Panic Ddisorders

Individuals with Panic Disorder regularly experience chronic intense episodes of anxiety, known as panic attacks. They worry about having more attacks, or about what the attacks imply might cause, and make changes to their behaviors because of the attacks.

These intense anxiety attacks consist of: shortness of breath; increased heart beat; trembling; dizziness; chest pain; sweating; hot flashes; headache; a feelings of unreality; tingling sensations; breathing faster than necessary; nausea; vertigo; lightheadedness; a burning sensations; choking sensations; fear of dying; a fear of insanity

Panic attacks begin suddenly and usually peak rapidly, within 10 minutes or less of starting. Multiple attacks with different intensities may occur within several hours. At first, panic attacks usually seem to appear suddenly but over time a person may come to expect them in certain situations. If a person begins to avoid these situations due to fear of a panic attack, they may also have agoraphobia.

Some people suffer panic attacks on a daily or weekly basis. The symptoms of a panic attack often result in social problems, such as embarrassment, stigma, or social isolation. However, people who have had these attacks for a long time are often able to restrain the signs of even very intense pain.

Panic Disorder is a serious mental health problem, but it can be successfully treated.  It often begins in young adulthood, about half the people who have Panic Disorder develop it before age 24. This is common if someone has been subjected to a traumatic experience. Women are a greater risk than men to develop Panic Disorder.

Panic Disorder can continue for months or years, depending on how and when treatment is started if left untreated, symptoms may become so severe that a person has significant problems with their personal relationships and jobs. Some people may experience several months or years of frequent symptoms, then remain symptom free for years. For others, symptoms persist at the same level indefinitely. There is some evidence that many people, particularly those whose symptoms begin at an early age, may naturally experience a partial or even complete reduction in symptoms after middle age.

The exact cause of Panic Disorder is not known, but like many other anxiety disorders, Panic Disorder runs in families, genetics may influence the determination of who will affected by it. Panic Disorder is often found in combination with other hereditary disorders such as bipolar disorder and alcoholism. Many people without a family history of Panic Disorder can develop it.

Other biological factors, stressful life events, and brooding about common bodily reactions are also may cause the onset of panic disorder. Often the first attacks are triggered by physical illnesses, major stressors, or medications. People with too many responsibilities may develop a tendency to suffer panic attacks. Individuals with post-traumatic stress disorder also show a much higher rate of Panic Disorder than other people. Some researchers suggest that hypoglycemia, hyperthyroidism, mitral valve prolapsed, among other disorders may trigger or worsen Panic Disorder.

Panic disorder can be treated with therapy and medicines to help minimize or eliminate panic attacks and decrease the anxiety that accompanies the fear of future attacks.

Cognitive-behavioral therapy, which focuses on changing abnormal thinking and behavior patterns, is the most effective type of therapy for panic disorder.

Early diagnosis and treatment can prevent other conditions linked with panic disorder, such as depression or substance abuse.

Night Terrors in Adults

Night terrors are a sleep disorder in which a person suddenly awakens from sleep in a terrified state.

Night terrors occur during deep sleep, usually during the first phase of sleep. The cause is unknown but night terrors may be triggered by fever, lack of sleep, or emotional tension, or stress.

Nightmares are more common in the early morning. They may occur after someone watches frightening movie or has an emotional experience. A person may remember the details of a dream upon awakening, and will not be disoriented after the episode.

Night terrors may run in families. They can occur in adults, especially with emotional tension or with substance use. Sleep terror or Night terrors disorder is frequently found in children, but adults can also have sleep terror disorder. It’s usually got a very different cause and treatment from the childhood kind, but the symptoms are similar.

A person with sleep terror disorder has symptoms that are distressing to anyone seeing them. They will usually awake in the night, generally within a few hours of falling asleep, with a feeling of sheer terror. They wake abruptly from stage of the REM sleep cycle, and it would seem to be between sleep and wake. When they wake, they usually scream, or moan, and have a very hard time awaking.

Other symptoms are physical ones that are to be expected when the person is feeling terror sweating, with large pupils. The pulse is usually racing, and their breathing is very fast and there is a look of fear or panic on their face. They can also look very confused. When adults have sleep terror disorder, there are other causes. There are many reasons to check for and different methods to alleviate the symptoms; they are unlikely to get better within a few weeks.

Proper diet and enough sleep, and managing stressful events in life can relieve Night terrors in many cases. Sometimes adults with sleep terror disorder have additional triggering factors, like trauma-based situations (post traumatic stress and genetic or chronic factors. If this is the case, the adult with sleep terror disorder should be in therapy. Psychotherapy and antidepressant medicine can often help immensely.

The adult with sleep terror disorder should also be checked for other medical factors, adults with hypoglycemia can have night terrors, as well as other symptoms.

The prognosis for Night terrors is fairly good with the person finding improvement in time the advice of a psychiatrist and psychotherapy may be necessary to reduce the number of Night terrors until they abate.

Nightmare Disorder in Adullts

Nightmares are more common among children, but one out of every two of the adult population is plagued by nightmares.

Are nightmares causing you significant distress and are they interrupting your sleep on a regular basis?  Determining what is causing your adult nightmares can help you to make changes to reduce their occurrence.

Nightmares are vividly realistic, disturbing dreams that cause you awake from a deep sleep.  Nightmares tend to occur most often during REM sleep, when most dreaming takes place. Because periods of REM sleep become longer as the night progresses, you may experience nightmares in the early morning hours.

If you've gone through a traumatic event, such as an attack or accident, you may have recurrent nightmares about your experience.

Nightmares and night terrors are different experiences. Night terrors occur in the first few hours after falling asleep. They are feelings, not dreams people who have night terrors do not recall why they are terrified upon awakening.

Nightmares in adults can be caused by a variety of factors and underlying disorders. Some people have nightmares after eating too late at night, which can increase metabolism and signal the brain to be more active. Medications also contribute to nightmare frequency. Drugs such as antidepressants and narcotics are often associated with nightmares. Non-psychotropic medications, including some blood pressure medications, can also cause nightmares in adults.

Withdrawal from medications and substances, including alcohol and tranquilizers, may trigger nightmares. Any difference in your nightmare frequency after a change in medication should be discussed with your doctor.

Sleep deprivation may be part of the cause of adult nightmares, which themselves often cause people to lose additional sleep.

There can be psychological triggers that cause nightmares in adults. Anxiety and depression can cause adult nightmares. Post-traumatic stress disorder commonly causes people to experience chronic, recurrent nightmares.

Nightmares in adults can be caused by certain sleep disorders; including sleep apnea and restless leg syndrome. When there is no other cause, chronic nightmares may be a sleep disorder. People who have relatives with nightmare disorder may be more likely to have the condition

A person experiencing nightmare disorder may have trouble going through everyday tasks; the lack of sleep and anxiety caused by the dreams can hinder the individual from completing everyday jobs efficiently and correctly

Nightmares can be caused by extreme stress or anxiety the death of a loved one or a stressful life event can be enough to cause a nightmare.

There are many ways to treat nightmare anxiety without seeking the help of a doctor. Alleviating stress in the home and personal life may eliminate any anxiety upon going to bed. A regular fitness routine and relaxation therapy can help to make you fall asleep faster and more peacefully. Yoga and meditation can also help to eliminate stress.  Formal Psychotherapy can also help you to learn how to cope and deal with the various stressors in your life.

Medication can only be prescribed by a psychiatrist or other physician. Therapy usually helps to deal with the subjects of the nightmares that cause fear and alleviate the recurrence of the dreams.  Treatments are generally very successful with few relapses.

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Delusional Disorder

Delusional disorder is a condition with non bizarre delusions; beliefs that can occur in real life; for instance being poisoned, being watched, being deceived, or having an illness, These delusions do not include other symptoms of schizophrenia or other disorders where delusions can occur. These delusions may seem believable, and the person may appear normal.  These delusions are not due to a medical condition or substance abuse.

The delusions are of different types:  a type where the person believes that a person, usually of higher social standing, is in love with the individual;  grandiose type the person believes that he has some great but unrecognized talent or insight, a special identity, knowledge, power, self-worth, or special relationship with someone famous or with God; jealous type the belief that his partner has been unfaithful; persecutory type the individual believes he is being cheated, spied on, drugged, followed, slandered, or somehow mistreated; somatic type where there is an experience of physical sensations or tactical; such as foul odors or insects crawling on or under the skin or he is suffering from a general medical condition or defect; mixed type more than one of the type of delusion. Delusions also occur as symptoms of many other mental disorders, especially the other psychotic disorders.

The cause of delusion disorders is not know however researchers find certain features indicate that when delusional disorders occur later in life they may be hereditary. Early childhood experiences may be a contributing factor.  Some researchers propose that any person with a sensitive personality is vulnerable to developing a delusional disorder.

Treatment of delusional disorders is drug therapy and psychotherapy.  Treatment is complicated, for many reasons, such as the patient's denial that they have a psychological problem.

Antipsychotic medications are used in the treatment of delusional disorder as well as in schizophrenic disorders. These medications work by reducing the incidence of psychotic symptoms; hallucinations and delusions. They also alleviate the anxiety and agitation.

Psychotherapy for patients with delusional disorder includes cognitive therapy. Psychotherapy has been said to be an effective form of treatment.

Sleep and Hypersomnia

Hypersomnia, or excessive sleepiness, is a condition in which a person has trouble staying awake during the day. People who have Hypersomnia can fall asleep at any time; at work or while they are driving. There may be other sleep related problems, a lack of energy and trouble thinking clearly.

Anxiety and stress may be the causes of recurrent nightmares.

There are other causes of Hypersomnia. The sleep disorders narcolepsy, daytime sleepiness, and sleep apnea interruptions of breathing during sleep.

Not getting enough sleep at night; being overweight; drug or alcohol abuse; head injury or a neurological disease; such as multiple sclerosis; prescription drugs, such as tranquilizers and genetics.

If you consistently feel drowsy during the day, talk to a doctor.  Expect the following questions when he is making a diagnosis of Hypersomnia, the doctor will ask you about your sleeping habits, how much sleep you get at night, if you wake up at night, and whether you fall asleep during the day. The doctor will also want to know if you are having any emotional problems or are taking any drugs that may be interfering with your sleep. The doctor may also order some tests.

If you are diagnosed with Hypersomnia the treatment can consist of trying various drugs, including stimulants, antidepressants, as well as several newer medications.

If you are diagnosed with sleep apnea, the doctor may prescribe a treatment known as continuous positive airway pressure which is for you wear a mask over your nose while you are sleeping. A machine that delivers a continuous flow of air into the nostrils is hooked up to the mask. The pressure from air flowing into the nose helps keep the airways open.

If you are taking a medication that causes drowsiness, consider changing to one that is less likely to make you sleepy. You may also want to go to bed earlier to try to get more sleep at night, and eliminate alcohol and caffeine.

Lack of sleep can cause major difficulties in your life and can interfere with work, social and everyday living.  Consult a doctor if it has become a chronic or troublesome.  Getting the right amount of sleep is essential to functioning to full capacity.

Circadian Rhythm Disorder

Circadian rhythm is a person's biological clock.  It regulates various biological processes on a 24 hour schedule.  The most prominent of circadian rhythms are the sleep-wake cycle; temperature system and endrocrine system.


When there is a disturbance in a person's circadian rhythm specifically the sleep-wake system it is called a disorder.  There are 2 types of sleep-wake disorders Transient disorder and chronic disorders. Transient is when the biological clock malfunctions due to Jet lag; a change in work or social tasks or an illness.  Chronic disorders can be categorized as Delayed sleep phase, it is a persistent inability to fall asleep or awake at acceptable times.  Individuals may fall asleep late in the early morning hours or wake up late in late morning hours or early afternoon.  Once asleep these persons with this disorder are able to maintain sleep and have a total normal sleep time.


Advanced sleep phase is a persistent early evening sleep time and an early morning wake up time.  Advanced sleep phase is less common than Delayed sleep phase and is most often see in the elderly and depressed people.


Treatment for Circadian Rhythm sleep disorder consists of Behavior therapy where the person is taught to avoid naps, caffeine, and other stimulants and to avoid using the bed for anything other than sleep.  Light therapy is used to advance or delay sleep.  Medications as a short term therapy have been effective. Any sort of disruptive sleep patterns should be consulted with a doctor.


Chronic sleep disturbances can be harmful both physically and mentally.

Impulse Control Disorders

Many psychological problems are characterized by a loss of control or a lack of control in specific situations. Usually, this lack of control is part of a pattern of behavior such as substance abuse problems which impairs the person’s ability to recognize the consequences of their actions. When loss of control is only an element of a disorder, it usually does not have to be a part of the behavior pattern, and other symptoms must also be present.

There are several psychological disorders that are classified primarily by loss of control. These impulse control problems are: Intermittent Explosive Disorder; Domestic Violence; Kleptomania; Pyromania; Pathological Gambling; Trichotillomania

Episodes of aggressive outbursts in which the results are either destruction of property or physical assaults on others are called Intermittent Explosive Disorder. This problem results in legal problems usually because the individual is often charged with assault, or a domestic violence charge. 

Loss of control is a characteristic of this disorder. The person, usually male, has had several incidents of losing control of anger, resulting in aggressive acting out, assaulting others, or destroying property. The aggression is out of proportion to any factors that might be present, such as an argument. These individuals will not take responsibility for their loss of control; they blame the victim, circumstances in their life, or something that may have been told to them.

Behavioral and cognitive therapies are used in this type of control problem. Anger management techniques and discovering ways to redirect the anger so that it can be controlled are employed.  

Domestic violence is also a form of Intermittent Explosive Disorder, because often these individuals only lose control within a close interpersonal relationship. Many of these people have a generalized anger management problem, but control it better outside their own home.  In those situations there is usually a substance abuse problem. Intoxication can also be a form of not accepting blame. The person may become intoxicated prior to a confrontation. It may be because of an inability to confront others.  The intoxication gives the person an excuse for loss of control.

Although the exact causes of impulse control disorders are unknown, it’s believed that the development of these problems is both biological and social have some bearing in the development of these disorders. For people with pathological gambling and intermittent explosive disorder, defects have been found in the way the brain processes chemicals,  Other research show that some impulse control problems might be at least partly explained by genetic factors that can be inherited. Disruptive and violent childhood experiences can also be linked to the development of some of these problems. Some believe that Trichotillomania may be a learned behavior.

The research on treatments for impulse control disorders is usually the use of cognitive behavioral therapy and medications. Cognitive behavioral therapy can help a person learn to relax, cope with stress, dispel negative thoughts, and prevent damaging behaviors.  There is little research to provide what treatments are best for pyromania, some treatments which has helped children stop setting fires is getting them to keep a chart of the association between their feelings, stress levels, and actions

Tourette Syndrome

Tourette syndrome is a neurological disorder in which there are repetitive, involuntary movements and sounds called tics. The early symptoms of Tourette syndrome commonly occur first in childhood, the average onset is between the ages of 7 and 10 years. All ethnic groups can develop this disorder with males being affected about three to four times more often than females.  

Although Tourette syndrome can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.

Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements including: eye blinking and other vision irregularities, facial grimacing, shoulder shrugging, and head or shoulder jerking. Simple might include repetitive throat-clearing, sniffing, or grunting sounds. 

Complex tics are distinct, coordinated patterns of movements that might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases. Thee tics which are the most concerning and severe include motor movements that result in self harm such as punching oneself in the face or vocal tics including cursing or repeating the words or phrases of others.

Some people with Tourette syndrome describe a need to complete a tic in a certain way or a certain number of times in order to relieve an urge. Tics are often worse with excitement or anxiety and better during calm activities. Tics do not go away during sleep but are often diminished.

Tics over time appear and disappear, vary in type, frequency, location, and severity. The first symptoms usually occur in the head and neck area and may progress to include other areas of the body. Motor tics generally emerge before the development of vocal tics and often complex tics follow simple tics. Most patients experience severity in tics the teen years which improves for the majority of patients in the late teen years and early adulthood. Some of those affected have a progressive course that lasts into adulthood.

There is no cure for Tourette syndrome. The disorder is generally lifelong and chronic, but it is not degenerative. Persons with Tourette syndrome have a normal life span. Tourette syndrome does not impair intelligence. Although tic symptoms tend to decrease with age, it is possible that disorders such as depression, panic attacks, mood swings can cause it to  persist and impair adult life.

Hair Pulling Known as Trichotillomania

Trichotillomania is currently classified as an impulse control disorder.  In a single individual with trichotillomania there is can be a variety of methods and reasons for pulling.

Trichotillomania at times seems like Obsessive Compulsive Disorder the person has the feelings of compulsion and repetitive behavior, but the two disorders have different symptoms and require different treatments. Trichotillomania may also resemble a tic disorder, as the action of pulling feels automatic and is there is an uncomfortable sensation that must be relieved.

It is also possible that hair pulling may have different causes. In some cases, people with trichotillomania also have other disorders such as depression or anxiety. The risk of developing trichotillomania is slightly higher in people who have relatives with the disorder, suggesting that a tendency for the disorder may be inherited.

It is known that people with trichotillomania generally have a tendency to pull their hair as a soothing mechanism. The behavior is a coping mechanism for anxiety and other difficult emotions. It does not hurt and they are not trying to damage themselves. It can be found in children as young as one year old.  The onset can be triggered by incidents such as itchy eyelashes, or by stress of life experiences, and it can occur quite suddenly.

The treatment of trichotillomania is diverse. There is also a strong possibility that there is more than one type of trichotillomania, and that different forms will respond to different treatments.

Drug therapy, either alone or in combined with cognitive behavior therapy proves to be beneficial. Many experience a reduction of the urge to pull, and some have experienced a complete end to the hair pulling. It is often temporary with relapses; and the results are mixed.

Dissociative Disorders

Dissociative disorders are a group of disorders with a strange feeling of being detached from reality. Dissociate is mental state in which a person blocks out memories, fails to recognize surroundings, or fails to recognize their own identity. This group of disorders includes dissociative amnesia, dissociative fugue, depersonalization disorder, and dissociative identity disorder a fugue is a longer time period during which a person forgets all or most of their personal identity.

Most people experience mild dissociation; like when they daydream. What makes this common experience different from a dissociative disorder is the severity and length of the dissociation. When a person experiences some form of dissociative disorder, the experience is beyond the person’s control.

For example, a person with dissociative amnesia or a dissociative fugue might not remember a significant part of their life, which goes beyond normal forgetfulness or old age. People with depersonalization disorder often feel detached from their bodies, as if they were watching themselves in a movie. People with dissociative identity disorder also experience missing time that they can not account for, and also feel as though a number of distinct personalities are living inside of them. This was known as multiple personality disorder. Many people with a dissociative disorder also have other mental health problems, like borderline personality disorder, depression, or drug or alcohol abuse.

Many people with dissociative disorders have also suffered from extreme traumas in their lives, such as physical and sexual abuse as children, rape, war, natural disasters, or witnessing a murder etc.  Some researchers believe that dissociation acts as a protective defense, preventing the person from being overwhelmed by the experience or memories of the experience.

The research on treating dissociative disorders is not as extensive as the treatment for other problems. There have been several effective treatments discovered. Some people may be treated on an outpatient basis, while those with more severe cases may require a hospitalization. The goal of treatment is to help people to recover lost memories, incorporate disconnected the basics of their personality, and keep them in the present moment when they start to dissociate.

The use psychological treatments, hypnotherapy, cognitive behavioral therapy, antidepressants, antianxiety medications have been proven helpful.

Until there is more research done for people with these disorders there are limited treatments available.  However, there are many studies in process and the prognosis for people with dissociative disorders is improving.

Problems in Thinking that May Indicate a Mental Disorder

Loose association: this is when the persons expressed ideas do not appear to be connected or related or have a peculiar relationship.  The person jumps from subject to subject.

Flight of ideas is when the person jumps rapidly from one idea to another not coming to a point.  The ideas do not seem to be related but there is a connection sometimes only by certain words.

Circumstantial thought is a type of thinking that has connection but the person is sidetracked by irrelevant details.  There are little goals to their sentences but they do eventually get to the point in a roundabout way.

Tangential thought is circumstantial thoughts where the person never reaches the point of their thoughts. They are sidetracked by details or thoughts that have no relationship and never get back on track.

Thought blocking. The flow of thought and speech stops suddenly many times often in midsentence.  The person may pause or lose the thought completely.  Usually the person has no explanation as to why they lose track of their train of thought.

Perseveration the person gets stuck on a word a phrase or an idea.  They may give the same response to different questions.

Word salad in this type of thinking there is a complete series of unconnected mixture of words and sentences that have no meaning or logic.

Clanging is where the connecting thoughts are rhyme.

Neologisms are the creating of new words.

Retardation is a slow speech and thoughts.

Concrete thinking is when the person can not understand abstract, symbolic meanings.

Vague thoughts are overly abstract thoughts and speech conveying little information.

Where these types of thinking is symptomatic of a mental disorder there can be medical reasons for someone to exhibit the various forms of thinking.  Professionals use these guidelines in diagnosing the different mental disorders.  Different disorders can be characterized by the different thought patterns.

Some Diagnostic Problems In Mental Health Field

Misdiagnoses often occur because of cultural, age differences, manner of speech and slang.  They are problems which crop up making a diagnosis difficult.  In certain cultures what may be considered acceptable behavior or normal for the people, such as anorexia, which is more frequently found in America and is tied to the American viewpoint of a female’s body image.

Spirit possession is common in Africa and other parts of the world with hallucinations that in the United States is considered to being psychotic symptoms, however, they are a group belief and in that group are normal.

The different speech patterns associated with age and slang used by the younger generation often causes misdiagnosis.  The term “going out” may be mistaken by an older professional as having agoraphobia, the fear of open spaces, and has the problem of going out of a dwelling.  To the younger generation the term “going out” means to party or go to a club or a dance.

The cultures of ethnic minorities influence many aspects of mental illness, including how patients from other cultures communicate and express their symptoms, their coping skills, their family and community supports, and their willingness to seek treatment. The cultures of the doctor and the service organization influence diagnosis, treatment. Cultural and social influences play important roles in the ability to properly address a person’s mental state and subsequently the outcome of treatment.