Monday, 14 July 2014

Gambling Addiction & Problem Gambling part 2

Gambling Addiction & Problem 


Dealing with gambling cravings

Feeling the urge to gamble is normal, but that doesn’t make it any easier when you are struggling to make better choices. Remember, as you build healthier choices and a good support network, resisting cravings will be easier and easier. The following strategies can help
  • Reach out for support. Call a trusted family member, meet a friend for coffee, or go to a Gamblers Anonymous meeting.
  • Do something else. Distract yourself with another activity, such as cleaning your house, going to the gym, or watching a movie.
  • Postpone gambling. Tell yourself that you’ll wait five minutes, fifteen minutes, or an hour — however long you think you can hold out. As you wait, the urge to gamble may pass or become weak enough to resist.
  • Give yourself a reality check. Visualize what will happen if you give in to the urge to gamble. Think about how you’ll feel after all your money is gone and you’ve disappointed yourself and your family again.
  • Avoid Isolation. If you gamble to socialize or be around other people, try healthier ways to build a social network. Volunteer, connect with old friends, make new friends.
If you aren’t able to resist the gambling craving, don’t be too hard on yourself or use it as an excuse to give up. Overcoming a gambling addiction is a tough process. You may slip from time to time; the important thing is to learn from your mistakes and continue working towards recovery.

Helping a family member with a gambling problem

Does my loved one have a gambling problem?

If your loved one has a gambling problem, he or she might:
  • Become increasingly defensive about his or her gambling. The more a problem gambler is in the hole, the more the need to defend gambling as a way to get money. Your loved one may get secretive, defensive or even blame you for the need to gamble, telling you that it is all for you and you need to trust in the “big win someday.”
  • Suddenly become secretive over money and finances. Your loved one might show a new desire to control household finances, or there might increasingly be a lack of money despite the same income and expenses. Savings and assets might mysteriously dwindle, or there may be unexplained loans or cash advances.
  • Become increasingly desperate for money to fund the gambling. Credit card bills may increase, or your loved one may ask friends and family for money. Jewelry or other items easily pawned for money may mysteriously disappear. 

How to help with a gambling problem

Compulsive and problem gamblers often need the support of their family and friends to help them in their struggle to stop gambling. But the decision to quit has to be theirs. As much as you may want to, and as hard as it is seeing the effects, you cannot make someone stop gambling.
If your family member has a gambling problem, you may have many conflicting emotions. You may try to cover up for a loved one or spend a lot of time and energy trying to keep him or her from gambling. At the same time, you might be furious at your loved one for gambling again and tired of trying to keep up the charade. The gambler may also have borrowed (or even stolen) money from you with no way to pay it back. He or she may have sold family possessions or run up huge debts on joint credit cards. When faced with the consequences of their actions, a gambler can suffer a crushing drop in self-esteem. This is one reason why there is a high rate of suicide among problem gamblers.

Tools for family members of problem gamblers:

  • Start by helping yourself. You have a right to protect yourself emotionally and financially. Don’t blame yourself for the gambler’s problems. The right support can help you make positive choices for yourself, and balance encouraging your loved one to get help without losing yourself in the process.
  • Don’t go it alone. It can feel so overwhelming coping with a loved one’s problem gambling that it may seem easier to rationalize their requests and problems “this one last time”. Or you might feel ashamed, feeling like you are the only one who has problems like this. Reaching out for support will make you realize that many families have struggled with this problem. Or you might consider therapy to help sort out the complicated feelings that arise from coping with a problem gambler.
  • Set boundaries in managing money. If a loved one is serious about getting help for problem gambling, it may help if you take over the family finances to make sure the gambler stays accountable and to prevent relapse. However, this does not mean you are responsible for micromanaging the problem gamblers impulses to gamble. Your first responsibilities are to ensure that your own finances and credit are not at risk.
  • Consider how you will handle requests for money. Problem gamblers often become very good at asking for money, either directly or indirectly. They may use pleading, manipulation or even threats and blaming to get it. It takes time and practice to learn how you will respond to these requests to ensure you are not enabling the problem gambler and keeping your own dignity intact.

Do’s and Don'ts for Partners of Problem Gamblers

Do
  • Seek the support of others with similar problems; attend a self-help group for families such as Gam-Anon.
  • Explain problem gambling to the children.
  • Recognize your partner’s good qualities.
  • Remain calm when speaking to your partner about his or her gambling and its consequences.
  • Let your partner know that you are seeking help for your own sake because of the way gambling affects you and the children.
  • Understand the need for treatment of problem gambling despite the time it may involve.
  • Take control of family finances; review bank and credit card statements.
Don’t
  • Preach, lecture, or allow yourself to lose control of your anger.
  • Make threats or issue ultimatums unless you intend to carry them out.
  • Exclude the gambler from family life and activities.
  • Expect immediate recovery, or that all problems will be resolved when the gambling stops.
  • Bail out the gambler.
  • Cover-up or deny the existence of the problem to yourself, the family, or others.
Source: Dept. of Mental Health & Addiction Services

Wednesday, 2 July 2014

Gambling Addiction & Problem Gambling part 1

Gambling Addiction & Problem Gambling

Warning Signs and How to Get Help



Addictive Gambling: Signs, Symptoms and Treatment


Whether you bet on sports, scratch cards, roulette, poker, or slots—in a casino or online—problem gambling can strain relationships, interfere with work, and lead to financial catastrophe. You may even do things you never thought you would, like stealing money to gamble or pay your debts. You may think you can’t stop but, with the right help, you can overcome a gambling problem or addiction and regain control of your life. The first step is recognizing and acknowledging the problem.

                               

Understanding gambling addiction and problem gambling

Gambling addiction, also known as compulsive gambling, is a type of impulse-control disorder. Compulsive gamblers can’t control the impulse to gamble, even when they know their gambling is hurting themselves or their loved ones. Gambling is all they can think about and all they want to do, no matter the consequences. Compulsive gamblers keep gambling whether they’re up or down, broke or flush, happy or depressed. Even when they know the odds are against them, even when they can’t afford to lose, people with a gambling addiction can’t “stay off the bet.”
Gamblers can have a problem, however, without being totally out of control. Problem gambling is any gambling behavior that disrupts your life. If you’re preoccupied with gambling, spending more and more time and money on it, chasing losses, or gambling despite serious consequences, you have a gambling problem.

Myths & Facts about Gambling Addiction and Problem Gambling

MYTH: You have to gamble every day to be a problem gambler.

FACT: A problem gambler may gamble frequently or infrequently. Gambling is a problem if it causes problems.
MYTH: Problem gambling is not really a problem if the gambler can afford it.

FACT: Problems caused by excessive gambling are not just financial. Too much time spent on gambling can lead to relationship breakdown and loss of important friendships.
MYTH: Partners of problem gamblers often drive problem gamblers to gamble.

FACT: Problem gamblers often rationalize their behavior. Blaming others is one way to avoid taking responsibility for their actions, including what is needed to overcome the problem.
MYTH: If a problem gambler builds up a debt, you should help them take care of it.

FACT: Quick fix solutions may appear to be the right thing to do. However, bailing the gambler out of debt may actually make matters worse by enabling gambling problems to continue.

Relieving unpleasant and overwhelming feelings without gambling

Unpleasant feelings such as stress, depression, loneliness, fear, and anxiety can trigger compulsive gambling or make it worse. After a stressful day at work, after an argument with your spouse or coworker, or to avoid more time spent on your own, an evening at the track or the casino can seem like a fun, exciting way to unwind and socialize. But there are healthier and far less expensive ways to keep unpleasant feelings in check. These may include exercising, meditating, spending time with friends, taking up new hobbies, or exploring relaxation techniques.
For many people, an important aspect of quitting gambling is to find alternate ways to handle these difficult feelings without gambling.  Even when gambling is no longer a part of your life, the painful and unpleasant feelings that may have prompted you to gamble in the past will still remain. So, it’s worth spending some time thinking about the different ways you intend to deal with stressful situations and the daily irritations that would normally trigger you to start gambling.

Signs and symptoms of problem gambling

Gambling addiction is sometimes referred to as the "hidden illness" because there are no obvious physical signs or symptoms like there are in drug or alcohol addiction. Problem gamblers typically deny or minimize the problem. They also go to great lengths to hide their gambling. For example, problem gamblers often withdraw from their loved ones, sneak around, and lie about where they’ve been and what they’ve been up to.

Do I have a gambling problem?

You may have a gambling problem if you:
  • Feel the need to be secretive about your gambling. You might gamble in secret or lie about how much you gamble, feeling others won’t understand or that you will surprise them with a big win.
  • Have trouble controlling your gambling. Once you start gambling, can you walk away? Or are you compelled to gamble until you’ve spent your last dollar, upping your bets in a bid to win lost money back?
  • Gamble even when you don’t have the money. A red flag is when you are getting more and more desperate to recoup your losses. You may gamble until you’ve spent your last dollar, and then move on to money you don’t have- money to pay bills, credit cards, or things for your children. You may feel pushed to borrow, sell, or even steal things for gambling money. It’s a vicious cycle. You may sincerely believe that gambling more money is the only way to win lost money back. But it only puts you further and further in the hole.
  • Family and friends are worried about you. Denial keeps problem gambling going. If friends and family are worried, listen to them carefully. Take a hard look at how gambling is affecting your life. It’s not a sign of weakness to ask for help. Many older gamblers are reluctant to reach out to their adult children if they've gambled away their inheritance. But it's never too late to make changes for the better.

Treatment for problem gambling

Every gambler is unique and so needs a recovery program tailored specifically to him or her. What works for one gambler won’t necessarily work for you. The biggest step in treatment is realizing you have a problem with gambling. It takes tremendous strength and courage to own up to this, especially if you have lost a lot of money and strained or broken relationships along the way. Don’t despair, and don’t try to go it alone. Many others have been in your shoes and have been able to break the habit.
Overcoming a gambling addiction or problem is never easy. But recovery is possible if you stick with treatment and seek support. To find help in your area, see Resources and References below.

Group support for gambling addiction and problem gambling

Gamblers Anonymous is a twelve-step recovery program patterned after Alcoholics Anonymous. A key part of a 12-step program is choosing a sponsor. A sponsor is a former gambler who has time and experience remaining free from addiction, and can often provide invaluable guidance and support.

Therapy for problem gambling

Cognitive-behavioral therapy for problem gambling focuses on changing unhealthy gambling behaviors and thoughts, such as rationalizations and false beliefs. It also teaches problem gamblers how to fight gambling urges, deal with uncomfortable emotions rather than escape through gambling, and solve financial, work, and relationship problems caused by the addiction.
The goal of treatment is to “rewire” the addicted brain by thinking about gambling in a new way. A variation of cognitive behavioral therapy, called the Four Steps Program, has been used in treatment of compulsive gambling as well. The goal is to change your thoughts and beliefs about gambling in four steps; re-label, reattribute, refocus, and revalue. More comprehensive information about cognitive behavioral therapy and applying it to your situation is found below.
Seeing a therapist does not mean you are weak or can’t handle your problems. Therapy is for people who are smart enough to realize they need help. It can give you tools and support for reframing your thoughts that will last a lifetime.

Maintaining recovery for problem gambling and gambling addiction

As you may have noticed, quitting problem gambling is relatively easy. It’s staying in recovery- making a permanent commitment to stay away from gambling- that is such a challenge. Maintaining recovery for problem gambling and gambling addiction  is possible if you surround yourself with people to whom you’re accountable, avoid tempting environments, give up control of your finances (at least at first), and find exciting or enjoyable activities to replace gambling.

Changing your lifestyle and making healthier choices

One way to stop yourself from problem gambling is to analyze what is needed for gambling to occur, work on removing these elements from your life and replace them with healthier choices. The four elements needed for problem gambling to continue are:
  • A decision: Before gambling occurs, the decision to gamble has been made. If you have an urge to gamble: stop what you are doing and call someone, think about the consequences to your actions, tell yourself to stop thinking about gambling, and find something else to do immediately.
  • Money: Gambling cannot occur without money. Get rid of your credit cards, let someone else be in charge of your money, have the bank make automatic payments for you, and keep a limited amount of cash on you at all times.
  • Time: Gambling cannot occur if you don’t have the time. Schedule enjoyable recreational time for yourself that has nothing to do with gambling, find time for relaxation, and plan outings with your family.
  • A game: Without a game or activity to bet on there is no opportunity to gamble. Don’t put yourself in tempting environments or locations. Tell the gambling establishments you frequent that you have a gambling problem and ask them to restrict you from betting at their casinos and establishments. Block online gambling sites on your computer.
Maintaining recovery from problem gambling or gambling addiction depends a lot on the reasons why you were gambling in the first place. Once you’ve quit gambling, reasons such as depression, loneliness, or boredom will remain, so in order to maintain your recovery, you’ll need to address these problems. There are alternative behaviors you can substitute for gambling. Some examples include:
Reason for GamblingSample Substitute Behaviors
To provide excitement, get a rush of adrenaline
Sport or a challenging hobby, such as mountain biking, rock climbing, or Go Kart racing
To be more social, overcome shyness or isolation
Counseling, enroll in a public speaking class, join a social group, connect with family and friends, volunteer, find new friends
To numb unpleasant feelings, not think about problems
Therapy, consult Helpguide’s Bring Your Life into Balance toolkit
Boredom or loneliness
Find something you’re passionate about such as art, music, sports, or books then find others with the same interests
To relax after a stressful day
As little as 15 minutes of daily exercise can relieve stress.  Or deep breathing, meditation, or massage
To solve money problems
  • The odds are always stacked against you so it’s far better to seek help with debts from a credit counselor 

Friday, 23 May 2014

HALLUCINATIONS---------just for fun have a look at this video

A hallucination is something that someone experiences which is not really there. 

Probably the best way to describe a hallucination is that it is like dreaming while you are awake. Not daydreaming, which comes from conscious thoughts, but the things contained in your sub-conscious which are projected from your mind and appear to blend in with the real world. Hallucinations can be quite deceiving (especially if it is a mix of a visual images, sound and even the sensation of touch) and, like dreams, sometimes you know it’s not real but other times you are unsure. Also like dreams, hallucinating can warp or distort your thinking, causing you to know things you shouldn’t and to completely forget things that are common sense, obvious and every day practice. 

There are five different types of hallucination: 
* visual (seeing things) 
* auditory (hearing things) 
* olfactory (smelling things) 
* gustatory (tasting things) 
* tactile (feeling things) 
Often, two or more of these will be mixed together at the same time...


just for fun have a look at this video--  (video from you tube)


Wednesday, 21 May 2014

Schizophrenia---world schizophrenia day..

Schizophrenia: Signs, Types & Causes

Understand the Symptoms, Types, Causes, and Early Warning Signs of Schizophrenia

Schizophrenia: Signs, Symptoms, Causes & Treatment
Schizophrenia is a challenging disorder that makes it difficult to distinguish between what is real and unreal, think clearly, manage emotions, relate to others, and function normally. But that doesn't mean there isn't hope. Schizophrenia can be successfully managed. The first step is to identify the signs and symptoms. The second step is to seek help without delay and the third is to stick with the treatment. With the right treatment and support, a person with schizophrenia can lead a happy, fulfilling life.


What is schizophrenia?


Most cases of schizophrenia appear in the late teens or early adulthood. However, schizophrenia can appear for the first time in middle age or even later. In rare cases, schizophrenia can even affect young children and adolescents, although the symptoms are slightly different. In general, the earlier schizophrenia develops, the more severe it is. Schizophrenia also tends to be more severe in men than in women.Schizophrenia is a brain disorder that affects the way a person acts, thinks, and sees the world. People with schizophrenia have an altered perception of reality, often a significant loss of contact with reality. They may see or hear things that don’t exist, speak in strange or confusing ways, believe that others are trying to harm them, or feel like they’re being constantly watched. With such a blurred line between the real and the imaginary, schizophrenia makes it difficult—even frightening—to negotiate the activities of daily life. In response, people with schizophrenia may withdraw from the outside world or act out in confusion and fear.
Although schizophrenia is a chronic disorder, there is help available. With support, medication, and therapy, many people with schizophrenia are able to function independently and live satisfying lives. However, the outlook is best when schizophrenia is diagnosed and treated right away. If you spot the signs and symptoms of schizophrenia and seek help without delay, you or your loved one can take advantage of the many treatments available and improve the chances of recovery.

Common misconceptions about schizophrenia

MYTH: Schizophrenia refers to a "split personality" or multiple personalities.
FACT: Multiple personality disorder is a different and much less common disorder than schizophrenia. People with schizophrenia do not have split personalities. Rather, they are “split off” from reality.
MYTH: Schizophrenia is a rare condition.
FACT: Schizophrenia is not rare; the lifetime risk of developing schizophrenia is widely accepted to be around 1 in 100.
MYTH: People with schizophrenia are dangerous.
FACT: Although the delusional thoughts and hallucinations of schizophrenia sometimes lead to violent behavior, most people with schizophrenia are neither violent nor a danger to others.
MYTH: People with schizophrenia can’t be helped.
FACT: While long-term treatment may be required, the outlook for schizophrenia is not hopeless. When treated properly, many people with schizophrenia are able to enjoy life and function within their families and communities.

Early warning signs of schizophrenia

In some people, schizophrenia appears suddenly and without warning. But for most, it comes on slowly, with subtle warning signs and a gradual decline in functioning long before the first severe episode. Many friends and family members of people with schizophrenia report knowing early on that something was wrong with their loved one, they just didn’t know what.
In this early phase, people with schizophrenia often seem eccentric, unmotivated, emotionless, and reclusive. They isolate themselves, start neglecting their appearance, say peculiar things, and show a general indifference to life. They may abandon hobbies and activities, and their performance at work or school deteriorates.

The most common early warning signs of schizophrenia include:

  • Social withdrawal
  • Hostility or suspiciousness
  • Deterioration of personal hygiene
  • Flat, expressionless gaze
  • Inability to cry or express joy
  • Inappropriate laughter or crying
  • Depression
  • Oversleeping or insomnia
  • Odd or irrational statements
  • Forgetful; unable to concentrate
  • Extreme reaction to criticism
  • Strange use of words or way of speaking
While these warning signs can result from a number of problems—not just schizophrenia—they are cause for concern. When out-of-the-ordinary behavior is causing problems in your life or the life of a loved one, seek medical advice. If schizophrenia or another mental problem is the cause, treatment will help.

Daniel’s story

Daniel is 21 years old. Six months ago, he was doing well in college and holding down a part-time job in the stockroom of a local electronics store. But then he began to change, becoming increasingly paranoid and acting out in bizarre ways. First, he became convinced that his professors were “out to get him” since they didn’t appreciate his confusing, off-topic classroom rants. Then he told his roommate that the other students were “in on the conspiracy.” Soon after, he dropped out of school.
From there, things just got worse. Daniel stopped bathing, shaving, and washing his clothes. At work, he became convinced that his boss was watching him through surveillance bugs planted in the store’s television sets. Then he started hearing voices telling him to find the bugs and deactivate them. Things came to a head when he acted on the voices, smashing several TVs and screaming that he wasn’t going to put up with the “illegal spying” any more. His frightened boss called the police, and Daniel was hospitalized.

Signs and symptoms of schizophrenia

There are five types of symptoms characteristic of schizophrenia: delusions, hallucinations, disorganized speech, disorganized behavior, and the so-called “negative” symptoms. However, the signs and symptoms of schizophrenia vary dramatically from person to person, both in pattern and severity. Not every person with schizophrenia will have all symptoms, and the symptoms of schizophrenia may also change over time.

Delusions

A delusion is a firmly-held idea that a person has despite clear and obvious evidence that it isn’t true. Delusions are extremely common in schizophrenia, occurring in more than 90% of those who have the disorder. Often, these delusions involve illogical or bizarre ideas or fantasies. Common schizophrenic delusions include:
  • Delusions of persecution – Belief that others, often a vague “they,” are out to get him or her. These persecutory delusions often involve bizarre ideas and plots (e.g. “Martians are trying to poison me with radioactive particles delivered through my tap water”).
  • Delusions of reference – A neutral environmental event is believed to have a special and personal meaning. For example, a person with schizophrenia might believe a billboard or a person on TV is sending a message meant specifically for them.
  • Delusions of grandeur – Belief that one is a famous or important figure, such as Jesus Christ or Napolean. Alternately, delusions of grandeur may involve the belief that one has unusual powers that no one else has (e.g. the ability to fly).
  • Delusions of control – Belief that one’s thoughts or actions are being controlled by outside, alien forces. Common delusions of control include thought broadcasting (“My private thoughts are being transmitted to others”), thought insertion (“Someone is planting thoughts in my head”), and thought withdrawal (“The CIA is robbing me of my thoughts”).

Hallucinations

Hallucinations are sounds or other sensations experienced as real when they exist only in the person's mind. While hallucinations can involve any of the five senses, auditory hallucinations (e.g. hearing voices or some other sound) are most common in schizophrenia. Visual hallucinations are also relatively common. Research suggests that auditory hallucinations occur when people misinterpret their own inner self-talk as coming from an outside source.
Schizophrenic hallucinations are usually meaningful to the person experiencing them. Many times, the voices are those of someone they know. Most commonly, the voices are critical, vulgar, or abusive. Hallucinations also tend to be worse when the person is alone.

Disorganized speech

Fragmented thinking is characteristic of schizophrenia. Externally, it can be observed in the way a person speaks. People with schizophrenia tend to have trouble concentrating and maintaining a train of thought. They may respond to queries with an unrelated answer, start sentences with one topic and end somewhere completely different, speak incoherently, or say illogical things.
Common signs of disorganized speech in schizophrenia include:
  • Loose associations – Rapidly shifting from topic to topic, with no connection between one thought and the next.
  • Neologisms – Made-up words or phrases that only have meaning to the patient.
  • Perseveration – Repetition of words and statements; saying the same thing over and over.
  • Clang – Meaningless use of rhyming words (“I said the bread and read the shed and fed Ned at the head").

Disorganized behavior

Schizophrenia disrupts goal-directed activity, causing impairments in a person’s ability to take care of him or herself, work, and interact with others. Disorganized behavior appears as:
  • A decline in overall daily functioning
  • Unpredictable or inappropriate emotional responses
  • Behaviors that appear bizarre and have no purpose
  • Lack of inhibition and impulse control

Negative symptoms (absence of normal behaviors)

The so-called “negative” symptoms of schizophrenia refer to the absence of normal behaviors found in healthy individuals. Common negative symptoms of schizophrenia include:
  • Lack of emotional expression – Inexpressive face, including a flat voice, lack of eye contact, and blank or restricted facial expressions.
  • Lack of interest or enthusiasm – Problems with motivation; lack of self-care.
  • Seeming lack of interest in the world – Apparent unawareness of the environment; social withdrawal.
  • Speech difficulties and abnormalities – Inability to carry a conversation; short and sometimes disconnected replies to questions; speaking in monotone.

Causes of schizophrenia

The causes of schizophrenia are not fully known. However, it appears that schizophrenia usually results from a complex interaction between genetic and environmental factors.

Genetic causes of schizophrenia

Schizophrenia has a strong hereditary component. Individuals with a first-degree relative (parent or sibling) who has schizophrenia have a 10 percent chance of developing the disorder, as opposed to the 1 percent chance of the general population.
But schizophrenia is only influenced by genetics, not determined by it. While schizophrenia runs in families, about 60% of schizophrenics have no family members with the disorder. Furthermore, individuals who are genetically predisposed to schizophrenia don’t always develop the disease, which shows that biology is not destiny.

Environmental causes of schizophrenia

Twin and adoption studies suggest that inherited genes make a person vulnerable to schizophrenia and then environmental factors act on this vulnerability to trigger the disorder.
As for the environmental factors involved, more and more research is pointing to stress, either during pregnancy or at a later stage of development. High levels of stress are believed to trigger schizophrenia by increasing the body’s production of the hormone cortisol.
Research points to several stress-inducing environmental factors that may be involved in schizophrenia, including:
  • Prenatal exposure to a viral infection
  • Low oxygen levels during birth (from prolonged labor or premature birth)
  • Exposure to a virus during infancy
  • Early parental loss or separation
  • Physical or sexual abuse in childhood

Abnormal brain structure

In addition to abnormal brain chemistry, abnormalities in brain structure may also play a role in schizophrenia. Enlarged brain ventricles are seen in some schizophrenics, indicating a deficit in the volume of brain tissue. There is also evidence of abnormally low activity in the frontal lobe, the area of the brain responsible for planning, reasoning, and decision-making.
Some studies also suggest that abnormalities in the temporal lobes, hippocampus, and amygdala are connected to schizophrenia’s positive symptoms. But despite the evidence of brain abnormalities, it is highly unlikely that schizophrenia is the result of any one problem in any one region of the brain.

Effects of schizophrenia

When the signs and symptoms of schizophrenia are ignored or improperly treated, the effects can be devastating both to the individual with the disorder and those around him or her.  Some of the possible effects of schizophrenia are:
  • Relationship problems. Relationships suffer because people with schizophrenia often withdraw and isolate themselves. Paranoia can also cause a person with schizophrenia to be suspicious of friends and family.
  • Disruption to normal daily activities. Schizophrenia causes significant disruptions to daily functioning, both because of social difficulties and because everyday tasks become hard, if not impossible to do. A schizophrenic person’s delusions, hallucinations, and disorganized thoughts typically prevent him or her from doing normal things like bathing, eating, or running errands.
  • Alcohol and drug abuse. People with schizophrenia frequently develop problems with alcohol ordrugs, which are often used in an attempt to self-medicate, or relieve symptoms. In addition, they may also be heavy smokers, a complicating situation as cigarette smoke can interfere with the effectiveness of medications prescribed for the disorder.
  • Increased suicide risk. People with schizophrenia have a high risk of attempting suicide. Any suicidal talk, threats, or gestures should be taken very seriously. People with schizophrenia are especially likely to commit suicide during psychotic episodes, during periods of depression, and in the first six months after they’ve started treatment.

Diagnosing schizophrenia

A diagnosis of schizophrenia is made based on a full psychiatric evaluation, medical history, physical exam, and lab tests.
  • Psychiatric evaluation – The doctor or psychiatrist will ask a series of questions about you or your loved one's symptoms, psychiatric history, and family history of mental health problems.
  • Medical history and exam – Your doctor will ask about your personal and family health history. He or she will also perform a complete physical examination to check for medical issues that could be causing or contributing to the problem.
  • Laboratory tests – While there are no laboratory tests that can diagnose schizophrenia, simple blood and urine tests can rule out other medical causes of symptoms. The doctor may also order brain-imaging studies, such as an MRI or a CT scan, in order to look for brain abnormalities associated with schizophrenia.

Mental health professionals use the following criteria to diagnose schizophrenia:

  • The presence of two or more of the following symptoms for at least 30 days:
    1. Hallucinations
    2. Delusions
    3. Disorganized speech
    4. Disorganized or catatonic behavior
    5. Negative symptoms (emotional flatness, apathy, lack of speech)
  • Significant problems functioning at work or school, relating to other people, and taking care of oneself.
  • Continuous signs of schizophrenia for at least 6 months, with active symptoms (hallucinations, delusions, etc.) for at least 1 month.
  • No other mental health disorder, medical issue, or substance abuse problem is causing the symptoms.

Conditions that can look like schizophrenia

The medical and psychological conditions the doctor must rule out before diagnosing schizophrenia include:
  • Other psychotic disorders – Schizophrenia is a type of psychotic disorder, meaning it involves a significant loss of contact with reality. But there are other psychotic disorders that cause similar symptoms of psychosis, including schizoaffective disorder, schizophreniform disorder, and brief psychotic disorder. Because of the difficulty in differentiating between the psychotic disorders, it may take six months or longer to arrive at a correct diagnosis.
  • Substance abuse – Psychotic symptoms can be triggered by many drugs, including alcohol, PCP, heroin, amphetamines, and cocaine. Some over-the-counter and prescription drugs can also trigger psychotic reactions. A toxicology screen can rule out drug-induced psychosis. If substance abuse is involved, the physician will determine whether the drug is the source of the symptoms or merely an aggravating factor.
  • Medical conditions – Schizophrenia-like symptoms can also result from certain neurological disorders (such as epilepsy, brain tumors, and encephalitis), endocrine and metabolic disturbances, and autoimmune conditions involving the central nervous system.
  • Mood disorders – Schizophrenia often involves changes in mood, including mania and depression. While these mood changes are typically less severe than those seen in bipolar disorder and major depressive disorder, they can make diagnosis tricky. Schizophrenia is particularly difficult to distinguish from bipolar disorder. The positive symptoms of schizophrenia (delusions, hallucinations, and disorganized speech) can look like a manic episode of bipolar disorder, while the negative symptoms of schizophrenia (apathy, social withdrawal, and low energy) can look like a depressive episode.
  • Post-traumatic stress disorder (PTSD) – PTSD is an anxiety disorder that can develop after exposure to a traumatic event, such as military combat, an accident, or a violent assault. People with PTSD experience symptoms that are similar to schizophrenia. The images, sounds, and smells of PTSD flashbacks can look like psychotic hallucinations. The PTSD symptoms of emotional numbness and avoidance can look like the negative symptoms of schizophrenia
     

Monday, 21 April 2014

INSOMNIA --PART 2

Insomnia cures and treatments: Changing habits that disrupt sleep

Some of the things you’re doing to cope with insomnia may actually be making the problem worse. For example, if you’re using sleeping pills or alcohol to fall asleep, this will disrupt your sleep even more over the long-term. Or if you drink excessive amounts of coffee during the day, it will be more difficult to fall asleep later. Often, changing the habits that are reinforcing sleeplessness is enough to overcome insomnia altogether. It may take a few days for your body to get used to the change, but once you do, you will sleep better.

Using a sleep diary to identify insomnia-inducing habits

Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia. Maybe your daily Starbucks habit affects your sleep more than you realize. Or maybe you’ve never made the connection between your late-night TV viewing or Internet surfing and your sleep difficulties. Keeping a sleep diary is a helpful way to pinpoint habits and behaviors contributing to your insomnia.
All you have to do is jot down daily details about your daytime habits, sleep routine, and insomnia symptoms. For example, you can keep track of when you go to sleep and when you wake up, where you fall asleep, what you eat and drink, and any stressful events that occur during the day.

Adopting new habits to help you sleep

  • Make sure your bedroom is quiet, dark, and cool. Noise, light, and heat can interfere with sleep. Try using a sound machine or earplugs to hide outside noise, an open window or fan to keep the room cool, and blackout curtains or a sleep mask to block out light.
  • Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends, even if you’re tired. This will help you get back in a regular sleep rhythm.
  • Avoid naps. Napping during the day can make it more difficult to sleep at night. If you feel like you have to take a nap, limit it to 30 minutes before 3 p.m.
  • Avoid stimulating activity and stressful situations before bedtime. This includes vigorous exercise; big discussions or arguments; and TV, computer, or video game use. Instead, focus on quiet, soothing activities, such as reading, knitting, or listening to soft music, while keeping lights low.
  • Don’t read from a backlit device (such as an iPad). If you use an eReader, opt for one that is not backlit, i.e. one that requires an additional light source.
  • Limit caffeine, alcohol, and nicotine. Stop drinking caffeinated beverages at least eight hours before bed. Avoid drinking alcohol in the evening; while alcohol can make you feel sleepy, it interferes with the quality of your sleep. Quit smoking or avoid it at night, as nicotine is a stimulant.

Preparing your brain for sleep

Your brain produces the hormone melatonin to help regulate your sleep-wake cycle. As melatonin is controlled by light exposure, not enough natural light during the day can make your brain feel sleepy, while too much artificial light at night can suppress production of melatonin and make it harder to sleep. To help naturally regulate your sleep-wake cycle and prepare your brain for sleep:
  • Increase light exposure during the day. Take breaks outside in sunlight, remove sunglasses when it’s safe to do so, and open blinds and curtains during the day.
  • Limit artificial light at night. To boost melatonin production, use low-wattage bulbs, cover windows and electrical displays in your bedroom, avoid bright light and turn off television, smartphone, and computer screens at least one hour before bed. If you can’t make your bedroom dark enough, try using a sleep mask.

Coping with shift work

Working nights or irregular shifts can disrupt your sleep schedule. You may be able to limit the adverse impact by practicing the healthy bedtime habits above, and following these tips:
  • Adjust your sleep-wake cycle by exposing yourself to bright light when you wake up at night, use bright lamps or daylight-simulation bulbs in your workplace, and then wear dark glasses on your journey home to block out sunlight and encourage sleepiness.
  • Limit the number of night or irregular shifts you work in a row to prevent sleep deprivation mounting up.
  • Avoid frequently rotating shifts so you can maintain the same sleep schedule.
  • Avoid a long commute that cuts into your sleep time. The more time you spend traveling home in daylight, the more awake you’ll become and the harder you’ll find it is to get to sleep.
  • Eliminate noise and light from your bedroom during the day. Use blackout curtains or a sleep mask, turn off the phone, and use ear plugs or a soothing sound machine to block out daytime noise.

Insomnia cures and treatments: Neutralizing anxiety when you can’t sleep

The more trouble you have with sleep, the more it starts to invade your thoughts. You may dread going to sleep because you just know that you’re going to toss and turn for hours or be up at 2 a.m. again. Or maybe you’re worried because you have a big day tomorrow, and if you don’t get a solid eight hours, you’re sure you’ll blow your presentation. But agonizing and expecting sleep difficulties only makes insomnia worse; worrying floods your body with adrenaline, and before you know it, you’re wide-awake.

Learning to associate your bed with sleeping, not sleeplessness


Use the bedroom only for sleeping and sex.
 Don’t work, watch TV, or use your computer or smartphone. The goal is to associate the bedroom with sleep and sex, so that when you get in bed your brain and body get a strong signal that it’s time to nod off or be romantic.If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to associate the bed with sleep, sex, and nothing else—especially not frustration and anxiety.
  • Get out of bed when you can’t sleep. Don’t try to force yourself to sleep. Tossing and turning only amps up the anxiety. Get up, leave the bedroom, and do something relaxing, such as reading, drinking a warm cup of caffeine-free tea, taking a bath, or listening to soothing music. When you’re sleepy, go back to bed.
  • Move bedroom clocks out of view. Anxiously watching the minutes tick by when you can’t sleep—knowing that you’re going to be exhausted when the alarm goes off—is a surefire recipe for insomnia. You can use an alarm, but make sure you can’t see the time when you’re in bed.
Challenging self-defeating thoughts that fuel insomnia
Self-defeating thoughtSleep-promoting comeback
Unrealistic expectations: I should be able to sleep well every night like a normal person.
Lots of people struggle with sleep from time to time. I will be able to sleep with practice.
Exaggeration: It’s the same every single night, another night of sleepless misery.
Not every night is the same. Some nights I do sleep better than others.
Catastrophizing: If I don’t get some sleep, I’ll tank my presentation and jeopardize my job.
I can get through the presentation even if I’m tired. I can still rest and relax tonight, even if I can’t sleep.
Hopelessness: I’m never going to be able to sleep well. It’s out of my control.
Insomnia can be cured. If I stop worrying so much and focus on positive solutions, I can beat it.
Fortune telling: It’s going to take me at least an hour to get to sleep tonight. I just know it.
I don’t know what will happen tonight. Maybe I’ll get to sleep quickly if I use the strategies I’ve learned.
Remember, replacing self-defeating thoughts takes time and practice. You may find it helpful to jot down your own list, taking note of the negative thoughts that pop up and how you can dispute them.

Insomnia cures and treatments: Harnessing your body’s relaxation response

Relaxation techniques such as deep breathing, meditation, yoga, and tai chi can help quiet your mind and relieve tension. They can also help you fall asleep faster and get back to sleep more quickly if you awaken in the middle of the night. And all without the side effects of sleep medication!

Relaxation techniques that can help you sleep

It takes regular practice to master relaxation techniques but the benefits can be huge. You can do them as part of your bedtime routine, when you are lying down preparing for sleep, and if you wake up in the middle of the night.
  • Abdominal breathing. Most of us don’t breathe as deeply as we should. When we breathe deeply and fully, involving not only the chest, but also the belly, lower back, and ribcage, it can help relaxation. Close your eyes and take deep, slow breaths, making each breath even deeper than the last. Breathe in through your nose and out through your mouth.
  • Progressive muscle relaxation. Lie down or make yourself comfortable. Starting with your feet, tense the muscles as tightly as you can. Hold for a count of 10, and then relax. Continue to do this for every muscle group in your body, working your way up from your feet to the top of your head.


Insomnia cures and treatments: Using supplements and medication wisely

When you’re tossing and turning at night, it can be tempting to turn to sleep aids for relief. However, no sleeping pill will cure the underlying cause of your insomnia, and some can even make the problem worse in the long run. Before taking any sleep aid or medication, talk to your doctor or pharmacist.

Dietary supplements for insomnia

There are many dietary and herbal supplements marketed for their sleep-promoting effects. Some remedies, such as lemon balm or chamomile tea, are generally harmless, while others can have side effects and interfere with other medications.
They don't work for everyone, but two of the most popular supplements are:
  • Melatonin – a naturally occurring hormone that your body produces at night. Evidence suggests that melatonin supplements may be effective for short-term use, especially in preventing or reducing jet-lag. However, there are potential side-effects, including next-day drowsiness.
  • Valerian – an herb with mild sedative effects that may help you sleep better. However, the quality of valerian supplements varies widely.

Over the counter (OTC) sleep aids

The main ingredient in over-the-counter (OTC) sleeping pills is an antihistamine, generally taken for allergies, hay fever and common cold symptoms. OTC sleep aids are meant to be used for short-term insomnia only. Sleep experts generally advise against their use because of side effects, questions about their effectiveness, and lack of information about their safety over the long term.

Prescription sleeping pills for insomnia

While prescription sleep medications can provide temporary relief, it’s best to use medication only as a last resort, and then, only on a very limited, as-needed basis. First, try changing your sleep habits, your daily routine, and your attitudes about sleep. Evidence shows that lifestyle and behavioral changes make the largest and most lasting difference when it comes to insomnia.

When to consider seeking professional insomnia treatment

If you’ve tried the insomnia cures and treatments listed above and are still having trouble getting the sleep you need, a doctor or sleep disorder specialist may be able to help. Seek professional help for insomnia if:
  • Your insomnia doesn’t respond to self-help strategies
  • Your insomnia is causing major problems at home, work, or school
  • You’re experiencing scary symptoms like chest pain or shortness of breath
  • Your insomnia occurs almost every night and is getting worse
Bring a sleep diary with you. Your doctor may be able to diagnose an illness or sleep disorder that's causing your insomnia, or refer you to a sleep specialist or cognitive behavioral therapist.

Cognitive behavioral therapy (CBT) for insomnia

CBT is aimed at breaking the cycle of insomnia. Poor sleep tends to lead to stress and anxious thoughts about not being able to sleep. This in turn leads to stress and tension, which leads to poor sleeping habits, such as the use of sleeping pills or alcohol to sleep or taking daytime naps to make up for lost sleep. This leads to worsening insomnia and so on.
The Vicious Cycle of Insomnia
insomniacycle
As well as improving sleep habits, CBT is aimed at changing thoughts and feelings about sleep that may be causing stress and contributing to your insomnia.
While CBT can be a much safer and more effective insomnia treatment than sleeping pills, it's not an instant remedy but one that requires time and persistence. Your sleep may even get worse at first if your therapist recommends sleep restriction therapy, whereby you initially shorten your sleep time. The idea is that by limiting the time you spend in bed to the number of hours you actually sleep, say from 1 a.m. to 6 a.m., you'll spend less time awake and more time asleep. As your sleep efficiency increases you'll gradually start going to bed earlier and getting up later until you reach your optimum sleep schedule.