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Psychiatry and Me: A forum for those serious about these disorders

Started by Jamie Clark74 · · 👁 5 views · 61 replies

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Participants Jamie Clark74Casey Palmer5casualmarlin9Edward GreenSteven Collins38Richard Jones2Timothy Ruiz5Kyle Lee7ADennis Torres7Donna Watson10melloworca6
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#1 ·


Having lived with psychosomatic illnesses for a long time, I wanted to share what I've learned with everyone else here. Over the last two years browsing various forums, I’ve stayed active, asking for advice, sharing my own experiences, or just looking for a bit of support.

The most recent suggestion I received was to try starting a dedicated thread here in the HEALTH section.
Specifically, a space focused on providing
support and discussing the nuances of our individual struggles.


First off, I’d like to ask the moderators, David and Casey Palmer5, for their support in managing
a topic like this, and for any guidance or
help they can provide when needed.

To start, I’ll post my medical report—unfortunately, it's in English—just so you all know you're talking to someone with genuine, long-term experience in this area.

I also think it might be useful to have a specific section for medical documentation, similar to this thread, where we can post clinical information. Then, we could have a separate second thread for support, discussion, and updates. Looking through the Health section, I notice the same questions popping up constantly.
In my opinion, the best way to handle this would be to keep the diagnoses and symptoms in one organized post... while keeping the actual conversation going in another.

Casey Palmer5 and David, please let me know what you think or if you have a better idea!

Thanks in advance,


🙂 😉 😎
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#2 ·

April 15, 1998

Dear Dr. Rogers,

RE: MR. WILLIAM KOVACIC D.O.S. 11/11/41

Thanks for your letter regarding Mr. Kovacic. He mentioned to me that he’s switched primary care physicians and is working with you now.

I’ve been treating Mr. Kovacic since March 1992. Back then, he was living in a smaller industrial town and had been managing a Workplace injury claim with an energy company for a while. He was originally under the care of Dr. Norman James, who had started his Depressive disorder treatment. However, since Dr. James moved to Victoria,
Mr. Kovacic was referred over to my practice.

When I saw Mr. Kovacic, I made a Major Depressive Disorder diagnosis, along with Panic Disorder, featuring Agoraphobia and Obsessional personality traits. We tried several different antidepressants early on, but nothing seemed to stick. Over the years, I've found that Antidepressant treatment consisting of Paroxetine 40 mgs a day and Clonazepam 2 mgs bd for his anxiety works best. While this keeps his depression relatively stable, his anxiety still flares up quite intensely, especially when things get stressful.


A lot has shifted in his life since we first met. He left his job with the energy company and relocated from his previous city to Adelaide. More recently, they have moved from their house in Adelaide to a unit in a retirement village. Beyond these big shifts in their own lives, changes involving their two sons have also added to the pressure.
It's definitely taken its toll on them.

While Mr. and Mrs. Kovacic feel certain they made the right choices, adjusting to life in a small retirement community hasn't been easy. Lately, they've been focused on planning trips to Europe, which has turned out to be another significant source of stress.

Another heavy blow this year was the "Asbestosis" diagnosis.

He's understandably worried about it, which was a huge factor in his decision to travel back to Europe to visit family.


Both Mr. and Mrs. Kovacic deal with various other medical issues as well.
They tend to dwell on these health concerns. Currently, Mrs. Kovacic is struggling with severe diarrhea that looks like irritable bowel. We tried immipramine, but it didn't help, so she’s back on moclobemide at 300mgs a day. Around the same time, Mr. Kovacic decided to test
if a different antidepressant could better manage his anxiety. That choice resulted in two months of total chaos. Ultimately, he realized Paroxetine was his best option, and he's just starting to find his footing again on it.


/ P1.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#3 ·

P2-
For the past year, Mr. Kovacic has been primarily preoccupied with his back pain. As you’re aware, he has been receiving care at the Mayo Clinic Pain Unit. Unfortunately, they haven't been able to provide much relief, so he is currently using Pain medication. He seems to have a high sensitivity to various analgesics, which can trigger bouts of aggression.
Pain medication tolerance suggests that Panadeine Forte is the one he handles best.

As you likely know, he was deeply shaken by his previous GP, who implied he was addicted to his analgesics and Clonazepam. This sent Mr. Kovacic into a panic regarding his prescriptions. True to his meticulous nature, he decided to
do a deep dive into every medication he was taking. After his research, he concluded that his current regimen is actually quite reasonable. This experience also prompted him to switch general practitioners.

To summarize, I believe his Major Depressive Disorder is fairly well managed with Paroxetine 40mgs a day. His anxiety is somewhat stabilized by Clonazepam 2 mgs bd. Right now, his main struggle remains his back pain.
Both Mr. and Mrs. have dealt with immense stress over the last few years, which has taken a toll on their health. Hopefully, things will begin to stabilize for them soon.
Mr. Kovacic, specifically, is still struggling to adjust to life in retirement.

Even though Mr. Kovacic has Obsessional personality traits and can be quite particular, I’ve always found him very reasonable to work with, provided you are straightforward and honest with him. He is also someone who
needs plenty of clear information regarding his condition and treatment plan.


I’ll continue seeing Mr. and Mrs. every six weeks and will keep you updated on how he’s doing.

Sincerely,

Dr. Jo Lammersma
Casey Palmer5 Casey Palmer5 Regular
470 messages
joined Jan 2016
#4 ·
You can talk about whatever you want, as long as you aren't hurting anyone and it stays within the realm of health topics.

Just be ready for just about any kind of reaction your post might trigger... people can get pretty intense. Some of the comments might even sting a little.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#5 ·
Casey Palmer5 said:You can say whatever you want, as long as you aren't hurting anyone and it stays within the realm of health topics.

That being said, get ready for a wide range of reactions to this post of yours—you might get anything. Some people probably won't like what they read.


Thanks,
I know we’re all different. My goal here is simply to outline what mental illnesses actually look like and how to spot them. In this day and age, about one in four people deals with something, though some of us, like myself, are stuck dealing with it for life.

From the Emails I receive, it's clear there are plenty of people interested in this.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#6 ·

Do doctors dream of electric sheep?

So far, computer development has always played in favor of both doctors and patients. But will the future belong solely to the patients?

We might reach a point in technological evolution where we wonder why doctors even exist—aside from perhaps babysitting machines every now and then? Or maybe just to act as psychiatrists.

Medicine is largely an exact science. Illness requires a diagnosis, and that diagnosis dictates the appropriate treatment.
Even today, a good portion of diagnoses are confirmed by drawing more or less obvious conclusions provided by machines. They analyze our bodily fluids, take increasingly detailed scans, and ultimately, they are incredibly helpful.

Computers and their software are evolving at breakneck speed. In fact, there is already experimentation happening with programs designed to assist doctors by generating precise diagnoses from relevant data. It’s not that they’ve taken the world by storm just yet, but...
The computer revolution is only just getting started.

What will a doctor look like in about 30 years? They’ll likely input relevant patient data into a screen and watch as the computer suggests the most accurate diagnosis.

And in 50 years? Will users simply buy even more advanced software and type in their symptoms at home? Much like how people use pregnancy tests now. Surgery? That’ll be left to robots. A human hand is too unsteady and poses too much risk to the patient. However, 70% of all doctors are psychiatrists.

The World Health Organization says that mental illnesses will flourish in the 21st century, becoming our greatest challenge.
It doesn't matter. By the 23rd century, even robots will have their own psychiatrists.

Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#7 ·

LET'S START WITH "PSYCHOSOMATIC ILLNESSES"

I know we can all find much better information online in just about any language, but I've noticed some people just don't like digging through the web. So, I’m sharing what I think is most useful.



:The data provided on these pages cannot, and is not intended to, serve as a substitute for a medical examination. Intermed is not and cannot be held responsible for any provisional diagnoses or treatments based on the information available here. Always entrust your healthcare to your personal physician.


Anxiety

Definition
A state characterized by feelings of tension, dread, fear—extending all the way to panic—accompanied by psychomotor tension, internal restlessness, and a sensation as if one might "explode." Anxiety is most often unmotivated and isn't tied to a specific object or person.

Everyone experiences anxiety from time to time. In fact, being unable to feel anxiety at all could actually be a sign of a serious issue. We live in a world full of risks, and anxiety is just one way our body helps the mind recognize danger.
As with most mental health conditions, the mere appearance of a symptom or psychological state isn't the problem; the problem lies in its intensity—specifically, how much it interferes with your normal life.

What are the symptoms?
Psychiatrists generally categorize anxiety into three main types: generalized anxiety, phobias, and Panic Disorder. If there is an especially difficult or problematic situation at work or home, the stress resulting from that situation can spill over into other parts of life, thereby creating anxiety.
Similarly, someone who has gone through a very terrifying experience might carry that fear into their daily life. This is known as Post-Traumatic Stress Disorder (PTSD). While it's little comfort for what the person is going through, it at least allows them to identify the cause of those unpleasant emotions.

It seems that emotional struggles rooted in anxiety tend to follow their own logic. Some psychiatrists refer to this as "free-floating anxiety."

Unlike phobias or panic, with generalized anxiety, the person doesn't always have a clear reason for why they feel anxious—they simply feel it all the time. When there is no identifiable cause, people often become anxious simply because they are *always* anxious! That’s how anxiety begins to feed itself, creating a vicious cycle.

People suffering from anxiety may frequently experience the following symptoms:
-low patience levels
-difficulty concentrating
-expecting the worst possible outcome in any situation
-constantly ruminating on the worst-case scenario
-trouble sleeping
-becoming depressed
-becoming preoccupied or obsessive about certain things

These psychological symptoms can lead to, or be accompanied by, physical symptoms:
-increased thirst
-nervous stomach
-flatulence
-frequent urination
-inability to respond to sexual stimulation
-chest tightness
-periods of heart palpitations
-muscle aches
-headaches
-confusion
-tremors
-missed or extremely painful periods in women

The link between physical and psychological symptoms can create a feedback loop where any one symptom can trigger another.

In a panic attack, anxiety progresses rapidly into a crisis. With generalized anxiety, patients often manage to keep things under control, even as the cycle continues. The effort required to maintain that control is incredibly stressful in itself—which essentially adds fuel to the fire. This is one way people start feeling anxious about being anxious, further intensifying the problem.

How likely am I to have this disorder?
Nearly 100% of people experience anxiety at some point. Over the course of a year, about 5% will deal with generalized anxiety severe enough to disrupt their daily lives. Most of those individuals won't even reach out for professional help.

What can I do to help myself?
The first step is trying to understand how anxiety actually works. It’s essentially a mix of physical and psychological symptoms—part of a biological response psychologists call "fight or flight." When the body senses a threat, it instinctively prepares to either fight back, defend itself, or simply run from the danger.

Relaxation
To tackle anxiety, you first have to break the cycle. One way to do this is by dampening those physical sensations through various relaxation techniques. Just a heads-up: relaxation isn't an instant fix. It's a skill you have to learn, and like any other skill, it only improves with steady, persistent practice.

Physical Exercise
Another strategy to ease the physical symptoms within that cycle is "aerobic" exercise. I'm talking about walking, running, or basically any activity that gets your heart rate up just a little bit.
Strengthening your heart muscle can make it more resilient, which may help reduce those sudden, uncomfortable bouts of palpitations. Exercise also helps release built-up tension in the body, which can otherwise fuel your anxiety.

Diet
Caffeine shows up in many refreshing drinks, not just coffee and tea. It’s a good idea to avoid caffeinated beverages as much as possible, as they can easily trigger that anxiety cycle. Caffeine affects the heart, speeds it up, and acts as a diuretic—both of which mimic the signs of generalized anxiety. It can also mess with your sleep, which is another anxiety trigger.
If you're exhausted, your emotions become harder to manage, making you more susceptible to anxiety. Trying to fix fatigue with caffeine usually just makes things worse.

Learn to say "no"!
This might actually be the best therapy there is. We often take on too many responsibilities without considering how difficult they'll be to handle. You might find yourself realizing you've overcommitted. Usually, it's not just one single thing causing the anxiety. But as we pile obligations onto our lives, we get more and more anxious with every new task.
Anxiety can build up until you feel like you're hitting a breaking point. It's just as draining to feel a little anxious about everything as it is to feel intense anxiety over one specific thing.

Monitor your thoughts and feelings
Sometimes it helps to think about anxiety the same way someone with asthma thinks about their breathing. Everyone breathes, just as everyone experiences anxiety at some point in their lives. Just as an asthmatic monitors their lung function, it’s useful to check in on your anxiety levels regularly. You can use specific techniques to spot problems before they escalate into something unmanageable.

Professional Help
For some, developing the tools to face and solve these issues is only possible with professional guidance. Your first point of contact should be your primary care physician or family doctor.
Many people find they can manage this disorder quite well if they utilize medication early on. A common group used is benzodiazepines; they are very effective, but they carry a risk of dependency. They shouldn't be taken for more than a month. The window of relief they provide is often enough to help a person stabilize and start tackling the underlying issue.

If the problem persists, you might need to see a psychiatrist or a clinical psychologist. At that stage, antidepressant treatment might be necessary, along with looking at the bigger picture of the person's life—things like friendships, romantic relationships, family dynamics, self-esteem, and overall life expectations.


🙂😉 :cool
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#8 ·


Phobias and panic attacks!


Definitions
Phobias involve the neurotic creation of fear symptoms at various levels—ranging from mild anxiety and apprehension to full-blown panic. These are usually tied to specific objects or situations that often lack a real basis or actual trigger. While phobias can occasionally pop up in healthy individuals, in neurotic cases, they manifest as an overwhelming compulsion, almost always triggered by a specific scenario: enclosed spaces, open areas, fear of blushing, and so on.

Panic (a panic state) is a form of intense fear regarding sudden danger; it frequently triggers physical movements designed to help you escape a hazardous situation.

Panic is essentially part of our "fight or flight" response—a vital component of our defense system. In everyday conversation, we sometimes use "panicking" in a different, more dismissive sense, implying someone is just being excessively fearful or cowardly.

Most of us will feel a surge of panic in a situation that is uncomfortable but actually warrants it. Imagine a pedestrian walking across the street when the light is green, only to have a car speed toward them without braking. In that moment, panic is the appropriate response—it makes your legs move faster to get you out of harm's way.
But what happens when a harmless, mundane situation triggers that same response? Or worse, what if we experience panic for no discernible reason and without any warning? While some people enjoy the thrill of being terrified—which explains why anyone would watch horror movies—it’s a completely different story when you don't know why you feel so frightened, why you're terrified, or when the feeling will finally end.

Common Phobias
You can technically have a phobia of anything, but the most frequent ones include:
-Visiting the dentist
-Flying
-Blood
-Social phobias
-Agoraphobia (fear of open spaces)
-Claustrophobia (fear of enclosed spaces)
-Fear of blushing (erythrophobia)
-Fear of fears (phobophobia)

When someone living with a phobia comes into contact with—or even anticipates contact with—the things or situations they fear, they develop acute physical symptoms of anxiety.
Anxiety can present itself through a wide variety of symptoms, and everyone reacts differently.
For many, this is enough to cause them to start avoiding certain things entirely—which can lead to a life structured around dodging specific objects or situations.
However, sometimes those situations are unavoidable. Avoiding the dentist for years can lead to serious dental issues requiring emergency surgery, or there are social encounters you simply can't skip. When a person with a phobic disorder is forced into such a situation, fear sets in, which is often followed by a panic attack.
The word "often" is key here—panic isn't inevitable, and it doesn't always happen in these scenarios. Many people with phobias will surprise themselves by pushing through a situation, even if it feels incredibly unpleasant.

Symptoms of a panic attack include:
-Rapid, pounding heartbeat
-Shortness of breath
-Chest pain
-Flushing and sweating
-Nausea/feeling ill
-Trembling in the hands or the whole body
-Feeling sick
-Confusion
-Dry mouth
-Urgent need to use the restroom
-Feelings of weakness.
The experience can be so distressing and intense that patients often believe they are having an acute heart attack. Some people find their bodily reactions so extreme and uncontrollable that they feel like mere spectators to their own situation.
While they might not describe it as an "out-of-body" experience, they do describe a sensation of being detached from what is happening—as if the entire situation has become unreal. This phenomenon is known as "depersonalization." Although it might seem like a relief or a way to distance oneself from the panic attack, depersonalization actually makes the experience much worse.

There is another group of patients who experience panic attacks out of the blue, spontaneously. This can often be attributed to a general sense of anxiety—characterized by the constant repetition of the symptoms that eventually peak during a panic attack. But panic attacks can also strike purely out of nowhere. When this happens, a fear of experiencing the same attack again arises, which can lead to the development of both phobias and generalized anxiety. As is often the case, the anxiety begins to feed itself, creating a vicious cycle.

How common is this disorder?
Some phobias show up more often than others. For instance, up to 10% of people experience phobias related to flying, visiting the dentist, or seeing blood annually. These are generally categorized as simple phobias. Social phobias are less frequent, affecting about 25 out of every 1,000 people each year. Agoraphobia affects roughly 30 out of 1,000 people, and it’s actually twice as common in women. Panic attacks occur in about 10 to 30 out of 1,000 people per year, also appearing about twice as often in women.

What can I do to help myself?
Relaxation
The first step in tackling phobias and panic is breaking that vicious cycle. Learning relaxation techniques can be incredibly helpful.
Desensitization
Try using your imagination to visualize a situation that triggers your anxiety, and then rate how intense that feeling is. Next, attempt to lower that anxiety level by applying those relaxation methods. It isn't easy—it takes persistence, willpower, and a lot of practice. Most people will likely need professional help or guidance too.

Sometimes self-help and psychotherapy aren't enough on their own. In those cases, a primary care physician or a psychiatrist might need to prescribe medication, usually sedatives or tranquilizers for short-term use.


🙂 😉 😎
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#9 ·



Obsessive-Compulsive Disorder (OCD)


Definition
OCD is shaped by a specific personality structure—often characterized by an obsessive temperament—alongside repetitive, intrusive thoughts and actions. These feel completely forced upon the individual, making them nearly impossible to resist.
While development often begins in childhood, most people see it manifest between the ages of 20 and 30.

At its core, OCD is driven by a personality type marked by intense self-control, over-scrupulousness, suspicion, rigidity, and perfectionism. This often manifests as emotional distance, a lack of imagination, a low tolerance for risk, and a struggle with creativity.

Where does it come from?
From a psychoanalytic perspective, when individuals face challenges in realizing their own impulses during psychophysical development—specifically regarding fixations at the anal-sadistic stage—they can fall into conflict-driven situations that trigger deep-seated fear. To neutralize that anxiety, the person may resort to regressive behaviors. Eventually, psychological mechanisms transform that fear into compulsive symptoms.

It might sound strange, but very few of us actually have total control over our own thoughts.
Most people have had that moment where they *know* they did something—like locking the front door or turning off the stove—yet they still find themselves wondering if they actually did it. Sometimes, you just have to check one more time just so you can move on with your day and focus on something else.

Given how often people dealing with anxiety and depression lose control over negative thought patterns, it isn’t really surprising that some experience a loss of control over other types of mental content.

Many of us have little rituals, often as a way to ensure we don't forget things. But sometimes, these take on a life of their own—like always locking the door in a specific sequence or serving food in a certain way. For some, these rituals spin out of control, and life becomes dominated by constant worry over trivialities and an endless need to perform ritualistic acts.

What are the symptoms?
The most frequent compulsions involve checking and counting. People might constantly double-check their actions or count repeatedly until they reach a certain "magic number."
It helps to view obsessions and compulsions separately. In terms of obsession, symptoms include intrusive and disruptive

-words
-ideas
-indecisiveness
-images
-doubts.

A person recognizes that these thoughts are coming from their own mind and desperately wants to stop them, but they simply can't. Obsessions can be quite dark in nature—sexual, violent, or blasphemous—and often clash violently with the person's actual moral standards.

Compulsions are typically the actions taken as a result of an obsession; they are one of the few ways a person tries to react to those intrusive thoughts.

Failing to complete a compulsion often triggers intense anxiety or panic, while living strictly by these rituals frequently leads to depression. Many people live for years with these struggles without ever seeking help. Common types of compulsions include:

-Ritualistic actions—performing tasks in a specific order or a set number of times.
-Cleaning.
-Checking completed tasks or actions.
-Arranging or organizing items, such as furniture, in a very specific way.

Compulsions can take many shapes, and the examples above are just the most common ones.

How common is it?
In any given year, about 2 in 1,000 people will experience episodes of OCD. Over a lifetime, roughly 2 to 3 in 100 people will encounter this disorder.

How can we help ourselves?
Since this disorder is rooted in thought patterns, and those thoughts are what drive the anxiety, the best place to start looking for solutions is within the thoughts themselves.
Monitoring your thoughts and practicing relaxation can be an effective way to tackle obsessions and compulsions. Developing specific relaxation techniques and learning to identify when—and under what circumstances—problematic thoughts arise, along with how intense they feel, can serve as a solid starting point for "desensitization."

To start, try visualizing situations where you don't engage in compulsive behavior. Rate the level of anxiety you feel and attempt to manage it using relaxation techniques. Keep practicing this until you feel your anxiety is under control while simply imagining yourself refraining from those compulsive actions.

The next step is to replicate this in real-life scenarios—perhaps by performing your ritual one fewer time, or waiting 30 seconds before acting on a compulsion. Again, lean on those relaxation techniques to help handle the rising anxiety. For many people, this gradual approach eventually leads to overcoming the issue entirely.

Before attempting a program like this on your own, I’d suggest consulting a psychiatrist for advice or looking for helpful literature that might support your efforts in managing the condition.

If it turns out that you aren't able to handle things solo and find you can't help yourself, please know you aren't alone—though it's true that professionals sometimes face significant challenges in helping too.

So, what kind of professional help is actually available?
Over the last decade, the prognosis for individuals living with OCD has improved significantly.

There are two primary approaches to treating this disorder, and they are frequently used in tandem. The first is Cognitive Behavioral Therapy (the exercises mentioned above are drawn from this method). Some may still need to seek out a psychiatrist for extra support, guidance, and encouragement. They might also require treatment for anxiety or depression, which can often surface if the obsessive disorder isn't successfully managed.

The second approach involves medication, often in the form of antidepressants that influence chemical reactions in the brain, specifically involving serotonin. It is believed that this connection, involving what we call neurotransmitters, plays a role in obsessive disorders, compulsions, and depression alike.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#10 ·
The next part follows Saturday, 07/19/03

Please start a new THREAD for correspondence!
🙂 😉 😎
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#11 ·



Entomophobia—the fear of insects.


Definition.
Entomophobia is the term used to describe a fear of insects. This category includes both acarophobia—the fear of mites—and arachnophobia, which is the fear of spiders.
Most people are pretty cautious, if not outright terrified, when it comes to bugs—or more accurately, arthropods.
That could be:
There’s a difference between irrational phobias and a healthy sense of caution based on actual experience—like being wary of bees, wasps, hornets, or mosquitoes. It's just common sense.
It’s irrational, really, but there's a cultural layer to why we find things like cockroaches and flies so utterly revolting.
Unfounded fear caused by a simple lack of information—like being afraid of grasshoppers, praying mantises, or crickets.

On the other hand, Entomophobia is characterized by the following criteria:
A persistent, irrational fear and an overwhelming urge to avoid insects, moths, spiders, or similar phobic triggers.
Significant stress can still hit hard, even when you know deep down that your fear is totally irrational.
Entomophobia isn't just a side effect of other mental health issues like schizophrenia or OCD.

It’s important to distinguish Entomophobia from parasitic hallucinations or illusions, much like how we differentiate it from schizophrenia and Obsessive-Compulsive Disorder. Even for an experienced psychiatrist, getting that distinction right can be tricky. Sometimes, the core of the phobia isn't actually the bugs themselves, but rather a deep-seated fear of infestation—the terrifying idea that one might become "infected" by parasites. This state is distinct from parasitic hallucinations because, in this case, the individual experiences the symptoms as if they truly have parasites living on them.
Fear of insect intrusion or contamination can trigger cleaning and sterilization rituals that look a lot like typical obsessive-compulsive behaviors. This syndrome is really just the tip of the iceberg; most people simply focus on avoiding insects, and they rarely seek help—or even realize they need it.

History.
Phobias have been documented for ages, but I doubt insects were ever major phobic triggers in the past. In our clean, urbanized Western societies, most people barely deal with anything more intimidating than flies, cockroaches, or mosquitoes. Living in these cities means we aren't mentally or physically prepared for an encounter with actual bugs the way someone in a rural community might be.

Psychopathology
It isn’t unreasonable to assume that the genuine danger and sheer annoyance insects have posed for centuries have left a deep-seated fear of them in most societies. Bites and stings affecting people and livestock don't just trigger toxic or allergic reactions; they serve as pathways for potentially fatal diseases. We’ve only recently gained control over illnesses like yellow fever and the plague, while others, such as malaria, remain significant issues. Because of this, a nearly Jungian fear of insects can actually be rationalized in all of us, even if it manifests as a learned exaggeration. Some authors suggest this stems more from typical family dynamics rather than repeated trauma, given that most people with Entomophobia don't actually have frequent encounters with the specific bugs they fear.
That kind of explanation could serve as more than just a basis for a non-clinical end to the phobic spectrum; it could actually provide the foundation for the criteria mentioned.
In these clinical cases, much like other phobias, the most likely cause is the displacement of anxiety onto an external focus that can be avoided. Choosing insects as the phobic object might be random, symbolic, or perfectly logical.
Symbolically, hooks often represent filth and contamination. At times, they can even be interpreted as symbols of sexual penetration that simply cannot be uprooted.
In 1960, Kolansky described the logical choice of a chicken as a phobic object. In one case involving an infantile neurosis and Entomophobia in a young girl, the symptoms surfaced after she was told her sister had died from tuberculosis.
Savory offered another explanation back in 1964. He suggests that Entomophobia stems from the way insects move; their rapid movements create an image on our retina similar to the sensation of falling. This triggers an adrenaline rush and increases muscle tone, causing the brain to react to insects with pure stress.

Treatment and prognosis.
An entomologist’s job isn't just about studying bugs; it's about dismantling the myths that fuel phobias. Education is really the heart of the matter—like teaching people that praying mantises aren't actually out to get them. We need to flip the script and show insects in a positive light, helping to break those irrational fears often passed down by parents. Zoos and museums can play a huge role here. Honestly, nothing beats live insect exhibits where staff members handle the bugs, letting visitors actually touch and pet them. It makes a world of difference.
Specialized treatment is sometimes necessary if a phobia significantly disrupts someone's daily life, though the specific approach usually depends on the therapist. Methods can include various types of psychotherapy, desensitization (gradual exposure through repeated contact with insects), group therapy, medication such as anxiolytics, modeling, hypnosis-based regression, or even a combination of several approaches.
For chronic phobias, the prognosis is generally good if the underlying conflict can be resolved. However, if the conflict runs deep and the phobia is more symbolic in nature, the outlook is less certain. If obsessive-compulsive elements—like excessive cleaning—are also present, the prognosis becomes even weaker.

The entomological aspect
Medical schools rarely include much entomology in their curricula, so doctors often need extra training to reassure patients that things like crickets or praying mantises aren't actually dangerous. Access to fundamental entomological texts and consulting with entomologists is essential to clearing up the basic misconceptions about insects that fuel these phobias.
It’s important to point out that only blood-feeding insects (mosquitoes, flies, ticks) actively seek out humans. Much more common phobic triggers, like spiders and bees, almost never bite or sting unless they feel trapped or seriously threatened. Usually, the first group is linked to issues like poverty or poor sanitation, while the second group—which actually provides certain benefits to humans—is more frequently the cause of phobias.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#12 ·



Bigorexia


Being obsessed with muscle growth can lead to a body image disorder similar to anorexia. Today, bigorexia (muscle dysmorphia) affects hundreds of thousands of men. For some, building muscle mass becomes so vital that they miss important life events just to stay in the gym. They’ll push through workouts even when they're sick, dealing with intense muscle soreness or even broken bones. In extreme cases, people even risk their jobs because they refuse to break their training schedule.
It’s a strange paradox: these same men aren't actually in love with their bodies. Despite having highly developed muscles, they often hide them and avoid any situation where they might have to show skin.
The term muscle dysmorphia was coined in 1997 to describe this specific type of body image disorder. It's also referred to as reverse anorexia or bigorexia. On one hand, bigorexia functions as an obsessive-compulsive disorder or a compulsive neurosis; on the other, it's a direct result of media pressure on men. Just as the media has pushed the "thin ideal" for women for years, it constantly forces an idealized image of the hyper-muscular man upon men.
The defining trait of someone suffering from bigorexia is that no matter how hard they work, their muscles never feel big enough. While this condition is primarily described in men, some female bodybuilders exhibit the exact same symptoms.
Most men with bigorexia are weightlifters, though that certainly doesn't mean all lifters have bigorexia. A typical dedicated lifter might spend about 40 minutes a day thinking about muscle growth, whereas those with bigorexia might spend five or more hours every single day fixated on how underdeveloped their bodies are.
As gyms become more common and more people join them, awareness of physical imperfections increases, which contributes to the rise of this disorder.

Typical signs of bigorexia:
- Mirror checking. Men with bigorexia might check themselves in the mirror at least 12 times a day.
- Social and work commitments: Important events like birthdays, hanging out with friends, or even business meetings are often missed or skipped because they interfere with a workout schedule.
- Diet: They follow incredibly strict dietary regimens. Someone with bigorexia will rarely eat out at a restaurant or at someone else's house because they can't control exactly what ingredients went into the food. These men are also more prone to developing other eating disorders, such as bulimia.
- Comparison: People with bigorexia constantly compare their physiques to others. Their perception is always skewed; even when looking at someone with a similar level of training, they will always perceive themselves as being weaker.
- Substances: The use of anabolic steroids is a common path for those with bigorexia. Many men continue using steroids despite side effects like extreme aggression, acne, gynecomastia, impotence, hair loss, and testicular shrinkage.
- Body fat: Those with bigorexia are typically much more concerned with their body fat percentage than their actual muscle mass.

Psychological factors
Unlike many bodybuilders who enjoy showing off their physique in public, those with bigorexia tend to dislike it. Many would rather hide away than face the perceived shame of having an "unattractive" body. A study by Pope et al. in 2000 showed that one individual with bigorexia would actually avoid sexual intimacy with his wife if it meant spending energy he had intended to use for training.
Men with bigorexia typically struggle with low self-esteem. Research conducted by Sullivan et al. in 2000 indicated that 29% of men with bigorexia suffered from anxiety disorders, and 59% dealt with some form of mood disorder.

Treatment
Currently, there isn't definitive research pinpointing which treatment method is most successful for this disorder. The biggest hurdle in therapy is that these individuals often don't believe they are sick—they don't see themselves as having a problem, much like those with anorexia. This makes cooperation with doctors difficult. Muscle dysmorphia, or this distorted view of one's own muscles, is partly a response to feelings of depression and low self-confidence. Because of this, seeking treatment often feels like admitting defeat to them.
Combining educational approaches with psychotherapy yields excellent results. Cognitive-behavioral techniques focus heavily on identifying and shifting patterns while helping patients set realistic expectations during their recovery exercises.

A newer area of study
Bigorexia—also known as reverse anorexia or muscle dysmorphia—remains a controversial concept. Even though it was first described back in 1993, it’s still quite rare for a doctor to officially provide this specific diagnosis for someone presenting with these symptoms.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#13 ·


Mood Disorders


Mania and Manic-Depressive Psychosis (Bipolar Disorder)


Defining Mania
Mania is an endogenous psychosis. It rarely shows up on its own; more often, it’s bundled with depression in a single cycle known as manic-depressive psychosis, which is why we call it cyclical (bipolar psychosis). Mania usually kicks in during youth and is characterized by disruptions in thought, mood, and motor skills. Thoughts come in rapid-fire bursts, and because the mood is elevated without any actual cause, the patient might radiate cheerfulness, happiness, or intense self-confidence. Eventually, however, they run out of steam.

Defining Manic-Depressive Psychosis (Bipolar Disorder)
Manic-depressive psychosis (bipolar psychosis) is an endogenous mental illness defined by alternating periods of mania and depression. It falls under the category of severe endogenous psychoses. The shift between phases is unpredictable—you might see short manic stretches followed by long depressive ones, or vice versa. It doesn't damage the individual's core personality, and between episodes, the person appears perfectly healthy. It tends to be slightly more common in individuals with higher body mass. The clinical picture changes depending on whether the illness is currently in a manic or depressive phase.

The world would be a pretty dull place if everyone's mood stayed exactly the same all the time—neither happy nor sad. In reality, our moods are rarely perfectly stable; small things can brighten our day or leave us feeling irritated and down. Some people are quite aware of the regular patterns in their emotional shifts. For others, spring brings a lift in mood as the weather improves, while winter brings a slump as nights get longer and days get shorter. Some women might notice mood shifts tied to different stages of their menstrual cycle. With these types of disorders, the issue isn't the recurring patterns themselves, but rather the extreme degree of the highs or lows, and the potential consequences of decisions made during a high (mania) or a low (depression).

What are the symptoms?
It’s important to distinguish three main elements of this disorder:
- depressive symptoms
- manic symptoms
- the cycles between these two states.

Depressive symptoms are covered in the section on depression.

Manic symptoms may include:
- euphoria
- irritability
- rapid switching between euphoria and irritability
- hyperactivity
- poor concentration or being easily distracted
- decreased or nonexistent sleep
- overeating
- increased libido
- jumping rapidly from one topic to another during conversation, making it hard for the listener to follow
- rapid speech that makes it difficult to understand what is being said
- grandiose ideas

Additionally, there are cycles that can repeat. This can present itself in several ways:

- A mixed pattern. It’s possible for a person to experience numerous manic symptoms while simultaneously struggling with severe depressive thoughts. This is especially common if the person is aware of what is happening to them.
- A cyclic pattern. Manic symptoms can be accompanied by depressive symptoms in a nearly predictable pattern. These mood shifts can occur within a timeframe ranging from a single day to a month. It is less common, but some people experience only depressive or only manic periods, yet still within regular, repeating patterns.

How common is this disorder?
About 1% of the general population will develop bipolar disorder at some point in their lives. If you have blood relatives with bipolar disorder, the likelihood of developing it increases—roughly 12% of people with a brother or sister suffering from bipolar disorder will develop the condition themselves.

What can I do for self-help?

Track your mood
With any disorder that moves in cycles, half the battle in managing the illness is tracking where you are in that cycle at any given time. To really tackle bipolar disorder, you sometimes have to approach it the way an asthmatic approaches asthma or a diabetic approaches diabetes. They have to perform daily checks on lung capacity or blood sugar levels, then use that data to plan how to handle the rest of their day.
It's similar with bipolar disorder; you can track your moods and thoughts. This helps you spot shifts in your mood that might signal an oncoming relapse. A relapse is still a possibility, but now you can actually plan for it.

Having someone you trust to monitor your mood
It’s vital to have a reliable friend or caregiver in your corner. You could set up a simple agreement: whenever they notice signs of a relapse, they let you know. From there, you can both take proactive steps to manage the situation. That might mean taking a few days off to rest, reassessing if you've overextended yourself lately, or scheduling a visit to your psychiatrist.

What kind of professional help is available?
For those experiencing extreme mood swings that can't be managed through mood and thought tracking alone, a specialist—typically a psychiatrist—might prescribe Lithium. It works to stabilize mood fluctuations, but maintaining the correct level in your bloodstream is absolutely critical. Too much can be toxic, while too little won't do anything to stabilize your mood. Because of this, anyone on Lithium needs regular check-ups at medical facilities to monitor their blood levels.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#14 ·


Mood disorders


Depression

Definition

Depression falls under the umbrella of mood disorders (specifically unipolar disorder). A depressive mood is typically marked by social withdrawal, profound sadness, a drop in energy levels, insomnia, loss of appetite, intrusive negative thoughts, slowed thinking, and feelings of hopelessness or helplessness.

We all hit a low point every now and then. It’s such a common human experience that some people almost view it as being similar to a common cold because of how often it happens.
But for certain individuals, a low mood can become a much more serious issue. It can paralyze someone, making everyday tasks feel impossible and leaving them feeling as though there is no hope or purpose in moving forward.

What are the symptoms?
Like many other mental health conditions, there is a wide range of symptoms, though it’s quite rare for one person to experience every single one. Generally, depression involves an overarching sense of misery, accompanied by the following:
- Fluctuations in mood throughout the day. Often, things feel worse in the morning and improve as the day goes on, though this pattern can be completely reversed.
- Sleep disturbances, frequently involving waking up very early in the morning and being unable to get back to sleep, often due to racing thoughts.
- A general slowing of thought processes, speech, and physical movement.
- Feelings of anxiety.
- Lack of energy.
- An inability to enjoy activities.
- Difficulty concentrating.
- Feeling forgetful.
- Negative outlooks regarding the future.
- Feelings of guilt.
- Self-blame and low self-esteem.
- A sense of hopelessness.
- Preoccupation with illness.
- Loss of appetite leading to weight loss.
- Decreased libido.

This is just a surface-level overview. It is important to remember that depression isn't a binary "yes or no" state. There is a spectrum, ranging from mild low moods to the full clinical picture described above. Even then, not everyone will show every symptom. Most importantly, depression is treatable, and if you take the right steps, it can often be managed or prevented.

How common is it?
Most of us experience states that share characteristics with depression at some point. Roughly 7% to 12% of the male population will develop and be diagnosed with depression during their lifetime. For women, that number is higher, ranging from 20% to 25%. There are various theories as to why this gap exists. For instance, the incidence of postpartum depression is certainly a contributing factor.
Other theories suggest looking at a woman's role in modern society and the specific hurdles they face in reaching life goals. Additionally, women might simply be more open about their emotions than men, which could make depression easier to identify in them.

What can I do to help myself?
Start by paying attention to your thoughts and feelings. That is the first step toward facing the problem. Doing this helps you build the skill of spotting a depressive episode before it becomes overwhelming. Using thought-tracking techniques can help you distinguish between what is actually happening in your environment and what is likely an unrealistic thought triggered by a dip in your mood.

Ask someone you trust to monitor your mood.
You won't always catch the onset of depression yourself. However, those closest to you are often able to spot the early warning signs. Being able to talk openly with them about what you're going through is probably your best strategy for fighting back.
It is also really helpful to stick to a routine of identifying and analyzing issues, even when you aren't feeling particularly low. The results might surprise you. Some simple ways to track this with friends or family include keeping a "log" of your thoughts and feelings, or checking in whenever an event occurs that might cause concern for your loved ones.

What kind of support is out there?
It’s incredibly helpful to talk to someone who has actually walked in your shoes and come out the other side. Sometimes, just having a listening ear is the best thing for someone struggling with depression. In the US, most major cities have crisis hotlines available to provide immediate psychological support.

What about professional help?
Your first step should probably be talking to your primary care physician. Depending on what you need, they can refer you to a psychiatric department within a general hospital or point you toward a private psychiatric clinic.

For some people, that alone might not cut it. Nowadays, there are plenty of antidepressants that psychiatrists can prescribe, which often work best when paired with cognitive therapy.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#15 ·


Suicidal behavior!

Suicide among young people.


According to the latest data, a young person takes their own life every two hours. Suicide claims more young lives than any disease or natural cause.
Suicidal behavior isn't caused by just one thing; it’s the result of a complex mix of psychiatric, social, and family factors. It’s also important to note that there are far more suicide attempts and gestures than actual completed suicides. One epidemiological study suggested that for every 23 attempts, only one results in death. Still, we have to stay vigilant and closely monitor those who make an attempt. About 10% of people who attempt suicide will go on to succeed in a subsequent attempt.
Suicide leaves a massive impact on a person's family, school, and entire community.

Social shifts driving the rise in youth suicide rates.
Social shifts that might be linked to the rise in youth suicide include an increase in childhood depression, weakening family stability, and easier access to firearms.
Suicidal behavior is frequently linked to depression, but depression alone is rarely enough to trigger it. Other conditions—like ADHD, substance abuse issues, or various phobias—can significantly ramp up the risk. High-stress life events can also act as a catalyst, especially for those with impulsive tendencies. Generally speaking, girls are more likely to attempt suicide, whereas boys are more likely to complete it.

Risk factors
Suicide risk factors include:
Previous suicide attempts.
Family members who have committed suicide.
Previous hospitalizations due to psychiatric illnesses.
Major recent stressors, such as losing close family members, friends, dealing with a parental divorce, or ending a relationship with a partner.
Social isolation can be devastating. It leaves a person with no social fallback and no perceived way out, making suicide feel like the only option left.
Drug or alcohol addiction? It essentially strips away your ability to control your own behavior. On top of that, many people try to self-medicate their depression by using heavy amounts of drugs or alcohol.
Exposure to violence within the home or one's social environment.
Having firearms in the house—especially if they’re loaded—is a serious matter.

Types of suicidal youth.
Based on certain studies, there are two distinct types of suicidal tendencies among young people. The first group struggles with long-term depression or anorexia nervosa. In these cases, suicide is typically planned and premeditated.
The second group consists of individuals exhibiting impulsive suicidal behavior. In these cases, attention disorders are common, and depression isn't always a factor. They also frequently display impulsive, aggressive behavior toward others.
Teenagers often end up covering for a friend who’s struggling with suicidal thoughts. They feel bound by a sense of loyalty to a secret, or they just don't trust adults to handle it right. This can really delay getting someone the help they desperately need. If a friend actually goes through with it, those who kept the secret are left carrying an immense burden of guilt and regret.

We need to make sure teenagers and kids understand how important it is to report any suicidal statements they hear. Ideally, you should listen to them with genuine empathy first, and then reach out to an adult for help.

Warning signs:
Let's talk about suicide.
Being preoccupied with death and dying.
Signs of depression.
Behavioral changes.
Giving away cherished belongings and trying to wrap up unfinished business.
Trouble sleeping and general sleep issues.
Taking unnecessary risks.
Increased drug use.
Loss of interest in everyday activities.

Risk factors.
Past suicide attempts or current suicidal ideation.
Drug or alcohol consumption.
Gun control.
Stressful situations.

Taking action.
Parents can take three specific steps:
Looking for psychiatric help for my child.
Supporting your child really comes down to a few simple things: actually listening to them, keeping the harsh criticism to a minimum, and making sure you stay connected.
Just looking to get some information.

Teenage friends can take these three steps:
- Take a friend's intentions seriously
- Encourage them to seek professional help and offer to go with them if needed
- Talk to a trusted adult about it. You shouldn't have to carry the burden of helping a friend all by yourself

Intervention
Intervention takes many forms, and ideally, all should be utilized.
Prevention involves educating students and the community while raising awareness about the dangers of suicidal intent. Intervening with a suicidal student focuses on protection and support. Postvention refers to the actions taken after a suicide has occurred to prevent further tragedies. In every case, having an action plan ready in advance is essential.
Prevention often relies on education, which can be conducted in classrooms by healthcare professionals, psychologists, or school counselors. This training should cover the risk factors that make individuals vulnerable to suicide. Other types of intervention are also necessary, such as reducing drug and alcohol use. It’s vital to guide parents toward maintaining open, daily communication with their children. One practical idea is a "TV-Free Week," where family members focus on listening to one another rather than watching screens. Parents also need to stay informed about the risks of unsecured firearms in the home. While peer education and mediation programs run by students themselves can be highly effective, it is absolutely critical to emphasize the importance of talking to adults. Psychologists and psychiatrists should be integrated into school life so students see them as accessible resources.
Intervening with a suicidal student: Some schools have policies regarding the expulsion of violent students, particularly those struggling with addiction. It is crucial to remember that these individuals are at a higher risk for suicide. If a student is actually expelled, faculty should step in to talk to the parents, urging them to seek psychiatric or psychological help immediately. The following steps are necessary:
1. De-escalate the immediate crisis. A suicidal student should never be left alone for even a minute. Always check if they are carrying any potentially dangerous items or medications. If they are, calmly persuade them to hand them over. You should never engage in a physical struggle to take these items away. At this point, you must call for a psychologist or psychiatrist.
2. A psychologist or psychiatrist needs to speak with the student to assess the level of suicide risk.
3. If the student is in possession of dangerous items, it is a high-risk situation. School staff should notify the police, emergency services, and the parents. Staff members need to remain calm and try to convince the student to surrender the items.
4. If the student doesn't have dangerous items but still appears to be at high risk, the situation is just as grave. Talking with them might reveal underlying causes—such as distress from physical or sexual abuse—which would require calling social services. If there are no signs of abuse or neglect, teachers should call the parents to pick up the student. They should describe the situation fully and encourage the parents to seek professional help.

Follow-up: It is necessary to document every action taken. After the incident, a crisis team can meet to review the entire sequence of events to identify patterns for future prevention. Friends of the student should be given appropriate information about what happened. It is also important to follow up with the parents and the student to ensure they have received help. Most importantly, the student needs to see that the school still cares about them.
Postvention: An attempted or completed suicide always leaves a deep impact on school staff and other students. There are reports of a "contagion" effect that can lead to subsequent suicides. Close friends of the deceased may struggle for years. One study noted an increase in major depression and PTSD roughly 1.5 to 3 years after a friend's suicide. We also see "clusters" of youth suicides. Some believe this is driven by media sensationalism or the romanticization of the deceased.
Schools really need a solid playbook for handling a situation like this. It starts with briefing the staff and then making sure teachers pass the right message down to the students. Consistency is key—everyone needs to hear the exact same story. We should also have counselors on standby for both faculty and students who might need extra support. For those students who seem hit hardest by the news, we need to reach out to their parents immediately and provide proactive counseling. Controlling the narrative is vital. A designated spokesperson should handle all media inquiries; if you dodge the press, you lose any chance to shape how the story is told. It’s also crucial to warn journalists that sensationalism can trigger more tragedies. The media should avoid repetitive, dramatic coverage and skip the grim details regarding the method, location, or timing. There should be no glorification of the deceased.

What can we actually say to a student struggling with suicidal ideation and low self-esteem?
- Listen actively. Help them build practical problem-solving skills.
- Encourage a growth mindset. Instead of letting them say "I can't," nudge them toward saying "I'll try."
- Help the student put together a list of their own strengths and positive qualities.
- Create opportunities for them to succeed. Offer praise whenever possible.
- Assist the student in drafting a step-by-step roadmap to reach their goals.
- Coordinate with the family so they can better grasp what the student is going through.
- Practice patience and build trust.
- Encouraging them to help others can be a great way to boost self-esteem.
- Get them involved in positive school activities or community service.
- If it fits their background, involving them in religious activities can help.
- You could even set up a behavioral contract where positive actions and new skills are rewarded.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#16 ·

Personality Disorders


Where do we even begin? We all know how complicated people can be. Even defining "personality" itself is a massive undertaking. Some experts argue that trying to pin down something as fluid and complex as human personality with a brief definition is a lost cause. In fact, many psychologists and psychiatrists prefer to present their entire body of work—their whole theoretical framework—as their "definition." Still, others have attempted to provide concise definitions, following the tradition of categorizing natural phenomena.

"Personality is a dynamic organization within the individual of those psychophysical systems that determine his characteristic behavior and pattern of adjustment to his environment" — Allport.

"Personality represents a system of relatively enduring dispositions through which an individual experiences, differentiates, or manipulates actual or perceived aspects of his environment, including himself" — Bronfenbrenner.

"Personality is what allows us to predict what a person will do in a given situation (...) Personality refers to an individual's total behavior, both public and private" — Cattell.

"Personality is the more or less stable and permanent organization of an individual's character, temperament, intellect, and physical constitution that determines his distinctive adjustment to his environment" — Eysenck.

"... the total sum of an individual's traits and patterns of behavior which, in their organization, describe that individual's unique way of adapting to his environment" — Hilgard.

"... a relatively enduring pattern of repetitive interpersonal situations that characterize human life" — Sullivan.

Anyway, I won't ramble. I hope this gives you a little insight into the complexities of something so common yet so deep: human personality. I won't get bogged down in scientific nomenclature or the specific hurdles psychologists face when studying the nature of personality.

Moving forward, we’ll discuss personality disorders and how they are categorized. But first, let's try to boil down those definitions mentioned above. Essentially, personality can be seen as the set of characteristics that drive a person's behaviors, thoughts, and emotions.

Now that we have a rough idea of what personality is, we can talk about personality disorders.

Personality Disorders
A personality disorder occurs when personality traits become maladaptive and inflexible, leading to significant social or professional struggles, or intense internal distress.

How can you spot a personality disorder?
People dealing with these disorders often struggle at work—sometimes showing up as hyperactive, "workaholics," or conversely, performing far below their actual capability. Beyond the workplace, these issues spill over into social lives. Making new friends is difficult, and maintaining old relationships is just as hard. People who interact with them often find them difficult to deal with, frequently feeling frustrated by unpredictable or irrational behavior. Generally speaking, patients with personality disorders struggle to handle any kind of stress.

The classification of personality disorders we are using here is based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV).

The DSM-IV outlines 10 distinct types of personality disorders. Because many of these traits overlap, they are grouped into three main clusters. Cluster A consists of odd or eccentric personalities; Cluster B covers dramatic, emotional, and erratic behaviors; and Cluster C includes anxious and fearful personalities.

Cluster A. This "odd or eccentric" group includes paranoid, schizoid, and schizotypal personality disorders.
Individuals with these disorders often rely on defense mechanisms like projection and fantasy, and may experience psychotic tendencies. Projection involves attributing one's own unpleasant thoughts or feelings to someone else (like prejudices or paranoia). Fantasy involves retreating into an imaginary world to cope with loneliness. Paranoia is that persistent feeling of being persecuted or treated unfairly by others (for instance, feeling like everyone is talking about you or laughing at you).

Group B. This category covers dramatic, emotional, or unstable clusters, including histrionic, narcissistic, antisocial, or borderline personality disorders.
People dealing with these disorders often rely on defense mechanisms like dissociation, denial, splitting—viewing the world in black and white—and acting out through uncontrolled physical expressions of thoughts and feelings. Dissociation involves unconsciously blocking out unpleasant emotions or associations. Denial is closely tied to dissociation; it’s when a patient refuses to acknowledge a thought or feeling, either because they won't or simply because they can't. Then there’s "splitting," where an individual sees others as either entirely good or entirely bad. This "romanticized" way of dividing the world makes it incredibly difficult to build the complex, nuanced social connections we need in everyday life.
Beyond these specific defense mechanisms, patients frequently report experiencing mood disorders.

Group C. This group consists of anxious and fearful personalities, including avoidant, dependent, and obsessive-compulsive types.
Those struggling with these issues often utilize isolation, passive aggression, and hypochondria as defense mechanisms. Isolation occurs when someone detaches unacceptable ideas or actions from their underlying emotions. Passive aggression shows up as indirect resistance, which is often turned inward against oneself. Hypochondria is also quite common among patients with personality disorders, particularly those with dependent or passive-aggressive traits.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#17 ·


Personality disorders—specifically Group A.


In this post, we’re going to take a closer look at Cluster A personality disorders, specifically covering schizoid, paranoid, and schizotypal personality disorders.

Schizoid Personality Disorder


This disorder is marked by a deep sense of detachment from one's social environment and a struggle to express emotions within relationships, typically surfacing in early adulthood. Pinning down exactly how common this is remains difficult, mainly because those dealing with it often don't want—or simply don't feel the need—to seek out professional help.

This type of personality disorder is defined by a lack of interest or desire for close interpersonal relationships. People with this condition often choose solitary activities, show little interest in sexual experiences with others, and rarely find pleasure or excitement in most activities. There’s typically a lack of close friends, along with noticeable indifference, emotional coldness, and detachment. To make an official diagnosis, at least four of these symptoms must be present.

Patients like this can be quite challenging to treat. They often view the hospital setting and psychiatric intervention as a direct assault on their personal world. Because of that, they frequently end up walking out on their medical care.

I’d suggest starting out with individual psychotherapy. If the patient feels up to it, group therapy would actually be the best way to go.

Paranoid Personality Disorder


Paranoid Personality Disorder is characterized by deep, unfounded suspicion and a fundamental distrust of others. It involves an intense hypersensitivity to people and a struggle to manage one's own emotions. People dealing with this don't typically show signs of psychosis or schizophrenia. While they remain quite capable of observing their surroundings accurately, they almost always misinterpret the actions of others as being intentionally threatening or humiliating. This often leads them toward mystical religious groups, pseudoscience, or fringe political movements, which only serves to isolate them further from society and fuels their sense that the world is out to get them.

Symptoms of this disorder typically involve a constant suspicion that others are exploiting or being malicious toward you, even when there’s absolutely no evidence to back it up. People dealing with this often get obsessed with unfounded doubts—like questioning whether friends or coworkers are actually being sincere. There is a deep-seated refusal to trust anyone because they are convinced that any information shared will eventually be used against them. They also tend to feel threatened or insulted by even the smallest gestures or comments that most people wouldn't think twice about. This leads to constant grumbling and a feeling that their character or reputation is under attack, even when it isn't obvious to anyone else. Naturally, this mindset results in sudden, angry outbursts or defensive counterattacks. Additionally, there is often unwarranted suspicion regarding the loyalty of a spouse or sexual partner, despite a total lack of proof. To make a formal diagnosis, at least four of these symptoms must be present.

People living with paranoid personality disorder rarely reach out for help on their own. If they do decide to seek support, individual psychotherapy is really the only way to kick things off. Group therapy can work occasionally, too. As for antipsychotics, it’s generally only justifiable to use them when the patient is experiencing significant agitation.

Schizotypal Personality Disorder


The defining trait of schizotypal personality disorder is that "odd" quality in how a person behaves, thinks, and carries themselves. While these characteristics are distinct, they aren't extreme enough to be classified as schizophrenia, and they don't involve full-blown psychotic episodes.
It's estimated that about 3% of the population deals with this disorder.

This disorder is defined by a persistent lack of social and interpersonal connections. Common symptoms include ideas of reference, odd beliefs, and magical thinking—things like believing in clairvoyance, telepathy, various superstitions, or having a "sixth sense." You also see unusual thought patterns paired with strange speech, which tends to be overly metaphorical, circumstantial, or repetitive. On top of that, there’s often paranoia, along with inappropriate or constricted affect. People with this condition can act and appear quite eccentric. Ultimately, this leads to a lack of close friends and intense social anxiety, likely fueled by those underlying paranoid fears.

Group therapy is a solid treatment method for these patients. Based on research findings, it actually tends to outperform individual psychotherapy. That said, some patients just aren't built for the group setting and can't tolerate it.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#18 ·

Cluster B Personality Disorders


In this section, we’ll take a look at Cluster B personality disorders—often described as the dramatic, emotional, and erratic group. This category includes four primary diagnoses: histrionic, narcissistic, antisocial, and borderline personality disorders.

What links these disorders is a shared tendency to rely on certain defense mechanisms, such as dissociation, denial, "splitting," and the phenomenon known as "acting out." Beyond these specific psychological defenses,
mood disorders and somatization are also frequently present among those living with these conditions.


Histrionic Personality Disorder


People with this disorder constantly seek attention and express emotions very intensely. However, these emotions often feel shallow and can shift quite rapidly. These individuals are typically perceived as charming or seductive, often placing an exaggerated emphasis on their physical appearance.

The core behavior involves highly expressive emotionality and a persistent need to be the center of attention, which usually begins in early adulthood. A hallmark of this disorder is a sense of discomfort when one isn't being noticed, alongside interpersonal interactions that may come across as inappropriately sexual, flirtatious, or provocative. Furthermore, their emotional responses can seem insincere—described more as superficial and fleeting. Such individuals often lean heavily on their physical looks to draw eyes toward them. Their speech tends to be impressionistic, full of flair but lacking in concrete detail. Additionally, there is often an increased susceptibility to the influence of others or surrounding circumstances, along with an intense focus on the importance of certain social connections.

Alongside these primary symptoms, mood disorders and somatization—where psychological distress manifests as physical symptoms—are common.

Treatment typically involves psychotherapy, both individual and group, as well as medication, particularly antidepressants.


Narcissistic Personality Disorder


Individuals diagnosed with this disorder possess a sense of grandiosity regarding their own importance, yet they remain incredibly sensitive to any form of criticism. They often struggle with empathy for others and tend to focus more on outward appearances than on actual substance.

Those affected exhibit grandiosity through either fantasy or mannerisms, showing a constant need for admiration and a lack of empathy that emerges during early adulthood.

As mentioned, these individuals display an inflated sense of self-importance, which might manifest as an overemphasis on their own talents or achievements. They often dwell on fantasies of unlimited success, power, uniqueness, beauty, or the perfect love. They truly believe they are special and can only be understood by other high-status people, which fuels their intense craving for praise. They also tend to hold unreasonable expectations, assuming others will automatically comply with their views. Their interpersonal relationships are often exploitative, benefiting themselves at the expense of others. Empathy is notably absent, and they frequently perceive others as being envious or jealous of them. Arrogance is a common trait here as well.

Similar to other disorders in this cluster, those affected often experience mood disturbances, primarily depression or depressive moods. There is also an extreme preoccupation with their own image, alongside issues with somatization.

Treatment consists of individual and group psychotherapy.


Antisocial Personality Disorder


People struggling with this disorder have a history of persistent and chronic antisocial behavior, which involves violating the rights of others.
The fundamental issue in this condition is an inability to control impulses. Those affected often show a profound lack of concern for others. They tend to be egocentric, selfish, and excessively demanding. Furthermore, signs of anxiety, remorse, or guilt are frequently absent.
Breaking rules and violating community norms is a hallmark of this personality disorder. Terms like "sociopath" or "psychopath" are often used to describe individuals who exhibit particularly deviant antisocial behavior.
This is generally considered a lifelong condition. For a formal diagnosis, it’s essential that behavioral issues were already present during adolescence.
People struggling with substance abuse often fall into the category of antisocial disorders. However, if an individual's issues stem strictly from drug abuse—and they actually feel guilt over their actions—then an antisocial personality disorder diagnosis can be ruled out.
Research conducted in the USA shows that roughly 3% of men struggle with this disorder.
The exact origins of this condition aren't entirely clear yet. We often see patterns of similar disorders within families. Because of this, current thinking suggests that both a person's upbringing and genetic factors play a role. Family issues involving alcoholism also increase the risk of antisocial behavior.
Antisocial behavior can also result from brain trauma or encephalitis.

Treatment should be carried out exclusively in inpatient settings, where group therapy has proven to be a more effective method.
In addition to psychodynamic approaches, some patients may see improvement through medication.


Borderline Personality Disorder


The core issue here is instability regarding self-image, interpersonal relationships, and mood.
A characteristic pattern involves instability in relationships, self-perception, affect, and emotional control, typically beginning in early adulthood.
The condition is marked by intense efforts to avoid real or imagined abandonment. Relationships tend to be unstable and highly intense. Self-identity is often fragile or shifting. Impulsivity is seen in at least two potentially self-damaging areas (such as sex, substance abuse, or binge eating). Suicidal behavior or self-harming tendencies may be present. There is also a chronic sense of emptiness, along with intense, uncontrolled anger that feels inappropriate to the situation.

This type of disorder affects about 1-2% of the population. It is diagnosed twice as often in women. The cause is most likely linked to disruptions in early personality development. Childhood abuse is a frequent finding.

Therapy utilizes psychodynamic approaches as well as medication.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#19 ·

Personality disorders and psychopathy


Some mental health professionals are generally skeptical about the idea that a person's personality can actually be changed.
Others accept that personality disorders exist—they just aren't sure if the medical community should be treating them.

The problem with personality


For most other mental health conditions, there are tests providing clear diagnostic criteria—however, standardized tests for personality disorders simply don't exist. Often, diagnosing these issues boils down to the clinical opinion of a few psychiatrists or psychologists who have spent significant time talking with patients and their families. Still, these expert conclusions follow standardized criteria—in the US, we refer to this via the International Classification of Diseases (ICD).

What are the symptoms?


If you look at a handful of personality traits, such as:
1. rigidity
2. self-confidence
3. sensitivity
4. jealousy
5. mistrust
6. impulsivity
7. attention-seeking
8. dependency
9. argumentative nature
10. aggressiveness
11. empathy

It isn't hard to think of the opposites of these terms. Ask yourself—if I drew a line between two opposing concepts, where would I land? Using only this brief, simplified list, we’d get as many different results as there are people. Which specific pattern would actually represent a personality disorder?

The answer comes in two parts. The first part concerns behavior—many wouldn't agree that certain actions are an inseparable part of someone's character. However, it's easy to imagine someone who knows they are overly sensitive and works hard to overcompensate so they don't react too strongly when hurt. This leads us to the second part of the answer—the internal aspect.
Someone with a personality disorder will display behavioral patterns that cause more problems than they solve—if not for themselves, then certainly for those around them. This way of thinking stems from a deeply ingrained belief system—acting in a way that reflects how they perceive the world. Their worldview is so powerful that any evidence suggesting otherwise is simply dismissed.
These individuals might notice the problems affecting the people around them, but they struggle to connect those issues back to their own behavior. If they face negative consequences, they often try to find a way out—but since their solutions are based on a flawed worldview, trying to fix the situation (or just coping with it) usually just creates even more trouble.
Such perspectives can be so integrated into a person's identity that they aren't even aware of them, nor are they aware of the role these views play when they find themselves in difficult situations.
Most of us aren't constantly conscious of our core principles and worldviews; they mostly serve as the foundation from which we make decisions and judgments. They act as the personal laws we use to navigate life.

Classifying personality
There are several different systems for classifying personality disorders, but the following are generally the most common.
First, there are personalities possessing traits linked to other mental disorders—these haven't yet been established as standalone diagnoses or are still in the early stages of research. These include:
-anxiety
-obsessive-compulsive traits
-paranoid
-depressive
-hyperthymic (or manic)
-cyclical (bipolar disorders)
-schizoid.

These aren't necessarily people who will eventually develop anxiety or depression, etc. They simply possess personality traits and resulting behaviors that are closely tied to those specific conditions.

A person with an obsessive-compulsive type personality will show a profound inability to adapt to new routines. They often deal with an intense urge toward perfectionism and an eye for detail, which frequently means they rarely finish tasks on time—if they finish them at all. This means that qualities usually highly valued—like reliable work and maintaining high standards—can actually "paralyze" such an individual when they try to get things done. For these people, rejecting criticism is easy and almost automatic—claiming that nobody understands them or recognizes the importance of the work they do.

Beyond that, there are some more controversial ways to classify personality disorders:
- antisocial
- borderline
- narcissistic
- passive-aggressive
- dependent.

Given how imprecise diagnosing personality disorders can be, it isn't surprising there’s disagreement over which patterns of worldview or behavior actually constitute antisocial personality disorder. Still, four specific traits tend to pop up repeatedly:
- an inability to form intimate bonds
- impulsivity
- a lack of guilt
- failing to learn from unpleasant experiences.
Antisocial personality disorder is the diagnosis most frequently—though not exclusively—linked to psychopathy.

Defining Psychopathy


A persistent personality disorder, or a state where behavior deviates significantly from the norm (the psychopathic personality). These are limited personalities sitting on the threshold between mental health and illness, usually without intellectual impairment—in fact, they are often above average intellectually. The primary shifts occur on the emotional and volitional planes of personality. It was originally thought that only those around them suffered (due to aggression, asociality, and antisocial behavior). However, it was later realized that some individuals suffer themselves because of their abnormal personality (such as depressive or suicidal psychopaths). They never reach the level of psychosis, even if they display symptoms similar to certain mental disorders (schizoid, paranoid, unstable, eccentric, depressive, hypomanic, etc.). Psychodynamic theorists interpret psychopathy as a weakness of the "ego," leading to uncontrolled impulses, combined with a weak "superego," which results in an inability to follow moral norms. Both unfavorable genetic factors and environmental influences shape psychopathic personalities. Therapeutic attempts almost always fail. The definition and true meaning of psychopathy remain subjects of ongoing debate.

How common is this?
Because of these diagnostic difficulties, it is hard to pinpoint exactly how prevalent this disorder is.

What can I do to help myself?
Since self-perception is such a massive hurdle in personality disorders, if you find yourself asking "What can I do to help myself?", it is entirely possible—as you begin to notice and define the issue—that you may not actually have a personality disorder. However, if you feel stuck in a cycle of behaviors and habits that you simply cannot break, and you feel these patterns are causing you harm, the best move is likely seeking advice from a psychologist or psychiatrist.
Jamie Clark74 Jamie Clark74 RegularOP
278 messages
joined Sep 2004
#20 ·


Schizophrenia and related disorders

A little something about schizophrenia.


There aren't many conditions surrounded by as much controversy as schizophrenia. We can't even seem to settle on what to call it; some people stick to the standard term, while others insist on a different spelling or variation. The name itself actually comes from a Greek compound: "schizo," meaning to split, and "phren," meaning mind or soul.

To explain schizophrenia, you might want to start by defining what it actually isn't:
Double or multiple personalities.
Triggered by parental behavior or the way someone was raised.
Incurable.
There is no guarantee that someone who falls ill will act out violently.
There is absolutely no guarantee that someone will end up hospitalized for the rest of their life.

Dealing with this condition is incredibly tough, both for the individual and their family, but there is still plenty of hope. About one in four people who experience symptoms of schizophrenia go into full recovery. We've seen significant medical progress in recent years, which means many people living with schizophrenia can maintain a normal lifestyle—staying connected with their families and keeping up with their social circles.

What are the symptoms of schizophrenia?
Schizophrenia symptoms can generally be split into two categories: positive and negative.
Positive symptoms tend to pop up more frequently during the acute stages or at the very beginning of the illness. Negative symptoms, however, are more common as the disease progresses over the long term.

Positive symptoms include:

Hallucinations happen when someone sees, hears, feels, or smells something that isn't actually there. There's no external stimulus—it’s an experience generated entirely within the individual.

False beliefs and delusions: there's often plenty of evidence suggesting someone is being misled, yet they cling to those ideas regardless of any logical explanation. To everyone else, these delusions seem completely unfounded and disconnected from reality.

People often build entire conclusions based on their own lies, which just drags them down a rabbit hole of even more deception. You'll frequently run into individuals or organizations that seem to be hunting them down or trying to corner them—what we call paranoid delusions or persecutory delusions.

Thought processes can get messy. Sometimes, thoughts race so fast they feel disorganized, like they're scrambling inside your brain. Other times, it’s the exact opposite—just a total blank, where your mind suddenly empties out completely. There are also those strange distortions in how people perceive their own thinking. It's common for patients to feel like their private thoughts aren't actually private, or even more unsettling, that they've somehow been replaced by someone else entirely.

Mood: It can shift pretty rapidly and often feels out of sync with what’s actually happening.

Other symptoms:

Given all those changes mentioned above, it’s hardly surprising that patients often become extremely preoccupied with things, easily distracted, or even withdrawn. Everyone experiences these behavioral patterns differently, and the severity of the symptoms varies from person to person.

Patients almost always struggle to truly grasp the reality of their own illness.

Once the acute phase of an illness passes, a patient often enters a chronic stage dominated by what we call "negative symptoms." This usually looks like a lack of motivation, social withdrawal, or avoiding people altogether. While some of the intense symptoms from the acute phase can linger into this period, they generally aren't quite as severe or overwhelming as they were at the start.

Delusions and hallucinations might persist, but the patient should eventually be able to distinguish these episodes from their everyday beliefs and social interactions. It’s important to consistently reassure them that these symptoms are strictly a byproduct of the illness.

It’s easy to feel pretty discouraged when you have a friend or a close family member living with schizophrenia. But there are two important points worth keeping in mind:
The severity of the illness varies quite a bit. Not everyone diagnosed with schizophrenia will present the exact same clinical picture.
This condition is manageable. Through a combination of psychological treatments and medication, you can significantly improve both the daily experience and the long-term outcome.
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How common is this disorder?
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Roughly 1% of people will develop schizophrenia at some point in their lives. It appears there's a genetic predisposition involved. Among those with a parent or sibling affected, about 10-15% will develop the disorder. If both parents have schizophrenia, that risk jumps to 40%. Interestingly, the risk rate stays the same whether the children were raised by their biological parents or adopted into another family.

Men face the highest risk of developing schizophrenia between the ages of 15 and 35, peaking in their twenties. Women also see their highest risk during their twenties—though the risk for women is lower than it is for men during those years, it doesn't drop off after twenty like it does for men; instead, the risk actually increases for women.

What actually happens to those diagnosed with schizophrenia?
About 20-25% of individuals will never experience another acute relapse. Another 20-25% will go through more than one acute phase but remain stable while on medication. Roughly 40-50% will develop long-term chronic phases. Among younger patients at the onset of an acute phase, there is a significant risk of suicide attempts.

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