Disorder

Bipolar affective disorder has been a mystery since the 16th century. History has shown that this disorder can appear in almost anyone. Even the great painter Vincent Van Gogh is believed to have had bipolar disorder. It is clear that in our society many people live with bipolar disorder, however, despite the amount of people suffering from it, we are still waiting for explanations for the causes and cure. The one fact of which we are aware is that bipolar disorder severely undermines its victim’s ability to obtain and maintain social and occupational success.

Because bipolar disorder has such debilitating symptoms, it is important that we keep looking for explanations of its causes and for more ways to treat this disorder. Bipolar has a large variety of symptoms, divided in two categories. One is the manic episodes, the other is depressive. (Halgin, 1997) The depressive episodes are characterized by intense feelings of sadness and despair that can turn into feelings of hopeless and helplessness.

Some of the symptoms of a depressive episode include disturbances in sleep and appetite, loss of energy, feelings of worthlessness, guilt, difficulty thinking, indecision, and many thoughts of death and suicide. Elevated or irritable mood, increased energy, decreased sleep, poor judgment and insight, and often reckless or irresponsible behavior characterize the manic episodes. These episodes may alternate with profound depressions characterized by a deep sadness, almost inability to move, hopelessness, and disturbances in appetite, sleep, problems with concentration and driving.

Bipolar affective disorder affects approximately one percent of the population (approximately three million people) in the United States. It occurs in both males and females. Bipolar disorder is diagnosed if an episode of mania occurs whether depression has been diagnosed or not. Most commonly, individuals with manic episodes do experience a period of depression. (Halgin, 1997) Symptoms include elated, excited, or irritable mood, hyperactivity, and pressure of speech, flight of ideas, inflated self-esteem, and decreased need for sleep, distractibility, and excessive involvement in reckless activities.

As the National Depressive and Manic-Depressive Association (MDMDA) has found out in their research, bipolar disorder can create martial and family disruptions, occupational setback, and financial disasters. (Hopkins, 1994) Many times, bipolar patients report that the depression is longer and increased in frequency as the person ages. Often bipolar states and psychotic states are misdiagnosed as schizophrenia. The onset of bipolar disorder usually occurs between the ages of 20 and 30 years of age, with a second peak in the mid-forties for women.

A typical bipolar patient may experience eight to ten episodes in their lifetime. However, those who have rapid cycling may experience more episodes of mania and depression that follow each other without a period of remission. (Hollandsworth, 1990) The three stages of mania begin with hypomania, in which patients report that they are energetic, extroverted and assertive. Hypomania progresses into the transition that is marked by extreme loss of judgment. (Jamison, 1990) Often, euphoric grandiose characteristics are displayed, and paranoid or irritable characteristics begin.

The third stage of mania is evident when the patient experiences paranoid delusions. Speech is generally rapid and hyperactive behavior sometimes turns into violence. Sometimes both manic and depressive symptoms occur at the same time. This is called a mixed episode. Those affected are at special risk because there is a combination of hopelessness, agitation, and anxiety that make them feel like they “could jump out of their skin. ” Up to fifty percent of all patients with mania have a mixture of depressed moods.

Patients’ report feeling dysphoric, depressed, and unhappy; yet they have the energy associated with mania. Rapid cycling mania is another form of bipolar disorder. Mania may be present with four or more episodes within a 12-month period. (Gelenberg, 1994) This form of the disease has more episodes of mania and depression than bipolar disorder, although this is believed to be a branch of actual bipolar disorder. Lithium has been the primary treatment of bipolar disorders sine its introduction in the 1960’s.

Its main function is to stabilize the cycling characteristic of bipolar disorder. (Gelenberg,1994) In four controlled studies by F. K. Goodwin and K. R. Jamison, the overall response rate for bipolar subjects treated with lithium was 78% (1990). Lithium is also the primary drug used for long-term maintenance of bipolar disorder. In a majority of bipolar patients, it lessens the duration, frequency, and severity of the episodes of both mania and depression. Unfortunately, as many as 40% of bipolar patients are either unresponsive to lithium of can not handle the side effects.

Some of the side effects include thirst, weight gain, nausea, diarrhea, and edema. Patients who are unresponsive to lithium treatment are often those who experience dysphoric mania, mixed states, or rapid cycling bipolar disorder. One of the problems associated with lithium is the act the long-term lithium treatment has been associated with decreased thyroid function in-patients with bipolar disorder. Evidence also suggest that hypothyroidism may actually lead to rapid cycling. Pregnant women experience another problem associated with the use of lithium.

Its use during pregnancy has been associated with birth defects. (Whybrow, 1990) There are other types for effective treatments for bipolar disorder that are used in cases where the patients cannot tolerate lithium or have been unresponsive to it in the past. The American Psychiatric Association’s guidelines suggest the next best treatment to be anticonvulsant drugs such as valproate and carbamazepine. These drugs are useful as antimanic drugs, especially in those patients with mixed states.

Winokur, 1987) Both of these medications can be used in combination with lithium or in combination with each other. Valproate is especially helpful for patients who do not wish to take lithium, experience rapid cycling, or abuse drugs or alcohol. Neuroleptics such as haldol or thorazine have also been used to help stabilize manic patients who are highly agitated or psychotic. Use of these drugs is often necessary because the responses to them are rapid, but there are risks involved in their use. Because of the often-severe side effects, benzodiasepines are often used in their place.

Benzodiasepines can achieve the same results as neuroleptics for most patients in terms of rapid control of agitation and excitement, without the severe side effects. (Gelenberg, 1994) Some doctors as treatment for bipolar disorder have also used antidepressants such as serotonin reuptake inhibitors (SSRI’S) luvox and Elavil. There are studies that say these help, but these are controversial, however, because conflicting research shows that SSRI’s and other antidepressants can actually cause manic episodes.

Hirschfeld, 1995) Most doctors can see the usefulness of antidepressants when used with mood stabilizing medications such as lithium. In addition to the mentioned medical treatments of bipolar disorder, there are several other options available to bipolar patients, most, of which are used in conjunction with medicine. ( Lish, 1994) One such treatment is electro-convulsive shock therapy. ECT is the preferred treatment for severely manic patients and patients who are homicidal, psychotic, catatonic, or severely suicidal.

In one study, researchers found improvements in 78% of patients treated with ECT, compared to 62% of patients treated only with lithium and 37% of patients who received neither ECT or lithium. A final type of therapy that I found is outpatient group psychotherapy. According to Dr. John Graves, spokesperson for The National Depressive and Manic Depressive Association has called attention to the value of support groups, and challenged mental health professionals to take a more serious look at group therapy for the bipolar population.

Research shows that group participation may help increase medication compliance, insight regarding the illness, and awareness of stress factors leading to manic and depressive episodes. Group therapy for patients with bipolar disorder responds to the need for support and reinforcement of medication management, and the need for education and support or the difficulties that arise during the course of the disorder.

If a child has attention deficit disorder then the child has attention deficit disorder, but if the child does not have attention deficit disorder, and a person goes down a yellow brick road to correct the malady under the pretense that attention deficit disorder is the focus, and the attention deficit disorder medications and therapy are the cure, then do not be disappointed with the results.

Attention deficit disorder is a syndrome of disordered learning and disruptive behavior that is not caused by any serious underlying physical or mental disorder and that has several subtypes characterized primarily by inattentiveness, rimarily by hyperactivity and impulsive behavior, or by the significant expression of both (Webster 11-12-00). Attention deficit disorder is overdiagnosed. Many people believe that attention deficit disorder is a disease, when attention deficit disorder is really only a behavior (Hales 120). Children who can not sit still because they are bored are considered to have attention deficit disorder.

Einstein, Ted Turner, and Bill Gates should all have been considered to have had attention deficit disorder if the diagnosis of attention deficit disorder is as simple as saying that a child is bored and can not sit still. The fact is hat attention deficit disorder is overdiagnosed and harmful medications used to treat the condition are overprescribed. The “Urban Myth” of doctors handing out Ritalin like candy to an abounding mass of misbehaving but misdiagnosed non-attention deficit disorder children appears to be true (Baughman 11-12-00).

Part of the problem is that the diagnosis is based on patient history and observation, without any laboratory or radiological confirmation (Silver 130). Since attention deficit disorder is overdiagnosed, children who do have attention deficit disorder are left with the difficulty of getting the appropriate treatment nd management they so desperately need. Everyone needs to remember that all wiggles of small children are not always symptoms of attention deficit disorder. Anxiety and depression can mimic the symptoms of attention deficit disorder which is an immense uncertainty (Barisic 11-12-00).

Not only can other conditions mimic attention deficit disorder, but some people would even say that individuals are trying to medicate away what are essentially normal childhood behaviors. This speculation is proven true especially for very active little boys. Over the past few years, the number of children and adolescents referred to rofessionals for attention deficit disorder has dramatically increased. Three to six percent of school aged children are diagnosed with attention deficit disorder (Silver 107-108).

One to two percent of adult men and women in the United States have been said to have attention deficit disorder and three to ten percent of children are diagnosed with attention deficit disorder in the Untied States, with three quarters of them boys (Hales 338). Not a single one of the five to six million children in the United Sates who have been diagnosed with attention deficit disorder bears unbiased evidence of a physical r chemical abnormality establishing proof that they are diseased, other than the fact that the children are normal (Baughman 11-12-00).

All children commonly lack persistence, lack attentiveness, are impulsive, and are constantly restless (Parker 209). Physicians in the United States misdiagnose attention deficit disorder more readily than doctors elsewhere in the world (Encarta 11-12-00). Many problems a person may face mirror the behaviors and diagnosis of attention deficit disorder and it is, many times, easier just to say a person has attention deficit disorder than look for the real cause. In short, attention deficit disorder probably has received much more attention than it deserves in recent years.

This extra attention has lead to a perception of over-diagnosis, which may or may not be based on fact. Parents and teachers should look carefully at the child before making any rash decisions about labels. Also, individuals need to stand for children with attention deficit disorder who really do have the syndrome, and also help those kids who may not “be attention deficit disorder”, but are still struggling for whatever reason. Teachers around the country routinely push pills on any students who are even a ittle inattentive or overactive (Parker 60).

Teachers are well meaning individuals who have the best interest of their students in mind, but when they see students who are struggling to pay attention and concentrate, it is not their responsibility to diagnose the child, but to bring information to the parents’ attention so that parents can take appropriate action. The majority of teachers only push pills and do not provide appropriate information so that parents can seek out suitable diagnostic help. Being on the front lines with children, teachers need to collect information, raise the suspicion of ttention deficit disorder, and bring the information to the attention of parents.

After the teacher provides sufficient information, the parents of the child need to have a full evaluation conducted outside the school (Parker 60). In most cases, the “suspicion” is proven faulty (Parker 61). The symptoms of attention deficit disorder must be present in school and at home before a diagnosis is made; teachers do not have access to sufficient information about the child’s functioning at home to make a diagnosis of attention deficit disorder or, for that matter, to make any kind of medical diagnosis (Barisic 11-12-00).

There are a number of unprofessional “diagnoses” being made by people who are not qualified to make any such medical judgment. Many teachers, parents, grandparents, and others compare childhood behavior to what they have heard on the morning talk shows and automatically make the connection that the child must have attention deficit disorder. Thankfully, these well intentioned but misguided people are not allowed to prescribe medications. Children who are under stress or in abusive situations can look like they have attention deficit disorder.

As adults, people learn to more or less compartmentalize their ives. If adults do not learn to separate their lives, then they at least learn how to fake life a lot (Parker 93). Children do not have this ability. Trouble at home means trouble for the student at school. Divorce, illness, or even just the normal uncertainty of childhood may all contribute to attention deficit disorder-like behaviors. Some children are being diagnosed as having attention deficit disorder with insufficient evaluation, and in some cases stimulant medication is prescribed when treatment alternatives exist (Hales 156).

There is evidence of widespread overdiagnosis nd misdiagnosis of attention deficit disorder and widespread overprescription of medications by physicians. Attention deficit disorder manifests itself in many ways and may vary with the individual (Silver 109). Attention deficit disorder is one of the hardest disorders to diagnose. The symptoms must exist in at least two separate settings (Encarta 11-12-00). The symptoms should be creating significant impairment in social functioning, academic functioning, or relationships (Parker 62-65).

Common symptoms of attention deficit disorder may include, but are not restricted to: forgetful, disorganized, distractible, defensive, mood wings, sleep disorder, social conflicts, easily frustrated, low self esteem, immaturity, impulsive, lacks leadership, often loses things, may engage in dangerous activities, interrupts conversations, off during conversation, day dreams, anxiety, hyperactivity, poor reading skills, reversals of letters, poor handwriting, poor spelling, and poor math skills (Silver 324).

There are many children who truly do not have attention deficit disorder but have many of these symptoms. The primary medications, which are methylphenidate (Ritalin), dextroamphetamine (Dexadrine), and pemoline (Cylert), are stimulants that produce a igh-intensity rush of euphoria in most people. Those with attention deficit disorder, however, have a paradoxical effect, aiding in concentration and reducing restlessness (Silver 115). Because patients do not feel euphoria or develop tolerance or craving, there is little danger of drug abuse or addiction.

Although, there is a big danger in using medications such as methylphenidate, dextroamphetamine, and pemoline when treatment is not necessary (Silver 116). “These drugs are mind-altering drugs. And in the case of Ritalin, it’s a drug almost identical to cocaine–goes to the same receptor site in the brain, auses the same high when taken in the same manner,” Dr. Mary Ann Block states (CNN 11-12-00). Researchers have found that medications for attention deficit disorder are given to nineteen to twenty percent of boys by the time the boys are in the fifth grade, which is dangerous because the drug can be so addictive (Barisic 11-12-00).

When indicated, children with attention deficit disorder are best advised to stick to proven treatments involving a multi-modal approach with behavior management, counseling, education, and medication (Parker 315). Prescribing medication to children ith attention deficit disorder has been a controversial topic in the United States for decades. Children with attention deficit disorder need structure and routine more so than medication. In a sense, establishing structure and routine is a form of behavior therapy.

Behavior therapy in a more formal sense may be useful to prevent a particular kind of aggressive or disruptive behavior that occurs in a few specific circumstances (Parker 123). Applying therapy to all the situations in which symptoms of attention deficit disorder appear would be impractical, so why should physicians give treatment to those ithout the syndrome also? Only fifty to ninety percent of children diagnosed with attention deficit disorder will be helped by medication (Parker 123).

If only fifty to ninety percent of children are helped by medication, just think of what the medication is doing to the children who are not diagnosed properly. The self-esteem of a child who has to take medication to “live properly” is lowered, especially when the child does not even have a disorder such as attention deficit disorder. Bad parenting and lack of discipline by parents is essentially the cause of attention deficit disorder. All that children with attention deficit disorder really need is old-fashioned discipline, and not any phony therapies.

There are still those who believe the century-old anachronism that child misbehavior is always a moral problem of the “bad child. ” Under this model, the treatment has been to “beat the Devil out of the child” (Baughman 11-12-00). Fortunately, most individuals are more enlightened today. By simply providing more discipline along with other interventions improves rather than worsens the behavior of children with attention deficit disorder. One can make a handicapped walk by applying iscipline.

Similarly, one can make a child with a biologically-based lack of self-control act better by simply applying discipline alone (Hales 172). What is now most often described as attention deficit disorder cannot only be a misguided remark or misdiagnosis because someone is not familiar with the condition, but also can be a misdiagnosis just because it is always easier to say a child has attention deficit disorder rather than dealing with the true problem. Attention deficit disorder is overdiagnosed and harmful medications used to treat the condition are overprescribed.

Just because a child is antsy and quick to anger does not mean that he or she has attention deficit disorder. It is easy to see how some would confuse a depressed child with one who truly has the disorder, but that is where parents need to be open to all possibilities of the child’s problems and be prepared to do what it takes to effectively treat what is really wrong. For children who truly have attention deficit disorder, Ritalin and other medications have been very effective, but the drug is not at all effective for those who do not have the disorder. The drug only makes matters worse.

Is bipolar disorder the cause of great madness or great genius? The symptoms of this mental illness may also be considered as the driving forces behind some of the most gifted and talented people to grace our society. Although individuals with this illness may have some obstacles to overcome, it can be accomplished. With all of the treatment programs that are widely available, people have many options and methods to turn to for help.

Bipolar disorder, also referred to as manic depression, is a mood disorder. A person with bipolar disorder will have extreme mood shifts between mania, a state of highly elevated euphoric feelings, and depression, a state of despondency and despair. These shifts can take weeks, days, or even minutes to happen. The period between shifts will vary for each individual, depending on the severity of the disorder (Williams & Wilkins, 1999, pp. 5-35).

Approximately two percent of adults have this mental illness, and about fifteen percent of those adults will attempt suicide. Bipolar disorder affects both men and women and the affected rates are similar between different cultures and countries. Most people with bipolar disorder experience their first mood episode in their twenties, although it is not uncommon to experience the first episode during childhood or in late life (Bi-polar Disorder: Innovative Research in Health, 2000).

Bipolar disorder is not a curable disorder, although it is treatable. Bipolar is “among the most treatable of the psychiatric illnesses” (Manic-Depressive/Bipolar Disorder, 2000). It is important for people who believe that they may need help to seek it as soon as possible because the earlier that bipolar disorder can be diagnosed the earlier treatments can start.

Even after experiencing an episode, even after sensing that something may be wrong, individuals who seek help may not initially receive the correct diagnosis from a medical professional. Because of the similarity of symptoms, bipolar disorder may initially be misdiagnosed as panic disorder, schizophrenia, or attention deficit disorder (Bi-polar Disorder: Innovative Research in Health, 2000). Bipolar may also be difficult to diagnose because the person seeking help may not be telling the doctor everything the doctor needs to know to correctly identify the problem. Medical professionals may only diagnose a person as having depression because they have no knowledge of the excessive enthusiasm that the patient feels. It is important for individuals seeking medical help to be accurate and thorough in describing their feelings or symptoms (Manic-Depressive/Bipolar Disorder, 2000).

A person experiencing a manic episode may have increased energy and/or racing thoughts. Feelings of euphoria and/or an increased pressure to talk may also be symptoms. A person in this stage of the illness may have uncharacteristically poor judgement and/or may be involved in some type of high-risk behavior, such as uncontrollable spending sprees, habitual reckless driving and/or participating in unusual sexual encounters and behaviors. Usually the individual denies that anything is wrong when in a manic state (Manic-Depressive/Bipolar Disorder, 2000).

A person experiencing the depression state of bipolar disorder may have feelings of worthlessness and/or guilt. Decreased energy and/or loss of interest in once pleasurable activities may also be symptoms of clinical depression. A depressed person may have trouble concentrating and/or have trouble making decisions. Depression may also leave individuals contemplating suicide (Manic-Depressive/Bipolar Disorder, 2000).

There are two classifications for bipolar disorder, bipolar II and bipolar I (Williams & Wilkins, 1999, pp. 5-35). The combination and degree of mania and depression determine the type of bipolar illness. It is also determined by how long each stage lasts and the time frame of euthymia, having normal moods, between stages. The cycling of stages may overlap, which is referred to as a mixed episode. The diagnostic system that is currently being used by mental health professionals is the ‘Diagnostic and Statistical Manual of Mental Disorders’ volume four, also known as DSM-IV (Manic- Depressive/Bipolar Disorder, 2000).

A patient diagnosed as having bipolar II disorder has or has had at least one episode of major depression and is experiencing or has experienced one or more episodes of hypomania. Hypomanic episodes have the same symptoms of mania only to a lesser degree. It is important for treatment to start now, to attempt the disorder from developing into bipolar I disorder (Bipolar Treatment, 2000).

Bipolar I disorder is the most severe form of bipolar disorder. Patients with bipolar I have full-fledged episodes of mania and experience major depressive states. These patients also have mixed episodes. In addition, some bipolar I patients may experience psychotic episodes. The symptoms of bipolar I severely affect the patients’ social and/or occupational functioning (Bipolar Treatment, 2000).

There are numerous treatment options for people with bipolar disorder. The patient and the patient’s doctor decide which treatment or treatments are best (Bipolar treatment, 2000). The options are chosen based on the degree of the disorder and the current circumstances surrounding the patient (Manic-Depressive/Bipolar Disorder, 2000).

The most predominant form of treatment is through psychopharmacology; the use of drugs that affect the patient’s the mood and behavior (What is Bipolar, 2000). Mood stabilizers, which are anti-depressants, anti-anxieties, and anti-psychotics, may be used alone or in combination to achieve and maintain a level of mental stability for the patient (Psychopharmacology Tips by Dr. Bob, 1999). These medications can significantly improve the patient’s disposition and demeanor (What is Bipolar, 2000).

Anti-depressants, used to treat clinical depression, come in two different chemical compounds, selective serotonin reuptake inhibitors, known simply as SSRIs, and monoamineoxidase inhibitors, also referred to as MAOs. SSRIs include the medications Zoloft and Prozac while MAOs include the medications Nardil and Parnate. Other anti-depressants are lithium (JAMA, 1999, v.281 pp. 23-32) and Depakote (Psychopharmacology Tips by Dr. Bob, 1999).

Some patients may experience abnormal apprehensions, in which an anti-anxiety drug may be needed to suppress the unnatural trepidation felt by the patient. Ativan and Valium are two of the most common anti-anxiety medications that are currently being prescribed to these patients (Psychopharmacology Tips by Dr. Bob, 1999).

In severe instances, usually patients diagnosed as having bipolar I disorder, an anti-psychotic medication such as Haldol or Risperdol may be needed. These medications help to control the excessive paranoia, uneasiness, and mistrustfulness that some bipolar patients feel (Psychopharmacology Tips by Dr. Bob, 1999).

Patients typically respond well to drug therapy. Psychopharmacology may be used alone or in conjunction with other treatments. One of these other treatments that may be used in combination with psychopharmacology, or used independently as treatment, is psychotherapy.

There are three major types of psychotherapy. They are insight therapies, cognitive therapies, and behavior therapies. Mental health therapy, by definition, is “the professional application of techniques intended to treat psychological disorders and reduce stress” (Rubin, Peplau & Salovey, 1993, p.492).

Insight therapies involve getting patients to discuss problems they are having and emotions they are feeling, which are thought to be the cause of their psychological dilemmas (Rubin, Peplau & Salovey, 1993, p.494). One such insight therapy is psychoanalytic therapy, developed by Sigmund Freud, which helps patients discover their unconscious motives and develop insights about how to adjust to them (Psychotherapy, 1990).

Cognitive therapies takes Freud’s therapy method one-step further. These therapies focus not only on what patients think, but also center on how and why patients think the way they do (Psychotherapy, 1990). Albert Ellis, a clinical psychologist, developed one type of cognitive therapy known as rational-emotive therapy. This therapy focuses on the irrational beliefs of patients and the techniques used to replace those beliefs with more realistic ones (Rubin, Peplau & Salovey, 1993, pp. 501-502).

Behavior therapies help the patients identify and change inappropriate behaviors (Psychotherapy, 1990). Systematic desensitization, a type of behavior therapy, seeks to replace negative thoughts with positive thoughts in relation to a specific fear or anxiety (Rubin, Peplau & Salovey, 1993, p. 502).

Psychotherapy may be conducted in private sessions, group sessions, or family sessions. Private sessions involve the patient and the doctor, group sessions include the patient and his/her peers, and family sessions are comprised of the patient and his/her loved ones. The benefit of any type of therapy treatment and/or any type of therapy session is the relationship that is created between doctor and patient. This relationship is built on trust, thus allowing the patient to feel more comfortable about discussing future problems or issues that may arise (Psychotherapy, 1990).

Hospitalization may be an element of treatment needed for patients under particular circumstances. Patients may be experiencing a severe bout of depression or a full-fledged manic episode. In these instances, hospitalization may be required to formulate the patient’s needed medication, adjust current doses of medications and/or to hold the patient in a secure environment to minimize the chance of self-injury (Bipolar Treatment, 2000).

Another method of treatment is through self-help This is when the patient endeavors in groups or research, outside of a doctors care, which help the patient maintain or even improve his/her mental condition. There are many support groups worldwide for people suffering from bipolar disorder, as well as an almost infinite number of resources available through local libraries or over the Internet. Self-help treatments are becoming more widely available because of the convenience of nearby support groups, updated libraries and personal computers (Bipolar Treatment, 2000).

Individuals with bipolar disorder may also turn to several alternative therapies for treatment. Some of these methods, while not openly discussed by mental health professionals, have statistical findings, which may lead patients to consider as usable methods of treatment. These methods include, but are not limited to, the ingestion of omega-3 fatty acids and magnet therapy.

One study compared omega-3 fatty acids, found in fish oils, with an olive oil placebo in individuals diagnosed with bipolar disorder. The preliminary findings indicated that patients receiving the fish oils “had longer periods of remission and performed better than the patients receiving placebos” (Archives of General Psychiatry, 1999, 56: pp. 407-416). This study is proclaimed to be a “landmark attempt in drug development” (Archives of General Psychiatry, 1999, 56: pp. 407-416).

According to a double-blind study at the Technion-Israel Institute of Technology, findings indicate that “magnetic stimulation of the brain eases severe depression” (Bipolar Treatment, 2000). Magnet therapy for mental illness can now be “backed up by scientific evidence” (Bipolar Treatment, 2000). Magnetic stimulation of the brain is capable of lessening the degree of depression in patients and “may become an alternative to electroconvulsive treatment (ECT), which causes painful convulsions and memory impairment” (Bipolar Treatment, 2000).

ECT is one of the most controversial treatments in psychiatry. The nature of the treatment itself is compounded with its history of abuse, detrimental media presentations, and powerful testimonies of former patients, giving it a negative reputation. This form of treatment is not administered lightly. The decision to offer ECT to a patient is based on his/her severity of disorder and nonresponsiveness to other forms of treatment. Although ECT does have some severe side effects, such as memory loss and identity confusion, it may still be an effective and needed form of treatment in some bipolar patients (Electroconvulsive Therapy BackGround Paper, 1988).

Another treatment method, psychosurgery, is also considered controversial. Psychosurgeries of the past included lobotomies, which bring to mind images of post-operative patients in an inanimate state of being. “The psychosurgery of today bears little resemblance to the grossly destructive technique” (Psychosurgery redux, 2000) that was once used in procedures such as lobotomies.

One of the procedures performed today, known as cingulotomy, uses a tool referred to as a stereotactic frame. With this new tool, surgeons can accurately burn away targeted brain tissue, causing “neither cognitive loss nor disturbing personality changes” (Psychosurgery redux, 2000) to the patient. Diagnosed bipolar patients, who have not responded well to other forms of treatment and/or those patients who are considered at high risk for suicide, may be candidates for psychosurgery (Psychosurgery redux, 2000).

Science and technology have made significant advances since the times of the ancient Greeks, when depression was thought to be caused by excessive black bile and mania to be caused by excessive yellow bile (Mondimore, 1999, p. 61). Today’s bipolar patient may receive proper and expedient treatment and may make use of any number of treatment options. Diagnosing bipolar disorder has become easier with the use of medical manuals such as the DSM-IV. Various treatment options have become more widely accepted since medical studies have provided convincing statistical findings. Today’s world provides bipolar patients with the opportunity to have long, productive, creative and happy lives.

People diagnosed with manic depression and those who suffer from it but have not yet been diagnosed, can be found in any social status and in any place. They may be a president, an artist, a homemaker, an actor, a homeless person, an author, or a neighbor. The simple fact is that they are all people. People with emotions, people who experience highs and lows, people just like every other person on the planet.

These people may have more difficulties coping with their surroundings. They may need help and support through medications, therapies, family, and/or friends. However, most of all, they need to be appreciated for their individuality, generativity, and creativity that they can offer to the world.

Two of the many productive and creative individuals suffering from bipolar disorder are George, a former student at Fernwood’s Devereux Center (Brandywine Programs Case Studies, 2000), and Joy, a homemaker, poet, and webmaster (Bipolar Disorder, 2000). These individuals have had to overcome many obstacles in their lives, but they have prevailed. They are now both enjoying happy, productive and creative lives.

George was sent to Fernwood, an all boys program, after being expelled from school for destructive behavior. An assessment found George to be suffering from bipolar disorder. At first he was frightened about the diagnosis, but now George educates others about bipolar, is involved in the community, and works at the local YMCA (Brandywine Programs Case Studies, 2000). He is just one example of a bipolar patient leading a productive life.

A fine example of a creative bipolar patient is Joy. She is the creator of a website entitled Bipolar, which can be found at www.frii.com/parrot/bip.html. Joy has educational materials, as well as fun facts and poetry, on her website. She uses her creative side to help educate others about her illness (Bipolar Disorder, 2000).

There are also a number of famous people with bipolar disorder. Edgar Allen Poe, Vincent Van Gogh, Abraham Lincoln and Marilyn Monroe, and all had bipolar disorder (Bipolar Disorder, 2000). These people are thought of as being exceedingly gifted and talented. Millions of people, across the world, would probably agree that these bipolars have definitely left their mark on the world.

The phenomenon of bipolar affective disorder has been a mystery since the 16th century. History has shown that this affliction can appear in almost anyone. Even the great painter Vincent Van Gogh is believed to have had bipolar disorder. It is clear that in our society many people live with bipolar disorder; however, despite the abundance of people suffering from the it, we are still waiting for definite explanations for the causes and cure.

The one fact of which we are painfully aware is that bipolar disorder severely undermines its’ victims ability to obtain and maintain social and occupational success. Because bipolar disorder has such debilitating symptoms, it is imperative that we remain vigilant in the quest for explanations of its causes and treatment. Affective disorders are characterized by a smorgasbord of symptoms that can be broken into manic and depressive episodes. The depressive episodes are characterized by intense feelings of sadness and despair that can become feelings of hopelessness and helplessness.

Some of the symptoms of a depressive episode include anhedonia, disturbances in sleep and appetite, psycomoter retardation, loss of energy, feelings of worthlessness, guilt, difficulty hinking, indecision, and recurrent thoughts of death and suicide (Hollandsworth, Jr. 1990 ). The manic episodes are characterized by elevated or irritable mood, increased energy, decreased need for sleep, poor judgment and insight, and often reckless or irresponsible behavior (Hollandsworth, Jr. 1990 ). Bipolar affective disorder affects approximately one percent of the population (approximately three million people) in the United States.

It is presented by both males and females. Bipolar disorder involves episodes of mania and depression. These episodes may alternate with profound depressions characterized y a pervasive sadness, almost inability to move, hopelessness, and disturbances in appetite, sleep, in concentrations and driving. Bipolar disorder is diagnosed if an episode of mania occurs whether depression has been diagnosed or not (Goodwin, Guze, 1989, p 11). Most commonly, individuals with manic episodes experience a period of depression.

Symptoms include elated, expansive, or irritable mood, hyperactivity, pressure of speech, flight of ideas, inflated self esteem, decreased need for sleep, distractibility, and excessive involvement in reckless activities (Hollandsworth, Jr. 1990 ). Rarest symptoms were periods of loss of all interest and retardation or agitation (Weisman, 1991). As the National Depressive and Manic Depressive Association (MDMDA) has demonstrated, bipolar disorder can create substantial developmental delays, marital and family disruptions, occupational setbacks, and financial disasters.

This devastating disease causes disruptions of families, loss of jobs and millions of dollars in cost to society. Many times bipolar patients report that the depressions are longer and increase in frequency as the individual ages. Many times bipolar states and psychotic states are misdiagnosed as schizophrenia. Speech patterns help distinguish between the two disorders (Lish, 1994). The onset of Bipolar disorder usually occurs between the ages of 20 and 30 years of age, with a second peak in the mid-forties for women. A typical bipolar patient may experience eight to ten episodes in their lifetime.

However, those who have rapid cycling may experience more episodes of mania and depression that succeed each other without a period of remission (DSM III-R). The three stages of mania begin with hypomania, in which patients report that they are energetic, extroverted and assertive (Hirschfeld, 1995). The ypomania state has led observers to feel that bipolar patients are “addicted” to their mania. Hypomania progresses into mania and the transition is marked by loss of judgment (Hirschfeld, 1995). Often, euphoric grandiose characteristics are displayed, and paranoid or irritable characteristics begin to manifest.

The third stage of mania is evident when the patient experiences delusions with often paranoid themes. Speech is generally rapid and hyperactive behavior manifests sometimes associated with violence (Hirschfeld, 1995). When both manic and depressive symptoms occur at the same time it is called mixed episode. Those afflicted are a special risk because there is a combination of hopelessness, agitation, and anxiety that makes them feel like they “could jump out of their skin”(Hirschfeld, 1995). Up to 50% of all patients with mania have a mixture of depressed moods.

Patients report feeling dysphoric, depressed, and unhappy; yet, they exhibit the energy associated with mania. Rapid cycling mania is another presentation of bipolar disorder. Mania may be present with four or more distinct episodes within a 12 month period. There is now evidence to suggest that sometimes rapid cycling may be a transient anifestation of the bipolar disorder. This form of the disease exhibits more episodes of mania and depression than bipolar. Lithium has been the primary treatment of bipolar disorder since its introduction in the 1960’s.

It is main function is to stabilize the cycling characteristic of bipolar disorder. In four controlled studies by F. K. Goodwin and K. R. Jamison, the overall response rate for bipolar subjects treated with Lithium was 78% (1990). Lithium is also the primary drug used for long- term maintenance of bipolar disorder. In a majority of bipolar patients, it lessens he duration, frequency, and severity of the episodes of both mania and depression. Unfortunately, as many as 40% of bipolar patients are either unresponsive to lithium or can not tolerate the side effects.

Some of the side effects include thirst, weight gain, nausea, diarrhea, and edema. Patients who are unresponsive to lithium treatment are often those who experience dysphoric mania, mixed states, or rapid cycling bipolar disorder. One of the problems associated with lithium is the fact the long-term lithium treatment has been associated with decreased thyroid functioning in patients with bipolar disorder. Preliminary evidence also suggest that hypothyroidism may actually lead to rapid-cycling (Bauer et al. , 1990).

Another problem associated with the use of lithium is experienced by pregnant women. Its use during pregnancy has been associated with birth defects, particularly Ebstein’s anomaly. Based on current data, the risk of a child with Ebstein’s anomaly being born to a mother who took lithium during her first trimester of pregnancy is approximately 1 in 8,000, or 2. 5 times that of the general population (Jacobson et al. , 1992). There are other effective treatments for bipolar disorder that are used in ases where the patients cannot tolerate lithium or have been unresponsive to it in the past.

The American Psychiatric Association’s guidelines suggest the next line of treatment to be Anticonvulsant drugs such as valproate and carbamazepine. These drugs are useful as antimanic agents, especially in those patients with mixed states. Both of these medications can be used in combination with lithium or in combination with each other. Valproate is especially helpful for patients who are lithium noncompliant, experience rapid- cycling, or have comorbid alcohol or drug abuse. Neuroleptics such as haloperidol or chlorpromazine have also been used to help stabilize manic patients who are highly agitated or psychotic.

Use of these drugs is often necessary because the response to them are rapid, but there are risks involved in their use. Because of the often severe side effects, Benzodiazepines are often used in their place. Benzodiazepines can achieve the same results as Neuroleptics for most patients in terms of rapid control of agitation and excitement, without the severe side effects. Antidepressants such as the selective serotonin reuptake inhibitors SSRI’s) fluovamine and amitriptyline have also been used by some doctors as treatment for bipolar disorder.

A double-blind study by M. Gasperini, F. Gatti, L. Bellini, R. Anniverno, and E. Smeraldi showed that fluvoxamine and amitriptyline are highly effective treatments for bipolar patients experiencing depressive episodes (1992). This study is controversial however, because conflicting research shows that SSRI’s and other antidepressants can actually precipitate manic episodes. Most doctors can see the usefulness of antidepressants when used in conjunction with mood stabilizing medications such s lithium. In addition to the mentioned medical treatments of bipolar disorder, there are several other options available to bipolar patients, most of which are used in conjunction with medicine.

One such treatment is light therapy. One study compared the response to light therapy of bipolar patients with that of unipolar patients. Patients were free of psychotropic and hypnotic medications for at least one month before treatment. Bipolar patients in this study showed an average of 90. 3% improvement in their depressive symptoms, with no incidence of mania or hypomania. They all continued to use light therapy, and all showed a sustained positive response at a three month follow-up (Hopkins and Gelenberg, 1994).

Another study involved a four week treatment of bright morning light treatment for patients with seasonal affective disorder and bipolar patients. This study found a statistically significant decrement in depressive symptoms, with the maximum antidepressant effect of light not being reached until week four (Baur, Kurtz, Rubin, and Markus, 1994). Hypomanic symptoms were experienced by 36% of bipolar patients in this study. Predominant hypomanic ymptoms included racing thoughts, deceased sleep and irritability. Surprisingly, one-third of controls also developed symptoms such as those mentioned above.

Regardless of the explanation of the emergence of hypomanic symptoms in undiagnosed controls, it is evident from this study that light treatment may be associated with the observed symptoms. Based on the results, careful professional monitoring during light treatment is necessary, even for those without a history of major mood disorders. Another popular treatment for bipolar disorder is electro-convulsive shock therapy. ECT is the preferred treatment for severely manic pregnant patients and patients who are homicidal, psychotic, catatonic, medically compromised, or severely suicidal.

In one study, researchers found marked improvement in 78% of patients treated with ECT, compared to 62% of patients treated only with lithium and 37% of patients who received neither, ECT or lithium (Black et al. , 1987). A final type of therapy that I found is outpatient group psychotherapy. According to Dr. John Graves, spokesperson for The National Depressive and Manic Depressive Association has called attention to the value of support groups, and hallenged mental health professionals to take a more serious look at group therapy for the bipolar population.

Research shows that group participation may help increase lithium compliance, decrease denial regarding the illness, and increase awareness of both external and internal stress factors leading to manic and depressive episodes. Group therapy for patients with bipolar disorders responds to the need for support and reinforcement of medication management, and the need for education and support for the interpersonal difficulties that arise during the course of the disorder.

Schizophrenia is a serious disorder which affects how a person thinks, feels and acts. Someone with schizophrenia may have difficulty distinguishing between what is real and what is imaginary; may be unresponsive or withdrawn; and may have difficulty expressing normal emotions in social situations.

Contrary to public perception, schizophrenia is not split personality or multiple personality. The vast majority of people with schizophrenia are not violent and do not pose a danger to others. Schizophrenia is not caused by childhood experiences, poor parenting or lack of willpower, nor are the symptoms identical for each person.

What causes schizophrenia?

The cause of schizophrenia is still unclear. Some theories about the cause of this disease include: genetics (heredity), biology (the imbalance in the brains chemistry); and/or possible viral infections and immune disorders.

Genetics (Heredity). Scientists recognize that the disorder tends to run in families and that a person inherits a tendency to develop the disease. Schizophrenia may also be triggered by environmental events, such as viral infections or highly stressful situations or a combination of both.

Similar to some other genetically-related illnesses, schizophrenia appears when the body undergoes hormonal and physical changes, like those that occur during puberty in the teen and young adult years.

Chemistry. Genetics help to determine how the brain uses certain chemicals. People with schizophrenia have a chemical imbalance of brain chemicals (serotonin and dopamine) which are neurotransmitters. These neurotransmitters allow nerve cells in the brain to send messages to each other. The imbalance of these chemicals affects the way a persons brain reacts to stimuli–which explains why a person with schizophrenia may be overwhelmed by sensory information (loud music or bright lights) which other people can easily handle. This problem in processing different sounds, sights, smells and tastes can also lead to hallucinations or delusions.

What are the early warning signs of schizophrenia?

The signs of schizophrenia are different for everyone. Symptoms may develop slowly over months or years, or may appear very abruptly. The disease may come and go in cycles of relapse and remission.

While no cure for schizophrenia exists, many people with this illness can lead productive and fulfilling lives with the proper treatment. Recovery is possible through a variety of services, including medication and rehabilitation programs. Rehabilitation can help a person recover the confidence and skills needed to live a productive and independent life in the community. Types of services that help a person with schizophrenia include: Case management helps people access services, financial assistance, treatment and other resources.

Psychosocial Rehabilitation Programs are programs that help people regain skills such as: employment, cooking, cleaning, budgeting, shopping, socializing, problem solving, and stress management. Self-help groups provide on-going support and information to persons with serious mental illness by individuals who experience mental illness themselves. Drop-in centers are places where individuals with mental illness can socialize and/or receive informal support and services on an as-needed basis. Housing programs offer a range of support and supervision from 24 hour supervised living to drop-in support as needed.

Employment programs assist individuals in finding employment and/or gaining the skills necessary to re-enter the workforce. Therapy/Counseling includes different forms of talk therapy, both individual and group, that can help both the patient and family members to better understand the illness and share their concerns. Crisis Services include 24 hour hotlines, after hours counseling, residential placement and in-patient hospitalization. Antipsychotic Medication The new generation of antipsychotic medications help people with schizophrenia to live fulfilling lives.

They help to reduce the biochemical imbalances that cause schizophrenia and decrease the likelihood of relapse. Like all medications, however, anti-psychotic medications should be taken only under the supervision of a mental health professional. There are two major types of antipsychotic medication: Conventional antipsychotics effectively control the positive symptoms such as hallucinations, delusions, and confusion of schizophrenia. New Generation (also called atypical) antipsychotics treat both the positive and negative symptoms of schizophrenia, often with fewer side effects.

Side effects are common with antipsychotic drugs. They range from mild side effects such as dry mouth, blurred vision, constipation, drowsiness and dizziness which usually disappear after a few weeks to more serious side effects such as trouble with muscle control, pacing, tremors and facial ticks. The newer generation of drugs have fewer side effects. However, it is important to talk with your mental health professional before making any changes in medication since many side effects can be controlled.

“Compulsive” and “obsessive” have become everyday words. “I’m compulsive” is how some people describe their need for neatness, punctuality, and shoes lined up in the closets. “He’s so compulsive is shorthand for calling someone uptight, controlling, and not much fun. “She’s obsessed with him” is a way of saying your friend is hopelessly lovesick. That is not how these words are used to describe Obsessive-Compulsive Disorder or OCD, a strange and fascinating sickness of ritual and doubts run wild. OCD can begin suddenly and is usually seen as a problem as soon as it starts.

Compulsives (a term for patients who mostly ritualize) and obsessives those who think of something over and over again) rarely have rituals or thoughts about nuetral questions or behaviors. What are their rituals about? There are several possible ways to list symptoms of OCD. All sources agree that the most common preoccupations are dirt (washing, germs, touching), checking for safety or closed spaces (closets, doors, drawers, appliances, light switches), and thoughts, often thoughts about unacceptable violent, sexual, or crude behavior.

When the thoughts and rituals of OCD are intense, the victim’s work and home life disintigrate. Obsessions are persistant, senseless, worrisome, and ften times, embarrassing, or frightening thoughts that repeat over and over in the mind in an endless loop. The automatic nature of these recurant thoughts makes them difficult for the person to ignore or restrain successfully. The essence of a Compulsive Personality Disorder is normally found in a restricted person, who is a perfectionist to a degree that demands that others to submit to his\her way of doing things.

A compulsive personality is also often indecisive and excessively devoted to work to the exclusion of pleasure. When pleasure is considered, it is something to be planned and worked for. Pleasurable activities are usually postponed and sometimes never even enjoyed. With severe compulsions, endless rituals dominate each day. Compulsions are incredibly repetitive and seemingly purposeful acts that result from the obsessions. The person performs certain acts according to certain rules or in a stereotypical way in order to prevent or avoid unsympathetic consequences.

People with compulsive personalities tend to be excessively moralistic, and judgmental of themselves and others. Senseless thoughts that recur over and over again appearing out of the blue; certain “magical” acts are repeated over and over. For some the thoughts are meaningless like numbers, one number or several, for others they are highly charged ideas-for example, “I have just killed someone. ” The intrusion into conscious everyday thinking of such intense, repetitive, and to the victim disgusting and alien thoughts is a dramatic and remarkable experience.

You can’t put them out of your mind, that’s the nature of the obsessions. Some patients are “checkers,” they check lights, doors, locks-ten, twenty or a hundred times. Others spend hours producing unimportant symmetry. Shoelaces must be exactly even, eyebrows identical to eachother. A case studied y the well-known art therapist, Judith Aron Rubin, Rubin tells of a young girl named Mary, who suffers from OCD, and how she drives her fellow waitresses frantic because she goes into a tailspin if the salt and pepper she has arranged in a certain order has been moved around.

All of the OCD problems have common themes: you can’t trust good judgment, you can’t trust your eyes that see no dirt, or really believe that the door is locked. You know you have done nothing harmful but in spite of this good sense you must go on checking and counting. There are many, many common obsessions, of all of them the most common s called “washing” this involves the victim to have a constant feeling of conamination, dirt and\or grime all over their body. The book,The Boy Who Couldn’t Stop Washing by Judith L.

Rapoport describes a long, sad case of a young boy who spent three or more hours in the shower each day. The boy “felt sure” that there was some sticky substance on his skin. He thought of nothing else. Our normal functioning probably consists of constant uncountable checking, a sort of radar operation, that we could not do contiously and still act efficiently. Something has gone wrong with the process for obsessive ompulsives, the usual shut-off such as “my hands are clean enough” or “I saw the gas was turned off on the stove” or “The door was locked. ” does not get through.

Everyday life becomes dominated by doubts, leading to senseless repetition and ritual. Obsessive phobias tend to have distinct features. According to Issac Marks, “They are usually part of a variety of fears of potential situations themselves. Because of the vagueness of these possibilities, ripples of avoidance and protective rituals spread far and wide to involve the patients life style and people around him\her. Clinical examination usually discloses bsessive rituals not directly connected with the professed fear; instead the obsessive fear is part of a wider obsessive-compulsive disorder. (Marks,1969)

“The sustained experience of obsessions and\or compulsions. ” make up what the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, calls Obsessive-Compulsive Disorder. It has also been called obsessional nuerosis. Psychiatrists have been fascinated by this disorder for over a hundred years. Priests have described symptoms like these for much longer than that. (A. P. A. ,80) Children suffer from OCD with exactly the same symptoms as adults. Normally an early start in mental disorder is unusual.

Other mental illnesses, such as depression or schitzophrenia often apear in a differant form in young children and in any case are much more rare in children than in adults. But with OCD it is the same at any age. In the book The Boy Who Couln’t Stop Washing, there is a story of a fourteen-year-old girl who has been diagnosed with OCD. As she is talking to her psychiatrist she says, “I have really lost touch with myself and that is really frightening. I wish I could get the ‘old Sally’ back. I keep hoping it’s just a dream and that I’ll wake up and everything will be normal.

I used to like who I was a lot, but now I feel I don’t even know myself anymore. I have so many goals and dreams I would like to accomplish, but I know I will never acomplish them with OCD. I feel like I am in a mental labyrinth from which I can’t escape. I hope I can get better. ” (Rapoport,’89,p. 80) To quote the author and psychiatrist, Judith L. Rapoport, “The disease affects some of the most able, sensitive, and talented people I have met.

Their otherwise normal ability to function, to become a good husband, wife, or friend akes working with obsessive-compulsive patients very rewarding and, when they are severely ill, very painful. (Rapoport,’89, p. 3) A few individual cases of OCD have been reported in the medical literature over the past 150 years, but only recently have we learned of the large number of adolesence and adults who suffer with it. More than 4 million people in the United States suffer from its’ disabling thoughts or rituals. Amazingly most of them keep their problem hidden. We are finding out that many of the adults who are being treated for it now went pretty much their whole life iding the problem because they were too humiliated or did not want to be considered crazy and thown in a mental institution.

In spite of the interesting individual cases of OCD in the past one hundred fifty years, there was not much work on treatment. There is little incentive to evaluate or develop new treatments for rare disorders. So up until the 1970’s the recommended treatment was psychotherapy or psychoanalysis. Doctors made these suggestions for lack of an alternative, but severe cases and follow-up studies of adults could not show any advantadge for this treatment. The Best studied Drug to reduce or stop OCD,is called Anafranil. Anafranil was first put on the market in 1990.

The side effects of Anafranil range from mild to severe. The most common side effects are dry mouth, constipation, and drowsiness. However a tremor, loss of sexual appetite, impotence-which is temporary until you stop taking the drug, and excessive sweating can be major problems. These are all side effects common to tricyclic anti-depressants-the group of which Anafranil belongs. In the most severe cases of OCD, psychosurgery was used regularly until the 1950s. With availability of other treatments psychosurgery is now a last esort.

In some cases, however, this drastic treatment seems to work when everything else has failed. A few medical centers in Boston, London, and Stockholm, for example, will still perform limited operations using newer techniques. The two newer treatments, behavior therapy and drug treatment with Anafranil, both seem to have long-term benefits. Behavior therapists have followed up their patients for a year or two and the effect seems to last. Anafranil has not been as well studied in follow-up, but what studies have been done show that it too is helpful over at least two years.

Even though Anafranil does work well it is not always nessesary. There are other aproaches. Some OCD’s have gotten help from just “coming out of the OCD closet”. Support groups have also been known to help. There is a wide variety of things you can do to help a person diagnosed with OCD. “Scientists have suggested that there may be a biological explanation for some obsessive compulsive disorders. There may be an imbalance in the frontal lobes of the brains of obsessive-compulsives that prevents the two brain regions from working together to channel and control incoming sensations and perceptions. “

Although American culture has changed over the years, parents today still want what is best for their children. Why then, are parents allowing their children to be put on medications that may have an adverse effect on their children? Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorder (ADHD) have increasingly been diagnosed among young children today. Parents should become more informed about the over diagnosing, side effects, results of the medication and all other pertinent information before they allow their children to become treated.

In this research paper we are first going to look at why ADD and ADHD diagnosing has become so widespread. Then we will look into the side effects of Ritalin; the number one drug prescribed for ADD and ADHD. Finally, we will consider the results of the treatment. ADD and ADHD have had a dramatic rate of increase since it was first discovered 25 years ago. This epidemic has grown from 500 thousand in 1985 to between five and seven million today. (Baughman) ADD and ADHD have become popular for many reasons. In todays American culture and fast paced society it is likely that both parents will work.

This breaks down the traditional family where only one parent would work and the other would stay home and take care of the children. This leads to a tremendous breakdown in parental supervision and involvement in their childrens academics. This lack of involvement by parents puts the burden onto the school system for a childs lack of achievement. When a child academically performs poorly or has a problem at school, parents want corrective action to be taken no matter what the cost, as long as, it is a fast remedy with little involvement by the parent.

In some cases, when a child is labeled with ADD or ADHD because he/she is doing poorly in school, the corrective action that needs to be taken is for the parent to simply spend more time with their children and tutor them in academic areas they re lacking in. Children feel the loss, (quality time spent with parents) and they take action for attention. They misbehave, they cry, they become defiant, aggressive. The parents seek answers and relief to the family turmoil. The school, which is also experiencing the childs defiance and aggression, seeks relief.

Enter the school psychologist who provides the convenient answer. The child has ADD. (DeWeese) Schools are looking for answers as to why students are doing poorly. These schools are also looking for a quick fix to the problem. Due to new federal programs and funding, (in 1991 federal education I grant were changed to provide schools with $400 per each student diagnosed with ADD) schools are now allocated with in-school clinics and psychologists to help determine if students have learning disabilities.

As a result of these new federal programs, and funding, schools today are no longer held responsible for a students lack of performance. Now schools have a new efficient system to protect themselves. It works like this: if a child has trouble in math, he is deemed to have a mental disorder under code number 315. 1 Mathematics Disorder, if a child cant write literature composition he/she must be suffering from code 315. 2 Disorder in written Expression. (DeWeese) The list goes on and on and it is quite obvious that schools are well protected. Teachers also play a key role in the over diagnosing of ADD and ADHD.

Teachers today, although they only receive education up to a masters degree to teach in K-12th grade, have become psychiatric doctors. Teachers are given lists of symptoms and unacceptable behaviors and instructed that if a student fits into the category they are to be marked and labeled, and the paperwork should be written up to begin their drug treatment. This may seem too outlandish to believe, but, I assure you this is how we have allowed are school system to become. Finally, I think that we need to look at the economical side of diagnosing children with ADD and ADHD.

Parents who are presented the option of putting their children on Ritalin face many questions and concerns, therefore they look for answers. CHADD (Children and Adults with deficit disorder) is the organization that parents turn to. What most parents are unaware of is that the makers of Ritalin sponsor CHADD. Since 1988, when CHADD and the Ciba-Geigy (now Navartis), the manufacturer of Ritalin, began their financial relationship, Ciba has given almost a million dollars to CHADD, helping it to expand its membership from 800 to 35,000 people.

In 1996, CHADD was given $750,000 to produce a video, Facing the Challenge of ADD, this video does not only mention the generic name of Ritalin but goes so far as to call it Ritalin, this is paid advertisement for Navartis by U. S. taxpayers. The Swiss pharmaceutical company Navartis is also soaring on the stock market, with federal funds to support the use of it in classrooms, and the purposed use of more drugs in the classroom (Luvox and Prozac). Domestic Ritalin sales have increased nearly five fold since 1990 and the increase is attributed to the use of Ritalin for ADD.

Ninety-percent of all Ritalin prescriptions are for Children diagnosed with ADD, although prescriptions for adults are escalating as well. (Breggin) Navartis tends to be the stock to invest in with an illustrious stock market portfolio, nearly tripling itself in 25 years, it is still steadily increasing and now has federal support and funding. With all the advertising of Ritalin as a cure for ADD and all the knowledge of its existence and use, few people seem to be concerned or know anything of the side-effects that Ritalin has.

Ritalin seems to the public to be a great drug to stop children from misbehaving and focus them on their academics to help them do better in school. Nothing could be farther from the truth. Ritalin however, actually has quite a few side effects to include but not limit to brain damage, impaired learning, psychosis, depression and apathy, obsessive-compulsive disorder, motor tics, insomnia, reduced appetite, cardiovascular disease, growth suppression and even death. (Breggin) In the Journal of the American Medical Association, Fred A.

Baughman writes about the danger and addictions of Ritalin. Ritalin and all amphetamines, causes growth retardation, brain entropy, seizures, psychosis, tics, and Tourettes syndrome. (Baughman) Baugman further writes about three cases he was consulted upon where the patients died of cardiac deaths, due to Ritalin treatment for ADD. These three cases were of an 11-year-old girl, a 14-year-old boy and a 9-year-old boy. Of the 2, 993 adverse reactions to Ritalin, reported to the FDA, from 1990 to 1997, there were 160 deaths and 569 hospitalizations.

26 of these adverse reactions were cardiovascular. (Baughman) Ritalin and other amphetamines due to their addictive side effects has also become a drug of choice in high schools and colleges. With the ease of being diagnosed and drug therapy, Ritalin is fast becoming used in many situations. With this illegitimate use of the drug in an uncontrolled environment, other side effects have been reported, such as blackouts, comas, and death when Ritalin is taken with alcohol to increase the buzz.

A bit of information not widely known about the Ritalin is that it does in some cases over a long period of time cause violent episodes. These violent episodes are not widely researched due to the fact that they are a long-term exposure side effect. Examples of these types of violent episodes are the Columbine shootings, where all the shooters had been diagnosed with ADD and prescribed Ritalin for drug therapy. The results of Ritalin are not what you would expect; in fact using Ritalin causes brain entropy and thus a decrease in the students academic performance.

As stated previously, I think that parents should strongly consider the underlying problems of a childs school performance before they consent to a diagnosment of ADD and drug therapy. It seems to me that parents are looking to quickly for an easy way out of problems with their children. I recently saw a movie that is symbolic of this parental approach. The title of the movie is Disturbing Behavior. In the movie, there is a scientist who develops a way through neurology to change childrens behavior, with minimal side effects-violent rages.

Although the community does not know how he is doing it, they really dont seem to care as long as their children are doing well in school. This scientist is not only, encouraged, rewarded and respected, but also looked upon as the hero of the community. This movie is truly symbolic of the parenting culture we live in and is definitely worth noting. In conclusion, American culture needs to change and become more of a traditional one again. Parents should reconsider drug treatment for ADD and look for alternatives; ones that provide healthy results.

College years can be one of the best times in life. They are filled with the discovery of freedom and independence. However, they can also be some of the most challenging times a person will face. It is a time when the majority of the population discovers that they have a disability, Attention Deficit Disorder, or ADD. ADD is discovered in college mainly due to the problems with time management, initiating, keeping or shifting focus, completing homework, and setting priorities (Quinn 1).

College students who discover ADD must first be educated as to what ADD is, how it is caused and what type of treatments there are, in order to achieve all that they can in their college career. Many children who continue to show visible difficulties with attention, impulse control, and excessive activity in the home and school environments are labeled with attention deficit disorder, or ADD (Bigler and Nussbaum 1). ADD is a neurological condition that affects learning and behavior. It affects approximately 5 – 10% of the population.

It develops in childhood, and usually is not grown out of (Quinn 2). ADD is characterized by persistent and excessive problems in which a child is unable to focus and pay attention, or conversely displays hyperactive and impulsive behavior (Nicholl and Stordy 4). It has only been recently that ADD has been recognized as a distinct disorder (Bigler and Nussbaum 2). The term ADD was not first used to describe the disorder. George Frederic Still, one of the pioneers of ADD, described children with “lawlessness,” and lacked “inhibitory volition.

The terms “minimal brain dysfunction,” “brain-injured child syndrome”, and “hyperactive child syndrome,” are all signs of generations with labels that were used to describe this disorder (Nicholl and Stordy 26). The disorder has been discussed throughout literature for over 30 years, but it was not until the 1980’s that a classification for ADD was developed (Bigler and Nussbaum 3). Some of the top characteristics of ADD are: attention difficulties, distractibility, hyperactivity, impulsivity, attention-demanding behavior, school difficulties, and learning disorders.

It is extremely difficult to describe the characteristics of children with ADD. The key to the characteristics is the intensity, the persistence, and the pattering of these symptoms (Wender 10-31). There are no real causes for ADD, and only a few common explanations are given, and of these, some are more believable than others. A family pattern seems to exist with ADD. Studies have shown that approximately 20 – 30% of children with ADD have a parent with similar attention troubles. This means that a subgroup of children with ADD may have inherited a type of gene that is related to ADD (Bigler and Nussbaum 20).

This cause of ADD is most accepted among physicians around the world. Many people used to believe that the nurture of a child, when being brought up, was an affect of the problem. The nurture versus nature issue is one the psychologists have been debating for several years. The debate still continues whether the child’s chemistry or the nurturing of children experiences through growing up causes ADD. Although certain types of child rearing may make the problem worse, they cannot cause ADD (Wender 34). After recognizing that a problem exists, the next step is to find out where to turn for help.

A knowledgeable physician usually directs families to the resources they need to deal with the many problems that are often associated with ADD. A child psychiatrist is usually the most frequent, and the best direction to go. They are trained medical doctors, and they can treat medicine and childhood disorders (Bigler and Nussbaum 37-38). Assessment of ADD is usually based on the observation of behaviors. The criteria for these behaviors are described in the Diagnostic and Statistical Manual of Mental Disorders, a manual that has been put together by the American Psychiatric Association (Lerner 236).

After a doctor has diagnosed someone with ADD, the treatment stage begins. There are many treatments that are used to help someone with ADD. The most favorable choice among patient is medical treatment. 96. 4% of all cases of ADD are prescribed on medication (Lerner 239). With most ADD sufferers, medical treatment is all that is needed, for others, a combination of medical treatment with psychological and education involvements are needed (Wender 67-68). The most commonly type of drug that is prescribed to people with ADD is psychostimulants.

Psychostumulants affect the brain of the individual by increasing the arousal or alertness of the central nervous system. One of the most common and most controversial psychostimulants is Ritalin (Lerner 238-240). Ritalin was first synthesized in 1955 and began to be used in the 1970’s (Wender 72). Ritalin is a methylphenidate; from the family of drugs know as central nervous system stimulants (psycweb). It’s on set of action is 30 minutes and its duration of action is 3 to 5 hours (Lerner 240). Doctors are uncertain how Ritalin works in the body. It affects the balance of chemicals in the brain.

Recent research indicates that it affects the balance of Serotonin working with Dopamine in the brain. Serotonin is a naturally occurring chemical in the brain. Serotonin appears to inhibit behavior and activity (About. com). The Dopamine dramatically reduces hyperactivity and improves the ability to focus, work, and consequently, learn (Torpey). Even though Ritalin is the preferred choice of medication, there are severe side effects for taking it. The most common side effects of Ritalin are loss of appetite, loss of sleep, nervousness, dizziness, drowsiness, headache, nausea, and stomach pain.

Ritalin is a “schedule II stimulant. ” A schedule II stimulant is the classification used by the Drug Enforcement Agency to indicate drugs with high potential for abuse (About. com). One of the controversies of Ritalin is its over use. In schools, more than a million school children across America travel to the office and stand in a line for their daily intact of Ritalin. Many people believe that Ritalin is used as an answer for disruptive students. One new, alternative to medication for the treatment of ADD, is EEG Biofeedback.

Now with knowing the treatments available for suffers of ADD, many college students can cope with their disorder. Neurofeedback, also called “EEG Biofeedback,” involves helping a person learn how to modify his or her brain waves activity to improve attention, reduce impulsivity, and to control hyperactivity behaviors. It was developed in the 1960’s, but only has recently been used as a treatment for ADD. The patient receives treatment through sensors that are placed one the scalp and the other on the ears. It is harmless and safe.

The feedback helps the individual learn to change his or her brain activity (Striefel). Dr. George von Hilsheimer, is located in Central Florida, has more than 40 years of experience with treating ADD children through EEG Biofeedback. 75% of the children that he has treated are free of ADD symptoms (EEGBiofeedback). The treatments involve sessions, which usually last from 30 to 60 minutes. The patient has at least 3 treatments a week. The duration of the treatments varies to the person. The average amount of sessions is about 35-40.

It depends on the severity that the individual has (Striefel). The advantage in using EEG Biofeedback is that there are no side effects. In fact, it can be beneficial. In addition to helping the symptoms of ADD, it works to eliminate seizures, helps with anger, anxiety, bulimia, chronic fatigue syndrome, malaise, pain panic, post traumatic stress disorder, and also is proven to increase IQ by at least 15% (EEGBiofeedback). Many students who are in their first year of college are diagnosed with ADD rather than in their childhood years. Several of them drop out, while others seek help.

Erik, a student who was diagnosed with ADD in his first year of college expresses his challenges: About this time [freshman year of college], I was diagnosed with ADD, but was not taking Ritalin. My decline continued through the first semester of my sophomore year. At the time, I was reevaluated, and decided to begin taking Ritalin upon the recommendation of a physician. The change was obvious. Almost immediately, my productivity increased tenfold. (Quinn 41) When students leave home for college, they are leaving behind the structure and balance that they have been used to.

The high school schedules, being at school from 8 to 4 o’clock, after school practices, and the family life. When the college career starts, there are longer classes, different breaks during the day, late night classes and early morning classes. This proves to be a huge challenge to the college student (Quinn 43-45). One of the best ways that you can ease the struggle from high school to college is to prepare for the transition. Leaving home is never easy. Learning how to do college, or be on your own, is not easy either. For people with ADD, the changes can be more difficult.

Researchers say that learning some of the practical issues of life, such as doing laundry, balancing a checkbook, managing time before leaving for college will help (Wender 115). They also say that it is important to understand that your adjustment experience is not unique. Everyone goes through similar struggles; they may just not be visible. There are successful stories of students who have ADD in college. The reason for this is that they seek help, and know that they cannot solve the problem on their own. For most graduates, college is remembered as the best years of their lives.

For others, college is a long, drawn-out affair that involves many changes, frustrations, and underachievement. However, with the knowledge of ADD and the treatments that are now available, students can more readily succeed. It is important to know the knowledge of ADD because many students, who do not know they have ADD and have it, are loosing the potential to achieve better grades and better cognitive skills. For many who enter college and suffer the first couple of months, they drop out. In order to have success in college with ADD, it is crucial that there is cooperation with parents, students, and faculty.

In most campuses, there is programs set up for students with ADD (McCormick and Quinn 71). The way to achieve the best in a college career with ADD is to find one that will accommodate the needs. There are many success stories for students who find their place in programs at colleges who end up having a successful life. God has made each and every one of us different, unique, and special in His eyes, and in everything, whether it is ADD or some other disorder, we have a lot to learn and a lot to gain, we just need to look to the One who can only give us the wisdom and insight necessary for peak performance in our daily lives.

Aspergers Disorder is a milder form of Autistic Disorder. They both fit in the same category know as either Autistic Spectrum Disorders or Pervasive Developmental Disorders. In Aspergers Disorder, affected people are characterized by social isolation and eccentric behavior in childhood. There are impairments in two-sided social interaction and non-verbal communication. Clumsiness is prominent both in their articulation and gross motor behavior. They usually have a circumscribed area of interest, which usually leaves no space for more age appropriate, common interests.

Some examples are cars, trains, French literature, doorknobs, hinges, cappuccino, meteorology, astronomy, or history. Qualitative impairment in interaction is usually caused from either a marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction or a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people.

Restricted repetitive and stereotyped patterns of behavior, interests, and activities are usually caused by encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is either in intensity or focus. The disturbances cause clinically significant impairment in social, occupational, or other important areas of functioning.

There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior, and curiosity about the environment in childhood. Severe impairment occurs when inability to interact with peers, socially and emotionally inappropriate behavior occurs, lack of desire to interact with peers, or lack of appreciation of social cues occurs. There is no specific treatment or cure for Aspergers Disorder. All the interventions are mainly symptomatic and/or rehabilitational.

Psychosocial interventions include, individual psychotherapy to help the individual to process the feelings aroused by being socially handicapped, parent education and training, behavioral modification, social skills training, or educational interventions. Psychopharmacological interventions include hyperactivity, inattention and impulsivity, clonidine, and tricylic antidepressants. They also include other medications such as mood stabilizers, beta blockers, clonidine, naltrexone, and neuroleptics.

Five year old Danny is in kindergarten. It is playtime and he hops from chair to chair, swinging his arms and legs restlessly, and then begins to fiddle with the light switches, turning the lights on and off again to everyone’s annoyance–all the while talking nonstop. When his teacher encourages him to join a group of other children busy in the playroom, Danny interrupts a game that was already in progress and takes over, causing the other children to complain of his bossiness and drift away to other activities. Even when Danny has the toys to himself, he fidgets aimlessly with them and seems unable to entertain himself quietly.

To many, this may seem like a problem; and it is. Danny most likely suffers from what is called Attention Deficit Disorder. Recent controversy has erupted as to whether Attention Deficit Disorder in fact deserves the title of \”disorder. \” Some people, like Thomas Armstrong, a psychologist and educator, believe Attention Deficit Disorder is merely a myth; \”… a dumping ground for a heterogeneous group of kids who are hyperactive or inattentive for a number of reasons including underlying anxiety, depression, and stresses in their families, schools , and in our culture. (Armstrong 15)

However, he and those who question the validity of Attention Deficit Disorder are mistaken. Attention Deficit Disorder is in fact a disorder because it is recognized as such in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), it is treatable through prescription medication and therapy and if left untreated inhibits one from functioning properly in society.

Before delving into the ways in which Attention Deficit Disorder matches the criteria established for what a disorder is, it is important to first understand the disorder and have some background information on it. The symptoms of Attention Deficit Disorders (ADD for short) exist on a continuum. Everybody has some of these symptoms some of the time. However, individuals with ADD have more of these symptoms more of the time and to the point that it interferes with their ability to function normally in academics, work and social settings, and to reach their potential.

People with ADD are often noted for their inconsistencies. One day they can \”do it,\” and the next they cannot. They can have difficulty remembering simple things yet have \”steel trap\” memories for complex issues. To avoid disappointment, frustration, and discouragement, do not expect their highest level of competence to be the standard. It is an unrealistic expectation of a person with ADD. What is normal is that they will be inconsistent.

Typically, they have problems with following through on instructions, paying attention appropriately to what they need to attend to, seem not to listen, be disorganized, have poor handwriting, miss details, have trouble starting tasks or with tasks that require planning or long-term effort, appear to be easily distracted, or forgetful. In addition, some people with ADD can be fidgety, verbally impulsive, unable to wait their turn, and act on impulse regardless of consequences.

However, it is important to remember — not all people with ADD have all of these difficulties, nor all of the time. Due to the fact that society has traditionally thought of a person with ADD as being \”hyper,\” many children who have ADD with no hyperactivity are not being identified or treated. Individuals with ADD without hyperactivity are sometimes thought of as day-dreamers or \”absent-minded professors. \” The non-hyperactive children with ADD most often seem to be girls (though girls can have ADD with hyperactivity, and boys can have ADD without hyperactivity).

Additionally, because of the ability of an individual with ADD to over-focus, or \”hyper-focus\” on something that is of great interest or highly stimulating, many untrained observers assume that this ability to concentrate negates the possibility of ADD being a concern, especially when they see children able to pay attention while working one-on-one with someone, doing something they enjoy, or who can sit and play an electronic game or watch TV for hours on end. ADD is not a learning disability.

Although ADD obviously affects the performance of a person in a school setting, it will also affect other domains of life, which can include relationships with others, running a home, keeping track of finances, and organizing, planning, and managing most areas of one’s life. ADD is considered to be a neurobiological disorder. The most recent research shows that the symptoms of ADD are caused by a chemical imbalance in the brain. To understand how this disorder interferes with one’s ability to focus, sustain attention, and with memory formation and retrieval, it is important to understand how the brain communicates information.

Each brain cell has one axon, the part of the cell that sends messages to other cells; and many dendrites, the part that receives messages from other cells. There is a space between the axon and the next brain cell called a neural gap. Since these nerve endings do not actually touch, special chemicals called neurotransmitters carry (transmit) the message from the end of the axon to the dendrites that will receive it. With ADD there is a flaw in the way the brain manages the neurotransmitter production, storage or flow, causing imbalances. There is either not enough of them, or the levels are not regulated, swinging wildly from high to low.

When diagnosing ADD, a thorough evaluation is very important. In order for an individual to be diagnosed with ADD, comprehensive evaluations must be administered that include a complete individual and family history, ability tests, achievement tests, and the collection of observations from people who are close to the person who is being assessed. It is also extremely important to have an assessment that is individualized and designed to uncover co-existing conditions, such as learning disabilities and behavior, mood or anxiety disorders (depression, generalized anxiety, obsessive-compulsive disorder, oppositional defiant disorder, etc. or any other problem that could be causing symptoms that look similar to the symptoms of ADD.

A thorough evaluation includes gathering information from a variety of sources. A thorough review of the person’s medical, academic and family history is essential. In the case of a child this is done through a detailed, structured interview with the parents. Behavior rating scales should be filled out by parents and teachers to provide information on types and severity of ADD symptoms at home and at school, as well as types and severity of other emotional or behavior problems.

Depression, anxiety and other emotional disorders are tested through a comprehensive psychological screening. Intellectual and achievement testing is used to help screen for and then assess learning problems, and areas of strength and greatest struggle. For decades, stimulant medications have been used to treat the symptoms of ADD. For many people, these medicines dramatically reduce their hyperactivity and improve their ability to focus, work, and learn. The medications may also improve physical coordination, such as handwriting and ability in sports.

Recent research by National Institute of Mental Health (NIMH) suggests that these medicines may also help those with an accompanying conduct disorder to control their impulsive, destructive behaviors. Current statistics show that about 1% to 3% of the school-aged population has the full ADD syndrome, without symptoms of other disorders. Another 5% to 10% of the school-aged population have a partial ADD syndrome or one with other problems, such as anxiety and depression present. Another 15% to 20% of the school-aged population may show transient, subclinical, or masquerading behaviors suggestive of ADD.

Reason 85) A diagnosis of ADD is not warranted if these behaviors are situational, do not produce impairment at home and school, or are clearly identified as symptoms of other disorders. It is the validity of the diagnosis of ADD which has sparked recent controversy. According to Richard Bromfield, Ph. D. , a psychologist on the faculty of Harvard Medical School: ADD exists as a disorder primarily because a committee of psychiatrists voted it so. In a valiant effort, they squeezed a laundry list of disparate symptoms into a neat package that can be handled and treated.

But while attention is an essential aspect of our functioning, it’s certainly not the only one. Why not bestow disorderhood on other problems common to people diagnosed with ADD, such as Easily Frustrated Disorder (EFD) or Nothing Makes Me Happy Disorder (NMMHD)? (Bromfield 22) His view illustrates the most controversial belief about Attention Deficit Disorder which is that it does not really exist and that children with the disorder are no different from their peers. There is also great controversy surrounding the stimulant most commonly used to treat ADD,

Methylphenidate, more commonly known as Ritalin. According to Bromfield, \”Ritalin is being dispensed with a speed and nonchalance compatible with our drive-through culture, yet entirely at odds with good medicine and common sense. \” (Bromfield 22) These issues have been at the core of the debate over the validity of ADD; other issues up for debate include the symptoms and causes of ADD, and the criteria for it’s diagnosis. The criteria for the diagnosis of Attention Deficit Disorder can be found in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), nicknamed DSM-IV.

The DSM-IV was developed in coordination with the tenth edition of the World Health Organization’s International Classification of Diseases, and groups some 230 psychological disorders and conditions into 17 categories of mental disorders. It is \”… the current authoritative scheme for classifying psychological disorders… \” (Myers 458a) In fact, most North American health insurance companies require a DSM-IV diagnosis before they will pay for therapy. The DSM-IV lists diagnoses for practically every conceivable complaint. Some critics find fault with the manual claiming it brings \”… most any kind of behavior within the compass of psychiatry. \” (Eysenck & Freedman & Wakefield 184)

However, for the DSM-IV categories to be valid, they must first be reliable. The guidelines for the DSM-IV work by asking clinicians a series of objective questions about observable behavior. In one study, 16 psychologists used the structured-interview procedure to diagnose 75 psychiatric patients as suffering from (1) depression, (2) generalized anxiety, or (3) some other disorder. Without knowing the first psychologist’s diagnosis, another psychologist viewed a videotape of each interview and offered a second opinion.

For 83 percent of the patients, the two opinions agreed. (Myers 458b) As evident, the DSM-IV is a reliable source, and the fact that Attention Deficit Disorder is recognized by the American Psychiatric Association in the DSM-IV aids in establishing it’s validity as a disorder. Another factor which aids in establishing ADD as a valid disorder is the fact that it is treatable through prescription medication and behavior therapy. There are two modalities of treatment that specifically target symptoms of ADD. One uses medication and the other is a non-medical treatment with psychosocial interventions.

The combination of these treatments is called multimodality treatment. Psychostimulants are the most widely used medications for the management of ADD symptoms. At least 70% to 80% of children and adults with ADD respond positively to psychostimulant medications, which have been used to treat the cognitive and behavioral symptoms of ADD for more than 50 years. (Laws [on-line]) Stimulant drugs, such as Ritalin, Dexedrine, and Aderall when used with medical supervision, are usually considered quite safe. Although they can be addictive to teenagers and adults if misused, these medication are not addictive in children.

They seldom make children \”high\” or jittery. Nor do they sedate the child. Rather, the stimulants help children control their hyperactivity, inattention, and other behaviors. Different doctors use the medications in slightly different ways. Ritalin and Dexedrine come in short-term tablets that last about 3 hours, as well as longer-term preparations that last through the school day. The short-term dose is often more practical for children who need medication only during the school day or for special situations, like attending church or a prom, or studying for an important exam.

As useful as these drugs are, Ritalin and the other stimulants have sparked a great deal of controversy. Most doctors feel the potential side effects should be carefully weighed against the benefits before prescribing the drugs. While on these medications, some children may lose weight, have less appetite, and temporarily grow more slowly. Others may have problems falling asleep. Other doctors say if they carefully watch the child’s height, weight, and overall development, the benefits of medication far outweigh the potential side effects. Side effects that do occur can often be handled by reducing the dosage.

However, doctors recommend that patients be taken off a medication now and then to see if it is still necessary. They recommend temporarily stopping the drug during school breaks and vacations, when focused attention and calm behavior are usually not as crucial; this precaution is referred to as a \”drug holiday. \” Drug therapy is a highly effective means of treating disorders, including ADD. They are \”… by far the most widely used biomedical treatments. \” (Myers 507b) When introduced in the 1950’s, drug therapy greatly reduced the need for psychosurgery or hospitalization.

\”Thanks to drug therapy… e resident population of state and county mental hospitals in the United States today is but 20 percent of what it was 40 years ago. \” (Myers 508a) For those not comfortable with drug therapy there are other means of treating ADD, such as behavior therapy. This is especially effective for children. For example, children with ADD need structure and routine. They should be helped to make schedules and break assignments down into small tasks to be performed one at a time. It may be necessary to ask them repeatedly what they have just done, how they might have acted differently, and why others react as they do.

Especially when young, these children often respond well to strict application of clear and consistent rules. In school, they may be helped by close monitoring, quiet study areas, short study periods broken by activity (including permission to leave the classroom occasionally), and brief directions often repeated. They can be taught how to use flashcards, outlines, and underlining. Timed tests should be avoided as much as possible. Other children in the classroom may show more tolerance if the problem is explained to them in terms they can understand.

When combined, drug and behavior therapies can be highly effective when treating Attention Deficit Disorder. Like many disorders, ADD is disruptive and if left untreated inhibits the proper functioning in society and of one’s daily activities. Family conflict is one of the most troublesome consequences of ADD. Especially when the symptoms have not yet been recognized and the diagnosis made, parents blame themselves, one another, and the child. As they become angrier and impose more punishment, the child becomes more defiant and alienated, and the parents still less willing to accept his excuses or believe his promises.

The home of an ADD child is frequently stressful and filled with conflict. The problems in the home vary based on the severity of symptoms, the make-up of the family and the personalities of family members. Take Johnny, for instance. A routine chore like getting dressed can become a battle as the parent first gently prompts Johnny to get dressed and stop playing with his toys, then nags and often, out of frustration, begins to yell. This scenario occurs almost every morning despite any repeated attempts by the parent to improve things.

A family dinner with an ADD child, rather than being a pleasant family gathering, becomes a dreaded hour. The child is bouncing around and knocks his plate on the floor. He constantly interrupts conversations and may erupt in a temper tantrum over a remark by a sibling. Daily life with an undiagnosed ADD child can cause a parent to question their parenting skills and ability to nurture a child. It can also stress the relationship between husband and wife especially if there is a disagreement about discipline methods or perception of the child’s behavior. Siblings’ rivalry is magnified.

If a child is extremely disruptive, the family may become isolated and certain members may withdraw from the family unit. School may also become of a place of chaos for an undiagnosed ADD child. ADD children often appear to be lazy or under-achievers. Their work is often incomplete, sloppy or lost. The paper may be done but directions were not followed. The child is often unprepared for class — he cannot find his pencil or worksheet or textbook. He may stare at the paper because they do not know how to start the assignment, and his performance is inconsistent.

Yet the ADD child is not dumb — in fact many have above average intelligence. Unbeknownst to most, Albert Einstein, Walt Disney, Winston Churchill, Henry Ford, and John F. Kennedy were all diagnosed with ADD. Children are not the only ones who may suffer if left undiagnosed; adults also struggle with this problem. Most adults with ADD were not diagnosed until they were adults. Throughout their lives, they have suffered a great deal of pain. Many have had to develop coping mechanisms to help them survive.

Over time, the constant pressure brought on by their new ways to cope with problems can bring about stress. As a result, some adults become overwhelmed, depressed, anxious, and lose confidence. As is evident, Attention Deficit Disorder clearly meets all the criteria for the definition of a disorder including the fact that it is recognized by the Diagnostic and Statistical Manual (Fourth Edition), it is treatable through prescription medication and behavioral therapy and if left untreated inhibits one from functioning in society properly.

At this time there is no cure for ADD, but much more is now known about effectively coping with and managing this persistent and troubling developmental disorder. Hopefully, the day is not far off when genetic testing for ADD may become available and more specialized medications may be designed to counter the specific genetic deficits of those who suffer from it.

Describing three recent events in which I have had cognitive dissonance is simple to describe. First I will define exactly what cognitive dissonance means. It is a state of unpleasant psychological tension that motivates us to reduce our cognitive inconsistencies by making our beliefs more consistent with one another. In simple terms it means stress of not knowing what to do. With that note I would like to describe my recent events dealing with inconsistencies in my normal thinking process.

My first event deals with attempting to get a job. In this area jobs are scarce and discovering a job available is rare but what if you were offered three jobs at one time and was indecisive in your final choice. Recently I was in this situation. Finding the effort for a job was stressful enough not to say being offered three at one given time. Then stress introduced me to three of his friends, which were the jobs themselves.

How was I to know which would be the best job, the promising job, and the most important issue of all income. Coming to my decision and solution of my dissonance I weighed all the factors, negative and positive, of the three jobs the one with the most advantages was my job choice. Concluding I had made the best choice for myself made me comfortable and my stress and dissonance level back to normal. My next stressful event was a major factor for the impact it would have on the rest of my life, college.

I am currently enrolled at Prestonsburg Community College but my degree is not offered here. My job preference and degree for the future is becoming an X-ray Technician. The colleges close to home that offer my degree are currently Hazard Community College, Morehead State University, and Lexington Community College. Figuring out what college is best for you and for your degree is very stressful concluding my cognitive dissonance is at a high rate.

To solve my stress and to plan the best future for myself I began to make plans. I paid visits to each college and subscribed information about the program, college, and miscellaneous issues. Reading all the information from each college, the location, and people there I am enrolling at Lexington Community College in the Fall Semester. Deciding on my future college plans left me at ease for my educational future. My third cognitive dissonance event is moving away from home. This stressful event is currently in effect.

Deciding plans to attend Lexington Community College results in me moving away from parents. At the age of nineteen I am really close to my parents and nervous about leaving home. It puts the stress issue currently in action at a tenaciously high rate. I worry about my parents getting sick or other natural problems that could occur. There is a point in time in every individual life to spread their wings and fly, be independent, be your own person, and in my life this time is approaching.

I know that the problems and issues that are a conflict to me at this time are situations that could happen even with me in my parents presence. I concluded that if I move away there is transportation and communication devices that will able me to stay in touch with my parents. After all I cant live with them forever. They have their own lives and I need to create mine. In all three of these situations I have experienced cognitive dissonance and solutions to all three events in the best knowledge possible to my individuality.

Five year old Danny is in kindergarten. It is playtime and he hops from chair to chair, swinging his arms and legs restlessly, and then begins to fiddle with the light switches, turning the lights on and off again to everyone’s annoyance–all the while talking nonstop. When his teacher encourages him to join a group of other children busy in the playroom, Danny interrupts a game that was already in progress and takes over, causing the other children to complain of his bossiness and drift away to other activities.

Even when Danny has the toys to himself, he fidgets aimlessly with them and seems unable to entertain himself quietly. To many, this may seem like a problem; and it is. Danny most likely suffers from what is called Attention Deficit Disorder. Recent controversy has erupted as to whether Attention Deficit Disorder in fact deserves the title of “disorder. ” Some people, like Thomas Armstrong, a psychologist and educator, believe Attention Deficit Disorder is merely a myth; “… umping ground for a heterogeneous group of kids who are hyperactive or inattentive for a number of reasons including underlying anxiety, depression, and stresses in their families, schools, and in our culture. ” (Armstrong 15)

However, he and those who question the validity of Attention Deficit Disorder are mistaken. Attention Deficit Disorder is in fact a disorder because it is recognized as such in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), it is treatable through prescription medication and therapy and if left untreated inhibits one from functioning properly in society.

Before delving into the ways in which Attention Deficit Disorder matches the criteria established for what a disorder is, it is important to first understand the disorder and have some background information on it. The symptoms of Attention Deficit Disorders (ADD for short) exist on a continuum. Everybody has some of these symptoms some of the time. However, individuals with ADD have more of these symptoms more of the time and to the point that it interferes with their ability to function normally in academics work and social settings, and to reach their potential.

People with ADD are often noted for their inconsistencies. One day they can “do it,” and the next they cannot. They can have difficulty remembering simple things yet have “steel trap” memories for complex issues. To avoid disappointment, frustration, and discouragement, do not expect their highest level of competence to be the standard. It is an unrealistic expectation of a person with ADD. What is normal is that they will be inconsistent.

Typically, they have problems with following through on instructions, paying attention appropriately to what they need to attend to, seem not to listen, be disorganized, have poor handwriting, miss details, have trouble starting tasks or with tasks that require planning or long-term effort, appear to be easily distracted, or forgetful. In addition, some people with ADD can be fidgety, verbally impulsive, unable to wait their turn, and act on impulse regardless of consequences.

However, it is important to remember — not all people with ADD have all of these difficulties, or all of the time. Due to the fact that society has traditionally thought of a person with ADD as being “hyper,” many children who have ADD with no hyperactivity are not being identified or treated. Individuals with ADD without hyperactivity are sometimes thought of as daydreamers or “absent-minded professors. ” The non-hyperactive children with ADD most often seem to be girls (though girls can have ADD with hyperactivity, and boys can have ADD without hyperactivity).

Additionally, because of the ability of an individual with ADD to over-focus, or “hyper-focus” on something that is of great interest or highly stimulating, many untrained observers assume that this ability to concentrate negates the possibility of ADD being a concern. Especially when they see children able to pay attention while working one-on-one with someone, doing something they enjoy, or who can sit and play an electronic game or watch TV for hours on end. ADD is not a learning disability.

Although ADD obviously affects the performance of a person in a school setting, it will also affect other domains of life, which can include relationships with others, running a home, keeping track of finances, and organizing, planning, and managing most areas of one’s life. ADD is considered to be a neurobiological disorder. The most recent research shows that the symptoms of ADD are caused by a chemical imbalance in the brain. To understand how this disorder interferes with one’s ability to focus, sustain attention, and with memory formation and retrieval, it is important to understand how the brain communicates information.

Each brain cell has one axon, the part of the cell that sends messages to other cells; and many dendrites, the part that receives messages from other cells. There is a space between the axon and the next brain cell called a neural gap. Since these nerve endings do not actually touch, special chemicals called neurotransmitters carry (transmit) the message from the end of the axon to the dendrites that will receive it. With ADD there is a flaw in the way the brain manages the neurotransmitter production, storage or flow, causing imbalances. There is either not enough of them, or the levels are not regulated, swinging wildly from high to low.

When diagnosing ADD, a thorough evaluation is very important. In order for an individual to be diagnosed with ADD, comprehensive evaluations must be administered that include a complete individual and family history, ability tests, achievement tests, and the collection of observations from people who are close to the person who is being assessed. It is also extremely important to have an assessment that is individualized and designed to uncover co-existing conditions, such as learning disabilities and behavior, mood or anxiety disorders (depression, generalized anxiety, obsessive-compulsive disorder, oppositional defiant disorder, etc. or any other problem that could be causing symptoms that look similar to the symptoms of ADD.

A thorough evaluation includes gathering information from a variety of sources. A thorough review of the person’s medical, academic and family history is essential. In the case of a child this is done through a detailed, structured interview with the parents. Behavior rating scales should be filled out by parents and teachers to provide information on types and severity of ADD symptoms at home and at school, as well as types and severity of other emotional or behavior problems.

Depression, anxiety and other emotional disorders are tested through a comprehensive psychological screening. Intellectual and achievement testing is used to help screen for and then assess learning problems, and areas of strength and greatest struggle. For decades, stimulant medications have been used to treat the symptoms of ADD. For many people, these medicines dramatically reduce their hyperactivity and improve their ability to focus, work, and learn. The medications may also improve physical coordination, such as handwriting and ability in sports.

Recent research by National Institute of Mental Health (NIMH) suggests that these medicines may also help those with an accompanying conduct disorder to control their impulsive, destructive behaviors. Current statistics show that about 1% to 3% of the school-aged population has the full ADD syndrome, without symptoms of other disorders. Another 5% to 10% of the school-aged population have a partial ADD syndrome or one with other problems, such as anxiety and depression present. Another 15% to 20% of the school-aged population may show transient, subclinical, or masquerading behaviors suggestive of ADD.

A diagnosis of ADD is not warranted if these behaviors are situational, do not produce impairment at home and school, or are clearly identified as symptoms of other disorders. It is the validity of the diagnosis of ADD, which has sparked recent controversy. According to Richard Bromfield, Ph. D. , a psychologist on the faculty of Harvard Medical School: “ADD exists as a disorder primarily because a committee of psychiatrists voted it so. In a valiant effort, they squeezed a laundry list of disparate symptoms into a neat package that can be handled and treated.

But while attention is an essential aspect of our functioning, it’s certainly not the only one. Why not bestow disorderhood on other problems common to people diagnosed with ADD, such as Easily Frustrated Disorder (EFD) or Nothing Makes Me Happy Disorder (NMMHD)? ” (Bromfield 22) His view illustrates the most controversial belief about Attention Deficit Disorder which is that it does not really exist and that children with the disorder are no different from their peers. There is also great controversy surrounding the stimulant most commonly used to treat ADD, Methylphenidate, more commonly known as Ritalin.

According to Bromfield, “Ritalin is being dispensed with a speed and nonchalance compatible with our drive-through culture, yet entirely at odds with good medicine and common sense. ” (Bromfield 22) These issues have been at the core of the debate over the validity of ADD; other issues up for debate include the symptoms and causes of ADD, and the criteria for its diagnosis. The criteria for the diagnosis of Attention Deficit Disorder can be found in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), nicknamed DSM-IV.

The DSM-IV was developed in coordination with the tenth edition of the World Health Organization’s International Classification of Diseases, and groups some 230 psychological disorders and conditions into 17 categories of mental disorders. It is “… the current authoritative scheme for classifying psychological disorders… ” (Myers 458a) In fact, most North American health insurance companies require a DSM-IV diagnosis before they will pay for therapy. The DSM-IV lists diagnoses for practically every conceivable complaint.

Some critics find fault with the manual claiming it brings “… almost any kind of behavior within the compass of psychiatry. ” (Eysenck & Freedman & Wakefield 184) However, for the DSM-IV categories to be valid, they must first be reliable. The guidelines for the DSM-IV work by asking clinicians a series of objective questions about observable behavior. In one study, 16 psychologists used the structured-interview procedure to diagnose 75 psychiatric patients as suffering from (1) depression, (2) generalized anxiety, or (3) some other disorder.

Without knowing the first psychologist’s diagnosis, another psychologist viewed videotape of each interview and offered a second opinion. For 83 percent of the patients, the two opinions agreed. (Myers 458b) As evident, the DSM-IV is a reliable source, and the fact that Attention Deficit Disorder is recognized by the American Psychiatric Association in the DSM-IV aids in establishing its validity as a disorder. Another that which aids in establishing ADD as a valid disorder is the fact that it is treatable through prescription medication and behavior therapy.

There are two modalities of treatment that specifically target symptoms of ADD. One uses medication and the other is a non-medical treatment with psychosocial interventions. The combination of these treatments is called multimodality treatment. Psychostimulants are the most widely used medications for the management of ADD symptoms. At least 70% to 80% of children and adults with ADD respond positively to psychostimulant medications, which have been used to treat the cognitive and behavioral symptoms of ADD for more than 50 years.

Laws [on-line]) Stimulant drugs, such as Ritalin, Dexedrine, and Aderall when used with medical supervision, are usually considered quite safe. Although they can be addictive to teenagers and adults if misused, these medications are not addictive in children. They seldom make children “high” or jittery. Nor do they sedate the child. Rather, the stimulants help children control their hyperactivity, inattention, and other behaviors. Different doctors use the medications in slightly different ways. Ritalin and Dexedrine come in short-term tablets that last about 3 hours, as well as longer-term preparations that last through the school day.

The short-term dose is often more practical for children who need medication only during the school day or for special situations, like attending church or a prom, or studying for an important exam. As useful as these drugs are, Ritalin and the other stimulants have sparked a great deal of controversy. Most doctors feel the potential side effects should be carefully weighed against the benefits before prescribing the drugs. While on these medications, some children may lose weight, have less appetite, and temporarily grow more slowly. Others may have problems falling asleep.

Other doctors say if they carefully watch the child’s height, weight, and overall development, the benefits of medication far outweigh the potential side effects. Side effects that do occur can often be handled by reducing the dosage. However, doctors recommend that patients be taken off a medication now and then to see if it is still necessary. They recommend temporarily stopping the drug during school breaks and vacations, when focused attention and calm behavior are usually not as crucial; this precaution is referred to as a “drug holiday. ” Drug therapy is a highly effective means of treating disorders, including ADD.

They are “… by far the most widely used biomedical treatments. ” (Myers 507b) When introduced in the 1950’s, drug therapy greatly reduced the need for psychosurgery or hospitalization. “Thanks to drug therapy… the resident population of state and county mental hospitals in the United States today is but 20 percent of what it was 40 years ago. ” (Myers 508a) For those not comfortable with drug therapy there are other means of treating ADD, such as behavior therapy. This is especially effective for children. For example, children with ADD need structure and routine.

They should be helped to make schedules and break assignments down into small tasks to be performed one at a time. It may be necessary to ask them repeatedly what they have just done, how they might have acted differently, and why others react as they do. Especially when young, these children often respond well to strict application of clear and consistent rules. In school, they may be helped by close monitoring, quiet study areas, short study periods broken by activity (including permission to leave the classroom occasionally), and brief directions often repeated.

They can be taught how to use flashcards, outlines, and underlining. Timed tests should be avoided as much as possible. Other children in the classroom may show more tolerance if the problem is explained to them in terms they can understand. When combined, drug and behavior therapies can be highly effective when treating Attention Deficit Disorder. Like many disorders, ADD is disruptive and if left untreated inhibits the proper functioning in society and of one’s daily activities. Family conflict is one of the most troublesome consequences of ADD.

Especially when the symptoms have not yet been recognized and the diagnosis is made, parents blame themselves, one another, and the child. As they become angrier and impose more punishment, the child becomes more defiant and alienated, and the parents still less willing to accept his excuses or believe his promises. The home of an ADD child is frequently stressful and filled with conflict. The problems in the home vary based on the severity of symptoms, the make-up of the family and the personalities of family members. Take Johnny, for instance.

A routine chore like getting dressed can become a battle as the parent first gently prompts Johnny to get dressed and stop playing with his toys, then nags and often, out of frustration, begins to yell. This scenario occurs almost every morning despite any repeated attempts by the parent to improve things. A family dinner with an ADD child, rather than being a pleasant family gathering, becomes a dreaded hour. The child is bouncing around and knocks his plate on the floor. He constantly interrupts conversations and may erupt in a temper tantrum over a remark by a sibling.

Daily life with an undiagnosed ADD child can cause a parent to question their parenting skills and ability to nurture a child. It can also stress the relationship between husband and wife especially if there is a disagreement about discipline methods or perception of the child’s behavior. Siblings’ rivalry is magnified. If a child is extremely disruptive, the family may become isolated and certain members may withdraw from the family unit. School may also become of a place of chaos for an undiagnosed ADD child. ADD children often appear to be lazy or under-achievers. Their work is often incomplete, sloppy or lost.

The paper may be done but directions were not followed. The child is often unprepared for class — he cannot find his pencil or worksheet or textbook. He may stare at the paper because they do not know how to start the assignment, and his performance is inconsistent. Yet the ADD child is not dumb — in fact many have above average intelligence. Unbeknownst to most, Albert Einstein, Walt Disney, Winston Churchill, Henry Ford, and John F. Kennedy were all diagnosed with ADD. Children are not the only ones who may suffer if left undiagnosed; adults also struggle with this problem.

Most adults with ADD were not diagnosed until they were adults. Throughout their lives, they have suffered a great deal of pain. Many have had to develop coping mechanisms to help them survive. Over time, the constant pressure brought on by their new ways to cope with problems can bring about stress. As a result, some adults become overwhelmed, depressed, anxious, and lose confidence. As is evident, Attention Deficit Disorder clearly meets all the criteria for the definition of a disorder including the fact that it is recognized by the Diagnostic and Statistical Manual (Fourth Edition).

It is treatable through prescription medication and behavioral therapy and if left untreated inhibits one from functioning in society properly. At this time there is no cure for ADD, but much more is now known about effectively coping with and managing this persistent and troubling developmental disorder. Hopefully, the day is not far off when genetic testing for ADD may become available and more specialized medications may be designed to counter the specific genetic deficits of those who suffer from it.

Approximately 3-5% of all American children have an Attention Deficit Disorder (ADD). ADD is a leading cause of school failure and under-achievement. ADD characteristics often arise in early childhood. As many as 50% of children with ADD are never diagnosed. Boys significantly outnumber girls, though girls are more likely to be undiagnosed with ADD. “ADD is not an attention disorder, but a disorder of impulse control ( Seminar notes Barkeley).

Characteristics of Attention Deficit Disorder can include : Fidgeting with hands or feet , difficulty remaining seated, awaiting turns in games, ollowing through on instructions , shifting from one uncompleted task to another, difficulty playing quietly, interrupting conversations and intruding into other children’s games, appearing to be not listening to what is being said, doing things that are dangerous without thinking about the consequences. Most scientist now believe that a brain dysfunction or abnormality in brain chemistry could be to blame for the symptoms of Attention Deficit Disorder.

The frontal lobes of the brain are thought to be most responsible for the regulation of behavior and attention. They receive information from the lower rain, which regulated arousal and screens incoming messages from within and outside of the body. The limbic system , a group of related nervous system structures located in the midbrain and linked to emotions and feelings, also sends messages to the frontal lobes. Finally, the frontal lobes are suspected to be the site of working memory, the place where information about the immediate environment is considered for memory storage, planning, and future-directed behavior.

Scientist believe the activity in the frontal lobes is depressed in people with ADD. Studies show a decrease in the ability of the ADD brain to use lucose, the body’s main source of energy, leading to slower and less efficient activity. Neurotransmitters provide the connection between one nerve cell and another. In essence, neurotransmitters allow electrical impulses to pass across synapses from one neuron to another. It is now suspected that people with Attention Deficit Disorder have a chemical imbalance of a class of neurotransmitters called catecholamines.

Dopamine, helps to form a pathway between the motor center of the midbrain and the frontal lobes, as well as a pathway between the limbic system and the frontal lobes. Without enough dopamine nd related catecholamines, such as serotonin and norepinephrine, the frontal lobes are under stimulated and thus unable to perform their complex functions efficiently. Attention Deficit Disorder is strongly considered genetically inherited, however, not all cases of ADD may be genetically linked. . Studies have shown that 20-30% of all hyperactive children have a least one parent with ADD.

The environment is a big influence on a child during pregnancy and after. Some studies show that a small percentage of ADD cases were influenced by smoking, drinking alcohol, and using drugs during pregnancy. Exposure to toxins, such as lead, may also alter the brain chemistry and function. If you suspect that you are suffering from Attention Deficit Disorder you will need to discuss it with your medical doctor. In most cases the doctor will recommend that you visit a psychologist for an evaluation.

The psychologist is professionally trained in human behavior and will be able to provide counseling and testing in areas related to mental health. The psychologist is not able to prescribe medication to help you, but may send you to a psychiatrist to prescribe and monitor medication. A neurologist may be consulted in order to rule out neurological conditions causing your symptoms. Your doctor will gather information about your past and present difficulties, medical history , current psychological makeup, educational and behavioral functioning.

Depending on your symptoms, your diagnosis may be categorized as ADD, inattentive type ADD, or hyperactive/impulsive type ADD. After your diagnosis you may learn that you are also suffering from a learning disability, depression, or substance abuse, which is often associated with ADD. There is no cure for Attention Deficit Disorder. Along with increasing awareness of the problem, a better understanding of its causes and treatment has developed (3 Wender)”. There is medication for ADD which will only alleviate the symptoms.

The medication will not permanently restore the chemical balance. Approximately 70% of adults with ADD find that their symptoms significantly improve after they take medication prescribed by their doctors. The patient is able to concentrate on difficult and time-consuming tasks, stop impulsive behavior , and tame the restless twitches that have been experienced in the past. Some ADD patient’s psychological and behavioral problems are not solved by medication alone, and are required more therapy or training .

There are two types of drugs that work to balance the neurotransmitters and have been found to be most effective in treating ADD. Stimulants are drugs that stimulate or activate brain activity. Stimulants work by increasing the amount of dopamine either produced in the brain or used by the frontal lobes of the brain. There are several different stimulants that may work to alleviate the symptoms of ADD, including methylphenidate (Ritalin), dextroamphetamine Dexedrine), and pemoline (Cylert). Stimulants are by far the most effective medications in the treatment of ADD.

Some patients respond well to antidepressants. Antidepressants also stimulate brain activity in the frontal lobes, but they affect the production and use of other chemicals, usually norepinephrine and serotonin. The antidepressants considered most useful for ADD include imipramine (Tofranil), desipramine (Norpramin), bupropion ( Wellbutrin), and fluoxetine hydrochloride (Prozac). All stimulants have the same set of side effects. Some patients complain f feeling nauseous or headachy at the outset of treatment, but find that these side effects pass within a few days.

Others find that their appetites are suppressed and or that they have difficulty sleeping. If the stimulant dosage is too high the patient may experience feelings of nervousness, agitation, and anxiety, In rare cases, increased heart rate and high blood pressure can result with the use of stimulants, especially if the patient has an underlying predisposition toward hypertension. Ritalin is the most widely prescribed drug used to treat ADD in both children and adults. Ritalin appears to work by stimulating the production of the neurotransmitter dopamine.

The benefits of Ritalin include improved concentration and reduced distractibility and disorganization. Dextroamphetamine is another stimulant medication that appears to have a slightly different pharmacological action than Ritalin. Both work to boost the amount of available dopamine. Dextroamphetamine, however, blocks the reuptake of the neurotransmitter while Ritalin increases its production (334 Kelly, Ramundo, Press). All the drugs used to treat ADD have the same goal: to provide the brain ith the raw materials it needs to concentrate over a sustained period of time, control impulses, and regulate motor activity.

The drug or combination of drugs that work best for you depends on the individuals brain chemistry and constellation of symptoms. The process of finding the right drug can be tricky for each individual. The physicians are not able to accurately predict how any one individual will respond to various doses or types of Attention Deficit Disorder medication. Medication is rarely enough for the patient. Most Attention Deficit Disorder patients require therapy to give guidance . Adult patients have the burden of the past that often hinders their progress.

The patient then needs help with the relief of disappointment, frustration, and nagging sense of self- doubt that often weighs upon the ADD patient. Some ADD patients suffer from low- grade depression or anxiety, others with a dependence on alcohol or drugs, and most with low self-esteem and feelings of helplessness. Therapy also helps the ADD patient fully understand the disorder and how it controls the patients life. The knowledge of ADD will make the patient and arents more capable of changing the behaviors or circumstances disliked and enhancing strengths and assets.

A second and most crucial part of the education process involves informing those around you about the disorder and its effects. Family members, friends, employers, and colleagues have been playing roles in the drama called ADD without ever being aware of it. Explaining how the disorder may affect the relationships around the patient will help repair any past damage as well as pave the way to a stable future. Attention Deficit Disorder is difficult for any family. ADD challenges the relationships and the issues of daily family life.

Getting a family household to function smoothly is challenging for any family, with or without the presence of ADD. Adults and children suffering from Attention Deficit Disorder have trouble establishing and maintaining physical order, coordinating schedules and activities, and accepting and meeting responsibilities. Parents with children suffering with ADD have to learn how to deal with the obstacles that they will have while raising their child. Adults dealing with ADD often have chronic employment problems, mpulsive spending, and erratic bookkeeping and bill paying.

Raising healthy, well-adjusted children requires patience, sound judgment, good humor, and, discipline which is difficult for an ADD parent to do. The presence of ADD often hinders the development of intimate relationships for a variety of reasons. Although many adults with ADD enjoy successful, satisfying marriages, the disorder almost always adds a certain amount of extra tension and pressure to the union. The non-ADD spouse bears an additional burden of responsibility for keeping the household running smoothly and meeting the needs of the children, he spouse with ADD, and, if he or she has time, his or her own priorities.

Parenting a child who has ADD can be an exhausting and, at times, frustrating experience. Parents play a key role in managing the disability. They usually need specialized training in behavior management and benefit greatly from parent support groups. Parents often find that approaches to parenting that work well with children who do not have ADD, do not work as well with children who have ADD. Parents often feel helpless, frustrated and exhausted. Too often, family members become angry and withdraw from each other. If untreated, the situation only worsens.

Parent training can be one of the most important and effective interventions for a child with ADD. Effective training will teach parents how to apply strategies to manage their child’s behavior and improve their relationship with their child. Without consistent structure and clearly defined expectations and limits, children with ADD can become quite confused about the behaviors that are expected of them. Making and keeping friends is a difficult task for children with ADD. A variety of behavioral excesses and deficits common to these children get in the ay of friendships.

They may talk too much, dominate activities, intrude in others’ games, or quit a game before its done. They may be unable to pay attention to what another child is saying, not respond when someone else tries to initiate and activity, or exhibit inappropriate behavior. I decided to write my research paper on Attention Deficit Disorder because my four-year old step-brother has recently been diagnosed with the disorder. I hope that my relationship with my brother can become closer now that I have a better understanding of what he is suffering from.

In the 1920’s, Leonard Lowe is a normal ten year old boy who is attacked by a mysteriously crippling disease. The onset of the disease manifests itself in periods of what I can only term suspended animation. At one moment, the victim is engaging in a normal activity, and at another he appears to be a living statue. Early in the disease, these periods of suspension last anywhere from a few moments to a few hours, and eventually, the victim is trapped seemingly forever in the statue phase. Only certain specific outside stimuli obtains a physical reaction, such as catching a ball or walking.

When the movie begins, they show Leonard to us as a normal and seemingly healthy ten year old boy who is afflicted with the “sleeping sickness” disease that reached epidemic proportions during that specific era. Like many others who contracted this illness, Leonard and those like him were often misdiagnosed and eventually placed in mental hospital facilities because of their apparent vegetative state. Doctors who worked on the earlier cases believed the patients mental faculties to have been destroyed by the illness.

Dr. Sayer (Dr. Oliver Sacks in real life) discovers that certain vegetative patients reacted to outside stimuli, such as a pattern on a floor, a tossed ball, or a television with a maladjusted vertical hold. Finally, Dr. Sayer comes across Leonard as a middle-aged man, some thirty years after he was originally afflicted with the disease. After doing some tests, the doctor comes to realize that there is brain activity and convinces his colleagues that further tests should be considered. He theorizes that a newly developed drug, L-Dopa, developed for the treatment of Parkinson’s patients may benefit these patients. He doses Leonard, with no initial success.

Once again he theorizes that the acid in the Orange Juice, which he had been giving with the medicine may actually be neutralizing the effects of the drug. He tries once more with milk, and obtains some rather startling results. The drug has not only succeeded in obtaining a reaction from the patient, but seemingly it has brought him completely out of his “comatose” condition. The doctor discovers him in the patient’s lounge area coloring in a coloring book. Unfortunately for Leonard, he is completely unaware that he is no longer ten years old. What Dr. Sacks discovered is what we today call Tourette’s Syndrome.

Tourette’s Syndrome is an inherited, neurological disorder characterized by repeated and involuntary body movements (tics) and uncontrollable vocal sounds. In a small amount of cases, the vocalizations can include socially inappropriate words and phrases — called coprolalia. These outbursts are neither intentional nor purposeful. Involuntary symptoms can included eye blinking, repeated throat clearing or sniffing, arm thrusting, kicking movements, shoulder shrugging or jumping. These and other symptoms typically appear before the age of 18 and the condition occurs in all ethnic groups with males affected 3 to 4 times more often than females.

Although the symptoms of TS vary from person to person and range from very mild to severe, the majority of cases fall into the mild category. Associated conditions can include obsessivity, attention problems and impulsiveness. Most people with TS lead productive lives and participate in all professions. For example, Mahmoud Abdul-Rauf (formerly Chris Jackson) is the leading free throw shooter in the NBA. A guard on the Denver Nuggets, he came to the NBA from Louisiana State University where he was an instant sensation, scoring 48 points in his third game.

Abdul-Rauf is featured in an independent documentary “Twitch & Shout” produced by two film makers with TS. It is said that Mahmoud’s obsessive-compulsive TS traits are the reason for his unbelievable proficiency at the foul line. Increased public understanding and tolerance of TS symptoms are of paramount importance to people with Tourette Syndrome. Before Tourette’s Syndrome was recognized as a disease, the effects could be as bad as Leonards. The early effects of this disease included living as a statue and only moving when approached by specific stimuli. This is the form of Tourette Syndrome depicted with in the movie Awakenings.

The tics associated with Tourette’s Syndrome can cause a extreme amount of psychological problems such as feelings of being an outcast, thoughts of suicide and much worse. Perhaps you’re riding a bus and you notice that the man next to you is blinking constantly and with exaggeration for no apparent reason. Maybe you’re in the video store and a woman choosing a film begins to yelp like a dog. Or you’ve sat down in a movie theater and a man two rows back spontaneously and frighteningly spouts profanities at no one in particular. The tics are associated with misbehavior and kids are often labeled bad.

This can cause immense psychological harm to this child, if the child has yet to be diagnosed. Even adults with undiagnosed TS can run into trouble. Only a few years ago, major league baseball player Jim Eisenreich’s career nearly ended because of unrecognized TS. With help, he has gone on to have a very successful baseball career. We have to be accepting [of people with TS], rather than rejecting them from society. We must give them the opportunity to see health-care professionals skilled in neurobehavioral disorders rather than classifying what they have as ‘mental illness,’ which limits benefits and access to providers.

We have to make reasonable accommodations for them in school and at work. If you meet a person with Tourette’s syndrome, it is recommended that you think of him/her as if he/she has a bad stutter. Simply wait for the tics to resolve, then continue conversation in a normal way. Just ignore the expletives or activity and converse as you normally would. If it’s intended as an insult, it will continue as a well-structured insult. Complex tics usually don’t have that much structure and sound more like someone venting in frustration.

In Bobbys second grade classroom, his teacher threw up her hands and said, That is it! On that very morning, Bobby leaped out of his seat seven times to go sharpen his pencil, each time accidentally colliding into other students desks and chairs, sending papers and books plunging to the floor. Bobby screamed out comments to every slightly comical part of the book that the teacher read. His teachers last straw was when, after repeatedly kicking the desk in front of him, it toppled to the floor, spewing all its contents to the ground.

This is a strong example of Attention Deficit / Hyperactivity Disorder (ADHD) in the 90s. However, most cases in which a doctor is brought in to rule if a child has ADHD are not like the previous example. A majority of these cases are with children in the gray area, not constantly showing the signs of ADHD, but showing signs only occasionally. This is where the over-diagnosis of children with ADHD comes into play, in that gray area. Attention Deficit/ Hyperactivity Disorder is a disorder composed of three major components: inattentiveness, impulsivity, and motor hyperactivity.

Symptoms of these components include excessive fidgeting with hands or feet, repeated difficulty remaining seated, following through on instructions, extreme difficulty in attempting to play quietly, and excessive interruption of conversations, just to list a few. A child with ADHD can bear one or all of these features, depending on the severity of the case. These children usually have functional impairments in a variety of places including the home, school, and in relationships with fellow peers.

These signs can come and go, being extremely prevalent one day and unnoticeable the next. ADHD is a very complicated disorder. Most people have the false perception that this disorder is like a chronic ear infection or diabetes, where prescriptions of penicillin or continual injections of insulin will cure the ailment. Well, ADHD is different and is surprisingly unclear. There is no clear consensus on what the cause or causes of this disease are. There have been countless theories however, and all have been disproved through studies.

There is no urine test, blood test, PET scan, or physical test or examination that can tell if someone does or doesnt have ADHD. This translates into mass confusion when parents, teachers, and even doctors are called upon to diagnose a child with this disorder or not. Psychiatrists around the world say that, about half the children who show up in their offices as ADHD referrals are actually suffering from a variety of other ailments, including learning disabilities, depression or anxiety-disorders that look like ADHD, but do not need Ritalin.

Some seem to be just regular kids. (Newsweek, pg. 52) It is estimated that ADHD effects two million children in the United States, this translates into three to five percent of all school-age children. Even more frightening, is that in some areas up to twenty percent of children have ADHD. However, these diagnoses are inconsistent. One reason for this enormous number of cases is due to the fact that there is not proper testing for ADHD before the diagnosis is completed. One familys situation was published in an October 1998 issue of Time.

The parents took their daughter, Erin to a psychiatrist just before her fifth birthday. The doctor saw the concerned parents for 45 minutes. During this time the doctor read the teachers report on Erin. Then he saw Erin for 14 minutes. After that short time span, he came to his conclusion, and said, Your daughter has ADHD, and heres a prescription of Ritalin. (pg. 6) The parents were astounded to here those words come out of his mouth, to prescribe a powerful drug like Ritalin after only a 15 minute meeting with their child to evaluate her condition.

In a recent report in the Archives of Pediatric and Adolescent Medicine almost half the pediatricians surveyed said they send ADHD children home in an hour. (pg. ?) Many of these doctors have those children walking back out of that door so quick with their new label of ADHD, that they do not even have time to contact the teachers, look at their educational records, or have the child meet with a psychiatrist, which is all very essential. Doctors are not taking the proper time to analyze a serious problem like ADHD. One of the reasons that doctors rapidly diagnose ADHD is due to the persistence of parents.

Doctors find themselves feuding with apprehensive parents that are worried that their child is ruining his/her future because of a bit of hyperactivity, or jitteriness that is apparent in the classroom or at home. They demand drugs from their doctors, and if they refused to fulfill their demand, they will find a physician that is more understanding of their views. Parents are getting to the point were they feel they need to mold their children into a little angel. They will go to any extreme, even drugs. to accomplish this.

As Lawrence Diller states in Running on Ritalin, In order for them to succeed, we make them take performance enhancers. (Diller pg. 96) What he is saying is that parents want their children to succeed so much that they are making them take performance enhancers, like Ritalin. What once was looked at as normal, children interested in different things and having different skills and talents, is now analyzed as a disease that needs to be fixed with powerful drugs. After these faulty diagnoses take place, most of the time doctors prescribe stimulant drugs, such as Ritalin, Dexedrine, Adderil, and Cylert.

Above all, Ritalin is the most popular stimulant to be prescribed and has a series of adverse side effects. Ritalin is actually the manufacturers name for the generic chemical methyphenidate, a derivative of amphetamine. Ritalin is similar to the street drug of speed. A child on Ritalin can exhibit several of the following short term side effects: loss of appetite and resulting weight loss, insomnia, headaches, stomach aches, drowsiness, potential liver damage, facial tics, and a sense of sadness, just to mention a few. Also, several authorities report that there can be devastating long term side effects.

Probably the most disturbing fact is that this is a drug that comes from the amphetamine group and can possess strong addictions. This very drug with its addictive qualities, is prescribed to children as young as four years old. Ritalin is used mainly in treating children, whose brains and personalities are still being formed and who do not make the decision themselves about talking the drug. This drug greatly enhances the chance of a person, especially a child, of having long term drug and alcohol abuse. In Lawrence Dillers book Running on Ritalin, he talks about a number of animal and human studies that took place from the 1930s on.

In these studies subjects that were given the opportunity to self-administer Ritalin would choice to continually repeat the amphetamine experience. Laboratory rats will self-administer intravenous Ritalin literally to death, repeatedly choosing the drug over food, and there by starving (Diller pg 23). These desires would increase over time over time, indicating a built up tolerance for the drug. This was followed by a similar pattern emerging outside of the lab by the late 1960s, finally revealing the darker side of stimulant drugs like Ritalin.

The surprising fact is that this drug, with its harmful side effects, is dealt to some children that, for the most part, are not even positively identified with ADHD. Doctors must set strict guidelines and start using structured parent questionnaires, rating scales, or teacher and school input to correctly diagnose kids, so they receive the proper medication and treatment. This will eliminate the harm done to the wrongly diagnosed children that are currently ingesting powerful drugs like Ritalin.

Doctors have to find a new way to deal with this overwhelming increase in ADHD more effectively, instead of continually administering Ritalin. There has been a new finding that is less harmful in helping children with ADHD. This new tool is EEG (electroencephalogram, or brain wave) biofeedback. The way they use this towards treating ADHD patients is quite simple. Technicians distinguish between training at higher frequencies (15-18 Hz, which is referred to as beta) and at lower frequencies (12-15 Hz, or SMR training) with the overall beta range of frequencies.

Thes have vastly dirrerent effects. In beta training we appear t obe dealing with conditions of underarousal, either in duded by trauma of some kind, or fo genetic origin. In SMR hypervigilance, of heightened stress susceptibility. The EEG in ADHD children tends to be of larger amplitude than that of other children. In particular, the DDG is higher at the lower frequencies. This condition is more appropriate to a sleep or day-dreaming state than an alert and focused state. IN these chidren, the EEG shows that cortical electrical activity is disregulated.

The greates point of difference between a typical ADHD EEG and a normal adult EEG is in the low-frequency component. The low frequency activity gradually diminishes as the child ages, and as the brain learns to stabilize and reulate the cortex. Hence, the EEG of an ADHD child looks like that of a younger child. Unfortunately, it may not mature in the normal fashion by itself. The symptoms may arise, then, from a condition of a disregulated EEG, in combination with whatever the childs particular weaknesses are, given his genetic makeup and any trauma he may have suffered.

The disregulated EEG shows up over a broad are of the cortex. The specific weaknesses related to localized areas of the cortex. So then in EEG training for ADHD, they present information to the child about what is happening at that moment in his cortex. They are seeing their own brain waves misbehave, and they try to get them under control. Gradually, the patient is able to do so. Once the childs brain has learned to regulate itself better, it continues to use that skill, just as other childrens brains do naturally. When this happens, there are numerous improvements.

Ones sleeping may improve, bedwetting may stop, headaches may disappear, less temper tantrums, reading level may increase, school behavior may become less disruptive, and his math and writing may also improve. Among the symptoms responding to the training, it is easiest to document progress with tests of cognitive function and of intelligence. In one thirteen year old boys case by the name of David tremendous results occurred. David was an eighth grade student who had reading and math shills one to two years below grade level. He was failing every subject and seemed distined to repeat the eigth grade.

His teachers described his as disruptive and oppostional in class and stated that he had difficulty paying attention during structured and unstructured activities. The school administrators contacted his grandparents and suggested that he was likely suffering form an Attention-Deficit Hyperactivity Disorder. They recommended that he be taken to his pediatrician and placed on Ritalin. At home his father virtually abandoned him from birth. His mother, overwhelmed by the task of raising him and his two sisters without spousal help, relapsed into drug and alcohol abuse.

She was frequently drunk and around David she was moody and volatile. He ran wild. He refused to obey her curfews, going to be late at night and failing to rise for school in the morning. Intermittently he wet the bed. He never helped the family with housekeeping or yard work chores. His mothers parents, sensing that she needed heip with David, and having been advised of his problems at school, intervened. Even though David attended a good school in an affluent district, his grandparents doubted the wisdom of placing David on drugs. They thought it would only compound his problems.

When they sought the advice of the family pediatrician, they asked for an alternative to Ritalin being concerned about Davids potential for developing a substance abuse problem like his mother. They referred to A Center for Educational and Personal Development (CEPD) where they could find a balanced, non-pharmacologic treatment approach which used as its cornerstone brainwave-based biofeedback, also called Neurofeedback. The director of the center, Barry Belt, a Licensed Psychologist and Certified Neurotherapist, found David so hyperactive that he could only sit still for a minute.

They measured Davids brain functioning, and found too much slow-wave activity and not enough fast wave activity. Simply put, his brain was daydreaming instead of paying attention far too much to allow him to learn effectively. David was put on a strict diet, entered an alternative school that fit his needs better, and was enrolled in counseling. However, most importantly, David began to use Neurofeedback which trained him to alter his brain functioning so the he would daydream less and pay attention more. They used special software and computer enhanced techniques which allow him to monitor his progress like it was a videogame.

After the third session of Neurofeedback David started to enjoy the sessions. By the tenth his mother mentioned that he was more attentive at home. After the fifteenth session he started to help the family with household chores. After the twentieth he stopped wetting his bed, and by the twenty-fifth his grades and behavior drastically improved. By the fortieth session his attention span had increased from less than a minute to over forty-five. After a six month time period his math and reading scores increased by one whole grade level. He was now on the honor roll, and his teachers described his behavior as excellent.

David looked forward to making it back to his original junior high school, at his respected grade level. He though of himself as responsive young man. David continued to experience greater success, but he also had his occasional setbacks. We know that most children that are diagnosed with ADHD do not have drug addictions running in their family. However, if this treatment can work for people like David, then it can most certainly be worth at least a try for other children with his same disorder, instead of repeatedly popping dangerous pills into their mouths, like Ritalin.

Attention Deficit / Hyperactivity Disorder is a condition that many of the children of the United States are continuously getting diagnosed with more and more. This prognosis comes in combination, for the most part, with Ritalin. There has been a 700 percent increase in prescribing this drug since 1990. This statistic would not be as frightening if there was a cause for this disease, so that there would be a proper way to diagnose, so over-diagnosis did not take place. What we are doing to our children is trying to put the pieces of their life together as we see fit, like a puzzle.

However, we stumble upon the situation where a piece does not fit were we want it to be. So, instead of taking our child for how they are, excepting their small differences and leaving the piece of lifes puzzle where it fits naturally, we try to smash the piece into place where it should be compared to all the other children. This is what happens when slightly different kids are diagnosed with ADHD and prescribed Ritalin. The kids are manipulated into something that they are not. Hopefully, with some time, there will be a medication found that can treat ADHD without masking the childs true feelings.

The following project aims to discuss the debilitating illness Premenstrual Dysphoric Disorder (PMDD), whilst comparing and contrasting the symptoms and severity of PMDD to Premenstrual tension (PMT). The last fifty years has finally shown recognition to the fact women suffer recurring symptoms surrounding their menstrual cycle. Women prior to this time had to endure these problems in silence and put up with them as part of their life.

Due to the change in society newly emancipated women given the freedom of speech spoke out and made an issue of these problems, with he topic made public many women finally realised it was normal to have such problems and began to seek medical assistance. With the increasing demand of treatment required further research was carried out which led doctors to establish women could indeed suffer from two forms of premenstrual disorder, these disorders were finally given titles Premenstrual Tension and Premenstrual Dysphoric Disorder.

Intensive research uncovered women could suffer extreme bouts of depression and abnormal behaviour which could lead to self-harming (see appendix 1) or iolence against others. With this knowledge PMT and PMDD were added to the Diagnostic and Statistical Manuel of Mental Disorders (DSM-IV). There has been much debate surrounding these illnesses, many critics have stated women exaggerate their problems for attention or for avoidance of arguments.

It is obvious from the ignorance of these individuals they haven’t had the misfortune of ever having to live with such a debilitating disease. The following hypothesis aims to prove men and the older generation have imited information surrounding both PMT and PMDD, or the results concluded may be due to chance alone Method of Research The method of research used within this psychological study was a questionnaire which consisted of ten closed questions.

The ten participants who performed the questionnaire were chosen using the matched participant design, five men and five women each of approximately equal age were used to create an equal and more precise questionnaire. The participants chosen were asked to complete the questionnaire in a eutral environment with minimum distractions, for this purpose the subjects attended the local library all at the same time and were seated so they had to answer independently. Once the questionnaire was complete the participants waited quietly for the others to finish.

I chose to study the topic PMDD as I have witnessed first hand the devastating repercussions that can occur through avoidance of treatment and unsupporting spouses. My mother has suffered from PMT related illnesses since she was twenty, during this time my sister and me were born, the elationship we had with our mother was extremely difficult, one day she was the best mum in the world who loved to plait our hair and take us to the park the next day she was a seething monster, I never knew from day to day which persona my mum would take.

As the years went by and I got older I began to notice the friction between my mum and dad which my monster mum caused, my dad would disappear for days or huge arguments would occur with a lot of shouting and pot throwing, the inevitable happened and finally they told me they didn’t love each other anymore. My mum moved out which led to seeing her only on a weekend, my sister and I were devastated I was nine years old.

Our family life became more sedate and quiet, and when I saw my mum she was mostly the happy mum again. As the years went by I started to notice a sequence in my mums behaviour, she would be the monster mum about a week before her period and the lovely mum the week during her period, during my first year at senior school the girls of my class were given a talk on periods and symptoms which were classed as PMT, all the ymptoms given were identical to my monster mums.

One weekend she was extremely upset and I knew she was suffering I suggested she see the doctor, she laughed at me and told me there was nothing he could do for her, I showed her a leaflet the school nurse had given me on PMT which explained possible treatments, she seemed interested and I left it with her to read, over the next few months the monster mum seemed to be lessening.

My mum had finally being diagnosed with PMDD, she now takes an ntidepressant which aids her symptoms, sometimes the monster mum does reappear but that’s usually when my step dad has annoyed her which is part an parcel of having a spouse any way. If I was to repeat my questionnaire again I would increase the amount of people used and add some further questions, and interview would probably back up any fresh findings and add fresh light on to how the severity of such a debilitating disease can affect an individual.

What is Premenstrual Dsyphoric Disorder? Millions of women around the world dread the inevitable recurrent symptoms f menses, experiencing breast tenderness, menstrual cramps, bloating and mild mood changes; these symptoms are activated by changes in a woman’s gonadotrophins due to the initiation of the menstrual cycle (see appendix 2), these symptoms alone are categorically referred to as Premenstrual Tension (PMT) the condition PMT is thought to affect at least 75% of menstruating women.

Net doctor 23/03/04) The condition Premenstrual Dsyphoric Disorder (PMDD) is sometimes confused with PMT, although many of the symptoms are similar the severity of PMDD an be debilitating, affecting 5% of menstruating women, (Net doctor 23/04/04) PMDD is known to be a disruptive illness, which can lead to women unable to carry out their usual day to day lives.

For many years it was believed PMDD was caused by the rise of hormone levels prior to menses, this statement has since been refuted. Obviously the onset of menses plays a significant part but it is actually changes in serotonin levels (see appendix 3) within the brain which cause many of the severe symptoms ontributing to PMDD.

PMDD and PMS are recognised medical condition’s which appear on the DSM-IV register, certain criteria needs to be established to differentiate between PMDD and PMS, in order for the correct treatment to be administered. The Symptoms of PMDD The symptoms of PMDD should surface after ovulation, progressively worsening the week before menses, the onset of menses alleviates the symptoms which become absent on approximately day two of menses; the PMDD sufferer should notice this pattern every month.

Schizophrenia is a devastating brain disorder affecting people worldwide of all ages, races, and economic levels. It causes personality disintegration and loss of contact with reality (Sinclair). It is the most common psychosis and it is estimated that one percent of the U. S. population will be diagnosed with it over the course of their lives (Torrey 2). Recognition of this disease dates back to the 1800’s when Emil Kraepelin concluded after a comprehensive study of thousands of patients that a “state of dementia was supposed to follow precociously or soon after the onset of the illness.

Eugene Bleuler, a famous Swiss psychiatrist, coined the term “schizophrenia,” referring to what he called the “splitting of the various psychic functions” (Honig 209-211). Having a “split personality” is often incorrectly associated with schizophrenia. Possessing multiple personalities on different occasions is a form of neurosis vice psychosis (Chapman). Symptoms most commonly associated with schizophrenia include delusions, hallucinations, and thought disorder (Torrey 1). Delusions are irrational ideas, routinely absurd and outlandish.

A patient may believe that he or she is possessed of great wealth, intellect, importance or power. Sometimes the patient may think he is George Washington or another great historical person (Chapman). Hallucinations are common, particularly auditory, as voices in the third person or commenting upon the patient’s thoughts and actions (Arieti). Persons may also hear music or see nonexistent images (Sinclair). Schizophrenic thought disorder is the diminished ability to think clearly and logically (Torrey 2). Many times, schizophrenics invent new words (called neologisms) with unique meanings (Chapman).

Often it is apparent by disconnected and meaningless language that renders the person incapable of articipating in conversation and contributing to his alienation from his family, friends, and society (Torrey 2). There appears to be three major subtypes of Schizophrenia: paranoid, hebephrenic, and catatonic. Delusions, often of prosecution, are prominent in the paranoid type (Arieti). Hebephrenic schizophrenia is characterized by thought disorder, chaotic language, silliness, and giggling (Eysenck, Arnold, and Meili 961-962).

In the catatonic form, the person may sit, stand, or lie in fixed postures or attitudes for weeks or months on end. The person may also have a symptom known as “waxy flexibility” in which he victim will maintain positions of the body in which he is put for long periods of time, even if they are uncomfortable (Arieti). There have been many theories to explain what causes schizophrenia. Heredity, stress, medical illness, and physical injury to the brain are all thought to be factors but research has not yet pinpointed the specific combination of factors that produce the disease (Sinclair).

While schizophrenia can affect anyone at any point in life, it is somewhat more common in those persons who are genetically predisposed to the disease (Torrey 3). Studies have shown that approximately 2% of the offspring will be schizophrenic if one parent has the disorder and 50% if both parents have the disorder. This may be due to the fact that the offspring are reared in an environment other than normal. Although statistics from adoption agencies show that these rates are more affected by genes rather than environment (Chapman). Three-quarters of persons with schizophrenia develop the disease between 16 and 25 years of age.

Onset is uncommon after age 30, and rare after age 40 (Torrey 3). Psychiatric patients are generally insulted by contentions that their trouble was brought on by bad parenting, hildhood trauma, or week character (Willwerth 79). Sigmund Freud has suggested that schizophrenia is developed from a lack of affection in the mother-infant relationship in the first few weeks after birth. Increased levels of the neurotransmitter dopamine in the brain’s left hemisphere and lowered glucose levels in the brain’s frontal lobes have been coupled to schizophrenic episodes (Chapman).

Treatment for schizophrenia includes electroconvulsive treatment (shock therapy), psychosurgery, psychotherapy, and the use of antipsychotic medications (Torrey 5). Shock therapy is the application of electrical current to the brain (Long). In 1937, shock therapy was first introduced and was the popular mode of treatment until the late 1950’s (Chapman). It is effective in the most severe catatonic forms of schizophrenia, but its use in other forms is debatable (Eysenck, Arnold, and Meili 964-965). Psychosurgery became common in the 1940’s and 1950’s but is now in disrepute.

Lobotomies, most often removal of the frontal lobes, was the most widespread form of psychosurgery. Scientists have since found that by artificially creating lesions in the area of the frontal lobes, one’s personality can seriously be modified (Baruk 196-197). For the ost part, society has condemned this form of treatment as inhumane. Psychotherapy achieves the best results when the physician listens carefully to his client’s symptoms, diagnosis promptly and accurately, advises the person of the diagnosis, and then prescribes a successful treatment program (Humphrey and Osmond, 189).

Psychotherapy can offer understanding, reassurance, and suggestions for handling the emotional problems of the disorder and help to alleviate stressful living situations (Long). The majority of mental health professionals believe that psychotherapy combined with drug therapy produce the est treatment of schizophrenia (Walsh 103-104). Since the late 1950’s, schizophrenia has been treated primarily with medications. Most of these drugs block the action of dopamine in the brain (Chapman). These drugs can help a great deal in lessening hallucinations and delusions, and in helping to maintain coherent thoughts.

But, they usually have serious side effects that contribute to people not taking their medication, and relapse (Long). Haldol is the most commonly prescribed antipsychotic drug to treat schizophrenia. Abbott Laboratories is presently in the process of testing the safety and efficiency of new drug, sertindole (Torrey 8). Nearly ten years ago the first studies of clozapine opened up a new line of medical research and it was hailed as a miracle drug. Unfortunately, a small percentage of patients on clozapine develop a blood condition known as agranulocytosis and have to stop taking the medication (Long).

Agranulocytosis is a disorder noted by a massive reduction in the number of white blood cells which usually results in the occurance of infected ulcers on the skin and throat, intestinal tract, and other mucous membranes. Agranulocytosis may cause a bacterial infection to become fatal ince white blood cells are an important defense against microorganisms (Chapman). A new medication, olanzapine, may be the next miracle drug on the market. Recent studies have shown that olanzapine offers many of the same benefits of clozapine but apparently without the side affects (Torrey 8-9).

Hospitalization is often necessary in cases of acute schizophrenia to ensure safety of the affected person, while also allowing initiation of medication under close supervision (Torrey 10-11). In milder cases, family therapy has been to be found helpful. With this type of therapy, family members learn to ive with the person in an understanding and accepting manner (Chapman). In the following excerpts from her life story, Esso Leete describes her 20-year battle with schizophrenia and her growing acceptance of her illness.

She has committed herself to leading the fullest life her disease will allow and to educating others about mental illness. She’s employed full time as a medical records transcriptionist at a hospital where she was once committed (Long). “It has been 20 years since I first became mentally ill. As I approach 40, I find myself still struggling with the same symptoms, still crippled by the same ears and paranoia. I am haunted by an evasive picture of what my life could have been, whom I might have become, what I might have accomplished.

My schizophrenia is a sad realization, a painful reality, that I live with every day. Let me tell you a little about my history. I probably inherited a predisposition to mental illness; my uncle was diagnosed as having dementia praecox”, an earlier term for schizophrenia. In my senior year of high school, I began to experience personality changes. I did not realize the significance of the changes at the time, and I think others denied them, but looking back I an see that they were the earliest signs of illness. I became increasingly withdrawn and sullen.

I felt alienated and lonely and hated everyone. I felt as if there were a huge gap between me and the rest of the world; everybody seemed so distant from me. I reluctantly went of to college, feeling alone and totally unprepared for life away from home. I was isolated and had no close friends. As time went on, I spoke to virtually no one. Increasingly during classes I found myself drawing pictures of Van Gogh and writing poetry. I forgot to eat and began sleeping in my clothes. Performing even the most routine activities, uch as taking a shower, rarely even occurred to me.

Toward the end of my first semester, I had my first psychotic episode. I did not understand what was happening and was extremely frightened. The experience left me exhausted and confused, and I began hearing voices for the first time. I was admitted to a psychiatric hospital, diagnosed as having schizophrenia, treated with medications and released after a few months. During my late teens and early 20s, when my age demanded that I date and develop social skills, my illness required that I spend my adolescence on psychiatric wards. To this day I mourn the loss of those years.

It was not until much later that I made a conscious effort to develop a sense of control, realizing that I had the power to decide what form my life would take and who I would be. For the next ten years, I did not require hospitalization. During that time, I was divorced from my first husband and married a community mental health center psychiatrist. Although I experienced some acute flare-ups of symptomatology during that period, I had no recurrence of persistent, disabling symptoms. When more serious symptoms returned about ten ears later, I denied their existence.

Having discontinued medications years earlier and now withdrawing from other forms of support, I experienced more symptoms. I decided to investigate a private psychiatric residential halfway house that one of the nurses at the hospital had told me about. I sought and gained admission to the program. Staff at this facility believed in my potential, and I began to develop confidence in myself. I was now ready to take control of my life. My estranged second husband and I moved into an apartment together, and I threw myself into the task of finding employment.

None of these steps were accomplished easily, but the pieces of my periodically disrupted life were coming back together. Like those with other chronic illnesses, I know to expect good and bad times and to make the most of the good. I take my life very seriously and do as much as I can when I am feeling well, because I know that there will be bad times when I am likely to lose some of the ground I have gained. Professions and family members must help the ill person set realistic goals. I would entreat them not to be devastated by our illnesses and transmit this hopeless attitude to us.

I would urge them never to lose hope, for we will not strive if we believe the effort is futile. ” As one can see, schizophrenia is a highly disruptive disease that has no regard for who it affects. Researchers and mental health professionals are committing vast amounts of time and energy to finding its cause and refining its treatment. Health care and lost resources cost approximately $33 billion per year in the United States alone (Torrey 2). Organizations of schizophrenic patients and families across the country offer their members support and comfort. Schizophrenia doesn’t affect one person-it affects whole families.

The ‘narcissistic personality disorder’ is a complex and often misunderstood disorder. The prominent feature of the narcissistic personality is the grandiose sense of self-importance, but actually underneath this grandiosity the narcissist suffers from a chronically fragile low self-esteem. The grandiosity of the narcissist, however, is often so pervasive that we tend to dehumanize him or her. The narcissist conjures in us images of the mythological character Narcissus who could only love himself, rebuffing anyone who attempted to touch him.

Nevertheless, it is the underlying sense of inferiority, which is the real problem of the narcissist, the grandiosity is just a disguise used to cover the deep feelings of inadequacy. The narcissist’s grandiose behavior is designed to reaffirm his or her sense of adequacy. Since the narcissist is incapable of asserting his or her own sense of adequacy, the narcissist seeks to be admired by others. However, the narcissist’s extremely fragile sense of self worth does not allow him or her to risk any criticism. Therefore, meaningful emotional interactions with others are avoided.

By simultaneously seeking the admiration of others and keeping them at a distance the narcissist is usually able to maintain the illusion of grandiosity no matter how people respond. Thus, when people praise the narcissist his or her grandiosity will increase, but when criticized the grandiosity will usually remain unaffected because the narcissist will devalue the criticizing person. discusses six areas of pathological functioning, which characterize the narcissist.

In particular, four of these narcissistic character traits best illustrate the pattern discussed above. 1) a narcissistic individual has a basic sense of inferiority, which underlies a preoccupation with fantasies of outstanding achievement; (2) a narcissistic individual is unable to trust and rely on others and thus develops numerous, shallow relationships to extract tributes from others;(3) a narcissistic individual has a shifting morality-always ready to shift values to gain favor; and (4) a narcissistic person is unable to remain in love, showing an impaired capacity for a committed relationship”. The narcissist who enters therapy does not think that there is something wrong with him or her.

Typically, the narcissist seeks therapy because he or she is unable to maintain the grandiosity, which protects him or her from the feelings of despair. The narcissist views his or her situation arising not as a result of a personal maladjustment; rather it is some factor in the environment which is beyond the narcissist’s control which has caused his or her present situation. Therefore, the narcissist expects the therapist not to ‘cure’ him or her from a problem which he or she does not perceive to exist, rather the narcissist expects the therapist to restore the protective feeling of grandiosity.

It is therefore essential for the therapist to be alert to the narcissist’s attempts to steer therapy towards healing the injured grandiose part, rather than exploring the underlying feelings of inferiority and despair. The most extreme form of narcissism involves the perception that no separation exists between the self and the object. The object is viewed as an extension of the self, in the sense that the narcissist considers others to be a merged part of him or her.

Usually, the objects, which the narcissist chooses to merge with, represent that aspect of the narcissist’s personality about which feelings of inferiority are perceived. For instance if a narcissist feels unattractive he or she will seek to merge with someone who is perceived by the narcissist to be attractive. At a slightly higher level exists the narcissist who acknowledges the separateness of the object, however, the narcissist views the object as similar to himself or herself in the sense that they share a similar psychological makeup. In effect the narcissist perceives the object as ‘just like me’.

The most evolved narcissistic personality perceives the object to be both separate and psychologically different, but is unable to appreciate the object as a unique and separate person. The object is thus perceived as useful only to the extent of its ability to aggrandize the false self (Manfield, 1992). Pending the perceived needs of the environment a narcissist can develop in one of two directions. The individual whose environment supports his or her grandiosity, and demands that he or she be more than possible will develop to be an exhibitionistic narcissist.

Such an individual is told ‘you are superior to others’, but at the same time his or her personal feelings are ignored. Thus, to restore his or her feelings of adequacy the growing individual will attempt to coerce the environment into supporting his or her grandiose claims of superiority and perfection. On the other hand, if the environment feels threatened by the individual’s grandiosity it will attempt to suppress the individual from expressing this grandiosity. Such an individual learns to keep the grandiosity hidden from others, and will develop to be a closet narcissist.

The closet narcissist will thus only reveal his or her feelings of grandiosity when he or she is convinced that such revelations will be safe (Manfield, 1992) Narcissistic defenses are present to some degree in all people, but are especially pervasive in narcissists. These defenses are used to protect the narcissist from experiencing the feelings of the narcissistic injury. The most pervasive defense mechanism is the grandiose defense. Its function is to restore the narcissist’s inflated perception of himself or herself.

Typically the defense is utilized when someone punctures the narcissist’s grandiosity by saying something which interferes with the narcissist’s inflated view of himself or herself. The narcissist will then experience a narcissistic injury similar to that experienced in childhood and will respond by expanding his or her grandiosity, thus restoring his or her wounded self-concept. Devaluation is another common defense which is used in similar situations. When injured or disappointed the narcissist can respond by devaluing the ‘offending’ person.

Devaluation thus restores the wounded ego by providing the narcissist with a feeling of superiority over the offender. There are two other defense mechanisms which the narcissist uses. The self-sufficiency defense is used to keep the narcissist emotionally isolated from others. By keeping himself or herself emotionally isolated the narcissist’s grandiosity can continue to exist unchallenged. Finally, the manic defense is utilized when feelings of worthlessness begin to surface.

To avoid experiencing these feelings the narcissist will attempt to occupy himself or herself with various activities, so that he or she has no time left to feel the feelings (Manfield, 1992). The central theme in the Psychodynamic treatment of the narcissist revolves around the transference relationship which emerges during treatment. In order for the transference relationship to develop the therapist must be emphatic in understanding the patient’s narcissistic needs. By echoing the narcissist the therapist remains ‘silent’ and ‘invisible’ to the narcissist.

In essence the therapist becomes a mirror to the narcissist to the extent that the narcissist derives narcissistic pleasure from confronting his or her ‘alter ego’. Once the therapeutic relationship is established, two transference like phenomena. The mirror transference and the idealizing transference, collectively known as self-object transference emerge. The mirror transference will occur when the therapist provides a strong sense of validation to the narcissist. Recall that the narcissistically injured child failed to receive validation for what he or she was.

The child thus concluded that there is something wrong with his or her feelings, resulting in a severe damage to the child’s self-esteem. By reflecting back to the narcissist his or her accomplishments and grandeur the narcissist’s self esteem and internal cohesion are maintained (Manfield, 1992). There are three types of the mirror transference phenomenon, each corresponding to a different level of narcissism (as discussed previously). The merger transference will occur in those narcissists who are unable to distinguish between the object and the self.

Such narcissists will perceive the therapist to be a virtual extension of themselves. The narcissist will expect the therapist to be perfectly resonant to him or her, as if the therapist is an actual part of him or her. If the therapist should even slightly vary from the narcissist’s needs or opinions, the narcissist will experience a painful breach in the cohesive self object function provided by the therapist. Such patients will then likely feel betrayed by the therapist and will respond by withdrawing themselves from the therapist (Manfield, 1992).

In the second type of mirror transference, the twin ship or alter ego transference, the narcissist perceives the therapist to be psychologically similar to him or herself. Conceptually the narcissist perceives the therapist and himself or herself to be twins, separate but alike. In the twin ship transference for the self-object cohesion to be maintained, it is necessary for the narcissist to view the therapist as ‘just like me’ (Manfield, 1992). The third type of mirror transference is again termed the mirror transference.

In this instance the narcissist is only interested in the therapist to the extent that the therapist can reflect his or her grandiosity. In this transference relationship the function of the therapist is to bolster the narcissist’s insecure self (Manfield, 1992). The second self object transference, the idealizing transference, involves the borrowing of strength from the object (the therapist) to maintain an internal sense of cohesion. By idealizing the therapist to whom the narcissist feels connected, the narcissist by association also uplifts himself or herself.

It is helpful to conceptualize the ‘idealizing’ narcissist as an infant who draws strength from the omnipotence of the caregiver. Thus, in the idealizing transference the therapist symbolizes omnipotence and this in turn makes the narcissist feel secure. The idealization of the object can become so important to the narcissist that in many cases he or she will choose to fault himself or herself, rather than blame the therapist (Manfield, 1992). The idealizing transference is a more mature form of transference than the mirror transference because idealization requires a certain amount of internal structure (i. , separateness from the therapist).

Oftentimes, the narcissist will first develop mirror transference, and only when his or her internal structure is sufficiently strong will the idealizing transference develop (Manfield, 1992). The self-object transference relationships provide a stabilizing effect for the narcissist. The supportive therapist thus allows the narcissist to heal his or her current low self-esteem and reinstate the damaged grandiosity. However, healing the current narcissistic injury does not address the underlying initial injury and in particular the issue of the false self.

To address these issues the therapist must skillfully take advantage of the situations when the narcissist becomes uncharacteristically emotional; that is when the narcissist feels injured. It thus becomes crucial that within the context of the transference relationship, the therapist shift the narcissist’s focus towards his or her inner feelings (Manfield, 1992). The prevailing opinion amongst Psychodynamic theorists is that the best way to address the narcissist’s present experience is to utilize a hands-off type of approach.

This can be accomplished by letting the narcissist ‘take control’ of the sessions, processing the narcissist’s injuries as they inevitably occur during the course of treatment. When a mirror transference develops injuries will occur when the therapist improperly understands and/or reflects the narcissist’s experiences. Similarly, when an idealizing transference is formed injuries will take the form of some disappointment with the therapist which then interferes with the narcissist’s idealization of the therapist.

In either case, the narcissist is trying to cover up the injury so that the therapist will not notice it. It remains up to the therapist to recognize the particular defense mechanisms that the narcissist will use to defend against the pain of the injury, and work backwards from there to discover the cause of the injury (Manfield, 1992). Once the cause of the injury is discovered the therapist must carefully explore the issue with the narcissist, such that the patient does not feel threatened.

The cure of the narcissist than does not come from the self-object transference relationships per se. Rather, the self-object transference function of the therapist is curative only to the extent that it provides an external source of support, which enables the narcissist to maintain his or her internal cohesion. For the narcissist to be cured, it is necessary for him or her to create their own structure (the true self). The healing process is thus lengthy, and occurs in small increments whenever the structure supplied by the therapist is inadvertently interrupted.

It is important to understand that the Self in analytical psychology takes on a different meaning than in psychodynamic thought (Self is thus capitalized in analytical writings to distinguish it from the psychodynamic concept of the self). In psychodynamic theory the self is always ego oriented, that is the self is taken to be a content of the ego. By contrast, in analytical psychology the Self is the totality of the psyche, it is the archetype of wholeness and the regulating center of personality. Moreover, the self is also the image of God in the psyche, and as such it is experienced as a transpersonal power, which transcends the ego.

The Self therefore exists before the ego, and the ego subsequently emerges from the Self (Monte, 1991). Within the Self we perceive our collective unconscious, which is made up of primordial images, that have been common to all members of the human race from the beginning of life. These primordial images are termed archetypes, and play a significant role in the shaping of the ego. Therefore, “When the ego looks into the mirror of the Self, what it sees is always ‘unrealistic’ because it sees its archetypal image which can never be fit into the ego” (Schwartz-Salant, 1982; P. 19)

In the case of the narcissist, it is the shattering of the archetypal image of the mother which leads to the narcissistic manifestation. The primordial image of the mother symbolizes paradise, to the extent that the environment of the child is perfectly designed to meet his or her needs. No mother, however, can realistically fulfill the child’s archetypal expectations. Nevertheless, so long as the mother reasonably fulfills the child’s needs he or she will develop ‘normally’. It is only when the mother fails to be a ‘good enough mother’, that the narcissistic condition will occur (Asper, 1993).

When the mother-child relationship is damaged the child’s ego does not develop in an optimal way. Rather than form a secure ‘ego-Self axis’ bond, the child’s ego experiences estrangement from the Self. This Self-estrangement negatively affects the child’s ego, and thus the narcissist is said to have a ‘negativized ego’. The negativized ego than proceeds to compensate for the self-estrangement by suppressing the personal needs which are inherent in the self; thus “the negativized ego of the narcissistically disturbed person is characterized by strong defense mechanisms and ego rigidity.

A person with this disturbance has distanced himself from the painful emotions of negative experiences and has become egoistic, egocentric, and narcissistic” (Asper, 1993; P. 82). Since the narcissistic condition is a manifestation of self-estrangement, the analytical therapist attempts to heal the rupture in the ego-self axis bond, which was created by the lack of good enough mothering. To heal this rupture the therapist must convey to the narcissist through emphatic means that others do care about him or her; that is the therapist must repair the archetype of the good mother through a maternally caring approach (Asper, 1993).

A maternal approach involves being attentive to the narcissist’s needs. Just as a mother can intuitively sense her baby’s needs so must the therapist feel and observe what is not verbally expressed by the narcissist. Such a maternal approach allows the narcissist to experience more sympathy towards his or her true feelings and thus gradually the need to withdraw into the narcissistic defense disappears (Asper, 1993). It is difficult for the individual to truly be himself or herself because society offers many rewards for the individual who conforms to its rules.

Such an individual becomes alienated because he or she feels that society’s rituals and demands grant him or her little significance and options in the control of his or her own destiny. To compensate such an individual takes pleasure in his or her own uniqueness (grandiosity), he or she enjoys what others cannot see and control. Thus, the alienated person “sees himself as a puppet cued by social circumstances which exact ritualized performances from him. His irritation about the inevitability of this is counterbalanced by one major consolation.

This consists of his narcissistic affection for his own machinery-that is, his own processes and parts” (Johnson, 1977; P. 141). The existential treatment of the narcissist is based on the existential tenant that “all existing persons have the need and possibility of going out from their centeredness to participate in other beings” (Monte, 1991; P. 492). The severely alienated narcissistic individual, however, does not believe in the validity of experience outside of the self. Unlike others, the narcissist does not believe that a constructive relationship with others is possible.

Existentialists therefore believe that the therapist, through emphatic understanding, must create a strong bond with the narcissist, so that he or she can see that others have feelings too (Johnson, 1977). The humanistic treatment of the narcissist is in general no different from the humanistic treatment of any other client. The humanistic therapist wants the narcissist to rediscover his or her individuality, which was suppressed by the conditions of worth imposed by significant others.

In order to accomplish this, the proper environment must be set in therapy, free of any conditions of worth. The narcissist must feel that whatever he or she does is all right with the therapist. The therapist therefore gives the narcissist unconditional positive regard. There is no judgment of the narcissist, instead the therapist honestly and caringly tries to see things through the eyes of the narcissist. When the narcissist comes to accept his or her true needs he or she will be congruent with the personal self and the narcissistic front will no longer be needed.

Each of the psychological approaches discussed above contains both strengths and weaknesses, in attempting to solve the narcissistic puzzle. Nevertheless, the psychodynamic model possesses a big advantage over the other approaches in its ability to offer both a comprehensive theory of etiology and a detailed description of treatment. With respect to etiology the other approaches suffer from: a lack of concrete observational validity (the analytical approach), lack of clarity in capturing the essence of narcissism (the existential approach), and lack of continuity in predicting narcissism (the humanistic approach).

The analytical model of narcissism depends on too many hypothetical concepts, such as the collective unconscious, which are not supported by any concrete evidence. By emphasizing the narcissist’s tendency to withdraw into the pleasures of the self, existentialists overlook the immense suffering which so characterizes the narcissist. With respect to treatment the major advantage of the psychodynamic approach is that it goes beyond the exclusive use of emphatic means to treat the narcissist. By limiting treatment to emphatic understanding the other approaches fail to address the underlying issues inherent in narcissism.

Therefore, the other approaches might shore up the narcissist’s damaged self-esteem in the short run, but it is doubtful if they will be able to transform the narcissist. Possibly the only weakness of the psychodynamic approach lies in the length that it takes to treat narcissism. Recall that a successful psychodynamic treatment requires the therapist to be very careful about maintaining the narcissist’s delicate self-perception. Only gradually can the psychodynamic therapist direct the narcissist’s attention towards the real underlying emotional feelings.

No matter which approach is utilized in the explanation and treatment of narcissism it is important to recognize that the narcissistic individual is a complex and multifaceted human being. Deep inside narcissistic individuals experience tremendous pain and suffering, for which they attempt to compensate for by the projection of the grandiose front. These people are not character disordered. They are people tortured by narcissistic injury and crippled by developmental arrests in functioning which rob them of the richness of life they deserve. They are good people, who are hurting. They are living and suffering the narcissistic style.

Polycystic Ovaries Syndrome (PCOS) is an ovulation disorder and infertility that occurs in many women. Polycystic ovaries syndrome dates back to 1845 where it was described in a French manuscript as being “changes in the ovaries”. It was called “sclerocystic”. Polycystic ovaries syndrome is a problem that occurs in with the ovaries. A “polycystic ovary is characterized as being a tough, thickened, shiny white covering overlying a layer of many small cysts just under the ovarian surface. ” (Thatcher, 10).

That was the description that was found in the French manuscript and is still being used to this day for doctors to define polycystic ovaries. A wedge resection in the early 1900’s was the first form of treatment for this syndrome. PCOS involves more than just the ovaries filled with small cysts. Polycystic Ovaries Syndrome causes infertility in women. Polycystic Ovaries Syndrome can cause a number of symptoms. Its can cause everything from obesity to missed periods. It also causes women to have more of the male hormone in their bodies, which cause male hair growth.

Not all of PCOS patients have excessive hair growth some may have other skin conditions, like acne. PCOS is the one of the most notorious cause if missed menstrual cycles and “infertility due to the lack of ovulation”. (Thatcher, 12) There are three main reasons women with PCOS get medical attention. The first is that they have missed menstrual cycles. A woman’s period should not be light, short, or irregular. There are steps that a woman’s body needs to go through in order for women to become pregnant.

There is a normal menstrual cycle that a woman’s body hould go through and if it doesn’t then the women has an irregular cycle. This process the movement of an egg to a fertilizing position, developing a lining in the uterus, then the shedding of that lining when the egg doesn’t become fertilized. The second reason woman get medical attention for PCOS, is that they have worries about their physical appearances due to obesity, and excessive hair growth. This reason includes weight gain and abnormal hair growth.

Abnormal hair growth means that the hair grows in places that it would normally grow on men. This extra hair growth can be a bad thing for a woman’s self-esteem. Alopecia is also another form of hair loss that can occur. Alopecia is the female type of male pattern baldness. The way to reversing all these symptoms is balancing the female hormones. “Scalp massages and stimulating shampoos can help”. (Hammerly, 77) The third is that they have abnormalities in their metabolic systems. This reason included blood fat levels, insulin/glucose levels, and high blood pressures.

There are also other signs that women might get concerned with but may not contact a specialist about. Acne is one of these signs. A cyst is known as a fluid filled structure that is formed with a wall and a cavity. A cyst is like a balloon filled with water. A cyst can be all kinds of different sizes and shapes. The different type of wall covering around a cyst is what categorizes them or the different types of fluid that a cyst contains. The cysts that are form when a woman has PCOS are small cysts that are never cancerous.

These cysts that cause PCOS produce male hormones more than they produce the female ones. There are three ways that a doctor can diagnose PCOS in their patients. These ways are one in the clinical findings, another in the laboratory testing, and the final way is in the ultrasound scan. The clinical findings are when you the patient and your doctor confirm the menstrual disturbances, hair and skin problems, and obesity. The laboratory testings are when the doctor has you under go certain tests The uses of genetics in the blame of PCOS are difficult to study.

There are many reasons why genetics are very complicated to study. These reasons are listed below. (Thatcher, 44) “Lack of a universally accepted diagnosis of PCOS Outward appearance (phenotype) can be vastly different despite similar genetic constitutions (genotype). PCOS patients often come from small families with a limited number of sisters and brothers (sibs) to compare. We are not sure what PCOS looks like in the male. There has been no specific genetic marker for PCOS.

Problems in collection of family histories. Males can pass the PCOS gene down through there families just as much as a female can pass it on. There are some males that are more hairy than other males; these males have been shown to carry the PCOS gene. Studies also show that males that carry the PCOS gene are more likely to have a lowered sperm count. It is also mentioned that the males of PCOS are insulin resistant. Miscarriages happen more often among women that have PCOS. Miscarriages happen due to hormonal imbalance but when an altered hormonal environment makes the risk of a miscarriage more likely to occur.

PCOS causes poor egg quality and that is the major reason of pregnancy loss. If a women ovulates passed day 14 then they are more than likely to have ovulated a defective egg, which means that they will probably not become pregnant. The last reason women may have a miscarriage is PCOS itself. When diagnosed with PCOS a woman must change her life and start trying to control it. There are ways that she can do this. She can establish new habits in the way she eats by creating a new diet to follow. She can start some type of exercising to aid in the control or the loss of weight.

These are the first steps to take in losing weight due to PCOS. A person with PCOS must be serious about wanting to help control it. As a person living with PCOS, I can say that it is something that can happen to you. I was just recently diagnosed with Polycystic Ovaries Syndrome in the summer of 2004. I was worried about not having a menstrual cycle. My gynecologist performed a vaginal ultrasound on me and found that my ovaries had tiny little cysts all over them. I want to become pregnant so my doctor prescribed fertility medicine to me in order to try and regulate my periods.

If I did not want to have a child then he would have prescribed some type of birth control pill to aid in this process of regulating my cycle. The little cysts form when my egg comes out and does not go any further than the outside of my ovary. My egg latches on to my ovary and forms into a cyst. This is what caused me irregular menstrual cycles. I am currently overweight and trying to get it under control by exercising and dieting. PCOS is something that is common among a lot of women and it can happen to anyone even the healthiest woman.

Down Syndrome is a chromosomal disorder. It occurs in about 1 of every 800 births. People with Down syndrome may have mild to severe learning disabilities. Physical symptoms include a small skull, extra folds of skin under the eyes, and a protruding tongue. People with Down syndrome are subject to a variety of medical problems including heart abnormalities and thyroid gland dysfunction. Survival rates have been increased dramatically in recent years as problems specific to Down syndrome become known, allowing the early treatment.

The life expectancy of people with Down syndrome now approaches that of people with out it. Usually its around 55 years old. You would have numerous abnormalities; it wouldnt go over well in school. People dont accustom to that very well in public schools. The genetic cause for Down syndrome is when a person inherits all or part of an extra copy of chromosome 21. Trisomy 21, the inheritance of an entire third copy of this chromosome, accounts for 95 percent of Down syndrome cases.

Two other abnormalities each account for 2 to 3 percent of all cases. The first, translocation, takes place when a child inherits an extra piece of chromosome 21 attached to a different chromosome. The second, called mosaic Down syndrome, results when only some cells in the body have the extra chromosome. There is no cure for Down syndrome although prenatal tests are available to identify fetuses with the disorder. Down syndrome can be diagnosed just by looking at the baby at birth. The facial features and characteristics can tell you that.

If the attending physician suspects Down syndrome, a karyotype a blood or tissue sample stained to show chromosomes grouped by size, number, and shape will be performed to verify the diagnosis. The most familiar physical traits of Down syndrome include: Low muscle tone Flat facial profile Upward slant to the eyes Abnormal shape and small size of the ears Single deep crease across the center of the palm Excessive ability to extend the joints Fifth finger has one bending joint instead of two Small skin folds on the inner corners of the eyes

Excessive space between large and second toe Enlargement of tongue in relationship to size of mouth The majority of these defects can be corrected, resulting in long-term health improvements. Children with Down syndrome also tend to have increased susceptibility to infection, respiratory problems, obstructed digestive tracts, and childhood leukemia. With Down syndrome there is no therapy except some of the defects listed above can be corrected like I stated. But the features of the face remain and cannot be fixed unlike the other ones that can be fixed.

There would be no therapy in the future that I can find in my research. Yes, it is possible to detect Down syndrome when the infant is in the uterus. You can do so by screening tests like the Triple Screen and the Alpha-fetoprotein Plus. Both tests measure quantities of various substances in the mothers blood, and together with the womans age, estimate her risk of having a child with Down syndrome. Typically they are offered between 15 and 20 weeks of pregnancy. More accurate are diagnostic tests, which include chorionic villus sampling, amniocentesis, and percutaneous umbilical blood sampling.

While these procedures are about 98% to 99% accurate in their detection of Down syndrome there is an increased risk of miscarriage because these tests are performed inside the uterus. Because of this risk, they are recommended primarily for women over the age of 35. For genetic counseling, there is no possible way to stop Down syndrome from happening. Its inherited and it just depends on if the chromosome 21 gets a third chromosome. Someone with Down syndrome could have a child and it could be perfectly normal just depends on the count of chromosome 21.

Attention Deficit Disorder, widely known as ADD, is a brain disorder which many people suffer from daily. The symptoms described by three authors all go hand in hand, but ADD varies greatly from person to person and some may have completely different symptoms than others. The diagnosis of ADD varies in each author with their own technique. ADD treatment is a long debated and very rough subject, as the authors have different views. The authors express their outlook on the symptoms, diagnosis, and treatment. There are eight common symptoms of ADD.

The carriers of ADD mostly have varying symptoms thus causing need for a different diagnosis’ and treatments. The best known symptom of ADD is inattention or distractibility. This symptom results in the sufferer being unable to sustain attention on a task or activity. This can greatly affect a child’s education while in class and trying to pay attention to a boring teacher. The second symptom is impulsivity, meaning acting out before thinking. An example of an impulsive ADD action is a child jumping in a swimming pool forgetting that he did not know how to swim.

The third symptom is impatience. The word speaks for its self; the patient will desire something and strive to get it no matter what. The fourth symptom is hyperactivity. This is more prominent in males and causes kids to go off the walls. The next symptom is emotional over arousal. The result of this symptom is extreme happiness on the positive side, and extreme anger on the negative side. The sixth symptom is noncompliance. This is one of the worst symptoms because it can cause a sufferer to not follow rules, and lead to aggressive behavior including arguing and yelling.

The seventh symptom is social problems. The patient may have a difficult time getting along with others possibly because of being too intense, bossy, aggressive, and competitive. The final symptom of ADD is disorganization. Disorganization causes one to be forgetful, lose track of time, and lose things. These symptoms can all be caused by ADD but do not all have to be present in order to have ADD. The diagnosis of ADD is done differently from doctor to doctor. Thomas A. Phlenan, Ph. D, diagnoses ADD in an 8 step program.

The first step is a parent interview used to discover present problems, developmental history, and family history. The next step is the child interview. Third, behavior rating scales are done describing home and school functioning. Fourth, data from school, such as grades, achievement test scores, and current placement are all noted. Fifth, psychological testing for IQ and learning disabilities are sometimes done. Finally, a recent physical exam is used. (Phelan, 1993, p63)

Daniel G. Amen, M. D. s a different approach at diagnosing ADD. Amen uses an imaging technique called SPECT to measure brain blood-flow and activity patterns in the brain. He has found that the ADD brain is different, and depending on his findings, he can give appropriate treatments for ADD patients that were not helped by former treatments. (Amen, 2001, p72) Dale R. Jordan, author of Attention Deficit Syndrome, diagnoses simply by the symptoms after close evaluation of the patient in and out of the office (Jordan, 1988).

The three doctors all vary slightly in their diagnosing of ADD. Like diagnoses, treatment for ADD varies from author to author as well. Phelan believes unless there are contraindications for using stimulants, they should be tried for all ADD patients. The medication he has used is Ritalin, Dexedrine, Cylert, Tofranil, Norpramin, Clonidine, Tegretol, Lithium, and Mellaril. Ritalin, Dexedrine, and Cylert are all stimulants used to calm down patients in hopes to be more focused and more organized.

Tofranil and Norpramin are antidepressants Phelan uses in most cases where stimulants are not successful, when the parent does not want to use stimulants, or when stimulant’s benefits do not last long and need to be prolonged with additional medication. Clonidine is actually a high blood pressure medicine that has similar effects of Ritalin but takes a lot long to kick in. Tegrtol and Lithium are sometimes used in cases of extreme behavioral problems. Mellaril is sometimes used by Phelan where a child shows symptoms of ADD but may also be extremely aggressive.

Phelan, 1993, p112-3) Amen classifies six different types of ADD, each with a specific treatment. Type one is what he calls “Classic ADD,” it consists of the primary symptoms and is best treated by stimulant medication such as Adderall or Ritalin. He also found that these patients benefited from higher protein diets. Type two he calls “Inattentive ADD,” which consists of the primary ADD symptoms with low energy and motivation and is diagnosed later in life, if at all. The treatment is the same for Type one and two.

Type three he calls “Over focused ADD” which consists of primary ADD symptoms with cognitive inflexibility and difficulty with shifting attention. They worry, bear grudges and are argumentative. He prescribes an antidepressant, combined with a stimulant and a high-carbohydrate diet. Type four he calls “Temporal-lobe ADD,” marked by primary ADD symptoms with a short fuse, periods of anxiety, memory problems and difficulty reading. For this type he prescribes a combination of an anti-seizure drug like Neurontin, a stimulant, and a high protein diet.

The last type he nick-named “the ring of fire. ” It features primary ADD symptoms with extreme moodiness, anger outburst, inflexibility, fast thoughts, and excessive talking. He gives these patients Neurontin, combined with antipsychotic medication such as Risperdal or Zyprexa. Amen quotes “ADD is a multifaceted illness that usually responds to well-targeted treatment. “(Amen, 2001, p72-3) Jordan differs from both of the previous doctors in the belief that medication and diet control need only be used in the more severe ADD cases.

His standpoint is to work with the patients who experience mild ADD instead of giving them medication. (Jordan, 1988) The biggest controversy over ADD is and always will be in the treatment of the disorder. People question the moral use of stimulants, anti-depressants, and high blood pressure medication to treat ADD. They worry about the side effects, allergic reactions, or just the idea of something unnatural in their body. The symptoms and questionable diagnosis and treatments of ADD are compared by Dale Jordan, Thomas Phelan, and Daniel Amen.

Tourette Syndrome was named for Georges Gilles de la Tourette, who first described the syndrome in 1885. Although the disease was identified in 1885, today in 1996, there still is a mystery surrounding Tourette Syndrome, its causes and possible cures. Tourette Syndrome is a neurological disorder that researchers believe is caused by and abnormal metabolism of the neurotransmitters dopamire and serotonin. It is genetically transmitted from parent to child. There is a fifty percent chance of passing the gene on from parent to child (Gaffy,Ottinger). Those most at risk are sons of mothers with

Tourette Syndrome. About three-quarters of Tourette Syndrome patients are male. Males with the disorder have a ninety-nine percent chance of displaying symptoms. Females, have a seventy percent chance of displaying symptoms. This ration of 3-4:1 for males and females may be accounted for by referral bias. Also, there is a frequent number of reported cases within the Mennonite religious isolate population in Canada. The specific genetic transmission however, has not been established. Some researchers believe that the mar is on an autosomal dominant trait.

Some cases however are sporadic, and there may not be a link to family history involved. These cases are mild however, and not full blown. The onset of Tourette Syndrome must be before the age of fifteen, and usually occurs after the age of two. The mean age onset of motor tics is seven. The mean age onset for vocal tics is nine. In order for a person to be classified as having Tourette Syndrome they must have both multiple motor tics and vocal tics. These tics however do not have to occur everyday. In fact, affected individuals may rarely exhibit all of the symptoms, or all of the tics.

The vocal and motor tics must also occur within the same year, for a person to be classified as having Tourette Syndrome. Symptoms can disappear for weeks or months at a time. However if people afflicted with the syndrome try and suppress their tics, they will re occur with increased ferver. Tics increase as a result of tension or stress, and decrease with relaxation or concentration on absorbing a task. Tics are classified into two groups: complex and simple tics. Simple tics are movements or vocalizations which are completely uncomprehendable and eaningless to those not suffering from the disorder (Peiss).

Complex tics are movements or vocalizations which make use of more than one muscle group to appear to be meaningful (Peiss). Simple motor tics are: eye blinking, head jerking, shoulder shrugging or facial grimacing. Simple vocal tics are: throat clearing, coughing, snorting, baiting, yelping. Examples of complex motor tics include: jumping, touching over people, and or things, smelling, stomping loudly, making obscene gestures, hitting or biting oneself. Complex vocal tics are any nderstandable words given out of context, and may including echoing and repetition.

Other problems associated with Tourette Syndrome include Attention- Deficit Disorder, Hyperactivity Disorder, disinhibition, obsessive compulsive disorder, dyslexia and other various learning disabilities, and various sleep disorders. People with Tourette Syndrome do tend to present more other Axis 1 disorders than the rest of the normal population not afflicted with the syndrome. People with Tourette Syndrome are also afflicted with obsessions of contamination, disease, sexual impulses, self harm, being “just right”, and eath.

Sixty percent of those who are diagnosed as having Tourette Syndrome will also display some type of learning disorder. Such disorders include: having difficulty organizing work, having difficulty playing quietly, talking excessively, interrupting and intruding on others, having a shorter attention span, losing necessary materials for school and home, and engaging in physically dangerous activity, with no thought given to the ramifications of their actions. Attention-Deficit/Hyperactivity Disorder is also found in sixty percent of those with Tourette Syndrome.

Those with ADHD are easily distracted, has difficulty getting along in groups, shifts from activity to activity, often blurts out answers before asked, and fidgets with hands, feet, or squirms in seat. Although these symptoms may seem fairly similar it Tourette Syndrome, it is important to remember that Tourette Syndrome is a genetically inherited disease. These other complexes are merely brought on by the neurological imbalance which affects the brain of those afflicted. Tourette Syndrome cannot be treated as a whole. Medications must be issued for the different aspects of the disease.

For example, Tics and movements are treated with Neuoleptics, Clonidine and SErotonin Drugs, which are prozac-like. These drugs are very good for treating muscle spasms as well as tremors. However the side effects may be unpleasant. Therefore the patients under such drugs must be monitored for the liver and heart. The Medical Treatment for OCD is augmenting dopamine agents (Orap) or Klonopin. These drugs help curtail depression, but how genital-urinary side-effects. The ADHD in Tourette Syndrome are treated with Ritalin because the tics may not increase if sed in reasonable dosages.

Hyperactivity is also curtailed. The side effects of Ritalin are urinary problems, skin changes, EEG monitor, and EKG monitor as well. The Tics may also be controlled by visits to doctors office, talking to friends, and staying away from social gatherings, and learning to deal with emotional trauma. Help however is available for Tourette Syndrome. The goals of health professionals concerning this disorder is to clarify reasons for school problems, and to develop and individualized multimodality treatment program.

Asthma is a disorder that affects 20% of Australians in their childhood. It causes airways to narrow making it difficult to breathe. Symptoms may include loss of breathe in cold weather, wheezing and whistling. It may occur periodically in sudden sharp attacks. When an attack occurs – The muscles around the wind pipe tighten shrinking the airways. The wind pipe lining then swells (picture) and a mucus called phlegm develops causing the cough to intensify and slightly more painful.

Attacks of Asthma occur due to a blockage in the bronchial tubes. This blockage results from a spasm that narrows the windpipe causing breathing difficulty for the sufferer. Asthma Triggers are things that make Asthma worse. Usual triggers are – Respiratory infections eg. Colds, flu, sore throats and bronchitis Allergic reactions sometimes cause Asthma eg. Pollen, foods, dust, animal fur or some seed. Air irritants (similar to Allergic reactions) eg. Cigarette smoke, gases or dust. Excessive/strenuous exercise can cause an Asthma attack.

Emotional Stress can also trigger an Asthma attack. Symptoms of Asthma Symptoms include wheezing from the chest or a slight whistling is heard when inhaling. It’s even louder when exhaling. Tightness of the chest, lung and lung area are closely associated with Asthma. Treatment for asthma There is no cure for Asthma but there are steps that doctors take to help relieve the symptoms of Asthma. As a first step doctors try to remove or get the patient to avoid Asthma triggers such as “animal dander” (eg. Fur or hairs).

These are very likely to trigger an Asthma attack. Places where animals dwell are advised to be kept clear of for a sufferer. Since it is impossible to remove or avoid all triggers there are medications that can be taken. Such as – Anti – Inflammatory Drugs : these reduce swelling of the windpipe and it’s lining. Oral Steroids – prednisone and prednisolone quickly reduce inflammation during an attack. Inhaled medicines – such as cromoyln sodium and inhaled corticosteroids keep inflammation from flaring up.

Bronchodilators : relax the muscles which have tightened around the windpipe. Adrenergic bronchodilators (“Beta 2 agonists”) provide temporary relief but do not treat inflammation. These are available as an Inhaler or a tablet form. Unfortunately the tablets are slower and have a few side affects. Theophylline is available in a liquid, capsule or tablet form. This drug has a long duration of action making it a very good soother for “night time” Asthma.

Ways of preventing asthma There are no ways of preventing Asthma because it is usually genetic, allergically related or following a dose of bronchitis, but there are ways to prevent it from flaring up and turning into an attack. A sufferer can be very careful about his or hers diet because the diet can greatly affect the Asthma. Due to allergic reactions etc. Staying away from pollens and animal fur settles down Asthma. The allergic reactions are the highest causes of Asthma. Make sure you always have medication with you such as Intal and Becotide. These preventative medicines will stop an attack occurring.

Summary For an Asthma sufferer breathing can sometimes be a great difficulty due to the fact that at any time their wind pipe can shrink due to inflammation, making it very hard to breathe. But with the right medication eg. Inhalers and Theophylline their life can be much easier. If they also stay away from triggers such as pollen, fur and cigarette smoke the air ways may not be so vulnerable. Even if you don’t have Asthma you should keep an eye out for the symptoms which are – chest and lung tightness, wheezing and loss of breath especially in cold weather.

Anxiety is a normal reaction to a threatening situation and results from an increase in the amount of adrenaline from the sympathetic nervous system. This increased adrenaline speeds the heart and respiration rate, raises blood pressure, and diverts blood flow to the muscles. These physical reactions are appropriate for escaping from danger but when they cause anxiety in many situations throughout the day, they may be detrimental to a normal lifestyle.

An anxiety disorder is a disorder where feelings of fear, apprehension, or anxiety are disruptive or cause distortions in behavior, (Coon, 526); they are psychiatric illnesses that are not useful for normal functioning. At times, an underlying illness or disease can cause persistent anxiety. Treatment of the illness or disease will stop the anxiety. Anxiety illnesses affect more than 23 million Americans with about 10 million Americans suffering from the most common, general anxiety disorder . (Harvard, 1). Common anxiety disorders are panic attacks (panic disorder), phobias, and general anxiety disorder (GAD).

Panic attacks Panic attacks can begin with a feeling of intense terror followed by physical symptoms of anxiety. A panic attack is characterized by unpredictable attacks of severe anxiety with symptoms not related to any particular situation. (Hale, 1886). The person experiencing the attack may not be aware of the cause. Symptoms include four or more of the following: pounding heart, difficulty breathing, dizziness, chest pain, shaking, sweating, choking, nausea, depersonalization, numbness, fear of dying, flushes, fear of going crazy.

Heredity, metabolic factors, hyperventilation, and psychological factors may contribute to anxiety causing panic attacks. (Hale, 1886) Panic disorder tends to run in families with first degree relatives of patients having four to seven times greater risk than the general population. Metabolically, the levels of three neurotransmitters, nor-epinephrine, gamma-aminobutyric acid (GABA), and serotonin, may play a role in anxiety. These neurotransmitters act as signals between brain cells. Drugs that change the levels of these neurotransmitters are useful in the treatment of anxiety.

Hyperventilation (rapid shallow breathing) can cause a decrease in carbon dioxide in the blood. This decrease in carbon dioxide has been associated with anxiety. Anxiety can be caused by psychological factors as well. One theory is that there is an unconscious conflict between certain wishes and desires, and guilt associated with these desires. Another theory is that certain fearful childhood situations provoke anxiety later. This later theory has been associated with agoraphobia in that the fear of being abandoned in the past may lead to fear of public places.

Panic disorder is treated with drugs, cognitive- behavior therapy and other forms of psychotherapy, and/or a combination of the two. Relaxation therapy is also used in combination with other treatments. Phobias Phobias are extreme and disabling fear of something that poses little or no danger and leads to avoidance of objects or situations. There are three types of phobias: agoraphobia, social phobia, and specific phobias. (Public Health, 293). People with agoraphobia fear that something extremely embarrassing will happen to them. (Coon, 533).

This phobia tends to start between the ages of 15 and 35 and is twice as common in women as in men. Anxiety occurs when the person is in or thinks about being in a place where escape may be difficult or help may not be available. The condition is managed with behavioral techniques such as exposure therapy and it is believed that these techniques may be more effective than drug therapy. Social phobia is a fear of being the focus of attention or scrutiny or of doing something extremely humiliating. Patients are afraid that others will think they are stupid, weak or crazy.

Anxiety can occur from exposure to a particular situation or the mere thought of being in the situation. People with social phobias realize that their fears are irrational but they still experience the dread and anxiety. Treatment consists of cognitive-behavior therapy or medication or a combination of the two. (Pamphlet, 5-6). Many people experience specific phobias – intense, irrational fears of certain things. Some of the more common specific phobias are dogs, closed-in places, heights, tunnels, bridges, and flying. Specific phobias tend to run in families and are more common in women.

They strike more than one in ten peole and no one knows just what causes them. Important career or personal decisions may be affected by a person’s specific phobia but many of the feared things are easily avoidable and help is not sought. Treatment employs desensitization or exposure therapy and is beneficial in three-fourths of patients. There are currently no drugs recommended for specific phobias however, certain medications may be prescribed to help relieve anxiety symptoms. Relaxation and breathing exercises are also helpful.

General anxiety disorder (GAD) GAD affects two to five percent of the general population, but it accounts for almost 30% of “psychiatric” consultations in general practice. GAD is chronic or exaggerated worry and tension. Worrying is often accompanied by physical symptoms like trembling, muscle tension, headache and nausea. People with GAD can’t seem to shake their concerns, seem unable to relax, have trouble falling or staying asleep, or feel lightheaded or out of breath. Some individuals startle more easily than other people, tend to feel tired, have trouble concentrating, and sometimes suffer depression.

Pamphlet, 2). Although GAD is the most common anxiety disorder, it is the least understood. It affects people of both sexes and all ages but is diagnosed more frequently in women than in men. The diagnosis of GAD is chronic, exaggerated worry and tension that has lasted for more than six months, although most people with the disorder can trace it back to childhood or adolescence. (Harvard, 2). Only 25% of people with the disorder seek professional care leaving millions of sufferers to go without simple treatments which can make a great difference.

Wickelgren, 56). Treatment consists of a mixture of medication and counseling, finding the most useful combination for each patient. Anxiety disorders can be confused with stress reactions. Stress reactions may have anxiety as a primary feature and include rapid response to sudden stressful life events, leading to disorientation, and adjustment reactions – slower responses to life events that occur days or weeks later as symptoms of anxiety, irritability, and depression. These are usually limited and helped by reassurance, ventilation, and problem solving.

Anxiety disorders oftentimes cannot be linked to specific life events and persist for months if not years at a time. Many people with anxiety disorders can be helped with treatment. Most of the medications which are prescribed are started at low doses and tapered off when treatment is near an end. Side effects generally become tolerated or diminished with time. Behavioral therapy and cognitive-behavioral therapy can be effective for treating several of the anxiety disorders. Behavioral therapy focuses on changing specific actions and uses different techniques to alter unwanted behavior.

Techniques include special breathing exercises and exposure therapy – gradually exposing patients to what frightens them and helps them cope with their fears. Cognitive-behavioral therapy teaches patients to react differently to the situations and bodily sensations that trigger panic attacks and other anxiety symptoms. Patients also learn to understand how to change their thoughts so that symptoms are less likely to occur. These techniques are designed to help people confront their fears. Without treatment, anxiety disorders can be extremely disabling and disrupt family, work and social relationships.

Post-traumatic Stress Disorder or (PTSD) is defined as being caused by exposure to violent events such as rape, domestic violence, child abuse, war, accidents, natural disasters and political torture. PTSD has effected thousands of people and it affects children, adults, men and women. It was thought to be a disorder of war veterans who had been involved in combat, but research studied reveals that PTSD can result in many types of trauma especially those being life-threatening.

It has been called shell shock, battle fatigue, and accident neurosis and post rape syndrome. PTSD has often been misunderstood or misdiagnosed although it has specific symptoms and is a serious mental illness. Although according to a recent survey it is a rare mental illness even among Vietnam combat veterans where it is commonly associated. Although accounts of war neurosis date back to Homer’s Iliad, the term post-traumatic stress disorder was not used formally until the publication of the third revision of the Diagnostic and Statistical Manual (DSM III) in 1980.

As a clinical entity, PTSD is defined as the development of characteristic symptoms following a psychologically traumatic event that produces fear, helplessness, or horror. Characteristic symptoms involve re-experiencing the event, reduced involvement with the external world, and a variety of autonomic, dysphoric, and/or cognitive symptoms. The symptoms of PTSD may simply be a normal reaction to witnessing a traumatic experience. Only if the symptoms persist longer than three months it is then classified as part of the disorder. Sometimes symptoms arise months or even years later after the event.

Psychiatrists categorize PTSDs symptoms in three categories: intrusive symptoms, avoidance symptoms and symptoms of hyper-arousal. People suffering from PTSD may have episodes where the traumatic event intrudes in their current life. This can occur in sudden vivid memories that are accompanied by painful emotions. Sometimes the trauma is re-experienced. This is a flashback so strong that the person thinks he or she is actually experiencing the trauma again or seeing it before their eyes and at times, re-experiencing occurs in nightmares.

Sometimes the re-experience comes in a rush of painful emotions that have no cause. These emotions are grief that causes tears, fear or anger. Another set of symptoms is called avoidance phenomena. This affects the persons relationships with others and he or she often avoids close emotional ties with family and friends. The person feels numb and can complete only routine, mechanical tasks. Often they are incapable of performing the necessary energy to respond appropriately in a healthy environment. Frequently, people who suffer from PTSD say they cannot feel emotions especially towards those whom are closest to them.

Emotional numbness and lack of interest in activities may be difficult issues to explain to a therapist. This is vital in children who suffer from PTSD and therefore observers such as family members, parents, teachers are crucial in providing information. A person with PTSD also avoids situations that are reminders of the traumatic event because the symptoms could get worse when he or she is reminded of the original trauma. Over time, he or she can be become so terrified that situations of their daily life are controlled by their attempts to avoid them.

Children suffering from PTSD may show a change towards their future, assuming they are not expected to marry or have a career. The last category of symptoms is called hyper-arousal. He or she has trouble concentrating or remembering current information and may develop insomnia. Therefore, this leads to irritability and causes poor relationships with family and friends. In addition, many suffer from physical symptoms such as perspiring, trouble breathing, heart rate increasing, dizziness or nausea and headaches.

Many people with PTSD develop depression and may at times use alcohol and other drugs as self-medication to dull the memory of the trauma. The problems and appeals of specific illegal drugs in combat PTSD is a very big subject that cannot be covered here, but all illegal drugs cause the following problems for combat vets with PTSD. Expense is the first problem I know there are Vietnam vets who have been very successful financially, but the men I know who have severe, chronic PTSD have a heroic struggle to make ends meet. I know it is stating the obvious, but the first problem of illegal drugs is the expense.

The second problem is much subtler, getting illegal drugs involves you in relationships with and obligations to people you normally would not let within a mile. Most of the combat vets I know have a very sharp eye for quality in human beings, and they feel constantly tainted by the people that they get involved with to support their habits. The third problem is that situation of real danger and the presence of weapons gets in the way of healing from PTSD. In this country and time it is not possible to sustain a drug habit over a period of years without running into situations that rekindle PTSD because of their real combat elements.

The fourth problem is the worst using illegal drugs often puts veterans in situations where they bring down other vets. Calling for rescue is a very common way of bringing down other vets, even if the rescue is “successful. ” Users need to be rescued from the medical complications of their habits, from the pressure of debts to dealers, and so on. Vets who have been on rescue missions are put back into combat-mode and are wired for weeks after a rescue. Sometimes users bring down other vets by asking them for dangerous favors (e. g. hold this for me till I come for it” where “this” is a parcel of drugs or drug-related weapons or money).

Finally this is obvious but it needs to be said if a fellow vet is trying to stay clean, and you are using, that amounts to a standing invitation to break out. Today, Psychiatrists and other mental health professionals have effective psychological and pharmacological treatments available for people who suffer from PTSD. Psychiatrists help people with PTSD by allowing them to cope that the trauma happened to them, without the overwhelming memories and without arranging their lives to avoid being reminded of the trauma.

It is crucial to establish safety and a sense of control. This helps him or her feel strong and secure enough to confront the reality of what happened. Also allowing sufferers to realize what he or she witnessed is not their fault in any way so they will not blame themselves. When someone has been badly traumatized, the support of loved ones is critical to their recovery. Family and friends should not assume the traumatized person can snap out of it; instead allowing time to grieve and mourn is all part of recovery process.

Being able to communicate with the feelings of guilt, self-blame, and rage about the trauma usually is effective in helping people put the event behind them. Psychiatrists have several medications such as beta-adrenergic blockers called proranolol, alpa2-adrenergic agonists called clonidine, antidepressants, valproic acid (anticonvulsant and mood stabilizer) and benzodiazepines (sedatives and anti-anxiety drugs). To make progress in easing flashbacks and painful thoughts and feelings PTSD sufferers need to confront what happened to them and learn to gradually accept it as a part of the past.

Therapists have several ways to help with this process. A form of therapy for those who suffer from PTSD is cognitive/behavior therapy. This form of treatment focuses on correcting his or hers painful re-occurring behavior, by teaching him or her relaxation techniques. Using other methods, the patient and therapist explore the patients environment to determine what might trigger the PTSD symptoms and work to reduce them and learn new coping skills. Psychiatrists also treat cases of PTSD by using psychodynamic psychotherapy.

This therapy deals with helping he or she examine personal values and how behavior and experience during the traumatic event violated him or her. The goal is to allow the sufferer to distinguish between the conscious and unconscious conflicts that were created. In addition, the individual works to build self-esteem control and develop a reasonable sense of security. Group therapy can be helpful as a treatment for PTSD. Once someone has been traumatized, they often lose the ability to form healthy relationships especially such traumas as rape and domestic violence.

It affects peoples assumption that the world is a safe and secure place and leaves them distrustful. Group therapy allows sufferers to communicate and form social skills allowing them to be able to create healthy and functional relationships. In addition, as in any group therapy it is comforting to know that you are not the only one suffering. PTSD is a rare mental illness however it does not excuse the fact that it is serious and cannot be ignored. Over the past 15 years, research has provided a major breakthrough of knowledge of how people deal with traumatic experiences.

For example, what places put them at risk for the development of long-term problems and ways to cope. Therapists who are receiving specialized training, so they can have the expert knowledge to provide the care individuals suffer from Post-traumatic Stress Disorder need. About 10 percent to 12 percent of women and 5 percent of men who become victims of trauma will suffer from PTSD. Although the syndrome can develop after any life-threatening episode, the symptoms may be more severe and protracted when one person causes another to experience trauma.

The disorder manifests itself in three ways: acute, chronic and delayed onset. Acute PTSD usually resolves in less than three months, but the chronic form can persist for years. In some instances, the onset of PTSD is delayed, emerging at least six months after the traumatic experience. The delayed onset form is the most difficult to treat. All PTSD sufferers experience intrusive recollections, such as flashbacks or nightmares. Victims may again find themselves drowning in a car, fighting off a rapist, or watching a fellow soldier die in combat.

In order to protect themselves or loved ones from further harm, victims may become obsessed with structuring their lives to ensure their safety. Reminders of the trauma, such as anniversaries, often trigger panic, extreme anxiety or guilt. Consequently, PTSD sufferers will go to great lengths to avoid activities, people, and places, thoughts or feelings that are associated with the trauma. Victims also may forget significant details of the traumatic experience or otherwise minimize its importance, lose interest in enjoyable activities or become emotionally detached from friends and family.

Abuse of drugs, alcohol, food or sex to dull emotional pain may occur. People with PTSD can be irritable, easily startled and prone to anger. Insomnia and poor concentration can make the simplest tasks seem arduous. All of this anguish takes a physical toll. PTSD sufferers seek more medical attention than the general population, yet they are reluctant to request mental health assistance. Fortunately, successful treatments are available using individual or group therapy, medication or a combination of both, depending on the severity of symptoms. Therapy begins with the establishment of trust and safety.

Both are crucial when patients are encouraged to revisualize the trauma during treatment. Clinicians also may use a variety of anxiety management strategies such as relaxation and social skills training, biofeedback, and helping patients replace distorted thinking about themselves and their world with more accurate assessments. Drug treatment can help reduce nightmares, flashbacks and social withdrawal. Depending on a patient’s symptoms and medical condition, clinicians may use either selective serotonin re-uptake inhibitors such as fluoxetine (Prozac), or monoamine oxidase inhibitors such as phenelzine (Nardil).

Addiction is a neurologically based disease. For many years recovery specialists have compared alcoholism or addictions to a physical disease: like diabetes. In reality addictions are more closely related to a neurological disorder like Tourette’s Syndrome* than they are to diabetes. If the problems you suffer stem from severe alcoholism or addiction, you must accept that these problems are not primarily mental or free will issues. Addictions are not about will power. The problems facing addicts, alcoholics, and their families are miserable, disgusting, and infuriating.

They are often hopelessly discouraging. But to imagine that an addict “could change if he wanted to” is a serious misunderstanding of the long term dynamic of addictive disorder. The fact is precisely that an addict cannot change in the long run even if he wants to! That is the definition of addiction: “the loss of control over the use of a substance. ” It is important to understand that this loss of control is manifested not in terms of days or weeks, but in longer term behaviors: terms of months and years.

The reason addicts have lost control is because they have suffered permanent physical neurological changes based in their brains and nervous systems. The disorder manifests in long term obsessive-compulsive behaviors outside the realm of the addicts own control. It is true enough that the use of chemicals begins with chosen behavior. But if alcoholism or addiction develops, the problem has moved outside the realm of free choice. It has developed into a long term mental and physical neurological disorder. All the emotional ‘feelings’ involved in drug or alcohol seeking are based in neurology.

Addiction is based in physical dependency created by altered neurotransmitter balances, and driven by millions upon millions of new living, functioning active neurological pathways which have been established to sustain the condition in the addicts brain. The new neurological pathways are permanently established, and they will not just disappear. The primary neurological disorder is only complicated by physical dependence on the substances. The physical dependence on the substances is secondary! Physical drug withdrawal does not change the underlying neurological addictive disorder.

After drug withdrawal, long term overpowering cravings are predictable. These cravings are, in reality, spontaneous nerve impulses. Even in the longer term, overwhelming cravings are outside the addicts control. Example of a Nerve Pathway It is difficult for people to grasp the meaning of a nerve pathway, or why this is related to addiction. Often when people hear a new idea like: an addictive impulse is the result of a nerve impulse – they are left unsympathetic. Addicts and non addicts alike have a hard time believing that drug or alcohol use is anything more than a choice that is made in response to a habit.

Deep down inside, most people believe that at it’s root – the behavior is always a choice. They are very, very wrong. This author was stuck in addiction for over a decade, so completely was he convinced that the mind was an immaterial spiritual power – and that to call alcoholism or addiction a disease was a cop-out for the weak-willed. This author believed that – each and every time – free choice was at the root of addictive behavior. Until one day, in another recovery facility – the author stumbled upon the concept of neuro-pathways – by reading a book called The Training of the Will – by a Jesuit priest.

That book was written in the early 1900’s. Even then, the Jesuits knew that the root of almost all behavior was based – not in free will – but in neurological wiring. For the Jesuits, training the will essentially consists in training the body. After reading that book, this author began to understand that while his mind – his intellect – was indeed an immaterial power, the overwhelming cravings for drugs or alcohol were based in his body. He came to believe that addiction really was a neurological disease. Consider the following: Most people can not wiggle their ears.

The wiggling of the ears is really nothing but flexing the muscles of the scalp above the ears. The reason most people can not wiggle their ears is because they are not familiar with the neurological pathway which controls the muscle of the scalp above their ears. However, without exception, every person in the world can be trained to wiggle their ears. Simply by applying electrodes to the muscles of the scalp above the ears causes the muscles to flex, or spasm. Once the person feels where these muscles are, he finds that in fact he CAN wiggle his ears.

The only reason he could wiggle his ears before, was because he had not established the neurological pathway which enabled him to do so. Like turning on a switch – a neurological pathway can be established simply by passing a charge of electrical current into the nerves of the body. Once a person has learned to wiggle his ears – he might actually do it spontaneously and unintentionally – just because the words are mentioned. This example is intended to illustrate how a simple neurological pathway is established. Before the electrode – there was no neurological pathway.

After the electrode – the pathway has been established. The addictive neurological response to drugs and alcohol on the brain is infinitely more complex than this, but the physical basis is the same. The overwhelming craving for drugs or alcohol that endlessly defeats addicts is in reality a neurological impulse – and they have absolutely no control over the craving when it is triggered. All they know is that they want, they need, they feel they MUST have the drug. This “desire”, this craving is not a free choice. This desire is an electro-chemical neurological brain impulse.

A person who suffers from these cravings to the detriment of his own life, and the lives of others, is suffering from a physical, neurological disease termed addictive disorder. Recovery from Addiction Withdrawing from physical dependence on the drug does not change the fundamental addictive disorder. The whole neurological, chemical and emotional being of an addict, or an alcoholic has become permanently disordered. An addict or an alcoholic has developed a very, very severe disease. He must take the matter very, very seriously. A quick 7 day “detox” will never be an answer.

The alcoholic-addict in the longer term, is like a rat that has become habituated by a scientist to choosing cocaine over food. The rat in the short term, can NOT control the neurological impulse to choose the cocaine! The rat will continue to seek it, ignoring food and water, until he dies! The rat’s nerve-impulse to use the cocaine has nothing to do with free will. The addict-alcoholic suffers from an identical disorder in the long term. The addict cannot control these spontaneous overwhelming neurological impulses to use, any more than the rat can on the short term! (The neurological impulse is called a craving.

Just by examining an addicted rat you can’t see the obvious problem. But the new neurological pathways that have now been established are permanent and life threatening! These are just as physical and real as any disease. Addiction is a self-contracted neurological disease. It IS a ‘created’ disorder. Nonetheless, it is also a physical problem on a neurological level, and it is very real. A chemically dependent person can NOT stop the over-powering cravings for the substance in the long term, any more than someone with Parkinson’s disease can stop tremors. “Self knowledge avails us nothing.

The addiction will never somehow go away without intervention of some kind. An addict will not ever recover if he can just “kick” for a few days. The whole emotional, physical, and neurological system has already been altered too drastically for any temporary kick to even scratch the surface of the underlying disorder. At the very minimum, an introductory 30 day dry-out period must somehow be enforced. Minimizing, hoping, or rationalizing that the problem might be somehow be overcome by more modest measures is wishful thinking. Addictive impulses are generated physiologically.

They often lie dormant for many days or weeks as the addict attempts to recuperate from the painful physical or emotional trauma the addictions themselves have inflicted. But, the underlying neurological conditions remain very much intact. Neurologically based impulses to use or drink require at least 4 weeks of enforced abstinence just to begin to dissipate enough to be manageable. Then another 6, extremely critical, weeks are required to adjust to living without the chemical. Depression, anger, boredom, and then “happy-excited feelings” are predictable. These feelings always follow initial detox.

All of these will feelings will eventually trigger an uncontrollable addictive impulse in early sobriety. There is NO way to turn off these inevitable overpowering addictive impulses! During this period the addict needs help. With the help they need, the chemically dependent person can improve dramatically, if he can work through the initial weeks of mandatory depression, cope with reoccurring anger, and maintain at least 10 weeks of abstinence. Seventy days seems like an eternity in early recovery, but shorter periods of abstinence do nothing to subdue the underlying neurological conditions.

With this in mind, it is essential that an addict prepare himself for almost 3 months of initial recuperation. It’s precisely when the addict feels that his system is stabilizing that he is in the gravest danger. This usually occurs at about 45 days clean. It is then when the addict must begin to resolve underlying emotional and social conflicts. For an addict: stress causes craving! To become free of addiction, an addict must resolve the conflicts in his life! He can do this by accepting responsibility for his actions, and by facing and resolving his deepest anxieties.

He must make amends to himself, to his family, and to society. The only way for an addict to relieve the stresses which cause him to use is to identify the interior and exterior conflicts in his life and resolve them. “You have to name it, to claim it. ” When conflicts are resolved serenity becomes possible. By achieving new levels of interior serenity, compulsive behaviors can be overcome. It is serenity which enables an addict to be relieved of compulsions. Serenity can only be achieved by the resolution of conflict. Over time, and the resolution of conflicts, addiction becomes manageable.

Most addicts are not consciously aware of many of the conflicts from which they actually suffer. For permanent relief an outside support system is the most helpful. According to Alcoholic’s Anonymous, the alcoholic-addict must come to accept that the underlying condition of the disease consists precisely in always being defenseless against taking the “first one. ” No matter how much clean time one accrues, he forever remains defenseless against using again. According the Big Book of Alcoholics Anonymous, at some point, at some time, for perhaps NO reason, the alcoholic-addict WILL ALWAYS use again!

That is exactly what true alcoholism-addiction is! The addict-alcoholic remains forever defenseless against using again that first time! His only defense against ‘the first one’ must come from a power greater (or other) than himself. The complete healing process comes from an internal dependency shift. Ten weeks of abstinence are required to subdue the strong neurological impulses to use. After a minimum ten week neurological pacification, (detox), the reoccurring compulsion to use the chemical can be permanently relieved. This is accomplished through a neurological “re-wiring.

The alcoholic-addict must stop imagining that they can somehow permanently stay clean by themselves. This doesn’t mean that they need to attend meetings for the rest of their lives. Eternal meetings are NOT the point. But, a radical dependency shift must be effected within the addicts own heart and mind. He must psychologically shift away from relying on the validity of his own thought process about his addiction! To effectively “re-wire” his disordered nervous system, he must come to rely fiercely and absolutely upon the directions provided from an external support system.

By mentally changing what he relies upon, his nervous system undergoes a profound change. Consider this example: Two new people attend a support meeting. (It’s not the type of meeting, or support group, that is important. ) The first person thinks to himself: “I don’t want to be here. These people are unattractive. The thought of having to associate with them forever disgusts me. ” He is now depending upon the validity of his own internal thought process. He drives away, and continues to try to stay clean on his own, and to continue to depend on the validity of his own thought process.

Then he has sorrowful trouble in his relationships, which break his heart. He fails to succeed as he thinks he ought to, which breaks his heart. Something bad happens, or something good happens, (it doesn’t matter), and he thinks to himself: “I can’t deal with sobriety right now! ” (This is the person depending upon the validity of his own thought process. ) His addictive impulse is triggered. In a matter of time the strong cravings (neurological impulses) overwhelm him and he begins to use again. Now, consider the second person who attends the support meeting. He also thinks to himself: “I don’t want to be here.

These people are unattractive. The thought of having to associate with them forever disgusts me. ” But, this person says OUT LOUD to the group: “I don’t want to be here! You people seem unattractive! The thought of having to associate with you disgusts me! ” And the whole group, with one voice says to him in reply: “That’s how you are supposed to feel! That’s OK! You should feel that way! You’re new! This is new! We are unattractive! The thought of associating with us should disgust you! It’s OK to feel that way. But, from now on you must become willing to take directions! You must become willing to listen to us!

You can NOT be in control of your own addiction anymore! You must let go absolutely, and no longer depend upon your own devices, or you will never recover from your addiction! ” This Person Accepts What They Say! He is willing to shift his internal dependency away from relying on himself for recovery. This begins to re-wire his neurology. His nervous system learns new responses to old stimuli. Then: he too has trouble in his relationships, which break his heart. He fails to succeed as he thinks he ought to, and this breaks his heart. He also thinks to himself: “I can’t deal with sobriety right now.

But He Is Under Orders! His habits kick in! He calls for support! The support system says with one voice: feeling bad IS ok … but using is NOT OK! You can’t do that. You will not do that! You would be better to drive up right now to the local mental institution and check yourself in …. because what you are thinking about doing right now is sheer insanity! Because he has now shifted his dependency, and he no longer relies upon the validity of his own thought process, he obeys! He takes directions! The re-wiring of the dependency shift has taken hold: and he stays clean!

He has established new neurological pathways and is able to stand fast through the critical moments. He has has effected the necessary dependency shift! His formerly disordered neurological system has become re-wired. When he is triggered, he automatically goes to the support system, even if it IS the local mental hospital, but he stays clean. Through a total dependency shift, he is soon permanently relieved of the obsession to use the chemicals. He recovers! Effecting this necessary dependency shift is most easily done through submission to programs like Alcoholics Anonymous.

Any unwillingness to completely accept the directives of a support program just as it is presented, is just a continuation of the addictive disorder. Sadly, anyone “who is special” or who “doesn’t need” to comply with a support program, (just as it is presented), will permanently suffer the misery of addiction. There can be NO permanent relief for anyone who cannot effect the requisite ‘dependency shift’. This is only happens when they stop depending on themselves to manage their own sobriety and they become fiercely willing to take directions. They must rely on the external support system more than they used to rely on the external chemical.

For many, the 12 Step programs have been the best answer to addiction. In this authors opinion, it really is God who gets miserable alcoholics and addicts clean anyway. Though human beings have physical bodies, and live in a material world: “the whole is greater than the sum of the parts. ” Human beings may be a complex mass of neurological pathways: but we are persons – not rats! We may be deeply frustrated, or disappointed, or wounded. Though we may suffer terribly, we do have an infinite capacity to heal, to achieve, to love and be loved, to create and to contribute! No one deserves the misery of addiction.

In this day and age, drugs are being prescribed without hesitation. In fact, many of these drugs are being prescribed for children with various disorders. One of these disorders is called Attention Deficit Hyperactivity Disorder (ADHD). An estimated five to ten percent of children are diagnosed with this syndrome. One of the methods to treat this disorder is to use stimulants, specifically Ritalin. This method is controversial because it has many side effects and its long-term effects are unknown. It can also lead to addiction.

Approximately two to three percent of elementary school children are taking some kind of stimulant to treat ADHD. Since so many children are taking this medication, new problems have arisen. Many of these children use these drugs in excessive amounts to get “high” with their friends. Some overdoses have even caused death. The alternative ways to treat this syndrome without medication are not adequately explored. Some doctors have found ways to combat this problem with little or no drugs. Why arent more doctors looking into these alternative methods?

What kind of example is this excessive drug use setting for the children? Finally, what actions can be taken to solve this problem? Attention Deficit Hyperactivity Disorder (ADHD) is a syndrome caused by a biochemical imbalance and uniqueness. It has hundreds of symptoms that appear selectively in a certain children. Some of these symptoms include distractibility, confusion, faulty abstract thinking, inflexibility, poor verbal skills, aimlessness, perceptual difficulties, constant movement, varied rates of development, food cravings, allergies, and sleeping nd coordination problems.

The children have “little ability to block out noises in order to concentrate”. Many qualities to look for in ADHD children are self-centeredness, impatience, recklessness, extreme emotionalism, and weak consciences. ADHD children have trouble in school with reading, handwriting and paying attention to what is important. They constantly fidget and squirm and cant express their thoughts into words. Detecting ADHD is a complicated matter since there are no blood tests or evident genetic tests to confirm this syndrome.

Anxiety and fear are often thought of as the same thing, but are actually somewhat different. Fear is thought of as a response to the presence or imminence of danger. Anxiety, on the other hand, can be looked at as a response that was created through learning or life experiences. Anxiety disorders are very common and may eventually turn every day tasks into unbearable and overwhelming activities. General symptoms of anxiety disorders can include the feeling of panic, uncontrollably obsessive thoughts, sweating or chills, and muscle tension, among others.

If untreated, people with anxiety disorders tend to get progressively worse. Anxiety disorders consist of panic disorder (with or without agoraphobia), phobias (social phobia, agoraphobia, and specific phobia), obsessive-compulsive disorder, post-traumatic stress disorder, and generalized anxiety disorder. The anxiety disorders are also the most common, or frequently occurring, mental disorders. Panic disorders may seem like normal occurrences, but they can occur at inappropriate times and be considered, in some cases, extreme.

Mainly, people with panic disorders experience a phenomenon called panic attacks. Key symptoms in people with panic attacks include the fear of losing control, a pounding heart, nausea, dizziness, feelings of unreality, numbness, and even shortness of breath, triggered by a stressful situation. The trigger causing panic attacks differs, depending on the person. Many people who have experienced panic attacks compare the feeling to a heart attack and report intense feelings of fear, along with the urge to escape from their location.

Panic attacks can also leave a person feeling extremely anxious, constantly awaiting the next attack to occur, and often reach their peak within 10 minutes or less. There are three types of panic attacks; unexpected, situationally bound, and situationally predisposed. Unexpected attacks have no specific trigger, occurring without notice. Situationally bound panic attacks, on the other hand, take place when a person is exposed or has thoughts about being exposed to a certain trigger. For instance, exposing a person, or them just them thinking about being exposed to something they fear can, in turn, cause a situationally bound panic attack.

Situationally predisposed attacks commonly occur when someone is exposed to a trigger but does not necessarily mean that every time exposed, an attack will occur. A person who is scared of flying doesnt necessarily get scared every time they are on a plane, therefore making this a situationally predisposed panic attack. Also, this type of attack does not have to transpire immediately after exposure to a trigger; it can happen minutes or hours after. The age and sex among people with panic disorders vary, but are commonly found to be women between their late teens and middle 30s (American Psychiatric Association, 1994).

Anxiety Disorders are suggested to be genetic, while environmental factors may also play a role in how susceptible a person will be to them, along with life experiences, personality, and biology. Phobias are among other popular forms of anxiety disorders. Phobias can be described as the uncontrollable and persistent fear of an activity, situation, or object. Phobias are irrational fears and can greatly interfere with a persons lifestyle. Three main types of phobias include social phobia, specific phobia, and agoraphobia.

Social phobia, also known as social anxiety disorder, can be easily described as the fear entailed in being embarrassed or punished in public, while speaking, gathering, or being around people. Social phobia also includes the fear of being watched and/or judged by others. The fact that people are scared of social situations can be debilitating. This type of phobia prevents them from engaging in everyday activities like eating, talking, or even being around other people, even though they acknowledge the fact that their feelings may be irrational.

Often, people with social phobias tremble, blush, and perspire, and are afraid that other people will notice. They will also anticipate events that they do not want to participate in, which may lead to greater anxiety, or have them avoid going anywhere all together. If a person under 18 is thought to have this disorder, they must have it for 6 months for them to be diagnosed. Treatment for social phobia is available and has been proven successful, using medication and psychotherapy. Another phobia, called specific phobia (previously simple phobia), also deals with an irrational fear to things that are relatively harmless.

For the most part, facing specific phobias may cause feelings of anxiety and can often trigger panic attacks almost immediately after the confrontation. There are 5 main subtypes of specific phobias listed by the American Psychiatric Association. The first specific phobia subtype being animal, which includes fear of insects or animals. This phobia is usually established during a persons early youth and includes fears of spiders, dogs, and others. Next is the natural environment phobia. Natural environment phobias include fear of things like heights, storms, and water.

Another phobia is blood injection injury, in which there is a fear of being hurt, injected, or seeing blood. A very common side effect in people with blood injection injury phobia is that they are 75% likely to faint when confronted with their phobia (American Psychiatric Association, 1994). Situational phobias include fears of things like flying, driving, tunnels, etc. Last is the other category where miscellaneous fears are placed like being scared of things like ghosts, clowns, an even choking. The amount of men and women with these phobias vary distinctly, depending on the type of phobia.

Phobias can be treated through psychotherapy. Agoraphobia entails fears like fear of public and open spaces, fear of a situation which may be embarrassing or not particularly easy to escape from and/or when a panic attack may occur and help may not be readily available. This disorder is very common when it comes to people seeking treatment and help, and can occur with or without panic disorder. Agoraphobia without a history of panic disorder is distinguished from panic disorder with agoraphobia in that there is an absence of recurring unexpected panic attacks.

Roughly close to half of the people who go untreated for unexplained panic attacks could develop agoraphobia (Doctor & Kahn, 2002). Agoraphobia is an anxiety disorder and phobia, which may eventually lead to seclusion because of fear. Agoraphobia occurs about two times more commonly among women than men (Magee et al. , 1996). For some individuals with agoraphobia, being accompanied by a spouse, sitting near a door, or even talking to themselves helped to relieve anxiety in some situations. Medication and therapy for this disorder has also been found to be significantly helpful.

Obsessive-compulsive disorder, otherwise known as OCD, is another disorder involving feelings of anxiety, and also includes obsessive and repetitive/compulsive behaviors, usually preformed in a routine manner. OCD is common in both men and women, and is found to be more prevalent in people with mental illnesses such as schizophrenia, major depression, panic disorders and tourettes. People with tourettes syndrome have a 35-50% chance in being obsessive compulsive, while only 5-7% of obsessive compulsive people may experience tourettes (American Psychiatric Association, 1994).

Among the most common obsessions are wanting things done perfectly and experiencing unreasonable and persistent thoughts. OCD sufferers can usually admit to their unreasonable behaviors but, for the most part, cannot control the impulse to act upon them. A study shows that aggressive obsession is the highest, comprising over 68% of the subjects, and the highest compulsion being checking, which consisted of over 80% of the subjects (Swinson, Antony, Rachman, & Ritcher, 1998).

Other popular obsessive-compulsive behaviors include washing/avoiding contamination, aggressively sexual obsessions, and the need to have things symmetrically positioned. Like phobias, OCD varies among men and women, depending on the obsession or compulsion, while it does not differ greatly where ethnicity is concerned. It is shown that in a specific group of OCD sufferers, 83. 5% were described as white (Swinson, Antony, Rachman, & Ritcher, 1998). Obsessive compulsive disorder usually onsets during adolescence and the early adult years of a persons life.

Post-traumatic stress disorder, also known as PTSD, is a condition that usually occurs after witnessing or taking place in a very traumatizing event. Symptoms of this disorder include reliving a negative past experience, detachment from reality, close family, and friends, and even a lack of emotion. Usually, the event that is remembered will be anything, ranging from things like: a violent attack, rape, a war, tragic natural disasters, serious accidents, and other severe trauma that may have been escaped from or witnessed.

Many times, people with post-traumatic stress disorder will be relived in forms of dreams, flashbacks, or even in the persons thoughts. While reliving an event, people with PTSD seem to be detached from reality. Most people suffering from PTSD will become unaffectionate, easily startled, and abandon activities they would normally participate in. Post-traumatic stress disorder can be classified into 3 main groups, using time span to differentiate them. Acute PTSD is the first, and the duration of the symptoms only last about three months.

Chronic PTSD lasts about three months or longer, while PTSD with delayed onset causes several months to pass between an event before symptoms of the disorder begin to occur. Usually, support groups and therapy seem to help the most when dealing with PTSD sufferers. When someone is constantly thinking about possible situations while dwelling on these thoughts, and there is no specific trigger for feelings of anxiety, this can be classified as general anxiety disorder, or GAD.

General anxiety disorder can be explained as excessive anxiety and thoughts of worry about almost anything (ranging from family, friends, health, work, etc. ). Symptoms include irritability, stomach aches, frustration, constant worrying, and inability to concentrate or relax, among others. People with general anxiety disorder can also acquire headaches, along with other pains, and often seek help for the pain without realizing they have this disorder. Usually, GAD mildly impairs functionalism, socially and occupationally and most commonly begins in late adolescence, but can occur while an adult.

Like most of the disorders listed above, GAD can be a product of several environmental and biological factors, although there is no one specific cause. Treatment for general anxiety disorder include cognitive-behavioral therapy and medication. Anxiety disorders are widespread and can affect many different kinds of people. Although sometimes found more commonly in women, anxiety disorders can strike any and all. Most often, these disorders occur between late adolescence and middle adulthood.

There is no specific cause for these disorders, instead a multitude of things are believed to instigate them. Biology, or genetics is thought to play a role, along with life experiences, chemicals in the body, and others. Perceptual, physiological, and biological symptoms of these disorders are (in ways) similar, many times causing confusion amongst them. Many people experiencing anxiety disorders are prone to acquire other disorders, like depression and become detached from friends, family, and co-workers.

Treatment should always be handled by a professional (it is helpful if they specialize/have history in working with anxiety disorders). Behavioral and cognitive therapy seem to work best among people with anxiety disorders. Behavioral therapy deals with techniques use to stop unwanted behaviors, and cognitive therapy helps patients understand their thoughts while changing them to help reduce the likely hood of the undesired behavior. When therapy and even medication is used, people with anxiety disorders can make significant improvements, gaining control of their lives and minds.

Autism is a disorder that impairs the development of a person’s capacity to interact with, communicate with, and also maintain regular “normal” bonds with the outside world. This disorder was described in 1943 by Leo Kanner, an American psychologist. Autism is considered one of the more common developmental disabilities, and appears before the age of three. It is known to be four or five times more common in males than in females. It most cited statistic is that autism occurs in 4. 5 out of 10,000 live births.

The estimate f children having autistic qualities is reported to be 15 to 20 out of 10,000. The gender statement noted before is not uncommon, since many developmental disabilities have a greater male to female ratio. Autistic characteristics are different from birth. Two more common characteristics that may be exhibited are the arching of the back while being held, to avoid contact, and also failing to anticipate being picked up (limpness in the body). Infants with autism are described as being either very passive, or very agitated.

Sometimes during nfancy there will be cases of head rocking, and or banging, against the crib, but this is not always the case. Approximately one-third of children develop normally until the ages of 1 1/2 to 3, and then the symptoms emerge, referred to as “regressive autism. ” During childhood, there is a commonality of the affected child insisting routine. The reasoning is that the child is not able to cope with “novel” situations. Wearing the same clothes, or eating the same foods during meals, are examples. Tantrums can occur when these perseverative behaviors occur.

Twenty years ago, most autistic individuals were institutionalized. Now only the most severe cases live in institutions. During adulthood, autistic individuals are known to live with their parents, in residential institutions, and some do live independently. Because there are so many forms of this disorder, it has been said that there is no true adjective to describe every type of person with autistic symptoms, or autism. My research shows that there are no physiological tests that can be performed to determine whether a person has autism.

The diagnosis is given when a person exhibits the characteristics of the disorder. Note: In the last five years, researchers have agreed that those who display autistic characteristics are commonly suffering from other related but distinct disorders, such as Asperger Syndrome, Fragile X syndrome, Landau Kleffner syndrome, Rett syndrome, and Williams syndrome. Physiological researchers have discovered abnormalities within the brain, but the reason for the abnormalities is not known, and it is not known where the relation to autism lies.

These abnormalities range from underdeveloped areas in the limbic system, to Vernal lobules VI and VII, being smaller than average. Biochemical research has found elevated beta-endorphins, relating to pain tolerance in autistic action. In the cognitive realm, there is much talk of the “theory of mind”, or the inability to realize that other people have their own unique view of the world. Some Cognitive theorists think that the autistic person isn’t able to understand that other people have different thoughts, plans, and perspectives than their own.

Cognitive theorists also examine the 10% statistic of savant skills, an ability that is considered remarkable by most standards. These savant skills are usually spatial in nature. Interventions and therapies are difficult. Family theorists try to work with the family of the patient, to try to develop appropriate behaviors. There is no reported drug that can be considered primary for the patient, although Ritalin is dispensed in many cases. Behaviorists look at the changing of behavior through positive reinforcement, behavior recess, and in turn examine the elf-stimulatory and self-injurious behaviors.

Physiological work such as visual training, and auditory integration training, is used to reduce sensitivities to sounds above normal range, or to sounds the patient can consider painful. When it comes to autism, the most important thing to remember is that parents and doctors in the medical field are now realizing that there can be treatments, and interventions, that can be effective. In addition, note that Federal Law now requires the states to provide early intervention services for autistic children between the ages of one to three.

This is a question that has remained unanswered for a very long time. ADD, also known as attention deficit disorder, has to do with the brain. This disorder was at one time thought to be related to brain damage. Nowadays however, it is actually quite common. It is reported that about 40 percent of the student body of an average school is ADD. Scientists think that this is at least one student per classroom in a school. ADD has really been recognized over the past twenty years. This is when most of the research about it has been done.

When someone has been diagnosed as having ADD it does not mean that they are lazy, stupid, or crazy. It only means that they have a difficult time trying to pay attention to a subject in which they have little or no interest. This is why ADD is usually first noticed in school. Before much research was done, ADD was not even called ADD. It had a different name. It was called Hyperknetics. This was really just a fancy term for saying that a child is easily distracted, and also very hyper. This was back in the days when doctors also thought that Hyperknesis was caused by some sort of brain damage.

This was potentially true however; there were a few rare cases in which some brain damage actually occurred in a child. The brain damage only happened naturally, like when the child was being developed. ADD is something that an individual person is born with, and not something that is developed over time. Many Doctors and specialists have discovered over time that there is more than type of ADD. Doctors now recognize three distinct types of ADD, normal ADD, ADHD, and residual ADD. The second, ADHD is normal ADD coupled with a hyperactive tendency.

The third type, residual ADD is the type of ADD that most commonly affects older children and adults. Hyperactivity is not usually associated with residual ADD. When it comes to ADD most people will associate it with the child being hyper or out of control. This can be the case some of the time, but hyperactivity isnt always the problem. There are actually quite a few kids who have an attention problem, but can appear perfectly normal and calm on the outside. Next, we will go into some of the symptoms of ADD.

These symptoms are as follows, 1. inattentiveness or distractibility, 2. Impulsivity, 3. difficulty delaying gratification, 4. hyperactivity, 5. arousal, 6. noncompliance, 7. social problems, and 8. disorganization. These are the main symptoms that doctors and specialists have used to haracterize and diagnose ADD. Now we have to break it down. Most of the kids who have ADD without an element of hyperactivity, will probably only display symptoms one, six, and eight. In the book All About the Attention Deficit Disorder gives a great breakdown of all of the different characteristics of ADD and determines into which category they fall.

The most important, or core symptom as they call it, is number one. This is inattention or distractibility. This is the first sign that is looked for when someone is going to be diagnosed with ADD. Next are symptoms two through five, these are the symptoms that efine the personality of a person with ADD. Items six through eight were saved to be the symptoms that follow the others due to them actually being the results of the others. These are the main symptoms that doctors diagnose people with. There will however, be others along the way.

According to the book All About the Attention deficit disorder, An ADD child has an attention span for which his or her age is too short. Unless the task is very interesting to them, the child will always say that it is boring. This is the reason ADD mostly takes place in schools. Many doctors, and the previously mentioned book have aid that nine times out of ten if you ask an ADD child what he or she mostly dislikes about school the answer will be the work. Now dont get the wrong idea, most kids will say the reason why they dislike school is because of the work they are given.

This is just kids being kids. However, an ADD child will experience something completely different. They can experience tremendous stress. This is because they have work that they know is due, but they have no idea how to do it because they were distracted in class. This can take place starting in elementary school. When the child gets older it ay develop to the point where it can become a very serious issue regarding the childs self esteem. This is because they are beginning to act, as some doctors and the book All About ADD call it, stupid or even lazy, when they are really neither.

They might not be able to handle the stress load as well as the other members of the class. At times they may just decide that since they dont know how to do the work they just wont do it. This is where the lazy factor comes in, when they really arent the least bit lazy. The child just doesnt want to be labeled as dumb or stupid because they cant do the work. They dont ant to be made fun of so they decide that if they dont work at least they wont be made fun of and labeled as stupid. In the book All About ADD it goes on to describe how children with ADD can actually pay attention.

This may only happen for limited periods of time though. However there are four characteristics necessary for this to be able to happen. 1. Novelty 2. High interest involved 3. Intimidation 4. Being one on one with an adult. Of these, number two and number four are probably the most significant characteristics. If the child has a high interest in the task at hand then it is really not the problem. It is just when the task does not interest the child that ADD and hyperactivity kick in and there is a complete loss of the childs attention.

Also when the child is with an authority figure, he or she will tend to be more calm, and more in tune with what is going on. This is due to the intimidation factor. Also, when the child had someone just paying attention to him or her, it makes him or her realize that they cant fool around. When the room is silent, and you are trying to concentrate on a single task, you may hear little noises such ass a clock, or perhaps someone tapping a pencil on a desk, owever you just go on about your business like it was no big deal. Well this is by far the worst situation for an ADD child. This type of ADD is called Auditory.

This is when certain noises are making it very difficult for a child to concentrate. Another type is visual. This is when there is something in the childs field of vision that may interest them more than the task that they are working on right now. The third type is sombic. This is one of the least common. This has to do with body sensations, as stated in All About ADD. When the childs sock or something is not in the right place they cannot stand it. It makes it almost impossible for them to concentrate. The fourth and final type is fantasy. This is when the child is a daydreamer.

He or she will think about other things that are more appealing to them. Another problem with ADD kids is that they will sometimes get a single idea in their heads and they will not let go of it. For example, when the child and a parent are shopping he may see something that he wants. The child will keep nagging and bugging his parents until he gets his way. Another ADD symptom is that of impatience. This is pretty easily defined because everyone can be impatient at one time or another. This sually occurs when the child is waiting in line or is looking forward to something they can wait no longer for.

A good example is when he or she is ready to go out to recess. Now we will go deeper into the world of hyperactivity. By far one of the leading symptoms of ADD, this is one of the most annoying parts of ADD. As describes in the book All About ADD, a child who is very hyperactive and has ADD will be told countless times to sit down, be quiet, or calm down. These are some of the terms that are very common around the house of an ADD child. Also, when it comes to being hyperactive, boys definitely win the prize. Specialists say that in nearly all cases boys will be more hyperactive than girls.

This is just due to the different chemical balances in both boys and girls. When kids have ADD without hyperactivity they can act and appear quite normal. You might just catch them in their own little world when youre trying to get their attention, but they wont be bouncing off of the walls like others tend to do. Another reason for boys higher level of hyperactivity is that boys exorcise more frequently. Since over forty percent of children, and about the same percentage of adults have this disorder, it is nowhere near as serious as some people may fear.

All that is risky is someone that is easily distracted. There are however some treatments, and most of them have to do with being prescribed different drugs. The two most popular drugs are Ritalin and Adderal. There are downfalls to these drugs however. By downfalls I really mean side effects. They can cause the child to become extremely tired, or to lose their appetite. However, a doctor or psychologist may be able to suggest an alternate route without having to use any antibiotics or drugs. So dont give up, there are things that can help, you just have to keep looking and hopefully you will find the answer.

In this day and age, drugs are being prescribed without hesitation. Many of these drugs are being prescribed for children with various disorders. One of these disorders is called Attention Deficit Hyperactivity Disorder (ADHD). ADHD is a syndrome caused by a biochemical imbalance. It has hundreds of symptoms that appear selectively in a certain children. Some of these symptoms are distractibility, confusion, faulty abstract thinking, inflexibility, poor verbal skills, aimlessness, perceptual difficulties, constant movement, varied rates of development, food cravings, allergies, and sleeping and coordination problems.

The children have difficulty blocking out noises so they can concentrate. Many qualities to look for in ADHD children are self-centeredness, impatience, recklessness, extreme emotionalism, and weak consciences. Children with ADHD have trouble in school with reading, handwriting and paying attention to what is important. They constantly fidget and squirm and cant express their thoughts into words. Detecting ADHD is complicated because there are no blood tests or genetic tests to confirm this syndrome. An estimated five to ten percent of children are diagnosed with ADHD.

About two to three percent of elementary school children are taking some kind of medicine to treat ADHD. One of the most common medications used for treating ADHD is Ritalin. For those children who have ADHD, Ritalin can be effective in controlling symptoms. There has been controversy surrounding the correct and effective use of this medication. Many people argue that children take it when they do not need it. However, for those who do have ADHD, Ritalin is very beneficial in alleviating symptoms. Some children who do not have ADHD use Ritalin to get a high.

They will often buy or steal the drug from children who are prescribed it and take it during school. I feel that school nurses should have to watch the prescribed child take the Ritalin, so they cannot take it to class and sell it. The nurse must also make sure the Ritalin is locked in a secure place when being stored. These simple precautions would greatly reduce the risk of Ritalin being used inappropriately while children are at school. Doctors should continue prescribing Ritalin to those who are correctly diagnosed with ADHD.

I personally know people who have ADHD and take Ritalin. They have said that it does control hyperactivity and helps them concentrate while at school. I have noticed differences in these people when they are regularly taking the prescribed dosage. They are more attentive and not as easily distracted. Although people who do not need to take it can abuse Ritalin, it is extremely beneficial to improving functioning of those who suffer from ADHD. Ritalin should not be prohibited to those who need it.

Attention-deficit hyperactivity disorder(ADHD) is much more prevalent in todays society compared to previous generations. More and more people are being diagnosed at an alarming rate. To our surprise, I learned this disorder does not only affect children. There are many adults who suffer from it also. ADHD characteristics are neuro-biologically based, and they often change as the individual gets older. One does not out-grow ADHD even though the behaviors, or symptoms may not be exhibited in the same manner or with the same intensity.

After learning his fact, I thought it would be very interesting to see how this disorder affects both children and college students. Therefore, I choose one journal article which relates ADHD to children, and the other which deals with the effects of ADHD on college students. The first journal article I researched, An Intervention Approach for Children with Teacher and Parent Identified Attentional Difficulties, explained that inattention, impulsivity, distractibility, and restlessness are all signs of a child with an attention-deficit hyperactivity disorder.

There are three subtypes of ADHD which have been defined by the Diagnostic and Statistical Manual of Mental Disorders as: predominantly inattentive, predominately hyperactive impulsive, and combined (Semrud-Clekeman, Nielsen, Clinton, Sylvester, Parle, and Connor, 1999). Usually children who exhibit these subtypes have difficulty completing assignments, displaying high qualities of work, and maintaining good behaviors. Children with the hyperactivity-impulsivity subtype do not display significant attentional problems, though they are identified as young as pre-schoolers.

However, symptoms of inattention dont typically emerge until the later ages, which must be why the predominately inattentive and combined subtypes of ADHD have been found in older school-age children. These children who have been identified as having ADHD, show an inability to use effective problem solving over a period of time. When researchers looked at their brain structures, they found that the frontal-striatal regions are involved with the childs ability to inhibit, focus, and shift attention. Researchers have formed interventions involving the behavioral or cognitive management of children with ADHD.

Attention-training strategies, classroom-based contingency systems, home-school contingencies, and peer-mediated contingencies are examples of these interventions. In an effort to measure students with ADHD, in addition to medication and intervention strategies, researchers conducted two types of tests. The first test, the visual attention task, required the child to scan fourteen rows of ds, each d had one to three marks around it. The child was instructed to select the ds with two marks around them. The children were also told to move down to the next row every twenty seconds.

The score is calculated by subtracting the errors from the total amount correct. It was suggested that this task assesses the capacity for sustained attention as well as accurate visual canning and inhibition of rapid responses(Semrud-Clekeman, Nielsen, Clinton, Sylvester, Parle, and Connor, 1999, p. 585). The second test, the auditory attention task, required the child to listen to random letters and numbers. Afterwards, they were asked to remember how many letters or numbers they heard. The child must keep in mind the letters and numbers they heard for each stimulus at the same time.

The test starts out with four stimuli and finishes with twelve. This task has been hypothesized to be a measure of auditory divided attention as well as sustained ttention(Semrud-Clekeman, Nielsen, Clinton, Sylvester, Parle, and Connor, 1999, p. 585). The results of this study confirmed that children with ADHD who had help through the intervention programs showed an increase in their performance on visual and auditory attention tasks, while the other children without the help of intervention programs did not show any improvement.

These children most likely represent a continuum of attention and activity / impulsivity problems and may describe the population of children with significant attention problems who are infrequently referred for an assessment beyond the ediatrician(Semrud-Clekeman, Nielsen, Clinton, Sylvester, Parle, and Connor, 1999, p. 587). It seems very probable that children with attention and work completion difficulties without significant behavioral and learning problems often go unaided in classrooms today.

The second journal article I selected is titled Psychological Functioning Differences Among College Students With Confirmed ADHD, ADHD by Self-Report Only, and Without ADHD. In an attempt to understand attention- deficit hyperactivity disorder, professor Lee A. Rosen, psychologist Cori Ann Ramirez, and doctoral student Tracy L. Richards have esearched the effects this disorder has had on college students. College students were researched based on three categories: those with confirmed ADHD, those with self-reported, and students without ADHD.

The team of researchers had difficulty in diagnosing students with ADHD because of three factors: establishing a childhood history of ADHD, conducting careful differential diagnoses, and assessing for comorbid diagnoses (Ramirez, Richards & Rosen, 1999, p. 299) Researchers also found that the abuse of drugs and/or alcohol, as well as various other diagnoses are usually associated with ADHD. As I learned from the first research article, symptoms of this disorder include inattention, hyperactivity, and impulsivity.

When researchers noted the symptoms in college students, they found many of these students exhibiting restlessness, impulsivity, distraction, poor performance in academic settings that require sustained attention and behavior regulation. To measure students for ADHD, researchers used several tests: the Brief Symptom Screening Form(BSSF), a self- report measure of ADHD, a Background Questionnaire, which involves information of ethnicity and medical history, and the ADHD Behavior Checklist for Adults was sed to measure the symptoms of ADHD over the past six months of the persons life as well as their childhood.

The other tests used were the Wender Utah Rating Scale(WURS), which helped to measure an adults assessment of their own childhood, the Symptom Checklist-90-R (SCL-90-R), that consists of ninety items to assess psychological symptoms of psychiatric and medical patients, and the last analysis used was The Conduct Disorder Scale, which instructed students to admit to any delinquent activities they took part in within the past twelve months. After researchers measured the scores from the aforementioned tests, they found hat ADHD students and self-reported ADHD students scored very similar.

Although the results between the two groups showed similarities, there were many problems in assessing the scores. Self-reported students and their parents did not agree on their condition. The article states, that parental recall of childhood behavior is more valid than patient recall because often times students may forget, exaggerate, or underestimate their own childhood behavior (Ramirez, Richards & Rosen, 1999, p. 304) Also, students of the self-reports could have been lying when answering the questionnaires. As one can see, this study may not be the most accurate way to determine if someone truly does have ADHD.

Overall, researchers agree that attention- deficit hyperactivity disorder is a common issue amongst college students, especially those who do not know why they are experiencing certain inabilities. Researchers feel that without proper measurements, many students who suffer from ADHD will not receive the appropriate assistance deemed necessary, and they will continue to have attentional problems that will interfere with their academic performance. The popular media article found in U. S. News and World Report , Taking a Picture of a Mind Gone Awhirl, focuses on a new imaging method used to diagnose ADHD.

It is said to be the first definitive test for ADHD. The new diagnostic exam, developed by psychiatrists at McLean Hospital in Belmont, Mass. , uses an infrared tracking device to measure difficult-to-detect movements of children as they attempt a tough but boring attention test, pressing the space bar each time a particular kind of star appears for a brief moment somewhere on the computer screen (Schrof Fischer, 2000). Researchers began a study on eleven boys who had previously been diagnosed with ADHD and six boys who do not have this disorder. If the oys pressed the space bar too quickly, it demonstrated how impulsive they were.

If they did not notice one of the stars on the screen, it determined how much their attention wandered. Using this rigorous screening, only six of the eleven boys were confirmed to fit a strict definition of ADHD (Schrof Fischer, 2000). This in turn means that five of the boys did not fit the strict definition of ADHD. Therefore they must have been misdiagnosed at some point. The article also discusses a part of the brain called the putamen and how it is different in an ADHD child. It seems as if this new test could be a much better way of diagnosing someone ith ADHD compared to the methods used in the two journal articles.

I feel the research presented in the journal articles does support the report in our popular media article by illustrating that there is continuous research taking place that just seems to be getting better as time goes by. All three articles also helped confirm my awareness of the fact that ADHD is presently such a widespread problem. The articles also helped me to realize how many individuals are misdiagnosed. All types of disorders, from anxiety to manic-depression to conduct disorders, are now mistaken for ADHD, and everyone suffers for that diagnostic loppiness (Schrof Fischer, 2000).

It comes as a relief to know that with modern technology, comes more accurate ways a determining whether an individual is suffering from ADHD. If this new test is confirmed to be reliable, it could help correct both the overuse of Ritalin and the undertreatment of kids whose ADHD is missed by the naked eye (Schrof Fischer, 2000). All in all, Ive learned a great deal about attention deficit hyperactivity disorder, and I am glad to now know that there is hope for our future generation to be prepared with more improved methods to accurately diagnose people with ADHD.

When I lived in Germany, I had a friend who played on my High School tennis team. On a sunny afternoon after our tennis lessons we decided to drink an ice tea and have a little snack at the tennis snack bar. We started talking about tennis strategies, but my friend, Thomas, was kind of depressed and sad. When I asked him what was really bothering him, he started tell me about his sick mother. He tried to explain her disease to me, but I could not understand it. He said, my mother is suffering from persecution mania and in addition, she sometimes talks about things that make no sense.

Nevertheless, I saw Thomas again after the summer holidays and I asked him how his mother was doing now. He responded with a very sad voice and also had tears in his eyes because his mother committed suicide and the doctors told him that she had schizophrenia. Schizophrenia is a mental disorder marked by the loss of contact with reality. When a person’s thinking, feeling, and behavior is abnormal, it interferes with his or her ability to function in everyday life. Delusions, hallucinations, and irregular thinking and emotions are produced. If these signs are present, he or she may have the mental illness called schizophrenia.

About one hundred years ago, schizophrenia was first recognized as a mental disorder and researchers have been searching for a cure ever since. The cause of schizophrenia is still unknown today and scientists have concluded that schizophrenia has more than one cause. Scientists have developed dozens of theories to explain what causes this disease, but researchers are focusing on four leading theories: the Genetic Theory, the Environmental Theory, the Biochemical Theory, and the Bio-Psycho-Social Theory. The Genetic Theory argues that schizophrenia is caused by traits in a person’s genetic makeup.

A normal person has twenty-three pairs of chromosomes. Each pair contains one chromosome from each parent. In corresponding locations called loci of each chromosome, the genes for specific traits are located. Some researchers believe that mutations with these genes can cause schizophrenia. We inherit our genes from our parents, but this does not mean that the parents of a schizophrenic are mentally ill. Problems in a persons genetic make up could come from mutated chromosomes or recessive genes. In an attempt to prove this theory, scientists study identical twins.

Due to the fact that identical twins have identical genetic make up, researchers are able to determine if heredity is the main cause of schizophrenia. However, evidence seems to disprove this theory. In some instances, both identical twins are schizophrenics and other times only one is affected. To defend this theory, it should be noted that this research is complicated. Identical twins are relatively rare, especially twins who are both diagnosed with schizophrenia. Studies have also shown that children with one parent diagnosed with schizophrenia have a ten percent chance of suffering from schizophrenia.

When both parents are schizophrenic, their risk raises to approximately forty percent. Little is known about the Environmental Theory. The theory is built mainly on the effects of stress on human behavior. Most researchers agree that stress alone cannot be the main cause of schizophrenia. Most researchers agree that stress could possibly trigger or worsen the symptoms when the illness is already present. Other researchers focus on drug abuse. Like stress, certain drugs such as amphetamines can make psychotic symptoms worse if a person already has schizophrenia. Furthermore, these drugs can, in a sense, create schizophrenia.

Other researchers that support the Environmental Theory believe that “slow viruses” may be to blame. Slow viruses are viral infections that go undetected for long periods of time. Signs and symptoms are delayed and may occur many years after the first infection. The Bio-Chemical Theory suggests that schizophrenia is caused by mixed up signals to the brain. When something acts upon one of our senses, electrical impulses are sent to the brain. These impulses allow us to feel, smell, taste, hear, see, and they also manage our thought processes. In our body we have a complex nervous system.

For example, there is not simply a single nerve that travels from our feet to our brain. In order for information to be sent to the brain, the nerves must interact with each other, translating the messages from one nerve to the next. Because the system is so complex, it is possible for the signal to get mixed up. When this happens, our brain may misinterpret the signal or may not receive it at all. If the signal does get mixed up on the way to the brain, the make up of the impulse can undergo a chemical change, resulting in irregular thought processes and abnormal behavior.

Scientists have undergone in-depth studies on a chemical in the brain called dopamine. They believe that schizophrenics have higher levels of this chemical than a mentally sound person does. To experiment this theory, researchers have injected animals and humans with amphetamines increasing the amount of dopamine reaching the brain. Following the injection, the animals exhibit the same type of behavior as humans who have been diagnosed with schizophrenia, such as standing still for long periods of time or continuously pacing.

In humans, research has shown that when given small doses of amphetamines the amount of dopamine in the brain slightly increases. Although the increase is small it still causes delusions and hallucinations. In conclusion, researchers believe that an increased amount of dopamine to the brain causes abnormal behavior, however, they cannot safely say that this is the sole cause of schizophrenia. The Bio-Psycho-Social Theory combines all of the previous theories. Some researchers believe that bio-chemical abnormalities are a contributing factor but that other events must also occur.

They suggest that environmental and social problems have to be considered along with biological problems. Social scientists believe that no chemical factors are involved, instead they believe “mental disorders are described as a consequence of human motivations, drives, and unconscious forces. ” (Schizophrenia, Douglas W. Smith). These scientists suggest that people become overloaded with stress, information, and stimulation. When this happens they lose their ability to cope with the anxiety which accompanies these stressors. Instead of dealing with their problems they seek peace in their own world.

For example, it is common for individuals to return to “happy times” in their life such as infancy and they begin to act like a child. Scientists have asked if there is a particular nationality that suffers more than any other. Studies have been done in Ireland and it appears that one in every twenty-five people show signs of schizophrenia, opposed to one in every hundred in the United States. E. Fuller Torrey has spent a great deal of time researching a number of schizophrenics in Ireland. Torrey has discovered that the population of schizophrenics has been rising since the 18th Century.

After he made his findings public other scientists began asking questions as to why the Irish are suffering so badly. The basis of their research has focused around their diet, mainly potatoes. If potatoes are exposed to too much sunlight they produce an alkaloid called solanine. Solanine has the ability to induce gastro-intestinal problems and psychotic symptoms such as hallucinations. The idea that schizophrenia in Ireland is caused by the potato is not as far fetched as people might believe. Closer to home, a mental disease that afflicted southerners, pellagra, was caused solely from the lack of the vitamin niacin.

This may lead us to believe that a mental disorder can be caused by too much exposure or lack of a certain type of food. Another possibility, is the amount of insecticides the Irish consume from the potato. At planting time farmers use high amounts of chemicals on their potatoes to protect them from insects. When an insect ingests the chemicals they are easily killed because the chemicals interfere with the normal functioning of the nervous system by disrupting the transmission of nerve impulses. If large doses of these chemicals have the same affect on humans as they do on insects this could answer the Irish dilemma.

These toxins could be especially dangerous to women who are pregnant by damaging the fetal nerve tissue. Despite all these theories, it is quite evident that the cause of schizophrenia is still a mystery. It also seems clear that this disease is not caused by any one factor. As of now, researchers are leaning toward the Bio-Chemical theory. The brain is the most complex organ in the human body and an imbalance of the brain’s chemical system has been suspected as the main cause of schizophrenia for a long time. As previously mentioned, some researchers point to an excess of or lack of dopamine a chemical substance in the brain.

Others suspect different neurotransmitters which are substances that allow communication between nerve cells. The area of the brain thought to be affected in most cases of schizophrenia is the limbic system. This is the area of the brain that acts like a gate for incoming stimuli or messages. In any case, it appears that all schizophrenics have some sort of abnormal chemicals that are not found in healthy people. Schizophrenia is a complicated and difficult disease. It is hard to diagnose mental disorders because there are no physical indications. In the case of schizophrenia, a person can be mistaken for a shy child or person.

They are not in touch with their surroundings. Besides recognizing these symptoms, other methods of diagnosing schizophrenia is with the use of pictures and drawings. The doctor will listen to what the patient “sees” and analyze it. In doing this it is possible to determine their state of mind. Another process used in the diagnosis is Rorschach, better known as inkblots. These inkblots are used worldwide and Doctors have analyzed normal and abnormal answers. By listening to answers a doctor can determine what a common answer from a schizophrenic is. A normal persons answer would be something ordinary like a person or a mountain.

A person suffering from schizophrenia would see something weird like a beast or some conflict. In the past individuals have schizophrenia were labeled as crazy and families were embarrassed to have a mentally ill person in their family. These people would be isolated in a mental institution with bars on the windows, the building being dark and desolate. Also a common treatment for schizophrenia was insulin shock treatment. A patient would receive enough insulin to induce a seizure. This treatment worked for very few patients. The environment that these patients lived in was more damaging to them than helpful.

Mental illness was not accepted or thought of as a disease. When patients were taken to the hospitals it was common for them to be left there. Family would generally desert them because the environment was terrible, family and friends dreaded visiting. The modern day treatment for schizophrenia has many aspects. It involves medicine, counseling, electro-convulsive therapy and hospitalization. The medications most commonly used are; anti-psychotics which are used to help calm agitation, diminish destructive behavior and hallucinations and may help correct disturbed thought processes.

Secondly are anti-depressants, normally slow acting drugs but if no improvement occurs within three weeks, they may not be effective at all. Thirdly, are mood normalizers such as lithium carbonate used in manic depressive states to help stabilize mood swings which are part of the condition. Lastly, tranquilizers are used for calming agitation and anxiety. Unfortunately, along with these medications come some side effects such as inability to concentrate, and tiredness. However, there are side effect controls available. Electro-convulsive therapy is the application of electrical currents to the brain.

It is mainly used for patients suffering from extreme depressions who are suicidal and who seem unable to shake the depression under any circumstances. Unlike in the past, hospitals now have a happy environment. The family is involved with the treatment of the patient. The family themselves try to cope. They learn how things can change when the patient returns home. After the patient is released it is possible for them to go on living a normal life. A schizophrenic will most likely have to take doses of medication for the rest of their life.

Side effects will be felt and unreasonable fears may still be evident but their life will be basically normal. Researchers anticipate massive progress on the treatment for schizophrenia in the future. They believe hospitalization will be a thing of the past. Patients will be injected with medications monthly and attend group therapy with their family. The disease is detected early because of education and research. The drugs used for treatment have few side effects. Scientists hope that in the years to come treatment for schizophrenia will be non-existent.

Researchers hope to pinpoint the cause and eliminate it at birth through screening. With this treatment schizophrenia could be wiped out. Although it may surprise some people, schizophrenia is a common disorder, striking one person in every hundred. For most people, young adulthood means leaving home, starting a job and starting a family. For most schizophrenics, young adulthood means first admission to a psychiatric hospital. An unfortunate reality for young schizophrenics is the need for hospitalization during their most vibrant and productive time.

The age of the first admission is younger for men than women, early twenties for males and mid-twenties for women. The reasoning behind this variation is not exactly known but there is speculation. One biological theory that exists is the help of the female sex hormones. Scientists speculate that these hormones may help delay the horrifying symptoms that afflict schizophrenics. Another question raised is who gets schizophrenia more commonly, men or women? Studies have shown there is no great variation in the numbers but in the severity of the symptoms. Men seem to suffer more severely.

Scientists have attempted to explain this through differences in the brain. Research has shown schizophrenia tends to affect the left side of the brain. Males are generally “left- brained” or “right-brained” while females have less specialization on either side of the brain. Yet another startling fact about schizophrenia is the amount of schizophrenics who are winter born. A scientific explanation for this is seasonal viruses, which may have infected the fetus but remain dormant or not as active until many years later. This fact was discovered as early as 1929 but was ignored for about forty years.

By the late 1960’s studies were being done in six countries using over 125,000 people in their research. Another theory is the lack of nutrition, babies developing during the summer months do not seem to receive as much protein, thus causing abnormalities in the child. Although schizophrenia is a serious and devastating disease the outcome is not always bad. At least 25% of the treated schizophrenics recover fully to live a normal life in every aspect. Another group are not so well off and remain severely psychotic, this occurs in about 10% of the treated schizophrenics.

In 1991, Governor William Weld modified parole regulations and permitted women to seek commutation if they could present evidence indicating they suffered from battered women’s syndrome. A short while later, the Governor, citing spousal abuse as his impetus, released seven women convicted of killing their husbands, and the Great and General Court of Massachusetts enacted Mass. Gen. L. ch. 233 23E (1993), which permits the introduction of evidence of abuse in criminal trials.

These decisive acts brought the issue of domestic abuse to the public’s attention and left many Massachusetts residents, lawyers and judges struggling to define battered women’s syndrome. In order to help these individuals define battered women’s syndrome, the origins and development of the three primary theories of the syndrome and recommended treatments are outlined below. The Classical Theory of Battered Women’s Syndrome and its Origins The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), known in the ental health field as the clinician’s bible, does not recognize battered women’s syndrome as a distinct mental disorder.

In fact, Dr. Lenore Walker, the architect of the classical battered women’s syndrome theory, notes the syndrome is not an illness, but a theory that draws upon the principles of learned helplessness to explain why some women are unable to leave their abusers. Therefore, the classical battered women’s syndrome theory is best regarded as an offshoot of the theory of learned helplessness and not a mental illness that afflicts abused women. The theory of learned helplessness sought to account for the passive behavior subjects exhibited when placed in an uncontrollable environment.

In the late 60’s and early 70’s, Martin Seligman, a famous researcher in the field of psychology, conducted a series of experiments in which dogs were placed in one of two types of cages. In the former cage, henceforth referred to as the shock cage, a bell would sound and the experimenters would electrify the entire floor seconds later, shocking the dog regardless of location. The latter cage, however, although similar in every other respect to the shock cage, contained a small area where the experimenters could administer no shock.

Seligman observed that while the dogs in the latter cage learned to run to the nonelectrified area after a series of shocks, the dogs in the shock cage gave up trying to escape, even when placed in the latter cage and shown that escape was possible. Seligman theorized that the dogs’ initial experience in the uncontrollable shock cage led them to believe that they could not control future events and was responsible for the observed disruptions in behavior and learning.

Thus, according to the theory of learned helplessness, a subject placed in an uncontrollable environment will become passive and accept painful stimuli, even though escape is possible and apparent. In the late 1970’s, Dr. Walker drew upon Seligman’s research and incorporated it into her own theory, the battered women’s syndrome, in an attempt to explain why battered women remain with their abusers. According to Dr. Walker, battered women’s syndrome contains two distinct elements: a cycle of violence and symptoms of learned helplessness.

The cycle of violence is composed of three phases: the tension building phase, active battering phase and calm loving respite phase. During the tension building phase, the victim is subjected to verbal abuse and minor battering incidents, such as slaps, pinches and psychological abuse. In this phase, the woman tries to pacify her batterer by using techniques that have worked previously. Typically, the woman showers her abuser with kindness or attempts to avoid him.

However, the victim’s attempts to pacify her batter are often fruitless and only work to delay the inevitable acute battering incident. The tension building phase ends and the active battering phase begins when the verbal abuse and minor battering evolve into an acute battering incident. A release of the tensions built during phase one characterizes the active battering phase, which usually last for a period of two to twenty-four hours. The violence during this phase is unpredictable and inevitable, and statistics indicate that the risk of the batterer murdering his victim is at its greatest.

The batterer places his victim in a constant state of fear, and she is unable to control her batterer’s violence by utilizing techniques that worked in the tension building phase. The victim, realizing her lack of control, attempts to mitigate the violence by becoming passive. After the active battering phase comes to a close, the cycle of violence enters the calm loving respite phase or “honeymoon phase. ” During this phase, the batterer apologizes for his abusive behavior and promises that it will never happen again.

The behavior exhibited by the batter in the calm loving respite phase closely resembles the behavior he exhibited when the couple first met and fell in love. The calm loving respite phase is the most psychologically victimizing phase because the batterer fools the victim, who is relieved that the abuse has ended, into believing that he has changed. However, inevitably, the batterer begins to verbally abuse his victim and the cycle of abuse begins anew. According to Dr. Walker, Seligman’s theory of learned helplessness explains why women stay with their abusers and occurs in a victim after the cycle of violence repeats numerous times.

As noted earlier, dogs who were placed in an environment where pain was unavoidable responded by becoming passive. Dr. Walker asserts that, in the domestic abuse ambit, sporadic brutality, perceptions of powerlessness, lack of financial resources and the superior strength of the batterer all combine to instill a feeling of helplessness in the victim. In other words, batterers condition women into believing that they are powerless to escape by subjecting them to a continuing pattern of uncontrollable violence and abuse. Dr.

Walker, in applying the learned helplessness theory to battered women, changed society’s perception of battered women by dispelling the myth that battered women like abuse and offering a logical and rationale explanation for why most stay with their abuser. As the classical theory of battered women’s syndrome is based upon the psychological principles of conditioning, experts believe that behavior modification strategies are best suited for treating women suffering from the syndrome. A simple, yet effective, behavioral strategy consists of two stages.

In the initial stage, the battered woman removes herself from the uncontrollable or “shock cage” environment and isolates herself from her abuser. Generally, professionals help the victim escape by using assertiveness training, modeling and recommending use of the court system. After the woman terminates the abusive relationship, professionals give the victim relapse prevention training to ensure that subsequent exposure to abusive behavior will not cause maladaptive behavior.

Although this strategy is effective, the model offered by Dr. Walker suggests that battered women usually do not actively seek out help. Therefore, concerned agencies and individuals must be proactive and extremely sensitive to the needs and fears of victims. In sum, the classical battered women’s syndrome is a theory that has its origins in the research of Martin Seligman. Women in a domestic abuse situation experience a cycle of violence with their abuser. The cycle is composed of three phases: the tension building phase, active battering phase and calm loving respite phase.

A gradual increase in verbal abuse marks the tension building phase. When this abuse culminates into an acute battering episode, the relationship enters the active battering phase. Once the acute battering phase ends, usually within two to twenty-four hours, the parties enter the calm loving respite phase, in which the batterer expresses remorse and promises to change. After the cycle has played out several times, the victim begins to manifest symptoms of learned helplessness. Behavioral modification strategies offer an effective treatment for battered women’s syndrome.

However, Dr. Walker’s model indicates that battered women may not seek the help that they need because of feelings of helplessness. An Alternate Battered Women’s Syndrome Theory: Battered Women as Survivors. Over the years, empirical data has emerged that casts doubt on Dr. Walker’s explanation of why women stay with their batterers or, in extreme cases, why they kill their abusers. Two researchers, Edward W. Gondolf and Ellen R. Fisher, make reference to voluminous statistics that refute the classical battered women’s syndrome theory, and suggest Dr. Walker erroneously attributes a victim’s refusal to leave her batterer to learned helplessness.

For instance, the two, in discounting Dr. Walker’s theory, cite a study conducted by Lee H. Bowker that indicates victims of abuse often contact other family members for help as the violence escalates over time. The two also note that Bowker observed a steady increase in formal help-seeking behavior as the violence increased. In addition to citing empirical data, Gondolf and Fisher point out that using Dr. Walker’s theory to explain the battered woman’s actions in extreme cases creates the ultimate oxymoron: a woman so helpless she kills her batterer.

In an effort to account for the shortcomings of the classical battered women’s theory, Gondolf and Fisher offered the markedly different survivor theory of battered women’s syndrome, which consists of four important elements. The first element of the survivor theory surmises that a pattern of abuse prompts battered women to employ innovative coping strategies and to seek help, such as flattering the batterer and turning to their families for assistance.

When these sources of help prove ineffective, the battered woman seeks out other sources and employs different strategies to lessen the abuse. For example, the battered women may avoid her abuser all together and seek help from the court system. Thus, according to the survivor theory, battered women actively seek help and employ coping skills throughout the abusive relationship. In contrast, the classical theory of battered women’s syndrome views women as becoming passive and helpless in the face of repeated abuse.

The second element of Gondolf and Fisher’s theory posits that a lack of options, know-how and finances, not learned helplessness, instills a feeling of anxiety in the victim that prevents her from escaping the abuser. When a battered woman seeks outside help, she is typically confronted with an ineffective bureaucracy, insufficient help sources and societal indifference. This lack of practical options, combined with the victim’s lack of financial resources, make it likely that a battered women will stay and try to change her batterer, rather than leave and face the unknown.

The classical battered women’s syndrome theory differs in that it focuses on the victim’s perception that escape is impossible, not on the obstacles the victim must overcome to escape. The third element expands on the first and describes how the victim actively seeks help from a variety of formal and informal help sources. For instance, an example of an informal help source would be a close friend and a formal help source would be a shelter. Gondolf and Fisher maintain that the help obtained from these sources is inadequate and piecemeal in nature.

Given these inadequacies, the researchers conclude that the leaving a batterer is a difficult path for a victim to embark upon. The fourth element of the survivor theory hypothesizes that the failure of the aforementioned help sources to intervene in a comprehensive and decisive manner permits the cycle of abuse to continue unchecked. Interestingly, Gondolf and Fisher blame the lack of effective help on a variation of the learned helplessness theory, explaining help organizations are too overwhelmed and limited in their resources to be effective and therefore do not try as hard as they should to help victims.

Whatever the case may be, the researchers argue that we can better understand the plight of the battered woman by asking did she seek help and what happened when she did, rather than why didn’t she leave. Because the survivor theory of learned helplessness attributes the battered woman’s plight to ineffective help sources and societal indifference, a logical solution would entail increased funding for programs in place and educating the public about the symptoms and consequences of domestic violence. There are battered women’s advocacy programs in place in courts located throughout the country.

However, inadequate funding limits their effectiveness. By increasing funding, citizens can assure that all battered women will receive the assistance that will permit them to escape their batterer. Additionally, if we educate citizens about the harmful effects of domestic abuse, the public will no longer treat victims with indifference. To recap, Edward W. Gondolf and Ellen R. Fisher developed the survivor theory of battered women’s syndrome to explain why statistics indicate that battered women increase their help seeking behavior as the violence escalates.

The theory is composed of four important elements. The first recognizes that battered women actively seek help throughout their relationship with the abuser. The second element posits that a lack of options, know-how and finances creates anxiety in the victim over leaving her batterer. The third element describes the inadequate and piecemeal help the victim receives. Finally, the fourth element concludes that the failure of help sources, not learned helplessness, accounts for why many battered women remain with their abusers.

Under the survivor theory, the best method for helping battered women is to increase funding for battered women’s assistance programs and agencies and educate the public about the harmful effects of domestic abuse. Battered Women’s Syndrome Equals Post Traumatic Stress Disorder Although the DSM-IV does not recognize battered women’s syndrome as a distinct mental illness or disorder, some experts maintain that battered women’s syndrome is just another name for post traumatic stress disorder, which the DSM-IV recognizes.

The post traumatic stress disorder theory is also applied to individuals who were never exposed to domestic abuse, and, in the domestic abuse ambit, does not exclusively focus on the battered woman’s perception of helplessness or ineffective help sources to explain why she stayed with her batterer. Instead, the theory focuses on the psychological disturbance an individual suffers after exposure to a traumatic event.

In 1980, the American Psychiatric Association added the post traumatic stress disorder classification to the Diagnostic and Statistical Manual of Mental Disorders III, a manual used by mental health professionals to diagnose mental illness. Although the diagnosis was controversial at the time, post traumatic stress disorder has gained wide acceptance in the mental health community and revolutionized the way professionals regard human reactions to trauma. Prior to the disorder’s inception, experts attributed the cause of emotional trauma to individual weakness.

However, with the advent of the theory of post traumatic stress disorder, experts now attribute the etiology of emotional trauma to an external stressor, not a weakness in the psyche of the individual. Since 1980, the American Psychiatric Association has revised the criteria for diagnosing post traumatic stress disorder several times. Currently, the diagnostic criteria for post traumatic stress disorder include a history of exposure to a traumatic event and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms and hyper arousal symptoms.

Recent data indicate that many individuals qualify for a post traumatic stress disorder under the current diagnostic criteria, with prevalence rates running between 5 to 10% in our society. As noted earlier, in order for a diagnosis of post traumatic stress disorder to apply, the individual must have been exposed to a traumatic event involving actual or threatened death or injury, or a threat to the physical integrity of the person or others.

The authors of the early theory of post traumatic stress disorder considered a traumatic event to be outside the range of human experience, such events included rape, torture, war, the Holocaust, the atomic bombings of Hiroshima and Nagasaki, earthquakes, hurricanes, volcanos, airplane crashes and automobile accidents, and did not contemplate applying the diagnosis to battered women. The American Psychiatric Association loosened the traumatic event criteria in the DSM-IV, which replaced the DSM-III and DSM-IIIR.

Presently, the traumatic event need only be markedly distressing to almost anyone. Therefore, battered women have little trouble meeting the DSM-IV traumatic event diagnostic requirement because most people would find the abuse battered women are subjected to markedly distressing. In addition to meeting the traumatic event diagnostic criteria, an individual must have symptoms from the intrusive recollection, avoidant/numbing and hyper arousal categories for a post traumatic stress disorder diagnosis to apply.

The intrusive recollection category consists of symptoms that are distinct and easily identifiable. In individuals suffering from post traumatic stress disorder, the traumatic event is a dominant psychological experience that evokes panic, terror, dread, grief or despair. Often, these feelings are manifested in daytime fantasies, traumatic nightmares and flashbacks. Additionally, stimuli that the individual associates with the traumatic event can evoke mental images, emotional responses and psychological reactions associated with the trauma.

Examples of intrusive recollection symptoms a battered woman may suffer are fantasies of killing her batterer and flashbacks of battering incidents. The avoidant/numbing cluster consists of the emotional strategies individuals with post traumatic stress disorder use to reduce the likelihood that they will either expose themselves to traumatic stimuli, or if exposed, will minimize their psychological response. The DSM-IV divides the strategies into three categories: behavioral, cognitive and emotional. Behavioral strategies include avoiding situations where the stimuli are likely to be encountered.

Dissociation and psychogenic amnesia are cognitive strategies by which individuals with post traumatic stress disorder cut off the conscious experience of trauma-based memories and feelings. Lastly, the individual may separate the cognitive aspects from the emotional aspects of psychological experience and perceive only the former. This type of psychic numbing serves as an emotional anesthesia that makes it extremely difficult for people with post traumatic stress disorder to participate in meaningful interpersonal relationships.

Thus, a battered woman suffering from post traumatic stress disorder may avoid her batterer and repress trauma-based feelings and emotions. The hyper arousal category symptoms closely resemble those seen in panic and generalized anxiety disorders. Although symptoms such as insomnia and irritability are generic anxiety symptoms, hyper vigilance and startle are unique to post traumatic stress disorder. The hyper vigilance symptom may become so intense in individuals suffering from post traumatic stress disorder that it appears as if they are paranoid.

A careful reading of post traumatic stress disorder symptoms and diagnostic criteria indicates that Dr. Walker’s classical theory of battered women’s syndrome is contained within. For instance, both theories require that the victim be exposed to a traumatic event. In Dr. Walker’s theory, she describes the traumatic event as a cycle of violence. The post traumatic stress disorder theory, on the other hand, only requires that the event be markedly distressing to almost everyone. Thus, the cycle of violence described by Dr. Walker is considered a traumatic stressor for the purposes of diagnosing post traumatic stress disorder.

Additionally, like the classical theory of battered women’s syndrome, the theory of post traumatic stress disorder recognizes that an individual may become helpless after exposure to a traumatic event. Although the post traumatic stress disorder theory seems to incorporate Dr. Walker’s theory, it is more inclusive in that it recognizes that different individuals may have different reactions to traumatic events and does not rely heavily on the theory of learned helplessness to explain why battered women stay with their abusers.

There are several methods a professional can utilize to treat individuals suffering from post traumatic stress disorder. The most successful treatments are those that they administer immediately after the traumatic event. Experts commonly call this type of treatment critical incident stress debriefing. Although this type of treatment is effective in halting the development of post traumatic stress disorder, the cyclical nature and gradual escalation of violence in domestic abuse situations make critical incident stress debriefing an unlikely therapy for battered women.

The second type of treatment is administered after post traumatic stress disorder has developed and is less effective than critical incident stress debriefing. This type of treatment may consist of psychodynamic psychotherapy, behavioral therapy, pharmacotherapy and group therapy. The most effective post-manifestation treatment for battered women is group therapy. In a group therapy session, battered women can discuss traumatic memories, post traumatic stress disorder symptoms and functional deficits with others who have had similar experiences.

By discussing their experiences and symptoms, the women form a common bond and release repressed memories, feelings and emotions. To summarize, many experts regard battered women’s syndrome as a subcategory of post traumatic stress disorder. The diagnostic criteria for post traumatic stress disorder include a history of exposure to a traumatic event and symptoms from each of three symptom clusters: intrusive recollections, avoidant/numbing symptoms and hyper arousal symptoms.

After exposure to a traumatic event, defined by the DSM-IV as one that is markedly distressing to almost everyone, an individual suffering from post traumatic stress disorder may suffer intrusive recollections, which consist of daytime fantasies, traumatic nightmares and flashbacks. The individual may also try to avoid stimuli that remind him/her of the traumatic event and/or develop symptoms associated with generic anxiety disorders. Critical incident stress debriefing, psychodynamic psychotherapy, behavioral therapy, pharmacotherapy and group therapy are all recognized as effective treatments for post traumatic stress disorder.

IV. Conclusion Although there are many different theories of battered women’s syndrome, most are all variations or hybrids of the three main theories outlined above. A sound understanding of Dr. Walker’s classical battered women’s syndrome theory, Gondolf and Fisher’s survivor theory of battered women’s syndrome and the post traumatic stress disorder theory, will permit the reader to identify the origins and essential elements of these various hybrids and provide them with a better understanding of the plight of the battered woman.

Given the prevalence of domestic abuse in our society, it is important to realize that the battered woman does not like abuse or is responsible for her victimization. The three theories discussed above all offer rationale explanations for why a battered women often stays with her abuser and explore the psychological harm caused by abuse while discounting the popular perception that battered women must enjoy the abuse.