Overview Bipolar disorder, also known as bipolar affective disorder and manic-depressive illness, is a mental disorder characterized by periods of elevated mood and periods of depression. The elevated mood is significant and is known as mania or hypomania depending on the severity or whether there is psychosis. During mania an individual feels or acts abnormally happy, energetic, or irritable. They often make poorly thought out decisions with little regard to the consequences. The need for sleep is usually reduced. During periods of depression there may be crying, poor eye contact with others, and a negative outlook on life. The risk of suicide among those with the disorder is high at greater than 6% over 20 years, while self harm occurs in 30–40%. Other mental health issues such as anxiety disorder and substance use disorder are commonly associated. Signs And Symptoms Mania is the defining feature of bipolar disorder, and can occur with different levels of severity. With milder levels of mania, known as hypomania, individuals appear energetic, excitable, and may be highly productive. As mania worsens, individuals begin to exhibit erratic and impulsive behavior, often making poor decisions due to unrealistic ideas about the future, and sleep very little. At the most severe level, manic individuals can experience very distorted beliefs about the world known as psychosis. A depressive episode commonly follows an episode of mania. The biological mechanisms responsible for switching from a manic or hypomanic episode to a depressive episode or vice versa remain poorly understood. Manic Episodes Mania is a distinct period of at least one week of elevated or irritable mood, which can take the... read more
Bipolar II disorder is a bipolar spectrum disorder characterized by at least one episode of hypomania and at least one episode of major depression. Diagnosis for bipolar II disorder requires that the individual must never have experienced a full manic episode. Symptoms of mania and hypomania are similar, though mania is more severe and may precipitate psychosis. The hypomanic episodes associated with bipolar II disorder must last for at least four days. Commonly, depressive episodes are more frequent and more intense than hypomanic episodes. Additionally, when compared to bipolar I disorder, type II presents more frequent depressive episodes and shorter intervals of well-being. The course of bipolar II disorder is more chronic and consists of more frequent cycling than the course of bipolar I disorder. Finally, bipolar II is associated with a greater risk of suicidal thoughts and behaviors than bipolar I or unipolar depression. Although bipolar II is commonly perceived to be a milder form of Type I, this is not the case. Types I and II present equally severe burdens. Bipolar II is difficult to diagnose. Patients usually seek help when they are in a depressed state. Because the symptoms of hypomania are often mistaken for high functioning behavior or simply attributed to personality, patients are typically not aware of their hypomanic symptoms. As a result, they are unable to provide their doctor with all the information needed for an accurate assessment; these individuals are often misdiagnosed with unipolar depression. Of all individuals initially diagnosed with major depressive disorder, between 40% and 50% will later be diagnosed with either BP-I or BP-II. Substance abuse disorders (which have... read more
What Is Depression? Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness. Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression. There are several forms of depressive disorders. Major depression,—severe symptoms that interfere with your ability to work, sleep, study, eat, and enjoy life. An episode can occur only once in a person’s lifetime, but more often, a person has several episodes. Persistent depressive disorder—depressed mood that lasts for at least 2 years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for 2 years. Some forms of depression are slightly different, or they may develop under unique circumstances. They include: Psychotic depression, which occurs when a person has severe depression plus some form of psychosis, such as having disturbing false beliefs or a break with reality (delusions), or hearing or seeing upsetting things that others cannot hear or see (hallucinations). Postpartum depression, which is much more serious than the “baby blues” that many women experience after giving birth, when hormonal and physical changes and the new responsibility of caring for a newborn can be overwhelming. It is estimated that 10 to 15 percent of women experience postpartum depression after... read more
Overview All of us worry about things like health, money, or family problems. But people with generalized anxiety disorder (GAD) are extremely worried about these and many other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks. Causes GAD sometimes runs in families, but no one knows for sure why some people have it while others don’t. Researchers have found that several parts of the brain are involved in fear and anxiety. By learning more about fear and anxiety in the brain, scientists may be able to create better treatments. Researchers are also looking for ways in which stress and environmental factors may play a role. Signs & Symptoms People with GAD can’t seem to get rid of their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. They can’t relax, startle easily, and have difficulty concentrating. Often they have trouble falling asleep or staying asleep. Physical symptoms that often accompany the anxiety include fatigue, headaches, muscle tension, muscle aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, having to go to the bathroom frequently, feeling out of breath, and hot flashes. GAD develops slowly. It often starts during the teen years or young adulthood. Symptoms may get better or worse at different times, and often are worse during times of stress. When their anxiety level is mild, people with GAD can function socially and hold down a job. Although... read more
What is Post-traumatic Stress Disorder (PTSD)? When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in post-traumatic stress disorder (PTSD), this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger. PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers. PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes. Signs & Symptoms PTSD can cause many symptoms. These symptoms can be grouped into three categories: 1. Re-experiencing symptoms 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. They 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. 2. Avoidance symptoms Staying away from places, events, or objects that are reminders of the experience Feeling emotionally... read more
What is Obsessive-Compulsive Disorder (OCD)? Everyone double checks things sometimes. For example, you might double check to make sure the stove or iron is turned off before leaving the house. But people with obsessive-compulsive disorder (OCD) feel the need to check things repeatedly, or have certain thoughts or perform routines and rituals over and over. The thoughts and rituals associated with OCD cause distress and get in the way of daily life. The frequent upsetting thoughts are called obsessions. To try to control them, a person will feel an overwhelming urge to repeat certain rituals or behaviors called compulsions. People with OCD can’t control these obsessions and compulsions. Most of the time, the rituals end up controlling them. For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror-sometimes they get “caught” in the mirror and can’t move away from it. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts. Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be... read more
Definition Alcohol abuse is defined as a pattern of drinking that results in one or more of the following situations within a 12-month period: Failure to fulfill major work, school, or home responsibilities Drinking in situations that are physically dangerous, such as while driving a car or operating machinery Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk Continued drinking despite having ongoing relationship problems that are caused or worsened by the drinking. Alcoholism, or alcohol dependence, is the most severe form of alcohol abuse. It is a chronic disease characterized by the consumption of alcohol at a level that interferes with physical and mental health and with family and social responsibilities. An alcoholic will continue to drink despite serious health, family, or legal problems. Alcoholism is influenced by both genetic and environmental factors. Alcoholism is chronic: It lasts a person’s lifetime. It usually follows a predictable course and has recognizable symptoms. Alcohol abuse and alcoholism cut across gender, race, and ethnicity. More men than women are alcohol dependent or have alcohol problems. Alcohol problems are highest among young adults ages 18-29 and lowest among adults ages 65 and older. Also, people who start drinking at an early age have a greater chance of developing alcohol problems at some point in their lives. Alcohol’s effects vary with age. Slower reaction times, problems with hearing and seeing, and a lower tolerance to alcohol’s effects put older people at higher risk for falls, car crashes, and other types of injuries that may result from drinking. More than... read more
What are opioids? Opioids are a type of medicine often used to help relieve pain. They work by lowering the number of pain signals your body sends to your brain and by changing how your brain responds to pain. Doctors most often prescribe opioids to relieve pain from toothaches and dental procedures, injuries, surgeries, and chronic conditions such as cancer. Some prescription cough medicines also contain opioids. Opioids usually are safe when they are used correctly, but people who misuse opioids can become addicted. Misusing opioids means that you don’t follow your doctor’s instructions for how to take the medicine, or you take the drug illegally. Opioid drugs include: opium codeine fentanyl heroin hydrocodone hydromorphone methadone morphine oxycodone oxymorphone paregoric sufentanil tramadol A person is said to have physical opioid dependence if they have high ‘tolerance’ of opioids, meaning they need more of the opioid to get the desired effect. Opioid withdrawal symptoms occur when the substance is stopped. Most patients who seek treatment for opioid addiction also have some degree of physical dependence. However, physical opioid dependence alone is not sufficient to make a diagnosis of addiction. A person can be physically dependent — as a cancer patient might be when prescribed opioids for severe pain — and not be addicted. The term ‘addiction’ refers to certain behaviors. Symptoms of Opioid Withdrawal Opioid withdrawal can occur in both the addicted patient and the patient who has opioid dependence but is not experiencing total opioid addiction. When an opioid is stopped or the dose is suddenly reduced, both types of patients experience withdrawal symptoms – sweating, chills, muscle and... read more
Caffeine-induced sleep disorder is a psychiatric disorder that results from overconsumption of the stimulant caffeine. When caffeine is consumed immediately before bedtime or continuously throughout the day, sleep onset may be delayed, total sleep time reduced, normal stages of sleep altered, and the quality of sleep decreased. Caffeine reduces slow-wave sleep in the early part of the sleep cycle and can reduce rapid eye movement sleep later in the cycle. Caffeine increases episodes of wakefulness, and high doses in the late evening can increase sleep onset latency. In elderly people, there is an association between use of medication containing caffeine and difficulty in falling asleep. The specific criteria for this disorder in the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) include that there must be a significant inability to sleep which is caused entirely by the physiological effects of caffeine as proven by an examination; if sleeping issues can be accounted for due to a breathing-related sleep disorder, narcolepsy, a circadian rhythm sleep disorder or a mental disorder, then caffeine-induced sleep disorder is not the cause. This condition causes a notable impairment in functioning in sufferers. Excessive ingestion of caffeine can lead to a state of intoxication. This period of intoxication is characterized by restlessness, agitation, excitement, rambling thought or speech, and even insomnia. Even doses of caffeine relating to just one cup of coffee can increase sleep latency and decrease the quality of sleep especially in non-REM deep sleep. A dose of caffeine taken in the morning can have these effects the following night, so one of the main practices of sleep hygiene... read more
Overview Cannabis dependence or cannabis use disorder is defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a condition requiring treatment. Cannabis is one of the most widely used drugs in the world. In the United States, 49% of people have used cannabis. Although physical addiction has not been proven, 9% of those who use cannabis develop dependence. In the US, as of 2013, cannabis is the most commonly identified illicit substance used by people admitted to treatment facilities. Demand for treatment for cannabis use disorder increased internationally between 1995 and 2002. Characteristics There is a high prevalence of cannabis use in the US. Among individuals who have ever used cannabis, 9% develop dependence, and 10-20% of those who use cannabis daily develop dependence. Cannabis use is associated with comorbid mental health problems, such as mood and anxiety disorders, and discontinuing cannabis use is difficult for some users. Psychiatric comorbidities are often present in dependent cannabis users including a range of personality disorders. Many other substances, such as alcohol, are often abused by individuals dependent on cannabis. Signs and symptoms Although not medically serious, cannabis withdrawal symptoms can occur in one half of patients in treatment for cannabis use disorders. These symptoms include dysphoric mood (anxiety, irritability, depressed mood, restlessness), disturbed sleep, gastrointestinal symptoms, and decreased appetite. Most symptoms begin during the first week of abstinence and resolve after a few weeks. According to the National Cannabis Prevention and Information Centre in Australia, a sign of cannabis dependence is that the person spends noticeably more time than the average recreational user, recovering... read more
Understanding Benzodiazepine Dependency and Tolerance Abuse of benzodiazepines is usually defined as using the drug to obtain a non-therapeutic effect. When benzodiazepines are taken for long periods, a person may become physically and psychologically dependent on the drug. It is also common for people taking benzodiazepines long-term to develop tolerance. This means the drug no longer has the desired effect. This encourages a person to increase their dosage in order to achieve the therapeutic effect they are used to. Benzodiazepine dependence is usually characterized by a number of symptoms that occur should the person suddenly stop taking the drug. Symptoms of physical dependence include anxiety, diarrhea, muscle cramps, and tremors. Psychological dependence is usually illustrated by a person’s complete preoccupation with taking benzodiazepines. They may appear obsessed with ensuring they take the drug regularly, at the cost of other activities in their life losing importance. Some users may not realize they have a dependency on benzodiazepines, while others may be too afraid to admit they may need help. Effects/Side Effects The benzodiazepine high has been described as experiencing an intense feeling of euphoria. It is also common for people to experience short-term effects such as increased self-confidence, becoming more talkative, and general feelings of enhanced happiness. Benzodiazepines are also likely to reduce a person’s anxiety, making them feel worry-free and much calmer than usual. As with most highs, users of benzodiazepines will experience a comedown. Feelings of depression, anxiety, and general agitation are not uncommon when coming down from benzodiazepines. The person may also experience uncomfortable physical symptoms such as stomach cramps and headaches. It is this comedown that... read more
Overview Amphetamine is a strong stimulant that has been used medically for situations when a person needs to be more alert, as in narcolepsy, a health problem that causes a person to fall asleep at any time. It has also been given to pilots and soldiers to keep them awake and alert for long hours. It does its job in these situations, but the side effects of this drug can be dangerous and damaging. Amphetamine can be given orally, can be snorted or given intravenously. Symptoms of use will show up immediately if it is injected, within 3-5 minutes if it is snorted and within 15-20 minutes if it is ingested. Signs and Symptoms There is a long list of the signs that show up when this drug is used medically or when it is abused. Many of them are typical of any stimulant use. Signs and Symptoms of Amphetamine Abuse include: Increased body temperature Euphoria Increased blood pressure Dry mouth Faster breathing Dilated pupils Increased energy and alertness Decreased fatigue Decreased appetite Before amphetamine’s addictive problems were known about, this drug was used for weight control, depression, nasal congestion, even hangovers. It was an inexpensive, long-lasting solution to a number of problems. It has been sold as Desoxyn, Benzedrine, Adderall, DextroStat and Dexedrine. After World War II, civilian use of amphetamines increased, and another form of the drug, methamphetamine – easily produced in small domestic labs – also hit the market. As more people used these two forms of the drugs, its addictiveness and other problems began to be obvious. In addition to the symptoms of use listed... read more
Understanding Cocaine Dependency and Tolerance Regular users of cocaine may find they quickly become tolerant to the euphoric effects of the drug. This means it will take more and more cocaine to produce the same feelings. An increased use of the drug is usually a solid indication that a person is suffering from cocaine dependence. Physical dependence occurs when a person begins to rely on the drug to properly function. This type of dependence is also characterized by an intense craving for cocaine, fatigue and an increase in appetite. The symptoms of psychological dependence are usually illustrated by a major change in a person’s personality. Cocaine also becomes their top priority and they may let other activities they have enjoyed in the past take a back seat. The person may also become obsessed with making sure they always have enough cocaine. Effects/Side Effects The cocaine high can change how a person feels emotionally, as well as changing the way they think. According to the CESAR website, the initial cocaine high lasts around 15-minutes. Cocaine affects the nervous system, as well as the brain, which means each cocaine user is likely to experience a unique high. Feelings of intense pleasure and complete euphoria are the most common high described by users of cocaine. This is one reason why people become addicted so quickly. An increase in self-confidence and social awareness is also common, with people instantly becoming more gregarious and talkative. The effect of coming down from cocaine will start as soon as the effects of the drug begin to dissipate. This comedown is often long and can leave... read more
What is Borderline Personality Disorder? Borderline personality disorder (BPD) is a serious mental illness marked by unstable moods, behavior, and relationships. In 1980, the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed BPD as a diagnosable illness for the first time. Most psychiatrists and other mental health professionals use the DSM to diagnose mental illnesses. Because some people with severe BPD have brief psychotic episodes, experts originally thought of this illness as atypical, or borderline, versions of other mental disorders. While mental health experts now generally agree that the name “borderline personality disorder” is misleading, a more accurate term does not exist yet. Most people who have BPD suffer from: Problems with regulating emotions and thoughts Impulsive and reckless behavior Unstable relationships with other people. People with this disorder also have high rates of co-occurring disorders, such as depression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides. Signs & Symptoms According to the DSM, Fourth Edition, Text Revision (DSM-IV-TR), to be diagnosed with borderline personality disorder, a person must show an enduring pattern of behavior that includes at least five of the following symptoms: Extreme reactions—including panic, depression, rage, or frantic actions—to abandonment, whether real or perceived A pattern of intense and stormy relationships with family, friends, and loved ones, often veering from extreme closeness and love (idealization) to extreme dislike or anger (devaluation) Distorted and unstable self-image or sense of self, which can result in sudden changes in feelings, opinions, values, or plans and goals for the future (such as school or career choices) Impulsive and often dangerous... read more
Overview Alzheimer’s disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills, and eventually the ability to carry out the simplest tasks. In most people with Alzheimer’s, symptoms first appear in their mid-60s. Estimates vary, but experts suggest that more than 5 million Americans may have Alzheimer’s. Alzheimer’s is the most common cause of dementia among older adults. Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. Dementia ranges in severity from the mildest stage, when it is just beginning to affect a person’s functioning, to the most severe stage, when the person must depend completely on others for basic activities of daily living. The causes of dementia can vary, depending on the types of brain changes that may be taking place. Other dementias include Lewy body dementia, frontotemporal disorders, and vascular dementia. It is common for people to have mixed dementia—a combination of two or more disorders, at least one of which is dementia. For example, some people have both Alzheimer’s disease and vascular dementia. Changes in the Brain Cross sections of the brain show atrophy, or shrinking, of brain tissue caused by Alzheimer’s disease. Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimer’s disease. It seems likely that damage to the brain starts a decade or more before memory and other cognitive problems appear. During this preclinical stage of Alzheimer’s disease, people seem to be symptom-free, but toxic changes are taking place in the brain. Abnormal deposits of proteins... read more
Overview When facing death, terminally ill patients must deal with extreme psychological distress. Undiagnosed mental illness and mood disorders such as depression often contribute to a person’s discomfort and pain at the end of life. However, patients will often disregard depressive symptoms as “normal” and hide them from physicians. Underdiagnosis and undertreatment of depression can degrade the quality of life and hasten death for a terminally ill patient. When Symptoms May Be Normal Sadness Grief is a normal part of the dying process. Feelings that are common among terminally ill patients may include: deep sadness and regret (this may include crying or sobbing) anger difficulty sleeping or changes in appetite fatigue restlessness disbelief disengagement or apathy When normal feelings of grief become excessive and start to interfere with every aspect of a person’s life, they may indicate a more serious problem. When Symptoms May Be Depression The symptoms of depression in terminally ill patients often correspond with symptoms of their disease, making it all the more difficult to diagnose. Symptoms to watch for include: severe mood swings or other mood disturbances prolonged difficulty sleeping prolonged difficulty eating loss of interest in once pleasurable activities or hobbies feelings of helplessness feelings of guilt persistent worrying suicidal ideation Older patients are more likely to seek general medical care rather than mental health care for their symptoms. They also tend to focus on the physical manifestations of their symptoms (such as sleeplessness) rather than on their depressed mood. When Symptoms May Be Side Effects of Medication Many medications may cause symptoms that might be mistaken for depression. They include: changes in appetite... read more
Overview In Greek mythology, Narcissus was a young man who fell in love with his own image reflected in water. He eventually died from starvation because he couldn’t tear himself away from his own reflection. Narcissistic Personality Disorder (NPD) is a term increasingly bandied about and refers to excessive self-love, however the concept is a bit more complicated than that because if sufferers of NPD securely loved themselves then this wouldn’t be a psychological problem. The key point is that this is a kind of insecure self-love which leads to certain compulsive behaviours and restlessness that eventually lands the sufferer in trouble. Another problem with NPD is that narcissists are usually great fun to be with during an initial encounter. It is the longer term relationships which become more problematic. And, of course it goes without saying that sufferers from NPD dominate the upper levels of public life and organizations. Symptoms of Narcissistic Personality Disorder Narcissists display an exaggerated sense of self-importance, dominance, beauty, and entitlement. Because they think they’re so wonderful, they exploit others mercilessly. Theirs is an unquenchable thirst for admiration from others. Narcissists also score high levels on sub-scales in personality tests measuring exhibitionism, feelings of superiority and vanity. Although some of the personality features may seem like high self-esteem or confidence – it is very different. Those with NPD believe that they are very much better than others. But beneath this exterior lies a very fragile self-esteem. They often have trouble coping with criticism and may react with contempt or rage to belittle others in order to make themselves feel better. The importance of seeking... read more
