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Lolli Bally Ball
Lolli Bally Ball
As an immigrant and an entrepreneur coming from another country, my main dream and goal was to secure a safe and better life for my family in the USA.
In addition to my MBA in business and banking management, I also was a professional soccer player.
A few years after I settled in the USA, while running a successful family business, I gained substantial public relations experience from dealing with all kinds of people. I decided to pursue my education PhD in Cognitive behavioral psychology and graduated in 2017.
Practicing my profession as a clinical psychologist, I have noticed that most of my patients either avoid or are not interested in physical exercise or they reluctantly do a specific activity to maintain a healthy physical and mental performance.
Simultaneously, as a soccer player, I have learned that the ball has a common interest among people despite their values and backgrounds.
The idea of the Lolli Bally Ball is intended to keep the ball attached to your body while walking, or talking, or standing, or exercising or trying to prove your talent.
Lolli Bally Ball provides various significant physical performances, by improving body fitness, and mental involvement.
The principle aim of Lolli Bally warm-up is to allow Soccer players to gradually adapt and prepare themselves both physically and mentally before getting into the game.
Who can do the Lolli Bally Ball exercise?
Everyone can do it, from the age of five to age 90 men and women.
Psychologically, getting your body moving can help to alleviate the symptoms of borderline personality disorder (BPD), depression, anxiety, OCD, ADHD, and many other mental health disorders. It becomes a behavioral therapy exercise.
According to the Anxiety and Depression Association of America, even just five minutes of aerobic exercise can begin to stimulate anti-anxiety effects.
Warming up Lolli Bally Ball increases your heart rate and therefore your blood flow. This enables more oxygen to reach your muscles.
An increase in body temperature, specifically in the muscles, improves explosive skeletal muscle performance.
The values of physical fitness
The five components of physical fitness are cardiovascular endurance, muscular strength, muscular endurance, flexibility, and body composition.
Being physically active can improve your brain health, help manage weight, reduce the risk of disease, strengthen bones and muscles, and improve your ability to do everyday activities. Adults who sit less and do any amount of moderate-to-vigorous physical activity gain some health benefits.
· Reduce your risk of heart disease.
· Help your body manage blood sugar and insulin levels.
· Help you quit smoking.
· Improve your mental health and mood.
· Help keep your thinking, learning, and judgment skills sharp as you age.
· Help you control your weight.
Lolli Bally Ball exercise is considered a measure of the body's ability to function efficiently, effectively and without injury in work and leisure activities, to pursue recreational activities and to cope with emergency situations.
Mental involvement and readiness
Including anxiety, pressure, texting, internet, OCD, it may also improve the condition of people with early signs of Parkinson’s or Huntington Disease or schizophrenia and other mental and physical impairments including:
· Reduction in stress hormones.
· Improved sleep.
· Greater social connection.
· Positive health behaviors.
· Reduce suicidal ideation.
· Improve stress response.
· Improve sleep.
· Reduce chronic pain.
· Reduce social isolation.
· Improve low self-esteem.
Getting a little nervous before a game or competition is normal. It is your body's way of gearing up to play as your stress hormones ramp up. However, severe feelings of anxiety can be challenging and may affect your athletic performance.
Soccer players and especially the subs on the sideline who want to warm up will have less pressure and anxiety when using the ball before getting into the game on the field.
Using the Lolli Bally for warm-up, the Subs on the side line in addition to feeling the density of the ball, they will be mentally and physically involved, committed and ready for the game.
When you exercise, you provide a low-dose jolt to the brain's reward centers—the system of the brain that helps you anticipate pleasure, feel motivated, and maintain hope. Over time, regular exercise remodels the reward system, leading to higher circulating levels of dopamine and more available dopamine receptors.
Conclusion
Engaging in daily Lolli Bally Ball exercise, you will be able to improve your health physically and mentally and might lower the risk of developing some diseases like obesity, type 2 diabetes including high blood pressure and more. It also helps to keep your body at a healthy weight and may improve an individual's cognitive performance, and psychological well-being.
Dr. Robert Shafie, PhD., MBA
Licensed clinical psychotherapist, hypnotherapist.
Boston, MA
July1, 2023
All rights reserved
Your personality, from the unknown to the known.
Robert Shafie, PhD., MBA
Licensed clinical psychologist, hypnotherapist
Boston, MA
Saturday September 16, 2023
How to live a normal life and reverse your depression, anguish, and dread into a cheerful outlook.
Moreover, this procedure may also apply to any person, business, or student.
Day one
On the left side of a blank sheet of paper write all what you like, and it will make you happy.
On the right side of the paper, write all your problems (concerns and worries).
Day two, the negative issues
On the right side of the paper, spend at least half of your day revising your problems.
On the right side, itemize and categorize your issues by listing the least important ones on top and leave the hard ones at the bottom of the list.
On the right side of the paper start removing (screening) the issues that you think are minor or of less importance.
Day three
On the right side of the paper read and screen the left-over of your problems and after you screen at least 90% of your negative issues that you feel time wasting, write a new draft and take a break for the rest of the day.
Day four
On the left part of your paper draft slowly and patiently, read over the things that make you happy.
Keep reading your notes and start planning your new and future projects.
Day five
Rejoicing and sharing your family members your happiness and expectations.
Practice mindfulness by adding meaning to your life and maintaining a moment-by-moment awareness of your thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens.
The happiest people appreciate what they have, they keep an open mind to new ideas and ventures, they use their leisure time as a means of self-development, and love good music, good books, good pictures, good company, and good conversation.
In other words, do little things every day to nurture your happiness.
-Smile, first thing in the morning.
-Go out and act like today is an impressive day.
-Stay active, engage in physical activities, and socialize.
-Pay attention to others (listen and learn).
-Try to ignore or avoid hanging out with people who whine and complain, surround yourself with people who do good things and make your life brighter.
-Make plans and work on something that is meaningful to you.
-Appreciate your life and those around you.
-Stay in contact with old friends and refresh your memories with them.
-Once in a while (if you can afford it) buy something for you that you could use for a long time, five or ten years, this reflects some hope for the future.
- Do not ignore yourself, always dress up well and update your look.
- Listen to music including nostalgia.
-Take a hot bath every day.
-Give away the things that you do not need (hoarding), down-size and save only what you need.
-Get enough sleep.
-Quit your bad habits, you know what I mean!
-Be open minded and try to meet new friends.
-Manage your finances. Try to manage living with one Dollar or six figures.
-Forgiveness is the best way to gain confidence.
-Smiling makes you look young, try not to abuse it, or lose it.
-Try to help others, be altruistic and excited and proud about the good things you are doing.
-Keep doing this and never give up.
Your healthy journey might take some time to reach your destination and fulfil your dreams.
Remember, stay positive, Rome was never built in a day!
Dr. Robert Shafie, PhD., MBA
Licensed clinical psychologist, hypnotherapist.
Boston, MA
Saturday September 16, 2023
How to live a normal life and reverse your depression, anguish, and dread into a positive attitude.
Moreover, this procedure may also apply to any person, business, or student.
Day one
On the left side of a blank paper write all what you like and make you happy.
On the right side of the paper, write all your problems (concerns and worries).
Day two, the negative issues
On the right side of the paper, spend at least half of your day revising your problems.
On the right side, itemize and categorize your issues by listing the least important ones on top and leave the hard ones at the bottom of the list.
On the right side of the paper start removing (screening) the issues that you think are minor or of less importance.
Day three
On the right side of the paper read and screen the left-over of your problems and after you screen at least 90% of your negative issues that you feel time wasting, write a new draft and take a break for the rest of the day.
Day four
On the left part of your paper draft slowly and patiently, read over the things that make you happy.
Keep reading your notes and start planning your new and future projects.
Day five
Rejoicing and sharing your family members your happiness and expectations.
Practice mindfulness by adding meaning to your life and maintaining a moment-by-moment awareness of your thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens.
The happiest people appreciate what they have, they keep an open mind to new ideas and ventures, they use their leisure time as a means of self-development, and love good music, good books, good pictures, good company, and good conversation.
In other words, do little things every day to nurture your happiness.
-Smile, first thing in the morning.
-Go out and act like today is an awesome day.
-Stay active, engage in physical activities, and socialize.
-Pay attention to others (listen and learn).
-Try to ignore or avoid hanging out with people who wine and complain, surround yourself with people who do good things and make your life brighter.
-Make plans and work on something that is meaningful to you.
-Appreciate your life and those around you.
-Stay in contact with old friends and refresh your memories with them.
-Once in a while (if you could afford it) buy something for you that you could use for a long time five or ten years, this reflects some hope for the future.
- Do not ignore yourself, always dress up well and update your look.
- Listen to music including nostalgia.
-Take a hot bath every day.
-Give away the things that you do not need (hoarding), down-size and save only what you need.
-Get enough sleep.
-Quit your bad habits, you know what I mean!
-Be open minded and try to meet new friends.
-Manage your finances. Try to manage living with one Dollar or six figures.
-Forgiveness is the best way to gain confidence.
-Smiling makes you look young, try not to abuse it, or lose it.
-Try to help others, be altruistic and excited and proud about the good things you are doing.
-Keep doing this and never give up.
Your health journey might take some time to reach your destination and fulfil your dreams.
Remember, stay positive, Rome was never built in a day!
Robert Shafie, PhD., MBA
Licensed clinical psychologist,
All rights reserved.
Anxiety Cause, causation, and relationships between Physical symptoms and psychological distress
Article
A symptom of Some-xiety is the result of disruption of the emotional processing center in the brain.
The brain's limbic system, comprised of the hippocampus, amygdala, hypothalamus, and thalamus, is responsible for most of our emotional processing.
When the amygdala notices potential danger, it sends signals to the hypothalamus, which triggers a fight or flight (stay and defend or runaway) response.
Anxiety weakens the connections between the amygdala and the prefrontal cortex (PFC). When the amygdala alerts the brain to danger, it helps you produce a rational, logical response. It also creates a feeling of deep anxiety or dread (Angst).
Pathological anxiety and chronic stress lead to structural degeneration and impaired functioning of the hippocampus and the PFC, which may account for the increased risk of developing neuropsychiatric disorders, including anxiety, depression, and dementia.
People with anxiety can experience a range of physical symptoms and Somatic Symptoms and Related Disorders (SSRD), such as:
Physical Symptoms
Lightheadedness
Sweating
Nausea
Feeling edgy and/or restless
Diarrhea
Body pains including headaches, joint pains, and muscle tension.
insomnia, and feelings of restlessness
Stomach aches, nausea, vomiting.
Fatigue, dizziness, memory problems.
Weakness, numbness.
Trouble breathing, shortness of breath.
Changes in vision or hearing including sudden blindness.
Thought patterns
Believing the worst will happen
Persistent worry
All-or-nothing thinking
Over generalizing (making overall assumptions based on a single event)
Anxious Behaviors
Avoidance of feared situations or events
Seeking reassurance
Second-guessing
Irritability and frustration in feared situations
Compulsive actions (like washing hands over and over)
Untreated anxiety (Cause and Causation) can lead to other mental disorders, such as depression or substance abuse. If not properly treated, have a higher risk of isolation, suicide, or self-harm behaviors.
Therapy can help you uncover the underlying causes of your worries and fears; learn how to relax; look at situations in new, less frightening ways; and develop better coping and critical thinking skills. Therapy gives you the tools to overcome anxiety and teaches you how to use them.
Anxiety disorders are done according to specific symptoms and diagnosis,
no one size fits all.
If you have obsessive-compulsive disorder (OCD), for example, your treatment will be different from someone who needs help for anxiety attacks. The length of therapy will also depend on the type and severity of your anxiety disorder. However, most anxiety therapies are short-term. According to the American Psychological Association, most people improve significantly within 8 to 10 therapy sessions.
The leading approaches are cognitive behavioral therapy (CBT), Hypnotherapy (Hypnosis) and exposure therapy. Each anxiety therapy is either used alone or combined with other types of therapy. Anxiety therapy is either conducted individually, or it may take place in a group of people with similar anxiety problems. But the goal is the same: to lower your anxiety levels, calm your mind, and overcome your fears.
Cognitive behavioral therapy CBT
Cognitive behavioral therapy focuses on:
· Helping you learn how negative thoughts, emotional reactions and behaviors maintain problems over time, (Diagnosis and treatment, Mayo Clinic).
· Challenging automatic negative thoughts and learning more-flexible ways of thinking.
· Learning alternate ways to help reduce mirror checking, reassurance seeking or excess use of medical services.
· Teaching you other behaviors to improve your mental health, such as addressing social avoidance and increasing engagement with healthy supports and activities.
You and your mental health provider can talk about your goals for therapy and develop a personalized treatment plan to learn and strengthen coping skills.
Hypnotherapy
Or hypnosis -- is a type of nonstandard or "complementary and alternative medicine" treatment. It uses guided relaxation, intense concentration, and focused attention to achieve a heightened state of awareness or trance.
Following are four types of physical symptoms that could lead to psychological distress including serious behavioral symptoms:
1-Body dysmorphic disorder BDD
Body dysmorphic disorder (BDD) is a distinct mental disorder in which a person is pre-occupied with an imagined physical defect, or a minor defect that others often cannot see.
Causes
Abuse or bullying.
Low self-esteem.
Fear of being alone or isolated.
Perfectionism or competing with others.
Genetics.
Depression, anxiety, or OCD.
Symptoms
Constantly checking yourself in the mirror.
Avoiding mirrors.
Trying to hide your body part under a hat, scarf, or makeup.
Constantly exercising or grooming.
Constantly comparing yourself with others.
Always asking other people whether you look OK.
Treatment
Treatment for body dysmorphic disorder often includes a combination of cognitive behavioral therapy and medications.
There is no cure for body dysmorphic disorder. However, treatment, including therapy, can help people improve their symptoms. The goal of treatment is to decrease the effect that the disorder has on a person's life so that they can function at home, work and in social settings.
2-Conversion Disorder
Conversion disorder is a psychiatric condition in which a person develops physical symptoms that are not under voluntary control and are not explained by a neurological disease or another medical condition, (Neurofeedback integrated therapy, WWW.neurofeedbackiti,com) Conversion disorder is also called functional neurological symptom disorder, referring to abnormal central nervous system functioning.
Diagnosis with conversion disorder, the physical symptoms must cause significant distress or impairment in day-to-day functioning. If the conversion symptoms exist within a culture and do not cause significant distress or disability, then a diagnosis of conversion disorder is ignored.
Causes
While exact causes are unclear, research suggests that it would be the result of abnormal flow to certain areas of the brain.
Conversion disorder may also be a psychological reaction to a highly stressful event or emotional trauma.
Other risk factors of conversion disorder include:
Being female (Women have a higher risk of developing the disorder).
Being highly conscientious, compulsive and a perfectionist
Having a family member with conversion disorder (People with a first-degree female relative—sister, mother, or daughter).
Having a mental health condition, including mood, or anxiety disorders, dissociative identity disorder or other personality disorders
Having maladaptive personality traits
Having a neurological disease that causes similar symptoms (such as non-epileptic seizures in people that have epilepsy)
History of physical or sexual abuse and neglect as a child
Symptoms
Motor symptoms include weakness or paralysis, abnormal movements such as tremor, and difficulty walking. Conversion disorder can also take the form of “psychogenic” or “non-epileptic” seizures, which include limb shaking and impaired or loss of consciousness but without the electrical activity that occurs in the brain during a seizure. Other common symptoms include episodes of unresponsiveness that resemble fainting or coma, reduced or absent speech volume, changes in articulation when speaking (slurred speech), a sensation of a lump in the throat, and double vision.
People with conversion disorder are not faking their symptoms. The severity of the disability caused by conversion disorder can be like that experienced by people with comparable medical diseases.
Treatment
Treatment for conversion disorder typically consists of psychotherapy, physical therapy, and/or medication.
The focus of psychotherapy is to help the individual understand the emotional conflict behind their physical symptoms, and to resolve this underlying psychological distress. Psychotherapy treatment can include individual or group therapy, hypnosis, biofeedback, and relaxation training.
Physical therapy attempts to maximize physical functioning and prevent any secondary complications that may result from physical symptoms, such as muscle weakness or stiffness that follows periods of physical inactivity.
3-Catatonic Disorder
Catatonia can occur in association with a psychiatric disorder, like schizophrenia, or in association with a medical condition such as encephalitis.
Encephalitis is an inflammation of the active tissues of the brain caused by an infection or an autoimmune response. The inflammation causes the brain to swell, which can lead to headache, stiff neck, sensitivity to light, mental confusion, and seizures.
With few patients, catatonia may be present without a known cause.
Catatonia could cause irregularities in the dopamine, gamma-aminobutyric acid (GABA), and glutamate neurotransmitter systems resulting from underlying neurological, psychiatric, or physical illness, such as:
Mutism (lack of verbal response), negativism (lack of response stimuli or instruction), posturing (holding a posture that fights gravity), mannerism (odd and exaggerated movements), and stupor (the state of being in a daze), (Understanding the signs and symptoms of Schizophrenia, health proadvice.com).
Causes
Historically, catatonia had been classified as a subtype of schizophrenia.
Catatonia is associated with medical conditions.
These conditions include:
Metabolic
Inflammatory
Infectious
Drug-induced (antipsychotics, immunosuppressants, antibiotics, illicit drugs)
Symptoms
A person must have at least three of the following twelve symptoms:
Not responding to other people or their environment.
Not speaking.
Holding their body in an unusual position.
Resisting people who try to adjust their body.
Agitation.
Repetitive, meaningless movement.
Mimicking someone else's speech.
When that part of your brain senses danger, it signals your brain to pump stress hormones, preparing your body to either fight for survival or to flee to safety.
Fight-or-flight response is more likely to trigger a person by emotions such as stress, fear, anxiety, aggression, and anger.
4-Somatization disorder or imagined
A person who experiences a long series of imagined physical complaints suffers from Somatization, (more common in females).
Somatic symptom disorder results from an extreme focus on physical symptoms — such as pain or fatigue — that causes major emotional distress and problems functioning, (Mayo Clinic-Family Health Book, 5th Edition).
Causes
There is no clear cause of SSD.
A variety of factors found to predispose a person to develop SSD.
Age: People who develop SSD typically begin to have signs of the condition before age 30.
Gender: It is more common in women than in men.
Genetics: A family history of SSD or anxiety disorders has been associated with developing the condition.
Personality: The disorder is more common in people who are extremely sensitive to physical or emotional pain or those with a negative outlook.
Personal history: People who have experienced physical or sexual abuse may be at an increased risk of developing SSD.
Symptoms
1. Specific sensations, such as pain or shortness of breath, or more general symptoms, such as fatigue or weakness
2. Unrelated to any medical cause could be related to a medical condition such as cancer or heart disease.
3. Mild, moderate, or severe Pain is the most common symptom.
Treatment
Here are few changes that could improve your symptoms:
Get more exercise: Getting more physically active can improve the way you feel physically, and it is also great for your mental health
Manage stress: Constantly being stressed can exacerbate the way you feel about any mild physical symptoms you might be experiencing
Cut out unhealthy habits: Drinking alcohol excessively or caffeine could make your symptoms feel worse
General Anxiety Medications:
Antidepressants are medications used to treat major depressive disorder, specific anxiety disorders, specific chronic pain conditions, and to help to treat addictions
SSRIs used to treat generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and post-traumatic stress disorder. The antidepressants most widely prescribed for anxiety are SSRIs such as Prozac, Zoloft, Paxil, Lexapro, and Celexa.
Dr. Robert Shafie, PhD., MBA
Licensed Clinical Psychologist
3:00 pm, June 17, 2022
Boston, Massachusetts
References:
Diagnosis and treatment, Mayo Clinic).
Neurofeedback integrated therapy, WWW.neurofeedbackiti,com)
Somatization and the Mind-Body Connection - Kelty Mental Health”)
Mayo Clinic-Family Health Book, 5th Edition).
Somatic symptom disorder, Mayo Clinic, 5t edition
Suicide, a Dark spot in the Brain
Prepared by: Robert Shafie, PhD, MBA
Boston, Massachusetts
Linda revealed her story; I remember making a sound that I’d never made before, a sound that wasn’t entirely human. “I grew up in a stable nuclear family, a loving brother and educated parents. We had a great relationship; we were much attached and loving. I was in graduate school and my young brother was ready to receive his engineering degree.
Two years ago, early February; it was dark and early 4 o’clock in the morning, the snow was almost 8”, and my phone rings, it was my brother David, he sounded very down and with a low tone told me that our Dad took his life away, he said, Mom called and said she found him dead in the basement. I immediately left to be with my family.
My dad had always been depressed, but he refused to take meds. He was a software engineer and believed that medication dulls your edge. He didn’t really want to admit that there was a problem. My mother did a good job of keeping him going. He’d attempted suicide a couple of times when I was a child, but my mother hid it from my brother and me. Now, this tragic incident ultimately changed our concept of life and the way we live. My mother was this bohemian in bright colors, the executive director of a non-profit organization. She immediately started wearing black, quit the job she loved, and moved to a new place. I used to wear velvet, polka dots, and jewel tones, and I completely stopped wearing colors. I left grad school, changed careers, stopped smoking, and started having a different vision of life.
My father’s suicide was a huge tragedy, a crippling blow for the entire family to cope with. But I can’t say I didn’t know it was coming. He spent his whole life, and most of my childhood, in and out of mental hospitals. My father’s crippling depression was too much for him, and he caved under it. My father left us this note:
“Nobody is at fault here. Please do not spend the rest of your days feeling like you did something wrong. I had a good life, with good people. I love you all and I could not put words to it. I’m not doing this because I hate you or I am selfish, I am doing this because I am very sick and it is a kind of sickness that I can only ever result in this, sooner or later. I’m choosing now. I love you all, and I am sorry. Be good”.
Suicidal thoughts are common and their cases differ from one person to another, and many people experience them when they are undergoing stress or depression. Since depression is a syndrome, then suicide thought is a syndrome. In most cases, they place the individual at risk for attempting or completing suicide.
The wounds suicide leaves in the lives of those left behind by it are often deep and long lasting. The apparent senselessness of suicide often fuels the most significant pain. Thinking we all deal better with tragedy when we understand its underpinnings. But, after all, we have to fight to survive, and if you ask me how then you have to read the story of the eagle’s survival:
Eagles can live up to 70 years, but to reach this stage, the eagle must make a hard decision. In its 40th year, its long and flexible talons can no longer grab prey which serves as food. Its long and sharp beak becomes bent, the feathers become old, sticky, thick and heavy. The thick and heavy feathers make it hard on the eagle to fly. Then the eagle is left with only two options; die, or go through a painful process to survive.
The process requires that the eagle fly to a mountain top to sit on its nest. Then the eagle knocks its beak against a rock until it plucks it out. The eagle then will wait for a new beak to grow back and until it plucks out its talons. When the eagle’s talons grow back, then it starts puking its old-aged feathers. After this stage, the eagle boosts confidence and takes its famous flight to rebirth and lives for 30 more years.
We too have to pluck our unpleasant memories, negative habits and fix our mindset. We have to free ourselves from past burdens and take advantage of the present, look forward to the future and let go our negative beliefs.
Open up your fixed mindset and let yourself fly again like an eagle.
What is suicide and suicidal behavior? Statements such as; I am not happy,”, “I feel down and sick, I'm going to kill myself," "I wish I were dead," "I wish I hadn't been born", “and I will sell my organs to keep my family safe and happy”.
Suicide is the act of taking one’s own life. Suicide is one of the leading causes of death in the world. The danger begins when this vague and dark attitude develops from an individual action to reach other members of the family to become a public habit in reaction to negative social or economic or health issues.
A number of questions are raised within the philosophy of suicide, included what constitutes suicide, whether or not suicide can be a rational choice, and the moral permissibility of suicide. Arguments as to acceptability of suicide in moral or social terms range from the position that the act is inherently immoral and unacceptable under any circumstances to a regard for suicide as a sacrosanct right of anyone who believes they have rationally and conscientiously come to the decision to end their own lives, even if they are young and healthy.
There is no legitimate reason why someone may try to take their own life, but certain factors may increase the risk. Someone may be more likely to attempt suicide if they have a mental health disorder. Most of the people who commit suicide have a mental illness at the time of their death. Depression is the top risk factor, but there are various other mental health disorders that can contribute to suicide, including Bipolar Disorder and Schizophrenia.
People who have suicidal thoughts are often so overwhelmed by feelings of sadness and hopelessness that they think they have no other choice. While it can be hard to know how someone is feeling on the inside, there are various behaviors that can indicate suicidal tendencies.
Aside from mental illnesses, there are several risk factors that may contribute to thoughts of suicide, attempted suicide, and actual suicide. These include:
· substance abuse
· incarceration or imprisonment
· family history of suicide
· poor job security or low levels of job satisfaction
· history of being abused or witnessing continuous abuse
· being diagnosed with a serious medical condition, such as cancer or HIV
· being stigmatized or socially isolated or a victim of bullying
· being exposed to suicidal behavior
· previous suicide attempts
Environmental factors also increase the risk for suicide which often occurs due to a stressful life event. This may include the loss of a person, pet, or job. Other causes include: social loss, such as the loss of a significant relationship, access to lethal means, including firearms and drugs, being exposed to suicide, being a victim of harassment, bullying, or physical abuse.
Sociocultural factors which cause suicide is the feeling of being stigmatized, isolated or of not being accepted by others. Feelings of isolation can be caused by sexual orientation, religious beliefs, discrimination and gender identity.
Other possible suicide catalysts in this category include: difficulty seeking help or support, lack of access to mental health or substance abuse treatment, following belief systems that accept suicide as a solution to personal problems.
A brain damage may be involved. Research is making important progress toward understanding that painful process. Studies have identified a deficiency of a specific chemical - serotonin - in the brains of some people who are prone to take their own lives in the face of life's difficulties. Serotonin, one of dozens of neurotransmitters that control the activity of brain cells, is instrumental, along with other brain chemicals, in regulating certain brain activities, including emotion.
Research believes that biological factors may play a far greater role in the events that end in suicide than has been realized. And the hope now is that a drug could eventually be developed to correct the chemical deficiency and prevent at least some future suicides. ''A low level of serotonin seems to be a biochemical marker for those depressed people who are most prone to suicide,'' according to Herman van Praag, a psychiatrist at the Albert Einstein College of Medicine who was among several researchers who presented new findings on suicide at a meeting last month of the New York Academy of Sciences.
Using new techniques, investigators have been able to find serotonin deficiency by measuring levels of one of its main metabolic products, a chemical with the formidable name 5-hydroxyindoleacetic acid, abbreviated as 5-HIAA. Researchers can determine levels of 5-HIAA in the brain during autopsies, and from spinal fluid.
Signs of suicide attempts. You can not see what a person is feeling on the inside, so it is not always easy to identify someone who is having suicidal thoughts. However, some outward warning signs that a person may be contemplating suicide include:
· talking about feeling hopeless
· making a will or giving away personal possessions
· searching for a means of doing personal harm, such as buying a gun
· sleeping too much or too little
· eating too little or too much, resulting in significant weight gain or weight loss
· engaging in reckless behaviors, including excessive alcohol or drug consumption
· avoiding social interactions with others
· expressing rage or intentions to seek revenge
· showing signs of anxiousness or agitation
feel alone
experience mood swings
Loss of motivation and desire
talking about having no reason to live or philosophical desire to die
They have made a mistake. This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.
Suicide prevention measures. Suicide is a complex issue and therefore suicide prevention efforts require coordination and collaboration among multiple sectors of society, including the health sector and other sectors such as education, labor, agriculture, business, justice, law, defense, politics, and the media. These efforts must be comprehensive, and integrated as no single approach alone can make an impact on an issue as complex as suicide.
In his recent book ''Definition of Suicide,'' Dr. Shneidman, who was a co-founder of the first suicide prevention center in the United States, suggests a number of practical preventive measures for dealing with someone who is suicidal: reduce the pain, build a realistic rapport, and offer options to suicide.
Additionally, there are a number of preventive measures that can be taken at population, sub-population and individual levels to prevent suicide and suicide attempts. These include:
reducing access to the means of suicide (e.g. pesticides, firearms, certain medications);
reporting by media in a responsible way;
introducing alcohol policies to reduce the harmful use of alcohol;
early identification, treatment and care of people with mental and substance use disorders, chronic pain and acute emotional distress;
training of non-specialized health workers in the assessment and management of suicidal behavior;
Follow-up care for people who attempted suicide and provision of community support.
Sources:
-Daniel Coleman, CLUES TO SUICIDE: A BRAIN CHEMICAL IS IMPLICATED. The National edition with the headline: Article, October 8, 1985, on Page C00001.
-Edwin S. Shneidman on Suicide Antoon A. Leenaars Norwegian Institute of Public Health, Division of Mental Health, Department of Suicide Research and Prevention Submitted to SOL: 3rd March 2010; accepted: 5th March 2010; published: Mar 2010.
-Mayo Clinic Staff. (2015, August 28). Suicide and suicidal thoughts.
Herman van Praag, a psychiatrist at the Albert Einstein College of Medicine. Article in World Psychiatry: Official journal of the world psychiatry association (WPA). 12(1):33-4 · February 2013.
Research: Parent-Child Relationships
Robert Shafie, Ph.D., MBA
Boston, Massachusetts
It was not known how American and American Lebanese parents perceive the influence of parent-child relationships on their children’s well-being. The purpose of this descriptive qualitative study was to establish a healthy parent-child relationship based on understanding and solid common grounds.
The target population for the study included American and American Lebanese who resided and were raising a child in the United States. The researcher selected a sample of 100 participants who were parents between 25 and 50 years of age residing in the USA. The primary data for the study were collected using a mostly open-ended online questionnaire and phone interviews. The data from the open-ended interviews consisted of direct quotations from people about their experiences, opinions, feelings, and knowledge. The sample was drawn from former alumni of the Lebanese American University (LAU). Interviews were conducted and transcribed by the researcher. The researcher gathered information on the different aspects of childhood attachment to parents and the relationships with their children.
This study builds on Bowlby’s attachment theory (1979) which supports the importance of healthy development in having a close and caring relationship with parents and other caregivers.
Qualitative analysis and descriptive methods were employed to analyze the gathered data.
The results of the study were then used to draw conclusions.
Two research questions guided this study:
RQ1: How do American and American Lebanese parents describe activities they engage in to develop relationships, and how do they describe their bonding, reciprocal communication patterns, and connectedness with their children?
RQ2: How do American and American Lebanese parents describe the main barriers to creating healthy relationships and how do they describe their hopes for their children as they grow up to creating healthy relationships and how do they describe their hopes for their children as they grow up?
keywords: parent-child relations, mother-child relations, child-rearing studies on parenting, ethnic values and identity, attachment behavior, bonding, reciprocity, barriers, change, connectedness, cultural attachment relations, and cultural characteristics.
Differences in national origins, socioeconomic backgrounds, and geographic patterns of settlement are important factors related to how immigrant parents raise their children in the United States. Adaptation outcomes are also determined by structural conditions in the host society (Portes & Rumbaut 1996). Furthermore, children of immigrants may lack meaningful connections to their immigrant parent’s home country. The children are thus unlikely to consider a foreign country as a point of reference and evaluate themselves by the standards of the country in which they are being raised (Portes 1995); in this case the United States.
There are cultural and ethnic variations that produce value systems, which essentially direct a parent’s manner and styles of parenting (Wong, 2002). Generally, this pattern of culture believes that social skills should be nurtured as much as academic skills. Also, immigrant parents differ from American parents, who view how their child is behaving in classroom just as important as what there is learning (Tcet, 2010). The most important goal of raising independent children is for American children to be self-sufficient and act on their own personal choices. On the other hand, the primary goal of raising interdependent children is for them to be part of a larger system of relationships to “depend” on others for well-being (Herberg 1955, pp. 79).
This study provided a basis for understanding the effects of healthy parent-child attachment during infancy and in adulthood. Brook (2012) revealed that most new parents have difficulty adjusting to their new roles because of anxiety about their evolving responsibilities. However, no method has been recommended to resolve this issue.
The findings in this study contributed to a better understanding of healthy attachment and parent–child relationships among the American and American Lebanese sample. This study results related to how parents perceive bonding, reciprocal communication, and connectedness influenced relationships with their children. Additionally, results provided information regarding barriers to and changes in the parent-child relationship. Results in this study, in part, described challenges and experiences in raising a child in a different geographic location and/or culture than that which the parent was born.
A child’s well-being is mostly viewed in terms of parents providing children with health, safety, education, financial security, love, values, beliefs, behavioral concerns, family rituals, social relationships, and a place in community participation (Sroufe, Carlson, & Shulman, 1993).
Certificate of Registration Number: TX-8-531-314
Year of completion: December 27, 2017
Nation of Publication: United States
Copyright: Robert Shafie
Dementia, a battle with the Unknown
Article Dated: July 30, 2018-Boston Massachusetts
By: Dr. Robert Shafie, Ph.D, MBA
It was a dark day of January 2018, cold and snow outside, where you could hardly drive your car. John, his wife Sandra and their three kids were in the hospital anxiously waiting for the MRI results. The doctor comes in and pulls out the MRI scans. A healthy brain on the right with a terrifying black hole and emptiness, smack bang in the middle of a brain growing rapidly, slowly devouring everything around it. The MRI doesn’t look good and nothing we could do at the moment, the doctor says to the wife. We all were in shock and Sandra started crying uncontrollably. The rapid deterioration at Sandra's brain health was shocking and it hit John like a 10 ton truck. Tears streaming down his face, John pleaded with the doctor, isn’t there anything you can do?
It was just another day at the Office for the Doctor who stood there, emotionless, itching to get out of the room and onto his next patient before lunch. We can put you on another course of medication, he said, looking at Sandra, but I'm not sure how effective it will be if at all, to be totally honest with you. I've never seen anything like this before, and then he added, Sandra, I'd be lying if I promise you any kind of improvement. In fact, I'd be amazed if you still recognize your children in three months from now, three months, 12 weeks.
All the happy memories with the family about to be ripped from her mind as if they never existed, like tearing pages from a book. The night I proposed to her, our wedding date the birth of our children, everything is gone. Sandra looked at her husband with tears in her eyes as she lay in the cold steel hospital bed contemplating the most depressing future she could imagine.
Naturally, as we age, we sometimes start losing part of our energy to become less active and unfortunately including our cognitive behavior, memory and thinking ability.
Aging is not the only factor that contributes to memory loss, however. Many older adults develop memory problems as a result of health issues that may be treatable. These would include: side effects due to medications, vitamin deficiencies, substance abuse or possibly even reduced organ function due to thyroid, kidney or living disorders. These could be serious medical conditions and could be treated.
In addition to the aforementioned medical issues which can precipitate in memory loss or impairment, there is what seems to be the most common reason: depression. Depression in older adults has been a steadily growing problem, and emotional problems such as stress and anxiety can – and quite often do – lead to forgetfulness, confusion and other symptoms that are similar to those of dementia.
What is Dementia?
Dementia is a broad category of brain that cause a long-term and often gradual decrease in the ability to think and remember that is great enough to affect a person's daily functioning. Other common symptoms include emotional problems, difficulties with language, and a decrease in motivation. A person's consciousness is usually not affected. A dementia diagnosis requires a change from a person's usual mental functioning and a greater decline than one would expect due to aging.
There is no known cure for dementia. Cholinesterase inhibitors such as Donepezil are often used and may be beneficial in mild to moderate disorder. Overall benefit, however, may be minor. There are many measures that can improve the quality of life of people with dementia and their caregivers.
Dementia is an umbrella term that Alzheimer's disease can fall under. It can occur due to a variety of conditions, the most common of which is Alzheimer's disease.
Types of Dementia
· Alzheimer's disease
· Vascular dementia
· Dementia with Lewy bodies (DLB)
· Mixed dementia
· Parkinson's disease
· Frontotemporal dementia
· Creutzfeldt-Jakob disease
· Normal pressure hydrocephalus
Alzheimer's disease. Alzheimer's disease is the most common cause of neurocognitive disorder
· Creutzfeldt-Jakob disease
· Dementia with Lewy bodies
· Frontotemporal dementia
· Parkinson's disease
· Huntington's disease
· Mixed dementia
· Normal pressure hydrocephalus
Each of these diseases is unique, and so is the pathology, meaning that memory impairment isn’t always the first sign of the disease.
It’s easy to overlook the early symptoms of dementia, which can be mild. It often begins with simple episodes of forgetfulness. People with dementia have trouble keeping track of time and tend to lose their way in familiar settings.
Neuropsychiatric symptoms that may be present are termed Behavioural and psychological symptoms of dementia (BPSD) and these can include:
· Balance problems
· Tremor
· Speech and language difficulty
· Trouble eating or swallowing
· Memory distortions (believing that a memory has already happened when it has not, thinking an old memory is a new one, combining two memories, or confusing the people in a memory)
· Wandering or restlessness
· Perception and visual problems
· Behavioral and psychological symptoms of dementia almost always occur in all types of dementia and may manifest as:
· Agitation
· Depression
· Anxiety
· Abnormal motor behavior
· Elated mood
· Irritability
· Apathy
· Dis-inhibition and impulsivity
· Delusions (often believing people are stealing from them) or hallucinations
· Changes in sleep or appetite.
When people with dementia are put in circumstances beyond their abilities, there may be a sudden change to crying or anger.
As dementia progresses, forgetfulness and confusion grow. It becomes harder to recall names and faces. Personal care becomes a problem. Obvious signs of dementia include repetitious questioning, inadequate hygiene, and poor decision-making.
In the most advanced stage, people with dementia become unable to care for themselves. They will struggle even more with keeping track of time, and remembering people and places they are familiar with. Behavior continues to change and can turn into depression and aggression.
People can have more than one type of dementia. This is known as mixed dementia. Often, people with mixed dementia have multiple conditions that may contribute to dementia. A diagnosis of mixed dementia can only be confirmed in an autopsy.
Memory loss is usually the most noticeable sign of dementia, but other early signs include things such as:
· Repeatedly asking the same questions
· Forgetting or mixing up common words when speaking
· Misplacing items in inappropriate places, such as putting a wallet in a kitchen drawer
· Getting lost in a normally familiar environment
· Sudden changes in mood or behavior, with no apparent cause
· Inability to follow directions
Dementia a syndrome , it describes a number of symptoms including memory impairment, as well as reduced reasoning, language and other thinking skills. In most cases, dementia progresses slowly until the point where it significantly impairs that person’s ability to work, maintain relationships and manage his or her own life.
The symptoms of dementia vary across types and stages of the diagnosis. The most common affected areas include memory, visual-spatial, language, attention and problem solving. Most types of dementia are slow and progressive.
Dementia is caused by neurodegeneration – the damage and death of the brain’s neurons. Depending on the types of neurons and brain regions affected, the form of dementia differs. For instance, frontotemporal dementia mainly affects the frontal and temporal lobes, whereas Lewy body dementia affects part of the frontal lobe and the motor cortex. In the brains of patients with advanced Alzheimer’s, there is widespread degeneration, and damage to the hippocampus – a part of the brain essential to memory formation, and which produces new neurons. The loss of brain tissue results in a shrunken brain, enlarged ventricles and more space between the folds.
Microscopic changes in the brain begin long before the first signs of memory loss.
The brain has 100 billion nerve cells (neurons). Each nerve cell connects with many others to form communication networks. Groups of nerve cells have special jobs. Some are involved in thinking, learning and remembering. Others help us see, hear and smell.
To do their work, brain cells operate like tiny factories. They receive supplies, generate energy, construct equipment and get rid of waste. Cells also process and store information and
communicate with other cells. Keeping everything running requires coordination as well as large amounts of fuel and oxygen.
Comparison of a normal brain (left) and degeneration from severe Alzheimer's disease (right).
Damage to the brain begins years before symptoms appear. Abnormal protein deposits form plaques and tangles in the brain of someone with Alzheimer’s disease. Connections between cells are lost, and they begin to die. In advanced cases, the brain shows significant shrinkage.
Scientists believe Alzheimer's disease prevents parts of a cell's factory from running well. They are not sure where the trouble starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs and, eventually die, causing irreversible changes in the brain.
The role of plaques and tangles
Plaques and tangles tend to spread through the cortex as Alzheimer's progresses.
Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells.
Plaques are deposits of a protein fragment called beta-amyloid that builds up in the spaces between nerve cells.
Tangles are twisted fibers of another protein called tau that builds up inside cells.
In most dementias, build-up of toxic proteins is a key part of brain degeneration. This causes a loss of the contact points between neurons (known as synapses) as well as a loss of the neurons themselves. What sparks this neurodegeneration remains unknown, but for dementias other than vascular dementia, a build-up of toxic proteins and the loss of their normal function are defining characteristics.
Proteins can naturally aggregate as the body’s systems for clearing them start to decline, which occurs increasingly as we age. In neurodegenerative disease, these toxic clumps, known as aggregates, can damage or kill neurons.
In Alzheimer’s disease, two key players called amyloid-ß (a peptide that forms plaques around neurons) and tau (a protein that forms ‘tangles’ inside neurons) are at play. In dementia with Lewy bodies (which also forms amyloid-ß deposits) and Parkinson’s disease, the major aggregates are formed by the protein α-synuclein. In frontotemporal dementias, deposits of protein are found, and each type of protein aggregate eventually leads to the death of affected neurons.
Plagues-A problem called amyloid-β
The main component of the hallmark plaques seen as lesions in the brains of Alzheimer’s patients is formed by a peptide called amyloid-ß (beta). Certain neurons, particularly in the cortex and hippocampus, create amyloid-ß. Its function is not well understood, but it has a role in neurogenesis (the creation of neurons), memory, and the normal operation of message transfer between neurons. When too much is made, or too little cleared, clumps of amyloid-ß build up around and between neurons. As these plaques grow in size, they envelop and destroy the dendrites (branches) of neurons, interfering with their ability to communicate.
Tau-a protein that forms ‘tangles’ inside neurons
Tau is a protein that normally has an important role in maintaining the structure of a neuron’s axon (the long cable that transmits signals). In dementias such as Alzheimer’s and frontotemporal dementia, more tau is made, eventually accumulating in the cell body and dendrites. Here, it forms large deposits known as ‘neurofibrillary tangles’ – clumps that build up and gradually interfere with the neuron’s function and eventually kill it.
Though autopsy studies show that most people develop some plaques and tangles as they age, those with Alzheimer’s tend to develop far more and in a predictable pattern, beginning in the areas important for memory before spreading to other regions.
Scientists do not know exactly what role plaques and tangles play in Alzheimer's disease. Most experts believe they somehow play a critical role in blocking communication among nerve cells and disrupting processes that cells need to survive.
It's the destruction and death of nerve cells that causes memory failure, personality changes, problems carrying out daily activities and other symptoms of Alzheimer's disease.
Reversible causes
There are four main causes of easily reversible dementia: hypothyroidism, vitamin B12 deficiency, Lyme disease, and neurosyphillis. All people with memory difficulty should be checked for hypothyroidism and B12 deficiency. For Lyme disease and neurosyphilis, testing should be done if there are risk factors for those diseases in the person. Because risk factors are often difficult to determine, testing for neurosyphillis and Lyme disease as well as the other mentioned factors may be undertaken as a matter of course in cases where dementia is suspected.
Alzheimer’s treatment
Dementia was reclassified as a neurocognitive disorder, with various degrees of severity. Diagnosis is usually based on history of the illness and cognitive testing with medical imaging and blood tests used to rule out other possible causes. The mini mental state examination is one commonly used cognitive test. Efforts to prevent dementia include trying to decrease risk factors such as high blood pressure, smoking, diabetes, and obesity.
disease is a progressive brain disorder that damages and eventually destroys brain cells, leading to memory loss and changes in thinking and other brain functions. It usually develops slowly and gradually gets worse as brain function declines and brain cells eventually wither and die. Ultimately, Alzheimer's is fatal, and currently, there is no cure.
But neuroscience research efforts are under way to develop treatments and ways to prevent the disease. Researchers are also working to develop better ways to care for affected people and better ways to support their families, friends and caregivers.
It’s impossible to diagnose Alzheimer’s with complete accuracy while a person is alive. The diagnosis can only be confirmed when the brain is examined under a microscope during an autopsy. However, specialists are able to make the correct diagnosis up to 90 percent of the time.
In some cases, treating the condition that causes dementia may help. Conditions most likely to respond to treatment include dementia due to:
· drugs
· tumors
· metabolic disorders
· hypoglycemia
In most cases, dementia isn’t reversible. However, many forms are treatable. The right medication can help manage dementia. Treatments for dementia will depend on the cause.
Treatment for vascular dementia will focus on preventing further damage to the brain’s blood vessels and preventing stroke.
No cure for Alzheimer’s is available, but options to help manage symptoms of the disease include:
· medications for behavioral changes, such as antipsychotics
· medications for memory loss, which include cholinesterase inhibitors donepezil (Aricept) and rivastigmine (Exelon) and memantine (Namenda)
· alternative remedies that aim to boost brain function or overall health, such as coconut oilor fish oil
· medications for sleep changes
· medications for depression
A future without Alzheimer's
The race is on. Alzheimer's and related dementias research is a dynamic field and momentum builds each year. In a research study dated July 4, 2018, published in the Science News, raising hope that it could offer a therapy for dementia. Scientists from University of Edinburgh have uncovered a potential approach to treat one of the commonest causes of dementia and stroke in older people. Studies with rats found the treatment can reverse changes in blood vessels in the brain associated with the condition, called cerebral small vessel disease. Treatment also prevents damage to brain cells caused by these blood vessel changes. This research gives hope for future diagnosis and improvement on the dementia syndrome.
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PTSD-Post-Traumatic Stress Disorder- Advanced Overview
By; Dr. Robert Shafie, PhD, MBA
Boston, MA Tuesday April 10, 2018
Most people who experience a traumatic event will have reactions that may include shock, anger, nervousness, fear, and even guilt. These reactions are common, and for most people, they go away over time. This could be a car or other serious accident, physical or sexual assault, war or torture, or disasters such as bushfires or floods. As a result, the person experiences feelings of intense fear, helplessness or horror. Symptoms most often begin within three months of the event. In some cases, however, they do not begin until years later. The severity and duration of the illness vary. Some people recover within six months, while others suffer much longer. People who have symptoms for longer than one month and cannot function as well as before the event occurred are diagnosed with PTSD.
Anyone can develop PTSD at any age. This include, children, and people who have been through a physical or sexual assault, abuse, accident, disaster, or many other serious events. Women are more likely to develop PTSD than men, and genes may make some people more likely to develop PTSD than others.
Many people with PTSD experience memory difficulties. They may have difficulty recalling certain parts of their traumatic event. Alternatively, some memories may be vivid and always present for these individuals. People with PTSD may also have problems overcoming their fear response to thoughts, memories or situations that are reminiscent of their traumatic event. Due to the hippocampus' role in memory and emotional experience, it is thought that some of the problems people with PTSD experience may lie in the hippocampus.
It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally.
Symptoms
PTSD may have roots in our biology as well as in experience and individual aspects of perception, cognition, temperament, and resilience. Psychotherapy, like trauma therapy and exposure therapy, and medication, help treat flashbacks, angry outbursts, physical distress, avoidance behaviors, and other signs of the disorder.
Re-experiencing symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms. Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating, bad dreams and frightening thoughts. Symptoms could be categorized as follows:
Arousal and reactivity symptoms include: Being easily startled, Feeling tense or “on edge”, having difficulty sleeping, having angry outbursts.
Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.
Avoidance symptoms include: Staying away from places, events, or objects that are reminders of the traumatic experience, avoiding thoughts or feelings related to the traumatic event.
Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.
Cognition and mood symptoms include: Trouble remembering key features of the traumatic even negative thoughts about oneself or the world, distorted feelings like guilt or blame, loss of interest in enjoyable activities. These symptoms can make the person feel alienated or detached from friends or family members.
Symptoms with children and teens: Children and teens can have extreme reactions to trauma, but their symptoms may not be the same as adults. In very young children (less than 6 years of age), these symptoms can include:
Wetting the bed after having learned to use the toilet
Forgetting how to or being unable to talk
Acting out the scary event during playtime
Being unusually clingy with a parent or other adult
Children age 7 to 11 may also act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
Children age 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior like substance abuse or running away.
Risk Factors and Resilience Factors for PTS:
Living through dangerous events and traumas
Getting hurt
Seeing another person hurt, or seeing a dead body
Childhood trauma
Feeling horror, helplessness, or extreme fear
Having little or no social support after the event
Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
Having a history of mental illness or substance abuse
Being able to act and respond effectively despite feeling fear
Treatments
There are two main types of treatment, psychotherapy (sometimes called counseling or talk therapy) and medication. Sometimes people combine psychotherapy and medication.
Psychotherapy
Psychotherapy for PTSD involves helping the person learn skills to manage symptoms and develop ways of coping. Therapy also aims to teach the person and his or her family about the disorder, and help the person work through the fears associated with the traumatic event. A variety of psychotherapy approaches are used to treat people with PTSD, including: Cognitive behavioral therapy which involves learning to recognize and change thought patterns that lead to troublesome emotions, feelings, and behavior.
Psychotherapy (sometimes called “talk therapy”) involves talking with a mental health professional to treat a mental illness. Psychotherapy can occur one-on-one or in a group. Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but it can last longer. Research shows that support from family and friends can be an important part of recovery.
Cognitive behavioral therapy (CBT) is the most widely-used therapy for anxiety disorders. Research has shown it to be effective in the treatment of panic disorder, phobias, social anxiety disorder, and generalized anxiety disorder, among many other conditions.
CBT addresses negative patterns and distortions in the way we look at the world and ourselves. As the name suggests, this involves two main components:
Cognitive therapy: examines how negative thoughts, or cognitions, contribute to anxiety.
Behavior therapy: examines how you behave and react in situations that trigger anxiety.
The basic premise of CBT is that our thoughts—not external events—affect the way we feel. In other words, it is not the situation you are in that determines how you feel, but your perception of the situation. For example, imagine that you’ve just been invited to a big party. Consider three different ways of thinking about the invitation, and how those thoughts would affect your emotions.
Cognitive Restructuring Theory (CRT) this helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about something that is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.
Prolonged Exposure (PE) where you talk about your trauma repeatedly until memories are no longer upsetting. This will help you get more control over your thoughts and feelings about the trauma. You also go to places or do things that are safe, but that you have been staying away from because they remind you of the trauma.
Exposure Therapy, this helps people face and control their fear. It gradually exposes them to the trauma they experienced in a safe way. It uses imagining, writing, or visiting the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings.
Eye Movement Desensitization and Reprocessing (EMDR) which involves focusing on sounds or hand movements while you talk about the trauma. This helps your brain work through the traumatic memories.
Generally, it is best to start with psychological treatment rather than use medication as the first and only solution to the problem. The main treatments for people with PTSD are medications, psychotherapy (“talk” therapy), or both. Everyone is different, and PTSD affects people differently so a treatment that works for one person may not work for another.
Medications
The most studied medications for treating PTSD include antidepressants, which may help control PTSD symptoms such as sadness, anxiety, anger, and feeling numb inside, including selective serotonion reuptake inhibitors (SSRIs)such as Paxil, Celexa, Luvox, Prozac, and Zoloft, and Tryciclic antidepressants such as Elavil and Dexopin. Mood stabilizers such as Depakote and Lamictal and atypical antipsychotics such as Seroquel and Abilify are sometimes used. Certain blood pressure medications are also sometimes used to control particular symptoms. For example, Prazosin may be used for nightmares, or propranolol may be used to help minimize the formation of traumatic memories.
Self treatment:
Engage in mild physical activity or exercise to help reduce stress
Set realistic goals for yourself
Break up large tasks into small ones, set some priorities, and do what you can as you can
Try to spend time with other people, and confide in a trusted friend or relative. Tell others about things that may trigger symptoms.
Expect your symptoms to improve gradually, not immediately
Identify and seek out comforting situations, places, and people
PTSD future Research
In the last decade, progress in research on the mental and biological foundations of PTSD has lead scientists to focus on better understanding the underlying causes of why people experience a range of reactions to trauma.
Research is looking at how fear memories are affected by learning, changes in the body, or even sleep. Research on preventing the development of PTSD soon after trauma exposure is also under way.
Still other research is attempting to identify what factors determine whether someone with PTSD will respond well to one type of intervention or another, aiming to develop more personalized, effective, and efficient treatments.
As gene research and brain imaging technologies continue to improve, scientists are more likely to be able to pinpoint when and where in the brain PTSD begins. This understanding may then lead to better targeted treatments to suit each person’s own needs or even prevent the disorder before it causes harm.
References:
-American Journal of psychology
-Journal of Psycho pharmacy
-Journal of Traumatic Stress
-National Cambridge Survey Replication
-Biological Psychiatry
-Annual Review of Psychology
-National Institute of Mental Health
-US Department of Health and Human Services
How to overcome depression
By: Dr. Robert Shafie, PhD, MBA
Depression
Depression is a common disorder and serious case that negatively affects how you feel, the way you think, and how you act. It could be the result of a disappointment emanating from a personal, social, family (The death of a loved one, loss of a job or the ending of a relationship), physical, biological, business, financial or mental abnormality. While we all feel sad, moody or low from time to time, some people experience these feelings intensely, for long periods of time (weeks, months or even years) and sometimes, without any apparent reason that make life more difficult. Depression can affect anyone—even a person who appears to live in relatively ideal circumstances.
Several factors can play a role in depression:
Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
Genetics: Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of 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 more likely to experience depression.
Environmental factors: Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.
Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home. Symptoms must last at least two weeks for a diagnosis of depression. Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can mimic symptoms of depression so it is important to rule out general medical causes
.Depression symptoms can vary from mild to severe and include:
Feeling sad or having a depressed mood
Loss of interest or pleasure in activities once enjoyed
Changes in appetite — weight loss or gain unrelated to dieting
Trouble sleeping or sleeping too much
Loss of energy or increased fatigue
Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)
Feeling worthless or guilty
Difficulty thinking, concentrating or making decisions
Thoughts of death or suicide
Depression can strike at any time, but on average, first appears during the late teens to mid 20. Women are more likely than men to experience depression. Some studies show that one-third of women will experience a major depressive episode in their lifetime.
Depression doesn’t discriminate who it affects by age, gender, race, career, relationship status, or whether a person is rich or poor. It can affect anyone at any point in their life, including children and adolescents (although in teens and children, it can sometimes be seen more as irritability than a sad mood).
Like most mental disorders, researchers still don’t know what exactly causes this condition. But a combination of factors is likely to blame, including: genetics, neurobiological makeup, gut bacteria, family history, personality and psychological factors, environment, and social factors in growing up.
Some people who develop a mental illness may recover completely; others may have repeated episodes of illness with relatively stable periods in between. Still others live with symptoms of mental illness every day. They can be moderate or serious and cause severe disability.
Through research, we know that mental disorders are brain disorders. Evidence shows that they can be related to changes in the anatomy, physiology, and chemistry of the nervous system. When the brain cannot effectively coordinate the billions of cells in the body, the results can affect many aspects of life.
Scientists are continually learning more about how the brain grows and works in healthy people, and how normal brain development and function can go awry, leading to mental illnesses.Major depression is now believed to be caused by abnormalities in immune cells of the brain. New research may be set to revolutionize next-generation psychiatric medication treatment, according to researchers.
Stress, Depression and Brain Structure
Depression often follows stressful experiences. The brain interprets events and decides if they are threatening, then controls the behavioral and physiological responses to those events. The brain’s reaction to stress is useful in that it supplies extra energy to help a person act on or flee from dangerous situations. Sometimes, however, brain chemical levels that increase during stressful situations stay at high levels and cause problems such as depression.
There is increasing evidence that stress and the resulting depression may involve structural changes in the brain. The good news is that these changes, known as remodeling, can be prevented and potentially reversed with the right treatment, such as antidepressant and mood-stabilizing medications. Brain imaging studies have shown that brain areas involved in mood, memory and decision making may change in size and function in response to depressive episodes.
Three brain structures the hippocampus, amygdala and prefrontal cortex help the brain determine what is stressful and how to respond. The hippocampus stores memories of events and responds to stress hormones in the blood. Many mental disorders, including depression, may cause it to shrink or weaken. The prefrontal cortex, a key structure in emotional regulation, decision-making and memory, may also shrink with depression. The amygdala, where emotional memories are stored, becomes more active in depressive illness and post-traumatic stress disorder. Repeated stress may enlarge the amygdala.
Depression Treatment.
Can depression actually be successfully treated? The short answer is yes. According to the National Institute of Mental Health and countless research studies over the past decades, clinical depression is readily treated with modern antidepressant medications and short-term, goal-oriented psychotherapy. For most people, a combination of the two works best and is usually what is recommended. Psychotherapy approaches scientifically proven to work with depression include cognitive-behavioral therapy (CBT), interpersonal therapy, and psychodynamic therapy.
Medication: Brain chemistry may contribute to an individual’s depression and may factor into their treatment. For this reason, antidepressants might be prescribed to help modify one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers. They are not habit-forming. Generally antidepressant medications have no stimulating effect on people not experiencing depression.
Psychotherapy: Psychotherapy, or “talk therapy,” is sometimes used alone for treatment of mild depression; for moderate to severe depression, psychotherapy is often used in along with antidepressant medications. Cognitive behavioral therapy (CBT) has been found to be effective in treating depression. CBT is a form of therapy focused on the present and problem solving. CBT helps a person to recognize distorted thinking and then change behaviors and thinking.
Electroconvulsive Therapy (ECT) is a medical treatment most commonly used for patients with severe major depression or bipolar disorder who have not responded to other treatments. It involves a brief electrical stimulation of the brain while the patient is under anesthesia. A patient typically receives ECT two to three times a week for a total of six to 12 treatments.
Self-help and Coping
There are a number of things people can do to help reduce the symptoms of depression. For many people, regular exercise helps create positive feeling and improve mood. Active social life, joining sports clubs, reading, meditation, drawing, and fishing, getting enough quality sleep on a regular basis, eating a healthy diet and avoiding alcohol (a depressant) can also help reduce symptoms of depression.
References
Alfred E. Mirsky Professor, Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology at the Rockefeller University Member, DBSA Scientific Advisory Board (SAB)
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.
Kessler, RC, et al. Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in McEwen, B.S. Mood disorders and allostatic load. Biol. Psychiat. 54, 200207 (2003).
The National Comorbidity Survey Replication. Arch Gen Psychiatry.
National Institute of Mental Health. (Data from 2013 National Survey on Drug Use and Health.)
Raz Yirmiya, Neta Rimmerman, Ronen Reshef. Depression as a Microglial Disease. Trends in Neurosciences, 2015; 38 (10): 637
Fibromyalgia
Common fibromyalgia Tender Points:
Back of the neck: If you have fibromyalgia, you may have tender points at the back of the neck, where the base of the skull and the neck meet. Neck pain can also be caused by injuries, rheumatoid arthritis, or activities that strain the neck, like slouching or sleeping in an uncomfortable position.
Elbows: Fibromyalgia patients may also feel tenderness on their forearms, near the crease of each elbow. The pain tends to be below the crease and toward the outer side of the arm.
Front of the neck: This pair of trigger points is located well above the collarbone, on either side of the larynx.
Hips: Hip pain is common in those with osteoarthritis, but people with arthritis tend to feel it in the joint. In contrast, people with fibromyalgia may have a tender point near where the buttock muscles curve to join the thighs.
Lower back: The lower back is one of the most common body parts to be the source of pain. However, people with fibromyalgia may have pain trigger points at the very top of the buttocks, right at the bottom of the lower back.
Knee: While knee trouble is common in people with fibromyalgia, the inside of each knee pad may feel tender to the touch.
Upper back: Tender points are often sites on the body where tendons and muscles meet. Such is the case for this pair of tender points, located where the back muscles connect to the shoulder blades in the upper back.
Shoulders: In addition to tenderness in the upper back, some people with fibromyalgia have tender points just above that, halfway between the edge of the shoulder and the bottom of the neck.
Chest: People with fibromyalgia may have tender points on either side of the sternum, a few inches below the collarbone (near the second rib). The sternum, also known as the breastbone, helps protect the heart and lungs.
Treatment
Although there is currently no cure for fibromyalgia, there are treatments, which may decrease symptoms. There are also strategies and self-help remedies that may reduce symptoms and improve quality of life.
Medications
Pain medication: Over-the-counter pain medication such as acetaminophen may be recommended. The United States Food and Drug Administration (FDA) have also approved a few medications to treat fibromyalgia. Drugs such as milnacipran and duloxetine work by changing brain chemistry so pain levels are controlled. One drug, pregabalin, blocks nerve cells involved in the transmission of pain.
Sleep medications: Various over-the-counter and prescription medications may be recommended to treat sleeping problems that are associated with fibromyalgia.
Antidepressants: In some cases, antidepressants may help decrease anxiety, depression, and sleep problems caused by fibromyalgia.
Self-help tips and home remedies
In addition to medication, complementary treatments may help some people with fibromyalgia. For example, massage therapy, acupuncture, and yoga can be helpful in managing symptoms. There is also a range of things a person with fibromyalgia can do at home to manage their symptoms. These include:
Developing a sleep schedule and practice good sleep habits: Going to bed at the same time each night and waking at the same time in the morning are helpful in developing a sleep pattern. Avoiding caffeine close to bedtime is also recommended.
Finding time to relax: It is useful to find ways to relax and unwind each day. Deep breathing, meditation, or yoga can be beneficial. Relaxing can improve mood, decrease fatigue, and may reduce pain. Relaxing and unwinding, including yoga and meditation, may help to reduce pain and improve mood.
Energy: Regular exercise will also help you sleep. You might try a simple nightly soak in the tub to help you relax and temporarily ease pain. During the day, plan your work and social events so you don't overdo it. Break down big tasks into manageable bites. Build in short rest periods between activities.
Stress Relief: Worry, anxiety, and feeling overwhelmed will drain your energy, too. Try to adopt a more "go with the flow" rather than "crisis" approach to life, set priorities, and remember it's OK to say "no" so you can focus on what's important. With guided imagery, you replace negative or stressful feelings with pleasant images. Once you learn how, you can do it on your own. Mindfulness meditation teaches you to focus your thoughts in a positive way. The more you practice it, the more pain relief it can bring. Other helpful approaches include cognitive behavioral therapy and biofeedback
Diet: Focus on nutrient-rich foods to have more energy and to avoid other health problems. Use your diary to see if any foods make you feel better, and keep drinking water and eat a lot of greens.
People with fibromyalgia tend to have low levels of vitamin D. That could worsen pain and other symptoms. A blood test can tell if you're short on D. You might consult your physician.
People with fibromyalgia tend to have low levels of vitamin D. That could worsen pain and other symptoms. A blood test can tell if you're short on D. You might consult your physician.
Avoid caffeine: While it may make you feel more alert, it can also put you on edge and make it harder to sleep. Drinking 4 or more cups of a caffeinated beverage a day has been linked with more fibro pain.
Exercise: According to the National Fibromyalgia Association, exercise is usually recommended for people who have the condition. Forms of aerobic exercise, such as walking, swimming, and biking may improve symptoms.
References:
American College of Rheumatology. May 2015. Archived from the original on 17 March 2016. Retrieved 16 March 2016.
Buskila D, Cohen H (October 2007). "Comorbidity of fibromyalgia and psychiatric disorders". Curr Pain Headache Rep. 11 (5): 333–8.
Clauw, Daniel J. (16 April 2014). "Questions and Answers about Fibromyalgia". NIAMS. July 2014. Archived from the original on 15 March 2016.
Ferri, Fred F. (2010). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders (2nd ed.). Philadelphia, PA: Elsevier/Mosby. p.
Fibromyalgia.
Fibromyalgia is a chronic disorder characterized by widespread musculoskeletal aches and pain accompanied by fatigue, sleep, memory and mood issues. primarily of the muscles, tendons, and connective tissue. It is sometimes referred to as muscular rheumatism or rheumatic syndrome. Unlike some types of arthritis and rheumatic conditions, fibromyalgia is not associated with joint damage or joint deformity
Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event. Researchers believe repeated nerve stimulation causes the brains of people with fibromyalgia to change. This change involves an abnormal increase in levels of certain chemicals in the brain that signal pain (neurotransmitters). In addition, the brain's pain receptors seem to develop a sort of memory of the pain and become more sensitive, meaning they can overreact to pain signals.
Common symptoms include:
Cognitive and memory problems (sometimes called "fibro fog")
Trouble sleeping
Morning stiffness
Headaches
Irritable bowel syndrome
Painful menstrual periods
Numbness or tingling of hands and feet
Restless legs Syndrome
Temperature sensitivity
Sensitivity to loud noises or bright lights
Depression and Anxiety
The following are also possible:
problems with vision, nausea, weight gain, dizziness, cold or flu-like symptoms, skin problems, chest symptoms, breathing problems Symptoms can appear at any time during a person's life, but they are most commonly reported around the age of 45 years.
Is Fibromyalgia acute or chronic?
Acute pain comes on suddenly and can be severe. For instance, think about how suddenly your back can ache after you've bent down to lift a heavy package or a child. Yet, in more than 80% of cases, acute pain goes away in about two weeks. It runs its course and disappears as the problem is relieved. If your pain from a strained muscle lasts only a few days or weeks, it is considered acute.
Chronic pain is pain that lasts much longer than someone would normally expect based on the original problem or injury. When pain becomes chronic, our bodies react in several ways. Chronic pain may be associated with abnormalities in brain hormones, low energy, mood disorders , muscle pain, and impaired mental and physical performance. As neurochemical changes in your body increase your sensitivity to pain, the chronic pain worsens. You begin to have pain in other parts of the body that do not normally hurt.
There are over 20 different kinds of nerve endings in your skin that tell you if among other sensations something is hot, cold, or painful. These nerve endings convert mechanical, thermal, or chemical energy into electrical signals that convey information to the brain and spinal cord -- also known as the central nervous system or CNS. These signals travel to areas of your CNS where you perceive the stimuli as the sensations you actually feel -- sensations such as searing, burning, pounding, or throbbing.
Research suggests that the pain associated with fibromyalgia is caused by a "glitch" in the way the body processes pain. This glitch results in a hypersensitivity to stimuli that normally are not painful. According to the National Institute of Artheritas and Musculoskeletal and Skin Diseases (NIAMS), research has shown that people with fibromyalgia have reduced blood flow to parts of the brain that normally help the body deal with pain.
Many people experience cognitive dysfunction (known as "fibrofog"), which may be characterized by impaired concentration, problems with short and long-term-memory, short-term memory consolidation, impaired speed of performance, inability to multi-task, cognitive overload, and diminished attention spam . Fibromyalgia is often associated with anxiety and depressive symptoms.
The constant pain causes more irritation and difficulty dealing with others, including family members, friends, and people at work. For women with fibromyalgia who must take care of family members and work full-time, coping with pain is a challenge. If there is undiagnosed pain and no effective treatment or medication for the fibromyalgia, the overwhelming feelings can lead to irritability, exhaustion, anxiety, social isolation, and depression. Fibromyalgia is not a life-threatening condition, but it can interfere with a person's ability to function normally. Employment, family, and social life can be greatly impacted. Overall quality of life can be decreased.
Recent research is showing that living with fibromyalgia pain is not a viable option. In fact, it is now known that living with fibromyalgia causes significant changes in the brain. A group of researchers compared brain images of 10 women with fibromyalgia to 10 women without fibromyalgia. Results showed that there was a significantly lower amount of gray matter in the brain in women with fibromyalgia. Gray matter plays an integral role in the central nervous system. Although gray matter loss naturally occurs with age, it appears to occur three times faster.
The cause of fibromyalgia is unknown; however, it is believed to involve a combination of genetic and environmental factors with half the risk attributed to each. The condition runs in families and many genes are believed to be involved. Environmental factors may include psychological stress, and trauma, and certain infections. The pain appears to result from processes in the central nervous system and the condition is referred to as a "central sensitization syndrome". Fibromyalgia is recognized as a disorder by the US National Institute of Health and the American College of Rheumatology. There is no specific diagnostic test. Diagnosis involves first ruling out other potential causes and verifying that a set number of symptoms are present.
Tender points are localized areas of tenderness typically above muscles, tendons or bones-- that hurt when pressed. Tender points are not areas of deep pain. Instead, they are superficial areas seemingly under the surface of the skin, such as over the elbow or shoulder. People with fibromyalgia often have 11 or more out of a possible 18 tender Points.
Addiction is your shadow
Yes, it is your shadow, your Lord and your nightmare. Addiction, or substance abuse, is a desire to engage in short-term urge for enjoyment, that threatens long-term goals. It is a bad habit encoded in your brain to become part of your neurotransmitters; it is the master of your disaster. It sticks to you to become your twin personality. Even if you quit, it does not mean that you are safe and drug free; unless, you maintain a plan to destroy this evil or abnormal episode. Look at you, you have lost trust in yourself, you have lost your natural desire, you are the slave of your habits. The physiology (Function) and anatomy (Structure) of your brain will not be the same anymore. You become confused and alert. You get reacted and agitated to every single incident, you lose your temper and you become Mr. bright right and you are never wrong. You become bipolar, depressed borderline and even schizophrenic. The addiction nightmare follows your steps to become the master of your disasters; unless, you seek for help.
The recent surge of opioid addiction and deaths from overdose is a global crisis. The consequences of addiction are numerous; it results in myriad health problems, harms and disrupts families and other relationships, and can leave individuals isolated, depressed and even suicidal. Addictions can lead to vulnerability to comorbid disorders; simultaneously, comorbid disorders can sometimes lead to addictions, making treatment of either condition particularly complex. Individuals with an addiction often deny the extent of the problem and resist treatment altogether. Despite all of these difficulties, countless people confront and overcome their addictions every year, often with the help of healthcare professionals and formal treatment programs.
This article explores the process of addiction – how, when and why it starts, what are its signs and symptoms, how the brain absorbs it, how it influences our cognitive and body behavior, how it affects our relationships and family, how it changes our routine and daily life activities and finally what are the procedures to put an end to this phenomenon. Addiction starts with one simple act and continues to unlimited loss of control of both your body and your mind.
For many years researchers believed that only alcohol and powerful drugs could cause addiction. However, recent studies in Neuroimaging technologies have shown that certain pleasurable activities, such as gambling, shopping, and sex, can also co-opt the brain. Drug addiction does not happen to everyone and it does not always happen intentionally. A person who craves a drug and continues to use it despite the negative effects is addicted. Addiction is a complicated case. And so, the process of gateway drugs cannot easily be resolved.
Addiction, or substance abuse, is a chronic brain disease which causes a person to compulsively seek out a certain habit despite its positive or negative influence on our cognitive behavior. However, repeated use of any abusive habit causes the brain to change its natural role and function, and would end up in catastrophic results including psychological, social and environmental negative effects such as stealing, losing friends, family problems, or other physical or brain moods. These brain moods include alterations in cortical (pre-frontal cortex) and sub-cortical (limbic system) regions involving the neuro-circuitry of reward, motivation, memory, impulse control and reasoning.
Many people have never experienced addiction of any sort. For those people it can be very hard to understand and grasp the logic behind drug abuse. But with drug use getting more and more prevalent, it’s now common for people to dig deeper and look for the reasons why people use drugs and alcohol. This is not meant to be a complete list, nor is meant to be medical advise, but I feel this article can shed some light for addicts or family members of addicts dealing with this burning question…Again, we don’t really know what causes addiction. Addiction is a complex disease that affects the physical brain, the psychological mind, and the spiritual self.
Sources of Addiction:
1. Biology (nature) – Addiction is in the genes. Genetics make some people more vulnerable to addiction than others.
2. Environment (nurture) – A person’s environment greatly affects whether or not s/he uses or abuses substances or behaviors.
Factors influence substance use, including:
• attitudes and beliefs
• family (quality of parenting)
• friends (peer pressure)
• personality traits or characteristics
• physical abuse
• quality of life
• school factors
• sexual abuse
• socioeconomic status
• stress
• mental health
Early use: Although taking drugs at any age can lead to addiction, research shows that the earlier a person begins to use drugs, the more likely they are to progress to more serious use. This may reflect the harmful effect that drugs can have on the developing brain. It also may be the result of early biological and social factors, such as genetics, mental illness, unstable family relationships, and exposure to physical or sexual abuse. Still, the fact remains that early use is a strong indicator of problems ahead—among them, substance abuse and addiction.
"Addictions," says Joseph Frascella, director of the division of clinical neuroscience at the National Institute on Drug Abuse (NIDA), "are repetitive behaviors in the face of negative consequences, the desire to continue something you know is bad for you." And yet, says Dr. Nora Volkow, director of NIDA and a pioneer in the use of imaging to understand addiction, "the use of drugs has been recorded since the beginning of civilization. Humans in my view will always want to experiment with things to make them feel good." That's because drugs of abuse co-opt the very brain functions that allowed our distant ancestors to survive in a hostile world. Our minds are programmed to pay extra attention to what neurologists call salience--that is, special relevance.
All addictions, whether related to substances or to behaviors, involve both physical and psychological processes. Each person’s experience of addiction is slightly different, but usually involves a cluster of some of the below signs and symptoms of addiction.
Signs and Symptoms
A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, sleepiness may be a symptom while dilated pupils may be a sign. So if you are concerned that someone else may have an addiction, look for signs as well as for symptoms.
Behavioral
The most common behavioral addictions include:
• Computer — for example, internet, video games, social networking sites, cybersex or online gambling
• Eating — for example, overeating, bingeing or purging
• Exercise — for example, weight loss or sports
• Gambling — for example, VLTs, casinos or slot machines • Gaming — for example, computer games
• Sex — for example, porn, cybersex or multiple partners
• Shopping — for example, spending or stealing
• Work — for example, overwork, money or power
• Secretiveness
• Lying
• Stealing
• Financially unpredictable, perhaps having large amounts of cash at times but no money at all at other times
• Changes in social groups, new and unusual friends, odd phone conversations
• Repeated unexplained outings, often with a sense of urgency
• Drug paraphernalia such as unusual pipes, cigarette papers, small weighing scales, etc.
• “Stashes” of drugs, often in small plastic, paper or foil packages
• Tolerance, which is the need to engage in the addictive behavior more and more to get the desired effect
• Withdrawal happens when the person does not take the substance or engage in the activity, and they experience unpleasant symptoms, which are often the opposite of the effects of the addictive behavior
• Difficulty cutting down or controlling the addictive behavior
• Social, occupational or recreational activities becoming more focused on the addiction, and important social and occupational roles being jeopardized
• The person becoming preoccupied with the addiction, spending a lot of time on planning, engaging in, and recovering from the addictive behavior
• Extreme mood changes — happy, sad, excited, anxious, etc
• Sleeping a lot more or less than usual, or at different times of the day or night
• Changes in energy — unexpectedly and extremely tired or energetic
• Weight loss or weight gain
• Unexpected and persistent coughs or sniffles
• Seeming unwell at certain times and better at other times
• Pupils of the eyes seeming smaller or larger than usual
Use of Substance The most common substance addictions include:
• Alcohol — for example, wine, beer or liquor
• Amphetamine or similarly acting sympathomimetics — for example, speed or crystal meth
• Benzodiazepines —– for example, Xanax, Valium or Klonopin
• Caffeine — for example, coffee, tea or sports drinks
• Cannabis — for example, marijuana, grass or hash
• Cocaine — for example, coke or crack • Hallucinogens — for example, acid or ecstasy
• Inhalants — for example, poppers or aerosols
• Nicotine — for example, cigarettes, cigars or nicotine patches
• Opioids — for example, heroin, morphine or painkillers
• Phencyclidine (PCP) or similarly acting agents — for example, angel dust or ketamine
• Sedatives, hypnotics, for example, sleeping pills or downers
The Brain
Is a complex communications network of 100 billion neurons, or nerve cells, it is just 3 pounds of gray-and-white matter that rests in your skull and its role is to maintain “mission control.” Networks of neurons pass messages back and forth thousands of times a minute within the brain, spinal cord, and nerves. These nerve networks control everything we feel, think, and do. Understanding these networks help in understanding how drugs affect the brain. Our brain allows us to think, breathe, move, speak, and feel. Information from your environment—both outside (like what your eyes see and skin feels) and inside (like your heart rate and body temperature)—makes its way to the brain, which receives, processes, and integrates it so that you can survive and function under all sorts of changing circumstances. When drugs enter the brain, they interfere with its normal processing and can eventually lead to changes in how well it works.
Drugs are chemicals and affect three primary areas of the brain: The brain stem, the limbic system and the cerebral cortex. When someone puts these chemicals into their body, either by smoking, injecting, inhaling, or eating them, they tap into the brain’s communication system and tamper with the way nerve cells normally send, receive, and process information. Different drugs—because of their chemical structures—work differently. We know there are at least two ways drugs work in the brain:
1- Imitating the brain’s natural chemical messengers
2- Over-stimulating the “reward circuit” of the brain
People are motivated by pleasure. While what brings about pleasure can differ from one person to another (sports, sex, music, art, nature, etc.), how the human brain processes pleasurable sensations is universal. When people do something that makes them feel good, their brain releases dopamine to teach them to seek out this activity in the future for that good feeling to be repeated. The human brain stores these memories. The feeling is connected with what activated it. In a healthy brain, dopamine is eventually reabsorbed. Dopamine levels return to normal. The euphoric feeling fades away, but the brain files the association away for future reference.
When a person takes drugs, the chemical functioning of the brain is altered. One of those changes is that the brain is made to produce more dopamine than it would for a non-drug-related reason. Re-absorption of the dopamine is blocked. There’s a prolonged sense of pleasure beyond what’s normal for the brain. The sensations are so powerful and long-lasting than the brain urges the user to find more of what did it. Normal activities – once enjoyed – now fade in value to the user. Drugs become the only well of contentment. Eventually, the body and mind become so hooked on the drug of choice that to not take it again causes uncomfortable – possibly painful – withdrawal symptoms. It is at that point that a diagnosis of addiction is certain. Desire turns to craving, and living without drugs becomes unimaginable
Although we know what happens to the brain when someone becomes addicted, we can’t predict how many times a person must use a drug before becoming addicted.
Factors related to taking drugs can lead to:
Loss of Interest and Apathy: Someone who is normally quite active and involved in a number of things can lose interest. Hobbies, talents, and skills that the individual normally enjoys, they will no longer seem interested in.
Physical Signs – Noticeable: When an individual uses drugs, there are a number of noticeable physical signs that can be picked up on. Blood Shot (red) eyes, dilated pupils, sniffling, itching, injection marks, puffy face, unusual skin color are all noticeable signs of use and abuse.
Change in Physical Appearance: The clothes they wear. An addict can experience rapid weight loss or gain.
Discovering Drug Paraphernalia: Cigarette wrapping papers, pipes, syringes, lighters, burnt spoons, bongs (glass or pottery made items used for smoking marijuana), razor blades, and cutting surfaces (like mirrors or glass) are all common types of paraphernalia that can be discovered.
Rapid Mood Swings: When determining rapid mood swings you must take into consideration what is normal for the individual. Someone who is usually calm and collected can be ultra-hyper and out of control. Someone who is usually pleasant and upbeat can be miserably depressed.
Reclusive and Private Behavior: The behavior of substance use is very isolating. The person can have all the appearance of hiding something, or being very private in their actions. Does the person spend a lot of time in their room? Do they lock their room on leaving and entering? These are indicators that they may be hiding something, possibly substance abuse.
Rapid Change in What is Considered “Normal” For the individual: Cutting out on work, school, and home life are indicators of a change in routine. This can stem from the behavior that is developed through a period of substance use. The things that are considered “normal” daily activities take a back seat to the constant need to obtain and use drugs of abuse.
Erratic Behaviors: They are behaviors that are not typical of the person. These behaviors can become dangerous situations. This is typical with violent behaviors caused by withdrawal. Some behaviors are magnified by substance use.
Sleep Habits: If the person is keeping off hours, staying up late, or overly sleeping, these are possible indicators. With some stimulants, the person must stay up for lengthy amounts of time to maintain the high. This also can result in a crash and excessive sleep.
Health - addiction to a substance, be it a drug, narcotic or nicotine usually has health consequences. In the case of drug/alcohol addiction there may be mental/emotional as well as physical health problems. In the case of nicotine addiction the problems tend to be just with physical health.
Coma, unconsciousness or death - some drugs, taken in high doses or together with other substances may be extremely dangerous. Some diseases - people who inject drugs have a risk of developing HIV/AIDS or hepatitis if they share needles.
Some substances, including specific drugs or alcohol can lead towards more risky sexual behavior (unprotected sex), increasing the probability of developing sexually transmitted diseases.
Accidental injuries/death - people with a drug/alcohol addiction have a higher risk of falling over, or driving dangerously when under the influence.
Suicide - the risk of suicide is significantly higher for a person who is addicted to a drug/alcohol, compared with non-addicted individuals. This is not the case with nicotine dependence.
Relationship problems - social, family and marital relationships can be severely strained, leading to family breakups, etc.
Child neglect/abuse - the percentage of neglected or abused children who have one or both parents with an addiction problem is higher compared to those whose parents are healthy. These figures apply to some drugs and alcohol, not to just nicotine dependence.
Unemployment, poverty and homelessness - a significant number of drug/alcohol addicts find themselves without work or anywhere to live.
Problems with the law - if the substance is expensive, the addicted individual may resort to crime in order to secure his/her supply, making it more likely there will be problems with police, including imprisonment.
Treatment
The main aim is usually to get the addictive substance out of the patient’s body as quickly as possible. Sometimes the addict is given gradually reduced dosages (tapering). In some cases a substitute substance is given. Depending on what the person is addicted to, as well as some other factors, the doctor may recommend treatment either as an outpatient or inpatient. The doctor or addiction expert may recommend either an outpatient or inpatient residential treatment center.
Withdrawal treatment options vary and depend mainly on what substance the individual is addicted to: Treatment will vary for each person, depending on the type of drugs used and the person’s specific circumstances. Generally, there are two types of treatment for drug addiction:
1-Behavioral treatment
In which people learn to change their behavior. There are many forms of evidence-based behavioral treatments for substance abuse. Some of the most strongly supported include:
Cognitive-behavioral therapy. CBT can help addicted patients overcome substance abuse by teaching them to recognize and avoid destructive thoughts and behaviors. A cognitive-behavioral therapist can, for example, teach a patient to recognize the triggers that cause his or her craving for drugs, alcohol or nicotine, then avoid or manage those triggers.
Motivational interviewing. This therapy technique involves structured conversations that help patients increase their motivation to overcome substance abuse by, for example, helping them recognize the difference between how they are living right now and how they wish to live in the future.
Contingency management. These behavioral treatments can sometimes be particularly effective when combined with pharmaceutical treatments that either mimic the effects of the drug in a controlled way (such as methadone and Buprenorphine for opiate addiction or nicotine chewing gum for cigarette addiction) or reduce or eliminate the "high" the user gets from the drug (such as Naltrexone for opiate or alcohol addiction).
Treatment programs – in an individual or group setting, these are educational and Therapeutic seminars on getting sober and staying sober.
Counseling – in an individual or group setting, counseling helps you cope with your addiction and overcome it, and may also include life counseling to identify any reasons why a person is addicted and how to improve his or her life.
Self-help groups: Alcoholics Anonymous and Narcotics Anonymous are two examples; these emphasize that constant treatment is necessary to quit the drug.
Detoxification: helps you to quit the drug quickly; reducing the dosage of the drug or administering other chemicals that produce similar effects to the drug with less extreme side effects.
2-Medical treatment Addiction to depressants -
these may include dependence on barbiturates or benzodiazepines. During withdrawal the patient may experience anxiety, insomnia, sweating and restlessness. In rare cases there may be whole-body tremors, seizures, hallucinations, hypertension (high blood pressure), accelerated heart rate and fever. In severe cases there may be delirium, which according to the Mayo Clinic, USA, could be life-threatening.
Addiction to stimulants - these may include cocaine and other amphetamines. During withdrawal the patient may experience tiredness, depression, anxiety, moodiness, low enthusiasm, sleep disturbances, and low concentration. Treatment focuses on providing support, unless the depression is severe, in which case a medication may be prescribed.
Addiction to Opioids – Opioids are a class of drugs that are commonly prescribed for their analgesic, or pain-killing, properties. They include substances such as morphine, codeine, Oxycodone, and methadone. Opioids may be more easily recognized by drug names such as Kadian, Avinza, OxyContin, Percodan, Darvon, Demerol, Vicodin, Percocet, and Lomotil. During withdrawal there may be sweating, anxiety and stuffy nose – symptoms tend to be mild. In rare cases there may be serious sleeping problems, tachycardia, hypertension and diarrhea. The doctor may prescribe methadone, or buprenorphine for cravings (alternative substances). Length of Treatment. Drug addiction typically is a long-lasting disorder.
Most people who have become addicted to drugs need long term treatment and, many times, repeated treatments—much like a person and needs to constantly watch changes in medication and exercise. The important point is that even when someone relapses and begins abusing drugs again, they should not give up hope. Rather, they need to go back to treatment or change their current treatment.
References
American Psychiatric Association. “Diagnostic and Statistical Manual of Mental Disorders” (4th Edition – Text Revision), Washington DC,
American Psychiatric Association. 1994.
Elizabeth Hartney, PhD Signs and Symptoms of Addiction. December 18, 2017
Joseph Frascella, director of the division of clinical neuroscience at the National Institute on Drug Abuse.
Marks, Isaac. “Behavioural (Non-Chemical) Addictions.” British Journal of Addiction 1990 85:1389-1394. 24 Jul. 2008.
Massachusetts General Hospital, Harvard Medical School, Recovery Research Institute.
Nora Volkow, director of NIDA Institute on Drug Abuse (NIDA).
Orford, Jim. “Excessive Appetites: A Psychological View of Addictions” (2nd Edition Wiley, Chicester, 2001. Society for the Advancement of Sexual Health. “Sexual Addiction.” March 28, 2014