Health related information and news from around the world. » Anti Depressants-Sleeping Aid

HOW TO DIAGNOSE BDD IN CHILDREN AND ADOLESCENTS: BDDQ

admin — Mon, 04 Jul 2011 17:59:09 +0000

Someone who appears to have BDD based on his or her answers on the BDDQ should then be asked questions from the adolescent version of the BDD Module to determine whether BDD is really present (see Appendix C). Because it’s common for adolescents to think a lot about their appearance, it’s important to be sure the adolescent is thinking in a negative way about a minimal or nonexistent appearance defect. It may also be helpful to put greater emphasis on impairment in functioning when diagnosing BDD in adolescents, to be sure that the appearance concerns truly are problematic and not just normal concerns.Kristin’s, Eric’s, and Holly’s concerns were clearly excessive and characteristic of BDD. Kristin avoided social interactions and dating, and she failed some of her courses and dropped out of school. Her suicide attempt and hospitalization were painfully clear signs that what she was experiencing wasn’t just “normal adolescence” or something she’d “grow out of.” Early on, Eric’s grades dropped, and he became anxious and depressed. While these signs weren’t dramatic, they signaled that something problematic and serious was occurring—that he wasn’t just “going through a phase” or having normal adolescent difficulties. When he dropped out of school and stopped playing soccer, it became crystal clear that his concerns were a serious problem. While Holly’s case was milder, the fact that she worried about her appearance for several hours a day and avoided friends signaled the presence of BDD.All three adolescents also had some typical BDD behaviors—mirror checking, camouflaging, reassurance seeking, and excessive grooming. These behaviors provided additional clues to the disorder’s presence.It’s equally important to be aware that BDD can easily be underdiagnosed in adolescents. In fact, in my experience this error is far more common than overdiagnosing BDD. To avoid underdiagnosing BDD in children and adolescents, it’s important to be aware that they may minimize BDD symptoms because they’re embarrassed by their concerns and reluctant to reveal them. Holly felt that she was selfish and shallow because she was so focused on how she looked, and she was very reluctant to tell anyone about her worries. While adults also have these feelings, secrecy may be particularly common during the teenage years because adolescents may hesitate to confide in and trust adults. Often, adolescents must develop a trusting relationship with an adult before they’re willing to divulge their concerns. The best approach to this problem is to simply ask. When adolescents show any signs of BDD, ask them whether they have any appearance concerns. The adolescent versions of the BDDQ and BDD Module can be a useful guide. The most important thing is to not consider such concerns a normal phase of development that will simply pass. It’s also important not to tease or criticise the adolescent because of their concerns. BDD is a serious disorder that needs to be treated.*160\204\8*

THE POLITICS AND ECONOMICS OF ST JOHN’S WORT: AWAITING FURTHER RESEARCH

admin — Wed, 29 Apr 2009 08:44:05 +0000

Should we reserve judgement about the effectiveness of St John’s Wort pending the conclusion of the latest studies ?

There does not seem to be much merit in this argument. In the use of St John’s Wort to treat depression, the Europeans have been leaders for over 350 years. Since the publication of Commission E in Germany in the mid-1980s, St John’s Wort has been actively studied there. A high-strength preparation of Hypericum was developed in Germany and when it was tested at a dosage of 900 mg per day was found to be superior to placebo in multiple controlled studies. While each of these studies may be flawed or limited in one way or another, taken together they portray a convincing picture of an active anti-depressant. While a large US multi-centre study such as the one currently being planned under the aegis of the National Institute of Mental Health, is likely to add valuable new information to our current knowledge, it is not in my opinion a necessary step in proving the anti-depressant efficacy of the herb. In addition, if we wait several years until the results of the US multi-centre study have been analysed and presented, many depressed people who might stand to benefit from the herbal anti-depressant in the meanwhile will suffer unnecessarily. Many people have already voted with their feet and decided to go ahead and try St John’s Wort. I believe they are justified in doing so.

*41\75\2*

COMING OFF TRANQUILLIZERS: GRACE’S STORY

admin — Tue, 21 Apr 2009 05:17:21 +0000

Grace, aged sixty-seven, was prescribed Tranxene six years ago because she was ‘run down’ after nursing her husband through a long illness. She had always been a strong outward-looking woman who spent a lot of her time helping the young mothers and the elderly in her area. She saw her doctor because she was becoming increasingly confused and agoraphobic. She was given a tonic and told to rest.

Her daughter telephoned her saying that she had read an article in a woman’s magazine saying the elderly should have greatly reduced doses of tranquillizers because they cannot excrete them at the same rate as the young. Because of this, the elderly are often confused and have frequent falls. Weight is also an important factor. So often a person weighing stones is prescribed the same dose as a heavy weight of 15 stones.

Grace telephoned the Citizens’ Advice Bureau to see if there was any help in her area. After a telephone call to the support group (and to her doctor for his permission), she started slow withdrawal. She had been cutting down for six weeks when she felt her old self returning. Her family said she had lost the dead look from her eyes and her skin looked a healthier colour.

She rang the group regularly for explanation of a symptom or for reassurance. Her main problems were headaches, slight incontinence, and a feeling that her bottom was ‘not there’. The agoraphobia was much better by the time her drugs were reduced to half, although by this time she was a bit shaky outside because she felt the ground was moving when she walked.

Her positive attitude to any problem was a great help to her. She was more confident when she pushed a shopping trolley. Walking with a stick was the next step. She now walks unaided, supports others (often using humour to ease tension), and is excited about her holiday when she is taking her grandson camping.

*71\49\8*

COMING OFF TRANQUILLIZERS: RELAXATION AND VITAMIN DEFICIENCY

admin — Tue, 21 Apr 2009 05:15:29 +0000

This is not just a set of silly exercises to fill in the afternoon. Muscles that are shouting for a chemical that you have stopped taking have to be re-trained.

If you tie a tight band around your arm, what happens to your hand? You will certainly get pain, swelling, loss of movement and an altogether unhealthy hand. You are effectively doing the same to your head by tension in the neck and shoulder muscles. Decreased circulation to the head causes headaches, sinus pains, jaw pain, ear problems (including tinnitus) depression, confusion and more. Is it worth working on your neck and shoulders?

Vitamin and Mineral Deficiency

During illness or stress the body’s need for vitamins and minerals is increased. Common deficiencies are: iron, calcium, magnesium, vitamin C (particularly if you smoke) and vitamin B complex. It is advisable to have advice about which supplements you need and the length of time you should take them. For instance, many people take vitamin B6 for pre-menstrual tension not realizing that if they take one of the B vitamins in isolation they deplete their store of the other B vitamins.

*55\49\8*

WITHDRAWAL SYMPTOMS: AGORAPHOBIA

admin — Tue, 21 Apr 2009 05:13:26 +0000

This is often thought of as fear of open spaces, but it is a great deal more wide-ranging. A man who can happily drive to work may be paralysed with fear if he has to travel by public transport. Even going to the local shop can be an impossible task for the agoraphobic.

Many people suffer agoraphobic symptoms both while on, and coming off tranquillizers. These will go eventually like all the other symptoms. Even people who were agoraphobic before they took pills, often recover because during withdrawal they face old fears and gradually overcome them. Don’t push yourself whilst you are still physically low.

depressed and they are in the caring role. Reassure them that you are only changing your feelings about yourself, not them.

*39\49\8*

WITHDRAWAL SYMPTOMS: LACK OF CONCENTRATION

admin — Tue, 21 Apr 2009 05:11:18 +0000

Calls come in saying ‘How is it that I am having difficulty doing simple things I have done all my life?’ One said ‘It has taken me two hours to fit a plug onto a kettle’. Many women have said that they could not understand the simplest recipe or knitting pattern.

There is some confusion between memory lapses and loss of concentration. Many people have said that they make appointments and then forget them. It may be that because of lack of concentration at the time, they have failed to take in the information rather than subsequently forgetting it. Concentration does improve as withdrawal progresses. Life can be very boring when you cannot concentrate on reading or watching television. Large print books (helpful if you have sore eyes) are available from most libraries. You may need to choose ‘light’ reading material for a while. Some people stimulate concentration by doing simple crossword puzzles.

*18\49\8*