Diagnoses Articles

Cheat Sheet / Updated 10-24-2022

Living with obsessive-compulsive disorder, or OCD, poses challenges, not the least of which is making sure you don’t let your OCD define you. If OCD is part of your life, make the effort to focus on other health needs as well. Learn about what the disorder is and the many forms it takes so that you can start overcoming the disorder.

Cheat Sheet / Updated 04-12-2022

Symptoms of Post-Traumatic Stress Disorder (PTSD) give medical professionals clues to help make proper diagnosis of the disabling condition. The right medications, a good attitude, and positive affirmations can help to relieve the overwhelming signs of PTSD.

Cheat Sheet / Updated 03-23-2022

As you're learning more about autism, this Cheat Sheet can serve as a handy reference to the related acronyms and helpful websites. It also provides tips on how to communicate with a person who has autism, make sure they get the most from their education, and ensure they are properly prepared for emergencies.

Cheat Sheet / Updated 03-23-2022

Obsessive-compulsive disorder (OCD) can be a highly distressing and disabling psychiatric problem. It’s characterized by unwanted recurrent, intrusive thoughts, impulses or images that cause marked distress. OCD is also characterized by compulsions — (often repeated) behaviors and/or mental acts in response to obsessions aimed at reducing distress or doubt or preventing harm to self or others. People with OCD often may also avoid triggers for their OCD or fears to avoid the distress of obsessions and the distress and time consumed by compulsions. Cognitive behavior therapy (CBT) is the evidence-based psychological treatment of choice for OCD.

Article / Updated 03-07-2022

Although men can and do fall victim to codependency, women comprise the majority of codependents. There are many reasons in many categories: biological, developmental, political, cultural, religion, and societal. Biological: While both women and men are biologically wired for relationships, under stress, men tend to prepare for action, while women’s hormones prepare them to make sure their relationships are healthy and intact. Developmental (gender identity): Generally, girls are more dependent upon and emotionally involved with their parents. Loss of a relationship may be their biggest stressor. They tend to be more accepting of parental values, and a separation that threatens the emotional attachment with their parents creates anxiety. Thus, autonomy is their biggest challenge. Males tend to have a drive to separate from their mothers and identify with their fathers in order to establish their male identities. For males, intimacy can be a challenge. Political: Universally, women have been subordinated to men and marginalized from access to equal money, rights, and power. Oppression for generations has made women more compliant. This continues today. They’re traumatized by physical and sexual abuse far more than men, which, among other serious medical issues, lowers their self-esteem. Cultural: In most cultures, girls are more restricted and have less opportunity for autonomy. Both hormones and societal norms encourage adolescent boys to be more rebellious and autonomous. They’re given more freedom and are willing to struggle for it. Religion: Many patriarchal religions view women in a subservient role to men and advocate that women defer to their husbands, brothers, and other men. Women have less freedom and rights, and may have less access to education or positions of authority. Societal: Women suffer from low self-esteem and depression far more than men. It’s not clear whether this is a cause, by-product, or concurrent with codependency; however, societal attitudes are a contributing cause. A Dove study found that over 40 percent of women are unhappy with their looks, and over two-thirds suffer low confidence about their bodies. Many blamed the airbrushed, ideal models for setting unrealistic, unattainable standards. Unfortunately, it starts in childhood. Seven in ten girls are dissatisfied with their looks, and a large number practice self-destructive behavior.

Cheat Sheet / Updated 02-24-2022

To manage bipolar disorder effectively, you first need to know what it is. Then you can develop and follow a treatment plan, which usually includes a combination of medication, therapy, self-help, and support from a network of understanding and committed friends and family members. This Cheat Sheet can help you get up to speed on the basics of bipolar disorder in a hurry.

Article / Updated 12-29-2021

Maybe you’re wondering whether you’re codependent. It may be hard to tell at first, because, unless you’re already in recovery, denial is a symptom of codependency. Whether or not you identify as codependent, you can still benefit from alleviating any symptoms you recognize. You will function better in your life. Recovery helps you to be authentic, feel good about yourself, and have more honest, open, and intimate relationships. Like most things, codependency varies on a scale from minimal to severe. When you’re under stress, symptoms flare. Some individuals show only slight symptoms, while others have all of the typical characteristics Some traits and examples may sound foreign, while you can relate to others. The severity of codependency varies depending on a number of things, such as the following: Your genetics Your culture, including your religious beliefs Your family’s dynamics Your experience of trauma Your role models Your addictions or use of drugs Intimate relationships you may have or had with addicts If you’re codependent, generally symptoms show up to some extent in all your relationships and in intimate ones to a greater degree. Or codependency may affect your interaction with only one person — a spouse or romantic partner, a parent, sibling, or child, or someone at work. Codependency may not affect you as much at work if you’ve had effective role models or learned interpersonal skills that help you manage. Maybe you weren’t having a problem until a particular relationship, boss, or work environment triggered you. One explanation may be that the parent has a difficult personality or the child has special needs, and the couple has adjusted to their roles and to one another, but avoids intimacy. The spectrum of codependency is illustrated here. The horizontal vector shows how opposite codependent personality traits can manifest in a relationship. Individuals may reverse roles. For example, you may be the pursuer in one relationship and a distancer in another, or flip back and forth in the same relationship. In an alcoholic marriage, the sober spouse may scold and blame the irresponsible, needy alcoholic, who behaves like a victim. Then their roles switch, and the alcoholic dominates and controls his or her partner. Sometimes the spouse who acts needy or “crazy” gets well, and the self-sufficient, invulnerable partner breaks down. Both the disease and recovery exist on a scale represented by the vertical vector here. Codependent behavior and symptoms improve with recovery, described at the top, but if you don’t take steps to change, they become worse in the late stage, indicated at the bottom. As you get better acquainted with the symptoms and characteristics of codependents, you may see yourself. If you feel overwhelmed by the thought of having codependency, instead focus on the patterns and behaviors you want to change. If you’re committed to change, it really doesn’t matter whether or not you consider yourself a codependent. However, it’s important to realize that codependency won’t get better or go away by itself. Support is essential, because you won’t be able to make permanent changes on your own.

Article / Updated 12-29-2021

Pinpointing the location of bipolar disorder in your brain is almost as difficult as finding affordable health insurance. Brain imaging studies have found few consistent changes when looking at large brain structures. They've had much more success looking at changes at the cellular level and, in particular, at functional changes in cells and groups of cells in different brain areas. Here is some basic brain anatomy and physiology that helps explain the research. Dissecting the brain Looking at a whole human brain from the outside, as shown, you see the cerebral hemispheres (the large sections, not labeled in the figure, that comprise most of the brain), the cerebellum (the small ball toward the back of the hemispheres), and the brain stem (a long, thin structure leaving the brain and connecting it to the spinal cord). The cerebral hemispheres are divided into four sections that serve broadly different functions — the frontal lobe, the parietal lobe, the temporal lobe, and the occipital lobe. When you open the brain up, pulling the two hemispheres apart into two equal parts, and look inside, you see a number of brain structures within the hemispheres. Within the outer layer, researchers have identified a number of cell areas related to different functions. Several of these areas appear frequently in studies of bipolar, including the prefrontal cortex and the anterior cingulate cortex. Below the large outer layer are a number of structures, some of which are quite important in bipolar disorder research, including the thalamus, hypothalamus, hippocampus, and amygdala. Exploring the functions of different areas of the brain Now that you have a bird's-eye view of the brain, consider the functions of some of these areas: Cerebral hemispheres: The cerebral hemispheres include most of the thinking and planning parts of the brain as well as areas important to sensory input and learning and memory. The areas are as follows: The frontal lobe is the executive of the brain, serving to coordinate and manage the many functions within the body and brain. The parietal lobe is involved in managing sensory experiences, in addition to playing a role in many other functions. The temporal lobe is involved in smell and auditory sensory input, speech and language, and memory and learning. The occipital lobe is the center for processing visual stimuli. All of these areas perform many other functions, as well, and functions may overlap between areas. Cerebellum: The cerebellum appears to manage the fine-tuning of complex movements and also seems to be involved in regulating thought, language, and mood responses. Brain stem: The brain stem manages basic survival mechanisms, such as breathing and the heartbeat, and is involved in the management of consciousness, alertness, and sleep/wake cycles. Cerebral cortex: The cerebral cortex is the outer layer of brain cells in the hemispheres. It's considered to be the site of higher level thinking, coordinating incoming information and generating movement, actions, and thoughts. It's broken down into a number of smaller areas associated with specific types of function. Prefrontal cortex: The prefrontal cortex is a section of the cerebral cortex that is highly developed and is involved in regulating complex thinking and behavior; it's considered a center of judgment and planning. Hippocampus: The hippocampus is located in the cortex (subcortical) and is especially important in learning and memory. Thalamus: The thalamus is a structure that sits below the cortex (subcortical) that serves as a relay station for sensorimotor input, conveying it to areas of the cortex. It also regulates sleep, consciousness, and levels of alertness. Hypothalamus: The hypothalamus is also subcortical and regulates many survival mechanisms such as hunger/thirst and sleep/wake and energy cycles, all components of circadian rhythms — physical, mental, and behavioral patterns that occur in approximately 24-hour cycles. Amygdala: The amygdala, another subcortical area, is a major player in the brain's reaction to emotions. Limbic system: The term limbic system is used to describe a number of brain areas important to emotional function. The list of areas can be different in different textbooks but the hippocampus, thalamus, hypothalamus, and amygdala are considered main components of this system. Anterior cingulate cortex: The anterior cingulate cortex is a part of the cortex that has strong associations between the prefrontal cortex and the limbic system and is thought to play an important role in regulation of strong emotions. Viewing the brain under a microscope The brain has several layers. The outer layer of the brain is called the cortex, often referred to as the gray matter. The layer beneath the cortex is a network of fibers that connect different areas of the brain, often referred to as the white matter. The fibers are protected and insulated by a layer called the myelin sheath. Within the brain is a system of cavities, including spaces called the ventricles, that make, circulate, and then reabsorb cerebrospinal fluid. This fluid serves as a mechanical shock absorber to the brain but also brings nutrients from and filters waste back into the blood stream. Another important component of brain anatomy is comprised of cells that make up all of these structures. Brain cells include neurons and glia. Neurons form the telecommunications system in the brain and body, dictating body functions by generating, sending, and reacting to electrochemical signals. Glial cells, once thought to be just a support network for neurons, play a major role in brain function and in the brain's communications and reaction systems. The gray matter of the cortex includes the cell bodies (central section) and dendrites (one of the connecting ends) of neurons, as well as glial cells. The white matter is made up of the axons (another type of connecting end) of neurons. Understanding how brain cells communicate Neurons communicate with one another in many different ways, but communication occurs primarily across the synapse — the space between neurons or between neurons and other cells, such as a gland or muscle cell. The most common type of communication occurs when one end of the neuron (often the axon, but not always) releases a chemical messenger into the synapse (as shown in the figure below). The next cell (often the dendrite of another neuron) receives the chemical messenger. Receptors on the outside of the second cell latch onto the chemical messenger. Cells have many different types of receptors for all of the chemical messengers; the type of receptor influences how the message is received and processed and how the instructions are transmitted to the second cell. After a chemical messenger occupies the receptor, it can generate many different responses in the receiving cell, depending on the chemical messenger and the receptor type. After the messenger has done its job, it's released from the receptor and then taken back into the first cell, a process called reuptake. In the brain, the chemical messengers are often referred to as neurotransmitters. Nervous system cells communicate in ways beyond the synapse. For example, chemicals called neuropeptides communicate between cells but not across synapses. Of great importance in the current research on bipolar disorder is the communication between glial cells and neurons. Disruptions in these communication systems may be at least as important as problems in neuron-to-neuron transmissions. Intracellular (within-cell) communication may also play a role.

Article / Updated 12-28-2021

The controversy around codependency is divided into two camps — for and against. At one end are mental health professionals who advocate that codependency is a widespread and treatable disease. On the other is an array of critics of codependency, who argue that it’s merely a social or cultural phenomenon, is over-diagnosed, or is an aspect of relationships that doesn’t need to change. Those in the “against” camp state that it’s natural to need and depend upon others. They claim that you only really thrive in an intimate relationship and believe that the codependency movement has hurt people and relationships by encouraging too much independence and a false sense of self-sufficiency, which can pose health risks associated with isolation. Other naysayers disparage the construct of codependency as being merely an outgrowth of Western ideals of individualism and independence, which have harmed people by diminishing their need for connection to others. Feminists also criticized the concept of codependency as sexist and pejorative against women, stating that women are traditionally nurturers and historically have been in a nondominant role due to economic, political, and cultural reasons. Investment in their relationships and partners isn’t a disorder, but has been necessary for self-preservation. Still others quarrel with Twelve Step programs (used for addiction recovery), in general, saying that they promote dependency on a group and a victim mentality. Committees have lobbied for codependency to be recognized as a mental disorder by the American Psychiatric Association, which would allow insurance coverage for treatment. A major obstacle is the lack of consensus about the definition of codependency and diagnostic criteria. For insurance purposes, clinicians usually diagnose patients with anxiety or depression, which are symptoms of codependency. Here are some things to think about, to help put the naysayers’ points in ­perspective: Codependency’s detractors are correct to claim that people are meant to need, love, and care for others. Yet, when you look at codependent relationships up close, you discover that many of the benefits of healthy, intimate relationships elude codependents due to their dysfunctional patterns of interacting. Instead of feeling supported and enhanced by relationships, the symptoms and consequences of codependency provoke anxiety in relationships and cause pain. Codependents complain of feeling lonely and unhappy in their relationships. Similarly, a “false sense of self-sufficiency” is part of codependency. Codependents ignore their needs and depend upon others and frequently self-sacrifice to an unhealthy degree. They care for others in a way that leads to control, resentment, and conflict. The concept of codependency isn’t to blame for the increase in divorce, loneliness, and unhappiness. Codependency itself limits our ability to have satisfactory intimate relationships. Some recovering codependents choose to leave an abusive or painful relationship as an act of self-preservation. Remaining in such a relationship may also pose health risks from the chronic stress. Separation doesn’t have to lead to isolation. It’s untreated codependency that can cause people to isolate. In contrast, recovery helps individuals cope with loneliness in healthy ways by reaching out to others. The goal is to create healthy, nurturing, interdependent relationships. Thus, recovery from codependency doesn’t necessitate ending a relationship to become independent. The aim is to be able to function better and to enjoy more intimacy and independence in your relationships. Calling codependency what it is doesn’t create the problem. Finally, the term codependency shouldn’t be used to judge people. It arose out of Western socio-political thought and should be considered in a cultural and ethnic context. There may be instances where codependency is adaptive, and change would be disruptive. This poses a problem as American and European ideas spread to Asia, the Middle East, and Africa.

Article / Updated 07-20-2021

A lot of codependents know what other people should do but have a tough time making decisions for themselves, even small ones, like what to order off a menu and what to do with their free time. They may avoid decision-making altogether and practice their addiction, daydream, worry about someone, or ask others their opinions. Trouble with deciding can stem from Not being allowed to make choices in childhood Growing up with a controlling or authoritarian parent Not being taught how to problem-solve Not having an internal locus of control Not being aware of your feelings Wanting to please someone else Fear of making a mistake and your self-judgment Fear of disappointment If you grew up in a family with strict rules, or if one parent was controlling, you didn’t have an opportunity to make important decisions nor have the support of parents to help you learn how to discover your feelings about something and weigh alternatives and consequences. Children can quickly learn how to think for themselves. Good parenting allows them to make age-appropriate decisions. It includes listening and reflecting back to a child their feelings and needs, and brainstorming consequences of different choices. Healthy parenting helps children identify and trust their feelings in order to develop an internal locus of control of what they want and need. When you don’t know what you feel and you’re not skilled in thinking through the consequences of your actions and probable outcomes, small decisions can feel monumental. Instead, you act without forethought and/or avoid them and develop a passive attitude toward your life. You may get in the habit of looking to others for guidance, and their opinions can become more important than yours. If you’re a pleaser, you won’t want to displease them. Beware not only of friends who tell you what you should do, but of authority figures as well. Even when you’re paying a professional for advice, explore various options and make sure the action you take is aligned with your values. It may be tempting to ask a psychotherapist to make your decisions. Instead, seek help in thinking through the consequences of your options, which empowers you to make your own decisions and solve your problems. In many dysfunctional families, children are punished for making innocent mistakes. In some cases, punishment is severe, arbitrary, and unpredictable. Those fears survive even when you’re no longer living with your parents. That parent still lives inside you as your Critic and won’t allow you to forgive yourself for mistakes. Perfectionism and the desire to be infallible can haunt every decision so that you have to research every purchase, rehearse intimate conversations, and avoid new experiences. Another factor is fear of disappointment. In troubled families, parents rarely take the time to comfort children when they’re disappointed. Coping with disappointment is a part of maturity, learned when parents understand and empathize with their children’s feelings. Here are some tips in making decisions: Write down all possible options. Write the consequences of each, including your feelings. To help you, visualize the results and experience how you feel in your body. Talk over your options with someone you trust who won’t judge you or tell you what to do, but who listens and lets you decide for yourself. A graph can help you visually compare aspects of different choices. List your options down the left side of the chart and write the elements to consider along the top, such as cost, convenience, time expended, value, and reward. You can add a column for consequences, and rank them from 1 to 10. Factors will vary, depending on the type of decision. Comparing which car to buy would include things like maintenance, comfort, price, depreciation, and mileage. (This technique doesn’t work as well with decisions that are more feeling-based.) Decisions aren’t right or wrong; there are only consequences. Many times you won’t know until you take a risk and make a choice. Give yourself permission to experiment, change your mind, and make mistakes. This is how you grow and get to know yourself and the world.