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Background Information

If you live through a terrifying event or experience, such as a horrific car crash, a killer tornado that cripples your hometown, or domestic violence, you are likely to feel shattered and experience difficulty coping and adjusting. However, as time goes on, and with good individual care, you are likely to get better and move on with your life. On the other hand, if you can’t stop reliving the experiences and it affects your everyday functioning, you might be suffering from post-traumatic stress disorder (PTSD).  If you are suffering from this debilitating condition, you are not alone, but great treatment options are available.

One of the few mental illnesses triggered by an outside, traumatizing event, you can suffer from PTSD by experiencing or witnessing a terrifying event. What is considered traumatic? Certain traumatic events can be so severely frightening and overwhelming to individuals that they can cause temporary and sometimes permanent changes to how we physically and psychologically respond to stress in our lives. You may find yourself wondering what types of trauma can cause these changes to our physical and psychological responses. Any unexpected violation to our physical and mental well-being can be considered a trauma. Some of the most common traumatic events that may lead to post-traumatic stress disorder include:

• Sudden death of a loved one
• War
• Rape
• Kidnapping
• Natural disasters (e.g., tornadoes, earthquakes, hurricanes)
• Terrorist attacks
• Car or plane crashes
• Assault
• Sexual or physical abuse
• Childhood neglect

Not everyone who experiences a traumatic event will suffer from PTSD. As mentioned above, it’s normal to have nightmares, be fearful, and find difficulty “forgetting” what happened. When you get stuck in a state of fear and shock and your symptoms don’t improve or get worse, post-traumatic stress disorder is likely settling in because your body is having problems restoring itself to equilibrium.

PTSD is found to occur in approximately one in ten of individuals affected by a traumatic event. On average, 60% of men and 50% of women experience a traumatic event during their lifetimes. Of these, 8% of men are found to develop PTSD and 20% of women are found to develop PTSD. Individuals experiencing rape have a higher likelihood of developing post-traumatic stress disorder over any of traumatic event; therefore, as women are more likely to be raped than men (9% vs. 1% likelihood), this explains the imbalance in the statistics of post-traumatic stress disorder among genders. Additional research shows the majority of individuals affected by post-traumatic stress disorder also suffer from another psychological disorder (e.g., depression, anxiety). These individuals are also more prone to problems with substance abuse of drugs and/or alcohol.

What are the Symptoms?

There is no way of knowing who will develop post-traumatic stress disorder after a traumatizing event. As evidenced by past research, the majority of people who witness or live through a traumatic event will not suffer from PTSD. Most will likely have memories of the events, but their lives will not become negatively impacted by it in their daily interactions.

Symptoms of PTSD are often grouped into types. These types include: avoidance, intrusive memories, changes in emotional reactions, and negative changes in thinking and mood. The most common symptoms of post-traumatic stress disorder include flashbacks, jumpiness (literally “jumping out of one’s skin”), emotional detachment. These symptoms can come and go and vary in intensity. We outline the four types below:

Avoidance Symptoms

• Avoiding talking about or thinking about the traumatic event
• Avoiding places, activities, or people that remind you of the traumatic event

Intrusive Memories

• Flashbacks – reliving the event as if it were happening all over again
• Upsetting dreams/nightmares about the traumatic event
• Recurrent memories of the traumatic event – even when you are trying not to think about them – as if they won’t “leave your mind”
• Experiencing severe emotional distress or physical reactions to things that remind you of the traumatic event

Changes in Emotional Reactions

• Overwhelming guilt or shame
• Jumpiness – being easily startled or frightened – jumping out of your skin
• Sleep disturbances
• Difficulty concentrating
• Always in “defense” mode – on guard for danger
• Irritability
• Angry outburst
• Aggressive behavior
• Self-destructive behavior (e.g., reckless driving, substance abuse)

Negative Changes in Thinking and Mood

• Feeling negatively about yourself and others
• Lack of interest in activities you once found enjoyment in
• Difficulty maintaining relationships with others
• Memory problems – not being able to remember parts of the traumatic event
• Feelings of hopelessness for the future (e.g., marriage, career, living a normal life span)
• Emotional numbness – feeling detached from others
• Inability to experience positive emotions

Children and adolescents may exhibit slightly different symptoms of post-traumatic stress disorder than adults. These symptoms include:

• Severe separation anxiety – fear of being separated from their parents
• Somber play that showcases a revival of the traumatic events
• Phobias unrelated to the traumatic event (e.g., fear of monsters)
• Acting out the traumatic experience through drawings, social play, or stories
• Loss of previously acquired skills (e.g., regression in toilet training)
• Sleep problems and nightmares not related to the event
• Irritability and aggression
• Aches and pains that have no apparent cause

Causes, Risk Factors, and Diagnosis

You are more likely to suffer from post-traumatic stress disorder if the traumatic event you endure is life threatening or severely traumatic to your personal safety. Additionally, the more exposure to the event or prolonged exposure to a traumatic event is also more likely to increase your chances of developing PTSD. Other risk factors of post-traumatic stress disorder include:

• Family history of PTSD and depression
• History of physical or sexual abuse
• High level of stress in your daily life
• Lack of coping skills
• Not getting help or support after the traumatic event
• History of depression, anxiety, or other mental illness
• History of substance abuse
• Careers that exposure you to traumatic experiences (e.g., military, police, first responders)
• Experiencing previous traumatic events, especially early in one’s life
• Extent that the traumatic event was uncontrollable, inescapable, or unexpected
• Type of traumatic event – intentional, human-afflicted harm (e.g., rape, sexual abuse) is more likely to result in PTSD than an act of God (e.g., hurricane, earthquake)

Suffering from post-traumatic stress disorder can increase your chances for other mental illnesses, such as depression and anxiety, suicide, eating disorders, and issues with drugs and alcohol. Therefore, it is especially important to seek treatment if you are suffering from PTSD for your own well-being. You should seek treatment for post-traumatic stress disorder if you are experiencing any of these symptoms and are not able to function or cannot function effectively in your day-to-day life.

Diagnosis of post-traumatic stress disorder is completed by medical professionals. Your diagnosis will be based on psychological evaluations of your signs and symptoms. To be diagnosed with post-traumatic stress disorder, you must meet the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychological Association. In addition to experiencing or witnessing a traumatic event, you must experience one or more of the following after exposure to the traumatic event:

• Reliving the traumatic event
• Upsetting dreams/nightmares about the traumatic event
• Experience of flashbacks
• Experience of emotional distress related to the traumatic event

In combination with these symptoms, you may also experience debilitating behaviors and emotions one month or more post-traumatic event to include things such as avoidance behaviors, memory loss, emotional numbness, self-destructive behavior, and difficulty sleeping.

Your doctor or mental health professional will then make a diagnosis of post-traumatic stress disorder and refer to you a number of treatment options.

Treatment Options for Sufferers of Post-Traumatic Stress Disorder

Several types of treatment options are available if you are suffering from post-traumatic stress disorder. The most often prescribed method of treatment is psychotherapy. Medications and other types of physical treatment options are also prescribed. Your doctor will formulate the best treatment course of action for you.

Psychotherapy, often referred to as “talk therapy” has been shown to elicit great responses from sufferers of post-traumatic stress disorder. Cognitive therapy is focused on recognizing patterns of thinking that get you “stuck” in your emotional state. For example, this type of therapy might help you in recognizing cognitive patterns associated with negative perceptions of normal situations. Exposure therapy is often coupled with cognitive therapy if you have been diagnosed with PTSD. Exposure therapy focuses on safe exposure to what is causing you intense fear. This exposure enables you to cope with the stimulus effectively and rationally. Eye movement desensitization and reprocessing (EMDR) is a form of therapy that combines exposure therapy with guided eye movements. These combination of events in EMDR help you in your cognitive processing of traumatic events and allow you to effectively change your reactions to these types of events.

Medications that have been found useful in the treatment of post-traumatic stress disorder include antidepressants and anti-anxiety medications. Selective serotonin reuptake inhibitors (SSRIs), including Zoloft and Praxil, have been approved by the Food and Drug Administration as antidepressant treatments for PTSD.

Anti-anxiety medications are typically prescribed short-term to relieve severe anxiety problems associated with PTSD. They are usually only prescribed temporarily because of the ease of addiction to this type of medication. Nightmare suppressant drugs (e.g., Prazosin) may also be prescribed if you are suffering from post-traumatic stress disorder to help you sleep more easily and with fewer disruptions.

Final Thoughts

If you have experienced a terrifying traumatic event and now suffer from post-traumatic stress disorder as a result, treatment does exist and following it can lead you to a life of well-being. To get the most of your treatment plans, follow these pieces of advice:

• Learn all you can about your disorder and what effects it has on your body – this allows you to recognize signs and symptoms and coping strategies
• Follow the treatment plans prescribed to you by your doctors and mental health providers – even if you are feeling “fine”
• Don’t turn to drugs and alcohol to “numb” your feelings
• Stay healthy – eat well-balanced meals and exercise on a regular basis
• Find support groups that can help you through difficult times – and to have a support base that you can talk to about anything

Symptoms, Types, Causes, and Treatments

Overview and Facts – What is Schizophrenia?

Are you having trouble separating reality from fantasy? Do you hear voices? Do you believe someone is reading your mind and controlling your thoughts? Are your thoughts “off” and are you having difficulty expressing how you feel, act, and think? If so, you may be suffering from schizophrenia, a debilitating brain and behavioral disorder with chronic and acute symptoms that occur continuously or intermittently throughout your lifespan.

Heavily stigmatized in American culture, schizophrenia is often confused with multiple personalitiesand the propensity to cause severe danger to others. Schizophrenic individuals may appear agitated, withdrawn, or unresponsive, inciting additional fear within the general public. Most do not realize that if you are suffering from schizophrenia, medications and psychological counseling have been found to substantially improve the lives of those suffering from this condition. And it’s most important to get treatment if you are suffering from schizophrenia, as it poses one of the highest risks of suicide among the general population, with up to 10 to 13% of schizophrenics carrying out successful suicide attempts within the first decade of diagnosis. The overall prevalence of the disorder is extremely low, affecting only 0.3% to 1% of Americans, though what makes this illness monumental is the severity of its symptoms.

Though able to occur at any age, if you are suffering from schizophrenia, the likely onset for men is between the late teens and early 20s and the late 20s to early 30s for women. It is very unlikely for a diagnosis of schizophrenia to occur in individuals less than 12 years old and older than 40 years old. Life expectancy for schizophrenic individuals is reduced by approximately 10 to 25 years less than the average, though this is likely caused by the increased occurrence of physical symptoms and much higher suicide rates than the general population.

Symptoms and Types of Schizophrenia

Symptoms

Signs and symptoms of schizophrenia are often categorized into positive and negative classifications and cognitive deficits. If you are suffering from schizophrenia and are undergoing treatment, you may have noticed that treatments tend to diminish positive symptoms pretty well. Negative symptoms are more prone to not respond to treatment as readily as positive symptoms. Deficits in cognitive abilities are large indicators of the impact schizophrenia has on the quality of life of an individual. If you are suffering from numerous cognitive deficits, your functioning as an adult with the illness will be minimized and successful treatment interventions will be harder to attain.

Positive Symptoms include:
• Delusions – false beliefs that stay stable even when presented with facts contradictory of the beliefs
• Hallucinations (tactile, auditory, olfactory, and gustatory) – including hearing voices, seeing things
• Thought Disorders (dysfunctional thinking)
• Movement Disorders (agitated body movements)

Negative Symptoms include:
• Emotionally flat (flat affect)
• Dull speaking, monotone, disconnected from reality
• Inability to start of follow through with activities
• Lack of motivation
• Poverty of Speech (i.e., speaking less)
• Little or no interest in life or relationships

Cognitive Symptoms include:
• Inability to understand information and use it to for decision-making purposes
• Trouble focusing or paying attention
• Disorganized thinking, thoughts, and speech
• Difficulty remembering things; problems with working memory
• Lack of Insight – termed “anosognosia” – where the affected individual has no awareness they are suffering from schizophrenia

Types

Paranoid Schizophrenia: The most common type of schizophrenia characterized by psychosis misaligned with reality. If you are suffering from paranoid schizophrenia, you may be unreasonably paranoid of others, have paranoid delusions that someone is after you and that they are trying to hurt you. Common paranoid delusions include coworkers, spouses, the government, and neighbors plotting to hurt you in some way. You may believe others are out to try to kill you, spy on your, make your life miserable, poison you, or cheat on you. Paranoid schizophrenia has a severe impact on relationships, understandably so, as if you are suffering from this disorder, you believe those that are close to you are trying to hurt you in some way. This may cause you to feel angered and agitated. To cause an even deeper impact on the situation, your paranoid delusions may be accompanied by hallucinations where you hear voices that are insulting you or prompting you to do bad things.

Schizoaffective Disorder: Schizoaffective disorder is a type of combination disorder that combines symptoms of schizophrenia with a mood disorder – most likely either major depression or bipolar disorder. This type of schizophrenia is chronic and appears in intermittent episodes. Mood (affective) symptoms occur at the same time as the schizophrenic symptoms and the schizophrenic symptoms often stay put after the mood symptoms disperse. Common symptoms of schizoaffective disorder include depression, mania, and classic schizophrenia.

Brief Psychotic Disorder: This is a short-term occurrence of schizophrenia, where there is a sudden onset of symptoms that only persist for less than one month. The causes of these brief stints of psychoses include an obvious stressor (e.g., death of a loved one, trauma from natural disasters), no apparent stressor (i.e., the symptoms come on due to no obvious reaction to a disturbing event), andpostpartum psychoses – occurring in women within 4 weeks of giving birth. During this brief episode of psychosis, you might experience hallucinations, delusions, and cognitive deficits, as present during more general schizophrenia. It is unknown what causes brief psychotic disorder to affect certain individuals, but certain genetic and environment factors have been examined as culprits, including predisposition to develop mood disorders and psychoses within the family history.

Schizophreniform Disorder: This is another short-form occurrence of full-blown schizophrenia, where the affected individual experiences distorted thinking, emotional reactions, and perceptions of reality. If you are suffering from this disorder, you likely have a very hard time distinguishing between what’s real and what’s imagined. Though the symptoms of schizophreniform disorder and general schizophrenia overlap, the major difference is the length of duration. If you suffer from schizophreniform disorder, you experience psychosis symptoms for six months or less. If they persist longer than this time frame, you are likely to receive a diagnosis of schizophrenia instead.

Delusional Disorder: As the name suggests, this is a form of psychosis where the main symptom is delusions – the inability to shake untrue beliefs. If you are suffering from this form of psychosis, it is not likely you are making up unbelievable scenarios – most delusions involve someone trying to poison you or harm you in some type of way. In reality, these delusions may be a heightened exaggeration of reality or just false altogether. A distinguishing characteristic of individuals suffering from this condition is that among other things, there is no bizarre behavior – you wouldn’t know someone is suffering from this condition if it weren’t for the delusions.

Shared Psychotic Disorder: Also known as “folie a deux” (the folly of two), this is a rare form of psychosis where an otherwise healthy individual begins to adopt the psychotic beliefs/delusions of someone suffering from schizophrenia. For example, if you are suffering from schizophrenia and believe monsters are after you and trying to abduct you, if your spouse (otherwise healthy) also starts to believe that monsters are out to get you, your spouse would be considered to suffer from shared psychotic disorder. If you and your partner separate, the delusions resolve.

Causes of Schizophrenia

Researchers have yet to pinpoint an exact case of schizophrenia, but the usual genetic and environment factors are lead agents in the causes of schizophrenia. It is no secret that schizophrenia runs in families. Research has shown that while schizophrenia occurs in less than 1% of the general population, if you have a first-degree relative with the illness, your chances of developing it increase to 10%. In twins, the risk is substantially increased, with there being a 50% chance of developing schizophrenia in the undiagnosed identical twin. But, this does not mean if your mother suffers from schizophrenia, you are automatically going to suffer from it as well. Though genes increase the risk of occurrence of schizophrenia, they only lay the groundwork. The right mix of environmental factors seem to need to mix with the genetic makeup to propel the development of schizophrenia into a full-blown illness.

Research has shown that some of the most prominent environmental factors that are conducive to interacting with pre-disposed schizophrenic genetic makeups include problems during birth, malnutrition before birth, exposure to certain viruses, and psychosocial factors.

The brain’s makeup is also thought to be a leading cause of the development of schizophrenia. An imbalance between neurotransmitters, dopamine, and glutamate seems to point to higher occurrence levels of schizophrenia in the general population. Similarly, impaired brain development during the gestational phase of life may lead to imbalanced connections between the brain chemistry and structure of the brain, in addition to hormonal changes/imbalances that occur during puberty.
There is some evidence that substance abuse/use may also predispose you to developing schizophrenia. Using mind-altering drugs in the teenage years and early adulthood can increase your risk of schizophrenia, including the use of marijuana.

Complications of Schizophrenia

As mentioned previously, the occurrence of suicide in schizophrenics is abnormally higher than other mental illness disorders. Such that, an estimated 20% to 40% of individuals suffering from schizophrenia will attempt suicide at some point in their lifetimes. Up to 13% are likely to successfully complete the act, the majority being males. Suicide is a tricky complication of schizophrenia because many suffering from this condition are unaware they have it, making treatment that much more difficult.

Substance abuse is another common complication of schizophrenia. Nicotine addiction is the most common substance abuse among schizophrenics, with schizophrenics being addicted to nicotine three times the rate of the general population. If you are suffering from schizophrenia, you have an increased propensity to abuse more harder substances in addition to nicotine, including marijuana, alcohol, and cocaine. Certainly compounding the already detrimental impact of substance abuse on one’s general health, taking medications to treat schizophrenia while abusing drugs makes the medication less effective, in fact, potentially dangerous. In addition, amphetamines (stimulants) make schizophrenic symptoms considerably worse.

Diagnosis and Tests of Schizophrenia

Diagnosis of schizophrenia occurs based on the presence of symptoms and the duration of symptoms. Generally speaking, the presence of two or more psychotic symptoms (e.g., delusions, hallucinations, disorganized speech, catatonic behavior) must be significant and occur for at least one month. In more severe cases, the presence of significant delusions and hallucinations can alone be used to make a diagnosis of schizophrenia.

Prior to initial diagnosis, a health care provider will rule out any other possible causes of the schizophrenic symptoms, including medical conditions, other mental illnesses, and brain tumors.

Treatment and Care

There are several treatments and therapies focused on eliminating the symptoms of schizophrenia. If you suffer from this condition, you might take antipsychotics, undergo psychosocial treatments, or coordinated treatment care. Antipsychotics are the most common form of treatment for individuals with schizophrenia. They significantly reduce positive symptoms – impacting the neurotransmitter systems. Commonly used medications for treatment include Haldol, and the more modern atypicalantipsychotic medications such as Clozapine, Geodon, Seroquel, Risperdal, Abilify and Zyprexa.

The second tier of treatment includes cognitive and behavioral therapy to “retrain” the brain once the antipsychotics reduce the positive symptoms associated with schizophrenia. Additionally, cognitive behavioral therapy improves self-care and teaches coping mechanisms so that schizophrenics can lead somewhat normal lives – going to work, going to school, and staying in relationships.

Coordinated specialty care (CSC) integrates a full course of treatments, including medication, psychosocial therapies, family involvement, and employment services to round out the schizophrenic treatment plans and courses back to normalcy. CSC projects to alter the normal trajectory of those suffering from schizophrenia and orient them toward productive, independent lives.

Living and Managing Life With Schizophrenia

It takes a village, that’s for sure. Family involvement, peer help, and care and support of a loved one with schizophrenia is no small feat. How do you respond to someone claiming aliens are after them? Or that the government set up spyware in their home? When faced with caring for a loved one suffering from schizophrenia, it’s helpful to keep in mind this is a biological illness. Express your concern and motivate them to seek treatment. Once they get in treatment, encourage them to stay there. Don’t make fun of their delusions, downplay them, or make light of any hallucinations that may be occurring. After all, to someone suffering from schizophrenia, these things are quite real.

Support and Resources

If you are suffering from schizophrenia, stay in treatment and join a support group. Joining clinical trials is also a beneficial way to explore different prevention, detection, and treatment options. Don’t abruptly stop medications – and don’t skip medicine dosages. Keep in mind that while there is no cure for this disorder, there are thousands suffering from the same condition. You are not alone. And schizophrenia is very treatable and manageable, especially when diagnosed early. You can still enjoy life while living with schizophrenia.

A Guide to Signs, Diagnosis, and Treatment

The Background

It’s a nice feeling to be admired. It naturally makes us feel good and feel important. And, yes, we sometimes boast and brag on ourselves as well. But, if people start describing you as cocky, manipulative, and demanding, you might be suffering from a more serious condition. Narcissistic personality disorder is a mental disorder affecting approximately 1% of the population, with a greater prevalence in men than women. It is characterized by an inflated sense of self-importance, a lack of empathy for others, and a great need for admiration. The hallmark definition of narcissistic personality disorder is grandiosity – the exaggerated sense of self-importance.  If you are living with this disorder, you may be preoccupied with power, prestige, vanity, and may think you deserve special treatment and fame.

Narcissistic personality disorder should not be confused with high self-confidence and self-esteem. Those with high self-esteem are still humble. If you are living with narcissistic personality disorder, you are likely selfish, boastful, and ignore others’ feelings and needs.  It was once thought that individuals suffering from narcissistic personality disorder have high self-esteem on the surface, but deep down are insecure. This theory was supported by the defensive state these individuals enter when provoked. Recent research discounts the earlier theory and now indicates that if you are suffering from narcissistic personality disorder, you likely also have high self-esteem – both on the surface and below the surface.

If you are living with narcissistic personality disorder, it is probably affecting your everyday life. . . in a negative way. In general, you may be unhappy with life in general and disappointed when others are not admiring you or giving you special treatment and attention. Your work, personal, and social relationships are likely suffering, though, you are unable to see your own role in these occurrences. Individuals with narcissistic personality disorder are unable to realize the damaging effects their behavior is causing themselves and others. If you have this condition, people likely will not enjoy being around you and you may feel unfulfilled at work, home, and in your social life.

What are the Symptoms?

Monopolizing conversations? Feelings of entitlement? Belittling others? These are all classic signs of narcissistic personality disorder. Do you know of someone who knows the “right” way and all other ways are wrong? Are they cocky, lack empathy, and think they are largely important? Then it’s possible they might be suffering from this condition.

Signs & Symptoms

Included below is a list of some well-recognized symptoms of narcissistic personality disorder.

• Preoccupied with fantasies of unlimited success
• Belief of great self-importance; only understood and should only associate with individuals of high-status
• Expectations of being realized as superior
• In need of and requiring constant admiration
• Exaggeration of achievements and talents
• Possessing a sense of entitlement
• Being envious of others and the exaggerated belief that others are envious of you
• Thinking about oneself the majority of the time and talking about oneself a lot; self-promotion
• Setting of unrealistic goals
• Expectation that others should do special favors for you
• Belief that nobody should question your motives and should have unwavering compliance with your requests
• Taking advantage of others to move forward in life and/or to get what you want, with no remorse toward the ones you stepped on to get there
• Arrogance, haughtiness
• Easily rejected, hurt
• Unemotional
• Power seeking
• Demonstrates superiority
• Responds to criticism with shame, anger, and humiliation
• Easily jealous

Oftentimes, individuals are initially attracted toward people with narcissistic personality disorder. You may find yourself attracted to the confidence, assertiveness, and excitement that surrounds a person with narcissistic personality disorder. However, getting to know the person in depth, you may start to despise the very same traits that initially attracted you to the person. This, of course, after realizing their unemotional response to relationships, the unattractiveness of their lack of empathy for others, and the grandiose belief they are greatly important and you should treat them as such.

What Causes Narcissistic Personality Disorder and How is it Diagnosed?

There is not a single defined cause of narcissistic personality disorder. But, researchers agree that both genetic and environmental causes are at play. Individuals with narcissistic personality disorder have been found to have less volume of gray matter in the left anterior insula, the part of the brain related to empathy, emotional regulation, compassion, and cognitive functioning.

Many of the traits of narcissistic personality disorder occur during normal stages of development. Scientists believe that full onset of narcissistic personality disorder may occur when interpersonal development during these phases is conflicted. Examples of types of negative or destructive interpersonal environments interacting with developmental phases include:

• Being born with an oversensitive temperament
• Learning manipulative behavior from parents or peers
• Being excessively praised for good behaviors and excessively criticized for bad behaviors
• Suffering from severe childhood abuse
• Inconsistent parental care giving – unreliable or unpredictable care
• Being overindulged by parents, peers, or family members
• Being excessively admired with no realistic feedback to balance you with reality
• Receiving excessive praise from parents or others over your looks or abilities

If you are suffering from narcissistic personality disorder, you might never head to the doctor for a diagnosis. Studies have shown that people suffering from this condition rarely enter treatment. If you do enter treatment, progress will be slow. However, if you or a loved one is suffering from narcissistic personality disorder, it’s important to get treatment. Prepare for your appointment by taking note of symptoms, personal experiences, medications, and your medical history. Your doctor will conduct a physical examination to rule out any underlying conditions and will then refer you to a mental health provider. A mental health provider will ask you a number of questions to gather information about your symptoms and the effects they are having on your life.

What are the Treatment Options?

Psychotherapy is the key approach in the treatment of narcissistic personality disorder.  Psychotherapy, also known as talk therapy, is used to help you learn how to relate to others better to encourage more functional interpersonal relationships and to gain a better understanding of your emotions and why you feel the way you do.

As noted above, the treatment prevalence for individuals living with narcissistic personality disorder is low and slow going. Because treatment is focused on personality traits, which are pretty steady over time, it may take many years of psychotherapy before realizing a break through. Change behaviors are focused on accepting responsibility for your actions and learning ways to engage inter personally in a more appropriate manner. These include:

• Accepting and maintaining relationships with co-workers and family
• Tolerating criticisms and failures
• Understanding and regulating your feelings
• Minimizing your desire to attain unrealistic goals and ideal conditions

There are no known medications to treat narcissistic personality disorder. But, oftentimes if you are living with this condition, you might also be living with depression and anxiety. Medications are helpful for these conditions and may be used to treat those. Individuals living with narcissistic personality disorder are also at a greater likelihood of abusing drugs and alcohol – so treatment for addiction problems is also beneficial in treating this condition.

Keep an open mind toward treatment, stick to treatment plans, educate yourself about your condition, and stay focused on your goal. You may feel negative toward treatment, but know that it can help.

A Guide to Signs, Symptoms, Causes, and Treatment

Background Information

Have you ever left your house, but stopped the car and went back inside because you couldn’t remember if you turned off the stove? A natural reaction to a potentially dangerous situation, right? Sure – we’ve all done it. Ever obsessively thought about whether you turned the stove off for hours on end. Or engaged in the repetitive checking and re-checking that you turned it off? Do you have no control over stopping these obsessive thoughts and compulsive behaviors? Then, you might be suffering from obsessive compulsive disorder (OCD). This condition is chronic and affects approximately 2% of the general population over the course of a lifetime. On any given day, 1.5% of people across the globe are suffering from OCD.

If you are suffering from obsessive-compulsive disorder, it is likely negatively affecting your life to some degree. You might engage in excessive hand washing that disrupts your lifestyle – spending over an hour a day washing your hands repeatedly to the point they become raw and blistered. Or, you might develop a counting ritual such that you can’t leave a room without turning the light on and off a certain number of times. If you are suffering from OCD, you likely know that your thoughts and behaviors are irrational. But, you still, uncontrollably, engage in the ritualistic behavior or can’t stop thinking about something obsessively. In addition, if you suffer from obsessive-compulsive disorder, you are more likely to also be coping with other mental health disorders, including eating disorders and depression; and your risk of developing anxiety, tics, and contemplating suicide are increased.

The typical onset of obsessive-compulsive disorder is before the age of twenty. It is very uncommon for obsessive-compulsive behavior to begin after the age of thirty-five, though it can occur. Obsessions and compulsions are prevalent among children and occur about equally in men and women. Often, obsessions and compulsions develop among some type of theme. For example, if you are suffering from this condition, you might be fearful of germs. You obsessively think about getting sick from these germs, so you engage in the compulsive act of excessive hand washing. Despite your best efforts to ward off these thoughts, you have no control over them, so you engage in more and more hand washing because of your fear of germs. Because the obsessive thoughts about germs never go away, your compulsions get worse, and the cycle goes on and on with no relief. This cyclical nature of obsession and compulsion is classic of obsessive-compulsive disorder.

So What are the Symptoms?

We’ve talked a lot about hand washing rituals. But this is only touching the tip of the iceberg when it comes to OCD. What exactly are obsessions and compulsions? What other types of behaviors represent this disorder? Read on to find out.

Obsessions are repeated thoughts, urges, or mental images that cause anxiety in an individual. Some of the more common themes of obsessions include:

• Fear of germs
• The need to have things in perfect, symmetrical order
• Taboo thoughts or other unwanted thoughts are things such as sex, religion, or harm
• Aggressive thoughts toward yourself or toward others

Some of the more common obsession signs and symptoms include:

• Fear of being contaminated with germs or dirt by shaking hands with another person or touching objects that are not yours
• Feeling intensely stressed out when certain belonging are not facing in the same direction (need for order and symmetry)
• Avoiding situations that could cause obsessive thoughts (e.g., avoiding shaking another person’s hand for fear of getting germs or dirt on your own hands)
• Constant doubt that you locked the door to your house/car and/or turned your stove off
• Thoughts about horrifically hurting yourself or hurting others
• Obsessive thoughts about shouting inappropriate things or obscenities
• Feeling stressed out when you replay unwanted sexual images in your head repeatedly
• Fear of being embarrassed
• Excessive doubt and need for reassurance

Compulsions are the direct result of obsessions. When you suffer from obsessive-compulsive disorder, your obsessive thoughts lead to repetitive behaviors (compulsions) you feel are necessary to perform. You perform these behaviors to reduce the anxiety produced from obsessive thoughts and to prevent something bad from happening. If you are coping with obsessive-compulsive disorder, you likely know that these compulsions only provide temporary relief and bring no pleasure.

Common themes surrounding compulsions include:

• Counting
• Checking
• Washing/cleaning
• Maintaining strict routines
• Orderliness
• Need for reassurance

Common compulsion signs and symptoms include:

• Excessive hand washing, often causing your hands to become raw and sometimes bleed
• Patterned counting behaviors
• Repeated checking that the stove is turned off
• Repeated checking of door locks
• Refusing to shake hands or touch door knobs
• Eating foods in a specific order and/or not allowing foods to touch
• Collecting or hoarding items
• Repeating a prayer or phrase to yourself
• Ordering and arranging things in a precise, symmetrical way

If you are suffering from obsessive-compulsive disorder, your symptoms may come and go over time and also vary in intensity.

How Is OCD Diagnosed and What Causes It?

What causes obsessive-compulsive disorder? Doctors and mental health professionals cannot pinpoint an exact cause but believe both genetics and environmental factors play a role in the occurrence of OCD. Twin and family studies reveal a higher likelihood of developing OCD if first-degree relatives also suffer from the disorder. Research has shown that the likelihood also increases if the first-degree relative developed OCD at an early age.

Individuals suffering from obsessive-compulsive disorder also have varying brain structures from those of a population without OCD. Studies indicate abnormalities in the frontal cortex and subcortical structures of the brain in OCD patients; however, more extensive research is needed to more definitively understand this biological occurrence.

Environmental factors that are thought to increase your chances of developing OCD include experiencing physical or sexual abuse during childhood or other types of trauma.

When obsessions and compulsions are negatively affecting your everyday life, it is wise to see a doctor or mental health professional.  Adults who are suffering from OCD are likely aware of their thoughts and behaviors; however, children are usually unaware that something’s amiss. Oftentimes, parents or teachers are the ones who first notice OCD symptoms occurring in youth or adolescents.  Its negative impact can affect your social, interpersonal, work, and school life, interrupting daily routines by spending excessive amounts of time on obsessive thoughts and compulsive actions.

Your mental health provider will perform a mental health assessment to confirm an OCD diagnosis and your physician will perform an exam and blood work to rule out other underlying causes. A number of comprehensive obsessive-compulsive disorder screenings exist to determine the occurrence of OCD and the severity of it.  Once diagnosed, you and your mental health provider will work together to determine the best treatment options and coping mechanisms.

OCD Treatment

The most common treatment options for obsessive-compulsive disorder are medication and psychotherapy. Or, a combination of both.

If you are suffering from OCD, you may be prescribed serotonin reuptake inhibitors (SRIs) or selective serotonin reuptake inhibitors (SSRIs) to control symptoms. Antidepressants are normally tried first to control OCD symptoms. The most commonly prescribed medications include:

• Sertraline (Zoloft)
• Fluoxetine (Prozac)
• Clomipramine (Anafranil)
• Fluvoxamine (Luvox, CR)
• Paroxetine (Paxil, Pexeva)

In some cases, antipsychotics are prescribed to treat OCD, or a combination of antidepressants and antipsychotics. If you have been prescribed a medication for treatment of OCD, it is important to note that many of these medications may take a number of weeks or months to have a full effect on your symptoms.

Your doctor might also suggest psychotherapy as a treatment option for obsessive-compulsive disorder. Psychotherapy is meant to change your negative thought patterns to related to obsessions and resultant compulsions. With OCD, exposure and response prevention (ERP) has been found to be the most effective treatment option. A form of cognitive behavioral therapy, this method of exposure therapy gradually exposes you to your obsession (e.g., dirt) to allow you to cope with your anxiety in a healthier way. Many times, doctors will prescribe ERP therapy in conjunction with medications when SRIs and SSRIs are not effective enough on their own. Individual, family, and group sessions of exposure therapy are available.

Obsessive-compulsive disorder is a chronic condition, meaning if you are suffering from this disorder, you may cope with it for your entire life. However, as our understanding of this condition grows, our treatment options and success rates of treatment evolve. Educate yourself about your condition, follow your doctor’s advice, and learn the warning signs and symptoms. Doing so keeps you proactive and informed of your disorder and enables you to live a healthy and productive life.

A Discussion of Signs, Symptoms, and Treatments

The Background

You just failed a big test and are pretty bummed about it. Or, you’re going through a bad breakup and feeling pretty down. We’ve all been there. In day-to-day life, everyone experiences ups and downs every now and then. Eventually, time passes on and our mood becomes better and we become “ourselves” again. Unlike the normal population, individuals living with bipolar disorder cycle through extreme mood swings that cause disruption to daily life.

Bipolar Disorder. Manic Depression. Bipolar Affective Disorder. All three terms are synonymous with each other and the name of a mental health disorder affecting approximately 3% of the American population. The classic symptoms of bipolar disorder are the periodic changes in mood, alternating between periods of elevated mood (mania or hypomania) and periods of depression. If you are living with bipolar disorder, you may feel energetic, abnormally happy, and make reckless decisions during manic states. During depressive states, you may feel the overwhelming urge to cry, experience feelings of hopelessness, and have a negative outlook on life. Hypomania is a less severe form of mania, where you generally feel  pretty good – with a better sense of well-being and productivity.

With bipolar disorder, you don’t just feel “down in the dumps;” your depressive state may lead to suicidal thoughts that change over to feelings of euphoria  and endless energy. These extreme mood swings can occur more frequently – such as every week – or show up more sporadically – maybe just twice a year. There is also no defined pattern to the mood swings. One does not always occur before the other – and the length of time you are in one state or the other varies as well. The good news is that there are a number of treatments that can keep your moods in check – allowing you to live a productive life.

Rates of bipolar disorder in men and women are about equal and the typical onset of symptoms occur around 25 years of age. There are many types of bipolar disorder; three of the most common include Bipolar I Disorder, Bipolar II Disorder, and Cyclothymic Disorder. Bipolar I Disorder is characterized by the occurrence of at least one manic episode, preceded or followed by a hypomanic or major depressive episode. Manic episodes may be so severe they significantly disrupt your daily functioning or may trigger a break from reality (psychosis). If you are suffering from Bipolar I Disorder, you may require hospitalization. If you are living with Bipolar II Disorder, you experience at least one major depressive episode lasting two weeks or more and at least one hypomanic episode lasting at least four days. But, you will not have experienced a manic episode.  Cyclothymic disorder is characterized by at least two years of multiple occurrences of hypomania symptoms and depressive symptoms – these symptoms are less severe than hypomanic episodes and major depressive episodes. During this time, symptoms present themselves at least half of the time and are constant for at least two months.

Signs and Symptoms

Because there are many different stages of bipolar disorder, the signs and symptoms vary from person to person and from type to type. Presented below are the most common signs and symptoms of bipolar disorder, categorized by emotional state.

Manic Symptoms

According to the DSM-5, a manic episode is characterized by a distinct and abnormal state of elevated, expansive, or irritable mood occurring for at least one week. The manic episode is persistently driven by a goal-directed behavior or energy. A hypomanic episode is a distinct and abnormal state of elevated, expansive, or irritable mood that lasts for at least four consecutive days.

If you have been diagnosed as suffering from bipolar disorder, you may experience any of the signs and symptoms during a manic period:

• long period of feeling “high” – an overly elated, happy, and outgoing mood
• feeling extremely irritable
• being easily distracted
• having racing thoughts
• talking very fast
• jumping from one thought to another when talking
• taking on a lot of new projects
• restlessness
• boundless energy
• sleeping very little
• not feeling tired
• unrealistically believing you can do something
• engaging in impulsive, pleasurable, and high-risk behaviors (e.g., poor financial investments, sexual indiscretions, shopping sprees)
• inflated self-esteem
• feelings of grandiosity
• increased agitation
• increased goal-directed activity
• high sex drive
• making grand and unattainable plans
• detachment from reality – psychosis that may include delusions or hallucinations

Manic behaviors interfere with functioning at school or work, in social situations, and in relationships. These behaviors occur on their own – they do not occur due to alcohol or drug use, a medical illness, or a side effect of a medication.

Depressive Symptoms

The depressive side of bipolar disorder is characterized by a major depressive episode resulting in a depressed mood or loss of interest or pleasure in life. If you are living with bipolar disorder, during depressive states, you may experience some of the following signs and symptoms:

• feeling sad, tearful, hopeless, or empty for the majority of the day on a daily basis
• no pleasure or interest in day to day activities
• weight fluctuations – including significant weight loss or weight gain
• sleep disturbances – sleeping too much or other sleep problems, such as insomnia
• restlessness or slowed behaviors
• suicidal thoughts, planning, or attempts
• feelings of guilt and worthlessness
• inability to concentrate
• indecisiveness
• loss of energy
• feelings of fatigue
• psychosis – being detached from reality; delusions or hallucinations
• loss of interest in activities you once enjoyed
• anxiety
• uncontrollable crying

Depressive behaviors can interfere with school or work, family or personal relationships, and social functioning. If you are suffering from bipolar disorder and undergoing a depressive episode, it is not the result of substance abuse, medications, an underlying medical condition, or stressful situation – such as grieving the loss of a loved one.

What is Causing It? How is it Diagnosed?

If you are suffering from bipolar depression, you may be wondering what it is that caused this condition. What are the risk factors? Like most mental illnesses, there is not one single cause that scientists can pinpoint to tell you why you are suffering from bipolar disorder. But, it appears genetics are likely to account for around 60-80% of the risk for developing bipolar disorder – indicating the key role heredity plays in this condition. Your risk of developing bipolar disorder is also increased significantly if you have a first-degree relative suffering from this mental state.

Environmental factors also have shown a connection to bipolar disorder – and they likely interact with genetic predispositions to catapult the onset of the disorder. What this means is that if you are living with bipolar disorder, it was probably a mixture of genes and a life event that triggered the disorder to present itself in your everyday life. You may have suffered from some type of traumatic event or abuse or a troubling and/or stressful interpersonal relationship of some type.

If you believe you are experiencing signs and symptoms of mania or depression, go see your doctor. Oftentimes, it is  your family or co-workers who are first to recognize signs and symptoms of bipolar disorder. If you are suffering from this condition, you may be reluctant to seek help at first – mostly because you are not able to notice how disruptive the disorder is on your life. And, you may enjoy feeling euphoric. However, it is important to treat this condition so you can manage your emotional states and live a productive, full life. Bipolar disorder will not go away on its own and you are likely to live with this condition for the rest of your life. However, with the right treatment plan, you can live a good life.

Your doctor or mental health provider will assess you physically to rule out any underlying medical conditions that may be causing your manic or depressive states. If no underlying medical conditions present themselves, you are likely to be referred to a mental health provider for further diagnosis.

Your mental health provider will  perform a series of psychological assessments to gather additional information about your condition. These assessments will aid your mental health provider in diagnosing the presence of this condition in your life and also determine which type of bipolar disorder you may be suffering from.

What are the Treatment Options?

Medications and psychotherapy are the most commonly prescribed treatment plans for people suffering from bipolar disorder. And the success rate of these treatment plans are great if followed correctly and consistently.

If you are living with bipolar disorder, you have likely been prescribed a number of different medications. The most common medications used to treat this condition include mood stabilizers, antidepressants, and atypical antipsychotics. The most often first course of drug therapy is the prescription of mood stabilizers. Lithium is one of the most well-known and effective mood stabilizers for individuals affected with bipolar disorder. You may also be prescribed an anticonvulsant for use as a mood stabilizer. Atypical antipsychotics are often combined with antidepressants to treat bipolar disorder. Because the use of antidepressants can trigger hypomanic or manic states, you will likely take an antidepressant with a mood stabilizer to even out emotions.

Psychotherapy has also been an effective tool for people living with bipolar disorder. Cognitive behavioral therapy will help you learn how to change negative or harmful thoughts or behaviors. Family-focused therapies involve your family members and focus on teaching coping strategies, communication counseling, and problem-solving techniques. Psychoeducation has also been a powerful therapy tool to teach individuals living with bipolar disorder about their condition and how to treat it. This education allows you to notice trigger points and impending mood swings so you can seek treatment before a full-blown episode occurs. Interpersonal and social rhythm therapy (IPSRT) is used often in treating bipolar disorder as well – as this form of psychotherapy focuses on the stabilization of daily rhythms – sleep, wake, mealtimes – to introduce consistent routines to better manage moods.

In severe cases, you may need to be hospitalized for your own safety and well-being. This may result from severe states of mania or depression leading to psychosis, risky behaviors, or thoughts of suicide.

If you are living with bipolar depression, it is important to follow your treatment plan. Pay attention to warning signs or triggers – this can help you seek additional treatment, talk with your counselor or mental health provider, and prevent the onset of a full attack. Avoid drugs and alcohol, and take your medication as prescribed – even on days you feel fine. Following your treatment plan, educating yourself about your disorder, and engaging in prevention techniques will positively contribute to your overall well-being and life satisfaction.