Depression and Disorder FAQ
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Depression and Disorder FAQ| frozentears |
Posted: July 30, 2006 05:21 am
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 Administrator  Group: Admin Posts: 56 Member No.: 1 Joined: July 28, 2006  |
Depression
What is depression? Depression is a treatable medical illness marked by changes in mood, thoughts, energy and behavior that affects more than 22 million adult Americans each year. It is the most common serious brain disease in the United States.Depression is more than the inevitable sadness or disappointment that accompanies life's ups and downs. It is a combination of five or more recognizable symptoms that are strikingly distinct from a person's normal range of feelings and behavior. These depressive symptoms persist for more than two weeks and interfere with daily individual and family functioning.Depression involves the whole body but researchers have detected it in the brain through modern imaging techniques. People with depression have an imbalance of certain brain chemicals known as neurotransmitters. This imbalance produces serious and persistent physical symptoms such as changes in sleep, appetite and energy; cognitive losses such as slowed thinking and indecisiveness; and discernible feelings like irritability, hopelessness and guilt. Major depression is characterized by a single depressive episode that may recur during a person's lifetime. Although distressing life events can trigger a depression, not all stressful events lead to depression, nor are all depressive episodes preceded by a stressful event. ----------------------------------------- What Are Common Symptoms of Depression?
----------------------------------------- What Causes Depression?
----------------------------------------- Is There Anything I can Do About My Depression? There are actually a lot of things you can do about depression. The most important thing is that you do something positive and constructive. You might start by getting yourself some paper and a pen and make headings for all the factors previously described: Environmental, Interpersonal, Physical/Medical, etc. Make a list of any problems, concerns, or negative feelings you have that relate to each of the areas. (It also helps to identify which of the areas are sources of strength, support, positive feelings.) As you break the depression down into smaller, more manageable contributing parts, some solutions will seem clear to you. Again, we're not operating on an "Either-Or" assumption---that you either have depression or you don't; we're assuming a continuum of depressive feelings or symptoms. So any changes you can make for the better, though they may not "fix" the depression or make it go away immediately, are definitely worth doing. Depression can leave you feeling helpless and out of control of your life, your thoughts, feelings, and behaviors. You want to regain and experience more power and control; you want to get to the point where you feel like you can do something to improve your situation and life. So for instance, you may realize that relationship problems are a key contributor to your depression, and decide that assertiveness or communications training would really help remedy that situation. Or you might notice that for you the symptoms are largely physical and choose to get a medical check-up to rule out other possible problems. Perhaps parental pressures and expectations have been burdening you and you'll decide to have that long, honest talk with your parents. Go over each area and do your own self-assessment, then write down what you think it would take to help the situation. No two lists will be exactly alike, but several general strategies often are beneficial to people struggling with feelings of depression. ----------------------------------------- What Are Some Stradegies For Helping me to Cope With My Depression?
----------------------------------------- Is There Any Therapy I can Try?
What Are Anit Depressants? For more serious depressions, psychiatrists sometimes prescribe anti-depressant medications to help get the person back on track more quickly. Many people have found that the medications helped them "lift the cloud" so they could function better and move toward "getting things back to normal." ----------------------------------------- When Should They Be Used? Medications generally are not seen as substitutes for therapy, but work best together with therapy not only to relieve the depressive symptoms but to enhance the person's understanding of the depression and expand his or her coping strategies for dealing with the conditions that led to depression in the first place. A consultation with a psychiatrist can answer your specific questions about medications and side effects. -------------------- Visit my other website Let's Kill Boredom
And I don't want the world to see me, 'cuz I don't think that they'd understand, when everything's made to be broken, i just want you to know who I am. ...26... |
  
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| frozentears |
Posted: July 30, 2006 05:37 am
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Administrator Group: Admin Posts: 56 Member No.: 1 Joined: July 28, 2006 |
Suicide
What Is Suicide? Suicide is the act of willfully ending one's own life. People who are suicidal are often depressed, hates oneself, and feels as there is no escape to their emotional pain. ----------------------------------------- Why Do People Commit Suicide? A suicide attempt is a clear indication that something is gravely wrong in a person’s life. No matter the race or age of the person; how rich or poor they are, it is true that most people who commit suicide have a mental or emotional disorder. The most common underlying disorder is depression, 30% to 70% of suicide victims suffer from major depression or bipolar (manic-depressive) disorder. ----------------------------------------- Warning Signs of Someone Considering Suicide Any one of these symptoms does not necessarily mean the person is suicidal, but several of these symptoms may signal a need for help:
----------------------------------------- What To Do If You Think Someone Is Suicidal Trust your instincts that the person may be in trouble. Talk with the person about your concerns. Communication needs to include LISTENING. Ask direct questions without being judgmental. Determine if the person has a specific plan to carry out the suicide. The more detailed the plan, the greater the risk.
----------------------------------------- The Statistics of Suicide
----------------------------------------- Preventing Suicide Although they may not call prevention centers, suicidal people usually do seek help; for example, nearly three-fourths of all suicide victims visit a doctor in the four months before their deaths, and half in the month before. ----------------------------------------- Helping a Suicidal Person No single therapeutic approach is suitable for all suicidal persons or suicidal tendencies. The most common ways to treat underlying illnesses associated with suicide are with medication, talk therapy or a combination of the two. Cognitive (talk therapy) and behavioral (changing behavior) therapies aim at relieving the despair of suicidal patients by showing them other solutions to their problems and new ways to think about themselves and their world. Behavioral methods, such as training in assertiveness, problem-solving, social skills, and muscle relaxation, may reduce depression, anxiety, and social ineptitude. Cognitive and behavioral homework assignments are planned in collaboration with the patient and explained as experiments that will be educational even if they fail. The therapist emphasizes that the patient is doing most of the work, because it is especially important for a suicidal person not to see the therapist as necessary for their survival. Recent research strongly supports the use of medication to treat the underlying depression associated with suicide. Antidepressant medication acts on chemical pathways of the brain related to mood. There are many very effective antidepressants. The two most common types are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). Other new types of antidepressants (e.g. alpha-2 antagonist, selective norepinephrine reuptake inhibitors (SNRIs) and aminoketones), and an older class, monoamine oxidase inhibitors (MAOIs), are also prescribed by some doctors. Antidepressant medications are not habit-forming. Although some symptoms such as insomnia, often improve within a week or two, it may take three or four weeks before you feel better; the full benefit of medication may require six to eight weeks of treatment. Sometimes changes need to be made in dosage or medication type before improvements are noticed. It is usually recommended that medications be taken for at least four to nine months after the depressive symptoms have improved. People with chronic depression may need to stay on medication to prevent or lessen further episodes. People taking antidepressants should be monitored by a doctor who knows about treating clinical depression to ensure the best treatment with the fewest side effects. It is also very important that your doctor be informed about all other medicines that are taken, including vitamins and herbal supplements, in order to help avoid dangerous interactions. Alcohol or other drugs can interact negatively with antidepressant medication. Do not discontinue medication without discussing the decision with your doctor. ----------------------------------------- Resources in Your Community Telephone hotlines (Can be obtained from the telephone book, local Mental Health Associations, community centers, or United Way chapters) Clergy Medical professionals Law-enforcement agencies -------------------- Visit my other website Let's Kill Boredom
And I don't want the world to see me, 'cuz I don't think that they'd understand, when everything's made to be broken, i just want you to know who I am. ...26... |
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| frozentears |
Posted: July 30, 2006 05:52 am
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Administrator Group: Admin Posts: 56 Member No.: 1 Joined: July 28, 2006 |
Self Injury
What is self-injury? (S.I.) It's called many things -- self-inflicted violence, self-injury, self-harm, parasuicide, delicate cutting, self-abuse, self-mutilation (this last particularly seems to annoy people who self-injure). Broadly speaking, self-injury is the act of attempting to alter a mood state by inflicting physical harm serious enough to cause tissue damage to one's body. Approximately 1% of the United States population uses physical self-injury as a way of dealing with overwhelming feelings or situations, often using it to speak when no words will come. ----------------------------------------- What is self-injurious behavior? The forms and severity of self-injury can vary, although the most commonly seen behavior is cutting, burning, and head-banging. Other forms of self-injurious behavior include:
Why does self-injury make some people feel better? It reduces physiological and psychological tension rapidly. Studies have suggested that when people who self-injure get emotionally overwhelmed, an act of self-harm brings their levels of psychological and physiological tension and arousal back to a bearable baseline level almost immediately. In other words, they feel a strong uncomfortable emotion, don't know how to handle it (indeed, often do not have a name for it), and know that hurting themselves will reduce the emotional discomfort extremely quickly. They may still feel bad (or not), but they don't have that panicky jittery trapped feeling; it's a calm bad feeling. Some people never get a chance to learn how to cope effectively. One factor common to most people who self-injure, whether they were abused or not, is invalidation. They were taught at any early age that their interpretations of and feelings about the things around them were bad and wrong. They learned that certain feelings weren't allowed. In abusive homes, they may have been severely punished for expressing certain thoughts and feelings. At the same time, they had no good role models for coping. You can't learn to cope effectively with distress unless you grow up around people who are coping effectively with distress. Although a history of abuse is common about self-injurers, not everyone who self-injures was abused. Sometimes invalidation and lack of role models for coping are enough, especially if the person's brain chemistry has already primed them for choosing this sort of coping. Problems with neurotransmitters may play a role. Just as it's suspected that the way the brain uses serotonin may play a role in depression, so scientists think that problems in the serotonin system may predispose some people to self-injury by making them tend to be more aggressive and impulsive than most people. This tendency toward impulsive aggression, combined with a belief that their feelings are bad or wrong, can lead to the aggression being turned on the self. Of course, once this happens, the person harming himself learns that self-injury reduces his level of distress, and the cycle begins. Some researchers theorize that a desire to release endorphins, the body's natural painkillers, is involved. ----------------------------------------- What kinds of people self-injure? Self-injurers come from all walks of life and all economic brackets. People who harm themselves can be male or female; straight, gay, or bisexual; Ph.D.s or high-school dropouts or high-school students; rich or poor; from any country in the world. Some people who self-injure manage to function effectively in demanding jobs; they are teachers, therapists, medical professionals, lawyers, professors, engineers. Some are on disability. Their ages range from early teens to early 60s. In fact, the incidence of self-injury is about the same as that of eating disorders, but because it's so highly stigmatized, most people hide their scars, burns, and bruises carefully. They also have excuses ready when someone asks about the scars. ----------------------------------------- Aren't people who would deliberately cut or burn themselves psychotic? No more than people who drown their sorrows in a bottle of vodka are. It's a coping mechanism, just not one that's as understandable to most people or as accepted by society as alcoholism, drug abuse, overeating, anorexia and bulimia, workaholism, smoking cigarettes, and other forms of problem avoidance. ----------------------------------------- Okay, then isn't it just another way to describe a failed suicide attempt? NO. Self-injury is a maladaptive coping mechanism, a way to stay alive. People who inflict physical harm on themselves are often doing it in an attempt to maintain psychological integrity -- it's a way to keep from killing themselves. They release unbearable feelings and pressures through self-harm, and that eases their urge toward suicide. And, although some people who self-injure do later attempt suicide, they almost always use a method different from their preferred method of self-harm. ----------------------------------------- Can anything be done for people who hurt themselves? Yes. Several websites offer self-help ideas. Many new therapeutic approaches have been and are being developed to help self-harmers learn new coping mechanisms and teach them how to start using those techniques instead of self-injury. These approaches reflect a growing belief among mental-health workers that once a client's patterns of self-inflicted violence stabilize, real work can be done on the problems and issues underlying the self-injury. Also, research into medications that stabilize mood, ease depression, and calm anxiety is being done; some of these drugs may help reduce the urge to self-harm. This does not mean that individuals should be coerced into stopping self-injury. Any attempts to reduce or control the amount of self-harm a person does should be based on the person's willingness to undertake the difficult work of controlling and/or stopping self-injury. Treatment should not be based on a practitioner's personal feelings about the practice of self-harm. ----------------------------------------- What problems may be encountered when getting professional help? Self-injury brings out many uncomfortable feelings in people who don't do it: revulsion, anger, fear, and distaste, to name a few. If a medical professional is unable to cope with her own feelings about self-harm, then she has an obligation to herself and to her client to find a practitioner willing to do this work. In addition, she has the responsibility to be certain the client understands that the referral is due to her own inability to deal with self-injury and not to any inadequacies in the client. People who self-injure do generally do so because of an internal dynamic, and not in order to annoy, anger or irritate others. Their self-injury is a behavioral response to an emotional state, and is usually not done in order to frustrate caretakers. ----------------------------------------- What problems may be encountered in the emergency room? In emergency rooms, people with self-inflicted wounds are often told directly and indirectly, that they are not as deserving of care as someone who has an accidental injury. They are treated badly by the same doctors who would not hesitate to do everything possible to preserve the life of an overweight, sedentary heart-attack patient. Doctors in emergency rooms and urgent-care clinics should be sensitive to the needs of patients who come in to have self-inflicted wounds treated. If the patient is calm, denies suicidal intent, and has a history of self-inflicted violence, the doctor should treat the wounds as they would treat non-self-inflicted injuries. Refusing to give anesthesia for stitches, making disparaging remarks, and treating the patient as an inconvenient nuisance simply further the feelings of invalidation and unworthiness the self-injurer already feels. Although offering mental-health follow-up services is appropriate, psychological evaluations with an eye toward hospitalization should be avoided in the emergency room unless the person is clearly a danger to his/her own life or to others. In places where people know that self-inflicted injuries are liable to lead to mistreatment and lengthy psychological evaluations, they are much less likely to seek medical attention for their wounds and thus are at a higher risk for wound infections and other complications. -------------------- Visit my other website Let's Kill Boredom
And I don't want the world to see me, 'cuz I don't think that they'd understand, when everything's made to be broken, i just want you to know who I am. ...26... |
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| frozentears |
Posted: July 30, 2006 06:01 am
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Administrator Group: Admin Posts: 56 Member No.: 1 Joined: July 28, 2006 |
Panic Disorder
What are panic attacks? Panic attacks are a panic disorder, which is a serious health problem in this country. At least 1.6 percent of adult Americans, or 3 million people, will have panic attacks at some time in their lives. The disorder is strikingly different from other types of anxiety in that panic attacks are so very sudden, appear to be unprovoked, and are often disabling. Panic attacks can occur at any time, even during sleep. An attack generally peaks within 10 minutes, but some symptoms may last much longer. Once someone has had a panic attack, for example, while driving, shopping in a crowded store, or riding in an elevator, he or she may develop irrational fears, called phobias, about these situations and begin to avoid them. Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point where the individual with panic disorder may be unable to drive or even step out of the house. At this stage, the person is said to have panic disorder with agoraphobia. Thus, panic disorder can have as serious an impact on a person's daily life as other major illnesses, unless the individual receives effective treatment --------------------------------------- What are the symptoms of a panic attack? As described above, the symptoms of a panic attack appear suddenly, without any apparent cause. They may include:
A panic attack typically lasts for several minutes and is one of the most distressing conditions that a person can experience. Most who have one attack will have others. When someone has repeated attacks, or feels severe anxiety about having another attack, he or she is said to have panic disorder. --------------------------------------- Are panic attacks serious? Yes, panic attacks are real and potentially disabling, but they can be controlled with specific treatments. Because of the disturbing symptoms that accompany panic attacks, they may be mistaken for heart disease or some other life-threatening medical illness. People frequently go to hospital emergency rooms when they are having a panic attack, and extensive medical tests may be performed to rule out these other conditions. Medical personnel generally attempt to reassure the panic attack patient that he or she is not in great danger. But these efforts at reassurance can sometimes add to the patient's difficulties: If the doctors use expressions such as "nothing serious," "all in your head," or "nothing to worry about," this may give the incorrect impression that there is no real problem and that treatment is not possible or necessary. The point is that while panic attacks can certainly be serious, it is not organ-threatening. --------------------------------------- What causes panic attacks? According to one theory of panic disorder, the body's normal "alarm system," the set of mental and physical mechanisms that allows a person to respond to a threat, tends to be triggered unnecessarily, when there is no danger. Scientists don't know exactly why this happens, or why some people are more susceptible to the problem than others. Panic disorder has been found to run in families, and this may mean that inheritance (genes) plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it. Often, the first attacks are triggered by physical illnesses, a major life stress, or perhaps medications that increase activity in the part of the brain involved in fear reactions. --------------------------------------- What is the treatment for panic attacks? Thanks to research, there are a variety of treatments available, including several effective medications, and specific forms of psychotherapy. Often, a combination of psychotherapy and medications produces good results. Improvement is usually noticed in a fairly short period of time, about 6 to 8 weeks. Thus, appropriate treatment for panic disorder can prevent panic attacks or at least substantially reduce their severity and frequency-bringing significant relief to 70 to 90 percent of people with panic disorder. In addition, people with panic disorder may need treatment for other emotional problems. Depression has often been associated with panic disorder, as have alcohol and drug abuse. Recent research also suggests that suicide attempts are more frequent in people with panic disorder. Fortunately, these problems associated with panic disorder can be overcome effectively, just like panic disorder itself. Tragically, many people with panic attacks do not seek or receive treatment. --------------------------------------- What happens if panic attacks are not treated? Panic attacks tends to continue for months or years. While it typically begins in young adulthood, in some people the symptoms may arise earlier or later in life. If left untreated, it may worsen to the point where the person's life is seriously affected by panic attacks and by attempts to avoid or conceal them. In fact, many people have had problems with friends and family or lost jobs while struggling to cope with panic attacks. There may be periods of spontaneous improvement in the attacks, but it does not usually go away unless the person receives treatments designed specifically to help people with panic attacks. Panic Attacks At A Glance
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And I don't want the world to see me, 'cuz I don't think that they'd understand, when everything's made to be broken, i just want you to know who I am. ...26... |
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| frozentears |
Posted: July 30, 2006 06:09 am
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Administrator Group: Admin Posts: 56 Member No.: 1 Joined: July 28, 2006 |
Obsessive Compulsive Disorder (OCD)
What Is OCD? Obsessive-compulsive disorder (OCD), one of the anxiety disorders, is a potentially disabling condition that can persist throughout a person's life. The individual who suffers from OCD becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. OCD occurs in a spectrum from mild to severe, but if severe and left untreated, can destroy a person's capacity to function at work, at school, or even in the home. For many years, mental health professionals thought of OCD as a rare disease because only a small minority of their patients had the condition. The disorder often went unrecognized because many of those afflicted with OCD, in efforts to keep their repetitive thoughts and behaviors secret, failed to seek treatment. This led to underestimates of the number of people with the illness. However, a survey conducted in the early 1980s by the National Institute of Mental Health (NIMH)—the Federal agency that supports research nationwide on the brain, mental illnesses, and mental health—provided new knowledge about the prevalence of OCD. The NIMH survey showed that OCD affects more than 2 percent of the population, meaning that OCD is more common than such severe mental illnesses as schizophrenia, bipolar disorder, or panic disorder. OCD strikes people of all ethnic groups. Males and females are equally affected. The social and economic costs of OCD were estimated to be $8.4 billion in 1990. Although OCD symptoms typically begin during the teenage years or early adulthood, recent research shows that some children develop the illness at earlier ages, even during the preschool years. Studies indicate that at least one-third of cases of OCD in adults began in childhood. Suffering from OCD during early stages of a child's development can cause severe problems for the child. It is important that the child receive evaluation and treatment by a knowledgeable clinician to prevent the child from missing important opportunities because of this disorder. ------------------------------------------ What Are Symptoms of OCD? Obsessions These are unwanted ideas or impulses that repeatedly well up in the mind of the person with OCD. Persistent fears that harm may come to self or a loved one, an unreasonable concern with becoming contaminated, or an excessive need to do things correctly or perfectly, are common. Again and again, the individual experiences a disturbing thought, such as, "My hands may be contaminated—I must wash them"; "I may have left the gas on"; or "I am going to injure my child." These thoughts are intrusive, unpleasant, and produce a high degree of anxiety. Sometimes the obsessions are of a violent or a sexual nature, or concern illness. Compulsions In response to their obsessions, most people with OCD resort to repetitive behaviors called compulsions. The most common of these are washing and checking. Other compulsive behaviors include counting (often while performing another compulsive action such as hand washing), repeating, hoarding, and endlessly rearranging objects in an effort to keep them in precise alignment with each other. Mental problems, such as mentally repeating phrases, list making or checking are also common. These behaviors generally are intended to ward off harm to the person with OCD or others. Some people with OCD have regimented rituals while others have rituals that change. Performing rituals may give the person with OCD some relief from anxiety, but it is only temporary. People with OCD show a range of insight into the senselessness of their obsessions. Often, especially when they are not actually having an obsession, they can recognize that their obsessions and compulsions are unrealistic. At other times they may be unsure about their fears or even believe strongly in their validity. Most people with OCD struggle to banish their unwanted, obsessive thoughts and to prevent themselves from engaging in compulsive behaviors. Many are able to keep their obsessive-compulsive symptoms under control during the hours when they are at work or attending school. But over the months or years, resistance may weaken, and when this happens, OCD may become so severe that time-consuming rituals take over the sufferers' lives, making it impossible for them to continue activities outside the home. OCD sufferers often attempt to hide their disorder rather than seek help. Often they are successful in concealing their obsessive-compulsive symptoms from friends and coworkers. An unfortunate consequence of this secrecy is that people with OCD usually do not receive professional help until years after the onset of their disease. By that time, they may have learned to work their lives—and family members' lives—around the rituals. OCD tends to last for years, even decades. The symptoms may become less severe from time to time, and there may be long intervals when the symptoms are mild, but for most individuals with OCD, the symptoms are chronic. ------------------------------------------ What Are Causes of OCD? The old belief that OCD was the result of life experiences has been weakened before the growing evidence that biological factors are a primary contributor to the disorder. The fact that OCD patients respond well to specific medications that affect the neurotransmitter serotonin suggests the disorder has a neurobiological basis. For that reason, OCD is no longer attributed only to attitudes a patient learned in childhood—for example, an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Instead, the search for causes now focuses on the interaction of neurobiological factors and environmental influences, as well as cognitive processes. OCD is sometimes accompanied by depression, eating disorders, substance abuse disorder, a personality disorder, attention deficit disorder, or another of the anxiety disorders. Coexisting disorders can make OCD more difficult both to diagnose and to treat. In an effort to identify specific biological factors that may be important in the onset or persistence of OCD, investigators have used a device called the positron emission tomography (PET) scanner to study the brains of patients with OCD. Several groups of investigators have obtained findings from PET scans suggesting that OCD patients have patterns of brain activity that differ from those of people without mental illness or with some other mental illness. Brain-imaging studies of OCD showing abnormal neurochemical activity in regions known to play a role in certain neurological disorders suggest that these areas may be crucial in the origins of OCD. There is also evidence that treatment with medications or behavior therapy induce changes in the brain coincident with clinical improvement. Recent preliminary studies of the brain using magnetic resonance imaging showed that the subjects with obsessive-compulsive disorder had significantly less white matter than did normal control subjects, suggesting a widely distributed brain abnormality in OCD. Understanding the significance of this finding will be further explored by functional neuroimaging and neuropsychological studies. Symptoms of OCD are seen in association with some other neurological disorders. There is an increased rate of OCD in people with Tourette's syndrome, an illness characterized by involuntary movements and vocalizations. Investigators are currently studying the hypothesis that a genetic relationship exists between OCD and the tic disorders. Other illnesses that may be linked to OCD are trichotillomania (the repeated urge to pull out scalp hair, eyelashes, eyebrows or other body hair), body dysmorphic disorder (excessive preoccupation with imaginary or exaggerated defects in appearance), and hypochondriasis (the fear of having—despite medical evaluation and reassurance—a serious disease). Genetic studies of OCD and other related conditions may enable scientists to pinpoint the molecular basis of these disorders. Other theories about the causes of OCD focus on the interaction between behavior and the environment and on beliefs and attitudes, as well as how information is processed. These behavioral and cognitive theories are not incompatible with biological explanations. A person with OCD has obsessive and compulsive behaviors that are extreme enough to interfere with everyday life. People with OCD should not be confused with a much larger group of individuals who are sometimes called "compulsive" because they hold themselves to a high standard of performance and are perfectionists and very organized in their work and even in recreational activities. This type of "compulsiveness" often serves a valuable purpose, contributing to a person's self-esteem and success on the job. In that respect, it differs from the life-wrecking obsessions and rituals of the person with OCD. ------------------------------------------- How Can I Treat OCD? Clinical and animal research sponsored by NIMH and other scientific organizations has provided information leading to both pharmacological and behavioral treatments that can benefit the person with OCD. One patient may benefit significantly from behavior therapy, while another will benefit from pharmacotherapy. Some others may use both medication and behavior therapy. Others may begin with medication to gain control over their symptoms and then continue with behavior therapy. Which therapy to use should be decided by the individual patient in consultation with his or her therapist. Medication Clinical trials in recent years have shown that drugs that affect the neurotransmitter serotonin can significantly decrease the symptoms of OCD. The first of these serotonin reuptake inhibitors (SRIs) specifically approved for the use in the treatment of OCD was the tricyclic antidepressant clomipramine (Anafranil). It was followed by other SRIs that are called "selective serotonin reuptake inhibitors" (SSRIs). Those that have been approved by the Food and Drug Administration for the treatment of OCD are fluoxetine (Prozac), fluvoxamine (Luvox), and paroxetine (Paxil). Another that has been studied in controlled clinical trials is sertraline (Zoloft). Large studies have shown that more than three-quarters of patients are helped by these medications at least a little. And in more than half of patients, medications relieve symptoms of OCD by diminishing the frequency and intensity of the obsessions and compulsions. Improvement usually takes at least three weeks or longer. If a patient does not respond well to one of these medications, or has unacceptable side effects, another SRI may give a better response. For patients who are only partially responsive to these medications, research is being conducted on the use of an SRI as the primary medication and one of a variety of medications as an additional drug (an augmenter). Medications are of help in controlling the symptoms of OCD, but often, if the medication is discontinued, relapse will follow. Indeed, even after symptoms have subsided, most people will need to continue with medication indefinitely, perhaps with a lowered dosage. Behavior Therapy Traditional psychotherapy, aimed at helping the patient develop insight into his or her problem, is generally not helpful for OCD. However, a specific behavior therapy approach called "exposure and response prevention" is effective for many people with OCD. In this approach, the patient deliberately and voluntarily confronts the feared object or idea, either directly or by imagination. At the same time the patient is strongly encouraged to refrain from ritualizing, with support and structure provided by the therapist, and possibly by others whom the patient recruits for assistance. For example, a compulsive hand washer may be encouraged to touch an object believed to be contaminated, and then urged to avoid washing for several hours until the anxiety provoked has greatly decreased. Treatment then proceeds on a step-by-step basis, guided by the patient's ability to tolerate the anxiety and control the rituals. As treatment progresses, most patients gradually experience less anxiety from the obsessive thoughts and are able to resist the compulsive urges. Studies of behavior therapy for OCD have found it to be a successful treatment for the majority of patients who complete it. For the treatment to be successful, it is important that the therapist be fully trained to provide this specific form of therapy. It is also helpful for the patient to be highly motivated and have a positive, determined attitude. The positive effects of behavior therapy endure once treatment has ended. A recent compilation of outcome studies indicated that, of more than 300 OCD patients who were treated by exposure and response prevention, an average of 76 percent still showed clinically significant relief from 3 months to 6 years after treatment (Foa & Kozak, 1996). Another study has found that incorporating relapse-prevention components in the treatment program, including follow-up sessions after the intensive therapy, contributes to the maintenance of improvement (Hiss, Foa, and Kozak, 1994). One study provides new evidence that cognitive-behavioral therapy may also prove effective for OCD. This variant of behavior therapy emphasizes changing the OCD sufferer's beliefs and thinking patterns. Additional studies are required before the promise of cognitive-behavioral therapy can be adequately evaluated. The ongoing search for causes, together with research on treatment, promises to yield even more hope for people with OCD and their families. ------------------------------------------- Self-Care People with OCD should:
When a family member suffers from Obsessive-Compulsive Disorder it may help to:
-------------------- Visit my other website Let's Kill Boredom
And I don't want the world to see me, 'cuz I don't think that they'd understand, when everything's made to be broken, i just want you to know who I am. ...26... |
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