SCHIZOPHRENIA

An abnormal social behavior and failure to understand what is real is termed as schizophrenia and is a mental disorder commonly characterized by false beliefs, unclear or confused thinking, hearing voices, reduced social engagement and emotional expression, and a lack of motivation. People with schizophrenia often have additional mental health problems such as substance abuse disorder. Symptoms of schizophrenia usually start between ages 16 and 30 and in some cases, children too suffer.

The symptoms of schizophrenia fall into three categories: positive, negative, and cognitive.

1. Positive symptoms: These are psychotic behaviours not generally seen in healthy people. People with positive symptoms may “lose touch” with some aspects of reality and the symptoms include:
   • Hallucinations
   • Delusions
   • Thought disorders (unusual or dysfunctional ways of thinking)
   • Movement disorders (agitated body movements)
2. Negative symptoms: They are associated with disruptions to normal emotions and behaviours and the symptoms include:
   • “Flat affect” (reduced expression of emotions via facial expression or voice tone)
   • Reduced feelings of pleasure in everyday life
   • Difficulty beginning and sustaining activities
   • Reduced speaking
3. Cognitive symptoms: These are subtle for some patients, but for others, they are more severe and patients may notice changes in their memory or other aspects of thinking. The symptoms include:
   • Poor “executive functioning” (the ability to understand information and use it to make decisions)
   • Trouble focusing or paying attention
   • Problems with “working memory” (the ability to use information immediately after learning it)

BIPOLAR DISORDER

Bipolar disorder is also known as manic-depressive illness and is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. 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). Sometimes a mood episode includes symptoms of both manic and depressive symptoms and is termed as 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.

PERSONALITY DISORDERS

Long-term pattern of thinking, behavior and emotion that causes distress and makes it difficult to function in everyday life is termed as personality disorder and people suffering from it find it hard to change their behavior or adapt to different situations. They may have trouble sustaining work or forming positive relationships with others.

People with personality disorders also have high rates of coexisting mental health conditions like depression and substance abuse and because of the nature of these disorders, it can be difficult for people to recognize they have a problem or to seek help.

Personality disorders are grouped into three main clusters:
Cluster A
Generally described as “odd or eccentric” in thoughts or behaviors:

• Paranoid personality disorder: people with this disorder are suspicious and mistrustful of others, interpret other people’s motives as harmful, and may be hostile or emotionally detached.
• Schizoid personality disorder: causes a lack of interest in social relationships and an unemotional response to social interactions.
• Schizophrenia personality disorder: may cause peculiar dress, eccentric behavior, unusual or bizarre thoughts and beliefs, being uncomfortable in social settings, and trouble forming close relationships.

Cluster B
General features include unstable emotions and dramatic or impulsive behaviors::

• Antisocial Personality Disorder: may cause a disregard for the law or for the rights of others with a lack of remorse, such as lying and stealing, aggression, violence or illegal behaviour.
• Histrionic Personality Disorder: such people are highly emotional and dramatic, have an excessive need for attention and approval, and may be obsessed with their appearance.
• Borderline Personality Disorder: is characterized by fear of abandonment, intense and unstable relationships, extreme emotional outbursts, deliberate self-harm or self-destructive behaviour and a fragile sense of self or identity.
• Narcissistic Personality Disorder: a pattern of inflated self esteem, need for admiration, lack of empathy or concern for others, and fantasies of success, power or beauty.

Cluster C
General features include anxious and fearful thoughts and behavior:

• Avoidant Personality Disorder: such people avoid social interaction and are extremely sensitive to negative judgments by others and may be timid and socially isolated with feelings of inadequacy.
• Obsessive-Compulsive Personality Disorder: people with this disorder are preoccupied by rules, orderliness and value work above other aspects of life; they are perfectionistic and have a need to be in control. Please note this is distinct from full-blown OCD (Obsessive-Compulsive Disorder), which is a form of anxiety diso
• Dependent Personality Disorder: this causes a fear of being alone and need to be taken care of, difficulty separating from loved ones or making independent decisions. They may be submissive and even tolerate domineering or abusive relationships.

OBSESSIVE COMPULSIVE DISORDER

Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over. These symptoms can interfere with all aspects of life, such as work, school, and personal relationships.

Obsessions are repeated thoughts, urges, or mental images that cause anxiety and commonly seen symptoms include:

• Fear of germs or contamination
• Unwanted forbidden or taboo thoughts involving sex, religion, and harm
• Aggressive thoughts towards others or self
• Having things symmetrical or in a perfect order

Compulsions are repetitive behaviors that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions include:

• Excessive cleaning and/or hand washing
• Ordering and arranging things in a particular, precise way
• Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off
• Compulsive counting

Everyone double checks things sometimes and not all rituals or habits are compulsions. But a person with OCD generally:

• Can't control his or her thoughts or behaviors, even when those thoughts or behaviors are recognized as excessive
• Spends at least 1 hour a day on these thoughts or behaviors
• Doesn’t get pleasure when performing the behaviors or rituals, but may feel brief relief from the anxiety the thoughts cause
• Experiences significant problems in their daily life due to these thoughts or behaviors

POST TRAUMATIC STRESS DISORDER

Some people who have experienced a shocking, scary, or dangerous event develop PTSD.

It is natural to feel afraid during and after a traumatic situation. The “fight-or-flight” response is a typical reaction meant to protect a person from harm and thus nearly everyone will experience a range of reactions after trauma. Most people recover from initial symptoms naturally but those who continue to experience problems may be diagnosed with PTSD and such people may feel stressed or frightened even when they are not in danger.

DEPRESSION

Depression (major depressive disorder or clinical depression) is a common but serious mood disorder and causes severe symptoms that affect how you feel, think, and handle daily activities, like sleeping, eating, or working. The symptoms must be present for at least two weeks so as to be diagnosed with depression.

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Thus, several persistent symptoms in addition to low mood are required for a diagnosis of major depression. People with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness while symptoms may also vary depending on the stage of the illness.

EATING DISORDERS

Eating Disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about body weight or shape and may include inadequate or excessive food intake resulting in damage to an individual’s wellbeing. The most common forms of eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.

Anorexia Nervosa- Individual will typically have an obsessive fear of gaining weight, refusal to maintain a healthy body weight, and an unrealistic perception of body image. Many people with anorexia nervosa will fiercely limit the quantity of food they consume and view themselves as overweight, even when they are clearly underweight. Anorexia can have damaging health effects, such as brain damage, multi-organ failure, bone loss, heart difficulties, and infertility with the risk of death being highest in such individuals.

Bulimia Nervosa- This is characterized by repeated binge eating followed by behaviors that compensate for the overeating, such as forced vomiting, excessive exercising or extreme use of laxatives or diuretics. Individuals suffering from bulimia may fear weight gain and feel severely unhappy with their body size and shape. The binge-eating and purging cycle is typically done in secret, creating feelings of shame, guilt, and lack of control. Bulimia has injuring effects, like gastrointestinal problems, severe hydration, and heart difficulties resulting from an electrolyte imbalance.

Binge Eating Disorder- Such individuals frequently lose control over his or her eating. However, it is different from bulimia nervosa as it is characterized by episodes of binge eating but not followed by compensatory behaviors like purging, fasting or excessive exercise. Because of this, many people suffering with binge-eating disorder may be obese and at an increased risk of developing other conditions, such as cardiovascular disease. Individuals who struggle with this disorder may also experience intense feelings of guilt, distress, and embarrassment related to their binge eating, which could influence further progression of the eating disorder.