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Depression in Children and Adolescents
Depression in Children and Adolescents
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2% school children and 5% adolescents have depression |
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Suicides amongst adolescents have increased 4 times |
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Suicide is the third leading cause of death for 15 to 24 year olds, and the sixth leading cause of death for five to 14 year olds |
| What are the Symptoms of Depression in Children and Adolescents? |
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Sadness or feeling low |
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Loss of interest and loss of pleasure |
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Withdrawn form social network, avoids friends and family |
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Weight, appetite and sleep changes |
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Deterioration in academic performance |
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Frequent complaints of pains, and aches |
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Crying, irritable, upset |
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Persistent boredom |
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Low energy |
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Poor concentration |
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Absenteeism from school |
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Behavioral problems |
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Conflicts with parents and other authority figures |
| What Causes Depression in Children and Adolescents? |
| Biochemistry - Deficiencies in two chemicals in the brain, serotonin and norepinephrine, are thought to be responsible for certain symptoms of depression, including anxiety, irritability, and fatigue. |
| Genetics - Depression can run in families. For example, if one identical twin has depression, the other twin has a 70% chance of also having the illness sometime in life. |
| Personality - People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be vulnerable to depression. |
| Environmental factors - Continuous exposure to violence, neglect, abuse, or poverty may make people who are already susceptible to depression all the more vulnerable to the illness. |
| What is the Treatment for Childhood and Adolescent Depression? |
| Medications from a Psychiatrist - Medications that restore chemical imbalances should be considered even in the case of children and adolescent. These are not addictive, they do not have sedation and are not taken life long, and do not have worrisome side effects especially when taken in a therapeutic dosage under the advice of a psychiatrist. |
| Cognitive behavioral therapy - Cognitive behavioral therapy has been shown to be especially effective with children and adolescents whereby help is provided to aid in thought restructuring and bring about behavioral changes as well. Active problem solving, social skills development, activity scheduling, and self-monitoring are often targeted and taught. |
| Family guidance - Education and guidance to parents and families helps them take a supportive role to help the child with his or her problem. |
Depression in Adults
Depression in Adults
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1 in 5 women and 1 if 10 men have depression in their life time. |
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This is going to be the 2nd largest illness in the world by 2010. |
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10-15% patients of depression commit suicide |
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45-70% of all suicides have a mood disorder |
| What Is Depression? |
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Feelings of unhappiness that don't go away |
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Losing interest in life |
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Becoming unable to enjoy anything |
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Finding it hard to make even simple decisions |
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Feeling utterly tired |
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Feeling restless and agitated |
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Losing appetite and weight (some people find they do the reverse and put on weight) |
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Difficulty in sleeping |
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Waking up earlier than usual |
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Going off 'sex' |
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Losing self-confidence |
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Feeling useless, inadequate and hopeless |
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Avoiding other people |
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Feeling irritable |
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Feeling worse at a particular time of day, usually mornings |
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Thinking of suicide |
| What Causes Depression? |
| Biochemistry - Deficiencies in two chemicals in the brain, serotonin and norepinephrine, are thought to be responsible for certain symptoms of depression. |
| Genetics - Depression can run in families. For example, if one identical twin has depression, the other twin has a 70% chance of also having the illness sometime in life. |
| Personality - People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be vulnerable to depression. |
| Environmental factors - Continuous exposure to violence, neglect, abuse, or poverty may make people who are already susceptible to depression all the more vulnerable to the illness. |
| However, it should be noted that depression could still occur under ideal living circumstances. This is important to understand as there is a feeling that only those who are weak have depression, or that people can self impose the illness and so on. But depression like any other medical illness can happen to anyone. |
| How Is Depression Treated? |
| Depression is among the most treatable of mental disorders. Between 80% and 90% of people with depression respond well to treatment, and almost all patients gain some relief from their symptoms. The treatment tends to be multipronged and includes the following strategies depending upon the individual's symptoms and personal factors. |
| Medication - Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, "uppers," or tranquilizers; they are not habit-forming and they generally have no stimulating effect on people not experiencing depression. Antidepressants usually take full effect within 3-6 weeks after therapy has begun. Psychiatrists usually recommend that patients continue to take medication for 5 or more months after symptoms have improved. |
| Psychotherapy - Psychotherapy, or "talk therapy," may be used either alone for treatment of mild depression or in combination with antidepressant medications for moderate to severe depression. Psychotherapy can involve only the individual patient or include others. Family or couples therapy helps to address specific issues that can arise within these close relationships. Depending on the severity of the depression, treatment can take a few weeks or substantially longer. There are also techniques like (CBT) Cognitive Behavior Therapy that are very effective in management of depression in which through various exercises and thought changing techniques depression can be resolved. |
| Both the medical and therapeutic treatments when used together have the best result. And if the treating professional has advised you medications then you must take them as advised. Furthermore, good social and family support can be very helpful in the management of depression and improves the prognosis of the patient and helps in faster recovery. |
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
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OCD is an Anxiety disorder |
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4% people have the illness |
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It happens both in men and women and is prevalent across all ages |
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It starts in adolescence and can also happen in children |
| What is Obsessive-Compulsive Disorder? |
| Typically OCD is characterized by what are called obsessions and compulsions. |
| Obsessions - Obsessions are constant, intrusive, unwanted thoughts that cause distressing emotions such as anxiety or disgust. People experiencing obsessions recognize that these persistent images are a product of their own mind and are excessive or unreasonable but they are unable to control them, and feel distressed by them. |
| Compulsions - Compulsions are urges to do something to lessen discomfort, usually discomfort that is caused by an obsession. Rituals are the behaviors in which people engage in response to a compulsion. In the most severe cases, a constant repetition of rituals may fill the day, making a normal routine impossible. |
| Some of the common obsessions and compulsions include the following, |
| Cleaning, contamination and hand washing - Provoked by the fear that real or imagined germs, dirt, or chemicals will "contaminate" them, some spend hours and hours washing themselves or cleaning their surroundings. |
| Repeating - To dispel anxiety, some utter a name, phrase, or behavior several times. They know these repetitions won't actually guard against injury but fear harm will occur if they don't do it. |
| Being meticulous and symmetry preoccupation - While neatness and tidiness don't signify a disorder, some individuals with OCD develop an overwhelming concern about where things go on a desk or the appearance of a room. |
| Checking - The fear of harming oneself or others by forgetting to lock the door or turn off the gas stove develops into the ritual of checking. |
| Brooding or rumination - some people reprt that they have continues thoughts, that are aboiut day to day things, or past events, or interpersonal issues, and these thoughts continue non-stop, making it difficult to rest, sleep or relax. |
| What Causes OCD? |
| The imbalance of brain chemicals, neurotransmitters, specially serotonin is considered the main cause for OCD. And medications that help to increase the levels of this neurotransmitter help in curing the illness. Genetics also seems to play a role, and there have been some studies on some brain structure changes in this illness. The principals of learning like conditioning and observational learning also play an important part in the starting and maintenance of anxiety disorders. |
| What is the Treatment for OCD? |
| Medications - SSRI mediations, that increase levels of serotonin are very useful it this illness, and have a good response. As a result, a psychiatrist must be seen if one has the symptoms of the illness. Other mediations which involve newer combinations are also useful in resistant cases. |
| Cognitive behavioral therapy - CBT(cognitive behavioral therapy), is very effective and useful through the medium of which the person is counseled how to control the compulsions and correct the obsessive thoughts, and when used with medications CBT gives a very good treatment response. |
| It is very important to see the right expert for this illness. The treatment must be under supervision of a psychiatrist and if medications are given they should be taken regularly as advised, and CBT by the clinical psychologist would be beneficial with the medications for a better, effective and long-lasting response. |
Schizophrenia
Schizophrenia
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Schizophrenia is found all over the world -- in all races, in all cultures and in all social classes |
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It affects 1 in 100 people worldwide. |
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Usual age of onset is between 16 and 25. |
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Early diagnosis and stabilization on modern treatment can greatly improve prognosis for the illness. |
| Symptoms of schizophrenia |
| There can be several types of clinical presentation of schizophrenia, and subtypes of the illness, but in general the types of symptoms could be divided into positive and negative symptoms. |
| "Positive" symptoms. - These are psychological features "added" as a result of the disorder, but not normally seen in healthy people: |
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hallucinations (hearing voices is the most common) |
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delusions |
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disorganised thinking |
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agitation |
| "Negative" symptoms - These are psychological capabilities which most people possess, but which people with schizophrenia have "lost": |
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drive or initiative |
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social interaction |
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enthusiasm |
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emotional responsiveness |
| The early signs and changes in an individuals' behavior that may indicate the development of schizophrenia include the following. |
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Deterioration of personal hygiene |
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Bizarre behaviour |
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Irrational statements |
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Sleeping excessively or inability to sleep |
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Talking to self |
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Social withdrawal, isolation, and reclusiveness |
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Shift in basic personality |
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Unexpected hostility |
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Deterioration of social relationships |
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Hyperactivity or inactivity -- or alternating between the two |
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Inability to concentrate or to cope with minor problems |
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Excessive writing without meaning |
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Dropping out of activities -- or out of life in general |
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Extreme reactions to criticism |
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Inability to express joy or Inability to cry, or excessive crying |
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Unusual sensitivity to stimuli (noise, light, colours, textures) |
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Strange posturing |
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Refusal to touch persons or objects; wearing gloves, etc. |
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Staring without blinking -- or blinking incessantly |
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Peculiar use of words or odd language structures |
| What causes schizophrenia? |
| Schizophrenia is a complex illness, and although its exact cause is still unknown but it is thought to be due to a number of different factors acting together. |
| Biochemistry - People with schizophrenia appear to have a neurochemical imbalance. Thus, some researchers study the neurotransmitters that allow communication between brain cells. Modern antipsychotic medications now target three different neurotransmitter systems (dopamine, serotonin, and norepinephrine.) |
| Cerebral Blood Flow - With modern brain imaging techniques (PET scans), researchers can identify areas that are activated when the brain is engaged in processing information. People with schizophrenia appear to have difficulty "coordinating" activity between different areas of the brain. |
| Molecular Biology - People with schizophrenia have an irregular pattern of certain brain cells. |
| Genetic Predisposition - Genetic research continues, but has not yet identified a hereditary gene for schizophrenia. Schizophrenia does appear more regularly in some families. Then again, many people with schizophrenia have no family history of the illness. |
| Stress - Stress does not cause schizophrenia. However, it has been proven that stress makes symptoms worse when the illness is already present. |
| What is the Treatment for Schizophrenia? |
| Medication - Medication is absolutely essential in schizophrenia. All patients who show signs of schizophrenia, must be taken to a psychiatrist and put on medications at the earliest. Early start of medications ensures a significantly better prognosis and recovery. Medications restore the chemical imbalance, and the newer medications that have come up do not have the worrisome side effects of the older medications, and have a better response and do not have serious problems related to long term treatment. These should be taken under regular psychiatry care. |
| Family Counselling - Since the patient and the family are often under enormous emotional strain, it may be advantageous to obtain counselling from professionals who understand the illness. |
| Hospitalization and Regular Follow-up - If someone becomes acutely ill with schizophrenia, they will probably require hospitalization. This allows the patient to be observed, assessed, diagnosed, and started on medication under the supervision of trained staff. The purpose of hospitalization is proper medical care and protection. Once the illness is stabilized and the patient is discharged from hospital, regular follow-up care will reduce the chances of relapse. |
| Residential and Rehabilitation Programs - Social skills training, along with residential, recreational, and vocational opportunities tailored to people with mental illness are very important. Used as part of the treatment plan, they can result in improved outcomes for even the most severely disabled people. |
Substance Abuse
Substance Abuse
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| Despite attempts to limit access to psychoactive substances, the use of substances is growing. Substance use can have profound acute and chronic effects on the behavior and emotional status of the user. Substance abuse can affect the psychosocial life of the individual. |
| What is Substance Abuse? |
| Substance abuse involves regular and continued use of substances (like drugs, alcohol, other chemicals) by the individual that leads to pathological behavioral changes. Some of the changes that take place indicating that the person is getting addicted include the following. |
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Sudden personality changes that include abrupt changes in work, quality of work, work output, etc. |
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Unusual flare-ups or outbreaks of temper |
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Withdrawal from responsibility |
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General changes in overall attitude |
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Loss of interest in what were once favorite hobbies and pursuits |
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Withdrawal or avoidance from family |
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Difficulty in concentration, paying attention |
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Sudden jitteriness, nervousness, or aggression |
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Deterioration of physical health |
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Borrowing of money |
| What may cause a person use substances? |
| Group psychology - Many of the users form groups. There is the 'in group', bonding that is very strong. A process known as 'deindividuation', in which the person loses the sense of self, and has a poor self decision-making and instead has a groupthink, in which his identity is lost to the identity of the group. And this is what makes him do things as a group that would not have been done otherwise. This is common in the stereotypical views about some specific work groups and sometimes one tends to use a substance to merely be recognized as a part of the group. |
| Media - Studies show that watching role models, actors and advertisements of substances results into higher usage of substances. The main effects of viewing violence on TV are disinhibition and desensitization to substance use, and a distortion in reality perception and learning through imitation. But most important is that there is "glamorization" of substances in media. |
| Misinformation - Most people who use any substance be it alcohol, or opiates, they are misinformed about its effect on health and life at large. People have a myth that it is good in small quantities, or that it helps to relax or de-stress, both being wrong notions. Some people also relate it with the glamour, be it as a part of a profession, or self-status, and this too is a stereotypical misconcept. |
| Substance dependence affects physical health in terms of serious medical complications, from cardiac and respiratory illnesses to brain disorders. It also affects the emotional and psychological self, makes the person have depressive symptoms, anxiety, and behavioral problems. Work is affected, job efficiency goes down, and the ability to perform complex, creative, and executive tasks is compromised. Social and family life gets destroyed due to substance indulgence, and for parents who use substances this can be the prime reason for children to experiment with substances. |
| What is the Treatment for Substance Abuse? |
| The most effective intervention for substance use disorders is preventing the initial development of substance use or pathological patterns of use. Although a consensus exists regarding the importance of prevention efforts, there is a lack of agreement of a conceptual goal for prevention; that is, what should be prevented0-use, abuse, or dependence? While some would have interventions directed at the prevention of various use patterns or consequences of substance use, a broader view of prevention would target the risk factors for the development of substance use or substance use disorders. |
| Targeting risk factors likely requires a host of measures involving the educational, mental health, and welfare systems. However, primary prevention efforts aimed at risk factors may prove more effective and influence the development of a wide range of problems and psychosocial dysfunction. |
| These interventions include educational approaches, family-based interventions, and community-based projects. The successful prevention programs appear to be those that target salient risk factors, are skills oriented, have sufficient intensity and duration, have follow-up, and respect the socioeconomic and cultural realities of the targeted communities. |
| Another important aspect of treatment involves the use of medications, counseling and therapy, under the guidance of a psychiatrist and a clinical psychologist which forms the most effective treatment strategy for substance use disorders. |
Anorexia Nervosa
Anorexia Nervosa
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| Anorexia nervosa is an eating problem that occurs when an individual is so afraid of becoming overweight that he or she eats as little as possible. If one has this disorder, one sees one's self as being overweight when one is not. This condition is both a physical illness and a mental illness. This illness occurs most often in young women. The illness can also occur in athletes, dancers, and actors who want to maintain low weight for better performance. Anorexia nervosa can be a very severe illness. Death may occur from starvation or suicide. |
| What are the Symptoms of Anorexia Nervosa? |
| The signs and symptoms of anorexia may include: |
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Weight loss from strict dieting, usually severe |
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Binge eating (eating large amounts of food in a short period of time) and purging (using laxatives, diuretics, or making yourself throw up) |
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Weakness and feeling dizzy |
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Brittle nails |
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Increased body hair |
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Feeling cold all the time |
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Feeling depressed or anxious |
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Trouble sleeping |
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If you are a woman, not having monthly periods when your weight drops below a certain level |
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Fasting or eating very little |
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Fearing weight gain even when you are underweight |
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Thinking about food all the time |
| What are the causes of Anorexia Nervosa? |
| The cause of anorexia nervosa is not very clear. Part of the cause in many cultures is thinking that being thin means being beautiful. An individual may be at risk of developing anorexia nervosa if he or she: |
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Has a family history of anorexia nervosa or other eating disorders
has a family or personal history of mood disorders, such as major depression and bipolar disorder (manic depression), anxiety disorders, or obsessive-compulsive personality disorder |
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Has a family or personal history of mood disorders, such as major depression and bipolar disorder (manic depression), anxiety disorders, or obsessive-compulsive personality disorder |
| How is it treated? |
| Anorexia can be very difficult to treat. It does not go away or get better on its own. |
| Medications - Medications as provided by a psychiatrist form an important part of the treatment strategy and it is absolutely essential that the appointments are not skipped and the medication adhered to without fail at all times. The medications may also be provided for mood disorders and any prescribed medication helps reduce the fear of becoming fat, reduce depression and anxiety, reduce the constant thoughts about food and thinnes and help gain weight. |
| Therapy - Therapy has been found to be especially helpful in the case of anorexia nervosa. Particularly when used in combination with medications it forms one of the most potent forms of treatment options available. The thereapy may be both individual as well as family therapy as the family also plays a major role in helping maintain and change the behaviors being engaged in by the individual with anorexia nervosa. |
| Hospitalization -
In severe cases hospitalization may also be indicated and necessary to ensure the safety and health of the concerned individual.
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Attention Deficit Hyperactivity Disorder (ADHD)
Attention Deficit Hyperactivity Disorder (ADHD)
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Attention-deficit/hyperactivity disorder (ADHD) is the most common mental health problem in children |
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The disorder begins in the preschool years and may last into adulthood |
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About one-third of children with ADHD also have learning problems such as a reading disability |
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About half of ADHD children and teenagers have behavior problems. This may include breaking rules, talking back, and hitting other children |
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ADHD is 7 times more common in boys than girls |
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Girls are more likely to have trouble paying attention |
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Boys are more likely to be hyperactive |
| What is ADHD? |
| The symptoms of ADHD, especially hyperactivity, usually appear by age 2 or 3 and by first grade at the latest. There are 3 main symptoms of ADHD: distractibility, impulsiveness, and hyperactivity. Children and teens with ADHD: |
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Are distracted by what is going on around him or her |
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Have trouble waiting in line or taking turns |
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Start many projects but do not finish things |
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React quickly without thinking of the outcome |
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Are quick to anger |
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Fidget and cannot sit still |
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Walk, run, or climb around when others are seated |
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Get bored very quickly |
| There are 3 forms of ADHD: |
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Combined ADHD - The child has all of the main symptoms: distractibility, poor impulse control, and hyperactivity |
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Predominately inattentive - The child has problems with focus and attention. This form of ADD is often missed because there may be very little hyperactivity or impulsivity. This form is especially common among girls |
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Predominately impulsive - hyperactive type - Poor self-control is the main problem |
| What causes ADHD? |
| The exact cause of ADHD has not yet been found. |
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ADHD seems to run in families. If a parent, uncle, or grandparent has ADHD, other family members may also develop it |
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People with ADHD have several small differences in the brain. These differences are in the front part of the brain (an area involved in self-control) and in some parts in the center of the brain |
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Much research has looked at whether ADHD is caused by sugar or things added to foods such as preservatives and coloring. The evidence has not connected these with ADHD. Allergies are not a common factor in causing ADHD either |
| What is the Treatment for ADHD? |
| The treatment of ADHD may involve 3 types of treatment: |
| Learning coping skills:
Children with ADHD learn to manage highly stimulating situations that distract and over-excite them. They should learn to study in quiet places and to take frequent breaks. In a classroom, they do best at individual desks rather than at a table with others. They also often find that background instrumental music is helpful. Children with ADHD need more structure and daily routine than most people.
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| Behavioral training:
Behavior programs may help a child develop a longer attention span and be able to sit still. One form of behavioral training is brain wave, or EEG, biofeedback. In this treatment, the child learns to maintain the brain waves related to attention and calmness. This treatment usually takes 15 to 30 sessions. Behavior changes may not last outside the treatment setting.
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| Medicines:
Stimulant medications can been given in the treatment of this disorder. About 70% of children with ADHD improve with these medicines. The most common side effects are loss of appetite and trouble getting to sleep. The child's dosage will be gradually adjusted to reduce side effects. Sometimes, medicines are used only on school days. When these medicines are not effective, there are other medicines that can help with ADHD.
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| Claims have been made that many health foods and supplements help with ADHD. Limiting sugar, food additives, or food colorings is not effective in treating ADHD. Omega fatty acid supplements and certain vitamins and minerals may help symptoms of ADHD. |
| About half of people with ADHD seem to "grow out of it" by their early twenties. The other half show a slight change or no change in symptoms as they grow into adulthood. Being more patient and better able to sit still are the most common improvements between late childhood and young adulthood. |
Somatization Disorder
Somatization Disorder
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Somatization disorder usually starts in the teen years or in early adulthood |
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It can begin in childhood |
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More women than men develop this disorder |
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It tends to run in families |
| What are the Symptoms of Somatization Disorder? |
| The symptoms of this disorder include: |
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Feeling pain with many body functions |
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Having nervous system symptoms, such as paralysis, fainting, or vision problems |
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Often having bloating, vomiting, diarrhea, or trouble eating |
| Reproductive system problems are common. Women may have irregular periods and men may have problems with erections. Women often have pain with menstruation, sexual intercourse, or urination. Millions of people in the world have this disorder. Most deny it. Many believe they are not getting good medical care. |
| What is the Treatment of Somatization Disorder? |
| Psychiatric medicines may help the symptoms, especially if an individual has anxiety, depression, or obsessions (ideas that you can't stop thinking about). |
| Counseling and psychotherapy are also helpful. One may may need to explore possible benefits from being seen as sick. For example, one may get extra attention and care from family and friends. Or one may avoid work or other responsibilities by being sick. Family members may also find counseling useful. |
| Support groups that meet regularly and offer socialsupport tend to be extremely beneficial in terms of coping with the condition and learning how to develop more effective ways of responding to situations. |
| Patience and support from friends and family is extremely essential for the success of the treatment. Understanding the problem and making the correct diagnosis may take months. Patience and counseling over time are the most helpful. This disorder usually has a long duration, with periods of getting better and getting worse, with treatment the symptoms do improve. |
Social Phobia
Social Phobia
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Social phobia is a type of anxiety disorder. People with this disorder fear that if they do things in public, they will look stupid and will be embarrassed. People with social phobia feel that everyone is watching and judging them. The fear may be tied to a common action such as public speaking, eating a meal, writing a check, or using a public restroom. As a result, they avoid situations in which they have to do these kinds of things. |
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Social phobia is not just being shy. Shy people may be uncomfortable in social situations, but it does not stop them from doing things. A person with social phobia is unable to work or take part in school or social activities because of the fear of doing something embarrassing. |
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This disorder does not go away by itself and can get in the way of day-to-day life |
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From 3 to 13% of people in the world have had this condition during their lives |
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Most people with social phobia don't know that they have a treatable disorder |
| What are the symptoms of Social Phobia? |
| People who have social phobia: |
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May be anxious when they are the focus of attention, even for a short time |
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Know that their anxiety is not logical or reasonable |
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Have a lot of anxiety or even a panic attack (intense fear, a sense of doom, sweating, dizziness) when they think about being in a social situation |
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Are afraid that other people will notice how nervous they are |
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Are afraid of unfamiliar places and stay away from them |
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Are unable to work or take part in school or social activities because of the fear of doing something embarrassing |
| What causes Social Phobia? |
| The cause of social phobia is unknown. Both genetic and environmental factors may play a part. Social phobia tends to run in families. It usually begins in adolescence, but may begin in childhood as well. |
| What is the Treatment for Social Phobia? |
| Cognitive Behavioral Therapy:
Through Cognitive behavioral therapy (CBT) an individual may learn to change the response to situations. Replacing negative thoughts with more positive ones can help an individual to exert control over the fear. Relaxation techniques such as deep breathing may help. Assertiveness training may help an individual feel self-confident and less scared. Support groups are very helpful. Hypnosis can also be very helpful in treating phobias.
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| Medications:
Anti anxiety medicines have been found to be effective in treating social phobia. A number of medicines that were originally approved for treatment of depression have been found to be effective for anxiety disorders.
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Bipolar (Manic-Depressive) Disorder
Bipolar (Manic-Depressive) Disorder
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Bipolar disorder used to be called manic-depressive disorder. It causes extreme changes in mood, thinking, and behavior. In the manic phase the individual feels highly energized and is very active. In the depressed phase the individual is very depressed. Most people with bipolar disorder have these severe mood swings many times during their lives. Some people have mostly manic phases. Others may have mostly depressed phases. |
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About 1% of people develop bipolar disorder |
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It usually begins during the young adult years |
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About as many men as women get bipolar disorder |
| What are the Symptoms of Bipolar Disorder? |
| During a manic episode an individual may: |
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Have a very high sense of self-worth and a feeling of being "on top of the world" |
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Be very talkative and talking fast, maybe so fast that others have trouble following what you are saying |
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Have racing thoughts and ideas to the point of being disorganized and muddled |
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Have trouble concentrating and jump between different ideas |
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Be very restless and hyperactive |
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Have more anxiety and panic |
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Go for days with little or no sleep and not feel tired |
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Be very irritable and get into fights with others |
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Have bursts of high interest in sex and sexual activity |
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Be too active and act recklessly. For example, you might spend all your money and go into debt, or take sudden trips |
| In cases where an individual has a very bad manic episode, he or she may also have symptoms like confusion, delusions (ideas that aren't true), or hallucinations. A manic episode may be followed by a period of normal mood and behavior or a period of depression. The individual may: |
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Be irritable |
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Have trouble falling asleep, wake up very early, or sleep too much |
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Notice changes in your appetite and weight, either up or down |
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Notice changes in energy level, usually down but sometimes feeling overexcited |
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Lose sexual desire and function |
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Feel worthless and guilty |
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Have trouble concentrating or remembering things |
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Feel hopeless or just not care about anything |
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Have unexplained physical symptoms |
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Think often about death or suicide |
| These symptoms may last for days or weeks and the individual may also have what is called a mixed episode. A mixed episode is mania with depressed symptoms at the same time. In a mixed episode the person may be overly active, withdraw from others, feel worthless, and cry often. |
| What causes Bipolar Disorder? |
The exact causes of the disorder are unclear. However, it does run in families. If an individual has relatives with bipolar disorder, he or she is more likely to have it.
Parts of the brain may not work normally during manic and depressive episodes. But exactly what triggers these switches is unclear. |
| If you are a woman, episodes may be more likely right before your monthly period or after the birth of a child. |
| What is the Treatment for Bipolar Disoder? |
| Medicines are the most effective treatment for bipolar disorder. If an episode is severe, an individual may need to spend some time in a hospital as well. |
| Medicines - The medications which work best for Bipolar Disoder are mood stabilizer medications. Sometimes an individual may need other medicines. For example an antidepressant, an antipsychotic, or an anti anxiety medicine may give you the best results. However, it is possible that symptoms may become worse if an individual were to take antidepressants. There are no nonprescription medicines for bipolar disorder. |
| Psychotherapy - Counseling and psychotherapy are usually very helpful. They help an individual learn how to maintain a positive lifestyle and attitude, which can reduce the episodes. Controlling stress, keeping to a regular sleep schedule, having friends or family to support you, and being more relaxed may help manage manic or depressive episodes. Treatments that might help individual control stress include biofeedback, art therapy, relaxation techniques and massage therapy. |
Postpartum (after pregnancy) Illnesses
Postpartum (after pregnancy) Illnesses
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Pregnancy is one of the most important events in a women's life. |
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Profound emotional significance. |
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Considered a major landmark in physical and psychological development of the woman. |
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Before and during the pregnancy, there are various psychological issues that go on in a woman's mind and tend to affect her well-being. |
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The relationship she shares with her husband is an important factor in the overall health of the mother and the child. |
| What are the Psychological Issues during Pregnancy? |
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Before pregnancy there may be doubts regarding conception, carrying forth with the pregnancy, and changes following pregnancy in work and home life. |
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During pregnancy there can be anxieties around development of the fetus. |
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Prospective mother-father role defining and readjustments, with new responsibilities as caretakers. |
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Couple must attend to unremitting needs of infant other than each other's dependency needs. |
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Anxiety about adequacy as parents and ambivalence about addition in family can also be seen during this phase. |
| What are Postpartum Illnesses? |
| There are 3 types of postpartum illnesses: |
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Postpartum or "baby" blues |
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Postpartum depression |
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Postpartum psychosis |
| Postpartum blues: |
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Seen in almost 50% of women. |
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Brief lasting from 2 to 24 days. |
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Characterized by the mother feeling very low. |
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Rapid swings of mood. |
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Hypersensitivity to interpersonal factors and feeling overwhelmed. |
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Frequent crying spells. |
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The condition remits on its own. |
| Post partum depression: |
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Seen in 10% women. |
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The symptoms are like a depressive episode. |
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Experience of sadness of mood. |
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Loss of interest. |
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Low energy levels (fatigue, exhaustion, sluggishness) |
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Appetite/weight changes |
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Sleep disturbance (difficulty sleeping or excessive sleepiness) |
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Suicidal thoughts |
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Feelings of guilt, hopelessness and worthlessness |
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Attention/concentration difficulties |
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Inability to be comforted |
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Social withdrawal |
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Less attachment towards infant or excessive anxiety about baby's health |
| Post partum psychosis: |
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Seen in 1 to 4 in 1000 women. |
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Patient has marked behavior disturbances and needs to be treated as early as possible. |
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Needs to be identified and the baby separated from the mother as she can cause him harm. |
| What are the Causes for Postpartum Illnesses? |
The postpartum period is regarded as a period of stress as various stressors are seen in this period like endocrinal (hormonal) changes, change of body image, the intrapsychic conflicts of being a mother and various psychosocial issues.
Biological factors: The different biological factors that are considered as causative factors are genetic factors, endocrinal factors, and biochemical factors. There was a tendency of postpartum disorders to be more common in families. Also the various hormonal changes during this phase are considered to result in mood changes. And biochemical changes, meaning change in the concentration of different body chemicals can result in the behavioral and mood changes.
Psychosocial factors: The personality of the individual, the basic conflicts and there handling before the pregnancy and the relationship with the husband and the preparation of pregnancy and parenthood are important for a normal pregnancy ad child birth.
Some factors that have been found to relate to psychiatry disorders following childbirth are |
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Low socio-economic condition |
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Unmarried status |
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Early sexual or marital problems |
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Previous abortions |
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Unstable, unsupportive husband |
| How is Postpartum Depression Treated? |
Care During pregnancy: During the pregnancy it is important to support the expecting mother with psychological and emotional support. The stress of the mother can affect the child and in this context it is of prime importance to take good care of the mother and in case of her feeling stressed to take proper psychological help. Preparing the mother by using various psychological techniques like relaxation training, supportive counseling and better coping skills help the mother to undergo pregnancy in a better way.
Pregnancy needs lot of adaptation by the couple, and the help of a psychiatrist to handle the pressures and stresses during this phase helps in the well being of the family and a healthy childbirth.
Also sometimes there is psychological distress in the father and this can affect the mother and the family and the therapist or mental health professional helps in dealing with this.
Preparation for parenthood, the changing roles of the couple, and understand the psychological need of the growing child are also to be discussed with the couple.
Psycho education of the couple, regarding pregnancy, childbirth, and postpartum disorders is also to be done by the psychologist or psychiatrist. |
| The treatment of postpartum psychiatry disorders would be based on the type of disorder. |
Postpartum psychosis is an emergency and would require hospitalization and medications, and a close observation as during this period the mother is not in a position to take adequate care of the infant.
Postpartum depression, would be treated based on the severity, and would also require medications. Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, "uppers," or tranquilizers; they are not habit-forming and they generally have no stimulating effect on people not experiencing depression. Antidepressants usually take full effect within 3-6 weeks after therapy has begun. Psychiatrists usually recommend that patients continue to take medication for 5 or more months after symptoms have improved. Psychotherapy may be used either alone for treatment or in combination with antidepressant medications. Techniques that treat depression by putting these problems in perspective are cognitive behavioral therapy, interpersonal therapy and many more. Depending on the severity of the depression, treatment can take a few weeks or substantially longer. Both the medical and therapeutic treatments when used together have the best result.
For postpartum blues emotional support and counseling are adequate treatment strategy. Common issues in psychotherapy for postpartum blues include overwhelming fears about new responsibilities and guilt over becoming extremely overwhelmed at such a crucial time. Good social and family support can be very helpful in the management and improves the prognosis of the patient and helps in faster recovery. Family and friends can offer nonjudgmental support, reassurance, hope, and validation of the new mother's abilities. |
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