Schizophrenia---world schizophrenia day..

Schizophrenia: Signs, Types & Causes

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

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
   

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 thought	Sleep-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

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.

Can’t Sleep---insomnia..part 1

Can’t Sleep?

Causes of insomnia.....

Do you struggle to get to sleep no matter how tired you are? Or do you wake up in the middle of the night and lie awake for hours, anxiously watching the clock? Insomnia is a common problem that takes a toll on your energy, mood, health, and ability to function during the day. Chronic insomnia can even contribute to serious health problems. Simple changes to your lifestyle and daily habits can put a stop to sleepless nights.

Can’t sleep? Understanding insomnia and its symptoms

Although insomnia is the most common sleep complaint, it is not a single sleep disorder. It’s more accurate to think of insomnia as a symptom of another problem, which differs from person to person. It could be something as simple as drinking too much caffeine during the day or a more complex issue like an underlying medical condition or feeling overloaded with responsibilities.Insomnia is the inability to get the amount of sleep you need to wake up feeling rested and refreshed. Because different people need different amounts of sleep, insomnia is defined by the quality of your sleep and how you feel after sleeping—not the number of hours you sleep or how quickly you doze off. Even if you’re spending eight hours a night in bed, if you feel drowsy and fatigued during the day, you may be experiencing insomnia.

The good news is that most cases of insomnia can be cured with changes you can make on your own—without relying on sleep specialists or turning to prescription or over-the-counter sleeping pills.

Symptoms of insomnia:

Difficulty falling asleep despite being tired Waking up frequently during the night Trouble getting back to sleep when awakened Exhausting sleep

Relying on sleeping pills or alcohol to fall asleep Waking up too early in the morning Daytime drowsiness, fatigue, or irritability Difficulty concentrating during the day

Causes of insomnia: Figuring out why you can’t sleep

In order to properly treat and cure your insomnia, you need to become a sleep detective. Emotional issues such as stress, anxiety, and depression cause half of all insomnia cases. But your daytime habits, sleep routine, and physical health may also play a role. Try to identify all possible causes of your insomnia. Once you figure out the root cause, you can tailor treatment accordingly.

• Are you under a lot of stress?
• Are you depressed or feel emotionally flat or hopeless?
• Do you struggle with chronic feelings of anxiety or worry?
• Have you recently gone through a traumatic experience?
• Are you taking any medications that might be affecting your sleep?
• Do you have any health problems that may be interfering with sleep?
• Is your sleep environment quiet and comfortable?
• Are you spending enough time in sunlight during the day and in darkness at night?
• Do you try to go to bed and get up around the same time every day?

Common mental and physical causes of insomnia:

Sometimes, insomnia only lasts a few days and goes away on its own, especially when the insomnia is tied to an obvious temporary cause, such as stress over an upcoming presentation, a painful breakup, or jet lag. Other times, insomnia is stubbornly persistent. Chronic insomnia is usually tied to an underlying mental or physical issue.

• Psychological problems that can cause insomnia: depression, anxiety, chronic stress, bipolar disorder, post-traumatic stress disorder. 
• Medications that can cause insomnia: antidepressants; cold and flu medications that contain alcohol; pain relievers that contain caffeine (Midol, Excedrin); diuretics, corticosteroids, thyroid hormone, high blood pressure medications.
• Medical problems that can cause insomnia: asthma, allergies, Parkinson’s disease, hyperthyroidism, acid reflux, kidney disease, cancer, chronic pain.
• Sleep disorders that can cause insomnia: sleep apnea, narcolepsy, restless legs syndrome.

Anxiety and depression: Two of the most common causes of chronic insomnia

Most people suffering from an anxiety disorder or depression have trouble sleeping. What’s more, the sleep deprivation can make the symptoms of anxiety or depression worse. Treating the underlying psychological issue is the key to curing insomnia

                           Emotional Eating

                 How to Recognize and Stop Emotional Eating

 

We don’t always eat simply to satisfy hunger. We also turn to food for comfort, stress relief, or as a reward. Unfortunately, emotional eating doesn’t fix emotional problems. It usually makes you feel worse. Afterward, not only does the original emotional issue remain, but you also feel guilty for overeating. Learning to recognize your emotional eating triggers is the first step to breaking free from food cravings and compulsive overeating, and changing the habits that have sabotaged your diets in the past.

If you’ve ever make room for dessert even though you’re already full or dove into a pint of ice cream when you’re feeling down, you’ve experienced emotional eating. Emotional eating is using food to make yourself feel better—eating to fill emotional needs, rather than to fill your stomach.

Using food from time to time as a pick me up, a reward, or to celebrate isn’t necessarily a bad thing. But when eating is your primary emotional coping mechanism—when your first impulse is to open the refrigerator whenever you’re upset, angry, lonely, stressed, exhausted, or bored—you get stuck in an unhealthy cycle where the real feeling or problem is never addressed.

Emotional hunger can’t be filled with food. Eating may feel good in the moment, but the feelings that triggered the eating are still there. And you often feel worse than you did before because of the unnecessary calories you consumed. You beat yourself for messing up and not having more willpower. Compounding the problem, you stop learning healthier ways to deal with your emotions, you have a harder and harder time controlling your weight, and you feel increasingly powerless over both food and your feelings.

Are you an emotional eater?

• Do you eat more when you’re feeling stressed?
• Do you eat when you’re not hungry or when you’re full?
• Do you eat to feel better (to calm and soothe yourself when you’re sad, mad, bored, anxious, etc.)?
• Do you reward yourself with food?
• Do you regularly eat until you’ve stuffed yourself?
• Does food make you feel safe? Do you feel like food is a friend?
• Do you feel powerless or out of control around food?

The difference between emotional hunger and physical hunger

Before you can break free from the cycle of emotional eating, you first need to learn how to distinguish between emotional and physical hunger. This can be trickier than it sounds, especially if you regularly use food to deal with your feelings.

Emotional hunger can be powerful. As a result, it’s easy to mistake it for physical hunger. But there are clues you can look for that can help you tell physical and emotional hunger apart.

• Emotional hunger comes on suddenly. It hits you in an instant and feels overwhelming and urgent. Physical hunger, on the other hand, comes on more gradually. The urge to eat doesn’t feel as dire or demand instant satisfaction (unless you haven’t eaten for a very long time).
• Emotional hunger craves specific comfort foods. When you’re physically hungry, almost anything sounds good—including healthy stuff like vegetables. But emotional hunger craves fatty foods or sugary snacks that provide an instant rush. You feel like you need cheesecake or pizza, and nothing else will do.
• Emotional hunger often leads to mindless eating. Before you know it, you’ve eaten a whole bag of chips or an entire pint of ice cream without really paying attention or fully enjoying it. When you’re eating in response to physical hunger, you’re typically more aware of what you’re doing.
• Emotional hunger isn’t satisfied once you’re full. You keep wanting more and more, often eating until you’re uncomfortably stuffed. Physical hunger, on the other hand, doesn't need to be stuffed. You feel satisfied when your stomach is full.
• Emotional hunger isn’t located in the stomach. Rather than a growling belly or a pang in your stomach, you feel your hunger as a craving you can’t get out of your head. You’re focused on specific textures, tastes, and smells.
• Emotional hunger often leads to regret, guilt, or shame. When you eat to satisfy physical hunger, you’re unlikely to feel guilty or ashamed because you’re simply giving your body what it needs. If you feel guilty after you eat, it's likely because you know deep down that you’re not eating for nutritional reasons.

Emotional hunger vs. Physical hunger
Emotional hunger comes on suddenly.	Physical hunger comes on gradually.
Emotional hunger feels like it needs to be satisfied instantly.	Physical hunger can wait.
Emotional hunger craves specific comfort foods.	Physical hunger is open to options–lots of things sound good.
Emotional hunger isn't satisfied with a full stomach.	Physical hunger stops when you're full.
Emotional eating triggers feelings of guilt, powerlessness, and shame.	Eating to satisfy physical hunger doesn't make you feel bad about yourself.

Stop emotional eating tip 1: Identify your triggers

People eat for many different reasons. The first step in putting a stop to emotional eating is identifying your personal triggers. What situations, places, or feelings make you reach for the comfort of food?

Keep in mind that while most emotional eating is linked to unpleasant feelings, it can also be triggered by positive emotions, such as rewarding yourself for achieving a goal or celebrating a holiday or happy event.

Common causes of emotional eating

• Stress – Ever notice how stress makes you hungry? It’s not just in your mind. When stress is chronic, as it so often is in our chaotic, fast-paced world, it leads to high levels of the stress hormone, cortisol. Cortisol triggers cravings for salty, sweet, and high-fat foods—foods that give you a burst of energy and pleasure. The more uncontrolled stress in your life, the more likely you are to turn to food for emotional relief.
• Stuffing emotions – Eating can be a way to temporarily silence or “stuff down” uncomfortable emotions, including anger, fear, sadness, anxiety, loneliness, resentment, and shame. While you’re numbing yourself with food, you can avoid the emotions you’d rather not feel.
• Boredom or feelings of emptiness – Do you ever eat simply to give yourself something to do, to relieve boredom, or as a way to fill a void in your life? You feel unfulfilled and empty, and food is a way to occupy your mouth and your time. In the moment, it fills you up and distracts you from underlying feelings of purposelessness and dissatisfaction with your life.
• Childhood habits – Think back to your childhood memories of food. Did your parents reward good behavior with ice cream, take you out for pizza when you got a good report card, or serve you sweets when you were feeling sad? These emotionally-based childhood eating habits often carry over into adulthood. Or perhaps some of your eating is driven by nostalgia—for cherishes memories of grilling burgers in the backyard with your dad, baking and eating cookies with your mom, or gathering around the table with your extended family for a home-cooked pasta dinner.
• Social influences – Getting together with other people for a meal is a great way to relieve stress, but it can also lead to overeating. It’s easy to overindulge simply because the food is there or because everyone else is eating. You may also overeat in social situations out of nervousness. Or perhaps your family or circle of friends encourages you to overeat, and it’s easier to go along with the group.

Keep an emotional eating diary

You probably recognized yourself in at least a few of the previous descriptions. But even so, you’ll want to get even more specific. One of the best ways to identify the patterns behind your emotional eating is to keep track with a food and mood diary.

Every time you overeat or feel compelled to reach for your version of comfort food Kryptonite, take a moment to figure out what triggered the urge. If you backtrack, you’ll usually find an upsetting event that kicked of the emotional eating cycle. Write it all down in your food and mood diary: what you ate (or wanted to eat), what happened to upset you, how you felt before you ate, what you felt as you were eating, and how you felt afterward.

Over time, you’ll see a pattern emerge. Maybe you always end up gorging yourself after spending time with a critical friend. Or perhaps you stress eat whenever you’re on a deadline or when you attend family functions. Once you identify your emotional eating triggers, the next step is identifying healthier ways to feed your feelings.

Stop emotional eating tip 2: Find other ways to feed your feelings

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If you don’t know how to manage your emotions in a way that doesn’t involve food, you won’t be able to control your eating habits for very long. Diets so often fail because they offer logical nutritional advice, as if the only thing keeping you from eating right is knowledge. But that kind of advice only works if you have conscious control over your eating habits. It doesn’t work when emotions hijack the process, demanding an immediate payoff with food.

In order to stop emotional eating, you have to find other ways to fulfill yourself emotionally. It’s not enough to understand the cycle of emotional eating or even to understand your triggers, although that’s a huge first step. You need alternatives to food that you can turn to for emotional fulfillment.

Alternatives to emotional eating

• If you’re depressed or lonely, call someone who always makes you feel better, play with your dog or cat, or look at a favorite photo or cherished memento.
• If you’re anxious, expend your nervous energy by dancing to your favorite song, squeezing a stress ball, or taking a brisk walk.
• If you’re exhausted, treat yourself with a hot cup of tea, take a bath, light some scented candles, or wrap yourself in a warm blanket.
• If you’re bored, read a good book, watch a comedy show, explore the outdoors, or turn to an activity you enjoy (woodworking, playing the guitar, shooting hoops, scrapbooking, etc.).

Stop emotional eating tip 3: Pause when cravings hit

Most emotional eaters feel powerless over their food cravings. When the urge to eat hits, it’s all you can think about. You feel an almost unbearable tension that demands to be fed, right now! Because you’ve tried to resist in the past and failed, you believe that your willpower just isn’t up to snuff. But the truth is that you have more power over your cravings than you think.

Take 5 before you give in to a craving

As mentioned earlier, emotional eating tends to be automatic and virtually mindless. Before you even realize what you’re doing, you’ve reached for a tub of ice cream and polished off half of it. But if you can take a moment to pause and reflect when you’re hit with a craving, you give yourself the opportunity to make a different decision.

All you have to do is put off eating for five minutes, or if five minutes seems unmanageable, start with one minute. Don’t tell yourself you can’t give in to the craving; remember, the forbidden is extremely tempting. Just tell yourself to wait. While you’re waiting, check in with yourself. How are you feeling? What’s going on emotionally? Even if you end up eating, you’ll have a better understanding of why you did it. This can help you set yourself up for a different response next time.

Learn to accept your feelings—even the bad ones

While it may seem that the core problem is that you’re powerless over food, emotional eating actually stems from feeling powerless over your emotions. You don’t feel capable of dealing with your feelings head on, so you avoid them with food.

Allowing yourself to feel uncomfortable emotions can be scary. You may fear that, like Pandora’s box, once you open the door you won’t be able to shut it. But the truth is that when we don’t obsess over or suppress our emotions, even the most painful and difficult feelings subside relatively quickly and lose their power to control our attention. To do this you need to become mindful and learn how to stay connected to your moment-to-moment emotional experience. This can enable you to rein in stress and repair emotional problems that often trigger emotional eating.

What’s more, your life will be richer when you open yourself up emotionally. Our feelings are a window into our interior world. They help us understand and discover our deepest desires and fears, our current frustrations, and the things that will make us happy.

Stop emotional eating tip 4: Support yourself with healthy lifestyle habits

When you’re physically strong, relaxed, and well rested, you’re better able to handle the curveballs that life inevitably throws your way. But when you’re already exhausted and overwhelmed, any little hiccup has the potential to send you off the rails and straight toward the refrigerator. Exercise, sleep, and other healthy lifestyle habits will help you get through difficult times without emotional eating.

• Make daily exercise a priority. Physical activity does wonders for your mood and your energy levels, and it’s also a powerful stress reducer.
• Make time for relaxation. Give yourself permission to take at least 30 minutes every day to relax, decompress, and unwind. This is your time to take a break from your responsibilities and recharge your batteries.
• Connect with others. Don’t underestimate the importance of close relationships and social activities. Spending time with positive people who enhance your life will help protect you from the negative effects of stress
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