What is Post Traumatic Stress Disorder?

What exactly is Posttraumatic stress disorder? Posttraumatic stress disorder (PTSD) is a type of an anxiety disorder. It usually develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience. PTSD sufferers re-experience the traumatic event or events in some way, tend to avoid places, people, or other things that remind them of the event (avoidance), and are exquisitely sensitive to normal sensory life experiences (hyperarousal). Although this condition has likely existed since human beings have endured trauma, PTSD has only been recognized as a formal diagnosis since 1980. However, it was called by different names as early as the American Civil War, when combat veterans were referred to as suffering from "soldier's heart." In World War I, symptoms that were generally consistent with this syndrome were referred to as "combat fatigue." Soldiers who developed such symptoms in World War II were said to be suffering from "gross stress reaction," and many troops in Vietnam who had symptoms of what is now called PTSD were assessed as having "post-Vietnam syndrome." PTSD has also been called "battle fatigue" and "shell shock."

(Courtesy: Internet)

PTSD statistics in children and teens reveal that up to more than 40% have endured at least one traumatic event, resulting in the development of PTSD in up to 15% of girls and 6% of boys. On average, 3%-6% of high school students in the United States and as many as 30%-60% of children who have survived specific disasters have PTSD. Up to 100% of children who have seen a parent killed or endured sexual assault or abuse tend to develop PTSD, and more than one-third of youths who are exposed to community violence (for example, a shooting, stabbing, or other assault) will suffer from the disorder.

Although not all individuals who have been traumatized develop PTSD, there can be significant physical consequences of being traumatized. For example, research indicates that people who have been exposed to an extreme stressor sometimes have a smaller hippocampus (a region of the brain that plays a role in memory) than people who have not been exposed to trauma. This is significant in understanding the effects of trauma in general and the impact of PTSD, specifically since the hippocampus is the part of the brain that is thought to have an important role in developing new memories about life events. Also, whether or not a traumatized person goes on to develop PTSD, they seem to be at risk for higher use of cigarettes, alcohol, and marijuana. Conversely, people whose PTSD is treated also tend to have better success at overcoming a substance-abuse problem.

What are the effects of PTSD?

Symptoms in women with PTSD who are pregnant include having other emotional problems, poor health behaviors, and memory problems. Women who were sexually abused at earlier ages are more likely to develop complex PTSD and borderline personality disorder. Babies who are born to mothers who suffer from this illness during pregnancy are more likely to experience a change in at least one chemical in their body that makes it more likely (predisposes) the baby to develop PTSD later in life. Individuals who suffer from this illness are at risk of having more medical problems, as well as trouble reproducing. In children and teens, PTSD can have significantly negative effects on their social and emotional development, as well as on their ability to learn.

What causes PTSD? 

Virtually any trauma, defined as an event that is life-threatening or that severely compromises the physical or emotional well-being of an individual or causes intense fear, may cause PTSD. Such events often include either experiencing or witnessing a severe accident or physical injury, receiving a life-threatening medical diagnosis, being the victim of kidnapping or torture, exposure to war combat or to a natural disaster, exposure to other disaster (for example, plane crash) or terrorist attack, being the victim of rape, mugging, robbery, or assault, enduring physical, sexual, emotional, or other forms of abuse, as well as involvement in civil conflict. Although the diagnosis of PTSD currently requires that the sufferer has a history of experiencing a traumatic event as defined here, people may develop PTSD in reaction to events that may not qualify as traumatic but can be devastating life events like divorce or unemployment.

What are the symptoms and signs of PTSD?

The following three groups of symptom criteria are required to assign the diagnosis of PTSD:

1. Recurrent re-experiencing of the trauma (for example, troublesome memories, flashbacks that are usually caused by reminders of the traumatic events, recurring nightmares about the trauma and/or dissociative reliving of the trauma)

2. Avoidance to the point of having a phobia of places, people, and experiences that remind the sufferer of the trauma or a general numbing of emotional responsiveness

3. Chronic physical signs of hyperarousal, including sleep problems, trouble concentrating, irritability, anger, poor concentration, blackouts or difficulty remembering things, increased tendency and reaction to being startled, and hypervigilance (excessive watchfulness) to threat. The emotional numbing of PTSD may present as a lack of interest in activities that used to be enjoyed (anhedonia), emotional deadness, distancing oneself from people, and/or a sense of a foreshortened future (for example, not being able to think about the future or make future plans, not believing one will live much longer). At least one re-experiencing symptom, three avoidance/numbing symptoms, and two hyperarousal symptoms must be present for at least one month and must cause significant distress or functional impairment in order for the diagnosis of PTSD to be assigned. PTSD is considered of chronic duration if it persists for three months or more.

A similar disorder in terms of symptom repertoire is acute stress disorder. The major differences between the two disorders are that acute stress disorder symptoms persist from two days to four weeks, and a fewer number of traumatic symptoms are required to make the diagnosis as compared to PTSD.

In children, re-experiencing the trauma may occur through repeated play that has trauma-related themes instead of or in addition to memories, and distressing dreams may have more general content rather than of the traumatic event itself. As in adults, at least one re-experiencing symptom, three avoidance/numbing symptoms, and two hyperarousal symptoms must be present for at least one month and must cause significant distress or functional impairment in order for the diagnosis of PTSD to be assigned. When symptoms have been present for less than one month, a diagnosis of acute stress disorder (ASD) can be made.

Symptoms of PTSD that tend to be associated with C-PTSD include problems regulating feelings, which can result in suicidal thoughts, explosive anger, or passive aggressive behaviors; a tendency to forget the trauma or feel detached from one's life (dissociation) or body (depersonalization); persistent feelings of helplessness, shame, guilt, or being completely different from others; feeling the perpetrator of trauma is all-powerful and preoccupation with either revenge against or allegiance with the perpetrator; and severe change in those things that give the sufferer meaning, like a loss of spiritual faith or an ongoing sense of helplessness, hopelessness, or despair.

What is the treatment for PTSD?

Treatments for PTSD usually include psychological and medical interventions. Providing information about the illness, helping the individual manage the trauma by talking about it directly, teaching the person ways to manage symptoms of PTSD, and exploration and modification of inaccurate ways of thinking about the trauma are the usual techniques used in psychotherapy for this illness. Education of PTSD sufferers usually involves teaching individuals about what PTSD is, how many others suffer from the same illness, that it is caused by extraordinary stress rather than weakness, how it is treated, and what to expect in treatment. This education thereby increases the likelihood that inaccurate ideas the person may have about the illness are dispelled, and any shame they may feel about having it is minimized. This may be particularly important in populations like military personnel that may feel particularly stigmatized by the idea of seeing a mental-health professional and therefore avoid doing so.

Teaching people with PTSD practical approaches to coping with what can be very intense and disturbing symptoms has been found to be another useful way to treat the illness. Specifically, helping sufferers learn how to manage their anger and anxiety, improve their communication skills, and use breathing and other relaxation techniques can help individuals with PTSD gain a sense of mastery over their emotional and physical symptoms. The practitioner might also use exposure-based cognitive behavioral therapy by having the person with PTSD recall their traumatic experiences using images or verbal recall while using the coping mechanisms they learned. Individual or group cognitive behavioral psychotherapy can help people with PTSD recognize and adjust trauma-related thoughts and beliefs by educating sufferers about the relationships between thoughts and feelings, exploring common negative thoughts held by traumatized individuals, developing alternative interpretations, and by practicing new ways of looking at things. This treatment also involves practicing learned techniques in real-life situations.

Eye-movement desensitization and reprocessing (EMDR) is a form of cognitive therapy in which the practitioner guides the person with PTSD in talking about the trauma suffered and the negative feelings associated with the events, while focusing on the professional's rapidly moving finger. While some research indicates this treatment may be effective, it is unclear if this is any more effective than cognitive therapy that is done without the use of rapid eye movement.

Families of PTSD individuals, as well as the sufferer, may benefit from family counseling, couple's counseling, parenting classes, and conflict-resolution education. Family members may also be able to provide relevant history about their loved one (for example, about emotions and behaviors, drug abuse, sleeping habits, and socialization) that people with the illness are unable or unwilling to share.

Medications that are usually used to help PTSD sufferers include serotonergic antidepressants and medicines that help decrease the physical symptoms associated with illness like some beta-blockers. Individuals with PTSD are much less likely to experience a relapse of their illness if antidepressant treatment is continued for at least a year. SSRIs are the first group of medications that have received approval by the U.S. Food and Drug Administration (FDA) for the treatment of PTSD. Treatment guidelines provided by the American Psychiatric Association describe these medicines as being particularly helpful for people whose PTSD is the result of trauma that is not combat-related. SSRIs tend to help PTSD sufferers modify information that is taken in from the environment (stimuli) and to decrease fear. Research also shows that this group of medicines tends to decrease anxiety, depression, and panic. SSRIs may also help reduce aggression, impulsivity, and suicidal thoughts that can be associated with this disorder.

Other less directly effective but nevertheless potentially helpful medications for managing PTSD include mood stabilizers, as well as mood stabilizers that are also antipsychotics. Antipsychotic medicines seem to be most useful in the treatment of PTSD in those who suffer from agitation, dissociation, hypervigilance, intense suspiciousness (paranoia), or brief breaks in being in touch with reality (brief psychotic reactions). The antipsychotic medications are also being increasingly found to be helpful treatment options for managing PTSD when used in combination with an SSRI. Benzodiazepines (tranquilizers) have unfortunately been associated with a number of problems, including withdrawal symptoms and the risk of overdose, and have not been found to be significantly effective for helping individuals with PTSD

(Disclaimer: The above article has various inputs from www.medicinenet.com . The images in the post are from various sources from the internet. 

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Cricket and the rise of the 'D' word!

'Depression doesn't care who it attacks: if it wants you, you cannot beat it off with a CV or a bank balance' - Marcus Trescothick

 I am writing this post in the wake of the recent events in the ongoing Cricket World Cup 2011, where an English Cricketer withdrew from the team because of depression. Michael Yardy, the left arm spinner from the England squad left the camp last week citing depression. It was so brave and honest of him to have come forward and accept the situation and letting it know to the authorities. But this is not the only event in which sports with the cruel and demanding image it has today, has taken its toll on the mental health of the athletes.

(Courtesy: Internet)

The 30-year-old Sussex man, who has played a bit-part role during the tournament but has been a regular on the one-day scene over the last two years, is flying back to England immediately after discussions with the squad's medical team. But Yardy was not the only English cricketer to feel the blues. Marcus Trescothick, the Ex-English opener too failed to beat depression  during his 2006 tour of India, which lead him to take a decision to quit his international career in 2008, cowed into submission by what he called the “black wings” of stress, sleeplessness and psychological torture.

The erratic schedule and the huge burden of expectations with lack of quality time with the loved ones have all contributed in players confronting their demons every now and then. The simple fact that Yardy spent only 4 days at home with his wife and the two kids in a span of 5 months explains the apathy of these brave sportsmen. I call him brave because Yardy did not try to beat around the bush by faking injuries or feigning illness. Instead he uttered the 'D' word with courage and honesty.

Graham Thorpe and Phil Tufnell were also the victims of the curse of Cricket. It is said that Tufnell had even spent a night in the psychiatry ward during the Ashes tour of 1994-95. Lou Vincent, who made a century on debut for New Zealand against an Australian attack containing Glenn McGrath and Shane Warne, also dropped out of top-class cricket because of depression.

Cricket today is such a game where the players spend more time with their team mates than their own families. Moreover, the uncertainty and the huge pressure to fight for your place in the playing eleven, especially in teams like India, South Africa, Australia who boast a terrific bench-strength, sometimes tears at the nerves. It has become a one-cap wonder game. One match you play good, you are the apple of so many eyes. The very next match you under perform, and you are on the hit-list of many. Though sport is all about showing your strengths and not your weakness, burning out of the cricketers due to a crazy schedule is becoming a serious issue today. Self-doubt, loneliness and home-sickness are the demons that these cricketers are confronting in this mad world of cut-throat competition.

But I believe there are more Yardys and Trescothicks in other teams too. And they are certainly not going to be the last ones. It is high time that constructive steps are taken into considerations, so as to avoid such circumstances. People like Geoffrey Boycott, should not criticize and overlook such new problems the current generation of cricketers are going through. These oldies need to realise one thing, that cricket has changed drastically today. It was very insensitive on Boycott's part to have correlated Yardy's confession of being depressed with his cricketing abilities. 

Depression is just like any other illness. It has nothing to do with the 'strength' or 'weakness' of one's mind. It is due to an imbalance of neurotransmitters in your brain that are responsible for your mood in your day to day activities. Comments like 'Pull yourself together mate' or 'Cheer up boy' will not serve any purpose. Once depression attacks someone the only way out is to seek professional help and even more importantly accept it honestly. Yardy did it with courage. Hats off to him. Wishing the man a speedy recovery...

Do not forget... 'Everyone is vulnerable!'

Liver or 'Lover'? Alcohol kills both!

William Shakespeare once said, 

"Alcohol provokes the desire but takes away the performance"

(Courtesy: Internet)

It is perfectly true that medically it is advisable to have alcohol in small amounts especially the red wine, as it increases the HDL which is the 'good' cholesterol. When in moderate amounts, it is also seen as an aphrodisiac, thereby increasing the libido during sex by removing the sexual inhibitions and intensifying the feelings of well-being and sexual satisfaction during intimacy. But the catch word here is 'moderate'. Overconsumption often leads to the culmination of the euphoria and thus results in the impotence that follows later. So how is alcohol and impotence connected? And what are the symptoms?

I have already discussed how Smoking may lead to impotence. Impotence is when the man is not able to maintain his erection sufficient enough to complete his act of sexual intercourse with his partner. The erection is lost much prior to ejaculation. It only includes the lack of sustaining the erection and not any other problem like failure to ejaculate, loss of libido, etc.

There are many theories why excessive alcohol can cause impotence. 

1. Long term alcohol abuse can result in interference in the signal pathways between the brain's pituitary gland and the genitals. This system is responsible for engorging the penis with blood by dilating the blood vessels in the penile architecture.

2. Some physicians also believe that the alcohol abuse can cause damage to the nerves of the penis thereby hindering the sensory input during the intercourse which is essential for the erectile mechanism to initiate.

3. After initial euphoric stimulation of the brain's libido center, excessive alcohol further causes inhibition of the center, thus reducing the sexual desire terminating the sexual pleasure. Concentration and judgement become cloudy as the brain is suppressed by the inhibition through alcohol and physical activity and movement are also impaired.

4. Many scientists believe that alcohol has a deleterious effect on the testosterone producing capacity of the cells in the testis. Testosterone is the masculine hormone that is responsible for differentiating a man from a woman.  Low levels of testosterone thus diminishes the sexual drive and function.

5. Heavy drinkers are often associated with co-morbid psychological conditions like depression, stress and anxiety. This makes them all the more susceptible to impotence. It is a vicious cycle in this case leading to the aggravation of the physical and psychological deterioration in their health increasing the chances of impotence. 

6. Since alcohol has a really bad effect on the liver, the body may develop chemical substances within the skin that create inflammation as well as irritation which will make sexual activity so uncomfortable that the psychological effect may cause your body to disassociate with intimate contact. Cirrhosis will even cause hypogonadism which atrophies a mans testicles, also reducing or even ruining the lovemaking drive and/or performance.

So what do you do when you end up with alcohol induced impotence?

a. Firstly you need to acknowledge that the problem exists and that Help is available. Early intervention can almost cure the disorder with effective co-operation between the physician and the patients themselves.

b. It is always advisable to just avoid alcohol when its time for intimacy or before your love making. Alcohol being a depressant, lowers blood pressure making it tough to stay in rigidity while keeping focused. Since alcohol constricts the bloodstream, particularly the smaller capillary routes, there is certainly much less awareness within the sensors which support erectile performance.

b. There are medicines available such as Viagra which can be prescribed by the physician after taking into consideration, the etiology, the risk factors and the benefits of starting the drug. 

c. If the impotence is as a result of physical damage to the vessels of the penis or the nervous system there are injectables that your doctor may offer you for correcting the impotence. 

d. Alcoholic induced impotence can best be addressed with a lifestyle adjustment. When one cannot remove drinking completely, one could at the least cut it right down. A 50% decline in drinking can give significantly enhanced efficiency potential. Changing to a more gentle kind of alcoholic drink, such as wine beverages, may also assist the return of sexual performance if this continues to be the main reason for impotence

So think ahead before sipping that glass before making love, because you may not just kill the liver inside you but also the 'lover' inside you...

(The above post is written only from informative point of view. Kindly do not consider it as a prescription. Talk to your physician for further details of the treatment discussed here.)

Are you addicted to Pornography?

What is pornography? Wikipedia states it is the portrayal of explicit sexual subject matter for the purposes of sexual excitement and erotic satisfaction. With the advent of the internet and in the age of YouTube, the current young generation have an easy access to free sexual content at the click of a button. There are hoards of websites scattered around the internet that provide ample of free uncensored sex related media that ranges from free pictures, watch videos, mms, movies and free webcam chatting too. Today in India even a schoolboy knows what 'XXX' stands for. In the land of Kamasutra, it wasn't long when 'desibaba' was a huge sensation in the adolescent minds, which has now given way to 'Savita Bhabhi'.

Porn: Good or Bad?

But it waits to be seen that whether pornography and the associated internet addiction does really have any effect on the psychology of these young minds. Some believe that pornography is not that bad as it is an healthy outlet for one's sexual needs. But most other psychologists are of the opinion that pornography can contribute to a distorted view of sex and unhealthy personal relationships. Medically speaking, some psychiatrists believe that this porn addiction can be a cause or an effect of depression, anxiety and bipolar disorder as well.

Love and Porn:

For a person to have a good mental health, love plays a very important role. But the uncensored sexual information that is relayed across the websites often depict the sex partner as an object of exploitation. Instead of looking at sex as a way to develop an emotional bond between the partners, a wrong message is usually passed through that it is all about reaching the big 'O' someway or the other. Love helps develop emotionally satisfying sexual relationships.

Whereas while indulging in Pornography it is usually one-sided. There is complete absence of emotional angle to it. It is usually followed with masturbation and hence can further push the subject into loneliness and depression. Low self esteem is often a sequelae. Clinical studies have proved a possible correlation between masturbation and depression in individuals. 

Relationships and Pornography:

Watching porn excessively not only alters sexual attitudes but also behavior. It is seen as a major threat to marriage, to family, to children and to individual happiness. In undermining marriage it is one of the factors in undermining social stability. Married men addicted to porn are found to be emotionally less interested in the real conjugal relations with wives and feel less satisfied. This gives way to infidelity and divorce collapsing even long relationships.

Psychology and Pornography:

Neuroscientists around the world have begun mapping the biological substrate of this unique addiction. It is found that an individual tends to become desensitized to the type of pornography they use. Eventually they become bored with it and then seek more perverse and more hardcore forms of pornographic content. Regular porn watchers have an increasing tendency towards abnormal and criminal sex behavior like rape, sexual aggression and promiscuity. Women are often seen as 'sex objects' by such men. The high risk behavior that follows often result in the individual getting exposed to STDs and legal issues like out-of-wedlock births, pulling them into a vicious cycle of stress and depression related debilities. 

Pornography and Help:

The main defenses against pornography are close family life, a good marriage and good relations between parents and children, coupled with deliberate parental monitoring of Internet use. The best way to deal with any kind of addiction is to seek the help of a qualified therapist. Though neither sex addiction nor porn addiction is considered an official mental disorder, they are definitely categorized under compulsions that can have serious effects on one’s sexuality and thus can be detrimental to social functioning.

So keep a check on yourself, the next time you type XXX in the search bar...

Are you really depressed?

Most of us feel sad in our daily life. Its not unusual for someone to feel the 'blues' now and then. But then what exactly falls in the criteria of being 'depressed'? Let me put up a few points for you to help you identify the signs and symptoms of Depression. Do NOT stop reading further! Even if you feel you are strong enough mentally to not 'encounter depression at any point ever', I insist you to go through this once, as it might help you help your dear ones or friends in their low times. I would specifically write focusing on the younger teen-agers who I feel are the most vulnerable lot during this exam season.

(Courtesy: Internet)

Being sad is not unusual but being sad most of the time is. The phrase 'most of the time' medically suggests a period of at least 2 weeks of sustained sadness of mood. If this sadness is often giving you problems with your studies or your performance in schools/colleges, your behavior at home or with friends or getting addictions like alcohol, smoking or problems during sex, then most probably you are going through DEPRESSION. To put it in a simpler way to help you identify I am putting down a check list below with criteria for depression. Remember that the following symptoms should not be secondary to any other medical condition.

1.You feel depressed most of the day, nearly every day like feeling empty or feeling sad. In younger age and children this may rather manifest as irritable mood. 

2. a significant decrease in interest in activities which used to be pleasurable before. 

3. a marked decrease or increase in weight or appetite. (>/= 5% of baseline body weight) 

4. inability to sleep or excessive sleep pattern 

5. feeling tired/lethargic most of the day, almost everyday. 

6. often feeling 'I am worthless' or excessive or inappropriate guilt about something. 

7. psycho-motor agitation/retardation : restlessness or slowing down while performing activities or doing mental work. 

8. inability to think rationally or finding it difficult to take any decision on your own. 

9. Lastly... recurrent thoughts about death and not just fear of dying, thinking about suicide with or without  a plan ready.

So if you check at least 5 out of the above 9 criterias, you are just one of the ten people in this world who are going through Depression. But as you can see, by that statistics, Depression is really common in todays world. At least 4 percent of adolescents get teen depression each year. But the good news is that you have treatment  ready and if you take early interventions, you need not worry much about the duration of the treatment or relapses.

(Courtesy: Aasra)

If you are depressed, please TALK to someone! It is very important to talk and ventilate yourself. There are many people out there waiting to LISTEN to you. The sooner you do this, the better. You can yourself visit some mental health professional or take someone's help, someone whom you trust the most, your family member, your friends, your teacher. Remember there is always some help around you. You need not feel ashamed of what you are going through, however down your life takes you. They say, "If you are going through hell... still Keep going!"

Having depression doesn't mean you are mentally 'weak', its just another ailment which needs 'treatment'. Some may require psychotherapy, some may need medicine and some need both. Your Psychiatrist, unlike few years ago, has many choices to choose the right medicines today with minimal side-effects. Anti-depressants are no longer always 'sedatives'. Psychopharmacology is an upcoming trend today. Needless to say, if you know someone who might be going through depression, please step forward and offer help. If directly helping doesn't work, talk to an adult related to that person whom you can trust. 

Why do people get depressed? The answer is a huge one. There are many causes for depression just like any other medical disease like diabetes, heart disease or say liver disease. Mental disorders are different only in the aspect that they affect your day to day activities and their management requires a psycho-socio-behavioral approach and not just an individualistic one.

I hope this article helps those who need help and also for those who are willing to help... Remember,

"We cannot help everyone, but Everyone can certainly help someone."

What is Schizophrenia?

Schizophrenia is a mental disorder in which the patient finds it difficult to tell the difference between real and unreal experiences, to think logically, to have normal emotional responses, and to behave normally in social situations. There are various symptoms, the combination of which establishes the type of Schizophrenia the person may be suffering from. Despite many researches and studies, there is still no concrete evidence as to what exactly causes Schizophrenia. 

CAUSES:  

(Courtesy: Internet)

1. Genetic factors play a major role. People with family history of schizophrenia may be more likely to get the illness themselves.

2. Environmental events may trigger schizophrenia in people with genetic background. For example, infection during intranatall development or stressful psychological experiences may increase the risk for developing schizophrenia later in life. Social and family support  plays a vital role in the improvement of the illness.

PREVALENCE:

Schizophrenia affects about approximately 1% of the people worldwide. However, it occurs equally among men and women. In women it is seen to begin later and is milder in intensity. Although schizophrenia usually begins in young adulthood, there are cases in which the disorder begins later (over age 45). Childhood-onset schizophrenia is the one which starts after age 5. 

SYMPTOMS:
Schizophrenia develops slowly over months or years. Like other chronic illnesses, it cycles between periods of fewer symptoms and periods of more symptoms. At first, you may feel tense, or have trouble sleeping or concentrating. You can become isolated and withdrawn, and have trouble making or keeping friends. As the illness continues, psychotic symptoms develop:

• Appearance or mood that shows no emotion (flat affect)
• Bizarre movements that show less of a reaction to the environment (catatonic behavior)
• False beliefs or thoughts that are not based in reality (delusions)
• Hearing, seeing, or feeling things that are not there (hallucinations)

Problems with thinking often occur:

• Problems paying attention
• Thoughts "jump" between unrelated topics (disordered thinking)

Symptoms can be different depending on the type of schizophrenia:

• Paranoid types often feel anxious, are more often angry or argumentative, and falsely believe that others are trying to harm them or their loved ones.
• Disorganized types have problems thinking and expressing their ideas clearly, often exhibit childlike behavior, and frequently show little emotion.
• Catatonic types may be in a constant state of unrest, or they may not move or be underactive. Their muscles and posture may be rigid. They may grimace or have other odd facial expressions, and they may be less responsive to others.
• Undifferentiated types may have symptoms of more than one other type of schizophrenia.
• Residual types experience some symptoms, but not as many as those who are in a full-blown episode of schizophrenia.

People with any type of schizophrenia may have difficulty keeping friends and working. They may also have problems with anxiety, depression, and suicidal thoughts or behaviors.

SIGNS AND TESTS:

A psychiatrist should perform an evaluation to make the diagnosis. The diagnosis is made based on a thorough interview of the person and family members. No medical tests for schizophrenia exist. The following factors may suggest a schizophrenia diagnosis, but do not confirm it:

• Course of illness and how long symptoms have lasted
• Changes from level of function before illness
• Developmental background
• Genetic and family history
• Response to medication

CT scans of the head and other imaging techniques may find some changes that occur with schizophrenia and may rule out other disorders.

TREATMENT:

During an episode of schizophrenia, you may need to stay in the hospital for safety reasons, and to receive basic needs such as food, rest, and hygiene.

MEDICATIONS:

Antipsychotic medications are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control the symptoms of the illness.

These medications are helpful, but they can have side effects. However, many of these side effects can be addressed, and should not prevent people from seeking treatment for this serious condition.

Common side effects from antipsychotics may include:

• Sleepiness (sedation) or dizziness
• Weight gain and increased chance of diabetes and high cholesterol

Less common side effects include:

• Feelings of restlessness or "jitters"
• Problems of movement and gait
• Muscle contractions or spasms
• Tremor

Long-term risks of antipsychotic medications include a movement disorder called tardive dyskinesia. In this condition, people develop movements that they cannot control, especially around the mouth. Anyone who believes they are having this problem should check with their doctor right away.

For people who try and do not improve with several antipsychotics, the medication clozapine can be helpful. Clozapine is the most effective medication for reducing schizophrenia symptoms, but it also tends to cause more side effects than other antipsychotics.

Because schizophrenia is a chronic illness, most people with this condition need to stay on antipsychotic medication for life.

SUPPORT PROGRAMS AND THERAPIES:

Supportive and problem-focused forms of therapy may be helpful for many people. Behavioral techniques, such as social skills training, can be used during therapy or at home to improve function socially and at work.

Family treatments that combine support and education about schizophrenia (psychoeducation) appear to help families cope and reduce the odds of symptoms returning. Programs that emphasize outreach and community support services can help people who lack family and social support.

Important skills for a person with schizophrenia include:

• Learning to take medications correctly and how to manage side effects
• Learning to watch for early signs of a relapse and knowing how to react when they occur
• Coping with symptoms that are present even while taking medications. A therapist can help persons with schizophrenia test the reality of thoughts and perceptions.
• Learning life skills, such as job training, money management, use of public transportation, relationship building, and practical communication

Family members and caregivers are often encouraged to help people with schizophrenia stick to their treatment.

PROGNOSIS:

The outlook for a person with schizophrenia is difficult to predict. Most people with schizophrenia find that their symptoms improve with medication, and some can get good control of their symptoms over time. However, others have functional disability and are at risk for repeated episodes, especially during the early stages of the illness.

To live in the community, people with schizophrenia may need supported housing, work rehabilitation, and other community support programs. People with the most severe forms of this disorder may be too disabled to live alone, and may need group homes or other long-term, structured places to live. Some people with milder forms of schizophrenia are able to have satisfying relationships and work experiences.

COMPLICATIONS:

• People with schizophrenia have a high risk of developing a substance abuse problem. Use of alcohol or other drugs increases the risk of relapse, and should be treated by a professional.
• Physical illness is common among people with schizophrenia due to an inactive lifestyle and side effects from medication. Physical illness may not be detected because of poor access to medical care and difficulties talking to health care providers.
• Not taking medication will often cause symptoms to return.

CALLING FOR HELP:

Call your health care provider if:

• Voices are telling you to hurt yourself or others.
• You feel the urge to hurt yourself or others.
• You are feeling hopeless and overwhelmed.
• You are seeing things that aren't really there.
• You feel like you cannot leave the house.
• You are unable to care for yourself.

PREVENTION:

There is no known way to prevent schizophrenia. If you do have the condition, the best ways to prevent symptoms from coming back are to take the medication your doctor prescribed, and see your doctor or therapist regularly. Always talk to your doctor if you are thinking about changing or stopping your medications

(Disclaimer: The above post has inputs from the PUBMED Health articles. It is written only from an informative point of view. It should not be taken as a consultation. Kindly discuss with your physician regarding the details about Schizophrenia.)