Therapy work sheet

At the start of therapy it is important to think about your goals for treatment.

DESCRIBE THE PROBLEMS THAT LED YOU INTO THERAPY

 

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Imagine that while you are sleeping all of your problems are solved. When you wake up how will you know that things are better? What specific changes do you notice.

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You Learn

After a while, you learn the subtle difference
Between holding a hand and chaining a soul,

And you learn that love doesn’t mean leaning
And company doesn’t mean security,
And you begin to learn that kisses aren’t contracts,
And presents aren’t promises.

And you begin to accept your defeats
With your head up and your eyes open,
With the grace of an adult
Not the grief of a child.

And you learn to build all your roads on today
Because tomorrow’s ground is too uncertain for plans
And futures have a way of falling down in mid-flight.

After awhile, you learn
That even the sunshine burns if you get too much.
So you plant your own garden, decorate your own soul,
Instead of waiting for someone to bring you flowers.

And you learn that you really can endure…
…That you really are strong
And you really do have worth.

And you learn and learn.
With every new change you learn.

JmaC
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Medical and psychiatric sleep disorders

Sleep disorders associated with medical disorders

1. Alcoholism

Alcohol abuse and dependency commonly disturb sleep. After 30 minutes of alcohol consumption, subjective sleepiness increases and stays high for four hours. After that, sleep become fragmented as the lowered alcohol level increases arousals. When alcoholics abstain from alcohol, sleep can be severely disrupted, and the short episodes of sleep they do get are often plagued by nightmares and other anxiety dreams.

2. Sleeping sickness (African sleeping sickness, Gambina trypanosomiasis)

This is a chronic protozoan brain infection that produces excessive sleepiness.

3. Nocturnal cardiac ischemia

Chest pains due to atherosclerotic heart disease that keep the sleeper awake at night.

4. Chronic obstructive pulmonary disease

Lung or bronchial problems that inhibit lung function (like emphysema) can cause severe insomnia.

5. Asthma

Asthma attacks during sleep usually wakes up the sleeper.

6. Sleep-related gastroesophageal reflux

The victim wakes up from sleep with a sour taste in the mouth or with heartburn. This is because some of the stomach contents have been regurgitated into the esophagus during the night.

7. Peptic Ulcer

The pain of ulcers can waken the sleeper frequently during the night.

8. Fibrositis syndrome (fibromyositis, fibromalgia)

This syndrome is characterized by diffuse muscle and bone pain, chronic fatigue during the day, and unrefreshing sleep at night.

Sleep problems associated with neurological disorders

1. Degenerative brain disorders

Cerebral degenerative disorders such as Huntington’s disease, Alzheimer’s disease, Pick’s disease, Parkinson’s disease, ALS, and others can disrupt sleep at night.. Fatal familial insomnia is a rare, inherited degenerative disorder that begins with sleep troubles and progresses within a few months to a total lack of sleep, and then death.

2. Sleep-related epilepsy

Epileptic seizures can be found in either wakefulness or sleep, and there are some types that are found mostly in sleep. These seizures disrupt sleep.

3. Sleep-related headaches

Headaches can strike during sleep. In some people, sleep- related headache is more common than waking headaches.

Sleep disorders associated with psychiatric disorders

1. Psychoses

Psychoses like schizophrenia and those that are drug-induced are characterized by delusions, hallucinations, incoherence, catatonic behavior, or inappropriate emotions. Insomnia or excessive sleepiness is also common in individuals suffering from such psychoses.

2. Mood disorders

Mood disorders include depression, mania, and hypomania. Insomnia is usually the result, but excessive sleepiness can occur too.

3. Anxiety disorders

Anxiety disorders are characterized by unusually great anxiety and avoidance of whatever seems to cause it. Anxiety disorders can create sleep-onset association disorders or sleep-maintainance insomnia.

4. Panic disorder

Panic disorders are commonly called phobias: claustrophobia (fear of enclosed spaces), agoraphobia (fear of open spaces), and the like. Extreme fear and anxiety can occur unexpectedly, and panic episodes can waken people from their sleep.

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Symptoms of stress

Early warning Signs of Stress

bullet Menstrual problems
bullet Speech difficulties
bullet More impatient
bullet Headaches
bullet Infertility
bullet Ulcers
bullet Nail biting
bullet Grinding teeth
bullet Low blood sugar
bullet High blood sugar
bullet Need more sleep
bullet Tired but can’t sleep
bullet Sudden weight loss
bullet Sudden weight gain
bullet Low blood pressure
bullet High blood pressure
bullet Lack of coordination
bullet Repeated influenza
bullet Repeated colds
bullet Muscle aches
bullet Hair loss
bullet Chest pain
bullet Forgetfulness
bullet Nervous talking
bullet Lower back pain
bullet Loss of appetite
bullet Increased appetite
bullet High cholesterol
bullet High triglycerides
bullet Excessive fatigue
bullet Gastric disturbance
bullet Withdraw from social life
Physical signs and symptoms of stress

bullet Increased heart rate
bullet Pounding heart
bullet Elevated blood pressure
bullet Sweaty palms
bullet Tightness of the chest, neck, jaw, and back muscles
bullet Headache
bullet Diarrhea
bullet Constipation
bullet Urinary hesitancy
bullet Trembling
bullet Twitching
bullet Stuttering and other speech difficulties
bullet Nausea
bullet Vomiting
bullet Sleep disturbances
bullet Fatigue
bullet Shallow breathing
bullet Dryness of the mouth or throat
bullet Susceptibility to minor illness
bullet Cold hands
bullet Itching
bullet Being easily startled
bullet Chronic pain and
bullet Dysponesis.

Emotional signs and symptoms of stress

bullet Irritability
bullet Angry outbursts
bullet Hostility
bullet Depression
bullet Jealously
bullet Restlessness
bullet Withdrawal
bullet Anxiousness
bullet Diminished initiative
bullet Feelings of unreality or over-alertness
bullet Reduction of personal involvement with others
bullet Lack of interest
bullet Tendency to cry
bullet Being critical of others
bullet Self-deprecation
bullet Nightmares
bullet Impatience
bullet Decreased perception of positive
bullet Experience opportunities
bullet Narrowed focus
bullet Obsessive rumination
bullet Reduced self-esteem
bullet Insomnia
bullet Changes in eating habits and
bullet Weakened positive emotional response reflexes.

Cognitive/Perceptual Signs and Symptoms of Stress

bullet Forgetfulness
bullet Preoccupation
bullet Blocking
bullet Blurred vision
bullet Errors in judging distance
bullet Diminished or exaggerated fantasy life
bullet Reduced creativity
bullet Lack of concentration
bullet Diminished productivity
bullet Lack of attention to detail
bullet Orientation to the past
bullet Decreased psychomotor reactivity and coordination
bullet Attention deficit
bullet Disorganization of thought
bullet Negative self-esteem
bullet Diminished sense of meaning in life
bullet Lack of control/need for too much control
bullet Negative self-statements and negative evaluation of experiences

Behavioral Signs and Symptoms of Stress

bullet Increased smoking
bullet Aggressive behaviors (such as driving – road rage, etc.)
bullet Increased alcohol or drug use
bullet Carelessness
bullet Under-eating
bullet Over-eating
bullet Withdrawal
bullet Listlessness
bullet Hostility
bullet Accident-proneness
bullet Nervous laughter
bullet Compulsive behavior and
bullet Impatience.

 

 

 

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Diagnosis for GAD General anxiety disorder

According to the diagnostic manual, you have Generalized Anxiety Disorder if:

bullet You are excessively anxious, worry about all kinds of things, and find it difficult to control the worry.
bullet Along with anxiety and worry, you have at least three of the following six symptoms:

(1) You feel restless or on edge.
(2) You get tired easily.
(3) You have trouble concentrating or your mind goes blank.
(4) You feel irritable.
(5) Your muscles are tense.
(6) You have trouble falling or staying asleep.

bullet The anxiety is not related to substance or medication use, to having a medical illness, or to having another psychiatric disorder.
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