Sunday, 21 October 2018

13 Songs To Help You Face Depression | Infmy

October 21, 2018

To everyone who is in need of a voice for themselves in tough times just always be true to yourself, letting go the past, STAY STRONG and there is always a way to believe in yourself.
Here is a list of songs that would be helpful for you if you found yourself as depressed. 



1) The Light Behind Your Eyes- My Chemical Romance 





''When I am no longer, you must be stronger..." this song is reason enough to live on. Though it's sad MCR broke up but they have always taught us to stay strong just like this song.

Their music will continually rule in our hearts forever. 



2) Never Too Late- Three Days Grace



When no one else could this song saved my life somehow. 

Sometimes life could be horrible in many unusual ways but there is always hope and a way to make things better and it's never too late to work on your life to make things better.



3- Keep Holding On - Avril Lavigne



This song will always fill you up with love and de-stress you from being lonely or sad as the singer Avril Lavigne has put all her emotions to create this song heart touching and beautiful.


4- Superheros by The Script

The song talks about the life's struggles that everyone faces in their life and how you fight every day with your problems to get the shit out it.

 "The pain that you are facing today will be your strength for tomorrow to make you stronger than before."


5- Saviour By Black Veil Bride


This is Andy Biersack song to all his fans, all he wants to convey through this song that you are not lonely or alone. You have to not afraid either, and if you have had a horrible past or anything that is holding you back in present and making you sad or depressed than you must listen to this song for once.



Andy has done a great work in this song. The music and lyrics will touch your heart and makes you realize that you are not alone, someone is always there who cares for you (but all you have to speak up about your emotions to someone who you trust).



6- Skillet- Not Gonna Die



It's a rock battle anthem song that you can relate with anything that is keeping you numb all the time no matter what. And the message in this song helps you to fight with your battle and taking your life back again to the way it's supposed to be like I  mean in a worthy way.

7- Simple Plan- This Song Saved My Life



This song is specially made for the fans of Simple Plan as said in an interview by the band members. The song is so emotional and has something special touch that you can relate to yourself if you are suicidal, depressed or no matter what the hell you are goin' through. 

As long as you have someone to speak about your problems and find comfort with them. So this song is a person who saved his/her life.

8- Lullaby by Nickelback 




This song is damn amazing, as the lullaby is something the pain that you are carrying on and the hopelessness that you are holding inside, but this song delivers a great message that not to give up on your life plus there is always someone who really cares about you and all you gotta have to speak up all the feelings and pain you carrying inside.


9- Skyscraper By Demi Lovato

As life is full of ups and down and people always try to knock you down and that makes a mess in your life and consequently if you are not strong enough such things could make your life worse and sometimes lead you to depression and anxiety, 

But the song Skyscraper help you to learn that still there is a hope, the lyrics interpreted that there is a battle to win over something (it could be depression, self-harm, SAD or any kind of disorder you are living in it.
So, don't lose hope and it's better to worth fighting for


10- Believe In Me by Demi Lovato

Demi Lovato has been always an inspiration to many people who have been through tough times such as depression, self-harm, anorexia, etc. 

All she wants to say that you got to change your ways of always getting weak and start feeling how beautiful you are from inside out, and stop being afraid of rejection and start believing in yourself.


11- Fight by Rachel Platten

This is such an empowering and emotional track that will help you to get stronger and face the tough times of your life, don't let people prove you that you are weak.

It's time to get up again, stay strong, believe in yourself and fight for your problems and never give up on yourselves. 


12- Demons- Imagine Dragons



The main theme of this song is that we all have a dark side and insecurities in our life that always been a reason for our failures, it's not bad to have the dark side because everyone does and rather than hiding it or pretending we haven't got any  we must embrace them and find a way to get out of it.


13- 
Iridescent - Linkin Park
 



This song is all about letting go all the worst things happened in your past, whatever the mistakes you have done you should keep moving on and looking forward to the things that make you happy and that make sense. 



The songs list could go on and on. Comment down below and let us know the song that has been helpful and makes you feel good when you are depressed.


Monday, 6 August 2018

5 Best Ways to Treat Your Depression

August 06, 2018
Best ways to treat Depression

how to treat depression at home
Best Way to Treat Depression
Depression can be treated in many different ways. People respond to different types of treatments in different ways. Not all depression treatments will affect different people in the same way. Some treatments may work better than others for you.





1. Antidepressants

Whenever anyone thinks of any type of medical condition, the first thing that comes to mind is medicine. Antidepressants can be used to treat depression. You can’t just get antidepressants over the counter at the pharmacy. Instead, a medical professional such as a psychiatrist prescribes you this medicine after assessing your situation and if they seem it necessary.


There are many different types of antidepressants. Here are some of them :


  • SNRIs – Serotonin & Norepinephrine Reuptake Inhibitors
  • SSRIs – Selective Serotonin Reuptake Inhibitors
  • NDRIs – Norepinephrine & Dopamine Reuptake Inhibitors
  • MAOIs – MonoAmine Oxidase Inhibitors
  • Tricyclic Antidepressants
  • Atypical Antidepressants

I won’t get into any details here with the different types of antidepressants, but you should make sure to discuss the different types with your prescribing doctor to see which one would work best for you.



2. Social Support

Depending on your personality type, it could be highly beneficial to have some social support to aid you in dealing with depression.

There are different ways in which you can get social support. If you know someone who you can trust such as a parent, sibling, best friend, co-worker, or any other person who you know will keep what you say confidential, it could be beneficial to start opening up and letting them know about depression and that you could use their help.

Another way you get can social support is through social support groups in your area. Millions of people suffer from depression probably in every single city in the world. Chances are that there are support groups in your area which meet frequently – similar to alcoholics anonymous or drug rehabilitation groups. This could be beneficial as you get a chance to hear what other people are going through and relate to them because you are going through the same thing.

Social support can also be in the simple form of an anonymous phone call to a depression hotline. There are free services out there which provide an ear to listen to what you have to say and possibly help you out with some advice. This also applies to those who are considering committing suicide. It is important to reach out to someone because you may not be in the right state of mind and sometimes all it takes is a friendly voice to talk you out of it.


If you are a private person and do not wish to share that you have depression with people, the hotlines are a good start. You can also join forums about depression online using a username which is not your real name. Forums are a great place to share things about yourself anonymously and get opinions and advice from others who have been or may be going through what you are going through. Just remember not to take any forum recommendations as professional medical advice because you don’t know who the actual person is and their level of knowledge/experience.

Know more how mental health support groups can help you



3) Exercise

 Exercise is a great cost-effective way to treat your depression. Just start your day with a 30-minute walk. After a week, turn it into a brisk walk. When you are ready, start jogging. Cardiovascular activities pump the blood through your body and to your brain. By getting blood to your brain, you can be more focused and get more energy overall when doing your daily activities.

If you have a treadmill, elliptical, exercise bike, or something else that helps you do cardio exercises, great! But if the weather is nice out, be sure to go outside! Not only will you get your exercise, you will also get fresh air and sunlight (which provides you with Vitamin D).

You could even pay a monthly fee to join a gym where you will have the added bonus of having people around you. Even though you may not talk to anyone at the gym, sometimes it does help to have social contact – especially if you are living alone or if you do not get a chance to interact with many people at work (I find those grey cubicles very depressing!).



4. Cognitive Behavioral Therapy (CBT)

CBT focuses on how your thinking affects your behavior. More specifically, how negative thoughts are irrational and how to turn negative thoughts and situations around for a more positive outcome. CBT uses different problems and scenarios for a person to work through and develop their skills in finding a positive solution to the problem.

For example, a person who thinks about car crashes might be afraid of ever driving a car or even riding in a car. The goal of CBT is to teach people that they cannot control people and situations around them, but they can certainly learn how to deal with them and not have such a negative outlook.


Typically, you will do a CBT session with a therapist in person (one-on-one), however, there are options to do it on a computer (over the internet), through books, or by participating in a group course. CBT sessions are meant only for the short-term (days or weeks if spread out). Once you have received CBT, it will be up to you to use the techniques you have learned when you get a relapse of depression. CBT doesn’t necessarily remove depression but helps you deal with it so that it can go away quickly and you can get back to your life.



5. Acupuncture

Acupuncture is an ancient Chinese art where they stick very thin needles into different points on your body. Does it hurt? Not really if done correctly. You may feel a tingling feeling or a sharp pain at sensitive areas, but the pain usually goes away after a few seconds. Acupuncture has been shown to help some people with depression.

It does sound crazy, but some people say that acupuncture does help while others find that it doesn’t. Some studies have also shown that it may help with depression. By placing needles at strategic points, your body and brain can react by releasing different compounds which act in a healing way. Acupuncture has been known to treat other conditions as well such as stress – which commonly goes hand-in-hand with depression.


In any case, it doesn’t hurt to try it because it certainly is a different experience. The benefit of acupuncture over other treatment methods (like antidepressants) is that acupuncture doesn’t have the side effects of medications.



Wednesday, 4 July 2018

How to Reduce Stress | 8 Easy Stress Relief Activities You Should Try

July 04, 2018

Feeling depressed or low?

Check out these real quick tips to boost up your mind from this goddamn depression and stress. Set these new positive goals and follow these stress reliever activities for a month at least.

easy ways to relief stress and aniety

Well,  Motivation is something that I really struggled with when I was deep in my dark days. These tips will be really helpful for those days when you feel that you can't bring yourself to do certain tasks. It may be that you lack motivation or you get really anxious about thinking about doing them and end up not doing them. 

All you have to just try them and promise yourself that you gonna follow these Stress Reliever Activities if any of them doesn't work for you try again that and if still doesn't work try one of the next.   


1) Most people don't know why they are depressed they're just feeling extremely sad and they just can't get out of it whereas, some people might have actual reasons for being depressed.


All you have to figure out what triggered your depression and once you know and understand your triggers you become more mindful of your environment who you're around what you're around how it affects you. And try replacing them with these Stress Reliever Activities given below.


  2) At the beginning of each day make a list of stuff that you'd like to accomplish and just work your way through the list.

This kinda works because they can be as simple or as complex, as you want them to be. 


3) Turn off the internet for a day and do something that fascinates you, go outside to see someone,  talk to somebody or either go for a movie, if you've got no friends (just like me lol) go on your own cook something or bake something but just remember do not use of  the internet to see the recipes, better you can use a recipe's book.


4) Deep Breathing! Now this one might seem easy but it's very easy to forget how to do it properly. First, of all make yourself comfy close your eyes, imagine yourself in a place which gives you a feeling of relaxation. Now slowly, take deep breaths in and out.
 Repeat this deep (inhale/exhale process) for next to 10-15 minutes. 

5) Record a video or write yourself a letter about what you want from life it could be for the next week, the next month, the next year, or for the next five or ten years or just pen down your life's ultimate goals. 

6) Tell yourself all of the great things about yourself and why you love yourself plus you could also tell yourself what you have to offer to the world (same as we talk in the above point about your life's ultimate goals).

7) Take photos, print them out and stick them around your room. Rearrange your bedroom furniture. It could be fun though. 
Draw, read a book or do anything at all just experience something real.

8) Call a friend who you haven't spoken for a long time.

 Or, find something or someone that you feel supported by it could be a  family member a friend or a music band just like MCR  (they saved my life somehow) whatever it just finds a way to express yourself.

Well, there could be many other possible ways out to relieve stress by doing other activities. I will be covering up them too very soon. You could discover your own stress reliever activities or if you have any other activities that help you always in your dark days. Do comment below I'd love to read them all.

X X 

Monday, 18 June 2018

14 Worst Foods to Avoid Depression and Stress

June 18, 2018
 The food we consume every day plays a major role in our health, as the nutrients and energy help our body to grow and develop. But not every food we eat is good for our health especially when it comes to our anxiety and depression. 


foods that cause depression



When we think about anxiety the first thing that comes to our mind is chocolates, that too dark ones without much sugar and milk solids as we've been consuming them to feel a bit better whenever something is making us too anxious. While food items like chocolates help us in coping up with anxiety or stress, there are several food items that have the exact opposite effect i.e, worsen your state of mind. And as we wouldn't want that, here are some common food items that should be avoided if you're already feeling uneasy.



1) Fruit Juice- As we know that fruit juice is beneficial for health, but not everytime juice's gonna help your body to boost up.

If juice isn't having sources of growing food (i.e full of proteins) and lacks fibers then this could affect your body's blood sugar level and eventually, it will lead you to dizziness and moodiness. 


2) Artificial Sweeteners-  According to the research, it showed that consuming sugar in large amount causes obesity and other health issues. As of today, thousands of products are flooded in the market with artificial sweeteners in them while having zero calories, which make the diet drinks and other snacks sweeter. 


But many of you won't be knowing that the ingredient that is found in diet drinks and other zero calories snacks is Aspartame (APM) which is an artificial non-sweetener used as a sugar substitute, has a tendency to stop the production of the neurotransmitter serotonin and hence seen to cause mood swings, depression, and insomnia. 


3) Caffeine- Caffeine influences anxiety and can also worsen if not consumed wisely. Caffeine increases the dopamine production in the brain that makes you feel better (150-200 mg of caffeine is basically large coffee) which results in increases the stress hormones that will affect your body like increased heart rates and blood pressure. Moreover it also increases muscle tension, a common symptom of anxiety.


Therefore,  adding a caffeine in your daily life will only trigger your anxiety. It even messes up with your sleeping patterns. So, try to avoid any caffeinated drinks and have a cup of green tea instead. 


4) Alcohol-  Alcohol is the most common drug consumed by people worldwide. Alcohol consumption and anxiety are quite often connected with one another because the main reason behind people drink is just to get rid of stress or mental disturbances. This may seem like an instant escape from reality but later on the chronic alcohol abuse can make their anxiety worse.


Moreover, alcohol consumers have a higher risk of circulatory system complications such as heart failure, high blood pressure, strokes, etc. Also, it will make your immune system weak.


5) Sugar- According to an article which was published in Diabetologia (Medical Journal), the researchers came to know that when the blood glucose levels increase in the body, the levels of protein which is essential for the growth of synapses and neurons falls down, consequently putting you at higher risk of depression, anxiety, and diabetes as well.


6) Tofu-   A rich source of protein also known as bean curd, made from soy. All soy products contain toxins and antinutrients plus the amount of copper present in a soy has a higher tendency to provoke your anxiety level. 


But if you are a tofu lover and don't wanna skip a single day without tofu, you can try the fermented one's i.e, natto or tamari which are easy to digest and wouldn't make you dizzy.



7) Canned Soup-   A chemical known as Bisphenol A (BPA) is used in most of the plastic containers and canned food liners. It can imbalance the stress-meditating portion of the brain which can further impact the higher risk of anxiety. 



In sight to this, a study showed in University of California- Berkeley that children who were exposed to BPA  in early ages had more common symptoms of anxiety and other mental health issues. So you might wanna consider putting it off the table.



8) White Food- Food such as white rice, white bread, pasta, cakes, processed white bread, etc are generally carbs and the effect they produce is called insulin dumping. 


And it has been found insulin upsurge triggers the depression and anxiety in many people. Also the refinded products can cause vitamin B1 (thiamine) deficiency, which leads to symptoms of anxiety and emotional instability.


9) Fried Food- Fried food! Hellyeah, though it is easy to cook and rich in taste but contributes to making your anxiety and depression worst. Sounds terrible. Right?


You must be wondering HOW?

Well, eating fried food blocks the arteries with fats and thus reduced the blood flow to the brain as well as in the whole body. When oxygen, enzymes, nutrients, and neurotransmitter and other chemical carried by blood into the brain, the hypothalamus (part of the brain that controls stress and mood) ain't perform properly.



10) Energy Drinks- Energy drinks can make you feel like energetic for an hour but the hidden ingredients such as guarana cause sleep issues and increase your anxiety.


Additionally, artificial sweeteners and sugar are also added to make energy drink sweeter that we have already discussed in 2nd and  5th points.


So start avoiding energy drinks from today they are not good enough for your health. Better you can have a glass of water.



11) Selenium- As Selenium is good for health but a new study at the University of Otago showed a strong bond between selenium levels that are too high or too low can put a person at higher risk of depression.


Know more about Selenium and depression click here at NCBI 


12) High Sodium Foods- High sodium foods are no more good for health. To make a food tastier we all add some amount of salt to our food, though salt plays a vital role in regulating water in our body also it is helpful for proper muscle growth. But foods such as Pizza, yeast bread, plain milk, tacos, pasta mixed dishes, bacon, sausages, etc contains the higher amount of sodium is ain't good for your health and could trigger your anxiety.


Moreover consuming high sodium foods could be the reason for higher risk of high blood pressure and heart attack as well. 


13)Salt- Just like sugar, large amounts of salt over a time can deplete your body of potassium, which is essential for proper functioning of the nervous system. Also, the diets which come under being salty will surely increase your blood pressure, making your heart working faster and this results in release of stress hormones causing a instant feel of the and anxiety.

So, alternatives like herbs should be used in place of salt to give that delicious feel in dishes which turns out be healthy for both your physical and mental state.


14) Junk Food- In today's world, we are caught up in our busy schedules, and most of us choose junk food as to save time and to have that instant energy. On a stressful day, even if you consume your favourite pizza or burger to feel good, chances are you will end up feeling bloated and anxious.

According to a study, the population whose diet is junk food is found to be more depressed with unhealthy mental health in comparison to those whose diet is traditional. So try to minimise the junk food intake whenever healthy options are available.


Also read Foods That Help Depression and Anxiety 





Thursday, 7 June 2018

CBT and DBT Therapies for Suicide Prevention

June 07, 2018

Suicide Prevention: Therapies That Works


Dial 1-800-273-8255  National Suicide Prevention Lifeline or visit your local emergency room promptly, if you or someone you know feeling suicidal.

People who are suicidal and suffers from self-harming experience lots of negative thoughts about themselves, about others and about the world. Thoughts like  I'm not good enough, everybody hates me, I can't handle this situation and so on.

The most important thing that you have to figure out is something that will really work for you and I guess one of the best treatment is talking and sharing that what is actually going on. Secondly, the National Suicide Prevention Lifeline because it gives an opportunity to people to talk and share their feelings and emotions that are holding them back.

Some of the most common therapies for suicide prevention are CBT (Cognitive Behavioral Therapy) and DBT (Dialectical Behavior Therapy) which basically help an individual to identify their mind patterns and try to change them in a positive way from negativity.



CBT and DBT for suicide prevention
Suicide Prevention 


DBT and CBT for Suicide Prevention


Dialectical Behavior Therapy(DBT)

DTB can work for most mental disorders. It's a base to work from which makes you recognize your patterns of behaviors and gives you tools to prevent you getting very unwell. Saying that you must already be in a prepared mental state of readiness to help yourself. 

Without being disrespectful, some people with mental health problems expect quick fixes and don't realize the only person who can make them better is themselves. If you have not come to this realization yet it won't help you, nothing will happen, until you do by yourself. 

Well, it's not easy as it seems to be because you have to work hard to feel ‘normal’ and there are relapses.

 Mine have been bearable (no suicidal behavior) since completing the course but you have to keep working on your skills and your lifestyle. 

Your whole life which can be overwhelming at times but takes each day at a time and some days you won't even need to consider your skills.


So stay strong and believe in yourself that you can also overcome this mental sickness.



CBT (Cognitive Behavioral Therapy)



CBT is a type of talking therapy that focuses on your belief, attitude, and thoughts and how they affect your feelings and behavior and teaches you coping skills that how you can face your problems.

So, cognitive therapy is all related to our thought process so cognitive examines what you think and behavioral therapy examining the things you do.

The theory behind CBT is based on the idea what we think and the way of thinking about a particular situation and it can affect the way we feel and behave.

For an example let's suppose you are in a situation and you interrupt as a negative then you might experience your feelings and emotions negative to that situation. And consequently, these negative thoughts and feelings will lead you to unhealthy behavior.

How does CBT Work

 In CBT your therapist will help you to identify and challenge any negative and thinking patterns and your behavior as well which may be the reason for causing new difficulties and helps you to change your behavior towards the situation.

For example, you have had bullying in school then you may have challenges with your relationships and all of the time and you have collected all of these negative thoughts and feelings.

So your therapist may ask you to focus on what's going on right now in your life (while doing your CBT) or maybe they gonna ask about your past that you are still carrying with you and that's making you mentally sick.




How to Find A Better Therapist?



If you still feel like your therapist is not doing anything for you or might be you are not experiencing that connection with your therapist that is required to have then don't feel afraid to change your therapist you can try and get another therapist and keep on doing over and over again until you find a better one because that's only what really matters.

So, better find a person whom you can actually make a connection with.

One of the best way to get in touch with if you or someone you know having a suicidal behavior just dial 2-1-1 (Big Bend) to speak with an online counselor.

 The people out there are helpful and awesome always ready to talk with you and providing you all the resources that would really help you out with this suicidal behavior and thoughts.


Monday, 28 May 2018

Mental Health Support Groups | How They Can Help You

May 28, 2018

How Depression Support Groups Can Help You?


It can be lonely to try and deal with depression by all alone. Depression is draining and can impact not only your energy levels but also your hopes and future plans as well. By taking the first step and trying to deal with depression, it will go a long way on your road to recovery.


Mental Health Support Groups | How They Can Help You
Mental Health Support Groups

At some point, you may come to realize that it feels like an uphill battle trying to fight depression on your own. It is important not to keep yourself isolated when you are depressed – it will only make things worse.

 Do you have someone who can help you through depression?

 Someone who has been through depression themselves? If you can admit that you need help with depression, you are taking a step forward in the right direction.

By building supportive relationships, you can get help from others to deal with your depression. Depression support groups are a convenient way to build these relationships. It involves a group of people who don’t know who you are but have a good idea of what you are going through. They are going through or have gone through it depression themselves.

In a depression support group, you get the opportunity to speak about your problems and try to work them out with others. Often, everyone in the group has experienced depression or knows someone who has depression. You will work together with others by learning and teach the techniques you have used to deal with depression. Being in a group environment can speed up the time it takes to deal with depression as opposed to trying to deal with it on your own.

It is difficult to talk to others in your everyday life about depression, especially if they have not gone through it themselves. Having a depression support group will give you the opportunity to open up and share your own experiences. You will be able to listen to other people talk about their emotions and feelings.

Meeting with a depression support group is safe and has proved to work when the group is a right fit for you. Before jumping into a depression support group, you will need to have a few sessions with a mental health professional. These professionals can be therapists, psychiatrists, or primary caregivers. They will be able to determine which group you would best fit into.

Depression support group sessions are usually moderated by a licensed counselor. Their job is to give everyone a chance to speak and direct the conversation. They also track changes in the levels of depression amongst the members of the group.

Don’t expect your depression to be gone after the first session – that is not how it works. You will need to invest your time and build a level of trust among the other members of the group to fight your depression.

 You may be in a support group for a few weeks to a few months. But it is common to be part of the group for years, even if you have overcome your depression. You can always provide your insights with new and existing members who are currently depressed.

Depression support groups can have a great impact on your outlook on depression. Maybe one day just as the support group helped you, you will be able to return the favor and help others.

 Depression support groups can give you a sense of belonging. You can gain the confidence to start achieving small steps which once seemed too large to handle on your own. By having regular meetings, you’ll be able to connect with others just like yourself. You won’t have to be afraid of rejection, being misunderstood or called crazy.

During your first session, you will have the chance to introduce yourself. No one will force you to get into your story right away. Instead, you will just be listening to others and see how the meeting progresses. Take your time to get comfortable and when you are ready to speak up, tell your story. You can start by talking about what you have been through with depression and how it has affected your life.

By cultivating these new relationships in your support group, you can develop lifelong friendships. These friendships can last beyond the depression support groups. You can even have those people just an earshot away in case you go through some hard times again one day. You can even be that friend in need one day when someone else needs you to get through depression.

You might be afraid to tell your family or friends about your depression. That’s completely fine because depression is something that many people like to keep private. Don’t be scared or embarrassed to attend sessions with a depression support group.

Why? Because everyone is there for the same reason. No one will judge you. No one will give you a hard time. Most importantly, no one will give you empty advice such as “hang in there, it will get better” or “just stop being depressed and be happy”. 

You will hear real stories from real people face-to-face on how depression is affecting them. You will even hear about things they have tried which have helped them deal with depression.

Sometimes, just talking about your issues can make a difference. If you keep it bottled up inside, nobody will ever know and nobody can ever offer you any advice. At the very least, you are getting it out. At the very most, someone might have some suggestions on what they did in a similar situation. It might be something that you can use to help you with your depression.

Feel free to ask your family physician to point you in the right direction and refer you to a therapist who can help. You can also find online mental health support groups if you wish to remain anonymous. 

But if, you are still isolating yourself from a computer and it is better to have social interaction of this nature in person. Having interactions in person gives you the chance to express your emotions and build real relationships with people.

Thursday, 24 May 2018

Schizophrenia :Risk Factors, Treatment, and Antipsychotics

May 24, 2018

Schizophrenia: Risk Factors and Treatment



Schizophrenia :Treatment


Potential Psychosocial risk factors for Schizophrenia  include: 

  • Childhood diversity:
    • Emotional abuse
    • Physical abuse
    • Sexual abuse
    • Ignorance
    • Death of parents.

  • Migration, especially becoming a member of a lower socio-economic ethnic minority in an affluent nation.

  • Being born in the urban area.

  • Any life event full of stress 

  • Illicit Substance Use- Drugs which increase Dopamine activity (Cocaine, Amphetamine, Cannabis)  can cause psychotic symptoms similar to Schizophrenia. 

However, a greater proportion of patients with Schizophrenia use illicit drugs compared to the general population. While these drugs can cause psychotic symptoms,  it is unlikely that they actually cause Schizophrenia, but, in vulnerable individuals, they can-

    • Increase the frequency of relapse in a patient with Schizophrenia.

    • Bring forward the age of onset of Schizophrenia.

    • Can also interfere with the effectiveness of antipsychotics.



Treatment of Schizophrenia- General Principles


Antipsychotics (Neuroleptics) are the mainstay of treatment for Schizophrenia. If available, Cognitive Behaviour Therapy (CBT) may be used in addition to antipsychotic for treatment-resistant psychotic symptoms.



In severe, chronic Schizophrenia, the patient would need psychosocial rehabilitation.


Rationale for Anti-Psychotics

Dopamine Hypothesis of Schizophrenia: This states that Schizophrenia is due to an excess of Dopamine in the brain, so by decreasing the activity of Dopamine, Schizophrenia can be treated. 



Classification of Anti-Psychotics is as follows:

 1) Older / First Generation /Typical:
    
       a)    Chlorpromazine

       b)    Haloperidol

2) Newer / Second Generation / Atypical:

         a) Risperidone

         b) Olanzapine

         c) Quetiapine

         d) Clozapine



Clozapine: Clozapine is superior to antipsychotics as compared to other antipsychotics in managing 'Treatment Resistant'. Schizophrenia. ('Treatment Resistant' Schizophrenia: Schizophrenia that has not responded to at least 2 different antipsychotics given at an adequate dosage for an adequate period of time i.e at least 4-6weeks each.).




 About 20% - 30% of patients with Schizophrenia are Treatment Resistant. The most important thing to keep in mind is Clozapine has also an antisuicidal effect.



General Principles Of Using Antipsychotics:

   "Start Low, Go Slow"
  • Start at a low dose 

  • If needed, increase the dose gradually

  • Review mental state regularly

  • Monitor for side-effects

  • Avoid antipsychotics 'polypharmacy'(using more than one at the same time).

General Principles When Using Antipsychotics:


  • It usually takes at least 2 to 3 weeks for the antipsychotic effect to manifest, and a further 2 to 3 weeks for it to maximize.

  • If the patient improves, do continue medication for several months after recovery.

  •  If the patient does not improve, change to another antipsychotic.

Long-Term Maintenance Treatment for Schizophrenia:


Maintenance treatment is given to:
  • Maintenance control over symptoms.

  • Reduce the risk of relapse.

  • Improve the quality of life/functioning.

How long it needs to be given depends on:

  • A number of episodes.

  • The severity of the episodes.

  • Impact of episodes on functioning.


Other treatment options for Schizophrenia:
  • Psychoeducation

  • Cognitive Behaviour Therapy (CBT)

  • Family Therapy 

  • Art Therapy

  • Cognitive Remediation Therapy

  • Social Skills Training.






Friday, 18 May 2018

Schizophrenia -Subtypes, Symptoms and Epidemiology

May 18, 2018

Schizophrenia Definition



The term Schizophrenia is derived from Greek which literally means 'split mind' (Schizo means to 'split' and phren means 'mind'). 


The term Schizophrenia was coined by the Swiss Psychiatrist Eugen Bleuler in 1908. Schizophrenia is different from Multiple Personality Disorder which is a Dissociative disorder. 

Previously the term 'Dementia praecox' is used for this illness.


schizophrenia causes


Clinical features of Schizophrenia 
  •  Schizophrenia is a 'Psychotic' disorder.

  • Psychosis is a condition in which the patient has experiences that do not have any basis in reality.

  • The two main psychotic phenomena are Hallucinations and Delusions.

Hallucinations
  • A hallucination is a sensory perception in the absence of sensory stimulus.

  • It can occur in any of the five sensory modalities: auditory, visual, somatic, olfactory and gustatory.

  • Most common type of Psychosis is an Auditory hallucination.

  • For example: 
    • Hearing voices from outside one's head (even when the patient is alone).

Delusions

A delusion is a false, fixed belief held by the patient with absolute conviction, despite evidence to the contrary and not shared by others from the patient's family or cultural group.

 In Schizophrenia, delusions usually have a persecutory theme for example:
    • 'My neighbor or someone trying to poison me.'

    • 'My movements are being monitored by the cameras, wherever I go.'

Sometimes they have a grandiose theme for example:

    • I am immortal.

    • I am the richest person in the world.



Positive and Negative Symptoms of Schizophrenia 

Positive Symptoms:

  •  Includes Hallucinations, Delusions and Thought Disorder.

  • Seen in the acute phase of the illness.

  • Tend to respond well to an antipsychotic treatment.

Negative Symptoms:

  • Include lack of motivation, lack of speech, poor self-care, etc.

  • Seen in the chronic phase of the illness.

  • Tend to respond well to treatment.

Main subtypes of Schizophrenia 



Paranoid Schizophrenia 

Hebephrenic Schizophrenia 

Catatonic Schizophrenia 

Simple Schizophrenia 

Clinical features of Paranoid Schizophrenia 

 Paranoid Schizophrenia is the main subtype of Schizophrenia that the doctors encounter in clinical practices.

 Duration for a diagnosis of Paranoid  Schizophrenia is one month. Some of the main clinical features are mention below:
  • Delusions, hallucinations and thought disorder are prominent.

  • Examples of delusional themes: persecution, jealousy, and grandiosity.

  • Examples of hallucinatory themes: commenting/discussing, threatening, bodily sensations.

  • Thought disorder manifest as incoherent and irrelevant speech.

Clinical features of Hebephrenic Schizophrenia 


  •   Incoherent, disjointed, rambling speech.

  • Aimless behavior rather than goal-directed.

  • Delusions and hallucinations are either absent or not prominent.

( Duration for a diagnosis of Hebephrenic Schizophrenia is one month.)


Clinical features of Catatonic Schizophrenia

Catatonic stupor is one if the most dramatic presentation, in a stupor the patient is mute or immobile.

 Duration for a diagnosis of catatonic schizophrenia is 2 weeks. Other catatonic signs include:
  • Posturing

  • Waxy flexibility

  • Negativism

  • Command automatism

  • Excitement

Clinical features of Simple Schizophrenia

The predominance of negativism symptoms are as follows:
  • Social withdrawal

  • Loss of motivation

  • Aimlessness

  • Apathy

  • Flattering of effect
A marked decline in social functioning and absence of positive symptoms.


Duration for a diagnosis of simple schizophrenia is 1 year.


Epidemiology of Schizophrenia
  •  Lifetime prevalence is about 1%.

  • Annual incidence is about 0.02 per 1000.

  • Lifetime risk may be about 40 percent higher in males.

  • The peak age of onset: 15 to 24 in males; about 5 to 10 years later in females.

Etiology of Schizophrenia

The exact cause of Schizophrenia is unknown. The general consensus from research is that there is a combination of different factors which include:
    • Genetic factors

    • Other biological factors

    • Psychological factors

    • Social (environmental) factors.


Other helpful resources-

Schizophrenia Treatment

NIMH