May is National Mental Health Month and it raises awareness about mental illness.  1 in 4 people will experience a mental health crisis in their lifetime, yet these illnesses are still highly stigmatized.  Mental illnesses  such as depression, anxiety, bipolar disorder, schizoaffective disorder or schizophrenia are common and treatable.  There is no shame in being diagnosed with a mental illness and, fortunately, attitudes towards mental health issues are beginning to change in the United States.  These positive changes are due to the dedicated educational efforts of the many mental health organizations and, most importantly, the willingness of individuals that live with a mental illness to talk about their illness.

If you are interested in finding Mental Health Awareness events, please check out some of these websites below (this is not a definitive list) or Google mental health awareness month.

https://www.nami.org/mentalhealthmonth

http://www.mentalhealthamerica.net/may

https://themighty.com/2017/05/mental-health-awareness-month-2017-mighty-voices/

http://www.takethis.org/2017/05/welcome-to-mental-health-awareness-month/

 

Image result for green ribbon mental health awareness

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Identifying Post Traumatic Stress Disorder

As the name suggests PTSD occurs after a stressful event. There isn’t a distinct type of stress exposure that certainly leads to PTSD. Some people can experience a life threatening event without any linger psychic effects and some will find themselves unable to cope. Those who experience trauma they can’t cope well with are often but not always PTSD victims.

When PTSD is suspected a number of key symptoms can help eliminate other possible diagnoses. Victims of PTSD tend to “relive” the traumatic events in their life through flashbacks and memory “triggers”. When in contact with something that reminds them of their trauma PTSD patients will try to avoid any interaction with the offending object. For example if a particular hat reminds a victim of someone who harmed them they will attempt to avoid interacting with anyone who wears that particular hat style.

Treating Post Traumatic Stress Disorder

While PTSD can have a severe impact on the lives of those afflicted with the disease and their loved ones there are ways to treat the disorder through psychotherapy and psychiatry. Therapy in particular can address the overlying symptoms of PTSD such as overreaction to triggering stimuli by helping sufferers desensitize themselves. Although PTSD is not considered a hereditary disorder there is a strong genetic component to the disorder. Genetics may account for 30% of the variance of post traumatic stress disorder. For this reason many persons with PTSD will need the assistance of psychiatric medicine.

The medicine used to treat PTSD comes in 3 important categories. Most commonly PTSD is treated with antidepressants such as selective serotonin reuptake inhibitors. SSRIs help sufferers by slowing down the breakdown of the neurotransmitter serotonin. Serotonin plays an important role in uplifting mood and may improve the ability to cope. Another option for PTSD is the use of benzodiazepines. This class of drugs helps PTSD victims by giving them a means of instantly relieving anxiety and insomnia caused by the disorder. Another important class of drugs used to treat PTSD is the use of glucocorticoids. Glucocorticoids are drugs that increase levels of the hormone cortisol. PTSD is often associated with low levels of cortisol and there is research suggesting that PTSD sufferers may have disrupted levels of cortisol or cortisol receptors.

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Schizoaffective disorder is characterized by persistent symptoms of psychosis resembling schizophrenia with additional periodic symptoms of mood (or affective) disorders.

Symptoms of Schizoaffective Disorder

The following are symtpoms that a person with Schizoaffective Disorder can experience.

Symptoms of depression:

  • Feel constantly sad and fatigued
  • Have lost interest in everyday activities
  • Are indecisive and unable to concentrate
  • Sleep and eat too little or too much
  • Complain of various physical symptoms
  • May have recurrent thoughts of death and suicide

Symptoms of mania:

  • Suffering from sleeplessness
  • Compulsively talkative
  • Agitated and distractible
  • Convinced of their own inflated importance
  • Susceptible to buying sprees
  • Prone to cheerfulness turning to irritability
  • Indiscreet sexual advances, and foolish investments
  • Paranoia, and rage

Symptoms of psychosis:

  • Hearing or seeing things that aren’t there
  • Bizarre thinking
  • Difficulty with emotions or appearing apathetic
  • Changes in speech
  • Have confused thinking
  • Paranoia
  • Strange or out of character behavior
  • And inappropriate emotional reactions

Difficulty In Distinguishing Illnesses

Schizoaffective Disorder is often confused with Bipolar Disorder with psychotic features. Both diagnosis include mood changes that impact life as well as symptoms of psychosis. A person diagnosed with Schizoaffective Disorder primarily experiences symptoms of psychosis even if mood problems don’t exist.  However, when mood problems flare up, such as during a depressed or manic episode, the symptoms of psychosis can worsen. Someone who is diagnosed with Bipolar Disorder with psychotic features often only experiences psychosis during a mood swing.

This distinction is not always as obvious as the description suggests. Emotion and behavior are more fluid and less easy to classify than physical symptoms. If you’re not sure about your diagnosis, it’s a great question to bring up with your therapist, doctor or support person. A mental health professional can help provide education and clarify issues to make sure you understand your options including treatment.

How is Schizoaffective Disorder Treated?

If a person is experiencing psychosis, a neuroleptic (antipsychotic) drug is most often used, since antidepressants and lithium (used for bipolar disorder) take several weeks to start working. Antipsychotic medications should help resolve symptoms quickly, sometimes as quickly as 3-5 days. Long term use of older antipsychotic drugs have been known to cause tardive dyskinesia, a serious and sometimes irreversible disorder of body movement. After symptoms of psychosis improve, mood symptoms may be treated with antidepressants, lithium, anticonvulsants, or electroconvulsive therapy (ECT). Sometimes a neuroleptic is combined with lithium or an antidepressant and then gradually withdrawn, to be restored if necessary. The few studies on drug treatment of this disorder suggest that antipsychotic drugs are most effective. The greater effectiveness of these new drugs may be partly due to their activity at receptors for the neurotransmitter serotonin, which is not influenced as strongly by standard antipsychotic drugs.

Outside of medications, finding help through counseling, family therapy, case management, peer supports, or other enhanced services like supported employment, supported education, or supported housing is very helpful. Mood problems and psychosis are likley to increase with stress and lack of sleep. Supports can help to reduce stress, problem solve, provide additional resouces and education and help understand how best to recover from mental health problems.  For Schizoaffective Disorder, combining therapy and medication treatments will increase chances of recovery.  Having access to various types of treatment might depend on where you live. To get more information about treatment, visit our Finding Help page.

To learn more visit:

Other Resources

The Brain and Behavior Research Foundation
1-800-829-8289
https://bbrfoundation.org 

National Institute of Mental Health Public Information and Communications Branch
1-866-615-6464
www.nimh.nih.gov

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Bipolar Disorder

Definition

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

There are four basic types of bipolar disorder; all of them involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

  • Bipolar I Disorder— defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depression and manic symptoms at the same time) are also possible.
  • Bipolar II Disorder— defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes described above.
  • Cyclothymic Disorder (also called cyclothymia)— defined by numerous periods of hypomanic symptoms as well numerous periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.
  • Other Specified and Unspecified Bipolar and Related Disorders— defined by bipolar disorder symptoms that do not match the three categories listed above.

Signs and Symptoms

People with bipolar disorder experience periods of unusually intense emotion, changes in sleep patterns and activity levels, and unusual behaviors. These distinct periods are called “mood episodes.” Mood episodes are drastically different from the moods and behaviors that are typical for the person. Extreme changes in energy, activity, and sleep go along with mood episodes.

This table is scrollable by touch on mobile devices.

People having a manic episode may: People having a depressive episode may:
  • Feel very “up,” “high,” or elated
  • Have a lot of energy
  • Have increased activity levels
  • Feel “jumpy” or “wired”
  • Have trouble sleeping
  • Become more active than usual
  • Talk really fast about a lot of different things
  • Be agitated, irritable, or “touchy”
  • Feel like their thoughts are going very fast
  • Think they can do a lot of things at once
  • Do risky things, like spend a lot of money or have reckless sex
  • Feel very sad, down, empty, or hopeless
  • Have very little energy
  • Have decreased activity levels
  • Have trouble sleeping, they may sleep too little or too much
  • Feel like they can’t enjoy anything
  • Feel worried and empty
  • Have trouble concentrating
  • Forget things a lot
  • Eat too much or too little
  • Feel tired or “slowed down”
  • Think about death or suicide

Sometimes a mood episode includes symptoms of both manic and depressive symptoms. This is called an episode with mixed features. People experiencing an episode with mixed features may feel very sad, empty, or hopeless, while at the same time feeling extremely energized.

Bipolar disorder can be present even when mood swings are less extreme. For example, some people with bipolar disorder experience hypomania, a less severe form of mania. During a hypomanic episode, an individual may feel very good, be highly productive, and function well. The person may not feel that anything is wrong, but family and friends may recognize the mood swings and/or changes in activity levels as possible bipolar disorder. Without proper treatment, people with hypomania may develop severe mania or depression.

Diagnosis

Proper diagnosis and treatment help people with bipolar disorder lead healthy and productive lives. Talking with a doctor or other licensed mental health professional is the first step for anyone who thinks he or she may have bipolar disorder. The doctor can complete a physical exam to rule out other conditions. If the problems are not caused by other illnesses, the doctor may conduct a mental health evaluation or provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder.

Note for Health Care Providers: People with bipolar disorder are more likely to seek help when they are depressed than when experiencing mania or hypomania. Therefore, a careful medical history is needed to ensure that bipolar disorder is not mistakenly diagnosed as major depression. Unlike people with bipolar disorder, people who have depression only (also called unipolar depression) do not experience mania. They may, however, experience some manic symptoms at the same time, which is also known as major depressive disorder with mixed features.

Bipolar Disorder and Other Illnesses

Some bipolar disorder symptoms are similar to other illnesses, which can make it hard for a doctor to make a diagnosis. In addition, many people have bipolar disorder along with another illness such as anxiety disorder, substance abuse, or an eating disorder. People with bipolar disorder are also at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses.

Psychosis: Sometimes, a person with severe episodes of mania or depression also has psychotic symptoms, such as hallucinations or delusions. The psychotic symptoms tend to match the person’s extreme mood. For example:

  • Someone having psychotic symptoms during a manic episode may believe she is famous, has a lot of money, or has special powers.
  • Someone having psychotic symptoms during a depressive episode may believe he is ruined and penniless, or that he has committed a crime.

As a result, people with bipolar disorder who also have psychotic symptoms are sometimes misdiagnosed with schizophrenia.

Anxiety and ADHD: Anxiety disorders and attention-deficit hyperactivity disorder (ADHD) are often diagnosed among people with bipolar disorder.

Substance Abuse: People with bipolar disorder may also misuse alcohol or drugs, have relationship problems, or perform poorly in school or at work. Family, friends and people experiencing symptoms may not recognize these problems as signs of a major mental illness such as bipolar disorder.

Risk Factors

Scientists are studying the possible causes of bipolar disorder. Most agree that there is no single cause. Instead, it is likely that many factors contribute to the illness or increase risk.

Brain Structure and Functioning: Some studies show how the brains of people with bipolar disorder may differ from the brains of healthy people or people with other mental disorders. Learning more about these differences, along with new information from genetic studies, helps scientists better understand bipolar disorder and predict which types of treatment will work most effectively.

Genetics: Some research suggests that people with certain genes are more likely to develop bipolar disorder than others. But genes are not the only risk factor for bipolar disorder. Studies of identical twins have shown that even if one twin develops bipolar disorder, the other twin does not always develop the disorder, despite the fact that identical twins share all of the same genes.

Family History: Bipolar disorder tends to run in families. Children with a parent or sibling who has bipolar disorder are much more likely to develop the illness, compared with children who do not have a family history of the disorder. However, it is important to note that most people with a family history of bipolar disorder will not develop the illness.

Treatments and Therapies

Treatment helps many people—even those with the most severe forms of bipolar disorder—gain better control of their mood swings and other bipolar symptoms. An effective treatment plan usually includes a combination of medication and psychotherapy (also called “talk therapy”). Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment helps to control these symptoms.

Medications

Different types of medications can help control symptoms of bipolar disorder. An individual may need to try several different medications before finding ones that work best.

Medications generally used to treat bipolar disorder include:

  • Mood stabilizers
  • Atypical antipsychotics
  • Antidepressants

Anyone taking a medication should:

  • Talk with a doctor or a pharmacist to understand the risks and benefits of the medication
  • Report any concerns about side effects to a doctor right away. The doctor may need to change the dose or try a different medication.
  • Avoid stopping a medication without talking to a doctor first. Suddenly stopping a medication may lead to “rebound” or worsening of bipolar disorder symptoms. Other uncomfortable or potentially dangerous withdrawal effects are also possible.
  • Report serious side effects to the U.S. Food and Drug Administration (FDA) MedWatch Adverse Event Reporting program online at http://www.fda.gov/Safety/MedWatch  or by phone at 1-800-332-1088. Clients and doctors may send reports.

For basic information about medications, visit the NIMH Mental Health Medications webpage. For the most up-to-date information on medications, side effects, and warnings, visit the FDA website .

Psychotherapy

When done in combination with medication, psychotherapy (also called “talk therapy”) can be an effective treatment for bipolar disorder. It can provide support, education, and guidance to people with bipolar disorder and their families. Some psychotherapy treatments used to treat bipolar disorder include:

  • Cognitive behavioral therapy (CBT)
  • Family-focused therapy
  • Interpersonal and social rhythm therapy
  • Psychoeducation

Visit the NIMH Psychotherapies webpage to learn about the various types of psychotherapies.

Other Treatment Options

Electroconvulsive Therapy (ECT): ECT can provide relief for people with severe bipolar disorder who have not been able to recover with other treatments. Sometimes ECT is used for bipolar symptoms when other medical conditions, including pregnancy, make taking medications too risky. ECT may cause some short-term side effects, including confusion, disorientation, and memory loss. People with bipolar disorder should discuss possible benefits and risks of ECT with a qualified health professional.

Sleep Medications: People with bipolar disorder who have trouble sleeping usually find that treatment is helpful. However, if sleeplessness does not improve, a doctor may suggest a change in medications. If the problem continues, the doctor may prescribe sedatives or other sleep medications.

Supplements: Not much research has been conducted on herbal or natural supplements and how they may affect bipolar disorder.

It is important for a doctor to know about all prescription drugs, over-the-counter medications, and supplements a client is taking. Certain medications and supplements taken together may cause unwanted or dangerous effects.

Keeping a Life Chart: Even with proper treatment, mood changes can occur. Treatment is more effective when a client and doctor work closely together and talk openly about concerns and choices. Keeping a life chart that records daily mood symptoms, treatments, sleep patterns, and life events can help clients and doctors track and treat bipolar disorder most effectively.

Finding Treatment

  • A family doctor is a good resource and can be the first stop in searching for help.
  • For general information on mental health and to find local treatment services, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357).
  • The SAMHSA website has a Behavioral Health Treatment Services Locator  that can search for treatment information by address, city, or ZIP code.
  • Visit the NIMH’s Help for Mental Illnesses webpage for more information and resources.

For Immediate Help

If You Are in Crisis: Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255), available 24 hours a day, 7 days a week. The service is available to anyone. All calls are confidential.

If you are thinking about harming yourself or thinking about suicide:

  • Tell someone who can help right away
  • Call your licensed mental health professional if you are already working with one
  • Call your doctor
  • Go to the nearest hospital emergency department

If a loved one is considering suicide:

  • Do not leave him or her alone
  • Try to get your loved one to seek immediate help from a doctor or the nearest hospital emergency room, or call 911
  • Remove access to firearms or other potential tools for suicide, including medications

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Signs and Symptoms of Depression

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms; some people suffer many. The severity of symptoms varies among individuals and also over time. To read about the symptoms of depression and to hear what real men say about their experiences with them, click through the list below:

If these signs and symptoms describe you or a man that you care about, talk to your healthcare provider, or check Getting Help for more information.

Thank you to NIMH website for this information.

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