Tranquil Mind Psychiatry

Products And Services

• Anger Management

  Anger management is the process of learning to recognize the signs of one's own encroaching anger and mastering techniques to deal with it safely and effectively. While anger is a normal, healthy emotion, in many people it becomes excessive and out of control, resulting in damaged relationships, employment difficulties, and even physical violence. Uncontrolled anger not only causes disharmony and pain, it is a frequent cause of criminal behavior. In recent years, there has been increasing recognition of how widespread issues with anger are and how greatly they affect the world around us. This has resulted in the development of various anger management techniques designed to channel anger in constructive ways. The Need for Anger Management Some individuals are well aware that they have problems with anger. More frequently, others around them recognize the severity of the problem. People with anger issues may have trouble holding anger in when they are in situations where expressing it is inappropriate, and may experience emotional symptoms like depression or physical symptoms like headaches as a result of their unresolved anger. Outward manifestations of unmanaged anger include: Feeling angry too much of the time Having frequent arguments at home, at work or elsewhere Having disagreements that frequently escalate into arguments Reacting with excessive anger while driving or doing daily chores Having unstable relationships because of recurring episodes of anger Threatening friends, intimates or colleagues with physical violence Damaging or breaking things, destroying property Becoming physical violent Having trouble with the law The Process of Anger Management There are several steps involved in anger management training. Such treatment may take place in a variety of individual or group settings. Sometimes the individual seeks help independently. Often such treatment is recommended as part of marital or parenting counseling or is mandated by an employer. Enrollment in anger management classes may also be mandated by the courts, particularly in cases of physical abuse or assault and battery. The process of anger management involves: Addressing underlying issues, such as depression or addiction Learning to recognize the early signs of one's own anger Cognitive behavioral therapy Meditation or progressive relaxation Learning problem-solving strategies Learning communication skills to explain anger rather than act it out Learning techniques of conflict resolution Benefits of Anger Management Anger management can provide a number of long-term benefits: Better communication with others Improved relationships Better physical and mental health Curbing of addictive behaviors involving alcohol, drugs or food Typically, anger management sessions are scheduled weekly and are ongoing, at least for several months to a year. The length of treatment depends on the severity of the problem. Anger management may involve both individual and group therapy and may include prescription medication such as antidepressants or mood stabilizers.

  Link: Anger Management

• Stress Management

  Now that the deep connection between physical health and emotional well-being has been established, stress management is recognized as an important component of daily life. Reducing stress has been found to improve relationships and personal satisfaction, and make students and employees more efficient. In order for successful stress management to take place, a stress assessment must be completed, designed to evaluate a patient's stress level and to highlight any areas of concern. These results are used to devise a customized treatment plan that provides patients with a variety of techniques to alleviate stress and increase comfort, energy level and productivity. Negative Effects of Stress We know that stress can produce physical, cognitive and psychological symptoms as well as exacerbate existing ones. Research has demonstrated that there are physiological reasons for this since the human body reacts to stress by producing cortisol, which alters metabolic, cardiovascular, neurological and immunological responses. While, almost any symptom can be precipitated, people who are stressed most typically experience: Anxiety Depression Headaches Forgetfulness Inability to concentrate Fatigue Appetite and sleep disturbances Gastrointestinal symptoms In addition, research has shown that stress worsens many medical conditions including: Asthma Chronic pain Fibromyalgia Multiple sclerosis High blood pressure Cardiovascular disease Stress also decreases the immune response, slowing healing and making individuals more susceptible to infection. Because of all the scientific data demonstrating the negative effects of stress, stress management is now available through health care providers, educational institutions and places of employment. Stress Management Techniques There are many ways to combat stress. A method that helps one person cope may not be as effective for another. It is often necessary for individuals to experiment in order to find which combination of techniques works best for them. Stress management can provide relief from stress-related symptoms and a pathway to a healthier lifestyle. For many people, eating a healthy diet and engaging in physical exercise are a good beginning for reducing stress levels. Various types of psychotherapy, in which the patient expresses and explores the causes of personal stress and is trained in new coping strategies, are often helpful. In extreme cases, medication may also be prescribed to get the individual through a particularly trying situation. For ongoing stress, a variety of other techniques from the world of alternative, or complementary, medicine are also available. These include: Meditation Deep breathing exercises Progressive muscle relaxation Visualization Acupuncture Aromatherapy Biofeedback Chiropractic care Herbalism Homeopathy Hypnotherapy Massage therapy Osteopathy Yoga Qi gong Reflexology Reiki Tai Chi While stress is an unavoidable part of modern living, stress management can make life more manageable, providing the ability to relax in the midst of turmoil and a sense of personal control. Typically, a combination of stress-reducing strategies works best.

  Link: Stress Management

• Addiction

  An addiction is an uncontrollable dependence on a certain substance or activity. People become addicted to different things for different reasons, but can be affected both physically and psychologically. With addiction, the activity or substance often becomes the major focus of a person's life, leading to the exclusion of other activities, impairing work, social, and family responsibilities, and affecting the individual's health, mood, and self-respect. Addicted individuals may suffer from anxiety, low self-esteem or depression and often feel as if they have no control over their lives or behavior. Types of Addictions Addictions can be considered physical or psychological. Both types of addictions affect the part of the brain that produces endorphins, or pleasure inducing substances. These chemicals make the person feel "high" or euphoric when indulging in their addiction. Physical Addictions Physical addictions are usually a result of the use of a particular substance. After excessive use, people build up a tolerance o that they need a larger and larger dose to feel the same effects of the substance. If they do not use the substance they may suffer from symptoms of withdrawal. Common types of physical addictions may include: Alcohol Drugs Caffeine Nicotine/Smoking Behavioral or Psychological Addictions Psychological or behavioral addictions occur when there is an uncontrollable urge to perform an activity. Behavioral addictions are not substance-related, and include a strong and recurring compulsion to engage in a certain activity despite the harmful consequences to either the individual or others. Behavioral addictions may include: Sex Internet Exercise Dieting Overeating Gambling Shopping Cell phone use Causes of Addiction There is no specific cause for a person to develop an addiction, however, an addiction may be influenced by a person's genetic makeup and social or environmental factors. Many people believe that genetics may cause a risk of addiction and environmental factors such as family life, upbringing and peer influences may also play a role in causing an addiction. Children who grow up in homes where a parent abuses drugs or alcohol or participates in other addictive behaviors may be at a greater risk for developing an addiction, for both genetic and environmental reasons. Treatment for Addiction Addiction is a treatable condition. The first step in the successful treatment of an addiction often begins when the individual admits that they have a problem and need help. Physical addictions to substances such as drugs or alcohol may be treated with medication. Behavioral therapy and counseling are also an important part of treatment. Behavioral therapy is often used to help patients identify, avoid, and cope with situations in which they are most likely to partake in addictive activities. Family or group therapy may also help the patient maintain a supportive environment and improve family relationships.

  Link: Addiction

• Bipolar Disorder

  Bipolar disorder, previously known as manic-depressive illness, is a complex psychiatric disorder that involves sudden and dramatic mood swings between mania and depression. An episode may last for hours, days, weeks or months and symptoms may be severe, sometimes resulting in dangerously impulsive or self-destructive behavior and sometimes leading to depression so deep it results in suicide. Causes of Bipolar Disorder It is known that individuals with bipolar disorder have physiological changes in their brains. Although precipitating factors have been researched, precise causes for the changes have not been pinpointed. The following genetic and environmental factors appear to play important roles in the development of bipolar disease: Imbalances in brain chemicals called neurotransmitters Hormonal imbalances Heredity, having a blood relative with a psychiatric disorder Environmental stress Childhood abuse Trauma Types of Bipolar Disorder There are three different types of bipolar disorder, characterized by the severity of the disease: Bipolar I Bipolar II Cyclothymic disorder or cyclothymia Patients with bipolar I typically suffer manic or depressive episodes lasting for a week or more. The episodes, though they may be alleviated with medication, are frequently severe enough to require hospitalization. Bipolar II is a less severe variety of the disorder. Patients with bipolar II may have noticeably elevated or depressed moods, though these are less severe, and last for shorter periods, than those of patients with bipolar I. Cyclothymic disorder is a milder form of bipolar disorder characterized by mood swings more extreme than those of the average person, but not disabling. There are other variations in bipolar disorder in which symptoms may differ in specific ways, such as: Seasonal changes in mood Rapid-cycling bipolar disorder Bipolar disorder with psychotic symptoms Bipolar disorder in children Mixed state bipolar disorder Hypomania Symptoms of Bipolar Disorder The symptoms of bipolar disorder are extreme versions of the emotional states all individuals experience. In patients with this disorder, however, the emotional states are not only exaggerated, but often seem to have no relation to experienced events. Beyond that, the symptoms start and stop abruptly, and are extreme enough to interfere with normal functioning.. Symptoms of Mania Symptoms of a manic episode have a wide range. While some symptoms are similar to those experienced during a period of joy, many topple over into a kind of chaos. Symptoms of mania include: Eupohoria Inflated self-esteem Rapid speech and racing thoughts Increased physical activity Agitation, irritation or aggression Heightened sexual desire Impulsive or risky behavior Distractibility Decreased appetite or need for sleep Substance abuse Symptoms of Depression Depressive episodes of bipolar disorder differ from simple sadness since they frequently are not reactions to a sad event and since they reach a depth of despair not experienced by healthy individuals. Symptoms of a depressive episode may include: Anxiety Hopelessness Dissociation Feelings of guilt Sleep disturbances Decreased or increased appetite Extreme fatigue or lack of energy Inactivity Loss of interest in sex and other pleasurable activities Inexplicable chronic pain Suicidal thoughts Symptoms of bipolar disorder can be exacerbated by many things, including hormonal changes, physical illnesses, traumatic events, and ongoing abusive treatment. Diagnosis of Bipolar Disorder Bipolar disorder is a complex psychiatric illness, diagnosed by a careful evaluation of symptoms by a qualified psychiatrist. Everyone experiences mood swings to a greater or lesser degree, but the mood swings of patients with bipolar disorder are more exaggerated and intense than those of the average person, interfering with their normal activities. Psychiatrists diagnose bipolar disorder by taking a thorough history of symptoms and through personal observation of behavior patterns. Patients' symptoms are assessed using criteria formulated in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, published by the American Psychiatric Association. Observable or reported symptoms of mania alternating with depression over an extended period of time are clues to the existence of the disorder. Since there is a genetic component to the disorder, a thorough family history will also be taken to assist in diagnosis.

  Link: Bipolar Disorder

• Depression

  Depression, is a medical condition that causes extreme feelings of sadness and emptiness. People who suffer from depression may lose interest in activities they once enjoyed and experience a constant feeling of hopelessness on a daily basis. Depression, also known as clinical or major depression, may be triggered by certain events or occur along with other illnesses. Severe depression can interfere with a person's ability to work, sleep, eat, interact with others or enjoy life. With treatment, however, depression can become a manageable condition. Causes of Depression The exact cause of depression is unknown. Depression can sometimes be triggered by a traumatic event such as the death of a loved one, divorce, emotional or financial stress, or childhood trauma. Other factors that may contribute to depression include: Hormonal changes Heredity Chemical imbalances or changes within the brain The use of certain medications such as steroids, or alcohol or drug abuse may contribute to the onset of depression. Patients suffering from serious illnesses such as cancer or other long-term conditions may also develop depression. Symptoms of Depression While most people may feels sad or blue every once in a while, clinical depression affects the lives of those afflicted on a daily basis. Symptoms of major depression include: Feeling sad or hopeless Loss of interest in normal activities Crying spells Trouble sleeping Trouble concentrating Irritability Change in appetite Fatigue Unexplained aches and pains Suicidal thoughts Depression is a serious condition that can severely affect individuals and their families. Left untreated, depression may lead to anxiety, isolation, difficulties at work or school, alcohol or substance abuse, and in extreme cases, suicide. Diagnosing Depression To diagnose depression, the doctor will conduct a full physical examination and a review of all symptoms. Blood and urine tests may also be performed to rule out any underlying medical conditions that may contribute to the depression. A full psychological evaluation is also performed to make a proper diagnosis and create a treatment plan. Treatment of Depression Depression is typically treated with a combination of psychotherapy and antidepressant medication. Antidepressants help to alter the brain chemistry to improve mood. Psychotherapy, in the form of therapy or counseling, aims to treat depression by by teaching the individual new ways of thinking and behaving, and changing habits that may be contributing to the depression. Individuals with severe depression that does not respond to medication or therapy, may benefit from electroconvulsive therapy, or ECT. With this therapy, electrical currents are passed through the brain, affecting the levels of neurotransmitters, which often results in immediate relief of severe depression. In extreme cases, hospitalization may be temporarily necessary if the patient cannot properly care for themselves or if they are in danger of harming themselves or others.

  Link: Depression

• Generalized Anxiety Disorder

  Generalized anxiety disorder, or GAD, is a psychiatric problem in which anxiety is not a temporary state but a chronic condition. While it is normal for all individuals to worry about an upcoming event such as an examination or job interview, patients with GAD are in a perpetual state of anxiety, unable to relax. The disorder may become so severe that it interferes with school, work or relationships. GAD is a very common disorder, affecting millions of individuals in the United States alone. More than twice as many women as men suffer from the disorder. Causes of GAD While precise causes for GAD have not been determined, the disorder is believed to be the result of abnormalities in the brain that may be, at least partially, hereditary. Hormonal changes, like those that occur prior to or during menstruation or during menopause, may be a factor in the development of the disorder, accounting for the fact that females are noticeably more prone to the disorder than men. GAD is thought to be exacerbated by environmental factors like trauma or extreme stress. Symptoms of GAD Symptoms of GAD, which most commonly begin during childhood or adolescence, may begin in adulthood as well. These symptoms may be both psychological and physiological. Often diffuse, these symptoms may be accompanied by a fear of dying. Psychological Symptoms Excessive worry about small things Perpetual worry Anxiiety without a perceived cause Fear or dread Inability to relax Restlessness, irritability, tension Difficulty concentrating Extreme or frequent startle response Physiological Symptoms Insomnia or other sleep disturbances Headaches, fatigue, nausea, lightheadedness Muscle aches, muscle twitching Palpitations, chest pain Gastrointestinal distress Other aches and pains Frequent urge to urinate Breathlessness Hot flashes or sweating Trembling Difficulty swallowing Dry mouth Diagnosing GAD Generalized anxiety disorder is typically diagnosed through a full medical history and a psychological evaluation. In order to be diagnosed with GAD, a patient has to meet the following criteria: Experience extreme anxiety for at least 6 months Be unable to overcome or control anxiety Have difficulty with everyday activities because of anxiety Have anxiety unrelated to another medical or psychiatric disorder In addition, in order to be diagnosed with GAD, adult patient must experience three of the following and children must experience at least one: Fatigue Sleep disturbances Irritability Restlessness Muscle tension Difficulty concentrating Treatment for Generalized Anxiety Disorder Generalized anxiety disorder is typically treated through a combination of medication and psychotherapy. The types of medications typically prescribed for generalized anxiety disorder include antidepressants, tranquilizers, busiprone, beta blockers, and benzodiazepines. These medications may differ in the length of time they require to provide symptomatic relief. Sometimes patients are given benzodiazepines, such as Xanax or Valium, to use temporarily until other medications, such as antidepressants, take effect. Several varieties of psychotherapy may be used in treating GAD. Cognitive behavioral therapy has been found to be particularly helpful. Alternative therapies, including various relaxation techniques and meditation are reported to assist some patients in maintaining a sense of calm. Maintaining a healthy lifestyle, including eating a healthy diet, getting regular exercise, and avoiding alcohol, caffeine and other stimulants can also help relieve the symptoms of GAD. A strong support system of family and friends is also beneficial.

  Link: Generalized Anxiety Disorder

• Learning Disabilities

  A learning disability, also referred to as a learning disorder, is a neurological disorder that prevents a child from learning, or significantly impairs the learning process. A learning disability is not a reflection of intelligence, and a child who has one may be of average or above-average intelligence. A child with a learning disability processes information differently from other children, and has difficulty performing specific tasks. A learning disability may affect attention span, coordination, the ability to understand or use spoken or written language or to perform math calculations. There are many different types of learning disabilities. Dyslexia is the most common type of learning disability characterized by trouble recognizing or processing letters and the sounds associated with them. It is usually characterized by difficulty reading, writing, spelling and recalling words. A nonverbal learning disability is a learning disorder characterized by difficulty with nonverbal cues, such as coordination and body language. A central auditory processing disorder is characterized by trouble understanding and remembering language-related tasks. Some children with learning disabilities also have attention deficit hyperactivity disorder (ADHD), which makes it hard to focus. Students with ADHD are often easily distracted and have trouble concentrating, and therefore find it difficult to learn and study. Learning disabilities often affect the brain's ability to receive, process, analyze, or store information. This can make it difficult for a student with a learning disability to learn at the same rate as other children. With early diagnosis and intervention, specific methods can be developed to address learning difficulties and help individuals overcome the challenges that they present. While in most cases, the cause of learning disabilities is unknown, research has indicated that they may be linked to genetics, medical conditions, brain development or environmental exposure. Signs of Learning Disabilities A learning disability is not always easy to detect. Symptoms of different learning disabilities can vary and may initially include a delay in achieving normal developmental milestones as well as: Speech problems Inability to focus Difficulty remembering Inability to follow instructions Inability to complete simple or complex tasks Inability to distinguish words Reversal of letters, words or numbers Lack of physical coordination Socialization problems Children with learning disabilities may also experience anxiety, depression and low self-esteem. Parents should advise the pediatrician of any concerns that they may have about their child's development or behavior. Early detection of learning disabilities is crucial for successful treatment. Diagnosis of Learning Disabilities If a learning disability is suspected, the pediatrician will refer the child to a specialist for a thorough evaluation. In some cases, a teacher may recommend an evaluation if the child is experiencing difficulties in school. A child psychologist or learning specialist performs an evaluation that includes a full review of the child's: Developmental history Cognitive abilities Academic capabilities Behavioral strengths and weaknesses Social skills After the evaluation, a specific diagnosis can be determined. The evaluator will discuss the findings with the child's parents (and teacher if applicable) and may make recommendations for treatment. Treatment of Learning Disabilities Treatment varies depending on the specific learning disability. An individualized education plan (IEP) may be created for the child to follow both at school and at home. An IEP has specific goals for the child based on her or his specific needs. It also outlines any assistance that the child will be receiving for their disability. In general, a child with a learning disability is eligible for special assistance at school and in some cases, at home. Treatments may include: Tutors Speech therapy Occupational therapy Extra help at school Medication may be prescribed for a child with ADHD to help improve attention span and the ability to focus. In addition, medication may be used to treat depression or anxiety. Early intervention and treatment can be very beneficial to children with learning disabilities.

  Link: Learning Disabilities

• Obsessive Compulsive Disorder

  Obsessive compulsive disorder (OCD) is a common anxiety disorder involving disturbing repetitive thoughts and rituals designed to try to alleviate such thoughts. The thoughts are obsessions; the rituals are compulsions. OCD affects millions of people and may be associated with other types of psychiatric disorders. In some cases, patients are able to perform well in school or the workplace in spite of the disorder, but in some cases the OCD is severe enough to interfere with work, concentration, and relationships. An enormous amount of time and attention may be used by patients with OCD in order to keep up with the ritualized behavior they cannot help but believe protects them. They may have difficulty finishing a routine task, such as showering, toileting, eating, or leaving the house because they cannot stop engaging in ritualized behavior. Common Obsessions and Compulsions Patients with OCD frequently have obsessions relative to germs or contamination, disorder or disobedience, harming others, humiliation, saying profane words or committing forbidden sexual acts. The compulsive acts they repeat in order to keep these disturbing thought at bay may involve one or more of the following: Repeated bathing or hand washing Locking doors a certain number of times Rechecking appliances to make sure they are turned off Rewashing or even discarding items because they seem unclean Counting, performing tasks a certain number of times Arranging things in a particular sequence or pattern Touching things in a certain order Not throwing certain things away Repeating words or prayers Signs of OCD in a patient include obsessional thoughts that cannot be quelled and repetitive behaviors that cannot be avoided without a high level of anxiety. Causes of OCD The true cause of OCD is not known, but certain biological and environmental factors play a role. In many cases, OCD seems to run in families. Most cases develop in childhood, adolescence or early adulthood. It is believed that abnormalities in the neurotransmitters in the brain exist in patients with OCD. It has also been hypothesized that OCD may be precipitated by certain infections or by extreme stress. Treatment of OCD Obsessive compulsive disorder can be exhausting and even disabling, and is sometimes complicated by the fact that patients are embarrassed and reluctant to seek treatment. Help is readily available, however. There are several successful treatment options. These treatments, often used in combination, may include: Medications, such as antidepressants and tranquilizers Psychotherapy, particularly cognitive behavioral therapy Exposure and response prevention (ERP) therapy Deep brain stimulation (used experimentally in severe cases) Medication usage, particularly the prescription of antidepressants, has to be monitored closely. In the case of children and adolescents, such medications may precipitate suicidal thoughts, especially during the early days of treatment. Also, antidepressant medication, though its benefits may be great, can require a month or more to provide symptom relief.

  Link: Obsessive Compulsive Disorder

• Personality Disorders

  A personality disorder is a psychiatric illness in which the patient's thoughts, emotions and behaviors are distorted in unhealthy ways. Patients with personality disorders tend to be inflexible and may appear irrational, at least at times, to those around them. Over a long time period, their behavior leads to serious difficulties in school, in the workplace and in relationships. For those with personality disorders, life is troubling and often stormy. For them, everyday stresses often represent overwhelming, or even, insurmountable problems. Believed to begin in childhood, personality disorders may have genetic, as well as environmental underpinnings and are often difficult to treat. Personality disorders have been divided into three groups, according to their thought and behavior patterns. In some cases, a patient may be diagnosed with one personality disorder but may also have some symptoms of another. Patients need not exhibit all of the symptoms to be diagnosed with a particular personality disorder. Cluster A Personality Disorders Cluster A personality disorders are characterized by odd or eccentric thinking or behavior. They differ according to the types of thoughts patients experience and the types of behavior they engage in. Paranoid Personality Disorder Patients with paranoid personality disorder are distrustful, suspicious, secretive and often hostile. They attribute malicious motives to those around them, interpret oversights as insults, and hold grudges over imagined slights. It is common for patients with this disorder to suspect disloyalty in friends, co-workers and sexual partners. Schizoid Personality Disorder Patients with schizoid personality disorder present as flat emotionally, appearing indifferent or cold. They show little excitement about activities normally considered pleasurable, such as sex, and usually prefer to be alone. Schizotypal Personality Disorder Patients with schizotypal personality disorder are considered odd by those who come into contact with them. Their peculiarities of speech, dress and behavior set them apart. Such patients frequently believe that their thoughts have magical powers or that they are being contacted through hidden messages. They may experience auditory hallucinations and have difficulty with social situations or close relationships. Cluster B Personality Disorders Patients with cluster B personality disorders are overly emotional and melodramatic. Their thinking and behavior are unpredictable and often disconcerting to those around them. Antisocial Personality Disorder Patients with antisocial personality disorder, previously known as sociopaths, are impulsive and irresponsible. They repeatedly lie, steal or misrepresent themselves, frequently veering into criminal behavior. They are unconcerned with the feelings of others and may become aggressive or violent. They may seem to have no conscience, expressing no remorse for their bad behavior. Borderline Personality Disorder Patients with borderline personality disorder engage in impulsive, risk-taking behavior, including gambling or unsafe sexual activity. Their relationships are intense and unstable and their lives are filled with drama. These patients are extremely moody, often fluctuating between euphoria and feelings of emptiness or abandonment. Those with borderline personality disorder may have violent outbursts of anger and may threaten or attempt suicide. Histrionic Personality Disorder Patients with histrionic personality disorder constantly need to be the center of attention. In order to achieve this, they behave in a theatrical manner, dressing flamboyantly and often being sexually provocative. They tend to exaggerate the details of their life to make them more interesting or dramatic and to believe their relationships are more involved or intimate than they actually are. These patients express themselves with hyperbole and express strong, controversial opinions in order to draw attention to themselves. Narcissistic Personality Disorder Patients with narcissistic personality disorder have never passed through the childhood phase of narcissism and continue to believe that they are more important, special and deserving than others. They are not tuned in to the needs or emotions of those around them and tend to be arrogant. Such patients exaggerate their talents and achievements, expecting constant adulation. They may believe that others envy them, but may also experience intense jealousy of those who garner more attention than they do. Cluster C Personality Disorders Cluster C personality disorders are characterized by anxious or fearful thinking and behavior. Patients with cluster C disorders tend to withdraw, depend excessively on others, or try to control their surroundings with overly organized routines.

  Link: Personality Disorders

• Phobias

  A phobia is a psychiatric disorder in which the patient suffers a lasting, irrational fear precipitated by a harmless object or situation. A patient with a phobia experiences intense anxiety upon exposure to the trigger and may experience anticipatory anxiety as well. Patients with phobias may be aware that their fear is irrational, but may nonetheless find it overwhelming or even disabling. Phobias which develop in childhood, such as a fear of bees or of thunder, are frequently outgrown, while phobias that develop in adulthood may be longer lasting. Nonetheless, about one-fifth of all phobias resolve without treatment. Phobias are the most common psychiatric disorder, experienced at some time by as much as 10 percent of the population, and are found with slightly greater frequency in women than in men. Patients may be troubled by more than one phobia. Symptoms of Phobias Patients with phobias experience extreme anxiety or even terror upon exposure to trigger object or situation. Fear may even develop when the trigger is discussed or observed as a two-dimensional image. The emotional and physical symptoms adult patients with phobias experience when confronted with the objects or situations they fear are similar to those experienced during anxiety or panic attacks. The difference is that, in the case of patients with phobias, the precipitating factor is constant and known. Symptoms of phobias include: Feelings of horror or dread Desire to escape Sweating, chills, tachycardia Shortness of breath or chest pain Gastrointestinal distress Dizziness or lightheadedness Inability to function normally Children with phobias may express their fear differently than adults, either by crying, clinging to adults, or having tantrums. Common Types of Phobias It is possible to have a phobia based on anything, but some of the more common ones include: Animal phobias, such as fear of dogs, spiders, snakes, birds, cats or rodents Situational phobias, such as fear of closed in spaces (claustrophobia) Fear of activities, such as flying or entering a tunnel Fear of social interactions or public speaking Fear of natural phenomena, such as storms, earthquakes or floods Fear of bodily invasion by injections, dental work or surgery Specific idiosyncratic fears, such as fear of clowns, nuns, or computers Treatment of Phobias Whether a particular phobia requires treatment depends on how severe the problem is and whether it interferes with the patient's everyday life. Many people have phobias that rarely bother them and therefore never have to be treated. Sometimes a particular fear, such as a fear of flying, is not troublesome until the patient is suddenly expected to travel extensively to meet the requirements of a new job and the phobia becomes crippling. Whenever a phobia intrudes on daily life, employment or relationships, it should be therapeutically addressed. Certain medications, usually tranquilizers and antidepressants, can be helpful in addressing the terrible anxiety patients with phobias experience. There are also several types of psychotherapy that have been found to assist in overcoming phobias. These include: cognitive behavioral therapy, desensitization, flooding, graded exposure and biofeedback. Support groups are also often helpful.

  Link: Phobias

• Sleep Disorders

  Sleep disorders are disturbances in sleep patterns. They involve difficulty falling asleep or staying asleep, excessive daytime tiredness, irregular breathing during sleep, or abnormal sleep behaviors. Sleep disorders may develop as a result of changes in the neurotransmitters of the brain, taking certain medications (such as corticosteroids), illness, stress, anxiety, depression, excessive caffeine or alcohol, or drug use. A sleep disorder can interfere with daily activities, and affect overall health and quality of life. When accurately diagnosed, however, most sleep disorders can be effectively treated. Types of Sleep Disorders Sleep disorders, depending on their symptoms, are divided into two categories that may require differing treatments. Dyssomnias Dyssomnias result in difficulty falling asleep or staying asleep, and are characterized by excessive sleepiness and disturbances in the amount or quality of sleep. Common dyssomnias include: Insomnia Snoring Sleep apnea (pauses in breathing during sleep) Narcolepsy (brief attacks of deep sleep) Dyssomnias often result in fatigue or mental confusion during the day. Parasomnias Parasomnias, on the other hand, involve abnormal movements, behaviors or emotional outbursts. These may include Sleepwalking Nightmares Restless legs syndrome REM sleep behavior disorder Sleep aggression Sleep-related eating disorder Sexsomnia (sexual activity while asleep) Bruxism (tooth grinding) Enuresis (bedwetting) Although patients with parasomnias may appear agitated or distressed during sleep, these disorders are no longer necessarily considered evidence of psychiatric disturbance. Instead, they are understood as abnormal neurological transitions between REM sleep, non-REM sleep, and wakefulness. Diagnosis of Sleep Disorders In order to diagnose a sleep disorder, doctors typically perform a full physical examination and may take blood tests to rule out underlying disease conditions. The patient is then admitted to a sleep clinic where various bodily functions, including respiration, brain waves, eye movements and heartbeat are measured and recorded. Treatment of Sleep Disorders Based on causes and symptoms, there are different options available for treatment of sleep disorders. Some sleep disorders respond well to simple remedies, such as: Following a consistent bedtime routine Exercising regularly Avoiding caffeine, nicotine and excessive alcohol Keeping the bedroom at a cool temperature Limiting bedroom activities to sex and sleep Relaxation techniques, cognitive behavioral therapy or light therapy may be helpful for some patients. Other possible treatments for sleep disorders include medications such as benzodiazepines (anti-anxiety medications) and anti-convulsants. In some situations, support groups for individuals with sleep disorders may also be of assistance.

  Link: Sleep Disorders