Comedian Dan Aykroyd, children’s author Hans Christian Andersen, movie director Tim Burton, naturalist Charles Darwin, poet Emily Dickinson, scientist and mathematician Albert Einstein, chess grandmaster Bobby Fischer, Microsoft founder Bill Gates, actress Daryl Hannah, late Apple CEO Steve Jobs, painter Michelangelo, music composer/ pianist Amadeus Mozart, and artist and cultural influencer Andy Warhol, just to name a few…
What do all of the above people have in common? Given their fame and success, I bet you’ll never guess. They all have islands of extreme expertise, but all also have social limitations in terms of their abilites to interact with others and their ability to communicate. What does that sound like? What diagnosis do they share? Autism.
Autism spectrum disorder (ASD) is a condition related to brain development that affects how a person relates to and socializes with others, and which also causes problems in communication and social interactions. Replacing just the single word autism, the term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and potential severity of the disorder of autism.
Autism spectrum disorder is said to be a “developmental disorder” because symptoms generally appear in the first two years of life. The disorder extends into adulthood, causing problems with functioning in society, in school, and at work. Children often show symptoms of autism within the first year of life, though signs may be subtle at first. Sometimes children appear to develop normally in their first year, but then exhibit regression between 18 and 24 months of age as they develop autistic symptoms.
Symptoms of ASD
Children can show signs of autism spectrum disorder in early infancy. These include reduced eye contact, lack of response to their name and/or indifference to caregivers. Some children may develop normally for the first few months or years of life, but then suddenly become withdrawn or aggressive or lose the language skills they’ve already acquired. Fairly definitive signs of ASD are usually seen by age two.
Each child with ASD will have difficulty with social interactions and will exhibit unique patterns of behavior and levels of severity, from low functioning to high functioning.
Some children with autism spectrum disorder may have difficulty learning, and some have signs of lower than average intelligence. Other children may have normal to high intelligence and learn quickly, but have difficulty communicating and applying what they know. Because of the unique mixture of signs and symptoms exhibited in each child, the severity of ASD can sometimes be difficult to determine. It’s generally based on the level of impairment and how that impairment impacts the ability to function.
A child or adult with ASD may have problems with social interactions and communication skills, including any of these signs:
Failure to respond to his/her name or appearing to not hear you at times
Resists cuddling and holding as child
Lacks facial expression
Prefers playing alone, retreats into his/her own world
Exhibits poor eye contact
Doesn’t speak/ has delayed speech/ loses previous speech ability
Can’t initiate or further conversation
Speaks with abnormal tone or rhythm; may use a singsong voice or robot-like speech
Repeats words or phrases verbatim, but doesn’t understand meaning
Doesn’t appear to understand simple questions or directions
Doesn’t express own emotions/ feelings and is unaware of others’ feelings
Inappropriate aggression or disruption to social interactions of others
Difficulty recognizing nonverbal cues, interpreting other people’s facial expressions, body postures, or tones of voice
A child or adult with ASD may exhibit limited and repetitive patterns of behavior, including any of these signs:
Performs repetitive movements, such as rocking, spinning or hand flapping
Develops specific routines or rituals, becomes disturbed at the slightest change
Performs self-harming activities, including biting or head-banging
Is unusually sensitive to light, sound, and/or touch, yet can be indifferent to pain or temperature
Has problems with coordination or exhibits odd movement patterns, such as clumsiness, walking on toes, and odd, stiff, or exaggerated body language
Is fascinated by small details of an object without understanding the overall purpose or function of the object. Ex: spinning wheels of a toy car
Doesn’t engage in imaginative or make-believe play
Fixates on an object or activity with abnormal intensity or focus
Has very specific food preferences: eats very few foods/ refuses certain textures
A child or adult with ASD may exhibit other signs and symptoms, such as:
Unusual Touch and Sound Sensitivities: They may recoil when touched, and/or may be extremely hypersensitive to certain sounds
Seizures: Approximately four out of ten people with ASD suffer from seizures; most commonly occurs in childhood or entering teenage years and in those with more severe cognitive impairment.
Bowel Disorders: People with ASD tend to have more gastrointestinal symptoms such as abdominal pain, constipation, and diarrhea than peers
Placing Inedible Objects in the Mouth: While it is common for babies and toddlers to put toys or other inedible objects in their mouths, older kids with autism may continue to do this even as they age. Some children have been known to put items like soil, chalk, and paints into their mouths, which means supervision is a must to prevent them from eating something toxic or choking on an object.
Sleeping Issues: Getting a child to sleep at an assigned time can be hard, but children with ASD often have different sleep patterns. ASD interferes with the “working clock” that regulates sleep patterns. Many children with ASD with sleep problems will have the problem in adulthood as well.
As they mature, some children with autism spectrum disorder become more engaged with others and show fewer behavioral disturbances, but some, usually those with the least severe problems, may end up leading normal or near-normal lives. But others continue to have difficulty with language or social skills, and for them, the teen years can bring even worse behavioral and emotional problems.
When to see a doctor
Babies develop at their own pace…they don’t necessarily follow the developmental timelines that Dr. Spock or other parenting book authors lay out. But children with autism spectrum disorder usually show some signs of delayed development before they are two years old. If you’re concerned about your child’s development or suspect that your child may have ASD, discuss your concerns with your pediatrician, as some ASD symptoms can look like other developmental disorders.
Your pediatrician may recommend developmental tests to identify if your child has delays in cognitive, language and social skills, or if your child doesn’t meet certain timelines:
Doesn’t respond with a smile or happy expression by 6 months
Doesn’t mimic sounds or facial expressions by 9 months
Doesn’t babble or coo by 12 months
Doesn’t gesture, point or wave by 14 months
Doesn’t say single words by 16 months
Doesn’t play “make-believe” or pretend by 18 months
Doesn’t say two-word phrases by 24 months
Loses language skills or social skills at any age
Causes of ASD
Autism spectrum disorder has no single known cause. Given the disorder’s complexity and the fact that symptoms and severity vary, there are probably many causes, with genetics and environment likely playing larger roles.
Genetics: Several different genes appear to be involved in ASD. For some children, ASD can be associated with another genetic disorder, such as Rett syndrome or fragile X syndrome. For other children, genetic mutations may increase the risk of autism spectrum disorder. Other genes may affect brain development or the way that brain cells communicate. Some genetic mutations are inherited, but others occur spontaneously.
Environmental factors: Researchers are currently exploring whether factors like viral infections, medications, complications during pregnancy, or air pollutants play a role in triggering autism spectrum disorder.
Not from childhood vaccines: One of the biggest controversies in autism spectrum disorder centers on whether childhood vaccines can cause ASD. Despite extensive research, no reliable study has shown a link between autism spectrum disorder and any vaccines. In fact, the original study that ignited the debate years ago has been retracted due to poor design and questionable research methods. Not only do vaccines not cause ASD, but
avoiding childhood vaccinations can place your child and others in danger of catching and spreading serious diseases, including whooping cough (pertussis), mumps, and/or measles. So don’t let the fear of ASD keep you from allowing your child to have their vaccines.
Risk factors for ASD
The number of children diagnosed with autism spectrum disorder is rising. It’s not clear whether this is due to better detection and reporting or a real increase in the number of cases, or a combination of the two.
Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child’s risk. These risk factors may include:
Your child’s sex: Boys are about four times more likely to develop autism spectrum disorder than girls are.
Family history: Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It’s also fairly common for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
Other disorders: Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Some examples include fragile X syndrome, tuberous sclerosis, and Rett synsyndrome.
Extremely preterm babies: Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
Parental ages: Children born to older parents may be more likely to develop ASD, but more research is necessary to fully establish this link.
Complications of living with ASD
The problems that come with ASD in terms of social interactions, communication, and behavior can lead to issues in life, including:
Problems in school and successful learning
Inability to live independently
Stress within the family
Victimization and being bullied
Prevention of ASD
There is no way to prevent autism spectrum disorder, but there are some treatment options. Intervention is helpful at any age, but early diagnosis and intervention is the most helpful to improve behavior, skills and language development. While children don’t usually outgrow autism spectrum disorder symptoms, with work, they may learn to function well within their environment.
Diagnosis of ASD
Your child’s doctor will look for signs of developmental delays at regular checkups. If your child shows any symptoms of autism spectrum disorder, you’ll likely be referred for an evaluation to a specialist who treats children with autism spectrum disorder, such as a child psychiatrist/ psychologist, pediatric neurologist or developmental pediatrician.
Because autism spectrum disorder varies widely in symptoms and severity, making a diagnosis may be difficult. There isn’t a specific medical test to definitively diagnose the disorder. Instead, a specialist will make observations. These may include:
Observing your child’s development, social interactions, communication skills and behavior; done over time to determine if there have been changes.
Give your child tests which will cover hearing, speech, language, developmental level, and social and behavioral issues.
Score your child’s social and communication interactions.
Include other specialists in order to definitively determine a diagnosis.
Recommend genetic testing to determine if your child also has a genetic disorder such as Rett syndrome or fragile X syndrome.
Treatment for ASD
While there is no cure for autism spectrum disorder, early and intensive treatment can make a big difference in the lives of most children with ASD. The goal of treatment is to maximize your child’s ability to function by reducing ASD symptoms while also supporting development and learning. Early intervention during the preschool years can help your child learn critical social, communication, functional, and behavioral skills that will make a huge impact on their adult lives.
The range of ASD “therapies” you’ll find on an internet search can be very overwhelming. If your child is diagnosed with autism spectrum disorder, talk to experts about creating a treatment strategy and build a team of professionals to meet your child’s needs.
Some ASD treatment options may include:
Behavioral and communication therapies: Many programs address the range of social, language, and behavioral difficulties associated with ASD. Some programs focus on reducing problem behaviors and teaching new skills. Other programs focus on teaching children how to act in social situations or how to communicate better with others. Applied behavior analysis (ABA) can help children learn new skills and apply these skills through a reward-based motivation system.
Educational therapies: Children with ASD often respond well to very structured educational programs. Successful programs typically include a team of specialists and a variety of activities to improve social skills, communication and behavior. Earlier intervention is better, and preschool children who receive intensive one on one behavioral intervention show more progress.
Family therapies: Parents and other family members can learn how to play and interact with their children in ways that promote social skills, manage problem behaviors, and teach communication and other daily living skills.
Other therapies: Depending on your child’s needs, they can have speech therapy to improve communication skills, occupational therapy to teach activities of daily living, and physical therapy to improve movement and balance. Any and all of these may be beneficial. Adding a psychologist to address problem behavior is also beneficial.
Medications: There are no specific medications to improve the core signs of autism spectrum disorder, but some medications can help control specific symptoms, including hyperactivity, behavioral issues, and anxiety. Always keep all health care providers updated on all medications or supplements your child is taking, as some can interact and cause dangerous side effects.
Some ASD takeaways
Autism spectrum disorder is a developmental disorder that causes problems with communication and social interactions. There are no specific tests for autism spectrum disorder, the diagnosis is made by observation and process of elimination. There are no one-size-fits-all therapies for autism spectrum disorder. Early detection and intervention are of utmost importance and make a greal deal of difference in determining the person’s likely functional level in adulthood. If your child exhibits some of the characteristics defined above, it is best to see your pediatrician for an evaluation.
For information on other psychiatric diagnoses and patient stories and experiences, please check out my book, Tales from the Couch, available on Amazon.com.Learn More
Ambien, generic name zolpidem, is the most commonly prescribed sleep aid, accounting for 85% of prescribed sleeping pills. It also ranks in the top 15 on the list of most frequently prescribed drugs in the country. Its popularity is clearly due to its efficacy. Zolpidem works as a hypnotic drug, meaning that it induces a state of unconsciousness, similar to what occurs during natural sleep. How does it do that? Zolpidem affects chemical messengers in the brain called neurotransmitters, specifically a neurotransmitter called GABA. By affecting GABA, it calms the activity of specific parts of the brain. One of the areas in the brain that is affected is the hippocampus. Along with other regions of the brain, the hippocampus is important in the formation of memory. Because of this hippocampal involvement,
zolpidem can cause memory loss, especially at higher doses, an effect colloquially referred to as “Ambien Amnesia.” If you take it and do not go to bed immediately as recommended, this is more likely to occur. When you get right in bed after taking it, a loss of memory is inconsequential…it doesn’t matter if you can’t remember lying awake for a few minutes before falling asleep. But there are many reports of people taking it and remaining awake and out of bed, and they commonly experience an inability to recall subsequent events shortly after taking it. Because of its effects on memory, there is some concern that zolpidem could affect long-term memory and contribute to the development of dementia or Alzheimer’s disease, though there has been no research to prove or disprove these possible associations. Zolpidem comes with a host of known side effects that range from weird and wacky to illegal and downright dangerous behaviors. Included are hallucinations, decreased awareness, disinhibition, and changes in behavior. Very serious problems may occur when someone who has taken zolpidem gets up during the night. They may exhibit very complex sleep-related behaviors while under the influence of zolpidem. These might include relatively innocuous sleeptalking, sleepwalking, sleep cleaning and sleep eating, to more disturbing behaviors like sleep cooking and sleep sex, to potentially deadly sleep driving. While in a confused state, a person on zolpidem may act in a way that is different from their normal waking behavior. This can lead to legal consequences, such as driving under the influence (DUI) or potentially even sexual assault charges stemming from disinhibited sexually charged behavior.
I have a long time patient named Deanna that takes zolpidem and regularly sleepwalks, also known as somnambulation for the Scrabble set. It happens that she has been a sleepwalker ever since she had the ability to walk, so being on the zolpidem now makes her nocturnal activities and behaviors really way out there. Just flipping back through her chart, I see she mentions: taking apart electronics and trying to put them back together with no success. Dumping all of her shoes out of their boxes onto her closet floor. Taking all of her clothes off their hangers and throwing them over her dining room chairs. Gathering all sorts of disparate items together, evidently whatever catches her eye at the time, and putting them in her oven. She said she learned that particular lesson the hard way. This one is whacked. She started “painting” a wall in her house….with a purple sharpie. She showed me a picture of that. She once found several pages of her stationery scrawled in words she knew she didn’t consciously write in a letter to someone, she didn’t know who. She brought that in. She said she would evidently clean in her sleep; she put shower gel all over the tile in her shower and “put things away” in odd places they didn’t belong in. She also sleep eats. Cereal, bread, ice cream, whatever she sees that looks good I guess. She regularly wakes up to a mess in the kitchen and destruction in the house. It used to really freak her out to see the evidence of activities she didn’t remember, but now she just feels unsettled as she surveys the damage from her night time escapades. But since it hasn’t ever been anything dangerous and because zolpidem works well for her, she doesn’t want to change it.
How is it that a person on zolpidem can achieve these complex behaviors while unconscious and asleep? It’s because the parts of the brain that control movement still function, but inhibition, consciousness, and the ability to create memory is turned off. Because of this, the person is disinhibited, and that can lead to unintentional actions and behaviors as discussed above.
Beyond zolpidem’s effects on memory, awareness, and behavior, there may be additional issues associated with its use. Some other common side effects include:
– “Hangover” or carry-over sedation, especially in women
– Loss of appetite
– Impaired vision
– Slow breathing rates
– Muscle cramps
– Allergic reactions
– Memory loss
– Inability to concentrate
– Emotional blunting
– Depression and/or suicidal thoughts
– Back pain
– Diarrhea or constipation
– Sinusitis (sinus infection)
– Pharyngitis (sore throat)
– Dry mouth
– Flu-like symptoms
– Breathing difficulties
– Palpitations (irregular heartbeat)
– Rebound insomnia
Any of these side effects could be bothersome and may interfere with the continued use of the medication. Sometimes the benefits of zolpidem outweigh the risks and/or side effects. If a symptom is particularly bothersome, discuss this with your prescribing doctor to see if an alternative treatment may be a better option for you.
If you take zolpidem, use it exactly as prescribed and get in bed immediately after taking it. It’s best to allow yourself at least 7 to 8 hours of sleep to help ensure avoidance of morning hangover effects. Keeping a regular sleep-wake schedule will also help. Taking zolpidem with other drugs that depress the central nervous system such as alcohol, opioid pain medications, or tranquilizers intensifies the sedative effects of zolpidem and increases the risk of overdose as a result of respiratory depression. Zolpidem is an abusable drug. Individuals who take it for non-medical reasons or at more than prescribed doses are at risk of experiencing intensification of adverse side effects, including the following:
– Excessive sedation
– Confusion and disorientation
– Lack of motor coordination
– Slow response times
– Delayed reflex reactions
– Impaired judgment
Men and women don’t metabolize zolpidem in the same way. Women metabolize it much more slowly, so they often wake up with a zolpidem hang over and feel cloudy in the morning. So an important note for women taking zolpidem is to be extra cautious about allowing at least 8 hours of sleep after taking it and to take lower doses of it due to the potential effects on morning function, especially driving.
Actor Roseanne Barr had probably taken a little too much when she “Ambien tweeted” a racist statement comparing an Obama aid to an ape. She admitted that she had taken zolpidem shortly before the 2am tweet that caused her eponymous show to be cancelled. Elon Musk, Mr. Tesla, can feel her pain. He shocked investors when he tweeted he was considering taking Tesla private at $420 a share and that funding was secured. He said he sometimes takes zolpidem because it’s either that or no sleep. Good thing he has people to protect him from himself when he’s in a zolpidem daze.
Zolpidem can be a safe and effective medication to treat insomnia, but if it affects your memory or causes sleep behaviors or other adverse side effects, you should probably consider alternative treatments for your insomnia. Hello Roseanne and Elon…that means you!!
I talk more about drugs for sleep like zolpidem and a host of other psychoactive drugs in my book, Tales from the Couch, available on Amazon.com.Learn More
A woman named Marianne messaged me wanting to know how to get off of Klonopin, which is a benzodiazepine, or benzo for short. She has been taking them regularly for more than twenty years, which is a very long time to be on a benzo. That will certainly complicate things. Before I go into how to stop taking benzos, I want to tell you what they are and what they do.
What are they?
Benzos are medications designed to treat anxiety, panic disorders, seizures, muscle tension, and insomnia. Some of the most commonly prescribed benzos include: Xanax (alprazolam), Klonopin (clonazepam),Valium (diazepam), Restoril (temazepam),
Librium (chlordiazepoxide), and Ativan (lorazepam). A 2013 survey found that Xanax and its generic form alprazolam is one of the most prescribed psychiatric drugs in the United States, with approximately 50 million prescriptions written that year. Unfortunately, this class of drug is also highly abused. Another 2013 survey found that 1.7 million Americans aged 12 and older were considered current abusers of tranquilizer medications like benzos. When abused, benzos produce a high in addition to the calm and relaxed sensations individuals feel when they take them.
How do they work?
Benzos increase the levels of a chemical in the brain called GABA. Meaningless trivia: GABA stands for gamma amino-butyric acid. GABA works as a kind of naturally occurring tranquilizer, and it calms down the nerve firings related to stress and the stress reaction. Benzos also work to enhance levels of dopamine in the brain. Dopamine is the feel good chemical, the chemical messenger involved in reward and pleasure in the brain. In simple terms, benzos slow down nerve activity in the brain and central nervous system, which decreases stress and its physical and emotional side effects.
Why can using them be problematic?
Benzos have multiple side effects that are both physical and psychological in nature, and these can cause harm with both short-term and extended usage. Some potential short-term side effects of benzos include, but are not limited to: drowsiness, mental confusion, trouble concentrating, short-term memory loss, blurred vision, slurred speech, lack of motor control, slow breathing, and muscle weakness. Long-term use of benzos also causes all of the above, but can also cause changes to the brain as well as mental health symptoms like mood swings, hallucinations, and depression. Fortunately, some of the changes made by benzos to the different regions of the brain after prolonged use may be reversible after being free from benzos for an extended period of time. On the scarier flip side of that coin, benzos may in fact predispose you to memory and cognitive disorders like dementia and Alzheimer’s. They’re many studies currently focusing on these predispositions. A recent study published by the British Medical Journal (BMJ) found a definitive link between benzo usage and Alzheimer’s disease. People taking benzos for more than six months had an 84% higher risk of developing Alzheimer’s dementia, versus those who didn’t take benzos. Long-acting benzos like Valium were more likely to increase these risks than shorter-acting benzos like Ativan or Xanax. Further, they found that these changes may not be reversible, and that the risk increased with age. Speaking of age, there are increased concerns in the elderly population when it comes to benzo usage. Benzos are increasingly being prescribed to the elderly population, many of which are used long-term, which increases the potential for cognitive and memory deficits. As people age, metabolism slows down. Since benzos are stored in fat cells, they remain active in an older person’s body for longer than in a younger person’s body, which increases the drug effects and risks due to the higher drug concentrations, like falls and car accidents. For all of these reasons, benzos should be used with caution in the elderly population.
A big problem with taking benzos for an extended period is tolerance and dependency. Benzos are widely considered to be highly addictive. Remember that benzos work by increasing GABA and dopamine in the central nervous system, calming and pleasing the brain, giving it the feel goods. After even just a few weeks of taking benzos regularly, the brain may learn to expect the regular dose of benzos and stop working to produce these feel good chemicals on its own without them. Your brain figures, “why do the work if it’s done for me?” You really can’t blame the brain for that! It has become dependent on the benzo. But as you continue to use benzos, you develop higher and higher tolerance, meaning that it takes more and more of the drug to produce the regular desired effect. This tolerance and dependence stuff really ticks off your brain. It’s screaming “why aren’t these pills working anymore?!” The answer is that it has become dependent and tolerant, so it needs more. Just to prove its point, it makes you feel anxious, restless, and irritable as it screams “gimme gimme more more more!!!” The problem is that the body is metabolizing the benzo more quickly, essentially causing withdrawl symptoms, and a higher dose is needed. The longer you’re on a benzo, the more you’ll need. It’s a vicious cycle and it’s sometimes tough to manage clinically.
The most severe form of physical harm caused by benzos is overdose. This occurs when a person takes too much of the drug at once and overloads the brain and body. The Centers for Disease Control and Prevention (CDC) cites drug overdose as the number one cause of injury death in the United States. A 2013 survey reported that nearly 7,000 people died from a benzo overdose in that year. Since benzos are tranquilizers and sedatives, they depress the central nervous system, lowering heart rate, core body temperature, blood pressure, and respiration. Generally, in the case of an overdose, these vital life functions simply get too low.
When combining other drugs with benzos, obviously the risk of overdose or other negative outcome increases exponentially. But mixing benzos with alcohol is a special case, deserving of a strong warning as it is life-threatening. BENZOS + ALCOHOL = DEAD. One of the most common and successful unintentional and intentional suicide acts in my patient population is mixing benzos with alcohol. The combo is lethal, plain and simple. The body actually forgets to breathe. People pass out and just never wake up. If you’re reading this and you take benzos with alcohol and you’re thinking that you don’t know what the big deal is, you do it all the time and have never had a problem, then my response to you is that you’re living on borrowed time, and I strongly suggest you stop one of the two, the booze or the benzos, take your pick.
What about withdrawl from benzos?
Benzo withdrawal can be notoriously difficult. It is actually about the hardest group of drugs to get off of. The level of difficulty is based on what benzo you’ve been taking, how much you’ve been taking, and how long you’ve been taking it. Obviously, if you’ve been on benzos for 25 years, it’s not going to be a walk in the park. To be honest, it’s going to be a rough road. Sorry Marianne. But it can be done. The first and most important thing is that you should never just stop benzos on your own, as it can be very dangerous and can include long or multiple grand mal seizures. Withdrawal from benzos should be done slowly through medical detox with a professional. It is best done with an addiction specialist like myself, because a specialist has the most current knowledge and experience. This is the safest way to purge the drugs from the brain and body while decreasing and managing withdrawal symptoms and drug cravings. As for the symptoms of withdrawl, these can include mood swings, short-term memory loss, seizure, nausea, vomiting, diarrhea, depression, suppressed appetite, hallucinations, and cognitive difficulties. Stopping benzos after dependency may also lead to a rebound effect. This is a sort of overexcitement of the nerves that have been suppressed for so long by the benzos, and symptoms can include an elevated heart rate, blood pressure, and body temperature. There may also be a return of the issues that lead you to take the benzos in the first place, insomnia, anxiety, and panic symptoms, and they can possibly be even worse than before.
I’m sure that just about everyone currently taking benzos is thinking “I’m NEVER stopping!” right about now. It is not easy to do, but there is a way to manage all of this, to come off of the benzo and deal with all of the physical and cognitive aspects of withdrawl. I do it everyday. I set up a tapering schedule to lessen the specific benzo dosage over time, sometimes over a period of months. I will also often add or switch to a long acting benzo, which can be very helpful. I use several drugs to deal with the withdrawl symptoms: clonidine for tremor and high blood pressure, neurontin for pain and to help prevent seizures, anti-psychotic like seroquel for sleep, and an anti-depressant for depression, thank you Captain Obvious. The drug regimen varies from patient to patient. I also utilize psychotherapy to help work out the psychological kinks associated with withdrawl and rebound effect symptoms. Another trick I strongly recommend to many of my patients, not just those withdrawing from alcohol or any drugs, is transcranial magnetic stimulation or TMS. This is a non-invasive procedure done in the office that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression and anxiety, and I’ve found that it seems to calm the nerves and offer relief to some people in withdrawl. Electrodes are placed on the forehead and behind the ears and painless stimuli are passed into certain regions of the brain for 40 minutes in each daily session for about a month. Many patients say it’s the best 40 minutes of their day.
I’d like to wish Marianne good luck. Please feel free to call me at the office at 561-842-9950 if you have any questions.
To everyone else: If you can avoid ever having to take benzos, I strongly suggest that you do. If you’re currently taking them, give some serious thought to finding an alternative medication. I can help with that. For more information and stories about benzos, other drugs, and the process of medical detox, check out my book Tales from the Couch on Amazon.com.Learn More
Attention Deficit Disorder
ADD, Attention Defecit Disorder is a chronic condition marked by issues with attention. It is most often seen in childhood, but can persist into adulthood, and there are 3 million US cases per year. Due to it’s high prevalence, I want to take the opportunity to discuss the diagnosis, symptoms, and treatment of ADD.
ADD has a sister disorder called ADHD, Attention Defecit Hyperactivity Disorder. What’s the difference between them? It’s pretty simple. ADHD includes the symptom of physical hyperactivity or excessive restlessness. That’s what the “H” is for. In ADD, the symptom of hyperactivity is absent.
What are the hallmarks of this disorder? Basically, it is a disorder of concentration, marked by problems concentrating and the inability to stay on task. These individuals are easily distracted and readily bored. They move from project to project without finishing and start projects without all of the appropriate tools needed to complete them. This all leaves them very anxious. In cases of ADHD, they are also impulsive, intrusive, disruptive, and hyperactive, often constantly fidgeting.
What percent on the population are we dealing with here? Roughly 20% of boys and 11% of girls have some type of attention deficit disorder.
What are the causes of attention deficit disorder? While we don’t know exactly, there are several suspects. Maternal use of alcohol or cocaine while in utero is an extremely common finding. Brain infections when pregnant or during early childhood, head trauma, and any birth defects that affect child development are also suspected. Exposure to enviromental toxins and pesticides are suspect. Excessive video games alter brain chemistry, as does a diet of processed foods and sugar, and these are also suspected causes for attention deficit disorder. I would say the number one cause of ADD is most likely genetic, inherited from mother or father.
What is the result of having attention deficit disorder? How does it affect one’s life? It results in having problems fitting into the academic world or the job world. People with attention deficit disorder don’t fit into a regimented or organized educational or work environment. They can be very intelligent and productive people, but they don’t fit into what we would consider the stereotypical or standard type of academic setting or work setting. Also, due to their impulsivity and their disorderly conduct, they can wind up getting in trouble in school and in trouble with the law. They can be unsuccessful at work, not because they aren’t smart enough, but because they cannot stay focused. In terms of lifestyle, they also have a much higher rate of obesity. This is likely due to lack of impulse control, causing them to overeat. They have problems in relationships, and their divorce rates are much higher. Their propensity toward domestic violence may also be higher. They may also be more prone to Alzheimer’s disease. Because of all of these failures and shortcomings in the stereotypical organized worlds of education and career, they have much lower self-esteem. There are studies that report that up to 52% of people with attention deficit disorder have drug or alcohol problems.
So how can we help these people? How do we treat these illnesses? The number one treatment is behavioral training with a mental health professional. The gist of that is educating them to focus on one thing at a time. They are not able to handle instructions with multiple levels at once, but they can focus on one thing at a time and have success with that. Pharmacologically, ADD and ADHD are generally treated with amphetamine stimulants. Some antidepressantants may also benefit people with attention deficit disorder. Essentially, a combination of behavioral therapies, special education programs and medications show the most promise in the treatment of attention deficit disorder. But a diagnosis of ADD or ADHD isn’t all future doom and gloom. Eventually, people find their niche in the world and can become successful. The actor Ryan Gosling takes medication for his ADD and says that it may take him longer to read his scrips than other actors, but he manages to get the job done. Uber successful comedian Howie Mandel has successfully done just about all there is to do in Hollywood. I have met a lot of CEO’s with ADD, and they function well because they have people around them to take care of all the boring mundane tasks, giving them the chance to think freely and create business opportunities. They are creative and capable people. They are another example of why you can’t judge a book by it’s cover…you can’t assume that someone with a psych diagnosis will never make it in the world. Ask Richard Branson. I think he’s done pretty well for himself in the corporate world despite his ADD. Justin Bieber has ADHD and has managed to record a few hit songs. Olympian Michael Phelps has ADD, depression and anxiety, and that hasn’t stopped him.These are some examples of people that have adapted and overcome their diagnoses rather than be labeled by them. If you have ADD or any psych diagnosis, I’d suggest you follow their lead.
For more patient stories, check out my book Tales from the Couch, on Amazon.com.Learn More
Rather than just introducing you to today’s topic, I want to play a little game of ‘Who am I?’ I’ll give you ten clues and let’s see if you can guess who I am. And no looking down below and cheating!
1. Everyone has me, either intermittently or constantly.
2. I am an unwelcome guest.
3. Some people deal with me better than others do.
4. I keep lots of people up at night.
5. I make some people physically ill.
6. I can shrink your brain.
7. Some people take drugs to deal with me.
8. I can make some people binge, purge, or starve themselves.
9. I can cause a whole host of medical problems.
10. I have a good side, but nobody ever gives me credit for it!
I am defined as “a physical, mental, or emotional factor that causes bodily or mental tension.”
So who am I?
I am STRESS!
I see so many stressed out people every day that I thought I’d do a little educational primer on stress.
Stress is a normal psychological and physical reaction to life’s everyday demands. A small amount of stress can be good. Positive stress is officially called eustress, and it can motivate you to perform well. But multiple challenges throughout the day such as sitting in traffic, meeting deadlines, managing children, and paying bills can push you beyond your ability to cope.
What’s going on in your brain when you feel stress? Your brain comes hard-wired with an alarm system for your protection. When your brain perceives a threat or a stressor, it signals your body to release a burst of hormones, especially cortisol, that increase your heart rate and raise your blood pressure. This is part of the fight or flight mechanism. But once the threat or stressor is gone, your body is meant to return to a normal, relaxed state. Unfortunately,some people’s alarm systems rarely shut off, causing chronic stress. When chronic stress is experienced, the body makes more cortisol than it has a chance to release. This has been shown to kill brain cells and even reduce the size of the brain. Chronic stress has a shrinking effect on the prefrontal cortex, the area of the brain responsible for memory and learning. So it’s very important to find effective ways to deal with stress. Stress management gives you a range of tools to reset your brain’s alarm system. Without managing stress, your body might always be on high alert, and over time, this can lead to serious health problems and contribute to mental disorders such as anxiety, depression and post-traumatic stress disorder. So don’t wait until stress damages your health, relationships, or quality of life…start practicing some stress management techniques.
To help combat the negative effects of stress and anxiety, here are five tips to help manage stress in your daily life…
1. Follow a Regular Sleep Routine
It may seem like simple advice, but often the simplest advice is the best advice. Following a regular sleep routine can help you decompress, recharge, and rejuvenate your body and mind after a stressful day. Try going to bed at the same time every night and aim for 7 to 8 hours of sleep. Resist the urge to stay up late watching TV. In fact, avoid screen time altogether before bed, including tablets and smart phones. Studies have proven that reading on a backlit device before bed interrupts the body’s natural process of falling asleep. These devices also impact how sleepy and alert you are the following day.
2. Use Exercise to Combat Stress
Exercising regularly can have an enormous impact on how your body deals with stress, and it is one of the most recommended ways doctors instruct patients to reduce stress. The endorphins released while exercising can help improve your overall health, reduce stress levels, regulate sleep pattern, and improve mood. The key to exercising is to choose something that you truly enjoy. Whether it’s going for a walk, taking an exercise class at the gym, going for a swim, or lifting weights, exercise keeps us healthy. Make sure to mix up your exercise routine to prevent boredom and stay motivated.
3. Learn How to Meditate
One of the simplest ways to help alleviate stress is to practice deep breathing and meditation. There’s no secret to this, and you don’t have to chant and burn incense or any of that. It’s just about finding a quiet space without distractions. It only takes a few minutes every day, either before bed or first thing in the morning. Breathe in through your nose, letting your abdomen expand. Hold your breath for a count of three, then breathe out slowly through your mouth. Repeat this three times. Focus on your breathing and your heart beat to prevent thinking about everything that you need to do. If doing it in the morning allows stressful thoughts of the upcoming day to intrude, try it at night. Deep breathing is especially important when your stress levels are high. Aim for meditating for at least 15 to 20 minutes, but if you’re feeling pressured during the day, a quick 5-minute meditation session can help you chill out.
4. Take Care of Your Skin
It may not seem like skin care and stress prevention are linked, but they are. Have you ever noticed that your skin is more prone to break out when you’re stressed out? How many times have you gotten up for work all stressed out about a presentation and looked in the mirror only to see a big zit on your nose? For crying out loud…why the heck is that?!!? How does your skin know you have a big presentation? Well, stress causes a chemical response that makes your skin more sensitive. And as we discussed, your body produces more cortisol when stressed, which causes your sebaceous glands to produce more oil. More oil means oily skin that is prone to acne. So it’s important not to neglect your skin care routine, especially when you’re stressed out. This goes for both guys and girls. You may be exhausted at night and want to go straight to bed, but taking an extra few minutes to wash your face and remove daily dirt and any facial products or makeup you’ve worn during the day will make a world of difference. And if you’re prone to oily or dry skin, always choose skin care products that are specifically designed for your skin type. Your skin will thank you for it by surprising you with big red zits less often.
5. Ask For Help When You Need it
Asking for help may not always be easy, but when you need a shoulder to cry on or someone to listen, it can help put things into perspective. Seeking support from family and friends or a professional isn’t a sign of weakness. In fact, it takes courage to admit you need help. Many patients that I see for the first time have been needlessly suffering for so long. I feel terrible for them. There is no reason not to seek help for any ailment affecting your health, especially your mental health. Patients who wait until they start to develop multiple physical and psychiatric issues before seeking help have a much harder time recovering than those who seek help sooner. Remember that friends and family are great support, but if you develop any signs of anxiety or depression or other mental health issues, get help from a licensed mental health professional immediately. In my experience, some patients may need medication, but some do not, they find relief through simple talk therapy with me. It’s very much an individualized assessment. While not a replacement for professional help, you can also look for online support groups for stress management. You’re not the only person who’s ever dealt with a specific stressful situation, so why not discover how other people managed their stress and overcame a potentially frustrating situation.
Hopefully after reading this you have a better understanding of what stress is, how it can impact your physical and mental health, and what you can do to start dealing with it effectively to minimize its role in your life. If you feel you need help, call my office for an appointment. I can help you. For more mental health topics and stories, check out my book Tales from the Couch, available on Amazon.com or for purchase in my Palm Beach office.Learn More
Slumber, shuteye, repose, siesta, snooze…Sometimes we have a love-hate relationship with it…we love it when it’s good and curse it when it’s bad, but we all need it. Whatever you call it, one complaint I hear from patients day in and day out is that they have difficulty sleeping. It’s so prevalent that I want to discuss how to get better sleep. In my 30 years of practice, I’ve compiled a list of 14 things in no specific order that you can do that should have you snoozing at night night in no time.
Rule 1: Bright light during the day. Your body has to have bright light during the day; sunshine is best, but even sitting in a bright room, like by a window, is helpful. Bright light tells your brain that it is day time, time to be awake. Darkness or the absence of bright light tells the brain it is night time, time to sleep. If you’re in a dark room all day, you probably won’t sleep well at night. So remember, in the day time, bright light is right.
Rule 2: Limit blue light. What is blue light? Blue light is what is emitted from your computer, laptop, and smartphone. The more blue light you are exposed to, especially at night, the more disruption you’ll have in sleep, as it disrupts circadian rhythm. Lots of people climb into bed with their cell phone or iPad, and that’s the worst thing to do. You should avoid looking at bright screens beginning two to three hours before bed. There are apps you can install on your phone that filter out the blue light. There’s also something called “F. Lux” that you can put on your computer or iPad which will block out the blue light. You never hear about it, but blue light exposure, especially at night, is a major factor in hindering sleep.
Rule 3: Captain Obvious here with a newsflash. Caffeine will keep you up at night. Don’t think you’re going to have coffee or tea after dinner or before bed and expect to sleep. And if you’re drinking sodas, coffee, or iced tea all day, it’ll still disrupt your sleep. I tell patients to limit caffeine consumption to under 250 – 300mg a day. As a guide, an 8oz cup of coffee has about 100mg caffeine, the same amount of tea has 24mg, a 12oz can of soda has 34mg, and those gnarly energy shots have 200mg of caffeine! I strongly advise against consuming caffeine after lunch if you plan on a bedtime between 10pm and midnight.
Rule 4: No naps! Boo! Hiss! Why is it that as kids, just the word nap sent us into a tizzy tantrum, but as adults we love naps? If anyone has an answer, please let me know. Anyway, as satisfying as it is, napping disrupts your sleep-wake cycle, temporarily resetting it to where you’re not likely to be able to go to bed between 10pm and midnight. Bummer.
Rule 5: Melatonin. I recommend 2 to 4mg of melatonin at bedtime; it really seems to help a lot of my patients. I do find that some patients get daytime hangover from it though, so you’ll have to see where you fall on that one. But it’s definitely worth a shot if you’re suffering from insomnia.
Rule 6: Get up at the same time every day, and go to bed at the same time every day. Yeah, it’s kind of a drag not sleeping in on weekends, but a sleep routine can make a big difference in your relationship with Mr. Sandman. You can’t regulate when you’ll fall asleep, but you can regulate when you wake up. So set your alarm and get up at the same time every day, no matter how tired you are. Don’t nap and go to sleep between 10pm and midnight, and you should fall asleep. If sleep still eludes you, stick to the same plan, and you should surely sleep the second night. You can’t decide when you’ll fall asleep at night, but you can regulate your sleep-wake cycle by deciding when you wake up. Stick to setting your alarm for the same time every day, and hopefully your brain will get the idea.
Rule 7: I recommend taking a glycine or magnesium supplement at night as well as L-theanine and lavender. They don’t make lavender teas, pillow sprays, lotions, and sachets for nothing. I have heard from people that swear by lavender as part of their wind down routine before bed. You can find these supplements on Amazon.com. Shameless plug: handily enough, you can also find my book, Tales from the Couch for sale there too. Check it out.
Rule 8: This is the Mac Daddy, numero uno, absolute, not-to-be-broken rule. Alcohol. If you consume alcohol before sleep, you will not sleep. Why? As the body metabolizes the alcohol, it goes into a withdrawl-like reaction and disrupts sleep. I know what you’re thinking. You’re thinking that a little nightcap helps you sleep. Wrong. Some people will tell you differently, but trust me…alcohol and sleep do not play well together.
Rule 9: A comfortable bedroom. Your bedroom should be an oasis of calm serenity. There should be no office or desk in the bedroom. It should be uncluttered. Anything not conducive to sleep should be out. Make sure it’s dark and quiet at bedtime. The weight of multiple blankets can help sleep. You can even purchase weighted blankets expressly for this purpose. The weight is comforting and relaxing to the body.
Rule 10: This sort of goes hand in hand with #9 above. Try a low temperature in the bedroom. I personally make sure my bedroom is at 70 degrees. The blankets from rule number 9 come into play here too. There’s something very comforting about burrowing under fluffy blankets to go to sleep. I mean, they’re called comforters for a good reason.
Rule 10: No eating late at night. People seem to mostly make terrible food choices at night, all in the name of snacks…chips, candies, baked goods. Sugary foods are especially bad. When you eat, the body goes into digestive mode, not sleep mode; it is very interfering to sleep. Sugars especially are no bueno. Evening or night snacking is one of the worst things you can do If you want to sleep.
Rule 11: Relax and clear your mind. There’s an older pop song that has a lyric, Free your mind and the rest will follow. It’s true. We all have problems and stresses throughout the day, and they seem to pop up when your head hits the pillow. You have to come to some resolution on how you’re going to handle the problems in your life and put them to bed so that you can put the rest of you to bed.
Rule 12: Spend money on a comfortable quality mattress. You’re going to spend a third of your life in your bed. Just suck it up and spend the money on the mattress. Don’t cheap out. Another place to spend money is on good linens. Few things are as inviting as a comfortable mattress covered in minimum 1,000 thread count all-cotton sheets. If you’ve never had nice linens, try them.You can pick them up on a white sale or online. You can thank me later.
Rule 13: No exercising late at night. When you exercise late at night, you raise blood pressure and heart rate, which will hype up the body, which is the antithesis of what you want when it’s time to sleep.
Rule 14: No liquids prior to sleeping. No rocket science here. If you put liquids in, you’re going to need to get liquids out. In other words, you’re going to have to get up in the middle of the night to pee. And you’re probably going to stub your toe. Not good.
This is my handy dandy guide on the do’s and don’ts when it comes to sleep. Anything is better than counting sheep. I don’t know who came up with that, but I would like to inform them that I have never in 30 years heard of it working. I’ve never before wanted people to fall asleep as a result of reading something I wrote, so this is a first! I hope you’ve learned some things here that will put you out like a light.Learn More
As a psychiatrist practicing in Palm Beach Florida, I come across a lot of bipolar patients. What are the warning signs of bipolar disorder? How can you recognize if someone you love or even yourself has bipolar disorder? You can’t get through an hour television program without at least 2 commercials for bipolar medications, so I thought it would be a good idea to talk about it.
First, what is bipolar? Bipolar disorder is a mental health disorder more commonly found in women that can cause dramatic changes in mood and energy levels. The term bipolar refers to the two poles of the disorder, the extremes of mood. Those two extremes of mood are mania and depression. The symptoms of bipolar can affect a person’s daily life severely as their mood can range from feelings of elation and high energy to depression. There are two types of bipolar, type 1 and type 2. Type 1 is more serious and disruptive than type 2, which can also be called hypomania.
Bipolar is sort of the Jekyl and Hyde of psychiatric disorders, with cycling of mania and depression. Manic episodes and depressive episodes have very specific signs and symptoms associated with them.
When someone is manic, they do not just feel very happy. They feel euphoric. Key features of mania include, but are not limited to:
– having a lot of energy
– feeling able to achieve anything
– having difficulty sleeping
– using rapid speech that jumps between topics.
– inability to follow through with ideas or tasks
– feeling agitated, jumpy, or wired
– engaging in risky behaviors, such as reckless sex, spending a lot of money, dangerous driving, or unwise consumption of alcohol and other substances
– believing that they are more important than others or have important connections
– exhibiting anger, aggression, or violence if others challenge their views or behavior
– in severe cases, mania can involve psychosis, with hallucinations that can cause them to see, hear, or feel things that are not there.
People in a manic state may also have delusions and distorted thinking that cause them to believe that certain things are true when they are not. While I have many patients that get delusions of grandeur, I have one patient that comes to mind. Her name is Felicia. Felicia is a 32-year-old receptionist. She was diagnosed with bipolar type 1 when she was 25, which happens to be the typical age of diagnosis. Felicia is on two medications for her bipolar with mixed results. She still cycles occasionally to a manic state. Sometimes that’s a clue that she may not be compliant with her meds. Like many bipolar people, Felicia loves loves loves her manic state. When Felicia is manic, she is on top of the world. Her house is pristinely clean, the meals she makes for her family are total gourmet, and her appearance is perfect. Sounds great, right? You may be thinking ‘Where’s the downside, Dr. A?’ Well, in this manic state, Felicia absolutely positively believes that she is descended from “the true” royalty. She believes that the father of the current Queen of England, the previous King George VI, actually stole the monarchy and the crown from her father. As a result, she believes that she should be the rightful current monarch. In reality, her father is a semi-retired urban planner living just outside of Topeka Kansas. Regardless, when Felicia is super manic, she will relay this story with a voice full of indignation and a perfectly straight face. She will tell anyone this story, so people think she’s totally nuts.
A person in a manic state may not realize that their behavior is unusual, but others may notice a change in behavior. Some people may see the person’s outlook as eccentric or sociable and fun-loving, while others may find it unusual or bizarre. The individual may not realize that they are acting inappropriately or be aware of the potential consequences of their behavior. In some cases, they may need help in staying safe when they are completely out of touch with reality. Bipolar type 1 patients can be some of the most dangerous patients in my practice, as they can be violent, prone to rage and acting out on that rage. They are chaotic. If you have an untreated or ineffectively treated bipolar 1 person in the household, you will know. One big problem is that patients enjoy the manic state of their disorder. They feel such increased energy and euphoria that they are prone to stop taking their meds. Once that happens, all hell breaks loose.
But eventually, that mania will cycle into deep depression with all of the symptoms that go with it, and may end with suicidal thoughts or acts. Key features of depressive episodes may include, but are not limited to:
– feeling down or sad
– having very little energy
– having trouble sleeping or sleeping a lot more than usual
– thinking of death or suicide
– forgetting things
– feeling tired
– losing enjoyment in daily activities
– having a flatness of emotion that may show in the person’s facial expression
– In very severe cases, a person may experience psychosis or a catatonic depression, in which they are unable to move, talk, or take any action.
Bipolar type 2, also called hypomania, is a disorder which is sort of like type 1-light. It features episodes of depression and hypomania. Symptoms of hypomania are similar to those of mania, but the behaviors are less extreme, and people can often function well in their daily life. But if a person does not address the signs of hypomania, it can progress into the more severe form of the condition at a later time. I see type 2 patients more often in my practice, and I see them as generally being much calmer than type 1 patients. They do not get as violent, do not hear voices, do not have hallucinations, and are not disorganized in their speech or behavior. However, they are usually irritable. They talk quickly. They have trouble sleeping. They have trouble concentrating. They have trouble getting things done. They have relationship issues. They have trouble sleeping. These periods of hypomania can last anywhere between minutes to days to weeks.
So what can be done for a patient suffering from bipolar disorder, whether type 1 or 2? There are multiple drugs which can be used to balance the patient. I find my go-to drug would be lamotrigine, as it is minimal in its side effect profile, is mood stabilizing, does not put on weight, does not make you drowsy, and does not have many drug interactions. There are other drugs which can be used, oxcarbazepine and divalproex, which are antiseizure mood stabilizers. These have some effectiveness and have various side effect profiles. In some cases, antipsychotic drugs like lurasidone are useful. Many times I put patients on at least two drugs, one to treat mania and one to treat depression. I can prescribe all the drugs in the world, but they won’t do any good if patients are non-compliant in taking them. So the biggest and most important key feature in treating bipolar is having a relationship with the patient and making sure they are compliant with medicine, because the manic state is so enjoyable to them that they may choose non-compliance. That’s really the biggest barrier to treatment. I always explain to my manic patients that while they may like the mania, they will have to pay the piper, because guess what? Next they’ll be hopelessly depressed and unable to get out of bed.
In my practice, I see many female patients with mood disorders. The way I approach treatment is to find the best tolerated drug. This may not be the best drug on the market, but may be the best drug for that patient because it is better tolerated and has a better side effect profile for that patient. If the drugs cause weight gain, make them drowsy, or cause sexual dysfunction, they won’t take them. And who would blame them? So I work very hard to explore all available pharmaceutical treatment options for each patient as an individual. The goal is to have a drug regimen which is the least invasive in that person’s life and to combine that with psychotherapy. Because bipolar disorder is a lifelong disease, treatment should also be lifelong. If you suspect that you have bipolar or a loved one has bipolar, contact a physician for referral to a mental health professional like myself. For more information, check out my book, Tales from the Couch, available on Amazon.com.Learn More
For many people, sleep is an important part of their life. When interrupted by tension or anxiety, the loss of sleep can bring about depression. Anxiety sleep disorder treatment is typically no effort to find, specifically if the loss of sleep is occasional, as opposed to chronic.
In some cases, the person may have to consult their physician for a more particular depression anxiety sleep disorder therapy such as prescription medicine. Most of the time, sleep issues are a sign of other problems, and until the underlying problem is resolved, the sleep disorder will continue.
Among the most common sleep problems is tension, as individuals are unable to ease their mind enough to sleep. Often times after they do get to sleep, they awaken in the middle of the night thinking about what is causing their stress. For most, an effective depression anxiety sleep disorder treatment may be a sleep aid to help clear their mind so they can fall asleep quickly. For others, a time release formula might be needed to help them stay asleep throughout the night.
Some nonprescription sleep aids might help at first, but, their effectiveness is iffy as a depression anxiety sleep disorder solution. Finding ways to take care of depression or stress will be more effective in the long term. Many sleep aids affect the nervous system to put an individual to sleep. Those dealing with depression anxiety sleep disorder, treatment may consist of drugs that work as an antidepressant, as well as calm their stress and anxiety.
Many of these have unwanted results such as building an addiction; requiring continued use to help them get to sleep. The good news is that many antidepressants prescribed by their physicians can end the depression and help them sleep without extra sleep aids.
For periodic problems with sleeping, over the counter medicine can help them sleep. For depression anxiety sleep disorder treatment, a physician can help identify the causes of depression and anxiety, and remove them. If it is a temporary circumstance, such as a major life-changing event, short-term aid can eliminate any long-lasting effects.
For a few, depression anxiety sleep disorder treatment could continue for many years without any obvious environmental cause of the depression or stress. As soon as the causes have been recognized and removed, the physician can then prescribe a continuing depression anxiety sleep disorder treatment to assist the patient with their sleep disorder.Learn More
For many people who are up all night, the internet has become a safe-haven for entertainment and relief. However, did you realize that you can actually get help and relief for your sleepless nights by joining one of the many insomnia online forums that have become available.
These forums are populated with hundreds of people, just like you, who also struggle with sleeplessness. Lots of people are embarrassed to join one of these forums, and to admit that they suffer from sleeplessness. In order to help relieve you from that embarrassment, we have put together a list of the leading reasons why anyone who has trouble sleeping can benefit from signing up with insomnia online forums.
If you have been dealing with insomnia for any extended length of time, you may have a hard time discussing it with your loved ones. Sleeping disorder online forums relieve this uncomfortable circumstance by enabling you to join as an anonymous user, and get advice from total strangers.
It has long been stated that occasionally, a stranger is simpler to talk with than a buddy. These online forums certainly prove that theory, as there are hundreds of people similar to yourself you are willing to lend an ear, as well as their own recommendations and ideas, to those struggling with sleepless nights.
One of the nicest aspects of insomnia forums, is that you can join using any name you want. You don’t ever have to offer your actual name, and so, there is no possibility of people discovering who you really are, if you don’t want them to. For instance, you could be a sleepless-mommy or dead-tired-daddy if you wished to be. Nobody ever needs to know your real identification.
While there are numerous doctors that visit sleeping disorder forums, what you find mostly are genuine individuals who are really suffering from the exact same thing you are. You will find out about treatments and natural remedies that you may not have known about before; all from individuals who have actually been there. Recommendations from a physician is wonderful, but in some cases, what works best are the tried and true techniques that others have used and been helped by.
You should not count on insomnia online forums, nonetheless, if you feel that your insomnia might be chronic in nature. Persistent sleeplessness can have disastrous results on your body and mind, and must be treated by a doctor right away. However, if you only experience moderate cases of insomnia, sleeping disorder forums might be just the thing for you.Learn More
Not being able to sleep during the night can truly be frustrating. Yes, no one has actually been reported of passing away because of lack of rest. However, lack of sleep has been identified as one of the primary causes of reduced productivity of people throughout the day. If you are among those individuals who have been suffering from lack of sleep that you cannot operate well throughout the day, it would be a great idea for you to seek treatment for insomnia.
Discovering an effective treatment for sleeping disorders is crucial, particularly if you have been losing sleep for more than a week. According to experts, losing a lot of sleep can weaken the immune system of our bodies. When the defense system of our body is weakened, we become prone to various kinds of health problems.
The very best way to find an effective treatment for sleeping disorders is to seek advice from a professional. Find a specialist on sleep disorders. Ask for an appointment with the specialist to discuss your sleep disorder. When meeting with the specialist, see to it that you ask questions regarding your circumstance and explore your options with the assistance of the specialist. Note that there are various sorts of treatment for sleeping disorders, so you have to pick out the one that is suitable for you.
When choosing the type of treatment for sleeping disorders, consider the effects of this treatment to your body. Do not just choose a sleeping pill right away. Yes, taking that tablet will be much easier, however, that might not be the best that you can do. Always bear in mind that treating a disorder with drugs is not always favorable. If you can discover some natural ways to treat your sleeplessness instead? A natural treatment for sleeplessness does have a great deal of benefits over those medicines. For one thing, natural treatment procedures do not have side effects, and they cost even less compared with those drugs.
Natural treatments for insomnia consist of simple and practical activities that you can do to help you relax before bed time. A good example of a natural treatment for a sleep disorder is a change in lifestyle. For instance, if you love drinking coffee throughout the day, as well as before bedtime, cut down on that habit.
Do not drink coffee or other kinds of beverages that has caffeine in it at least three hours before bedtime. Keep in mind that caffeine in your blood will keep you awake longer. If you get rid of the source of caffeine in your blood hours before bedtime, you will have better chances of getting to sleep easily.Learn More
If your child awakens in the middle of the night shouting in sheer terror, they might be experiencing pavor nocturmus, commonly referred to as sleep terror disorder. Frequently, this is confused with nightmares, but there is a major difference, because the child often remembers exactly what caused their nightmare while they might not wake up at all throughout an episode of sleep terror disorder, and will not remember being awake.
Episodes of sleep terror disorder are prevalent in children between about three and eight years of age, although they can be experienced by older kids, as well as adults. The specific reason for sleep terror disorder is unknown, however, it is typically associateded with stress or lack of rest. During an episode, which can be frightening to the parents, normally the episode will last between ten and twenty minutes, after which the child will go back to sleep and have no memory of the event the next morning.
Figuring out the difference between sleep terror disorder and the child awakening during a bad dream should be simple enough, as the kid might have the ability to explain about monsters under the bed, and falling through space when they have a nightmare. While these frightening dreams happen during the REM sleep stage, the memory of the occasion is typically vivid when the child gets up. They will also be awake instantly after the dream, while being comforted by a parent.
Seldom will a child suffering from sleep terror disorder have any idea the next day of what terrified them awake. While a parent is holding the child throughout an episode, the child will continue to be asleep, entirely unaware they are having a problem. Regardless of repeated attempts by the parents to calm the child, they will not be consciously awake and will be incapable to talk about what triggered the fear.
If a child continues to suffer from sleep terror disorder, removing the environmental causes of the anxiety and seeing to it the child is getting appropriate sleep most evenings can really help decrease the number of sleep terror disorder episodes. In some serious and lasting cases, the physician might suggest sedatives to remove the tension, and help the child sleep throughout the night.
Parents, however, should not try to self-diagnose or medicate the child without speaking with a medical professional. There might be some concealed causes of anxiety to the child that the physician can detect and help eliminate. Usually, after the age of eight, the sleep terror disorder will vanish by itself.Learn More
If you are struggling with a sleep disorder of any kind, you can rest assured that you are not alone. In fact, there may be as many as 40 million individuals in the United States alone who are presently experiencing some kind of sleep disorder.
Some of these individuals have turned to their physician for help, while others are using over the counter remedies or merely suffering through. The good news is that there are symptoms that can be used to accurately diagnose this condition so that effective treatment options can be explored. Sometimes the remedy can be as simple as way of life changes that will help to promote an excellent night’s sleep. In other cases, your physician might recommend medication or suggest therapy as a means of overcoming your sleep disorder.
While it may seem quite simple to recognize a sleep disorder, a lack of a good night’s sleep is not the only sign that doctors will search for. Various other symptoms might include fatigue or irritability throughout the day, inability to focus or remember things, slow reactions, emotional outbursts, and an overall appearance of looking worn out.
You might also drop off to sleep easily during the day, even when carrying out activities like driving or working at your desk. You might turn to caffeinated drinks and various other methods to stay awake and alert throughout the day. Any or all of these symptoms might also point to a possible sleep disorder, and needs to be gone over with your physician.
Treatment of a sleep disorder will depend in part on exactly what type of condition you are diagnosed with. Insomnia, the inability to sleep or remain asleep throughout the night, is commonly dealt with through way of life modifications and occasionally prescribed sleep aids. Depending upon the reason behind the sleeping disorder, therapy may also be suggested. Another common sleep disorder, sleep apnea, should be identified and treated by your doctor, because there are potentially major medical problems that can result from this disorder. Treatment will frequently include devices to use during sleep, behavioral changes, and occasionally, surgery.
There are various other kinds of sleep disorders that are not as typical, but will need their own specialized treatment strategy. The best individual to identify and treat your sleep disorder is your doctor. If you are experiencing any of the above symptoms, and you suspect that a sleep disorder is the reason, it is a good idea to make an appointment with your doctor to discuss your diagnosis and treatment alternatives.Learn More
As an increasing number of people find it difficult to sleep during the night for numerous reasons, many kinds of sleep disorder treatments have actually been invented through the years. Many of these sleep disorder therapies are quite effective, and there are likewise a few of them that simply just don’t work at all.
The effectiveness of a specific sleep disorder therapy is usually influenced by the state of emotions and the environment of the person who is struggling with sleeplessness. Thus, before an individual begins on a sleep disorder treatment, he or she ought to make it a point to delve much deeper into the cause of his or her insomnia. Understanding the causes of insomnia will make treatment easier.
Among the most highly recommended sleep disorder treatments is basic relaxation. According to specialists, the most common cause of sleeplessness is stress. A lot of people who are hyperactive during the day, and those who are handling some personal issues are typically too keyed-up to sleep during the night. As a result, these people lie awake in bed through the wee hours of the morning. Some of them fall into a fitful sleep, and they commonly get up several times in the night. In any case, the outcome is often the same. Not having the ability to sleep at all or fitfully sleeping through the night can make a person feel worn out and drowsy during the day.
To fight off insomnia, a person who is under stress must learn the best ways to relax and loosen up before going to sleep. There are numerous relaxation methods that one can adopt to calm his/her nerves before bedtime. A few of these relaxation techniques consist of yoga exercises, hypnosis or simply reading a great book.
Battling off sleeplessness can be rather complicated for many people. A great deal of people are simply too stressed out and too edgy that they require more potent sleep disorder treatment like drug treatment to help them relax and get some sleep. In cases like this, the sufferer should consult his or her physician initially prior to taking any medications.
Taking over the counter drugs is not actually a great idea. Although taking sleeping pills can be very helpful at times, taking the pill is not actually advisable in the long run. Like any other forms of drugs, sleeping pills can have some adverse effects on the body. Furthermore, there is likewise the danger of becoming dependent on the drug.Learn More
The trouble with some females is that they frequently suffer from pregnancy and insomnia, and even regardless of feeling extremely exhausted and tired, sleep is something that will continue to elude them. It frequently can become a brand-new challenge that impacts both the pregnancy and their own psychological makeup as well.
Such females should follow particular steps in order to come to terms with their pregnancy and insomnia problem, and an initial step in that direction would be to wind down their day at least thirty minutes prior to their bed time.
To get over the difficulty of pregnancy and insomnia, it is suggested for patients to get rid of any tasks that are of a stimulating kind, as well as to remember to not indulge in conversations that lead to stimulation. Therefore, not making phone calls or viewing television is advised, and special mention must be made of having to stay clear of paying attention to newscasts referring to world catastrophes, which are usually highlighted in the ten o’ clock news each night.
It is also a much better idea to take a warm herbal bath with lighting not much brighter than that of candlelight, which ought to promote relaxation prior to turning in for the night. It also happens that in pregnancy and insomnia, mothers-to-be commonly wake up in the middle of the night because of maybe the movement of the unborn baby, or due to various other reasons; in such situations, when sleep does not come to them, it would be advisable to just lie and rest. If you keep a light snack by the bed, you should be able to have something to chew on in the middle of the night rather than having to get up and fetch something out of the refrigerator.
A typical issue in pregnancy and insomnia is that mothers-to-be frequently let insomnia get to them and become anxious and lose rest stressing, which only makes for even more sleep loss. Relying on sleeping pills as a solution is also not suggested, considering that it can endanger the health of your unborn infant. Rather, you would be much better off if you accept your pregnancy and insomnia for what it is. Just let it be because with time it too will have gone by.
Even reading a book at night is a method of conquering pregnancy and insomnia, while getting up and carrying out some activity that is not too stimulating will likewise help, as too will taking short naps throughout the day.Learn More
It’s 3 a.m., you cannot sleep. It’s been like this for many nights now. You understand that there are pills available that you can take to help you sleep, but, a lot of of them have abnormal side effects, and you certainly don’t want to become addicted to anything. Their is still a healthy alternative. You do not have to take a prescription to help you sleep. There are literally hundreds of natural remedies for sleeping disorders just waiting to help you get a good night’s rest.
A lot of individuals have forgotten the older, natural remedies for sleeplessness. It’s a shame, actually. These tricks and tips have been around for hundreds of years, helping folks get a great night’s sleep without using any drugs whatsoever. Our specialists have scoured the world over to find as many all natural treatments for sleeplessness they might discover; and they have brought them all here for you. So settle in, have a read, and, hopefully, you will discover a natural remedy for your sleeping disorder.
When it concerns all natural treatments for sleeplessness, there’s just no beating good old-fashioned chamomile tea. This aromatic tea is a mix of the dried leaves and flowers of the chamomile plant. Consuming two or three cups of this tea is a time honored tradition for those dealing with sleeping disorders.
If chamomile isn’t your style, there are a great number of various other herbal, natural remedies for insomnia. These remedies ought to be taken as directed on the bottle, or by your physician; usually two or three times every day. These natural herbs for sleeplessness include cat nip, valerian root, and vervain tea.
Various other natural treatments for sleeplessness aren’t ingested at all. Taking a bath with lavender fragrance in it is a tried and true technique for getting into a relaxed, sleepy state. This method has actually been proven to be so effective, in fact, that many manufacturers now offer baby bath with lavender fragrance.
Forget your grandma’s cup of hot milk, today’s natural remedies for sleeplessness include foods that should be found in every healthy diet. Believe it or not, each of the following foods can help your body to unwind at bed time, and will help you get a great night’s sleep: bananas, spinach, turkey, yogurt, and lettuce. Make sure to include a lot of these foods in your diet, and you will be able to see a dramatic reduction in your insomnia.
While there are lots of natural remedies for insomnia, they are not all suitable for everybody. If you are pregnant or nursing, talk with your doctor before implementing any of the preceding natural remedies for insomnia into your daily routine.
Everyone deals with a sleep deprived night at one time or another. There are a lot of reasons why sleep can be disturbed for a night or two, however, when sleep deprivation ends up being a chronic condition, it can lead to a lower performance at work, or a negative impact on your overall life.
Not getting sufficient quality rest can even influence your body physically, making you more vulnerable to illness and accidents. This is why it becomes so essential to seek insomnia treatment alternatives if you are experiencing the signs of sleep deprivation over the long term.
Prior to determining which insomnia treatment will work the very best for you, it is great to understand exactly what insomnia looks like. For some, this sleep disorder will suggest the inability to fall asleep during the night. Others will have problems with waking in the middle of the night, or very early in the morning, and not being able to get back to sleep. The end result will be the exact same daytime tiredness and irritability, failure to concentrate, and difficulty staying awake.
If you are experiencing any of these signs, it might be time to talk to your physician about the very best insomnia treatment for you. If your insomnia is still relatively moderate, you might be able to treat the problem by yourself at home. This might consist of modifications to your routine, like staying clear of a heavy meal, or exhausting exercise too close to bed time. You might attempt following a routine evening schedule that consists of a late night bath or various other methods for relaxing. You will likewise want to ensure that you go to bed and get up at the exact same time every day to help train your body to an appropriate sleep time. For many, simple behavioral changes like these are sufficient sleeplessness treatments, and no additional intervention will be needed.
If you find that you need extra insomnia treatment alternatives, your physician will have more remedies for you to try out. These may consist of a medicine that can be used temporarily, in case your sleep deprivation is influencing your life in apparent and unfavorable ways. Your doctor might have additional behavior modifications that you can attempt that will attend to the underlying reasons behind your insomnia. In some cases, your doctor may likewise recommend counseling as an insomnia treatment. The good news is that there are many options in sleeping disorder treatment that will help get you back on the path to an excellent night’s sleep.Learn More
For many people sleeplessness is an occasional annoyance, triggering them to lose rest for a night or two while for others it is a continuous problem. For occasional sleeplessness, medicines offered over the counter can assist an individual sleep and stay asleep throughout the night, nonetheless adverse effects of a few of these medications might cause other troubles. In addition, taking sleeplessness medicines can mask other, more serious rest disturbances.
Usually, insomnia is called the inability to drop off to sleep and remain asleep, and some of the typical causes consist of anxiety and pain. A number of various insomnia medications can assist the person get to sleep. However, some of them can produce a reliance on the medicines after long-lasting use. In addition, some of the over the counter insomnia medicines include antihistamines that can cause an adverse communication with other medications being taken.
Some of the more recent insomnia medications on the market work well in helping people sleep rapidly but throughout tests lots were getting up in the middle of the night. They were then reformulated for an extended release of the medicine to allow them to continue to be sleeping throughout the night. One of the cautions that included many of the present crop of medicines is that the individual must have the time to sleep a minimum of seven or eight hours as getting out of bed faster can trigger drowsiness throughout the day.
In most cases insomnia is a sign of other issues and taking insomnia medicines that are aimed at the issue can be much better than simply taking a sleeping pill. As an example, one medicine is aimed at the sleep cycle and not at depressing the central nerves. This helps reset the circadian clock without the danger of being mistreated and has shown to be safe for lasting use.
Antidepressants might be suggested as one of the sleeplessness medicines for those who have trouble sleeping due to tension or depression. The medication deals with the depression, which in turn normally helps the individual sleep faster. Some of the older sleeping disorder medicines were made to remain in the system longer and are utilized for sleep disorders such as sleep walking and night terror.
These medicines can trigger fatigue during the day along with develop a dependency where the person will always require them to drop off to sleep. These insomnia medicines are not offered over the counter and needs to not be taken unless directed by your physician.Learn More
Post-traumatic stress disorder (PTSD) is a severe anxiety disorder that can develop after exposure to any event that results in-psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one’s own or someone else’s physical, sexual, or psychological integrity, overwhelming the individual’s ability to cope. As an effect of psychological trauma, PTSD is less frequent and more enduring than the more commonly seen acute stress response. Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increasedarousal – such as difficulty falling or staying asleep, anger, and hypervigilance. Formal diagnostic criteria (both DSM-IV-TR and ICD-10) require that the symptoms last more than one month and cause significant impairment in social, occupational, or other important areas of functioning.Learn More
Mood disorder is the term designating a group of diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV TR) classification system where a disturbance in the person’s mood is hypothesized to be the main underlying feature. The classification is known as mood (affective) disorders in ICD 10.
English psychiatrist Henry Maudsley proposed an overarching category of affective disorder. The term was then replaced by mood disorder, as the latter term refers to the underlying or longitudinal emotional state, whereas the former refers to the external expression observed by others.
Two groups of mood disorders are broadly recognized; the division is based on whether the person has ever had a manic or hypomanicepisode. Thus, there are depressive disorders, of which the best known and most researched is major depressive disorder (MDD) commonly called clinical depression or major depression, and bipolar disorder (BD), formerly known as manic depression and characterized by intermittent episodes of mania or hypomania, usually interlaced with depressive episodes.
Disorders in this CategoryLearn More
Anorexia nervosa (AN), also known as simply Anorexia, is an eating disorder characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight. It is often coupled with a distorted self image which may be maintained by various cognitive biases that alter how the affected individual evaluates and thinks about her or his body, food and eating. Persons with anorexia nervosa continue to feel hunger, but deny themselves all but very small quantities of food. The average caloric intake of a person with anorexia nervosa is 600–800 calories per day, but extreme cases of complete self-starvation are known. It is a serious mental illness with a high incidence ofcomorbidity and the highest mortality rate of any psychiatric disorder.
Anorexia most often has its onset in adolescence and is most prevalent among adolescent girls. However, more recent studies show that the onset age of anorexia decreased from an average of 13 to 17 years of age to 9 to 12. While it can affect men and women of any age,race, and socioeconomic and cultural background, Anorexia nervosa occurs in females 10 times more than in males.Learn More