Monthly Archives: February 2014
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.