As a family member of someone who has schizophrenia, the caregivers might struggle with a plethora of emotions, fears, guilt, anger, frustration and hopelessness. It is difficult to accept the illness. And it is equally difficult to separate the illness from the sufferer. Family members are often worried about the stigma of schizophrenia or confused and embarrassed by strange behaviors you don’t understand. As a caregiver, you need to understand that it is important to accept the illness and its difficulties and be realistic in what you expect of the person with schizophrenia and of yourself.
Following suggestions can be followed in order to achieve a better quality of life while living with a person with schizophrenia:
- Educate yourself: Learning about schizophrenia and its treatment will allow you to make informed decisions about how best to manage the illness, work toward recovery, and handle setbacks.
- Reduce stress: Stress can cause schizophrenia symptoms to flare up, so it’s important to create a structured and supportive environment for your family member. Avoid putting pressure on your loved one or criticizing perceived shortcomings.
- Set realistic expectations: It’s important to be realistic about the challenges and limitations of schizophrenia. Help your loved one set and achieve manageable goals, and be patient with the pace of recovery.
- Make time for yourself: Schedule time into your day for things you enjoy, whether it be spending time in nature, visiting with friends, or reading a good book. Taking breaks from caregiving will help you stay positive and avoid burnout.
- Look after your health: Neglecting your health only adds to the stress in your life. Maintain your physical well-being by getting enough sleep, exercising regularly, eating a balanced diet, and staying on top of any medical conditions.
- Cultivate other relationships: It’s important to maintain other supportive, fulfilling relationships. Don’t feel guilty for looking after your social needs. You need support, too. These relationships will help buoy you in difficult times.
- Practice acceptance: The “why me?” mindset is destructive. Instead of dwelling on the unfairness or life, accept your feelings (even the negative ones). Your burdens don’t have to define your life unless you obsess about them.
- Seek out joy: Taking out time for fun is a necessity. It isn’t the people who have the least problems who are the happiest, it’s the people who learn to find joy in life despite adversity.
- Recognize your own limits: Be realistic about the level of support and care you can provide. You can’t do it all, and you won’t be much help to a loved one if you’re run down and emotionally exhausted.
- Avoid blame: In order to cope with schizophrenia in a family member, it’s important to understand that although you can make a positive difference, you aren’t to blame for the illness or responsible for your loved one’s recovery.
- Provide options: Your loved one may be more willing to see a doctor if he or she can control the situation somewhat. If your relative appears suspicious of you, suggest another person to accompany him or her to the appointment. You can also give your family member a choice of doctors.
- Focus on a particular symptom: A person with schizophrenia may resist seeing a doctor out of fear of being judged or labeled “crazy.” You can make the doctor less threatening by suggesting a visit in order to deal with a specific symptom such as insomnia or a lack of energy.
- Seek help right away: Early intervention makes a difference in the course of schizophrenia, so don’t wait to get professional help. You family member will need assistance finding a good doctor and other effective treatments.
- Encourage independence: Rather than doing everything for your family member, encourage self-care and self-confidence. Help your loved one develop or relearn skills that will allow for greater independence of functioning.
- Be collaborative: It’s important that your loved one have a voice in his or her treatment. When your family member feels respected and acknowledged, he or she will be more motivated to follow through with treatment and work toward recovery.
- Take side effects seriously: Many people stop taking their schizophrenia medication because of side effects, so pay attention to your loved one’s drug complaints. Bring any distressing side effects to the attention of the doctor. The doctor may be able to reduce adverse effects by reducing the dose, switching to another antipsychotic, or adding another medication that targets the troublesome side effect.
- Encourage your loved one to take medication regularly:Even with side effects under control, some people with schizophrenia refuse medication or take it irregularly. This may be due to a lack of insight into their illness and the importance of medication, or they may simply have trouble remembering their daily dose. Medication calendars, weekly pillboxes, and timers can help people who are forgetful.
- Track your family member’s progress: You can help the doctor track treatment progress by documenting changes in your family member’s behavior, mood, and other symptoms in response to medication. A journal or diary is a good way to record medication history, side effects, and everyday details that might otherwise be forgotten.
Relapse can occur if the person is not taking medicines. However, learning to recognize early signs of relapse can help prevent crisis. The warning signs of relapse are often similar to the symptoms and behaviors that led up to the person’s first psychotic episode.
Common warning signs of schizophrenia relapse:
- Social withdrawal
- Deterioration of personal hygiene
- Increasing paranoia
- Confusing or nonsensical speech
- Strange disappearances
Despite your best efforts to prevent relapse, there may be times when your family member’s condition deteriorates rapidly and drastically. During a schizophrenia crisis, you must get help for your family member as soon as possible. Hospitalization may be required to keep your loved one safe. It’s also wise to go over the emergency plan with your family member. The crisis situation may be less frightening and upsetting to your loved one if he or she knows what to expect during an emergency.
Tips for handling your loved one during a schizophrenia crisis:
- Remember that you cannot reason with acute psychosis
- Remember that the person may be terrified by his/her own feelings of loss of control
- Do not express irritation or anger
- Do not shout
- Do not use sarcasm as a weapon
- Decrease distractions (turn off the TV, radio, etc.)
- Ask any casual visitors to leave—the fewer people the better
- Avoid direct continuous eye contact
- Avoid touching the person
- Sit down and ask the person to sit down also
For more help in dealing with family members who may have schizophrenia or other mental health needs; contact World Brain Center Hospital today.
Good Sleep Hygiene Handout
The most common cause of insomnia is a change in your daily routine. For example, traveling, change in work hours, disruption of other behaviors (eating, exercise, leisure, etc.), and relationship conflicts can all cause sleep problems. Paying attention to good sleep hygiene is the most important thing you can do to maintain good sleep.
1. Go to bed at the same time each day.
2. Get up from bed at the same time each day. Try to maintain something close to this on weekends.
3. Get regular exercise each day, preferably in the morning. There is good evidence that regular exercise improves restful sleep. This includes stretching and aerobic exercise.
4. Get regular exposure to outdoor or bright lights, especially in the late afternoon.
5. Keep the temperature in your bedroom comfortable.
6. Keep the bedroom quiet when sleeping.
7. Keep the bedroom dark enough to facilitate sleep.
8. Use your bed only for sleep (and sexual activity). This will help you associate your bed with sleep, not with other activities like paying bills, talking on the phone, watching TV.
9. Establish a regular, relaxing bedtime routine. Relaxing rituals prior to bedtime may include a warm bath or shower, aromatherapy, reading, or listening to soothing music.
10. Use a relaxation exercise just before going to sleep or use relaxing imagery. Even if you don’t fall asleep, this will allow your body to rest and feel relaxed.
11. Keep your feet and hands warm.
12. Designate another time to write down problems & possible solutions in the late afternoon or early evening, not close to bedtime. Do not dwell on any one thought or idea—merely jot something down and put the idea aside.
1. Exercise just before going to bed. Try to keep it no closer than 3-4 hrs before bed.
2. Engage in stimulating activity just before bed, such as playing a competitive game, watching an exciting program on television or movie, or having an important discussion with a loved one.
3. Have caffeine in the evening (coffee, many teas, chocolate, sodas, etc.)
4. Read or watch television in bed.
5. Use alcohol to help you sleep. It actually interrupts your sleep cycle.
6. Go to bed too hungry or too full.
7. Take another person’s sleeping pills.
8. Take over-the-counter sleeping pills, without your doctor’s knowledge. Tolerance can develop rapidly with these medications.
9. Take daytime naps. If you do, keep them to no more than 20 minutes, 8 hrs before bedtime.
10. Command yourself to go to sleep. This only makes your mind and body more alert.
11. Watch the clock or count minutes; this usually causes more anxiety, which keeps you up.
12. Lie in bed awake for more than 20-30 minutes. Instead, get up, go to a different room (or different part of the bedroom), participate in a quiet activity (e.g. non-excitable reading), and then return to bed when you feel sleepy. Do not turn on lights or sit in front of a bright TV or computer; this will stimulate your brain to wake up. Stay in a dark, quiet place. Do this as many times during the night as needed.
13. Succumb to maladaptive thoughts like: “Oh no, look how late it is, I’ll never get to sleep” or “I must have eight hours of sleep each night, if I get less than eight hours of sleep I will get sick.” Challenge your concerns and avoid catastrophizing. Remember that we cannot fully control our sleep process. Trying too hard to control it will make you tenser and more awake.
14. Change your daytime routine the next day if you didn’t sleep well. Even if you have a bad night sleep and are tired it is important that you try to keep your daytime activities the same as you had planned. That is, don’t avoid activities or stay in bed late because you feel tired. This can reinforce the insomnia.
15. Increase caffeine intakes the next day, this can keep you up again the following night.
All children can be naughty, defiant and impulsive from time to time, which is perfectly normal. However, some children have extremely difficult and challenging behaviours that are outside the normal and expected behavior for their age.
The most common disruptive behaviour disorders include oppositional defiant disorder (ODD), conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD). These three behavioural disorders share some common symptoms, so diagnosis can be difficult and time consuming. A child or adolescent may have two disorders at the same time. Other factors that can worsen these symptoms can include emotional problems, mood disorders, family difficulties and substance abuse.
Oppositional defiant disorder (ODD)
Around one in ten children under the age of 12 years are thought to have oppositional defiant disorder (ODD). More boys than girls end up having this problem.
Behavior pattern of children with ODD:
- Easily angered, annoyed or irritated
- Frequent temper tantrums
- Argues frequently with adults, particularly the most familiar adults in their lives, such as parents
- Refuses to obey rules
- Seems to deliberately try to annoy or aggravate others
- Low self-esteem
- Low frustration threshold
- Seeks to blame others for any misfortunes or misdeeds.
Conduct disorder (CD)
Children with are often judged as ‘bad kids’ because of their delinquent behaviour and refusal to accept rules. Around five per cent of 10 year olds are thought to have CD. Gain, more boys than girls end up having this disorder.
Behavior pattern of children with CD:
- Frequent refusal to obey parents or other authority figures
- Repeated truancy
- Tendency to use drugs, including cigarettes and alcohol, at a very early age
- Lack of empathy for others
- Being aggressive to animals and other people or showing sadistic behaviours including bullying and physical or sexual abuse
- Keenness to start physical fights
- Using weapons in physical fights
- Frequent lying
- Criminal behaviour such as stealing, deliberately lighting fires, breaking into houses and vandalism
- A tendency to run away from home
- Suicidal tendencies – although these are more rare.
Attention Deficit Hyperactivity Disorder (ADHD)
Around two to five per cent of children are thought to have attention deficit hyperactivity disorder (ADHD), with boys outnumbering girls by three to one.
Behaviour pattern of children with ADHD:
- Inattention – difficulty concentrating, forgetting instructions, moving from one task to another without completing anything.
- Impulsivity – talking over the top of others, having a ‘short fuse’, being accident-prone.
- Overactivity – constant restlessness and fidgeting.
Diagnosing behavioural disorders:
Disruptive behavioural disorders are complicated and may include many different factors working in combination. For example, a child who exhibits the delinquent behaviours of CD may also have ADHD, anxiety, depression, and a difficult home life.
Diagnosis methods may include:
- Diagnosis by a specialist service, which may include a paediatrician, psychologist or child psychiatrist
- In-depth interviews with the parents, child and teachers
- Behaviour check lists or standardised questionnaires.
It is important to rule out emotional, physical or family stressors that might be disrupting the child’s behaviour. For example, a sick parent or bullying by other children might be responsible for sudden changes in a child’s typical behaviour and these factors have to be considered initially.
Watch out this space on more information about behavioural disorder and their management. Or if you feel that your child is suffering from any of the above mentioned behavioural patterns, contact Word Brain Center Hospital today!
Caring for family members with OCD
Living with someone who has OCD can be a taxing experience. Family members not only are unable to handle problematic behaviours, they also end up feeling stressed out themselves at times. It is important to strengthen relationships between patients and their families. Keeping in mind the following points would empower families dealing with obsessive –compulsive behaviours:
Family members should learn to recognize the warning signs of OCD. Changes in behaviour are easily observable, even thoughts which are not expressed freely can lead to behaviour changes. Taking long time to finish tasks, such as in bathroom, getting dressed, doing self study, repeating certain things, repeated questioning, staying up late to get things done, inability to sleep properly, avoiding certain activities, and extreme emotional reactions to small things are signs that should be watched out for.
Differentiating between OCD and the person
People with OCD usually report that their symptoms get worse the more they are criticized or blamed, because these emotions generate more anxiety. So, it is essential that the family learns to view these features as signals of OCD and not as personality traits. This way, the family can join the person with OCD to combat the symptoms rather than become alienated from them.
Having realistic expectations
People with OCD report that change of any kind, even positive change, can be experienced as stressful. It is often during these times that their symptoms tend to increase. Family can help in reducing stress by modifying their expectations during these times of transition. Family conflicts result in increasing symptoms. Validating that the person may be undergoing stress as his or her life is undergoing change is reassuring. The path of recovery is never a straight line. Even while improving the person with OCD may slip and needs support as well as encouragement. Suddenly expecting too much from the person who is showing improvement may prove to be counter-productive.
Recognize “Small” Improvements
Persons with OCD often complain that their family members do not understand what it takes to achieve even small improvement. Cutting down time taken to have a bath or starting buying groceries may involve huge efforts for the person. While these gains seem insignificant to family members, it is really a big step for the person suffering from OCD. Acknowledgment of these seemingly small accomplishments is a powerful tool that encourages them to keep trying. This lets them know that their hard work to get better is being recognized and can be a powerful motivator.
Support the person; not the illness
It is understandable that OCD can be unnerving for both the sufferer and family. However, please remember that the more you can avoid personal criticism, the better it is.
It is not so that acceptance and support means ignoring the compulsive behavior. Do your best to not participate in the compulsions. In an even tone of voice explain that the compulsions are symptoms of OCD and that you will not assist in carrying them out because you want them to resist as well. Make the person understand each time that you are against OCD and not against the person who is suffering.
Before you ensure that the person with OCD is regular with medicines, it is important to be convinced yourself that it is helpful to take these medicines. Passing comments such as “No matter how much money we spend, these medicines are doing no good to you!” will only propel the patient to leave medicines or undermine their importance. Also understand that medicines cannot make the symptoms evaporate overnight. Medicines take time to have effect on brain functioning and it is important to remember that periodical review with your Doctor is of utmost importance. Stopping the medicines or reducing the dosage on your own can prove to be counter-productive. Remind the patient of these facts when he or she loses hope.
During therapy/counselling, certain limits on obsessive and compulsive behaviours might be set. Family members can help the patient stick to these limits. As per the suggestions by the therapists, family members may find that they have to be firm about:
1) Prior agreements regarding assisting with compulsions;
2) How much time is spent discussing OCD;
3) How much reassurance is given; or
4) How much the compulsions infringe upon others’ lives.
Limit setting works best when these expectations are discussed ahead of time and not in the middle of a conflict.
Communicating with person suffering from OCD
It is beyond doubt that the family means well for the patient. However, it may not be possible to communicate your good intentions to the patient all the time. He or she might feel that the family does not understand what he or she is going through. Avoid lengthy explanations and rationales. It is likely to upset the person and thus might result in an increase in anxiety and consequently the symptoms. While communicating; separate the illness from the person. Instead of starting a sentence by saying “you always keep on checking the door”, try saying “I understand that you always feel like checking the door again and again”.
Individuals with OCD report that their mood determines the extent to which they can divert obsessions and resist compulsions. When the patient is having an irritable mood, or a low mood, it is best to back off, unless there are chances that the person might hurt himself or herself.
Family members often have the natural tendency to feel like they should protect the individual with OCD by being with him all the time. This can be destructive because family members need their private time, as do people with OCD. Give them the message that they can be left alone and can care for themselves. It may seem obvious that family members and individuals with OCD are working toward the common goal of symptom reduction, but the ways in which people do this varies. Creating goals as a team along with your treating team reduces conflict, preserves the household, and provides a platform for families to begin to “take back” the household in situations where most routines and activities have been dictated by an individual’s OCD. By improving communication and developing a greater understanding of each other’s perspective, it is easier for the individual to have family members help them to reduce OC symptoms instead of enabling them. It is essential that all goals are clearly defined, understood, and agreed upon by any family members involved with carrying out the tasks in the contract. Families who decide to enforce rules without discussing it with the person with OCD first find that their plans tend to backfire.
World Brain Center Hospital provides not only pharmacological and psychological treatment for OCD, but family counselling for family members of patients suffering from OCD as well.
The Facts on Huntington’s Disease
Huntington’s disease, also called Huntington’s chorea, is a hereditary condition that affects the brain, specifically an area called the basal ganglia (located deep in the brain).
The disease follows an autosomal dominant pattern of inheritance, meaning that if one parent has the disease, each child has a 50% chance of inheriting it. Huntington’s disease is quite rare, occurring in about 1 in 10,000 people.
The disease destroys nerve cells (neurons) in parts of the brain resulting in lower levels of chemicals called neurotransmitters that carry signals in the brain. People with this disease experience uncontrolled movements, loss of mental abilities, and changes in personality or behaviour.
Causes of Huntington’s Disease
Huntington’s disease is caused by mutations in a gene which produces a protein called huntingtin. The role that this protein plays in normal brain function is not well understood.
Symptoms and Complications of Huntington’s Disease
The onset of the disease is slow and subtle. The first symptoms usually begin in the fourth or fifth decades of life although occasionally they may start in childhood or be delayed into the 60s.
In the early stages of the disease, personality changes such as depression, dementia, or other psychiatric changes may be noticed. This sometimes happens before or at the same time as movement disorders. Abnormal motions occur on one side of the body, commonly affecting the face and arms. Symptoms include facial movements that look like mild grimacing and speech problems. When the person becomes emotionally upset, symptoms tend to worsen and become more severe.
As the disease progresses, abnormal movements become faster – almost violent – and purposeless. Patients tend to display jerky, almost dance-like motions (chorea). There is often severe dementia associated with this late stage of the disease.
Eventually, people with this disease are unable to look after themselves and need help with daily activities and functions such as eating, hygiene, and toileting. People tend to become bedridden and may suffer complications such as congestive heart failure and pneumonia.
Diagnosing Huntington’s Disease
During a physical exam, a doctor will look for irregular and uncontrolled movements and signs of muscle deterioration or reduced mental or intellectual function. A family history of the disease will help diagnose Huntington’s disease, and DNA analysis will detect genetic defects.
Other possible tests include computed topography (CT) or magnetic resonance imaging (MRI) scans to look for areas of the brain (caudate nucleus) that may haveatrophied (decreased in size).
Treating and Preventing Huntington’s Disease
Because there is no cure for this disease, treatment aims to lessen the severity of symptoms and make people comfortable. Medications are usually given to help control abnormal muscle movements, including tranquilizers, benzodiazepines, neuroleptics, neuroleptics, and medications that work on the nervous system such as tetrabenazine*.
Because of the delayed onset of symptoms, the disease can be transmitted to children before you even know you have it. If you have a family history of Huntington’s disease, you may want to consider genetic testing before deciding to have children. An experienced genetic counsellor can help guide you through the many complex issues involved in making the best decision for you.
Social Anxiety and Social Phobia
Anxiety is a feeling of discomfort, fear, or worry that is centered on our interactions with other people and involves a concern with being judged negatively, evaluated, or looked down upon by others. While it can often happen during the social exchange itself, it may also pop up in anticipation of a social occasion, or afterward when we review our performance in a given situation. Because social anxiety can often seem unwieldy or even overwhelming to understand as a single concept, it is often helpful to view it in terms of three separate components that are interrelated and can strengthen one another, leading to a cycle of anxiety:
Anxious sensations in our bodies, such as:
• Racing heart
• Shaking or tremor
• Dry mouth
• Shortness of breath
• Feeling faint
Anxious thoughts about ourselves, others, and the situation:
• “Everyone is staring at me.”
• “They’ll think I’m a loser.”
• “I don’t belong here.”
• “I won’t have anything to say.”
• “People will see how nervous I am.”
• “They won’t want to talk to me again.”
• “I will keep looking more and more foolish.”
Anxious behaviors, which can be triggered by anxiety, but can also make the anxiety worse over the long term:
• Avoiding entering social situations
• Leaving situations
• Only entering “safe” places or with “safe” people
• Using mobile phones, MP3 players, or other devices to avoid being in conversations
• Apologizing excessively
• Asking for reassurance from others
• Preparing excessively (memorizing what to say, extreme grooming)
• Trying to direct people’s attention away from one’s performance (e.g., by making jokes, dressing in a particular way, etc.)
• Watching for signs that people are judging us
Social anxiety can emerge in a wide range of situations – essentially, whenever we are in contact with other people or believe we may become a focus of others’ attention. While the possibilities are many, following is a list of common situations in which people experience social anxiety: Interpersonal situations – our anxiety is triggered by our interactions with others.
• Going on a date
• Starting a conversation with a stranger
• Asking for directions
• Starting a conversation
• Keeping a conversation going
• Attending a party
• Being interviewed for a job
• Holding eye contact Performance situations – our anxiety is triggered by potentially or actually being the focus of attention.
• Public speaking
• Public singing
• Eating at a restaurant alone
• Dropping something in a public place
• Spilling a drink
• Reading in front of others
• Voicing an opinion during a class or meeting
Anxiety is a normal and healthy part of being human. It mobilizes our bodies and minds to take action in dangerous or unhealthy situations. Without anxiety, we would probably not be alive – it is what tells us to get out of the way of the bus heading right toward us or to get that 3-week-old cough looked at. Social anxiety is no different. Social anxiety helps us to remain sensitive to the feelings and needs of others, which is a core foundation of cooperation and building relationships. Even strong social anxiety can occasionally be useful; for that job interview, we’ll likely do better if we’re extra careful in choosing our words and our outfits. When Does Social Anxiety Become a Problem? Social anxiety becomes a problem only when it is so severe that it is excessive or outside the “norm,” and when it causes major problems in our overall functioning and quality of life. When our social anxiety leads us to consistently avoid social situations, to be very distressed when exposed to them, to have excessive fears of being negatively judged by others, or to miss out on things that we otherwise strongly want or need to do, mental health professionals may consider a diagnosis of Social Phobia.
Although there are dozens of treatments that have been claimed to be useful for anxiety-based problems, only a small number of these have actually been found to be effective in systematic scientific studies based on individuals suffering with Social Phobia. These include medication treatments, cognitive-behavioral therapy, and combinations of these.
It’s not always easy to see when your drinking has crossed the line from moderate or social use to problem drinking. But if you consume alcohol to cope with difficulties or to avoid feeling bad, you’re in potentially dangerous territory.
Alcoholism and alcohol abuse are due to many interconnected factors, including genetics, how you were raised, your social environment, and your emotional health.
People who have a family history of alcoholism or who associate closely with heavy drinkers are more likely to develop drinking problems. Finally, those who suffer from a mental health problem such as anxiety, depression, or bipolar disorder are also particularly at risk, because alcohol may be used to self-medicate.
You may have a drinking problem if you…
§ Feel guilty or ashamed about your drinking.
§ Lie to others or hide your drinking habits.
§ Have friends or family members who are worried about your drinking.
§ Need to drink in order to relax or feel better.
§ “Black out” or forget what you did while you were drinking.
§ Regularly drink more than you intended to.
Unlike alcoholics, alcohol abusers have some ability to set limits on their drinking. However, their alcohol use is still self-destructive and dangerous to themselves or others.
Common signs and symptoms of alcohol abuse include:
Repeatedly neglecting your responsibilities at home, work because of your drinking. For example, performing poorly at work, flunking classes, neglecting your kids, or skipping out on commitments because you’re hung over.
§ Using alcohol in situations where it’s physically dangerous, such as drinking and driving, operating machinery while intoxicated, or mixing alcohol with prescription medication against doctor’s orders.
§ Experiencing repeated legal problems on account of your drinking. For example, getting arrested for driving under the influence or for drunk and disorderly conduct.
§ Continuing to drink even though your alcohol use is causing problems in your relationships. Getting drunk with your buddies, for example, even though you know your wife will be very upset, or fighting with your family because they dislike how you act when you drink.
§ Drinking as a way to relax or de-stress. Many drinking problems start when people use alcohol to self-soothe and relieve stress. Getting drunk after every stressful day, for example, or reaching for a bottle every time you have an argument with your spouse or boss.
Not all alcohol abusers become full-blown alcoholics, but it is a big risk factor. Sometimes alcoholism develops suddenly in response to a stressful change, such as a breakup, retirement, or another loss. Other times, it gradually creeps up on you as your tolerance to alcohol increases. If you’re a binge drinker or you drink every day, the risks of developing alcoholism are greater.
*Do you have to drink a lot more than you used to in order to get buzzed or to feel relaxed? Can you drink more than other people without getting drunk? These are signs of tolerance, which can be an early warning sign of alcoholism. Tolerance means that, over time, you need more and more alcohol to feel the same effects.
*Do you need a drink to steady the shakes in the morning? Drinking to relieve or avoid withdrawal symptoms is a sign of alcoholism and a huge red flag. When you drink heavily, your body gets used to the alcohol and experiences withdrawal symptoms if it’s taken away. These include:
§ Anxiety or jumpiness
§ Shakiness or trembling
§ Nausea and vomiting
§ Loss of appetite
In severe cases, withdrawal from alcohol can also involve hallucinations, confusion, seizures, fever, and agitation. These symptoms can be dangerous, so talk to your doctor if you are a heavy drinker and want to quit.
Contact World Brain Centre for help for yourself or for your loved ones if alcohol has become a problem you cannot handle anymore!
The symptoms of depression are very common. Some people experience these only at times of stress, while others may experience them regularly at certain times of the year. Seasonal affective disorder (SAD) is characterized by recurrent episodes of depression, usually in winters, alternating with periods of normal or high mood the rest of the year.
It has been suggested that women are more likely to have this illness than men and that SAD is less likely in older individuals. SAD can also occur in children and adolescents, in which case the syndrome is usually first suspected by parents and teachers rather than the individual themselves.
For all depressive episodes, it is important to understand what stresses or triggers contribute to the depressive symptoms. In SAD, the seasonal variation in mood states is the key dimension to understand. Through recognition of the pattern of symptoms over time, developing a more targeted treatment plan is possible. Symptoms of SAD usually begin in early winters and subside around onset of summers. Depressions are usually mild to moderate, but they can be severe. Treatment planning needs to match the severity of the condition for the individual. Safety is the first consideration in all assessment of depression, as suicide can be a risk for more severe depressive symptoms.
Although some individuals do not necessarily show these symptoms, the characteristics of winter depression include oversleeping, daytime fatigue, carbohydrate craving and weight gain. Additionally, many people may experience other features of depression including decreased sexual interest, lethargy, hopelessness, suicidal thoughts, lack of interest in normal activities and decreased socialization.
A person with any of these symptoms should feel comfortable asking their doctors about SAD. A full medical evaluation of a person who is experiencing these symptoms for the first time should include a thorough physical examination.
Antidepressant medications have been found to be useful in treating people with SAD. Some people may require treatment of their symptoms only for the period of the year in which they experience symptoms. Other people may elect for year-round treatment. Psychotherapy—specifically types of psychotherapy with documented clinical efficacy in the treatment of depression including cognitive behavioral therapy (CBT)—is likely a useful additional option for some people with SAD.
Getting a handle on your anger!
Like all emotions, we have experienced anger. People across all ages, across all situations or cultures experience it. It is a complex emotion and receives maximum attention because not only it affects the person who is experiencing it, but also the people who are related to him. As a result it is often termed as a negative emotion. It is a feeling that can range from annoyance to rage. It is a feeling that when suppressed can continue to build up until it is released. Release can be in a healthy manner or in a harmful manner. People have different styles of expressing anger. It may be expressed as rage, verbal abuse, or striking out at others and things. It can be quick, like a viper’s bite or it can be like a boom of a cannon, or it can be slow and seething. It can zoom from “ 0” to “10” in a split second, and spin out of control! Other people shove it down and let it smoulder like hot coals. Some people feel resentment and shame. Some people feel anger day in and day out. Anger can pierce deep into the heart. Anger may lead to problems when it happens too often, lasts a long time, gets out-of-control and is destructive. It hurts you and other people. The aftermath of fury or isolation can be a painful time.
Most of us, especially the adolescents and young adults are much more prone to anger than rest of the population. As students and growing adults; most of you are faced with daily life challenges that include making choices about family and professional lives, handling various stressors and add to it one’s quest for identity. More often than not you might find yourself in a situation in which you experience extreme mental pressure and feel easily agitated. Some of these situations might see you “getting off the handle”. On the other hand you could be silently sulking and further mentally tormenting yourself. After such incidents get over, most of us promise ourselves and to significant others, “I won’t get angry now”. However what we should actually promise is that “I wouldmanage my anger effectively now onwards”. How can we prevent ourselves from experiencing an emotion that in so human in nature!
Here some practical tips in which anger can be managed effectively are being presented. If practiced regularly and sincerely these methods or tips can go a long way in ensuring easy management. If you do not succeed in the first attempt, don’t give up, keep trying in a systematic manner. Maintaining a diary or log of the methods you use is often helpful.
- Talking directly to the source of the anger without using blame or shame. You own your anger. No one else is responsible for how you feel. A good way to start the conversation is to say, “I feel angry when…..” Sometimes, it isn’t feasible to talk to the person about your feelings. They may not be in an emotionally good place to hear your truth. Some people may use what you’ve shared to hurt you further or fuel more anger/upset. Be mindful of your emotional and physical safety in sharing your feelings.
- Talking about anger with a friend or counsellor is another healthy way to release anger.
- Engaging in a physical activity, such as walking, cycling, working out at the gym or sports helps to release anger and benefits your health.
- Relaxation or meditation help to ease and calm your mind.
- Writing in a journal is a good way to express feelings.
Harmful ways of releasing anger:
- Yelling, screaming, belittling or hitting the people close to you not only hurts those around you but hurts you also. It can cause you to feel ashamed and regret the pain you’ve caused. You can feel out of control or feel like a monster and end up driving away the people who love you the most.
- Driving can be a deadly combination with unreleased angercausing road rage.
- Bullying and sarcasm
- Drinking and substance abuse
- This is not a comprehensive list. You may have other harmful ways of releasing anger that aren’t listed here.
How do you know when anger is becoming a problem?
- When it interferes with relationships, work or school.
- When you hurt those around you.
- When you hurt yourself due to anger.
- When you have had involvement with the courts and law due to your anger.
- When you decide that anger is preventing you from having the life you want.
Anger is a human experience. It serves a purpose. Anger gets in the way of living life when it’s too much, too often and severe in expression. It can be made a smaller part of life and used appropriately, so that living is filled with freedom, laughter and love!
If you feel that you cannot manage your anger, get help today by visiting mental health professionals who not only help you cope withanger, but help you in dealing with other issues that might be causinganger.
Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying everyday thoughts and behaviors, with the aim of positively influencing emotions. The general approach developed out of behavior modification and cognitive therapy, and has become widely used to treat mental disorders. CBT is widely accepted as an evidence-based, cost-effective psychotherapy for many disorders. In CBT, the therapist identifies faulty patterns of thought process, interpretations, emotional reactions and dysfunctional behavior. Then the therapist clarifies implications of such thought patterns, emotional reactions and interpretations and suggests ways and means for overcoming the problem.
Cognitive behavior therapy postulates that feelings and behaviors are caused by a person’s thoughts, not on outside stimuli like people, situations and events. People may not be able to change their circumstances, but they can change how they think about them and therefore change how they feel and behave, according to cognitive-behavior therapists.
CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interact together. Specifically, our thoughtsdetermine our feelings and our behavior. Therefore, negative – and unrealistic – thoughts can cause us distress and result in problems. CBT can help break this vicious circle of altered thinking, feelings and behavior. When one sees the parts of the sequence clearly, one can change them – and so change the way he/she feels.
The Cognitive Side
Cognition is defined as the psychological result of perception, learning, and reasoning. Simply put, thoughts have an enormous impact on our mental health. Cognitive Therapy is not as simple as thinking positive. Human thought is complex, and changing the way we think can mean attempting to undo years of thought patterns. Some of these thought patterns may be negative and automatic.
We are all inherently imaginative beings with an endless amount of thoughts zipping in and out of our minds throughout the day. When these thoughts are negative in nature, they begin to disrupt our lives and slowly change our perspective from one that creatively visualizes to one that only has the capacity for negative visualization. Thoughts like, “We are all going to die anyway, so what’s the point in doing anything at all?” often carry great emotional weight without any real solution. A major part of eliminating damaging automatic thoughts is to determine the core beliefs that these thoughts are rooted in.
Core beliefs can be divided into two categories: those of helplessness, and those ofunlovability. For example, a person may have the automatic thought, “I can’t get along with anyone,” which stems from the unlovable core beliefs. The automatic thought “I can’t control my feelings anymore” is rooted in a helpless core belief structure.
By changing our core beliefs and the resulting automatic thoughts, we can change overall perceptions, feelings, and actions.
The Behavior Side
The way we think and feel usually determines the actions that we take. If a person believes that he or she is unlovable, he or she may take actions to avoid being in relationships, something that could further validate their core belief. If someone thinks they are worthless, he or she may participate in dangerous, impulsive activity. Thoughts, feelings, and actions are completely linked together. By changing thought processes, actions can be changed as well.
The first step to addressing an emotional disturbance is to become aware of the thoughts and feelings that drive it. Actively investigating the thought processes from both a cognitive and a behavioral point of view can dramatically affect our ability to resolve any emotional disturbance permanently.
How does CBT work?
One of the objectives of CBT typically is to identify and monitor thoughts, assumptions, beliefs and behaviors that are related and accompanied to debilitating negative emotions and to identify those which are dysfunctional, inaccurate, or simply unhelpful. This is done in an effort to in a wide array of different methodologies replace or transcend them with more realistic and self-helping ways.
It helps you challenge your negative beliefs and to think about times when you have been successful or to consider what happens to other people in similar situations. Once you are thinking more realistically, you are encouraged to imagine how you would go about confronting a feared situation. You will then be gradually exposed to real life situations.
The aim of CBT is to provide you with a timescale for overcoming a problem and to give you the insight and skills to improve your quality of life. You will then be able to cope and progress on your own once therapy is finished.
What problems can CBT help?
CBT can help people who have: anger issues, anxiety and panic attacks, chronic fatigue syndrome, depression, drug or alcohol problems, eating disorders, obsessive-compulsive disorder, persistent pain, phobias, post-traumatic stress, schizophrenia, sexual or relationship issues or sleep problems. Daily life problems, such as difficulty establishing or staying in relationships, problems with marriage or other relationships you’re already in, job, career or school difficulties, feelings of being “stressed out”, insufficient self-esteem (accepting or respecting yourself), inadequate coping skills, or ill-chosen methods of coping can also be benefited by CBT.
How Long Does Cognitive Behavior Therapy Take?
Cognitive behavioral therapy generally is not an overnight process. Even after patients have learned to recognize when and where their mental processes go awry, it can take months of effort to replace a dysfunctional cognitive-affective-behavioral process or habit with a more reasonable and adaptive one. Because cognitive behavior therapy is a structured, goal-oriented educational process focused on the immediate problems of the alcohol or drug-dependent patient, the process is usually short-term. Although other forms of therapy and psychoanalysis can take years, cognitive behavior therapy is usually completed in 12 to 16 sessions with the therapist.