Personality Disorders

 

personality disorder

Personality disorders are a class of mental disorders that involve the maladaptive way a person acts, feels, thinks, and perceives things which often deviate from normal norms.  These abnormal patterns of cognition and perception are enduring and disrupt an individual’s personal, social, and career lives.

A personality disorder may be diagnosed as such if it falls under the criteria outlined in the mental and behavioural disorders section of the International Classification of Diseases (ICD), published by the World Health Organization.  The ICD is the international “standard diagnostic tool for epidemiology, health management, and clinical purposes.”

Normal Personalities vs. Personality Disorders

Although normal people do behave differently from one another, they still have a set pattern of behaviour and thinking which are fairly predictable and conform to the general accepted criteria.  Normal healthy personalities are flexible enough to adapt to life changes or mistakes.  People with personality disorders on the other hand have limited coping mechanisms and are therefore more inflexible in the face of stress.  Because of the curtailed range of emotions, attitudes, and behaviours,  people with personality disorders often find life changes, whether minor or major, difficult to manage and so that daily life becomes a constant struggle.  Consequently it also becomes difficult for other people to adequately relate to them.

Personality disorders become markedly distinct in adolescence or early adulthood, although these illnesses may have begun in childhood.  Because the affliction distorts perceptions and behaviour, it often makes working with or relating to other people, difficult.  Unstable personalities often feel isolated or alienated because people may seem scary, threatening, or simply not very understanding of the way they see things, for the most part.

Types of Personality Disorders

As the term personality disorder refers to an umbrella malady, there exist many types of mental illnesses under this broad category which are further divided into three sub-categories:

  1. Cluster A

This group tends to exhibit more eccentric or strange behaviours as its constituents seem to exist in a world of their own.  Disorders under this sub-category are:

  • Paranoid personality disorder — characterized by suspicion and distrust.  Paranoid people tend to:
    • read threats where none exists
    • be constantly watchful of signs of hostility and betrayal in other people
    • be mistrustful even of close friends or family
    • often think they are being fooled or being taken advantage of
  • Antisocial personality disorder (ASPD) — characterized by an absence of consideration for other people because these types behave for themselves without regard for other people’s antisocialfeelings or situations.  Antisocial people may show the following behaviour:
    • reckless and impulsive actions without thought about consequences to self and other people
    • may be aggressive, constantly irritable, and may pick fights with others
    • may engage in criminal or illegal actions
    • may truly believe in the survival of the fittest philosophy in which he grabs every opportunity to the detriment of others and even to himself
    • may have had a misdemeanour or disorderly conduct charge before the age of 15.
    • possess no guilt or regret for hurting others and therefore would put his needs over anyone else’s always
  • Schizoid personality disorder — typified by the following characteristics:
    • uninterested in forming close relationships with anyone, including family
    • cold and emotionally distant
    • wants to live alone away from the company of others
    • have little interest in sex or intimacy
    • has a very negative outlook or perception about life
  • Schizotypal personality disorder — manifests weird or aberrant behaviour.  People with this disorder tend to:
    • express themselves unusually like using their own language or vocabulary for certain things
    • believe they have extraordinary powers or gifts such as a sixth sense or future forecasting
    • have extreme difficulty in forming any social relationship, even with a family member
    • behave oddly
    • exhibit paranoia and anxiety in social situations
    • feel tense and nervous around anyone who do not share their beliefs
  1. Cluster B

The Cluster B personality disorder group struggles to control their emotions which often swing erratically between positive and negative moods.  Behaviour from this group is often unpredictable, exaggerated, and disturbing.  Disorders that fall under this group are:

  • Narcissistic personality disorder — symptomised by:
    • an extreme and pervading feeling of entitlement that puts the individual in a rank above others
    • having low self-esteem that needs to be fed by recognition of one’s worth and needs by others
    • selfishness
    • resentment of other people’s achievements and successes
    • having the capacity to take advantage of other people
  • Histrionic personality disorder — A person with this disorder always needs to be the centre of attention and is very needy about getting the approval of others.  A histrionic personality will flirt, seduce, or “put on a show” to get the attention and focus he craves.

 

  1.  Cluster C

This third group struggles with chronic anxiety and fear and therefore manifests antisocial behaviour that is more withdrawn than hostile.  This group includes:

  • Avoidant personality disorder — People in this group are often extremely shy and inhibited because of overwhelming feelings of inadequacy.  Rejection is often a very sensitive spot for people in this category.
  • Dependent personality disorder — typified by extreme passiveness and submissiveness stemming from very low self confidence and severe neediness.  People with a dependency disorder may not be able make their own decisions or function well without help or support.  These people view themselves as so much less capable than others in many aspects.
  • Obsessive-Compulsive Personality Disorder (OCPD) — characterized by the obsessive need for perfectionism.  OCPD is different from Obsessive-Compulsive Disorder (OCD) which is a form of behaviour rather than a personality type.

 

People with a personality disorder may find hope in recovery over time.  What is needed is adequate support and professional help.  Mild to moderate personality disorders may improve with psychotherapy alone.

 

 

 

Electroconvulsive Therapy (ECT)

 

What is Electroconvulsive Therapy?

Electroconvulsive Therapy or ECT is a form of medical therapy for people with severe mental illness who do not respond to counselling, medication, or other forms of treatment.  The therapy involves sending carefully controlled electric impulses to the brain to stimulate a brief epileptic fit with the goal of relieving extreme depression, mania, or catatonia.  The electric stimuli seem to provoke changes in brain chemistry which help alleviate the patient’s mental symptoms.

When ECT is administered, the patient is given a muscle relaxant and put to sleep with anaesthesia.  Electrodes are placed on the head after which a finely channelled electric current is sent to stimulate the brain.  These impulses trigger slight seizure-like movements in the sleeping patient.  The session is painless and lasts only several minutes after which the patient awakes with no memory of the treatment or the events leading up to it.  He may also wake up disoriented but this will last only for a while.

Improvements in patients are noticed usually after the first three sessions and major improvements are palpable after six.  These improvements could manifest as better sleeping patterns, less lethargy, or better appetites.

Is Electroconvulsive Therapy Dangerous?

ECT today is a generally safe method as it involves no pain or bad shocks.  There is a side effect though which involves memory impairment lasting about several weeks after the treatment.  Although memory is usually resolved in the short-term, there are rare cases in which patients do lose personal and skill memories and have difficulty processing new information.

In cases of extreme depression, the benefits however may outweigh the risks of a memory disadvantage especially in patients whose need for some symptom alleviation are urgent.  For instance, a mother with severe postnatal depression may require the symptom alleviation ECT may provide, when other therapies have failed to, in order to for her to adequately nurture her infant.

ECT has gotten a bad reputation because of the errors done during its early developmental phase.  ECT’s stigma stemmed from misuse of equipment, inadequate information and staff training, and improper treatment administration.  These errors had proved to be injurious to some patients who were administered with high electric charges without anaesthesia causing memory loss, fractured bones, and other serious injuries.  Electroconvulsive therapy has evolved to today’s relatively safe administration of finely controlled charges, anaesthesia, and strict supervision.

electroconvulsive-therapy-adverse effects

Who are Candidates for ECT?

Patients who merit a prescription for electroconvulsive therapy may be:

  • suicidal because of severe depressive symptoms.  About 80% of these cases report a mood improvement with ECT.
  • unresponsive to drugs or talking therapies
  • in a severe manic episode lasting for a long period of time
  • catatonic
  • those that have a history of responding well to ECT therapy in the past
  • aggressive or extremely agitated because of dementia
  • pregnant and cannot take medications
  • intolerant of the side effects of drugs
  • mothers with severe postnatal depression.  As electroconvulsive therapy works more quickly than counselling or medication, it helps cut down the time that the mother spends away from infant nurture.
  • nutritionally compromised because patient refuses food or sustenance owing to extreme depression
  • severely psychotic or schizophrenic

Is ECT Effective?

There is a huge body of evidence now that ECT is an invaluable treatment tool for those with acute depression and psychosis.  Although electroconvulsive therapy can go a long way in treating patients, this must be followed up with talking therapies and medication to avert recurrence of extreme symptoms.

Types of Electroconvulsive Therapies

There are two types of ECT administration which is differentiated by the location of electrode placement:

  • Right Unilateral Treatment

Right unilateral treatment involves the placement of one electrode at the crown of the head and the other, at the right temple.  The placement produces milder stimuli and therefore has lower risks of side effects concerning memory.  The patient response rate, however, is also slower compared to bilateral ECT, the other type of treatment.  If patients do not respond to right unilateral treatment, they may be switched to the stronger bilateral one.

  • Bilateral Treatment

Bilateral treatment is a full-on type that requires electrodes to be placed on both the left and right temples of the patient’s head.  In this case, the electric stimuli are much stronger, but still controlled, and therefore more effective in resistant patients.  Bilateral ECT however carries more risk of some memory loss.

Bilateral ECT

The patient and doctor should work out which treatment type is best.  This usually involves taking into consideration the patient’s medical and psychiatric history, severity of symptoms, and personal concerns as well.

 

 

Major Mental Disorders (MMD)

The acronym MMD stands for Major Mental Disorder of which there are five broad categories:  anxiety disorder, mood disorder, psychotic disorder, dementia, and eating disorder.  These mental illnesses are not a result of one cause but rather an interplay of a variety of factors which include environment, genetics, and lifestyle.

mmd

Anxiety Disorders

An anxiety disorder is positive in a diagnosis if the patient has any of these three symptoms:

  • illogical or inappropriate fearful and anxious response to objects, events, people, and situations
  • inability to control these fear responses
  • having no control over anxious feelings so much so that it disrupts normal functioning

Anxiety disorders are specifically manifested by these mental sub-illnesses:

  • Generalized Anxiety Disorder (GAD) — GAD is characterized by excessive or chronic worrying about one or many areas of life such as family, income, career, friends, and school, among other things.  The fears may often be unfounded and skew off tangent; if there is some basis, the amount of worrying is excessively way out of proportion to the real situation.  A person afflicted with GAD may find himself unable to go about his life normally because of excessive dread.
  • Panic Disorder — characterized by feelings of terror and fear which may or may not occur suddenly.  These are repeated panic attacks accompanied by physical symptoms such as rapid heartbeat, chest pain, sweat, tremors, and disorientation.
  • Phobias — intense fear, often irrational, of something that actually does not pose any immediate or even potential danger.  Ex.  fear of enclosed spaces (claustrophobia); fear of crowds (agoraphobia);  fear of darkness (achluophobia)
  • Post-Traumatic Stress Disorder (PTSD)  — often characterized by emotional numbness and recurring vivid memories of traumatic incidents.

 

Psychotic Disorders

Psychotic disorders are known as a set of mental illnesses that involve a distortion of reality.  To someone plagued with psychosis, delusions (assignations of unreal meaning to normal and innocent events) and hallucinations (experiences of non-existent things that are not connected to any genuine sources such as hearing voices) are perceived to be as real as normal people see things to be.

Mental maladies under psychotic disorders are:

  • Schizophrenia — a serious mental disorder that is marked by distorted thought patterns, hallucinations, delusions, and paranoia, all of which lead the individual toward strange, irrational behaviours.  Schizophrenics may hear voices not attached to any source or may believe in delusions such as being a real princess or warrior.
  • Schizo-affective Disorder — a variant of schizophrenia mixed with mood disorders such as mania or depression.

Mood Disorders

Mood disorders are also known as affective disorders.  Persistent feelings of sadness or abnormal elation over a certain period of time may qualify under this mental malady.  Extreme emotional fluctuations also characterize this category under which these illnesses belong:

  • Bipolar Disorder — a disorder identified by extreme changes in mood from mania (“high” mood state) to depression (“low” mood state).     major mental disorder
  • Clinical Depression — surpasses the normal feelings of sadness and puts one in a chronic state of pessimism, hopelessness, emptiness, worthlessness, anxiousness, and other severely low mood situations.  Patients cannot just bounce back from their low moods, unlike unafflicted individuals who have the abilities to cope with abysmal feelings.  Clinical depression has been known to be the cause of some suicide cases.
  • Dysthymic Disorder — an illness marked with constant low-grade depression for more than two years.  Symptoms include low energy, feelings of hopelessness and low self-esteem, sleep and appetite problems, poor focus, and indecisiveness.

The danger to these depressive mood disorders is that the risk for suicide among sufferers is high.

Dementias

Dementia refers to a slew of mental health problems symptomised by rapidly declining memory and other cognitive functions.  Dementia is diagnosed when the one or more of the following are impaired:

  • Memory
  • Ability to concentrate or pay attention
  • Visual perception
  • Language and communication abilities
  • Judgement and reasoning

The cause to all these impairments are brain cell damages which hinder these cells from communicating adequately with each other.  Alzheimer’s disease makes up a large percentage of dementia cases, followed closely by vascular dementia and dementia due to medical problems such as Parkinson’s and Huntington’s disease.  Toxic substances such as drugs, alcohol, mercury, lead, etc. can contribute to the development of dementia as well.

Eating Disorders

Eating disorders involve extreme thoughts, attitudes, and behaviour towards food and weight.  These disorders manifest as either of these issues:

  • Anorexia Nervosa  — a condition that is indicated by an overwhelming and all-consuming dread of being fat.  Anorexics have a distorted body image and obsessive thoughts about food, calories, and weight on which they impose severe restrictions.  For sufferers, one can never be too thin.  Anorexia is dangerous because the condition can cause death from suicide, cardiac arrest, starvation, and other medical complications.
  • Bulimia Nervosa —  an eating disorder in which the sufferer chronically binge eats and then frantically purges the calories consumed as an attempt to lose weight or not gain the pounds from overeating.  Bulimics, like anorexics, have an obsession with food; only they overeat with the thought that they can purge their “sins” later.  A person with bulimia can consume between 3,000 – 5,000 calories in a short hour.  In the next, he often guiltily purges what he has consumed by inducing vomiting, applying enemas, exercising voluminously, or going on crash diets.  The constant binge-and-purge cycle wreaks havoc on the metabolic system, forcing bulimics to gain weight over time.
  • Binge Eating Disorder — chronic overeating without any purging involved.  The cycle moves around binge eating, feeling guilty and ashamed for gluttony,  then emotional eating again to assuage the guilt.  Binge eaters are usually obese and may suffer from hypertension, cardiovascular disease, depression, and anxiety.

 

These major mental illnesses are treatable but need the help of professional mental health practitioners.  The stigma associated with mental maladies however is the main cause of why  people avoid treatment or fail to recognize that they need treatment.  More information and education about mental illnesses should be provided so that early stages may be recognized and tended to correctly.

Post-Traumatic Stress Disorder (PTSD)

The human mind can be both fragile and tenacious, depending on whom it belongs to.  A seriously traumatic event may have different responses from individuals who have been exposed to it.  A person’s mind may be provoked towards high levels of stress while another individual may find ways to mitigate the experience.

Fighting a war, being a victim of rape or sexual abuse, witnessing a terrible crime, and being homeless after a flood are examples of traumatic events that can unhinge many people, mentally.  Post-traumatic stress disorder is usually the result of shock to one’s nervous system.

ptsd veteran

What Post-Traumatic Stress Disorder (PTSD) Is

Post-traumatic stress disorder is a severe form of anxiety disorder caused by traumatic, frightening, or distressing events.  More often than not, purposeful violent acts cause more shock than do natural or accidental incidents although these account for many PTSD cases as well.

PTSD can manifest itself right after a traumatic event or take months, even years, to make itself known.  The response from each person varies and it is unclear why some individuals develop the disorder while others cope well enough to live normally after the stressful experience.

When the mind is assaulted with shock, it may numb itself as a coping mechanism then open itself to emotional and physical reactions later.  These reactions may include insomnia, nightmares, feeling upset, and others.  These are natural responses to trauma which normally takes the mind a short time to resolve.  In some people, however, their responses to trauma may continue for over a month or may show some time way later after the traumatic incident.  In this case, PTSD becomes a developing issue for which psychiatric intervention may be imperative.

PTSD disrupts lives and can cause a person to have marital problems, poor career and personal relations, and social isolation.  If not treated urgently, the disorder may deteriorate to include other issues such as depression, acute fear, memory disruptions, substance abuse, and self harm.

Signs of PTSD

It is important to recognize PTSD so that the root cause, not just the manifestations, may be addressed.  A person is experiencing post-traumatic stress disorder when he is experiencing these three types of symptoms:

  • Reliving the Trauma

Trauma can leave behind a vivid footprint to plague the PTSD sufferer.  When a similar or unrelated event, object, or person, triggers intense memories, these often occur as flashbacks.          Flashbacks can seem so real that the afflicted may believe the event most feared is happening again.  A war veteran may react to an exploding firecracker as a gunshot or grenade explosion.  He     may experience intense fear, go into survival mode, or relive whatever emotions he had during a shoot-out.

Some of these intense memories may not even need a trigger.  These may come unbidden at any time, forcing the person to relive the trauma and experience the following:

  • nightmares
  • flashbacks or vivid images that jolt the person into thinking that his worst fears are happening again
  • intense distress at anything reminding the person of the trauma
  • physical symptoms such as sweating, pain, nausea, and tremors
  • feeling on edge
  • being easily angry, upset, or startled
  • lack of concentration or focus
  • insomnia and disturbed sleep patterns

 

  • Avoidance and Numbing

When someone experiences something bad, it is but natural to avoid things that remind him of it.  A PTSD victim however would avoid everything that smacks as a reminder of the traumatic           experience, part of which would be his memories.  Avoidance would constitute these behavioural symptoms:

  • keeping extremely busy
  • Avoidance of persons, places, things, events, and even sights, sounds, taste, and smells that remind the person of the traumatic incident.  People with PTSD may avoid watching a particular TV show or go anywhere near where the trauma took place.
  • using drugs or alcohol to numb the impact of memories or forget them

Numbing is another coping strategy of the mind that allows the person to cut off his feelings.  This emotional disconnection renders the person unable to be in touch with his feelings and to             express what he feels.  Sometimes the person literally forgets or refuses to talk about the major parts of the traumatic event.  A numb person experiences:

  • difficulty in empathising with others
  • difficulty showing or expressing affection
  • emotional desensitisation
  • social isolation

 

  • Arousal Symptoms

People suffering from PTSD have very heightened emotions and alertness.  Their emotions are aroused so that these individuals always seem to be on their guard.  Their chronic vigilance    causes them to experience:

  • constant tension
  • sudden bursts of anger, annoyance, and irritability
  • sleeping problems
  • difficulty keeping focus or concentration
  • being easily startled
  • panic when faced with reminders of the trauma, whether related to or not

People with PTSD often have difficulty functioning normally.  The syndrome is especially prevalent in war veterans who have more social, familial, and unemployment problems than many in the PTSD group.  Vietnam vets with post-traumatic stress for instance seem to struggle with keeping interpersonal relationships intact, holding down jobs, and reducing their propensity for violence.

PTSD can cause other mental health problems to crop up such as depression and other anxiety disorders.  It may cause physical or medical problems as well although research is still ongoing on this matter.

Post-traumatic stress disorder is a treatable syndrome.  If you know anyone or are yourself undergoing acute stress from trauma, get professional help as soon as possible to help you come to terms with your trauma.  You cannot change your past but know that you can be in control of your present.      

PAT-E749-P.T.S.D. Not all wounds are visible

Antipsychotic Medication

Antipsychotic medications are prescribed drugs used to treat people with some form psychosis.  Psychosis is an umbrella of mental disorders that are characterized by radically impaired emotions and thought patterns, so convoluted that the afflicted person actually loses touch with reality.  These mental disorders include bipolar disorder, borderline personality disorder (BPD), schizophrenia, and paranoia, all of which include the psychotic marks of delusions and hallucinations in their roster of symptoms.

ANTIPSYCHOTIC-DRUGS

How Do Antipsychotic Drugs Work?

Antipsychotic drugs target the neurotransmitters in the brain which are dopamine, noradrenaline, serotonin, and acetylcholine.  These brain chemicals have the main hand in regulating moods, emotions, and behaviour.  Of all these neurotransmitters, dopamine is the most important target.

By changing the effect these neurotransmitters currently have on an individual’s brain, antipsychotic drugs can suppress, reduce, or even prevent the onslaught of:

  • hallucinations (ex. hearing voices)
  • delusions (perceiving things, situations, and events not based on reality.  Ex.  A delusional person may firmly believe that the restaurant waitresses are laughing at him because they know his spouse has been cheating with someone else…even if they do not know him.)
  • Extreme mood swings
  • Thought disorders

What antipsychotics cannot do is cure a patient of his mental disorder.  These drugs can only act on the symptoms not on the entire illness.

Types and Side Effects

Antipsychotic medication was introduced in the 1950s and has to a large extent been successful in alleviating hallucinatory and delusional symptoms in psychotic patients so much so that these individuals have been able to lead a relatively normal life.  Although a boon to the mental health field at that time, early antipsychotics (termed typical) possessed its fair share of mild to severe side effects which manifested as:

  • muscle stiffness
  • tremors and spasms
  • restlessness
  • increased skin sensitivity to sunlight
  • low blood pressure
  • liver poisoning; so with some typical medications, liver tests may be mandatory
  • Parkinson’s disease-like symptoms
  • gastrointestinal disturbance
  • weight loss
  • skin rashes, ranging from mild to serious cases which may develop into Stevens-Johnson syndrome, a life-threatening illness  (rare side effect)
  • spontaneous ejaculation
  • tinnitus (ringing in the ears)
  • vertigo
  • drooling
  • excessive thirst

These typical drugs are still prescribed today because there are patients who tolerate these better than the newer atypical drugs.

Atypical antipsychotic drugs are considered the newbies in its category although the first, clozapine (Clorazil) was formulated over twenty years ago in 1990.  Atypicals have fewer side effects thanantipsychotic meds the older typical antipsychotics and are thus more often prescribed as a first-line treatment.

Most of the atypical drugs were developed for the treatment of schizophrenia and mania.  These are contraindicated for people with cardiovascular problems or with a history of epilepsy or Parkinson’s disease.  Many of these drugs such as risperidone and olanzapine should not be prescribed to older people as they increase the risk for stroke.  Atypical drugs may also compromise cognitive skills such as driving or operating heavy machinery.

The most noteworthy side effect of atypical antipsychotics is weight gain, increased appetite, and other metabolic issues.  Other side effects are:

  • dizziness
  • extreme sleepiness
  • low blood pressure when standing
  • fainting
  • rapid heartbeat (tachychardia); slow heartbeat, irregular heartbeat
  • tardive dyskinesia — uncontrollable movements of the lips, tongue, face, trunk, and limbs.  Usually a side effect of long-term drug use.
  • Parkinsonism
  • insomnia
  • anxiety; restlessness; agitation
  • raised prolactin levels provoking milk production
  • sexual problems
  • seizures
  • indigestion
  • headache
  • lethargy; lack of energy; tiredness
  • drooling
  • impulsive behaviour like gambling (attributable to Aripiprazole)
  • unusual taste sensations
  • numb lips and mouth
  • still muscles
  • raised levels of enzymes in liver
  • loss of menstrual periods
  • blurred vision

Side effects vary from individual to individual.  Other symptoms not on the common list may manifest as well; so, medical monitoring is crucial.

Withdrawing Intake of Antipsychotic Drugs

It is highly inadvisable to suddenly stop taking the prescribed drugs once already under antipsychotic medication.  Doctor’s approval is highly recommended as one has to follow a medical plan for a gradual and slow withdrawal from the drug over a period of several weeks or months.  While there are people who can stop taking their prescriptions without issues, the majority usually experience a recurrence of psychotic symptoms when suddenly going off their medications.

Furthermore, withdrawing from the drug is not a simple matter of gradual decrease of intake.  Situational factors such as timing of circumstances and availability of support from family and friends are crucial to making this huge leap.  Withdrawal can begin when there are no life-changing events or stressful things going on such as moving house, getting a new job, travelling to a new place, etc.  But as people can never be pigeon-holed, there are some patients that do withdrawals well when preoccupied with new things going on in their life.  No matter what type of patient one is, it is important to know that the manner of withdrawing from antipsychotic drugs is crucial because the aim is to avoid relapses.

Drug and Alcohol Addiction

Drug-and-Alcohol-addiction-is-destructive-600x448

Substance abuse is perhaps one of the most prevalent health and economic problems facing Britain today.  One in 20 adults (1.6 million adults) are alcohol-dependent and 1 in 100 (380,000) are cocaine or heroin addicts.  These statistics do not yet include the number of adolescents addicted to these substances.

What is Substance Abuse?

The World Health Organization defines substance abuse:

Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs.  Psychoactive substance use can lead to dependence syndrome – a cluster of behavioural, cognitive, and physiological phenomena that develop after repeated substance use and that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state.”

Alcohol is a Drug

Drugs are substances that alter a person’s mental and physical condition.  These are either prescribed as medicines or used for recreational purposes.  Those used for the latter are usually chemical substances that change an individual’s mental state so that his feelings, cognition, perceptions, and behaviour are altered from their normal states.  These drugs fall under the psychoactive drug category.

Because alcohol has the same mind-altering properties, alcohol is considered a psychoactive drug.  It is a close relative of crack (street word for cocaine), heroin, shabu, ecstasy, and other mind-altering drugs.  So when we talk of drugs, we refer to psychoactive drugs of which alcohol is very much a part of.

ALCOHOL

 

Understanding Drug and Alcohol Use, Abuse, and Addiction

Not all who use recreational drugs get to abuse it.  Not all abusers are in the state of addiction; although, they may well be on the road to it.  People try out or use drugs for a variety of reasons: some for experimentation; others, because it feels good for the moment; a few for athletic enhancement.  The list is rather long.  There is no specific level one can pinpoint at which using turns to abuse and then to addiction.  For others with high tolerance, their copious use may not have led to addiction yet; while with others, small amounts could well land them squarely in the addiction stage.  Resistance to drug addiction varies greatly from individual to individual.  Genes, mental health, family and environmental situations all play roles in determining one’s risk factors and tolerance.

Signs of Drug and Alcohol Abuse

  • Drug use is causing relationship problems.  One’s behavioural changes and thought patterns while under the influence may be causing serious problems with family, old friends, and colleagues at work.
  • One is under the influence without regard for the high risk situation he may be in like driving, having unsafe sex, or being in unsecured surroundings.
  • Drug use is developing or perpetuating illegal behaviour.  This may range from misdemeanours such as reckless driving and shoplifting to more serious crimes such as rape.
  • Drug use is causing chronic irresponsibility at work, school, family, and other areas of the user’s life.

 

Signs of Drug Addiction or Alcoholism

  • High tolerance for drugs
  • Drugs taken to relieve withdrawal symptoms which may include tremors, anxiety, depression, restlessness, insomnia, nausea, and many more
  • Helplessness or powerlessness in stopping the drug use even if one wants to
  • Total or almost complete abandonment of things one liked to do such as hobbies, socialization, sports, etc.
  • Exhibiting signs of paranoia, blackouts, mood swings, and other serious mental health problems
  • All focus is on drugs—how to get the next fix, how to recover from effects, etc.—to the exclusion of other important aspects in life such as family, friends, career, and the like.
  • High dependency on drugs, physically and emotionally, to get through the day

 

Help for Drug Addiction

One always feels hopeless in the face of such a seemingly insurmountable situation as that of drug addiction.  There is however hope for recovery if the patient and his support group make the effort.  The first step a patient must make is to realize that he indeed has a serious problem and that he is addicted to drugs.

Drug addicts who believe that they do not need help need to be pushed toward treatment, whether they agree to or not.  Drug addiction is not an issue one can simply back off from if the addicted person in question refuses to receive therapy.  Furthermore, drug addiction is a community problem; therefore, it is a concerted effort by family, friends, medical personnel, and even police enforcement to ensure that addicted individuals undergo treatment.

Paranoia

paranoia (1)

Understanding Paranoia

Paranoia is a state of mind in which the individual thinks other people are out to do him harm, physically, socially, or otherwise.  It encompasses an irrational dread of some present or impending disaster or bad thing for which other people are responsible.  Paranoid thoughts are often unfounded but the paranoid person believes all these as realities.

Being on one’s toes or being rightfully distrustful of other people do not make one a true paranoid; but, when this same individual starts weaving complex scenarios justifying their suspicions and experiencing intense suffering and fear from their thoughts to the exclusion of rationality, then he may be diagnosed as paranoid, possibly with schizophrenia.

Psychotic or schizophrenic people often have these persecutory delusions so that they live in fear of being harmed, controlled, plotted against, vilified, and socially disparaged.  These individuals often feel they are of particular importance and that is why they feel singled out for persecution.  Severe cases of paranoia may include hearing of voices, all malicious or threatening.

Causes of Paranoia

By itself, paranoia is not classified as a mental illness as schizophrenia and bipolar disorders are.  Instead, it is an indicator that something is wrong and that there is some underlying mental health issue or even a neurological disease such as Parkinson’s and Huntington’s disease.

Paranoia may also be caused by street drugs such as barbiturates, LSD, marijuana, and cocaine.  Impaired cognitive functions and chronic fatigue from chronic sleep deprivation may generate paranoia as well.

Traumatic life experiences such as a spouse’s betrayal or sudden loss of a job can cause a person to have extreme thoughts of persecution.  Uncontrollable environmental disasters such as bombings and high crime may understandably trigger paranoid delusions, some justified but most not.

Recent research has also discovered that individuals who have problems understanding other people’s perspectives and have low empathetic abilities tend to make negative assumptions of other people’s behaviour.  While these characteristics by themselves do not automatically make one paranoid, stressful life events may push such an individual toward feeling more threatened and consequently, paranoid.

paranoid-person-quotes-2

 

Treatments for Paranoia

One unfortunate side effect of paranoia is that the individual may not think of himself as needing any kind of help.  In fact, a genuinely paranoid person may think that their patterns of thoughts have developed from rational deductions and inferences of their personal observations.  While their beliefs are far from reality, paranoid people may scoff at treatments unless they suspect that they could partly be wrong.  Herein lies the difficulty in persuading a paranoid person to accept psychological or psychiatric intervention.

Treatments for paranoia may include:

  • Talking Treatments

Talking treatments refer to therapies that encourage patients to talk about their thoughts and emotions with a mental health professional.  Talking to trained therapists help paranoid persons come to terms with their fears and to perceive them as they are.  Doing so also help individuals take more control over their thoughts, allowing them to make positive thought and behavioural changes.  Talking treatments may involve the following therapy types:

  • Medication

Antipsychotic drugs such as clozapine, risperidone, and olanzapine may be prescribed for severe paranoia.  Know that paranoid people may be highly suspicious of drugs, even prescribed ones, as they may have delusions of their own doctor conspiring against them.

  • Hospitalization / Day Care Centres

In cases when a severely paranoid person becomes violent or is threat to himself and others, the person may be admitted to the hospital whether he goes voluntarily or not.  Once, he has been stabilized, he may be discharged and entitled to a treatment plan.

Care centres also exist as aftercare hostels where patients have the opportunity to live under a supportive environment.  Under such an arrangement, acute paranoia sufferers may be given the chance to develop the skills needed for getting back in society and reacquiring some independence.

 

Sleep Problems

young man in bed with eyes opened suffering insomnia and sleep disorder thinking about his problem

Waking up tired?  Have a difficult time falling asleep at the right time?  Do you fall asleep during the day?  If you have answered yes to one or all of these questions, then consider that you may have a sleeping problem.

Having occasional bouts of late night sleeping and morning sleepiness do not mean that you have a sleeping problem.  The chronic inability to get a good night’s rest however qualifies for a sleeping disorder; more so if this sleep inability starts to impact negatively on your day-to-day life.

Lack of sleep can affect your moods, energy levels, and cognitive functions.  You may start to become depressed, irritable, forgetful, and always exhausted.  Together with diet and exercise, sleep is an integral component of optimal human health.  Take one of these legs off from the diet-exercise-sleep triad and you get an individual with an imbalanced state of being.  Adequate rest is vital for the maintenance of both physical and mental health.

Common Types of Sleeping Problems

Sleeping problems must be addressed if one is to maintain that balance.  Sleep problems come in many forms and it is good to be aware of many of them.  Here are three common examples of sleep disorders:

Insomnia

Insomnia tops the common sleep problem list as about one third of the British population are insomniacs, according to The Guardian.  Insomnia is so common that the issue is affecting the country’s productivity and degrading overall British health.

Insomnia is a condition in which one has difficulty falling asleep at the right time or getting back to sleep when awakened at night.  Insomniacs may also find themselves frequently waking up at night and experiencing difficulty in getting right back to sleep.  Insomnia is a problem because the sleep deprived sufferers are inclined to fall asleep in the daytime, often during their supposed productive hours, a bad tendency which impacts their day-to-day work, school, and family life.

Chronic insomnia has often been linked to depression and anxiety.  Cognitive behavioural therapy (CBT)  has proven to be effective in breaking the cycle of poor sleep by modifying thoughts and feelings that give rise to stress which cause insomnia.

Sleep Apnoea

Sleep Apnoea is characterized by chronic heavy snoring and breathing pauses of about 10-20 seconds.  This condition affects the sleeper’s breathing pattern so that the sleeper is often jolted out of their natural sleeping rhythms.  A person with sleep apnoea spends most of the night in light sleep and hardly any in deep REM stage where sleep is most restorative.

Because those afflicted with sleep apnoea are chronically sleep deprived, they often experience these accompanying symptoms:

  • Sleepiness during the day.  This is dangerous because one may be falling asleep while driving or working with heavy machinery.  Chronic sleepiness at work impairs productivity and job security.                                                                                                    sleep on the job
  • Irritability
  • Severe mood swings
  • Personality changes
  • Sore throat and a dry mouth first thing in the morning
  • Waking up many times to urinate
  • Impaired cognitive functions.  Have difficulty learning, remembering, and concentrating.
  • Morning migraines

Sleep apnoea needs medical intervention but it is a treatable condition.

Oversleeping

Here’s a classic case where too much of a good thing becomes bad.  Hypersomnia or oversleeping is the polar opposite of most sleeping disorders as this entails getting too much sleep instead of less; yet as a chronic condition, it is cause for concern.

The average or normal beneficial sleeping duration is 7 to 8 hours of sleep a night for adults.  Should you be averaging more than this, you may be oversleeping.  Chronic oversleepers feel extremely sleepy and lethargic throughout the day.  Napping does not refresh them.  Hypersomniacs often experience low energy levels, tiredness, anxiety, and forgetfulness.  Despite their long hours of sleep, oversleepers crave more sleep and exhibit the symptoms of the sleep deprived.

Oversleeping has been linked to other medical problems such as obesity, diabetes, depression, and cardiovascular disease.  Studies have also discovered that hypersomniacs have significantly shorter life spans than those who sleep normally.

Sleep Problems and Mental Health

When sleeping difficulties become chronic, these problems can escalate to become mental health problems.  If the sleep problem is a by-product of a mental health issue, the lack of sleep or too much thereof may exacerbate the originating mental health disorder.  This may seem like a chicken-and-egg thing; but the crucial thing here is that sleep problems must be dealt with as soon as possible.

Constant sleep issues exhaust a person both physically and mentally so that he may experience:

  • Deterioration of self-esteem — Fatigue can undermine an individual’s ability to face day-to-day decisions and challenges.  Forgetfulness, inability to focus, learning difficulties and other cognitive issues may degrade his opinion of himself, diminishing his ability to cope and opening the doors for depression and anxiety to step in.
  • Loneliness — Because of exhaustion from inadequate rest, the sleep deprived can lose interest in social activities, causing a self-imposed social isolation.  Loneliness can further escalate into mental health problems such as anxiety and depression.
  • Negativity — Chronic tiredness may engender negative thought processes such as hopelessness and irrational thinking which may morph to or exacerbate mental health problems as well.
  • Psychotic episodes —  Sleep deprivation may trigger mania, psychosis, or paranoia in people already suffering from a psychotic disorder

Treatments

Sleep clinics and talking treatments such as CBT, stimulus control therapy, and relaxation therapies are common types of treatment.  Talking treatments given for free by the NHS are available; however, waiting lines may stretch too long for comfort.  Alternatively, a private therapist may be more of a help.  If you decide on one, be sure to check that he or she is properly trained and accredited by the British Association for Counselling and Psychotherapy (BACP) or the British Association for Behavioural and Cognitive Psychotherapies (BABCP).