain a
normal level of activity. Excessive activity, impatience, constant distraction, shifting from one
activity to another and restless sleeping are common to ADD. But these behaviors may develop
as a result of other problems, like an inability to see or hear adequately, or another physical or
emotional illness. A physician should conduct a thorough medical examination to diagnose ADD
and/or rule out other possible problems.
Signs and Symptoms
Children who suffer from mental or emotional disorders may display one or more of the following
behaviors:
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Talk of suicide or threats to others
Prolonged feelings of intense tension or anxiety
Sudden changes in eating and/or sleeping habits
Atypical thoughts and speech
Sudden and/or extreme changes in mood and behavior
Withdrawal from friends and family
Loss of interest in favorite activities Loss of energy
Physical ailments that occur seemingly without cause
Treatments
Mental health professionals offer a wide range of effective therapies and treatments, drawing on
significant advances in procedures and technologies. Like mental illnesses in adults, childhood
disorders usually require a combination of medication and supportive psychological therapies
either in the hospital or on an outpatient basis.
Medication is commonly prescribed for childhood disorders and has been proved an increasingly
effective tool. This type of treatment requires careful supervision by a physician and is targeted at
the chemical imbalances associated with these disorders. Like any drugs, these medications may
have side effects.
Psychotherapy addresses the emotional response to childhood disorders. Coping with life's
stressful events is especially difficult for children with mental or emotional illness.
Psychotherapists help children understand their emotions and deal with their problems in a more
confident, healthy way.
Supportive therapies include a number of related activities designed to enhance treatment of
childhood disorders.
The most successful treatments of medication, psychotherapy and supportive therapies are
tailored to the individual child's needs under the close supervision of a psychiatrist - a physician
who specializes in childhood disorders.
Types of Depression
Depression occurs in several forms, and some of these may overlap. In the
case of depression, psychiatrists may give more than one diagnosis because
the illness is often linked with other problems like substance abuse, eating
disorders or anxiety disorders.
Clinical depression refers to a condition serious enough to require professional
treatment. A person who experiences severe depression during a single period
is said to have had an episode of clinical depression. Major depression is
marked by more severe or exaggerated symptoms.
A more recently identified form of depression - seasonal affective disorder
(SAD) - is triggered by seasonal changes, like weather patterns or the amount
of available daylight.
Another severe type of depression is manic-depression, or bipolar disorder, so
named because its sufferers experience not only the lows of depression but
also the highs of mania.
Causes
While research has led to a significant understanding of depression, scientists
have not found the exact mechanism that triggers depression. Most likely there
is no single cause. However, recent studies have linked depression to genetic
changes in body chemistry. These changes usually involve imbalances of
neurotransmitters (chemicals that allow brain cells to communicate), particularly
serotonin and norepinephrine.
Other factors, such as negative family relationships, serious illness, major loss
or change, and substance abuse, can cause or complicate depression. Close
relatives of people with depression are sometimes more likely to develop either
depression or manic-depression than the general population.
Signs and Symptoms
True clinical depression is frequently mistaken for occasional sadness,
discouragement, disappointment or "the blues." These feelings usually appear
in depression, but in a more intense and prolonged form. People who suffer
from depression will likely display one or more of the following behaviors:
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Feelings of worthlessness, hopelessness, helplessness, total
indifference and/or extreme guilt
Prolonged sadness; unexplained crying spells
Jumpiness or irritability
Withdrawal from formerly enjoyable activities or relationships
Inability to concentrate or remember details; indecisiveness
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Noticeable change in appetite with sudden weight loss or gain
Changes in sleep patterns: constant fatigue, insomnia, early waking,
oversleeping
Physical ailments that cannot be explained otherwise
Thoughts of death or suicide attempts
Treatments
Depression is one of the most treatable of all mental illnesses. As many as 90
percent of people with depression respond well to treatment, and nearly all of
those treated experience some benefit. Like many other mental illnesses,
depression is usually treated with medication, psychotherapy or a combination
of the two. Patients can usually see relief of their symptoms in just a few weeks.
Medication Therapy
Antidepressant medications are used to correct imbalances of certain
neurotransmitters. Five groups of medications are most often prescribed for
depression: tricyclic antidepressants; monoamine oxidase inhibitors (MAOIs);
selective serotonin reuptake inhibitors (SSRIs); and serotonin and
norepinephrine reuptake inhibitors (SNRIs); and other "atypical"
antidepressants.
The effectiveness of antidepressant medications depends on a person's overall
health, weight and metabolism, and other unique physical traits, and they are
usually prescribed to fit the individual. If one medication doesn't work, the
physician may try another or a combination of medications to determine the
most effective regimen. Generally, antidepressants become fully effective within
three to six weeks.
Other forms of therapy are electroconvulsive therapy (ECT) and light therapy.
While its use has decreased as more advanced medications have been
developed, ECT remains very effective for treating patients who cannot tolerate
or take medications due to medical conditions, old age, malnutrition, or those
who do not respond to anti-depressant medications. Light therapy is used
primarily for those who suffer from seasonal affective disorder. Patients using
this treatment spend regular, therapeutic sessions bathed in light from a fullspectrum light source.
Psychotherapy
Psychotherapy involves the verbal interaction between trained professionals
and patients. The therapist uses techniques to help the patient gain personal
insight that will allow him or her to positively change thoughts, feelings or
behaviors.
Several forms of this "talk treatment" have proven to be helpful in the treatment
of depression. They include interpersonal psychotherapy, cognitive-behavioral
therapy, psychoanalysis and psycho-dynamic psychotherapy.
Living with Depression
Depression can make a person feel fatigued, worthless, helpless and hopeless.
It is important to realize these feelings are a result of the depression and do not
accurately reflect a person's true situation. Until treatment takes effect, a person
suffering with serious depression should:
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limit commitments;
set realistic goals and expectations;
spend time with other people;
participate in enjoyable activities;
seek the advice of close friends or family before making important
decisions;
realize they will not "snap out" of their depression;
think positively and reject negative thoughts.
How Family and Friends Can Help
The most important thing family and friends can do for the depressed person is
to help him or her get treatment. This may involve encouraging the patient to
stay with the treatment, going with the patient to the doctor, or even monitoring
whether the patient is taking medication.
Another important way to help is to offer emotional support - understanding,
patience, affection and encouragement. Always listen to the depressed person.
Do not ignore any remarks about suicide; report them to the doctor
immediately.
(OCD) Obsessive Compulsive disorder
A type of anxiety disorder, obsessive-compulsive disorder is marked by obsessions recurring,
unwanted and unpleasant thoughts that cause anxiety and compulsions repetitive, ritualistic
actions performed to relieve the anxiety. These rituals can literally take hours to perform each
day, interfering with every aspect of life. Victims are powerless to control the thoughts and rituals,
even though they know they make no sense.
Obsessive-compulsive disorder afflicts millions of Americans and can strike at any age. The
disorder causes embarrassment and confusion in many victims to the extent that they refuse or
are unable to seek treatment. But treatment is available, and advances in medications and
therapies have successfully returned many people with obsessive-compulsive disorder to
productive, satisfying lives.
Causes
While research has led to a significant understanding of obsessive-compulsive disorder, scientists
have not found the exact mechanism that triggers the illness. However, recent studies have
linked obsessive-compulsive disorder to imbalances in brain chemistry. These changes usually
involve serotonin, which controls moods and feelings.
Then there is always the genetic link. Obsessive-compulsive disorder usually runs in families, and
accompanying disorders, other anxiety disorders and depression, are also common not only in
the victim but family members as well. Other factors, such as head trauma, birth trauma, epilepsy
and other serious illnesses, are believed to cause or complicate obsessive-compulsive disorder.
Signs and Symptoms
People who suffer from obsessive-compulsive disorder will likely display one or more of the
following obsessive thoughts and compulsive behaviors:
Typical Obsessions
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Fear of contamination, by dirt, germs, chemicals, disease, bodily waste
Fear of causing harm to themselves or another person
Preoccupation with body parts; fear of physical deformation or inadequacy
Fear of making a mistake
Fear of socially unacceptable behavior - profanity, sexual advances, saying the wrong
thing
Typical Compulsions
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Cleaning - excessively bathing, washing hands, house-cleaning
Completing - performing a series of complicated steps in precise order until completed to
perfection
Repeating - saying a name or phrase, or counting to a certain number until completed to
perfection
Checking - repeatedly checking items or locations to prevent harm to themselves or
others
Hoarding - constantly collecting and storing useless items, usually counting them
repeatedly
Meticulousness - constantly tidying and arranging items in a certain way
Slowness - taking an unusually long time to complete a particular task
Treatments
Obsessive-compulsive disorder can be successfully treated with medication behavior therapy.
Because individuals respond differently to the variety of therapies, it is important to work closely
with your doctor to find the right combination for you.
Medication Therapy
Two categories of medications are approved for use in treating obsessive-compulsive disorder:
tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs). These medications
counter the brain's imbalance of serotonin, the chemical linked with obsessive-compulsive
disorder. It is important to monitor your response to medication, which usually becomes fully
effective within several weeks.
Behavior Therapy
While medication helps level chemical imbalances, behavior therapy helps patients to learn to
resist their obsessions and compulsions. In therapy, patients are gradually exposed to the things
which cause their anxieties and provoke the obsessive behaviors. However, they are not allowed
to perform the rituals that usually relieve the anxiety. Over time, patients learn that their feared
consequences do not occur, and their anxieties decrease.
Behavior therapy has been proven very effective, but its effectiveness relies on the patient's
willingness to follow the treatment as prescribed by the doctor. Group therapy brings patients
together to share experiences and draw support from one another.
Living with Obsessive-Compulsive Disorder
Obsessive-compulsive disorder can disrupt a victim's life. It can keep someone from going to
work or attending school. It can keep someone from living in his or her own house. It can be
embarrassing to the extent that a person refuses to seek treatment. But treatment is essential,
and can usually help or end needless anguish.
How Family and Friends Can Help
The most important thing family and friends can do for a person with obsessive-compulsive
disorder is to help him or her get treatment. This may involve encouraging the patient to stay with
the treatment, going with the patient to the doctor, or even monitoring whether the patient is
taking medication.
Another important way to help is to offer emotional support - understanding, patience, affection
and encouragement. Always listen to the victim. Do not blame them for their disorder, make fun of
them or tell them to simply stop their behaviors. Also, never participate in the rituals.
Schizophrenia, one of the most debilitating and baffling mental illnesses, defines a group of
disorders that cause distorted thought and perception. Thoughts can be scrambled or jump
from subject to subject. Perceptions can be distorted beyond reality, causing people to see or
hear things that are not there.
People with schizophrenia go through periods of getting better and worse --- remission and
relapse. They can go for long periods of time without any symptoms, but because
schizophrenia is often a chronic illness, it requires ongoing medical attention, like hypertension
or diabetes.
Schizophrenia is neither a "split" personality nor multiple personality disorder, a different and
extremely rare problem. Though often stigmatized for the behaviors caused by the illness,
people with schizophrenia did not bring the illness upon themselves by becoming involved with
the "wrong" crowd or interests. And, contrary to the beliefs that are reinforced by movies,
television and books, people with the disorder are more likely to withdraw into isolation or
become victims of crime than they are to hurt anyone else.
Much less common than other chronic diseases, schizophrenia occurs in around 150 of every
100,000 people, or about one to one and a half percent of the population, and usually appears
during adolescence or young adulthood. However, it can be one of the most catastrophic
illnesses because it can cause devastating impairments, emotional and financial loss and the
need for long-term, intensive medical and supportive care.
Types of Schizophrenia
Schizophrenia can appear in one of many forms. For example, a person who has constant
feelings of being watched, followed or persecuted is said to have paranoid schizophrenia. A
person who is incoherent but has no delusions is said to have disorganized schizophrenia. A
person who lacks initiative, motivation, social interest, enjoyment and emotional
responsiveness is said to have undifferentiated schizophrenia. Schizophrenia can vary in
intensity, severity and frequency of both psychotic and residual symptoms from person to
person. Therefore, scientists use the word "schizophrenia to refer to a range of illnesses from
mild to severe.
Causes
Research has not yet identified the cause of schizophrenia. However, most experts agree that
a serious of factors combine with a genetic risk to contribute to the start of the disorder.
Just as the risks for diabetes and heart disease are thought to run in families, the risk to
develop schizophrenia is often thought to have a genetic link. For example, if one identical twin
develops schizophrenia, the other twin has a 50 to 60 percent chance of developing the illness
as well.
Exactly what triggers the illness in those with a family risk for schizophrenia is not yet known.
Some theories suggest that because schizophrenia most often first occurs during the hormonal
changes of puberty, these changes in biochemistry set off the illness in those who are at risk. In
addition, viral infection, severe stress such as poverty or violence, and other similar external
factors are all viewed as possible causes of the disorder.
Signs and Symptoms
Early signs of schizophrenia may not be noticed by family and friends. People who suffer from
schizophrenia sometimes display one or more of the following symptoms in the early stages of
the illness:
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prolonged feelings of tension
sleeplessness
poor concentration
social withdrawal
personality change
As the disorder progresses, the symptoms become more intense and bizarre. The person
develops peculiar behavior, begins talking nonsense and has unusual perceptions. These more
severe symptoms are usually the reason for seeking treatment.
Delusions are unusual beliefs that are not based in reality. For example, people suffering from
schizophrenia might believe that someone can hear their thoughts or control their feelings,
actions or impulses.
Hallucinations are distortions of the senses. Auditory hallucinations cause people to hear
sounds that are not there. Visual hallucinations cause people to see things that do not exist.
Tactile hallucinations are sensations without cause, like burning or itching. Olfactory
hallucinations, smelling non-existent odors, can also occur.
Preoccupations are thoughts that take on more importance in the sufferer’s mind than they
normally would. The same though returns often and can become unrealistic. This may include a
preoccupation with health, or “doing the right thing”.
Disordered thinking interferes with planning, motivation and communication. For example, a
person may use words that make no sense, or jump from one thought to another unrelated
thought.
Social withdrawal causes the schizophrenic to seek isolation. This may include an intolerance
of being in crowds, small gatherings or even with just one other person.
Lack of motivation and emotion as well as apathy are symptoms, which are troubling for family
members to see in their loved ones. Few people experience all these symptoms at once. Some
may occur during the remission phase and may worsen in the most active phase of the
disorder.
Myths
"Any person with schizophrenia is incapable of making life decisions and requires the help of a
legal guardian.”
The diagnosis of schizophrenia does not mean that the person will always be dependent upon
others to make decisions and care for them. In fact, most people with this illness handle their
own affairs successfully. However, just as people with other medical conditions may have
symptoms that cause periods when their ability to make decisions is impaired, people with
schizophrenia may require the appointment of someone to handle their affairs for a specified
length of time.
"Smoking ‘pot’ can help sometimes more than regular medicine.”
This is a myth. The use of any illicit drug is dangerous and illegal, no matter who uses them.
For people with schizophrenia, such use can impair judgment, worsen symptoms and cause
interactions with medications. People with schizophrenia often have difficulty with healthy social
interaction. Being with people who use or sell drugs can place an already vulnerable person in
a potentially dangerous position.
For these reasons, it is important to inform the treating psychiatrist of any substance abuse or
use. He or she will recommend steps to take to avoid illicit drug use and deal with the reasons
why the medication appears not to help.
"People with schizophrenia are violent.”
Violence is not a symptom of schizophrenia and is not common in people with this disorder. In
fact, people with schizophrenia are more likely to become victims of violence themselves.
However, if violence or aggression occurs, it usually does when a person feels cornered or
misunderstands the intentions of the other person. Usually hallucinations, delusions,
preoccupations or jumbled thoughts have caused the fears and misunderstandings that lead to
violence.
Treatments
Like many other mental illnesses, schizophrenia is usually treated with a combination of
therapies, tailored to the individual’s symptoms and needs.
Antipsychotic medications under the supervision of a psychiatrist is the treatment of choice for
schizophrenia, because the illness is related to biochemical imbalances. These medications
can reduce hallucinations, delusions and disordered thinking, but few of them adequately treat
the social withdrawal and apathy that occurs in schizophrenia.
As with all medications, antipsychotic medications have side effects. Some, such as dry mouth,
dizziness, drowsiness and constipation, go away with time. Other side effects include
restlessness, tremor and muscle spasms, cramping or stiffness. An irreversible side effect is
tardive dyskinesia, which causes abnormal movements in the mouth, face and later in the arms
and legs.
Many of these side effects can be helped or avoided when reported to the psychiatrist. It is
important not to abruptly stop taking the medications, increase the medications or take
additional medications without consulting a doctor. Such changes can cause relapse or other
serious problems.
Medication is usually prescribed through the remission phase of the illness to prevent relapse.
Though relapse may occur even when medication is taken as prescribed, taking the medication
provides the best protection from future relapse.
Psychotherapy and other supportive therapies address the emotional and practical responses
to these illnesses and are typically recommended in addition to medication.
The hallucinations, delusions and isolation caused by schizophrenia can impair a person’s
relationships with other people, daily living, spiritual growth and job skills. Individual
psychotherapy helps patients to understand their emotions and deal with life’s problems in a
more confident, healthy way. Group psychotherapy allows patients to learn social skills and
gain emotional support for the difficult times as well as offer support to others.
Occupational therapy helps patients return to daily living skills and routines, which may have
been impaired by mental illness. Activity therapy focuses on problems through recreational and
group activities.
Living with Schizophrenia
The outlook for people with schizophrenia has improved over the past two decades. While no
absolute cure has been identified, modern treatments have allowed many schizophrenic
patients to lead independent, fulfilling lives. It is important, however, that people who might
have the disorder be diagnosed quickly so that treatment can begin as soon as possible.
How Family and Friends Can Help
The first way family and friends can help is to take an active role in having the patient seek
treatment. The schizophrenic person usually believes that delusions and hallucinations are real
and that psychiatric treatment is not needed.
When treatment begins, recognize that many of the antipsychotic medications will likely cause
the patient to require more sleep than usual. Also, understand and be prepared to recognize
possible medication side effects as well as symptoms that would require contacting the doctor.
Speak clearly and simply. Because the illness can cause problems with thinking, it is helpful to
limit conversation to the most simple statements and questions. Recognize delusions and
hallucinations as symptoms. The perceptions are real to the patient; do not argue that the
delusion is true or false. Pointing out that he or she does not have to listen to the voice or wait
for the voice to speak again can be helpful.
Find a way to empathize. For example, the loud music played by the neighbors at night might
be interpreted in a delusion as a tactic to control the patient’s thoughts. Rather than insisting
that this is untrue, acknowledge how upsetting loud music can be while trying to sleep.
Provide structure. Help the person recovering from the illness to plan the days to include plenty
of sleep, healthy food, fresh air, time for exercise, cleanliness and social interaction.
Family and friends should plan ahead and be prepared for possible crises. Medications, phone
numbers and other important information and materials should be kept readily available.
Dealing with a relative or friend with schizophrenia can be tremendously stressful. Family and
friends can find emotional support, understanding and hope from outreach, education and
advocacy groups. Whether you are the victim, a family member or friend, everyone who is
affected by this mental illness should seek help.
Oppositional defiance disorder ODD
What is it?
ODD is a psychiatric disorder that is characterized by two different sets of
problems. These are aggressiveness and a tendency to purposefully bother and
irritate others. It is often the reason that people seek treatment. When ODD is
present with ADHD, depression, tourette's, anxiety disorders, or other
neuropsychiatric disorders, it makes life with that child far more difficult. For
Example, ADHD plus ODD is much worse than ADHD alone, often enough to
make people seek treatment. The criteria for ODD are:
A pattern of negativistic, hostile, and defiant behavior lasting at least six
months during which four or more of the following are present:
1. Often loses temper
2. often argues with adults
3. often actively defies or refuses to comply with adults' requests or rules
4. often deliberately annoys people
5. often blames others for his or her mistakes or misbehavior
6. is often touchy or easily annoyed by others
7. is often angry and resentful
8. is often spiteful and vindictive
The disturbance in behavior causes clinically significant impairment in social,
academic, or occupational functioning.
How often is "often"?
All of the criteria above include the word "often". But what exactly does that
mean? Recent studies have shown that these behaviors occur to a varying
degree in all children. These researchers have found that the "often" is best
solved by the following criteria.
Has occurred at all during the last three months8. is spiteful and vindictive
5. blames others for his or her mistakes or misbehavior
Occurs at least twice a week
6. is touchy or easily annoyed by others
1. loses temper
2. argues with adults
3. actively defies or refuses to comply with adults' requests or rules
Occurs at least four times per week
7. is angry and resentful
4. deliberately annoys people
MORE
What Are the Symptoms of Oppositional Defiant Disorder?
Symptoms of ODD may include:
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Throwing repeated temper tantrums
Excessively arguing with adults
Actively refusing to comply with requests and rules
Deliberately trying to annoy or upset others, or being easily annoyed by others
Blaming others for your mistakes
Having frequent outbursts of anger and resentment
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Being spiteful and seeking revenge
Swearing or using obscene language
Saying mean and hateful things when upset
In addition, many children with ODD are moody, easily frustrated and have a low self-esteem.
They also may abuse drugs and alcohol.
How Is Oppositional Defiant Disorder Treated?
Treatment is determined based on many factors, including the child's age, the severity of
symptoms, and the child's ability to participate in and tolerate specific therapies. Treatment
usually consists of a combination of the following:
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Psychotherapy: Psychotherapy (a type of counseling) is aimed at helping the child
develop more effective ways to express and control anger. A type of therapy called
cognitive-behavioral therapy aims to reshape the child's thinking (cognition) to
improve behavior. Family therapy may be used to help improve family interactions
and communication among family members. A specialized therapy technique called
parent management training (PMT) teaches parents ways to positively alter their
child's behavior.
Medication: While there is no medication formally approved to treat ODD, various
medications may be used to treat some of its distressing symptoms, as well as any
other mental illnesses that may be present, such as ADHD or depression.
What Is the Outlook for Children With Oppositional Defiant Disorder?
If your child is showing signs of ODD, it is very important that you seek care from a qualified
doctor immediately. Without treatment, children with ODD may experience rejection by
classmates and other peers because of their poor social skills, and aggressive and annoying
behavior. In addition, a child with ODD has a greater chance of developing a more serious
behavioral disorder called conduct disorder. When started early, treatment is usually very
effective.
Behavioral Strategies and Approaches for Children
with ODD
Getting a reaction out of others is the chief hobby of children with ODD. They like to see you get
mad. They try to provoke reactions in people and are often successful in creating power
struggles. Therefore it is important to have a plan and try not to show any emotion when reacting
to them. If you react too emotionally, you may make big mistakes in dealing with this child. Plan
in advance what to do when this student engages in certain behaviors and be prepared to follow
through calmly.
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Decide which behaviors you are going to ignore. Most children with ODD are doing
too many things you dislike to include all of them in a behavior management plan. Thus,
target only a few important behaviors, rather than trying to fix everything.
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Make this student a part of any plan to change behavior. If you don't, you'll become
the enemy.
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Provide consistency, structure, and clear consequences for the
student’s behavior.
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Praise students when they respond positively.
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Establish a rapport with the ODD child. If this child perceives you as reasonable and
fair, you'll be able to work more effectively with him or her.
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Avoid making comments or bringing up situations that may be a source of argument for
them.
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Never raise your voice or argue with this student. Regardless of the situation do not
get into a "yes you will" contest. Silence is a better response.
Do not take the defiance personally. Remember, you are the outlet and not the cause
for the defiance- unless you are shouting, arguing or attempting to handle the student
with sarcasm.
Avoid all power struggles with this student. They will get you nowhere. Thus, try to
avoid verbal exchanges. State your position clearly and concisely and choose your battles
wisely.
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Always listen to this student. Let him/her talk. Don't interrupt until he/she finishes.
Address concerns privately. This will help to avoid power struggles as well as an
audience for a potential power struggle.
In the private conference be caring but honest. Tell the student calmly what it is that is
causing problems as far as you are concerned. Be sure you listen as well. In this process,
insist upon one rule- that you both be respectful.
When decisions are needed, give two choices or options. State them briefly and
clearly. Students with ODD are more likely to complete or perform tasks that they have
chosen. This also empowers them to make other decisions.
Give the ODD student some classroom responsibilities. This will help him/her to feel
apart of the class and some sense of controlled power. If he/she abuses the situation, the
classroom responsibilities can be earned privileges.
When you see an ODD child getting frustrated or angry, ask if a calming down
period would help. But don't force it on him/her. Rather than sending the student down
to the office for this cooling down period, it may be better to establish an isolated
“calming down” place in the classroom so he/she can more readily re-engaged in
classroom activity following the cooling down period.
Ask parents what works at home.
Instructional Strategies and Classroom
Accommodations for the ODD Student
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Establish clear classroom rules. Be clear about what is nonnegotiable.
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Post the daily schedule so the student will know what to expect.
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Make sure academic work is at the appropriate level. When work is too hard, students
become frustrated. When it is too easy, they become bored. Both reactions lead to
problems in the classroom.
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Pace instruction. When the student with ODD completes a designated amount of a nonpreferred activity, reinforce his/her cooperation by allowing him/her to do something
they prefer or find more enjoyable or less difficult.
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Systematically teach social skills, including anger management, conflict resolution and
how to be assertive in an appropriate manner. Discuss strategies that the student may use
to calm him/ or herself down when they feel their anger escalating. Do this when the
student is calm.
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Select materials that encourage student interaction. Students with ODD need to learn
to talk to their peers and to adults in an appropriate manner. All cooperative learning
activities must be carefully structured, however.
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Minimize downtime and plan transitions carefully. Students with ODD do best when
kept busy.
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Allow the ODD student to redo assignments to improve their score or final grade.
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Structure activities so the student with ODD is not always left out or is the last person
picked.