Sleep disorders are conditions that affect the normal sleeping patterns in humans or animals, which can, if manifested for a prolonged period of time, seriously affect one’s health and well functioning in a waking state.
Sleep disorders are usually accompanied by psychological dysfunctions (depression, schizophrenia, anxiety disorders etc.), but they may also come as a stand-alone dysfunction. In order to determine what type of sleep disorder a person has, polisomnography is used as a tool for diagnosing the patient by monitoring his physiological symptoms during sleep (eye moments, muscle activity, brain activity and heart rate).
Types:'
According to DSM-IV, there are three major types of sleep disorders:
1) primary sleep disorders, including:
hypersomnia – a person manifests excessive amounts of sleepiness during daytime. There is a difference between this and simple fatigue, in that patients often have great difficulty in handling their normal tasks from their work place, tasks which usually require minimal focus. There are various causes for this, from brain lesions to obesity and hypothyroidism.
Insomnia – the inability of an individual to fall asleep, despite the amount of accumulated fatigue and prolonged efforts (Roth, 2007). Insomnia may be transitory, acute or chronic.
Narcolepsy – excessive and prolonged sleep that can culminate with falling asleep spontaneously in the middle of daily activities
breathing related sleep disorders – sleep apnea, snoring.
circadian rhythm sleep disorder – Delayed sleep phase syndrome, advanced sleep phase syndrome, non-24-hour sleep-wake syndrome.
2) Parasomnias, including:
nightmare disorders – n increased frequency in nightmares, which leads to a disturbance in the sleeping pattern and fatigue
sleep terror disorder – usually encountered with children (2 to 6 years); the child wakes up in a state of unmotivated terror, which is apparently not caused by nightmares, usually during the first 4 hours of sleep
sleepwalking disorder
3) Other types (sleep problems caused by certain medical conditions):
bruxism – teeth grinding during sleep-time
restless leg syndrome – an imperious need of moving one’s leg during sleep.
Somniphobia – the fear of falling asleep
Nocturia – the need to wake up very often in order to use the bathroom without having a bladder disorder.
Sleep paralysis – the sensation of not being able to move for prolonged periods of time before falling asleep or immediately after waking up, despite a great desire to do so.
Treatment:
According to Poceta & Milter (1998), there are two kinds of treatment: one that relies on medication, is prescribed by a doctor, whose indications must be strictly and rigorously followed, as well an alternative one (based an teas, aromatherapy, relaxation techniques, breathing techniques, meditation, psychotherapy, biofeedback, etc.)
The most common used psychotherapies in treating sleep disorders are cognitive behavioral therapy, adlerian therapy, gestalt therapy and rational-emotive therapy. The approach can be oriented on treating or elimination the causes (for instance, quitting alcohol or certain drugs can lead to the restoration of a normal sleeping pattern) or on results (especially with behaviorist therapy that promotes assuming a certain routine that can allow the psyche to learn new behavioral patterns and, implicitly, new sleeping behaviors).
References:
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author
Poceta, J. S. & Mitler, M. M. (1998). Sleep disorders: Diagnosis and treatment. Totowa, New Jersey/US: Humana Press.
Tuesday, March 27, 2012
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Schizophrenia is a very serious psychosis, usually of a chronic type, that manifests in some young patients and is clinically characterized by signs of mental dissociation, affective dissonance and an incoherent, raving activity. It generally leads to losing contact with the exterior world and to bringing the individual to a state of degradation, both from a social point of view, as well as from a psychological and biological one, even more so if specialized treatment is not being applied.
History
According to Beck, Rector, Stolar & Grant (2009), the condition has a long standing history, with manifestations of a schizophrenic nature being noted by James Tilly Matthews and accounts being given by Philipe Pinel in the publications of 1809. However, the recognition of schizophrenia as a psychological disorder that affects young adults and late adolescents has been made in 1853 by Benedict Morel, the one who also deemed it with the term “early dementia”. Arnold Pick and Emil Kraepelin have used the term dementia praecox in describing a psychological disorder that affects the brain, is a form of dementia, yet in the same time is completely different from the one that occurs with Alzheimer’s disease (usually specific to the old age).
The term “schizophrenia” (translated as “splitting out the mind”) was first used by Eugen Bleuler. Bleuler was a Swiss psychiatrist, who intensely studied the problem of this psychosis and has come to characterize it through the four A’s: Affect, Autism, impaired Association of ideas and Ambivalence.
Ever since the ’50s and up to the present day, with the discovery of new drugs and new types of psychotherapy designed to help the patient with regaining balance after delirium episodes, schizophrenia has slowly but surely become a much better tolerated condition from a social point of view, even though it still bears a stigma that affects the people diagnosed with it. Socially reintegrating people who suffer from this chronic condition and improving their life quality with the latest medication are factors that give the patient the hope that his/her condition is not the end of the world for him/her or for his/her loved ones.
Today, real examples show that it’s possible to live with schizophrenia and even perform at the highest levels despite it (for instance, the case of John Nash, the famous mathematician awarded with a Nobel prize, who also suffered from schizophrenia).
Causes and diagnostics
The causes for this condition vary greatly and there is always a myriad of factors contributing to its development. The first and most spoken of cause is genetic, the risks of developing schizophrenia for someone who has first degree relatives diagnosed with it being greater than for someone who has no family history with the disease. Researchers also speak of environmental factors, such as life conditions (social adversity, racial discrimination, family dysfunctions, unemployment and poor housing conditions (Selten, Cantor-Graae & Kahn, 2007)), drug use (cannabis, cocaine, alcohol and amphetamines (Picchioni & Murray, 2007)) or prenatal stressors (infections, hypoxia, malnutrition of the mother during pregnancy (van Os & Kapur, 2009)).
The diagnosis is usually made considering the DSM-IV (2000) criteria:
Characteristic symptoms: Two or more of the following, each present for much of the time during a one-month period (or less, if symptoms remitted with treatment).
Delusions
Hallucinations
Disorganized speech, which is a manifestation of formal thought disorder
Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behavior
Negative symptoms: Blunted affect (lack or decline in emotional response), alogia (lack or decline in speech), or avolition (lack or decline in motivation)
If the delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient’s actions or of hearing two or more voices conversing with each other, only that symptom is required above. The speech disorganization criterion is only met if it is severe enough to substantially impair communication.
Social or occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care, are markedly below the level achieved prior to the onset.
Significant duration: Continuous signs of the disturbance persist for at least six months. This six-month period must include at least one month of symptoms (or less, if symptoms remitted with treatment).
Treatment
Currently, the diagnosis for schizophrenia automatically includes the prescription of specific, anti-psychotic medication. Gradually, psychotherapy methods have been implemented alongside the medication (Lynch, Laws, McKenna, 2010): cognitive behavioral therapy (for the purpose of reducing the symptoms and preventing a relapse into delirium), social therapy (for the purpose of social reintegration), family therapy (addressing the patient, as well as the patient’s family for gaining a better and more accurate understanding of his/her condition), occupational therapy (for the purpose of reintegrating into the work-place), as well as drama therapy and art therapy.
The curative approach involves medication, but also psychological stabilization through psychotherapy as well as social integration. In the present day, hospitalization is being kept to a minimum and the individual can live in society under normal conditions.
Reducing the social stigma of this condition through social campaigns meant to raise awareness and understanding what the people who are diagnosed with it are going through are also ways of helping them and of providing them with a normal life experience.
History
According to Beck, Rector, Stolar & Grant (2009), the condition has a long standing history, with manifestations of a schizophrenic nature being noted by James Tilly Matthews and accounts being given by Philipe Pinel in the publications of 1809. However, the recognition of schizophrenia as a psychological disorder that affects young adults and late adolescents has been made in 1853 by Benedict Morel, the one who also deemed it with the term “early dementia”. Arnold Pick and Emil Kraepelin have used the term dementia praecox in describing a psychological disorder that affects the brain, is a form of dementia, yet in the same time is completely different from the one that occurs with Alzheimer’s disease (usually specific to the old age).
The term “schizophrenia” (translated as “splitting out the mind”) was first used by Eugen Bleuler. Bleuler was a Swiss psychiatrist, who intensely studied the problem of this psychosis and has come to characterize it through the four A’s: Affect, Autism, impaired Association of ideas and Ambivalence.
Ever since the ’50s and up to the present day, with the discovery of new drugs and new types of psychotherapy designed to help the patient with regaining balance after delirium episodes, schizophrenia has slowly but surely become a much better tolerated condition from a social point of view, even though it still bears a stigma that affects the people diagnosed with it. Socially reintegrating people who suffer from this chronic condition and improving their life quality with the latest medication are factors that give the patient the hope that his/her condition is not the end of the world for him/her or for his/her loved ones.
Today, real examples show that it’s possible to live with schizophrenia and even perform at the highest levels despite it (for instance, the case of John Nash, the famous mathematician awarded with a Nobel prize, who also suffered from schizophrenia).
Causes and diagnostics
The causes for this condition vary greatly and there is always a myriad of factors contributing to its development. The first and most spoken of cause is genetic, the risks of developing schizophrenia for someone who has first degree relatives diagnosed with it being greater than for someone who has no family history with the disease. Researchers also speak of environmental factors, such as life conditions (social adversity, racial discrimination, family dysfunctions, unemployment and poor housing conditions (Selten, Cantor-Graae & Kahn, 2007)), drug use (cannabis, cocaine, alcohol and amphetamines (Picchioni & Murray, 2007)) or prenatal stressors (infections, hypoxia, malnutrition of the mother during pregnancy (van Os & Kapur, 2009)).
The diagnosis is usually made considering the DSM-IV (2000) criteria:
Characteristic symptoms: Two or more of the following, each present for much of the time during a one-month period (or less, if symptoms remitted with treatment).
Delusions
Hallucinations
Disorganized speech, which is a manifestation of formal thought disorder
Grossly disorganized behavior (e.g. dressing inappropriately, crying frequently) or catatonic behavior
Negative symptoms: Blunted affect (lack or decline in emotional response), alogia (lack or decline in speech), or avolition (lack or decline in motivation)
If the delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient’s actions or of hearing two or more voices conversing with each other, only that symptom is required above. The speech disorganization criterion is only met if it is severe enough to substantially impair communication.
Social or occupational dysfunction: For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care, are markedly below the level achieved prior to the onset.
Significant duration: Continuous signs of the disturbance persist for at least six months. This six-month period must include at least one month of symptoms (or less, if symptoms remitted with treatment).
Treatment
Currently, the diagnosis for schizophrenia automatically includes the prescription of specific, anti-psychotic medication. Gradually, psychotherapy methods have been implemented alongside the medication (Lynch, Laws, McKenna, 2010): cognitive behavioral therapy (for the purpose of reducing the symptoms and preventing a relapse into delirium), social therapy (for the purpose of social reintegration), family therapy (addressing the patient, as well as the patient’s family for gaining a better and more accurate understanding of his/her condition), occupational therapy (for the purpose of reintegrating into the work-place), as well as drama therapy and art therapy.
The curative approach involves medication, but also psychological stabilization through psychotherapy as well as social integration. In the present day, hospitalization is being kept to a minimum and the individual can live in society under normal conditions.
Reducing the social stigma of this condition through social campaigns meant to raise awareness and understanding what the people who are diagnosed with it are going through are also ways of helping them and of providing them with a normal life experience.
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