Coping with grief -There are many grief support groups for bereavement counseling and grief therapy

PATHOLOGICAL ( ABNORMAL ) GRIEF

SIGN AND SYMPTOMS

A mortal with abnormal grieving haw exhibit many of the healthy signs of grieving. He or she haw also exhibit unusual behaviors. For example, a mortal who is grieving in a healthy manner haw "hear" the vocalise of the dead person, but the episodes are short and fleeting. Someone with abnormal grieving haw continually "hear" the dead person's voice.

Abnormal grieving haw last for an excessively daylong period of time. The mortal haw exhibit intense finding with the lost idolized one. There haw be a belief that he or she will soon die of the same cause as the idolized one. The grieving mortal haw insist that the idolized digit is ease alive and exhibit too intense reactions in assorted situations.

DIAGNOSIS

The intensity and emotional response to expiration vary according to many factors, including the importance attributed to the loss, the circumstances of the modification and the availability and utilisation of hold networks. The size and intensity of sorrow old by the bereaved varies depending on the nature of the relationship and the honor of attachment. The strength and existence of ambivalence of the relationship has an effect on the intensity of sorrow felt. Relationships that include a high honor of ambivalence may lead to comprehensive feelings of guilt ofttimes accompanied by anger.

The mode of modification impacts on the honor of sorrow experienced. Worden (1991) categorises modification into four groups: natural, accidental, suicidal, and homicidal. Sudden and accidental deaths are likely to hit the large effect on grief.

MORBIDITY AND MORTALITY

Grief exacerbates not only fleshly rate but medicine rate as well, particularly in cases associated with the expiration of a spouse. Studies hit found that bereaved individuals suffer from more depressive symptoms during the prototypal assemblage after the expiration than non-bereaved controls. The teen are more susceptible to fleshly distress and take taking for symptom relief. Further, following the modification of a relative there is an increase in symptoms such as headaches, trembling, dizziness, hunch palpitations and gastrointestinal symptoms .

TREATMENT

The goal of treatment is to refer and help hold any difficulties that prevent the mortal from completing the tasks of mourning. Grieving is considered to be rank when the mortal is healthy to experience pleasure, verify on new roles, and countenance forward to new events. Occasional feelings of sadness haw remain. However, memories of the deceased no longer drive physical responses of rue or pain.

The goal of grief therapy is to refer and facilitate the partitioning of difficulties that are preventing the individual from completing the tasks of manifestation . Worden suggested that certain procedures should be considered for therapy, after ensuring the presenting symptoms are not due to some fleshly disorder. For example, identifying which of the grief tasks have not been resolved and working through these with the person. If the therapist believes that a previous death haw be at the root of the underway problems, serving the bereaved to explore the past relation haw resolve the underway problems.

Psychotherapy  may be needed if a person is otherwise not able to complete the grieving process. Medicine such as antidepressants may be helpful. There are many support groups for people who have lost a loved one...... read more

Grief support for depressive reaction to momentous loss

GRIEF SUPPORT

PATHOLOGICAL ( ABNORMAL ) GRIEF

This is a particular kind of fitting disorder.It can be charcterized as excessive and /or prolonged grief, or even absent grieving with abnormal forgoing of the bereavement.Usually the relative module be stuck in grief,with insomnia and repeated dreams if the dead person,anger at doctors or even the enduring for dying,consequent guilt in equal measure,and an inability to say "good bye" to loved ones by dealing with their effects.

GUIDED MOURNING  

Uses cognitive and behavioral techniques to allow the relative to stop grieving and move on in life.

NORMAL GRIEF  

Immediately follows bereavement, is spoken openly, and allows a person to go through the social ceremonies and individualized processes of bereavement.The threesome stages are firstly shock and disbelief,secondly the emotional phase ( anger,guilt and sadness )and thirdly acceptance and resolution.This connatural process of fitting may take up to a year,with movement between every threesome stages occuring in a sometimes haphazard fashion.

Grief is a depressive reaction to momentous loss which usually resolves after a period of quaternary to six weeks. Significant losses in chronicle can take the form of the death of a loved one, separation or divorce, loss of a valued possession (especially the home), severe illness, a change in job, financial loss, or loss of status or prestige. Grief becomes pathological (abnormal) if it extends much beyond this period of instance or is attended by severe psychosomatic (physical) symptoms such as weight loss.

Grief affects all aspects of one's life. Most often, it is the response to expiration of a loved digit through modification or separation. It may also follow the expiration of something that is highly valued, such as a job, an object, or status. People ofttimes hit emotional, physical, and behavioral reactions to an sealed loss. Grief usually lessens over time.



CAUSES

Unresolved sorrow may advance to higher rates of depression, anxiety, and another psychological disorders. Abnormal grieving is more likely to become in difficult circumstances. It is more common, for example, when there are multiple losses within a brief punctuation of time.

Although there are a number of behaviours associated with grief which may be of anxiety to the bereaved, they generally subside over time. Complications in the grieving process or a depressive modify may be indicated if the behaviours impede a person’s ability to function. The most commonly reported behaviours allow disturbances in sleep, altered appetite (either over-eating or under-eating), absent mindedness, social withdrawal, dreams of the deceased, and avoidance behaviour in which the grieving may go to enthusiastic lengths to avoid some situations or objects that remind them of the deceased. Additionally, the grieving may feel restless, breathless or encounter themselves searching or calling discover for the deceased. Another behaviour ofttimes associated with grief is crying, a response which is believed to relieve emotional stress, though the exact mechanism by which this occurs is not known (Worden, 1991)..... read more

Early detection of specific phobia and social phobia is a key to seek treatment for prevention

PHOBIA DISORDER

CLINICAL FEATURES

Recurring ,irrational fears of specific objects,activities,or situations,with subsequent avoidance behavior of the phobic stimulus.Diagnosis is made only when the avoidance behavior is a significant source of distress or interferes with social or occupational functioning.

1.AGORAPHOBIA : Fear of being in public places.May occur in absence of panic disorder,but is almost invariably preceded by that condition.

Agoraphobia is diagnosed in about 4% of women and 2% of men during any 12-month period. Most people with this modify amend it in their early 20s. Agoraphobia rarely develops after age 40.

Some people amend agoraphobia after experiencing a panic move in digit of these situations. Other people exclusive feel uneasy in these settings and may never, or exclusive later, amend panic attacks. Agoraphobia often interferes with daily living, sometimes so drastically that it makes people housebound.

2.SOCIAL PHOBIA:   

 Persistent irrational fear of ,and need to avoid,any situation where  there is risk of scrutiny by others,with potential for embarassment or humiliation.Common examples include excessive fear of public speaking and excessive fear of social engagements. 

Although some anxiety in ethnic situations is normal, grouping with ethnic phobia hit so much anxiety that they either avoid ethnic situations or withstand them with distress. About 13% of grouping hit ethnic phobia sometime in their life. The modify affects about 9% of women and 7% of men during any 12-month period. Men are more likely than women to hit the most severe modify of ethnic anxiety, avoidant personality modify (see Personality Disorders: Avoidant Personality). Some grouping are shy by nature and, early in life, exhibit timidness that after develops into ethnic phobia. Others first undergo anxiety in ethnic situations around the time of puberty.

3.SIMPLE PHOBIA:         

Persistent irrational fears and avoidance of specific objects.Common examples include fear of heights ( acrophobia ),closed spaces ( claustrophobia ) and animals.

Some specific phobias cause lowercase inconvenience, while others seriously interfere with functioning. For example, a municipality dweller who is afraid of snakes may have no trouble avoiding them. However, a municipality dweller who fears small, winking places much as elevators may connexion them frequently.

Some specific phobias, much as emotion of large animals, the dark, or strangers, begin primeval in life. Many much phobias kibosh as people get older. Other phobias, much as emotion of rodents, insects, storms, water, heights, flying, or enclosed places, typically develop after in life.

TREATMENT

Agoraphobia is treated as for panic disorder.Beta blockers (e.g propranolol,20 to 40 mg orally 2 hour before the event ) are particularly effective in the treatment of 'performance anxiety '.Selective serotinin reuptake inhibitors are very helpful in trating social phobias.Social and simple phobias respond well to cognitive behavior therapy and relaxation techniques and to systemic desensitization and exposure treatment. 

Because many phobic disorders refer avoidance, danger therapy, a form of psychotherapy, is the treatment of choice. With scheme and hold from a clinician who prescribes danger homework, patients seek out, confront, and remain in occurrence with what they emotion and avoid until their anxiety is gradually relieved through a impact called habituation. Exposure therapy helps > 90% of those who carry it discover faithfully and is almost ever the only treatment needed for limited phobias. Cognitive-behavioral therapy is effective for agoraphobia and social phobia. Cognitive-behavioral therapy involves teaching patients to recognize and control their distorted intellection and false beliefs as well as instructing them on danger therapy. For example, patients who describe speed of their hunch evaluate or shortness of respite in certain situations or places see by existence repeatedly exposed to those situations that their worries about having a hunch attack are unfounded and are taught to respond instead with slow, controlled breathing or other methods that encourage relaxation.

Very short-term therapy with a benzodiazepine (eg, lorazepam 0.5 to 1.0 mg po) or a β- blocker ( propranolol is generally preferred—10 to 40 mg po), ideally about 1 to 2 h before the exposure, is occasionally useful when exposure to an object or situation cannot be avoided (eg, when a mortal who has a phobia of flying must fly on short notice) or when cognitive-behavioral therapy is either unwanted or has not been successful.

Many grouping with agoraphobia also hit panic disorder, and many of them goodness from take therapy with an SSRI. SSRIs and benzodiazepines are effective for ethnic phobia, but SSRIs are probably desirable in most cases because, unlike benzodiazepines, they are unlikely to interfere with cognitive-behavioral therapy. β-Blockers are useful for phobias related to public performance....... READ MORE

Women have twice the prevalence of most phobia disorder than men - Causes and Pathophysiology

PHOBIC DISORDERS

Phobias are common conditions  in which intense fear is triggered by a single stimulus,or set of stimuli,that are predictable and normally cause no particular concern to  others (e.g agoraphobia ,claustrophobia ,social phobia ).This leads to avoidance  of the stimulus.The patient knows that the fear is irrational,but cannot control it. The prevalence of all phobias is 8% with many patients having more than one. Many phobias of 'medical' stimuli exist (e.g of doctors, dentist ,hospitals, vomit,blood and injections ) which affect the patient's ability to receive adequate healthcare .

Phobias are the most common form of anxiousness disorders. An dweller study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias. Broken down by geezerhood and gender, the study found that phobias were the most common mental sickness among women in every geezerhood groups and the second most common sickness among men older than .

Phobias are not mostly diagnosed if they are not specially distressing to the patient and if they are not frequently encountered. If a phobia is defined as "impairing to the individual", then it module be treated after being rhythmic in environment by the degree of severity. A super percent of the dweller accumulation is afraid of public speaking, which could range from mild uncomfortability, to an intense anxiousness that inhibits every social involvement.


PATHOPHYSIOLOGY

Several theories are postulated for the natural etiology of phobic disorders, most focusing on the dysregulation of endogenous biogenic amines. Sympathetic troubled grouping activation is ordinary in phobic disorders, resulting in elevations in hunch rate and blood pressure, as substantially as symptoms such as tremor, palpitations, sweating, dyspnea, dizziness, and/or paresthesias.
Psychological theories range from explaining anxiety as a displacement of an intrapsychic conflict (psychodynamic models) to conditioning (learned) paradigms (the cognitive-behavior models). Many of these theories getting portions of the disorder.



AETIOLOGY

Phobias may be caused by classical conditioning,in which a response ( fear and avoidance ) becomes conditioned to a previously benign stimulus ( a lift ) often after an initiating shock ( being stuck in a lift ) .In children , phobias can arise though imagined threads (e.g stories of ghosts told  in the playground ). Women have twice the prevalence of most phobias than men.Phobias aggregate in families ,but genetic factors are probably weak.

Phobias are generally caused by an circumstance recorded by the amygdala and hippocampus and labeled as deadly or dangerous; thusly whenever a specific situation is approached again the body reacts as if the circumstance were happening repeatedly afterward. Treatment comes in some way or another as a replacing of the memory and reaction to the previous circumstance detected as deadly with something more realistic and based more rationally. In actuality most phobias are irrational, in the sense that they are intellection to be dangerous, but in actuality are not threatening to survival in any way.

Phobias are known as an emotional salutation learned because of difficult life experiences. Generally phobias occur when emotion produced by a threatening status is transmitted to another similar situations, patch the original emotion is ofttimes inhibited or forgotten. The excessive, unreasoning emotion of water, for example, may be supported on a childhood experience of almost drowning. The individual attempts to avoid that status in the future, a salutation that, patch reducing anxiousness in the short term, reinforces the connexion of the status with the onset of anxiety.

Phobias are more often than not linked to the amygdala, an Atlantic of the mentality located behind the pituitary gland in the limbic system. The amygdala secretes hormones that control fear and aggression. When the fear or aggression salutation is initiated, the amygdala releases hormones into the embody to put the human embody into an "alert" state, in which they are ready to move, run, fight, etc. This antitank "alert" land and salutation is generally referred to in psychology as the fight-or-flight response....... read more

Obsessive compulsive disorder anxiety - Causes of obsessive compulsive disorder , symptoms and signs of ocd

OBSESSIVE - COMPULSIVE DISORDER

Obsessive and compulsive disorder is defined by obsessional ruminations and ambitious rituals.It is specially associated with and/or secondary to both depressive illness and Gilles de la Tourette syndrome .The prevalence is upto 2% in the generalized accumulation and there is an equal organisation by gender. 

SYMPTOMS 

The obsessions and compulsions are so persistent and intrusive that they greatly impede a patient's functioning and drive goodish distress. There is a constant requirement to check that things have been finished aright and no turn of reassurance can remove the small turn of uncertainty that persists.Some rituals are derived from superstitions ,such as actions repeated a required number of times,with the requirement to start again if interrupted.When nonindulgent and direct .OCD can terminal for many years and is resistnt to treatment.However,obsessional symptoms commonly become in other disorders, most notably general anxiety disorder,depressive illness and schizophrenia,and disappear with the resolution of the direct disorder.

Examples of obsessions are a fear of germs or a fear of being hurt. Compulsions allow washing your hands, counting, checking on things or cleaning. Untreated, OCD can take over your life.

Researchers conceive brain circuits may not work properly in people who have OCD. It tends to separate in families. The symptoms ofttimes begin in children or teens. Treatments that combine medicines and therapy are ofttimes effective.

Minor degrees of obsessional symptoms and ambitious rituals or superstitions are common in people who are not ill in requirement of treatment,particularly in nowadays of stress.

The mildest grade is that of obsessional personality traits much as over-conscientiousness.tidiness,punctuality and other attitudes and behaviors indicating a strong way towards conformity and inflexibility.Such individuals are perfectionists who are intolerant of shortcomings in themselves and others, and verify pride in their high standards.When much traits are so marked that they lie other aspects of the personality,in the absence of clear-cut OCD,the diagnosis is obsessional ( anankastic ) personality 

It’s normal, on occasion, to go back and double-check that the iron is unplugged or your car is locked. But in obsessive-compulsive modify (OCD), obsessive thoughts and compulsive behaviors embellish so excessive that they interact with daily life. And no matter what you do, you can’t seem to shake them.

If you or someone you love has obsessive-compulsive disorder, you may feel unaccompanied and helpless, but there is help available. Many treatments and self-help strategies can reduce the symptoms of OCD.

AETIOLOGY

GENETIC

OCD is found in 5-7% of the first-degree relative.        

BASAL GANGLIA DYSFUNCTION

OCD is related with a sort of medicine modify involving dysfunction of the striatum,including Parkinson's disease,Sydenham's and Hunting ton's chorea.OCD crapper study head trauma.Neuroimaging suggests that abnormalities subsist in the adornment lobe and basal ganglia.Hyperactivity of the orbitofrontal cortex has been a consistent finding in brain imaging investigate on OCD patients .More past work suggests the caudate organelle is smaller than in healthy controls.

SEROTININIts function is belike abnormal in patients with OCD, Serotinin reuptake inhibitors are trenchant drugs.Postsynaptic serotinin organ hypersensivity may study chronically low levels of synaptic serotinin.

CONDITIONING  This suggests that compulsive rituals are classically conditioned rejection responses, which therefore lend themselves to treatment with graded exposure therapy .......read more

TREATMENT

PSYCHOLOGICAL TREATMENT

PHYSICAL TREATMENT

PSYCHOSURGERY

PROGNOSIS

Two third of cases improve within a year through obsessive compulsive disorder treatments

TREATMENTS OF OBSESSIVE COMPULSIVE DISORDERS

PSYCHOLOGICAL TREATMENT

A behavior therapy that is particularly trenchant for rituals is response prevention.Patients are taught not to carry out their rituals. There is an initial rise in painfulness but with persistence both the rituals and the painfulness diminish.Patients are pleased to execute response prevention, while backward to situations that ordinarily make them worse.

MODELLING involves the therapist demonstrating to the enduring what is required and hortative the enduring to study this warning .In the case of hand-washing rituals this might involve retentive an allegedly septic goal and carriying out other activities without washing the enduring being pleased to study suit.

THOUGHT STOPPING can reduce obsessional ruminations.The enduring is taught to arrest the obsessional intellection by arranging a sudden intrusion ( e.g.snapping an elastic adornment ,clicking the fingers )

COGNITIVE BEHAVIOR therapy allows these techniques as behavioral experiments along with the identification and hard of the illness-maintaining schema.

PHYSICAL TREATMENT          



ANXIOLYTIC drugs provide short-term characteristic relief for resistless anxiousness on a short-term basis.

SEROTONIN REUPTAKE INHIBITORS are the important stay of drug treatment.Their efficacy is independent of their antidepressent action .Clomippramine is the tricyclic most commonly utilised in the UK.Specific side-effects include significant quake and postural hypotension.

SELECTIVE SEROTININ REUPTAKE INHIBITORS hit been show to be trenchant in reducing obsessive compulsive disorder symptoms, but the doses required are usually some 50-100% higher than those trenchant in depression.Three months treatment with high doses may be necessary for a positive response .Positive corelations. between reduced severity of obsessive compulsive disorder and decreased orbitofrontal and caudate metastasis following behavioral and SSRI treatment hit been demonstrated in a number of studies

PSYCHOSURGERY is very occasionally recommended in cases of chronic and nonindulgent obsessive compulsive disorder that has not responded to other treatments. The development of stereotactic techniques has led to the equal of the earlier,crude leucotomies with more precise preoperative intervention such as subcaudate tractomy and cingulotomy,with small metal radioactive implants,which induce lesions in the cingulate Atlantic or yhe ventromedial quadrant of yhe adornment lobe.Psychosurgery is now performed only in a few doc centres in the UK, and formal and careful consent requirements are ordered down in the pertinent noetic upbeat act.

PROGNOSIS

Two thirds of cases improve within a year .The remainder run a fluctuating or persistent course.The prognosis is worse when the personality is anankastic and the obsessive compulsive disorder is primary and severe.


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SYMPTOMS

AETIOLOGY

TREATMENT

PHYSICAL TREATMENT

PSYCHOSURGERY

PROGNOSIS