In the 1980s, when the diagnosis of PTSD was added in DSM the media drew attention to the psychological aftereffects of combat experienced by Vietnam War veterans. It was the most publicized but not the only one. Reports of psychological dysfunction following exposure to combat emerged after the Civil War and received increased attention with conditions called shell shock, traumatic neurosis, combat stress and combat fatigue. Survivors also were reported to suffer long term psychological effects including the “survivor syndrome” of chronic depression, anxiety and difficulties in interpersonal relationships. The lifetime prevalence of PTSD is 6.8 per cent with a yearly prevalence of 3.5 per cent. The symptoms of PTSD and related disorder such as depression can persist for many years.  Women are more likely to develop it than men.

SYMPTOMS

There are four types of symptoms but they are different for everyone. The types are as follows:-

1. Avoidance Symptoms– It happens when an individual tries to avoid the situation or people that trigger the traumatic event. They do not discuss the event with anyone. It leads to a loss of interest in activities and getting emotionally detached. They also try to stay from places and objects that remind them of the event. Example, if you lost someone in a plane crash you might stop travelling by plane.
2. Re-experiencing symptoms are like flashbacks which make the person feel like they are going through the event again. It involves Nightmares, Frightening Thoughts, Fearful thoughts or intense mental or physical reactions.
3. Arousal and Reactivity symptoms– It includes problems such as irritability, difficulty in sleeping, frustration and anger outbursts, feeling tense or anxious. Individual also face jumpiness or they get startled by the thought of the event, difficulty in concentration and self- destructive behaviours such as rash driving.
4. Cognition and mood symptoms– It includes negative changes in feelings and beliefs. Other problems are memory loss, feeling hopeless for future and difficulty in maintaining interpersonal relationships. Constant feeling of guilt and blame. They feel like leaving alone.

The symptoms for children are different from adults. Children face problems such as-

1. Separation Anxiety can lead to Separation Anxiety Disorder
2. Loss of skills such as toilet training
3. Sleep problems
4. Phobias and anxieties
5. Narrating out trauma trough help of plays, stories or drawings
6. Pains with no actual cause
7. Aggression

Physical symptoms such as sweating, headache, dizziness, stomach ache, weak immune system are also faced by people.

CAUSE

A traumatic experience is an external event but researches propose that traumatic events may lead to changes in the brain that make it hypersensitive to possible danger in the future. Individuals with PTSD experience alterations in the hippocampus, the structure responsible for memory. As a result, a person is unable to distinguish between harmful situation from the ones in which real trauma occurred. Levels of hormones responsible for ‘flight or fight’ situation are different than a person not having PTSD. Other causes are as follows:-

1. Family History of depression and PTSD
2. Lack of coping skills
3. A lot of stress in daily life
4. Sexual Abuse
5. History of anxiety or other mental illness and substance abuse
6. Careers such as police or military that lead to traumatic events
7. Lack of support

DIGNOSIS

PTSD can increase chances for disorders such as depression, anxiety, eating disorder, substance abuse and suicide. Diagnosis should be done under medical professionals. To be diagnosed with PTSD a person should meet the criteria listed under DSM by the American Psychological Association. They should have at least one re-experiencing, avoidance symptom and two arousal and cognition and mood symptoms.

TREATMENT

The treatment include:

1. Medication- SSRI antidepressants are the only FDA approved medications for people with PTSD. The response rate of patients to this medication is rarely more than 60 percent and less than 20 to 30 percent achieve full remission of their symptoms. Researchers do not support the use of benzodiazepines in the treatment of PTSD. Antipsychotic medication risperidone might benefit individuals.
2. Psychological Perspective- People with PTSD have a high level of neuroticism, negativity etc. so their coping and personality styles are very important. Cognitive Behavioral Therapy is considered one of the most effective therapy. It combines some type of exposure with relaxation and cognitive restructuring. Other alternative methods include interpersonal therapy, mantra repetition and acceptance and commitment therapy.

In Eye Movement Desensitization Reprocessing (EMDR) the clinicians ask the client to think about a traumatic event while focusing rapid movement of the clinician’s finger for 10 to 12 eye movements. Though being used to an increasing degree, EMDR lacks the effectiveness associated with some type of exposure therapy.

Positive Psychology proposes that people can grow through the experience of trauma. With this approach, trauma potentially allows clients to find the positive interpretation of their experiences.

CONCLUSION

Things happen in life which can change everything but we should not lead that happen. We should always move on in life because it is an important thing. Learning about your own symptoms is very important. There is always someone who can help you so seek help from people. Accepting and healing does not mean forge eying but it helps to build confidence that we come up with bad memories.

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Separation Anxiety Disorder is experienced by children when they have intense anxiety concerning separation from their home or caregivers. It is natural for a young child to feel anxious when they are separated from their parents. It usually starts from a child’s first birthday and can last up to their fourth birthday. Parents can ease their child’s anxiety by being patient and by setting some limits. However, some kid’s anxiety does not go away and it becomes a sign of a larger problem that is separation anxiety disorder. It is not a normal stage of development. Children with this disorder avoid situations in which they will be parted from their caregivers. Even the thought of separation causes extreme anxiety. Situations like when their caregivers are going to work or before going to sleep at night they become anxious. They ask one of their parents to stay with them and leave them after they sleep because they get nightmares regarding separation. Adults avoid going out and staying with others for example going to a friend’s house for a night out.

When they are separated from their caregivers they develop intense fear. They think something terrible will happen to their caregivers or themselves. The fear gets intense that they feel they will get kidnapped.  To avoid this situation they complain about physical symptoms such as stomach ache, fever etc. They become panicky, miserable, homesick, socially withdrawn and sad. They also demand constant attention and sometimes become so clingy that they will not allow one of their caregiver to go out of sight. People with separation anxiety disorder are also at greater risk of subsequently developing other anxiety disorder such as panic disorder.

SYMPTOMS

The symptoms of separation anxiety disorder include:

1. Fear and worry that something will happen to their caregivers
2. Children refuse to go to school
3. Insomnia
4. Complains about headache and stomachache
5. Clinging to the caregiver
6. Nightmares about separation
7. Fear of being alone
8. Bedwetting
9. Temper tantrums

Children and adolescents should show at least three symptoms from the above mentioned symptoms. The symptoms should last for at least four weeks and cause significant distress.

CAUSES

It occurs because of the fear a child has in some ways. If we can know the actual cause we will be one step closer to help the child through their struggles. A strong genetic component was used as evidenced by analyses based on twin data. Important environmental factors such as low-income environment, new house or school can trigger symptoms. They can also develop it because of natural or manmade disasters such as losing a loved one in an attack or tsunami etc. An overprotective parent or insecure attachment can also be a problem because they manifest their own anxiety about separation on the kid. 

DIAGNOSIS

Separation Anxiety Disorder is diagnosed on the basis of the signs and symptoms shown by the person. It varies from age to age. Children in the range of 5 to 8 show more symptoms than the 9 to 12 age group. Young children report more nightmares. Adolescents are more likely to report physical symptoms. Parents and child symptoms differ from each other. Clinicians are more likely to diagnose children with the disorder when parents report their symptoms. There are no laboratory tests for this disorder but the clinicians can ask for a blood test. If no physical illness is found, the child is sent to a psychologist to diagnose and treat them.

TREATMENT

The majority of children diagnosed with the disorder are completely free of symptoms within 18 months. However, people those who need help get the proper treatment from the clinicians. Behavioural techniques such as Systematic Desensitization, Exposure Therapy and Modeling is used for treating fear and anxieties. Contingency management and self management are also useful in teaching child to react positively to their fear-provoking situations. The therapies can be given individually or in combination. Cognitive Behavioral Therapy seems to be the most promising. It helps to reshape the child’s thinking and behaviour. Other therapies include Talk Therapy and Family Counseling to help the child to fight from their fears of separation.  There are no specific medications but in severe cases, antidepressant or anti-anxiety pills can be given to the person. Parents can also help their children at home by making proper plans for them and replacing their anxiety provoking thoughts into positive thoughts and also by setting some limits. They should also allow the child to stay or go to some place alone and should give up on their insecurities regarding their children.

CONCLUSION

Most children with the disorder get better and healthy with time. They need family support and love and when this thing combines with the treatment the chances of recovery improves. There is no way of preventing it but acting and recognizing it at the right time is important. They should live at a better place and should adapt with the changes and should give away their fears and accept the challenges with a positive attitude.

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Anorexia Nervosa is an eating disorder in which a person is unable to maintain normal weight and have an intense fear of gaining weight and have distorted body image. Three basic symptoms shown by the person involves restricted eating, unrealistic fear of getting fat and disturbed self-perception of body shape. The person has abnormally low body weight. They feel that they are overweight even though they are seriously underweight. The depletion of nutrients that occur because of anorexia leads to a lot of health changes some of them can be life-threatening. Starting from the brain, they cannot think right, there are changes in their brain chemistry and they have bad and fainting memory. Their hair gets thin and brittle. Have low blood pressure and slow heart rate and can also face heart failure. They also face anaemia and other blood problems like low potassium, magnesium and sodium in the blood. Weak and swollen joints and more prone to fractures. May face kidney stones and kidney failure. Constipation and bloating, menstruation stop, bone loss and women face problems in getting pregnant and there are higher risks of miscarriage. Skin gets bruises easily and gets dry. Hair all over the body, skin gets pale and nails get brittle.

There are two types of anorexia, the “restricting” type involves that they get engage in restricting calories. The other is “Purging” type in which they lose weight by vomiting. People who have anorexia experience a core disturbance in their body image. In one study it was shown that women suffering from anorexia showed distinct arousal patterns in area of the brain involve in processing emotions. Women with the restricted form appears not to value thinness so much as they are repelled by the idea of being overweight. The lifetime prevalence in women is 0.9 percent and 0.3 in men. The majority of individuals who develop it are in their early 20’s. Men have 25 per cent lower lifetime prevalence than women.

Many people get confused between Anorexia Nervosa and Bulimia Nervosa which is another type of eating disorder. In Bulimia, a person engages in binge eating during which they eat an excessive amount of food during a short period. In order to avoid weight gaining, they involve in purging which causes different physical and psychological issues.

CAUSES

The exact cause of anorexia is unknown. The conditions may run in families. From a biological point of view, the researchers are interested in the role of dopamine which plays a role in the feeling of pleasure including those which are related to eating. The abnormal processing of emotions in people may be related to other genes that are related to depressive mood. There are environmental or social factors such as constantly comparing their bodies to others and never getting satisfied with one own self and hormonal changes. The messages from social media and the fashion industry that thin is beautiful. Other factors are physical or sexual abuse or being bullied.

SYMPTOMS

There are two types of symptoms Physical and Psychological.

The Psychological Symptoms are as follows:

1. Refusing to eat
2. Not eating in front of others
3. Feeling sad and anxious
4. Low self-esteem
5. Lying about eating
6. Fixation on body image
7. Denying that they are underweight
8. Using diet pills and purging
9. Lack of emotions
10. Reduce sex drive
11. Memory loss
12. Changes in sleeping patterns
13. Trouble in relationships

The Physical Symptoms are as follows:

1. Dizziness
2. Loss and thinning of hair
3. Constipation
4. Dehydration
5. Pale and dry skin
6. Feeling cold all the time
7. Tremendous weight loss
8. Loss of periods in women
9. Loss of muscle mass
10. Low blood pressure and heart rate
11. Swollen hands and legs
12. Brittle nails
13. Bad breath and tooth decay
14. Over-exercising

DIAGNOSIS

Early diagnosis and proper treatment help the person to fight this disorder. They should show the following symptoms for the treatment of Anorexia Nervosa. The physicians detect signs of anorexia they should also test for diabetes, chronic infections, malabsorption, cancer etc. and blood test and image scans. People with anorexia also have mood disorders such as depression, anxiety disorders, obsessive compulsive disorder and social phobia.

According to the American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), the diagnostic criteria for anorexia nervosa are as follows:

1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

TREATMENT

The primary aim of treatment involves identifying and changing the individual’s maladaptive assumptions that occur regarding their body shape and weight.

In Cognitive Behavioral Therapy, clinicians attempt to change what are selective biases people regarding eating disorder that lead them to focus on the parts of bodies they dislike. By using Exposure Therapy in which clients view their bodies in the mirror in an attempt to reduce negative emotions that they experience. They teach them mindfulness techniques to reduce negative cognitions and affect their bodies by giving them psychoeducation about the ways that their beliefs reinforce their negative body image. In the sociocultural perspective, clinicians use family components for clients. Parents take the whole charge of their eating and weight. It can also involve family therapy and nutrition counselling to help the client to regain healthy eating habits.

There is no specific medication for this disorder. They can be given medication to control anxiety, depression and OCD. SSRIs such serotonin and olanzapine can be given when their weight is 95 percent of normal of their height and age. Hospitalization may also be needed if there is severe weight loss and the client refuses to eat.

CONCLUSION

May researchers believed that it not a disorder which cannot be treated.  The person can live a normal and healthy life by not being judgmental of other people and being kind and respectful. They should meet people who can help them and should take treatment from professionals. They should have high self-esteem and should believe that they are getting better day by day.

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Narcissistic Personality Disorder is primarily characterized by an unrealistic, inflated sense of self-importance and a lack of sensitivity to the needs of other people. It comes under Cluster B personality disorder. The term comes from a character in Greek mythology called Narcissus. He saw his reflection in the water and fell in love with it.

It should not be confused with high self- confidence and self- esteem. High self-esteem people are humble while people with NPD are likely to be selfish; they boss over people and ignore other feelings and needs. They may have high self-esteem but they are insecure. They think of themselves as better than others. Some individuals have grandiose self which is referred by clinicians as Grandiose Narcissism. They rely on other people to confirm their worth. They are more sensitive to rejections, feel a sense of shame. They are shy and not empathic. When they feel that they have not lived up to their standards they withdraw themselves socially. They derive themselves from the way that they believe other people view them.  In their personal relationships, they cannot develop true closeness with their partners because they are so focused on themselves that they ignore other person feelings and needs.  They are unhappy with their life in general and take it n a negative way. They are unable to see the damaging effects their behavior is causing to themselves and others.

According to studies, NPD may occur in approximately 1 per cent of the population. The ratios are higher in the population of individuals seeking clinical treatments with those estimates ranging from 2 to as high as 36 percent.

CHARACTERISTICS

People with NPD have following traits-

1. A lot of attention from others
2. Feeling of Jealousy
3. They want to achieve high and want importance
4. Easily gets hurt when rejected
5. They always imagine about success and power
6. Lack of ability to understand others feelings and needs
7. Respond to criticism with anger, humiliation and shame
8. Always expect others will agree with them
9. Whatever they have or want is the best
10. Cannot maintain healthy and personal relationships

SYMPTOMS

The traditional Freudian psychoanalytic approach regards narcissism as the individual’s failure to progress beyond the early, highly self-focused stages of psychosexual development. In order for a person to be diagnosed with NPD must have at least five or more symptoms. The symptoms are as follows:

1. Should have a grandiose sense of self importance
2. Should be preoccupied with their fantasies of success, power, talent and beauty
3. Should believe they are special or unique
4. Require excessive admiration
5. Strong sense of entitlement
6. Take advantage of others to achieve their goals
7. Lack of empathy
8. Envious of others
9. Regularly showing arrogance attitude

CAUSES

The exact reason for this disorder is still unknown.  The clinicians believed that it may result from a combination of factors which include childhood traumas such as physical, sexual or verbal. Relationships with parents, friends and other family members also matter. The Genetic structure or family history can be a reason. Different Personality and temperament can also be a cause.

DIAGNOSIS

There are no specific lab tests for this disorder. As it is a personality disorder and can overlap with other personality disorders. To solve this problem Diagnostic and Statistical Manual of Mental Disorders, DSM is used. The symptoms should match with personal behaviour and attitudes. Researchers agree that both genetics ad environmental factors play their role. Individuals with this disorder have less volume of grey matter in their left anterior insula of the brain which is responsible for emotional regulation, empathy and cognitive functioning. 

TREATMENT

Many people suffering from Narcissistic Personality Disorder rarely seek treatment. But it is important to seek treatment from clinicians. There are different ways by which a person can be treated, those are as follows:

1. Clinicians who work within a psychodynamic perspective try to provide a corrective developmental experience. They use empathy to support the person. They guide them toward a more realistic appreciation that no one is flawless. As the client feels that their therapist supports them, they become less grandiose and self-centred.
2. Cognitive- Behavioral theorists focus on maladaptive ideas of the client. They try them to convince them to act less selfishly and show them a better way to reach their goals. The therapist avoids the client’s demands for special favours and attention. They also make them learn to put limits in life.
3. No medication has been approved for this disorder. They may be prescribed with mood stabilizers or antidepressants. Medication may be given to treat co-occurring conditions such as mood disorders and anxiety disorders.
4. Self-help strategies include setting boundaries to expectations. A person should practice self-care. They should take help from the therapist. They should start showing support to others feelings and needs and should see their life as positive rather than having a negative attitude for others and themselves.

CONCLUSION

It can be challenging to treat a narcissistic person but by taking help from a therapist can prove very helpful because changes in behaviour can happen any time.  The person should feel free to praise others when they do something right. Show empathy to others and acknowledge them.  A great partnership between both the person suffering from the disorder and the people in the environment will help the person to treat quickly and in a much better way.

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