MENTAL HEALTH DISORDERS

Anxiety Disorders

AGLG

• Age as a risk factor depends on the type
• Some types are more common in females
• Chronic stress is a risk factor. Lifestyle is a very large factor [see neurohacking tutorials].
• Some types run in families

Anxiety may or may not have an obvious cause. Temporary anxiety is normal in bereavement and similar trauma. But when anxiety causes problems with everyday life, it is considered a disorder.

It takes a number of different forms. The most common is a persistent state of anxiety that is difficult or impossible to control. Another form is panic disorder, which includes alarming physical symptoms. Panic attacks occur unpredictably and have no obviously connected triggers. Panic attacks may alternate with persistent anxiety.

Phobias are disorders in which severe anxiety is produced by a known trigger, and the trigger can be a situation, activity, creature or object. [See: Phobias, in this section]. Sometimes anxiety disorders exist alongside other mental health disorders, such as depression.

What Are the Causes?

An increased susceptibility to anxiety may be inherited and/or due to experiences in childhood. For example, poor bonding between a parent and child and/or abrupt separation of a child from it’s parent, especially when very young, have been shown to play a part in anxiety overall. Anxiety can be caused and/or exacerbated by traumatic life events or an ongoing lifestyle causing chronic stress [see neurohacking tutorials].

Symptoms

They may include both the physiological and psychological, including [psychological]: a sense of foreboding, being on edge and unable to relax, impaired concentration, repetitive worrying thoughts, disturbed sleep, nightmares and depression; [physiological]: headaches, abdominal cramps, diarhoea, vomiting, frequent passing of urine, sweating, flushing and tremor, a feeling  of something stuck in the throat. During a panic attack sufferers may experience shortness of breath, sweating, trembling and nausea, palpitations, dizziness and fainting, fear of choking, and a sense of unreality or surreality and fears about loss of sanity.

Panic attacks may be due to a related disorder such as attention-seeking due to insecurity, although the sufferer may be unaware of this.

What Might Be Done?

Relaxation exercises and yoga or martial arts can help reduce anxiety. Your diet should be reviewed and ‘fast food’ and processed foods eliminated as much as possible. Make sure you are getting enough sleep, that you go to bed when you are tired and wake up naturally; before the alarm goes off. Don’t go to excess with any intoxicants or stimulants, including caffeine, and lay off sugar and salt.

If the problem remains, and you are unaware of the cause, counselling or behavior therapy can help [although there’s enough in these files for you to find out everything you need to know]. Again, prevention is better than cure. Consult the neurohacking tutorials for further information.

If your anxiety has a known cause, for example bereavement or trauma, drugs may assist you to cope [see drugs section], but should not become a habit.

Quick Hack for a Panic Attack

The rapid breathing in a panic attack causes dizziness and fainting due to hyperventilation. Breathing in and out with a paper bag over your mouth and nose will help. Do ten breaths in and out with the bag, then breathe normally without the bag for 15 seconds. Continue until you no longer need to breathe rapidly. If you’re a diver or an astronaut, you’ll have been taught in your training that in a panicattack you should turn off the oxygen supply for ten breaths and back on again for a count of fifteen…and so on. -You/they are effectively inside the bag, see?

What Is the Prognosis?

In most cases, the sooner that anxiety is addressed, the better the chances of recovery. Without treatment, an anxiety disorder may develop into a lifelong condition and significantly increase your chances of further mental problems such as dementia and schizophrenia.

Phobias

AGLG

• Most commonly develop from late childhood to early adulthood
• Gender risk factors depend on the type
• Lifestyle is a relevant factor, sometimes because of past trauma
• Genetic factors depend on the type

Persistent and irrational fears of, and compelling desire to avoid, certain situations, activities or objects. Popular phobias are of the dark, heights, insects, blood, and enclosed spaces, but anything is a possible candidate. [People have had morbid fears of things as diverse as sex, mysticism, peas, sticking plasters, cotton wool, poetry, air travel and sausages.] Being exposed to the object of the phobia causes a panic attack.

Phobias take many different forms, but they can be broadly divided into simple and complex phobias.

Simple phobias are specific to a particular object, situation or activity, such as a fear of spiders, heights, or air travel.

Complex phobias have a number of more complicated fears, for example, people who have an overwhelming fear of embarrassing themselves or of being humiliated in public may also have sociophobia, claustrophobia and acute shyness.

What Are the Causes?

Sometimes a single phobia can be traced to a past traumatic experience, and is a lingering symptom of PTSD. Simple phobias can also be familial, i.e., they can be copied from adults by children. This is a big problem when an adult thinks their phobia is ‘normal’, for example with the attitude: “Everybody’s afraid of the dark; it’s natural”.

Often though there is no reasonable explanation for the phobia. This may be due to repressed memories of trauma or confabulation due to attention seeking or other dysfunction.

Phobias may develop from a general tendency to be anxious, or after an initial panic attack. A person who is lacking in self esteem generally is more likely to develop phobias.

Symptoms

Exposure to or sometimes even thinking about the object, creature or situation that generates the phobia leads to intense anxiety, possibly  accompanied by dizziness and feeling faint, palpitations, sweating and trembling, nausea and/or shortness of breath.

What Might Be Done?

If you have a phobia, you should sort it out asap. Behavior and desensitisation therapies can help.

What Is the Prognosis?

Simple phobias tend to resolve themselves as the person gets older. Some people use alcohol or drugs to relieve the fear.

Complex phobias tend to persist unless they are treated. Yet more than 90% of treated cases experience no further problems when treated.

PTSD [Post Traumatic Stress Disorder]

AGLG

• Most common in children and elderly people
• Gender not significant
• Lifestyle a risk factor; witnessing trauma can cause PTSD. Persons in emergency services, in the military or medicine may experience more than their fair share of trauma.
• Genetics not relevant

A prolonged emotional response to an extreme experience.

What Are the Causes?

It occurs when a person is involved in or witnesses traumatic events that trigger persistent intense emotions for some time afterwards, for example rape, natural disasters, accidents, being attacked, or the horrors of warfare or disease.

A history of anxiety disorders predispose a person to PTSD.

Symptoms

They boccur either soon after the event or develop weeks, months, or rarely years later. They may include: Involuntary thoughts about and repeated reliving of the experience, daytime flashbacks of the event, panic attacks with shortness of breath and fainting, denial [frantic avoidance of reminders of the event and refusal to discuss it], sleep disturbances and nightmares, poor concentration and irritability. People with PTSD often feel emotionally ‘numb’, detached from events, and estranged from family and friends. They may lose interest in everyday activities. Depression and anxiety disorders may coexist with PTSD. Occasionally, the disorder leads to alcoholism or drug abuse due to self-medication.

What Might Be Done?

Counselling may help. Drugs may be used together with counselling [see drugs section]. This approach is usually effective after about 8 weeks, although drugs may need to be used for up to a year.

If symptoms persist and become disabling, people may consider erasing the memory, not of the traumatic event itself but the memory of their emotional response to it. The result is that the event is recalled as though it were a movie or it happened to someone else, although the person is fully aware of the reality of the situation. Memory wiping uses a combination of counselling and drugs [see drugs section].

What Is the Prognosis?

If you are determined to sort it out, extremely good. Usually, symptoms disappear within a few months of treatment with drugs and counselling, although some symptoms may persist for years.

Once a person has experienced PTSD, there is an increasing likelihood of it recurring if they experience another traumatic event.

For cases not responding to treatment, memory-wiping is not currently legal in most countries [2006] although the technique has been used in clinical trials on war veterans [with informed consent] and has so far proved very successful.

Obsessive-Compulsive Disorder [OCD]

AGLG

• Usually develops in adolescence
• Gender is not a significant factor
• Anxiety is a risk factor
• Sometimes runs in families

Uncontrollable thoughts that are often accompanied by irresistible urges to carry out acts or rituals to relieve anxiety, for example an act such as checking that keys are in the pocket is carried out again and again. The affected person does not want to perform these actions but feels driven to do so. Obsessive thoughts may be concerns about hygiene, personal safety, or security of possessions. Alternatively, there may be violent and/or obscene thoughts that are completely out of character. Common compulsions are: hand washing, checking that windows and doors are locked, and arranging objects on a surface in precise patterns. Carrying out the ritual brings short term relief, but in severe cases the ritual is performed hundreds of times a day and interferes with work and social life.

What Are the Causes?

Obsessive compulsive disorder sometimes runs in families. Traumatic events, anxiety and/or personality disorders can trigger the condition. The most common symptoms include intrusive, irrational mental images, repeated attempts to resist thoughts, and repetitive behavior. The person may be aware that the behavior is irrational and be distressed by it but cannot control the compulsions.

You should try to identify factors that make you anxious and eliminate them.

What Might Be Done?

OCD is usually easily diagnosed because the symptoms are very distinct. You may have a psychological assessment to look for factors that might have been a cause, such as a traumatic event.

Psychotherapy and drugs are available to help OCD.

What Is the Prognosis?

A combination usually offers the best chance of success. Initially, it might seem even more difficult once therapy begins, but given time it can be of great use. More than 90% of people begin to improve within a year of starting treatment. The rest have a long-term illness that fluctuates in severity, and is exacerbated by personality disorders.

Insomnia

AGLG

• More common in elderly people
• More common in females
• Anxiety and a high intake of junk foods, sugar, some drugs, food additives or stimulants are risk factors
• Genetics not a significant factor

A regular difficulty in sleeping. Problems include difficulty in falling asleep and waking during the night and being unable to get back to sleep. Insomnia may lead to excessive tiredness and a general inability to cope.

What Are the Causes?

Sleep problems usually start when a person is worried and anxious. A high intake of any of the factors listed above may be a cause. Jet lag is a classic cause and should be avoided [see neurohacking tutorials]. A confused sleeping pattern because of parties or shiftwork can cause insomnia, as can being hungry, thirsty or cold. Insomnia can be a side effect of some drugs and illnesses, such as Ritalin [see drugs section], asthma or hyperthyroidism. Anxiety disorders and other mental health problems may be responsible.

What Might Be Done?

You should first treat any physical or mental problems that could be causing your insomnia, for example, depression. If there is no obvious cause, you may wish to be assessed during your sleep by an assistant or at a professional sleep clinic. Tests often show that many people sleep more hours than they think they do but wake frequently. If this is the case, you may wish to view a recording of your brainwave patterns in order to make sure you are getting enough quality dream time.

It may be necessary to change your lifestyle, such as taking more exercise or cutting out stimulants. Obviously you are advised to cut out daytime naps.

‘Sleeping pills’ are a really bad idea, but can be used as a last resort for a short time. They should not be used long term because they are strongly addictive and they prevent REM sleep, causing loss of memory and confusion.

Depression

AGLG

• More common from age 28 onwards, although teenage and childhood depression in on the increase.
• More common in females
• Anxiety, apathy, depressing input and diet are risk factors, and lifestyle in general is important, especially social isolation or indifference. Drug abuse or coming down from drugs including alcohol can cause temporary depression
• Sometimes runs in families

Feelings of hopelessness and sadness or despondency, often accompanied by a loss of interest in life and reduced energy. Sadness is a normal emotion in times of adversity or personal misfortune, such as bereavement, but when feelings of unhappiness intensify and last for a considerable time, depression can result.

What Are the Causes?

Depression can develop when a person has to face one or more traumatic life events. The trigger is often some form of loss, such as the breakdown of a personal relationship or a death in the family. A traumatic event early in life can increase the susceptibility to depression later on.

Several physical illnesses can also cause depression, as can disablement and mental health disorders.

Depression can also be a side effect of some medications.

It sometimes runs in families and there may be an inherited tendency.

Symptoms

A feeling of sadness or misery that is worse in the mornings and lasts for most of the day. It may or may not be accompanied by: loss of interest in and enjoyment of work and leisure activities, diminished energy levels, poor concentration, reduced self esteem, feelings of guilt, tearfulness, inability to make decisions, early waking and insomnia, loss of hope for the future, recurrent thoughts of death, weight loss or increase in weight, and decreased sex drive.

There may be associated physical problems, such as tiredness, constipation or headaches.

Depression may alternate with periods of euphoria in ‘manic depression’ [bipolar disorder].

Severely depressed people may see or hear things that are not there, and irrational delusions may occur, usually of a paranoid nature such as the person suspects they are being followed, hacked, bugged, or sent secret messages.

What Might Be Done?

Deliberately altering and organizing your own life habits can be useful. Make a list of what you have to do each day, beginning with the most important, which should be ‘look after myself’. Tackle one task at a time, and reflect on what matters and what doesn’t. Set aside a few minutes each day to relax and do a relaxing exercise, like stretching or yoga. Meditation can be helpful to steady the mood and calm the mind. Physical exercise itself can lift depression and alter your chemistry, but you should not overdo it and exhaust yourself. Make sure you eat a healthy diet; junk foods and processed foods are bad news for brain and body chemistry. Make sure you get enough sleep.

Taking up something new is a very good idea to get your brain back into gear. Make it something you enjoy doing rather than a ‘work’ task. Meeting new people is also a good move, so consider joining a group or club in the areas of your interest, online or IRL [In Real Life].

Too much depressing input is bad news at any time, and if you are depressed you should avoid indulging in depressing news on television, in newspapers and online. Let the world get on with its problems for a short time, while you get on with sorting out your own.

Martial arts, dancing or meditation have helped some people.

Laughing is very good for depression; if you have favorite comedy movies etc now is the time to indulge yourself. You should go out of your way to do things that make you laugh. [See neurohacking tutorials].

If the depression remains, you may arrange for blood tests to make sure that your low energy levels and mood are not caused by a physical illness. You may wish to take a psychological assessment to see if there may be other mental health problems causing or contributing to the depression.

There are many drugs for depression [see drugs section] and therapy is very successful for many people. Drugs though can have nasty side effects and you should choose your medication very carefully. Addiction is a problem, especially with things such as alcohol or stimulants. Drugs for depression can also take a long time to begin having an effect, giving you the impression that they are not working, so an understanding of how they do work can be helpful [see drugs section].

Technology may be used for depression; there have been promising results from TMS, NMS and CES [see technology section].

What Is the Prognosis?

If depression is mild, symptoms may disappear completely if you are given help and support by those close to you. Depression can almost always be treated successfully, and you should not put off seeking help if you continue to feel low.

Drugs are effective at treating 3 out of 4 cases of depression. When drugs and therapy are used in combination, depression can usually be relieved completely within 2 to 3 months.

There is a possibility of recurrence with no obvious trigger.

Left untreated, depression can delay recovery from a physical illness and intensify pain whatever the cause. A person who is depressed for a long time may contemplate suicide.

Bipolar Affective Disorder

AGLG

• Usually develops in the early 20s
• Gender not a significant factor
• Lifestyle is important. Social isolation, poor diet, depressing input and anxiety are risk factors.
• Sometimes runs in families

Bipolar disorder is also known as ‘Manic Depression’. Episodes of elation and abnormally high activity levels [mania] alternate with episodes of low mood and abnormally low energy levels [depression].

What Are the Causes?

There is a genetic factor. Episodes are sometimes brought on in response to a major life event, such as marital break up or bereavement. A case of depression can become bipolar disorder, and this may be an attempt at homeostasis; the brain attempting to reverse an imbalance of neurochemicals and going too far in the opposite direction! [see drugs & chemicals section].

Symptoms

Tend to alternate, each episode lasting for an unpredictable length of time. Between periods of mania and depression, mood and behavior are generally normal. Occasionally, a bout of mania may be followed immediately by depression. Sometimes, one or the other predominates so that it is difficult to diagnose.

During a manic episode, you may experience any of the following: Elated, expansive or sometimes irritable mood, inflated self esteem, which may lead to delusions of great wealth, accomplishment, creativity or power. Increased energy levels and decreased need for sleep, distraction and poor concentration, loss of social inhibitions, unrestrained sexual behavior, spending large sums of money on luxuries or travel. Speech may be difficult to follow because the person tends to speak rapidly and change topic frequently. At times, s/he may be aggressive or violent and may neglect personal hygiene. In severe cases there may be auditory or visual hallucinations and it can be difficult to distinguish from schizophrenia. Sufferers may lack insight into their condition and refuse to believe that they are ill.

During an episode of depression, you may experience any of the following: feeling generally low, loss of interest and/or enjoyment, diminished energy level, reduced self esteem, loss of hope for the future.

What Might Be Done?

Treatment will depend on whether the person is in the manic or depressive phase. For the depressive phase drugs are often prescribed [see drugs section] but their effects have to be monitored to ensure that they do not precipitate a manic phase. Drugs are also available for the manic phase.

Some people prefer to be admitted to hospital or a clinic until the problem is brought under control. Emotions felt during the ‘manic’ phase can be very pleasurable and people tend to be reluctant to take the medication which they say makes them feel ‘flat’ emotionally.

What Is the Prognosis?

Recurrences are common [more than 50% of sufferers have a repeat episode], so initial treatments may be replaced with mood-stabilising drugs on a long term basis [see drugs section].

Once symptoms are under control, a person will need regular checkups to look for signs of mood changes. Some forms of therapy are useful in helping to come to terms with the disorder and reduce anxiety levels, and factors in the lifestyle that may contribute to them.

Discipline is necessary, but when awareness is applied there is no reason why there should not be a complete recovery.

Schizophrenia

AGLG

• Usually develops in males between ages of 18 and 25. Usually develops in females between ages of 26 to 45. Adolescent and childhood schizophrenia are on a rapid increase.
• Gender is not a significant factor.
• Anxiety and traumatic life events are a risk factor. Complications during the sufferer’s mother’s pregnancy and birth, especially viral infection of mother during pregnancy is a factor [more likely if the sufferer was carried or born in winter, and in an urban environment, and especially if the family kept pets]. Oxygen deprivation at birth is a risk factor [more common if the mother gave birth in hospital under anesthetics]. Nutrition, from the fetal stage up, plays a role.
• Sometimes runs in families, but may be familial as well as genetic [traumatic events taking place that affect all members of the same family, such as abuse, or bad feeding habits]

A severe and disrupting mental illness, schizophrenia DOES NOT MEAN ‘SPLIT PERSONALITY’. This mistake is a hangover of wrong diagnosis because before we could see the difference with MRI,  ‘Multiple Personality Disorder’[MPD; now called 'Dissociative Identity Disorder] used to be mistaken for schizophrenia.

Schizophrenia is actually an impairment of a person’s perception of reality that leads to irrational behavior and disturbed emotional reactions. It difficult for a person to tell the difference between real and unreal experiences, to think logically, to have normal emotional responses to others, and to behave normally in social situations.

What Are the Causes?

There appears to be no single cause, but a combination of factors all contribute to its development. A genetic factor is suspected, but familial and environmental factors also play a big role. There is a noticeable excess of schizophrenia sufferers born in the winter, and a significant excess in urban areas as opposed to rural. There is some evidence that childhood exposure to pets increases the risk, and all this ties together when you know that viral infections can predispose a person to the disease. Particularly, infection of the mother during pregnancy or infection as a child. Herpes, rubella and influenza viruses are all implicated.

The way that you were born can increase or decrease your predisposition to schizophrenia. Those born in hospital are at a higher risk, but only if the mother was on anesthetics and/or the umbilical cord was cut too quickly, resulting in ‘minor’ oxygen deprivation. Anyone who needed ‘resuscitation’ at birth its at a higher risk.

Those on a bad [non-nutritional] diet are at a higher risk. Astonishingly, those who smoke tobacco are at a lower risk! [This tells us something rather interesting about the nature of tobacco and its effect on the mind –see drugs section]. Factors such as abuse in childhood also put you at risk.

From all the factors involved, if you have all the information, you can compute your likelihood of ever suffering schizophrenia.

Different types

There are 5 recognized types of schizophrenia: catatonic, paranoid, disorganized, undifferentiated, and residual. Features of schizophrenia include its typical onset before the age of 45, continuous presence of symptoms for 6 months or more, and deterioration from a prior level of social and occupational functioning.

Symptoms: People with schizophrenia may show a variety of symptoms. Usually the illness develops slowly over months or even years. At first, the symptoms may not be noticed. For example, people may feel tense, may have trouble sleeping, or have trouble concentrating. They become isolated and withdrawn, and they do not make or keep friends. As the illness progresses, psychotic symptoms develop:

• Delusions - false beliefs or thoughts with no basis in reality
• Hallucinations - hearing, seeing, or feeling things that are not there
• Disordered thinking - thoughts "jump" between completely unrelated topics (the person may talk nonsense)
• Catatonic behavior - bizarre motor behavior marked by a decrease in reactivity to the environment, or hyperactivity that is unrelated to stimulus
• Flat affect - an appearance or mood that shows no emotion

Symptoms

Catatonic type

• Motor disturbances
• Stupor
• Negativism
• Rigidity
• Agitation
• Inability to take care of personal needs
• Decreased sensitivity to painful stimulus

Paranoid type

• Delusional thoughts of persecution or of a grandiose nature
• Anxiety
• Anger
• Violence
• Argumentativeness

Disorganized type

• Incoherence (not understandable)
• Regressive behavior
• Flat affect
• Delusions
• Hallucinations
• Inappropriate laughter
• Repetitive mannerisms
• Social withdrawal

Undifferentiated type

Patient may have symptoms of more than one subtype of schizophrenia.

Residual type

Prominent symptoms of the illness have abated, but some features - such as hallucinations and flat affect - may remain. 

What Might Be Done?

If schizophrenia is suspected, it is wise to admit the person to hospital or a clinic for further assessment and to begin treatment asap. You may have blood or urine tests to exclude other possibilities, and you may have CAT scans or MRI investigation for the same reason.

Because other diseases can also cause symptoms of psychosis, psychiatrists should make the final diagnosis. The diagnosis is made based on a thorough psychiatric interview of the person and family members. As yet, there are no single defining medical tests for schizophrenia. The following factors may suggest a schizophrenia diagnosis, but do not confirm it:

• Developmental background
• Genetic, family and birth history
• Changes from level of functioning prior to illness
• Course of illness and duration of symptoms
• Response to pharmacological therapy

Drugs are available for schizophrenia [see drugs section]. Older drugs are cheaper but may cause unpleasant side effects, so make sure of what medication is used. Treatment with adjusted doses of drugs usually continues after the symptoms subside.

It’s essential to have a calm and supportive environment, as any further episodes of unpleasantness may exacerbate symptoms.

Supportive and problem-focused forms of psychotherapy may be helpful for many individuals. Behavioral techniques, such as social skills training, can be used in a therapeutic setting, or in the patient's natural environment to promote social and occupational functioning.

What Is the Prognosis?

For most affected people, schizophrenia is a long-term illness. About 20% of cases are just ‘one-offs’, from which people recover completely and return to normal life.

While some patients become chronic sufferers, in and out of hospital and care all their lives, others recover completely and live more or less normal lives. Those diagnosed and treated early have a higher chance of successful recovery.

Without proper support and treatment, sufferers are likely to harm themselves or possibly others. The outlook is worst for people who develop schizophrenia gradually while they are young.

Noncompliance with medication will frequently lead to a relapse of symptoms.

Physical illness occurs at high rates among people with schizophrenia due to psychiatric treatment itself (side effects from medication) and living conditions associated with chronic disability. These may go undetected because of poor access to medical care and because of difficulties communicating with health care providers.

Persons with schizophrenia have a high risk of developing a coexisting substance abuse problem, and use of alcohol or other drugs increases the risk of relapse.

Delusional Disorders [Paranoid Delusions]

AGLG

• More common over the age of 40
• More common in females
• Anxiety is a risk factor
• Genetics not a significant factor.

The development of one or more persistent delusions of persecution or jealousy. Delusional disorders cause irrational beliefs such as are held in schizophrenia, but the sufferer shows no other symptom of schizophrenia itself. The person appears well, and work, etc are not affected.

Their beliefs will persist despite any rational evidence to the contrary, and usually centre around ideas such as a they are being spied on, hunted or persecuted in some way, or they can take the form of extreme jealousy because of the paranoid fear of ‘losing’ a partner or loved one. Extreme possessiveness may result. Another manifestation of this disorder is fearing abduction by aliens [not at all the same thing as believing yourself to have been already abducted, or as it actually having happened].

What Are the Causes?

Major life events involving the ‘unknown’, such as moving to another country or experiencing sweeping changes in economy, or any situation where a person feels ‘out of their depth’ seems to be a trigger. Alcohol abuse is a trigger, as is abuse of some drugs [see drugs section]. Emotional rejection is a risk factor, as is ongoing anxiety. Some illnesses can induce paranoia, and an event such as becoming disabled or being fired unexpectedly can bring it on, as can being a victim of physical violence, especially as a child. Delusional disorders usually develop suddenly.

What Might Be Done?

Communication and discrimination are important here! People with a delusional disorder are usually suspicious or dismissive of others who are trying to help them, but also, quite incredible things can actually happen to people and be blamed on delusional behavior. Retired CIA members and spies are often brought to the attention of doctors by their friends, who think they are paranoid, and we must consider the possibilty that they are merely better informed than the rest of us and that paranoia can in fact be a job-related state of mind or even a work skill  :  )

If the probability of delusion is high, tests may be done to ascertain that there are no signs of schizophrenia. Attempts may be made to find out how firmly held or ‘fixed’ any delusions are and whether the person is likely to act on them. If there is a risk of violence or self harm, the person may need to be admitted to a hospital. Delusions of jealousy may pose a risk of violence towards a partner or friend.

Drugs are available to reduce symptoms [see drugs section].

Counselling may help to bring about a shift in perspective.

Alcohol and large quantities of recreational drugs should be avoided at all costs.

What Is the Prognosis?

Generally, delusional disorders tend to persist but without being severe enough to cause disruption, although delusions of jealousy can make it very difficult to form relationships.

Attacking the underlying anxiety may be the only way to reverse the problem [see neurohacking tutorials].

Personality Disorders

AGLG

• Develop in adolescence or early childhood
• Gender risk factors depend on the type
• Lifestyle risk factors depend on the type
• Genetic risk factors depend on the type

A group of disorders in which habitual patterns of thought and behavior cause persistent life problems. An affected person often fails to see that his or her personality is unusual and may or may not be aware that it is causing problems in everyday life.

Personality disorders can develop at any time of life due to injury, disease, decline, trauma, genetic problems or harmful epigenetic changes including those caused by anxiety.

Personality disorders are divided into three broad groups as follows:

A Sentimental or erratic (Can be antisocial (bully extro); histrionic (wimp extro); narcissistic; or ‘borderline’)

B Eccentric or odd (paranoid; pronoid; schizoid; or schizotypal)

C Anxious or fearful (may manifest as ‘Avoidant’ (wimp intro); Passive-aggressive (bully intro); Obsessive-compulsive; or Dependent)

Note that the descriptions for disorders focus on the type of problematic behavior they cause; they are NOT implying there is a particular 'type of person' who gets personality disorders. Thus we are not looking for an 'antisocial person', we are looking for behavioral symptoms of an underlying mental condition which is impairing perception & awareness and undermining our personality; as we are not able to express ourselves genuinely when they affect us. We are, in effect, 'not ourselves'. Everyone finds their perception and awareness impaired momentarily from time to time; it happens most days, and certainly most weeks, to all of us. We also enjoy impairing our own perception and awareness regularly with alcohol and a variety of other stuff. None of this indicates a personality disorder.

Where a disorder IS present, we find our perception and awareness warped against our will (and often without our knowledge) for long periods of time; much as it is in hypothermia, heatstroke or concussion. If there is a clear cause; such as shock, injury or trauma, disturbances in personality will most likely be temporary, but as personality disorders can be indicative of more serious problems (such as tumors or dementia), it is always wise to investigate and deal with them promptly. Also, the more time a problem has to become habitual or 'chronic', the longer it can take to shift it.

Below is a brief description of the types of symptomatic behavior (remember, they only indicate a problem if they are frequently or permanently present). Because behavior functions in sync with neurochemistry, we have included some possible 'tell-tale' neurotransmission issues with each description, which could indicate remedial NH measures. We should NOT however attempt to self-diagnose these disorders; that would be a bit like trying to understand that we have hypothermia while suffering from hypothermia! Sometimes we really do need a 'second opinion' and it is wise to seek one from those who know a lot about the neurochemistry involved.

Sentimental or Erratic

Can be antisocial, histrionic, narcissistic or ‘borderline’

antisocial

Antisocial behavior is typically bully-extro, impulsive, destructive behavior that often disregards the emotions and rights of others. A person with this disorder shows arrogance and they cannot tolerate frustration. They cannot wait for anything. They may have problems with relationships or trouble with the law. GABA, Oxytocin and/or acetylcholine deficiency can be a factor.

histrionic

histrionic (wimp extro) behavior expresses sentiments that are exaggerated and shallow. People with this disorder become self-centred, inconsiderate, easily bored, and constantly demand reassurance or approval. Can occur with hypochondriasis. Serotonin and/or oxytocin deficiency can be a factor.

narcissistic

narcissistic behavior occurs when someone believes themselves to be more than unique; such as genius, special, and inherently superior to others. They constantly seek attention and admiration and lack any concern for the problems of others or any interest in others' lives.

‘borderline’

‘borderline’ behavior presents as multiple abnormalities that may include an uncertainty about our personal identity, poor self esteem and an inability to form stable relationships. People who have this disorder feel habitually bored, may have anhedonia, and may indulge in excess promiscuity, excess hedonism, and/or excess substance abuse. They may also harm themselves or threaten suicide. Serotonin and/or dopamine deficiency can be a factor.

Eccentric or Odd

This may be behavior than is paranoid, schizoid, or schizotypal. What’s the difference?

paranoid

paranoid behavior tends to be mistrustful, jealous and self-important. Someone with this disorder readily interprets other people’s actions as hostile and they may feel continually rebuffed and convinced that others are (a) deeply interested in them and (b) hostile. Can occur with hypochondriasis. GABA, Serotonin and/or oxytocin deficiency can be a factor.

Pronoid

pronoid behavior tends to be narcissistic, arrogant, naïve, self-deluding and self-important. Someone with this disorder interprets other people’s actions as servile and they may feel everyone likes them, fancies them, loves them, is interested in them, and thinks they are as wonderful as they do. Dopamine, acetylcholine and/or oxytocin deficiency can be a factor.

Schizoid

schizoid behavior is emotionally cold and indifferent to others. People with this disorder tend to be prone to fantasy, resent being disturbed and are ill at ease in company. Note the name of this disorder is NOT related to schizophrenia. Oxytocin and/or dopamine deficiency can be a factor.

schizotypal

schizotypal behaviors display as superstitious and suspicious, are often accompanied by odd ideas, such as a belief in supernatural forces or mystical/magical beings or powers. People with this disorder may lose the ability of self care, have an unhygienic or unkempt appearance and/or vague, abstract speech patterns and/or may talk to themselves. Hallucinations may or may not be present. Serotonin, acetylcholine and/or oxytocin deficiency can be a factor.

Anxious or Fearful

May be avoidant, passive-aggressive, obsessive-compulsive, or dependent.

‘Avoidant’

‘avoidant’ behavior is wimp-intro; timid, shy, oversensitive to rejection, and nervous of new experiences or responsibilities. Those with this disorder are generally ill at ease in social situations. Oxytocin and/or dopamine deficiency can be a factor.

Passive-aggressive

Passive-aggressive (wimp extro) behavior causes people with this disorder to react to any demands made on them by being stubborn or argumentative. They put off tasks and are deliberately innefficient and critical of people in authority. Acetylcholine and/or oxytocin deficiency can be a factor.

Obsessive-compulsive

obsessive-compulsive behavior is marked by a continual striving for perfection that disregards both our own wellbeing and the emotions of other people. Generally people with this disorder become judgemental, inflexible, and narrow-minded. Somatic symptoms are repetitive and can include hand washing, checking and rechecking, or hoarding. Can occur with hypochondriasis and/or kleptomania. Serotonin and/or oxytocin deficiency can be a factor.

Dependent

dependent behavior is also wimp-intro, and shows as weak-willed and submissive, those with this disorder considering themselves ‘victims’. They appear helpless, lack self-reliance, and leave all decisions to other people. Can occur with hypochondriasis. Glutamate, Dopamine deficiencies and/or low PFC neurotransmission in general can be a factor.

What Are the Causes?

There may be genetic factors in the tendency to any of these extremes, but the only common factor is anxiety.

What Might Be Done?

A person with a personality disorder is generally unaware that there is anything ‘wrong’. The person’s behavior should be assessed, and how it affects others. You should then look for provoking factors, such as possible alcohol abuse or the presence of another disorder.

Therapy is the usual course of action, although drugs might be used to control the symptoms [see drugs section].

What Is the Prognosis?

If treated, excellent, but the underlying anxiety must be addressed. See the advice for those suffering from depression for an idea of how lifestyle may have to be changed. Generally, a personality disorder tends to improve as people grow older, but if it becomes more severe it can predispose you to other mental illness, so always pay attention to it.

Addiction

AGLG

• Most common between adolescence and age 40
• More common in males
• Anxiety, social factors and peer pressure are risk factors.
• Predisposition  may run in families

Addiction is the excessive and compulsive use of anything for its effects on mental state. Often, increasing quantities of a substance or increasing time spent in an activity are needed to produce the same effect, and physical symptoms may appear if the activity or substance is stopped.

People can become addicted to alcohol, drugs [including medications], physical exercise, sugar, gambling, television and even stealing [kleptomania].

What Are the Causes?

Initially, a pursuit may be followed for either a psychological ‘high’ or relief from anxiety. Occasionally addiction will begin through seeking pain relief, or doing something because of trying to conform with peers. Anxious people are much more susceptible, as are those with personality disorders. The risk of dependence depends on what the pursuit is and the nature of the person doing it. Sugar, heroin, tobacco and caffeine are strongly addictive regardless of the personality. Alcohol, television, chocolate and gambling are only addictive to certain personalities.

Anxiety is a large risk factor, as is social isolation or peer pressure.

Symptoms of Addiction to Something

• Mood changes or swings when not performing the activity/taking the substance
• Impatience to get back to it or frustration when you cannot have access to it
• Physical symptoms when the object of addiction is denied
• Neglect of relationships or work in favor of the pursuit
• Committing crime to pay for the pursuit [if you would not have committed crime previously]
• Getting into enormous debt to pay for the pursuit
• Feeling or believing that you could not live without the activity or substance
• Loss of awareness and control of how much time you spend doing the pursuit
• Violence or aggression towards those who criticise the excess or suggest that you should stop doing it
• Needing to do or take the thing more and more to get the same effects

If you notice these signs appearing in your life related to anything, you should consider the possibility that you may be addicted. Remember, it doesn’t have to be a drug. You can become addicted to almost anything!

Doing or taking anything for a long time for medication purposes does not mean that you are addicted. There is a difference between doing something a lot and not being able to stop doing it without severe distress.

What Might Be Done?

People may not accept that there is a problem until things get pretty severe. An assessment can reveal any underlying disorders such as anxiety or depression.

Drugs are available to help with some addictions, notably food, tobacco alcohol or opiates [see drugs section]. Therapy has a high rate of success, especially if there is social support. There are special clinics to assist compulsive gamblers and alcohol abusers.

It is best to replace an addiction, rather than just remove it, because it is highly likely that either re-addiction will recur, or the person will become addicted to something else. Something must be found to replace the bad habit with a good one, and the underlying anxiety treated to reduce the likelihood of re-addiction, and it must be something healthier than the original addiction. It’s no use giving up smoking and taking up eating vast quantities of candy or alcohol instead! Taking up a healthy new interest is of great help in breaking bad habits!

Autism Spectrum Disorders

AGLG

• Normally apparent from birth or before the age of 3
• More common in males
• Lifestyle is a significant factor
• Sometimes runs in families, but may be familial as well as genetic.

Severely impaired development of empathy, communication and social skills.

There are various forms of autism and affected people have a wide range of symptoms. In general, there is a failure to develop communication skills, inability to form social relationships, and a marked need to follow routines.

Most autistic people have generalised learning disabilities, but in the form known as Asperger’s syndrome there may be increased intellectual or creative ability in only one or two particular areas, notably mathematics, technical drawing, or music. Intelligence in other areas is deficient, notably in empathic, social and emotional understanding.

What Are the Causes?

Physical isolation and/or sensory deprivation at or shortly after birth is a risk factor.

About 10% of people with autism have a known genetic abnormality, such as Fragile X syndrome.

Persons with autism are deficient in a particular kind of neurons in the brain called ‘mirror neurons’. These are important for our abilities to empathise and to mimic and copy, which may explain autistic persons’ difficulty with learning skills and with understanding the emotions of others. The condition may be familial in that an infant given no example of empathy or mimicking [i.e., with autistic parents] will develop deficiently in the neural nets that such experience would furnish [see neurohacking tutorials] although social contact would eliminate the problem [so social isolation could be a risk factor].

Symptoms

Absence of emotional facial expression and/or body language, failure to make eye contact, clumsiness, lack of imaginative play, repetitive behavior, such as rocking or hand clapping, obsession with specific objects or particular routines. May also include: failure to develop normal speech, severe learning difficulties. About one in three sufferers develops epilepsy. There is a possibility that sufferers may self harm. They can often be clumsy and uncoordinated in movement.

What Might Be Done?

Therapy is of use with autistic people only if they can understand that there is a problem and that it can be corrected.

Blood tests can be performed to look for genetic abnormalities.

Language and speech therapy can improve communication skills. Behavioral therapy can help to replace abnormal behaviors with more appropriate ones, and occupational therapy can help to improve physical skills.

Attempting to initiate the growth of more mirror neurons may be the most effective way to approach the problem [see neurohacking tutorials].

What Is the Prognosis?

Most people with autism spectrum disorders cannot lead independent lives and need long term care.

Some people with Aspergers syndrome achieve academic success, although they may always have poor social skills.

ADD (attention deficit disorder), aka ADHD (attention deficit hyperactivity disorder)

AGLG

• Usually develops in early childhood, between 3 and 7
• More common in males
• Lifestyle is a significant factor, notably diet, sleep and early experiences
• Often runs in families, but may be familial as well as genetic.

A behavioral disorder in which a person cannot pay attention to anything for any reasonable length of time and has difficulty attending to tasks. There may or may not be an inability to keep still or even sit down.

What Are the Causes?

Too often, difficult younger people are incorrectly labeled with ADHD when their responses are merely the natural ones to unhealthy surroundings and lifestyle. Young brains need physical action and interaction with the world in order to grow. Stuffing them with intellectual facts slows their growth, and often biology knows this. The situation is compounded by a diet filled with toxins that causes the release of chemicals affecting neurotransmission. Sufferers then handle neurotransmitters (including dopamine, serotonin, and adrenalin) differently from their peers.

There is a genetic factor involved, but behavior is strongly influenced by environmental factors such as wrong input at home/school, poor diet, not enough exercise, and sleep deprivation. There is a strong positive correlation with junk food and food additives, also with allergies.

Boredom is a risk factor, as is lack of needed input for experience as a young child [to be outdoors and moving about].

Symptoms

The Diagnostic and Statistical Manual (DSM-IV) divides the symptoms of ADHD into those of inattentiveness and those of hyperactivity/impulsivity.  

To be diagnosed with ADHD, a person should have at least 6 attention symptoms or 6 activity/impulsivity symptoms -- [in children, to a degree beyond what would be expected for children their age.]  

The symptoms must be present for at least 6 months, observable in 2 or more settings, and not caused by another problem. The symptoms must be severe enough to cause significant difficulties. Some symptoms must be present before age 7.  

Older persons who still have symptoms, but no longer meet the full definition, have ADHD in partial remission.  

Some people with ADHD primarily have the Inattentive Type, some the Hyperactive-Impulsive Type, and some the Combined Type. Those with the Inattentive type are less disruptive and are easier to miss being diagnosed with ADHD.

Inattention symptoms

1. Fails to give close attention to details or makes careless mistakes
2. Difficulty sustaining attention in tasks or play
3. Does not seem to listen when spoken to directly
4. Does not follow through on instructions and fails to finish tasks or projects
5. Difficulty organizing tasks and activities
6. Avoids or dislikes tasks that require sustained mental effort (such as story comprehension)
7. Often loses toys, assignments, pens, books, or tools needed for tasks or activities
8. Easily distracted
9. Often forgetful in daily activities

Hyperactivity symptoms

1. Fidgets with hands or feet or squirms in seat
2. Leaves seat when remaining seated is expected
3. Runs about or climbs in inappropriate situations
4. Difficulty getting on with things quietly
5. Often "on the go", acts as if "driven by a motor", talks excessively

Impulsivity symptoms

1. Blurts out answers before questions have been completed
2. Difficulty awaiting turn
3. Interrupts or intrudes on others (butts into conversations or games)

Overall

Inability to finish tasks, short attention span and difficulty concentrating, difficulty following instructions, tendency to talk excessively and interrupt others, difficulty waiting or taking turns, inability to entertain yourself alone, physical impulsiveness. Also may include: difficulty in forming friendships, low self esteem. Sufferers are in danger of constant criticism if others fail to see that there is a problem.

What Might Be Done?

The diagnosis is based on very specific symptoms, which must be present in more than one setting. The person should have a clinical evaluation if ADHD is suspected.

Evaluation may include:

• Questionnaires for those who know the person well
• Psychological evaluation of the person AND family including IQ testing and psychological testing
• Complete developmental, mental, nutritional, physical, and psychosocial examination

The first course of action must be lifestyle changes. Every effort should be made to manage symptoms and direct the person's energy to constructive and anxiety-free paths.

• First of all, do not try to force the person to attend to anything s/he seems uncomfortable with. Get a perspective. Forget about work or school, because without health they will never do well in either. Right now health must come first.
• Set specific, appropriate target goals to change lifestyle factors.
• Medications should NOT be used just to make life easier for the parents, work or a school. Medication and/or behavior therapy should be started only if lifestyle changes fail to give any results after one month.
• Children who are removed from school into home learning and who are allowed to play a lot, especially out of doors, often do the best. Limit distractions in the sufferer's environment [e.g., television or radio]
• Provide constant companionship for learning at home.
• Make sure the child gets enough sleep.
• Make sure the child gets a healthy, varied diet, with plenty of fruit, vegetables and no processed or junk food
• Make sure the sufferer gets outdoors, preferably into natural surroundings. Gardens are ideal, [and gardening is an excellent pursuit for older people with ADD]
• Read the sufferer stories that s/he is interested in. This is a very fast way to improve attention skills.
• Computer games can assist some persons to concentrate, however they are more useful to older sufferers

When lifestyle changes have not caused any improvement, evaluate the original diagnosis, the possible presence of other conditions, and how well the lifestyle change plan has been implemented before considering drugs and therapy.

Systematic reviews during treatment are important to regularly reassess target goals, results, and any side effects of medications. Information should be gathered from people who know the person well, and the person themselves.

There are now several different classes of ADHD medications that may be used alone or in combination. [see drugs section].

Behavioral therapy can improve responses. Techniques that induce calm such as martial arts or meditation or yoga, can help adolescents and those older to improve their attention and concentration skills. Alternative remedies have become quite popular, including herbs, supplements, and chiropractic manipulation. However, there is little or no solid evidence for many remedies marketed to parents so far [2006] with the exception of fish oil [omega 3]  and liquid multivitamins.

What Is the Prognosis?

In most affected children, the disorder continues into adolescence, although the behavioral problems may become less severe in older children. A small proportion of sufferers get worse, becoming anti social and violent.

A great deal of effort must be addressed to the problem if success is to be the outcome. Major lifestyle changes may be necessary and the discipline to carry them through. With enough effort, the disorder can show much improvement.