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Overview

Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event - either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.

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Symptoms

Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere with your ability to go about your normal daily tasks.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.
Intrusive memories
Symptoms of intrusive memories may include:

Recurrent, unwanted distressing memories of the traumatic event

Reliving the traumatic event as if it were happening again (flashbacks)

Upsetting dreams or nightmares about the traumatic event

Severe emotional distress or physical reactions to something that reminds you of the traumatic event

Avoidance
Symptoms of avoidance may include:

Trying to avoid thinking or talking about the traumatic event

Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood
Symptoms of negative changes in thinking and mood may include:

Negative thoughts about yourself, other people or the world

Hopelessness about the future

Memory problems, including not remembering important aspects of the traumatic event

Difficulty maintaining close relationships

Feeling detached from family and friends

Lack of interest in activities you once enjoyed

Difficulty experiencing positive emotions

Feeling emotionally numb

Changes in physical and emotional reactions
Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:

Being easily startled or frightened

Always being on guard for danger

Self-destructive behavior, such as drinking too much or driving too fast

Trouble sleeping

Trouble concentrating

Irritability, angry outbursts or aggressive behavior

Overwhelming guilt or shame

For children 6 years old and younger, signs and symptoms may also include:

Re-enacting the traumatic event or aspects of the traumatic event through play

Frightening dreams that may or may not include aspects of the traumatic event

Intensity of symptoms
PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you're stressed in general, or when you come across reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.
When to see a doctor
If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your doctor or a mental health professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
If you have suicidal thoughts
If you or someone you know has suicidal thoughts, get help right away through one or more of these resources:

Reach out to a close friend or loved one.

Contact a minister, a spiritual leader or someone in your faith community.

Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

Make an appointment with your doctor or a mental health professional.

When to get emergency help
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

If you know someone who's in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person to keep him or her safe. Call 911 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.

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Causes

You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.

Doctors aren't sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:

Stressful experiences, including the amount and severity of trauma you've gone through in your life

Inherited mental health risks, such as a family history of anxiety and depression

Inherited features of your personality - often called your temperament

The way your brain regulates the chemicals and hormones your body releases in response to stress

Risk factors

People of all ages can have post-traumatic stress disorder. However, some factors may make you more likely to develop PTSD after a traumatic event, such as:

Experiencing intense or long-lasting trauma

Having experienced other trauma earlier in life, such as childhood abuse

Having a job that increases your risk of being exposed to traumatic events, such as military personnel and first responders

Having other mental health problems, such as anxiety or depression

Having problems with substance misuse, such as excess drinking or drug use

Lacking a good support system of family and friends

Having blood relatives with mental health problems, including anxiety or depression

Kinds of traumatic events
The most common events leading to the development of PTSD include:

Combat exposure

Childhood physical abuse

Sexual violence

Physical assault

Being threatened with a weapon

An accident

Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, plane crash, torture, kidnapping, life-threatening medical diagnosis, terrorist attack, and other extreme or life-threatening events.

Complications

Post-traumatic stress disorder can disrupt your whole life - your job, your relationships, your health and your enjoyment of everyday activities.

Having PTSD may also increase your risk of other mental health problems, such as:

Depression and anxiety

Issues with drugs or alcohol use

Eating disorders

Suicidal thoughts and actions

Prevention

After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what's happened. Fear, anxiety, anger, depression, guilt - all are common reactions to trauma. However, the majority of people exposed to trauma do not develop long-term post-traumatic stress disorder.

Getting timely help and support may prevent normal stress reactions from getting worse and developing into PTSD. This may mean turning to family and friends who will listen and offer comfort. It may mean seeking out a mental health professional for a brief course of therapy. Some people may also find it helpful to turn to their faith community.

Support from others also may help prevent you from turning to unhealthy coping methods, such as misuse of alcohol or drugs.

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Post-traumatic stress disorder (PTSD) - Symptoms and causes

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Post-traumatic stress disorder (PTSD) is a mental health condition triggered by a terrifying event, causing flashbacks, nightmares and severe anxiety.

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Posttraumatic Stress Disorder (PTSD) is a mental health problem that can occur after a traumatic event like war, assault, or disaster. PTSD treatment can help. Find handouts, apps, videos, and courses based on current research. This site provides educational resources for Veterans and also for health care providers, researchers, and the general public.

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Alon and Augustin

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"An estimated 1.2% of U.S. adults had OCD in the past year" - National Institute of Mental Health (2007)

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Split Official Trailer 1 (2017) - M. Night Shyamalan Movie

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https://www.webmd.com/mental-health/obsessive-compulsive-disorder#1

https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder

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Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia generally restrict the number of calories and the types of food they eat. Some people with the disorder also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.

Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities. Historians and psychologists have found evidence of people displaying symptoms of anorexia for hundreds or thousands of years.

Although the disorder most frequently begins during adolescence, an increasing number of children and older adults are also being diagnosed with anorexia. You cannot tell if a person is struggling with anorexia by looking at them. A person does not need to be emaciated or underweight to be struggling. Studies have found that larger-bodied individuals can also have anorexia, although they may be less likely to be diagnosed due to cultural prejudice against fat and obesity.

DIAGNOSTIC CRITERIA

To be diagnosed with anorexia nervosa according to the DSM-5, the following criteria must be met:

1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.

2. Intense fear of gaining weight or becoming fat, even though underweight.

3. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

Even if all the DSM-5 criteria for anorexia are not met, a serious eating disorder can still be present. Atypical anorexia includes those individuals who meet the criteria for anorexia but who are not underweight despite significant weight loss. Research studies have not found a difference in the medical and psychological impacts of anorexia and atypical anorexia.

WARNING SIGNS & SYMPTOMS OF ANOREXIA NERVOSA
Emotional and behavioral

Dramatic weight loss

Dresses in layers to hide weight loss or stay warm

Is preoccupied with weight, food, calories, fat grams, and dieting

Refuses to eat certain foods, progressing to restrictions against whole categories of food (e.g., no carbohydrates, etc.)

Makes frequent comments about feeling "fat" or overweight despite weight loss

Complains of constipation, abdominal pain, cold intolerance, lethargy, and/or excess energy

Denies feeling hungry

Develops food rituals (e.g., eating foods in certain orders, excessive chewing, rearranging food on a plate)

Cooks meals for others without eating

Consistently makes excuses to avoid mealtimes or situations involving food

Expresses a need to "burn off" calories taken in

Maintains an excessive, rigid exercise regimen - despite weather, fatigue, illness, or injury

Withdraws from usual friends and activities and becomes more isolated, withdrawn, and secretive

Seems concerned about eating in public

Has limited social spontaneity

Resists or is unable to maintain a body weight appropriate for their age, height, and build

Has intense fear of weight gain or being "fat," even though underweight

Has disturbed experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight

Postpuberty female loses menstrual period

Feels ineffective

Has strong need for control

Shows inflexible thinking

Has overly restrained initiative and emotional expression

Stomach cramps, other non-specific gastrointestinal complaints (constipation, acid reflux, etc.)

Difficulties concentrating

Abnormal laboratory findings (anemia, low thyroid and hormone levels, low potassium, low blood cell counts, slow heart rate)

Dizziness

Fainting/syncope

Feeling cold all the time

Sleep problems

Menstrual irregularities-amenorrhea, irregular periods or only having a period while on hormonal contraceptives (this is not considered a "true" period)

Cuts and calluses across the top of finger joints (a result of inducing vomiting)

Dental problems, such as enamel erosion, cavities, and tooth sensitivity

Dry skin

Dry and brittle nails

Swelling around area of salivary glands

Fine hair on body (lanugo)

Thinning of hair on head, dry and brittle hair

Cavities, or discoloration of teeth, from vomiting

Muscle weakness

Yellow skin (in context of eating large amounts of carrots)

Cold, mottled hands and feet or swelling of feet

Poor wound healing

Impaired immune functioning

HEALTH CONSEQUENCES OF ANOREXIA NERVOSA

In anorexia nervosa's cycle of self-starvation, the body is denied the essential nutrients it needs to function normally. Thus, the body is forced to slow down all of its processes to conserve energy, resulting in serious medical consequences.

The body is generally resilient at coping with the stress of eating disordered behaviors, and laboratory tests can generally appear perfect even as someone is at high risk of death. Electrolyte imbalances can kill without warning; so can cardiac arrest. Therefore, it's incredibly important to understand the many ways that eating disorders affect the body.

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Anorexia nervosa is an eating disorder characterized by weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, distorted body image. People with anorexia generally restrict the number of calories and the types of food they eat.

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https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651

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Bulimia nervosa - causes, symptoms, diagnosis, treatment & pathology

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Dissociative identity disorder (previously known as multiple personality disorder) is thought to be a complex psychological condition that is likely caused by many factors, including severe trauma during early childhood (usually extreme, repetitive physical, sexual, or emotional abuse).

What Is Dissociative Identity Disorder?

Dissociative identity disorder is a severe form of dissociation, a mental process which produces a lack of connection in a person's thoughts, memories, feelings, actions, or sense of identity. Dissociative identity disorder is thought to stem from a combination of factors that may include trauma experienced by the person with the disorder. The dissociative aspect is thought to be a coping mechanism -- the person literally shuts off or dissociates himself from a situation or experience that's too violent, traumatic, or painful to assimilate with his conscious self.

Who Is At Risk for DID?

Research indicates that the cause of DID is likely a psychological response to interpersonal and environmental stresses, particularly during early childhood years when emotional neglect or abuse may interfere with personality development. As many as 99% of individuals who develop dissociative disorders have recognized personal histories of recurring, overpowering, and often life-threatening disturbances or traumas at a sensitive developmental stage of childhood (usually before age 6).

Dissociation may also happen when there has been persistent neglect or emotional abuse, even when there has been no overt physical or sexual abuse. Findings show that in families where parents are frightening and unpredictable, the children may become dissociative. Studies indicate DID affects about 1% of the population.

How to Recognize Dissociative Identity Disorder and Its Associated Mental Disorders

Dissociative identity disorder is characterized by the presence of two or more distinct or split identities or personality states that continually have power over the person's behavior. With dissociative identity disorder, there's also an inability to recall key personal information that is too far-reaching to be explained as mere forgetfulness. With dissociative identity disorder, there are also highly distinct memory variations, which may fluctuate.

Although not everyone experiences DID the same way, for some the "alters" or different identities have their own age, sex, or race. Each has his or her own postures, gestures, and distinct way of talking. Sometimes the alters are imaginary people; sometimes they are animals. As each personality reveals itself and controls the individuals' behavior and thoughts, it's called "switching." Switching can take seconds to minutes to days. Some seek treatment with hypnosis where the person's different "alters" or identities may be very responsive to the therapist's requests.

Continued

Other symptoms of dissociative identity disorder may include headache, amnesia, time loss, trances, and "out of body experiences." Some people with dissociative disorders have a tendency toward self-persecution, self-sabotage, and even violence (both self-inflicted and outwardly directed). As an example, someone with dissociative identity disorder may find themselves doing things they wouldn't normally do, such as speeding, reckless driving, or stealing money from their employer or friend, yet they feel they are being compelled to do it. Some describe this feeling as being a passenger in their body rather than the driver. In other words, they truly believe they have no choice.

There are several main ways in which the psychological processes of dissociative identity disorder change the way a person experiences living, including the following:

Depersonalization. This is a sense of being detached from one's body and is often referred to as an "out-of-body" experience.

Derealization. This is the feeling that the world is not real or looking foggy or far away.

Amnesia. This is the failure to recall significant personal information that is so extensive it cannot be blamed on ordinary forgetfulness. There can also be micro-amnesias where the discussion engaged in is not remembered, or the content of a meaningful conversation is forgotten from one second to the next.

Identity confusion or identity alteration. Both of these involve a sense of confusion about who a person is. An example of identity confusion is when a person has trouble defining the things that interest them in life, or their political or religious or social viewpoints, or their sexual orientation, or their professional ambitions. In addition to these apparent alterations, the person may experience distortions in time, place, and situation.

It is now acknowledged that these dissociated states are not fully mature personalities, but rather they represent a disjointed sense of identity. With the amnesia typically associated with dissociative identity disorder, different identity states remember different aspects of autobiographical information. There is usually a "host" personality within the individual, who identifies with the person's real name. Ironically, the host personality is usually unaware of the presence of other personalities.

Continued

How Is Dissociative Identity Disorder Diagnosed?

Making the diagnosis of dissociative identity disorder takes time. It's estimated that individuals with dissociative disorders have spent seven years in the mental health system prior to accurate diagnosis. This is common, because the list of symptoms that cause a person with a dissociative disorder to seek treatment is very similar to those of many other psychiatric diagnoses. In fact, many people who have dissociative disorders also have coexisting diagnoses of borderline or other personality disorders, depression, and anxiety.

The DSM-5 provides the following criteria to diagnose dissociative identity disorder:

1. Two or more distinct identities or personality states are present, each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self.

2. Amnesia must occur, defined as gaps in the recall of everyday events, important personal information, and/or traumatic events.

3. The person must be distressed by the disorder or have trouble functioning in one or more major life areas because of the disorder.

4. The disturbance is not part of normal cultural or religious practices.

5. The symptoms cannot be due to the direct physiological effects of a substance (such as blackouts or chaotic behavior during alcohol intoxication) or a general medical condition (such as complex partial seizures).

The distinct personalities may serve diverse roles in helping the individual cope with life's dilemmas. For instance, there's an average of two to four personalities present when the patient is initially diagnosed. Then there's an average of 13 to 15 personalities that can become known over the course of treatment. Environmental triggers or life events cause a sudden shift from one alter or personality to another.

What Other Psychiatric Illnesses Might Occur With DID?

Along with the dissociation and multiple or split personalities, people with dissociative disorders may experience a number of other psychiatric problems, including symptoms:

Continued

Are There Famous People With Dissociative Identity Disorder?

Famous people with dissociative identity disorder include comedienne Roseanne Barr, Adam Duritz, and retired NFL star Herschel Walker.

Walker wrote a book about his struggles with DID, along with his suicide attempts, explaining he had a feeling of disconnect from childhood to the professional leagues. To cope, he developed a tough personality that didn't feel loneliness, one that was fearless and wanted to act out the anger he always suppressed. These "alters" could withstand the abuse he felt; other alters came to help him rise to national fame. Treatment helped Walker realize that these alternate personalities are part of dissociative identity disorder, which he was diagnosed with in adulthood.

What's the Treatment Plan for Dissociative Identity Disorder?

There are currently no formal, evidence-based guildelines to treat DID. Many treatments are based on case reports or are even controversial.

While there's also no "cure" for dissociative identity disorder, long-term treatment can be helpful, if the patient stays committed. Effective treatment includes:

Psychotherapy: Also called talk therapy, the therapy is designed to work through whatever triggered and triggers the DID. The goal is to help "fuse" the separate personality traits into one consolidated personality that can control the triggers. This therapy often includes involving family members in the therapy.

Hypnotherapy. Used in conjunction with psychotherapy, clinical hypnosis can be used to help access repressed memories, control some of the problematic behaviors which accompany DID as well as help integrate the personalities into one.

Adjunctive therapy. Therapies such as art or movement therapy have been shown to help people connect with parts of their mind that they have shut off to cope with trauma.

There are no established medication treatments for dissociative identity disorder, making psychologically-based approaches the mainstay of therapy. Treatment of co-occurring disorders, such as depression or substance use disorders, is fundamental to overall improvement. Because the symptoms of dissociative disorders often occur with other disorders, such as anxiety and depression, medicines to treat those co-occurring problems, if present, are sometimes used in addition to psychotherapy.

Sources

SOURCES:

National Alliance on Mental Illness: "Dissociative Identity Disorder."

Mayo Clinic: "Dissociative disorders."

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Dissociative identity disorder (previously known as multiple personality disorder) is thought to be a complex psychological condition that is likely caused by many factors, including severe trauma during early childhood (usually extreme, repetitive physical, sexual, or emotional abuse).

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– It’s a rich person’s disease.
– It’s a woman’s disease.
– It’s all about body image, influenced by the media.
– It’s a way to attention seek.
– It’s a physical illness
– As long as a person is eating, they are recovered.
– Everyone with an eating disorder struggles with anorexia.
– You’d know if someone had an eating disorder because they would be real thin.
– People with an eating disorder choose to have one and can “snap out of it.”
– It’s a diet and is primarily about food and weight.
– Recovery is impossible.

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Anorexia nervosa, commonly referred to as anorexia, is a serious eating disorder in which a person has a distorted body image and does not maintain a healthy weight. It can have life-threatening consequences if not treated appropriately.

Help for anorexia is available. However, people who have a family member or friend with anorexia may not know how to talk to the person or how to choose between treatment options. Many times, a person with anorexia will deny they have a problem.

This article will cover how to get help for anorexia, including:

Understanding Anorexia

Anorexia is an eating disorder in which the person loses more weight than is considered healthy for their age and height.Those with anorexia take extreme measures to control their weight. They avoid or restrict food, constantly weigh themselves, excessively exercise, and try to rid themselves of excess calories through vomiting, laxatives, diuretics, or enemas. 1,2

Signs and Symptoms

To be diagnosed with anorexia, a person must: ²

Have an intense fear of gaining weight.

Refuse to keep a healthy weight.

Maintain a distorted body image.

Have amenorrhea, or the absence of a period for 3 or more cycles (in women).

Common signs that someone may have anorexia include: 2,3

Cutting food into small pieces and/or moving food around the plate instead of eating.

Excessive exercising, even in bad weather, when injured, or when busy.

Excusing oneself to go to the bathroom immediately after meals.

Refusing to eat around other people or avoiding social situations where food will be part of the activities.

Blotchy or yellow skin, covered in fine hair (lanugo).

Brittle hair and nails.

Confused or slow thinking, poor memory, or judgment.

Depression.

Dry mouth.

Sensitivity to cold.

Loss of bone strength.

Loss of muscle and body fat.

Severe constipation.

Excessive tiredness.

Causes

The exact cause of anorexia is unknown. But certain factors may lead a person to develop it, such as:

Genetics. Genetics can play a role in the development of an eating disorder. Being in a family with a history of eating disorders makes you more likely to develop one. 1

Social pressures. Western society tends to place a great deal of importance on beauty, which can cause some people to develop a distorted body image. 5

Family pressures. In some instances, people may have family members who place a heavy emphasis on beauty, weight, and exercise, putting pressure on the person to maintain a certain weight. 5

Anorexia, like other eating disorders, most often begins during the adolescent or young adult years and is more common in females. Other risk factors include: ²

Excessive worry about body image.

Having an anxiety disorder as a child.

Negative self-image or low self-esteem.

Perfectionism or obsession with rules.

Having a risk factor does mean that a person will develop an eating disorder. The person does, however, have a greater possibility of developing one.

Anorexia is very difficult to overcome alone. If you believe you or someone you know may have anorexia, call to get more information about treatment options.

Where to Get Help for Anorexia

The right anorexia treatment program for a person depends on needs, symptoms, and the severity of the disorder, as well as the length of the illness. Below is a brief list of possible treatment options.

Inpatient Treatment

Inpatient anorexia treatment is provided in a facility with 24/7 medical support and monitoring. Many programs offer individual counseling and group therapy, nutritional counseling, and family therapy. The length of stay will vary depending on the individual and the severity of their eating disorder.

Residential treatment - Some people with anorexia may require residential treatment. The person lives at the facility and receives ongoing medical support and services. These programs remove the person from their everyday environment and allow them to receive support from staff and peers who are in recovery.

Hospitalization - A doctor may recommend hospitalization at the beginning of treatment if the symptoms are severe or there are health complications (ex., severe malnutrition, dehydration, heart problems, suicidal thoughts).

Luxury or executive treatment centers - These programs are similar to residential treatment centers, except they provide additional amenities, such as spa services, horseback riding, and yoga. They also cater to working professionals.

Outpatient Treatment

Outpatient anorexia treatment allows the person to attend regularly scheduled treatment sessions at a recovery center or therapist's office and then either return home, go to work, or carry out other daily responsibilities outside of treatment hours.

Individual counseling - The therapist and the patient meet one-on-one. The therapist uses a form of psychotherapy, such as cognitive behavioral therapy, that allows the person to talk through and analyze their thoughts and behaviors. Adolescents may participate in family-based treatment or family counseling.

Group counseling - A therapist with a background in eating disorders leads groups on different topics, such as developing a healthy body image and improving self-esteem.

Support groups - These groups, such as Eating Disorders Anonymous, are modeled on the 12-step program of Alcoholics Anonymous. They provide a safe and supportive setting for people to share and learn from others going through recovery from an eating disorder. Often, a sponsor, or someone who has completed treatment, is available to help walk the person through the process.

Nutritional Counseling

In inpatient or outpatient programs, a healthcare provider will likely work with or make a referral to a nutritional counselor, who can help the person to better understand healthy eating habits and how to develop a realistic nutrition plan.

Medication

Providers may prescribe medications in an inpatient or outpatient setting. Medications can treat symptoms associated with anorexia as well as any comorbid illnesses, such as depression and anxiety.

Common medications used for anorexia include:

If you need help choosing a program, call to be connected to a caring advisor who can help you navigate treatment options.

Deciding Between Anorexia Treatment Options

When you're ready to get help for anorexia, spend some time exploring the different treatment options available.

Some factors to consider when choosing a program include:

Cost - Each treatment option will vary in cost. Luxury and executive treatment centers usually cost the most, followed by other residential treatment options. Outpatient may be a cheaper option, but some intensive outpatient options can be expensive as well. Support groups are typically free, but they do not offer medical care or professional therapy.

Insurance - Insurance coverage will impact cost. Talk to your insurance provider to determine which options are covered and if there are any preferred providers. Insurance may not cover executive treatment centers.

Location - Not all treatment options may be available in your community, and you may have to commute to get the treatment you need. Proximity makes it easier and more likely to get and continue treatment. Some prefer to go out of their community to separate from their daily life. However, getting treatment in your community can allow you to apply your treatment plan in a realistic setting and help to prevent relapse.

Symptoms and severity - A healthcare provider can help you determine the best treatment option based on symptoms and the severity of the eating disorder. The more severe the symptoms are, the more likely they will recommend residential or inpatient care.

Amenities - Inpatient treatment settings offer a range of amenities to help with the treatment and recovery process. Review the amenities available when making your choice to determine if they will be beneficial to you.

How to Talk to Someone with Anorexia

It can be difficult-even daunting-to help someone with anorexia. Often, the most difficult part of treating anorexia is getting the person to recognize that they have a problem. Denial is a key part of any eating disorder, and it may be difficult to convince someone to get treatment.

The key is to be kind, supportive, and respectful.

Here are some recommendations for how to talk to someone with anorexia: ⁶

Set a time to talk in a private setting. Choose a place where you will not be distracted.

Express your concerns. Use specific examples of their behaviors.

Encourage them to talk to their healthcare provider about these concerns. You can even offer to help them make an appointment and go with them to the appointment.

Avoid conflicts. If the person denies the problem, restate your concerns and make it clear that you are available if they want to talk.

Do not place blame or guilt. Do not use "you" statements, such as "you need to eat." Replace those statements with "I" statements, such as "I am worried about you" or "It makes me worried when you don't eat."

Offer and provide support. Tell them that you care and want the best for them.

Helping Someone with Anorexia

Helping someone with anorexia includes supporting them as well as taking care of yourself. Once they've decided to seek treatment, you can do a number of things to aid their recovery. Just make sure you set boundaries and don't allow their recovery to consume your life.

Educate yourself about eating disorders, including the causes, risk factors, signs, and symptoms.

Be patient and non-judgmental.

Focus on positive traits that don't relate to appearance.

Check in with them and ask how they're feeling.

Provide supportive follow-up with statements such as "how is treatment?" or ask if you can attend therapy or a support group with them.

Avoid discussions about food, their weight, or their eating habits. They may become defensive or even shut down.

Get support for yourself. Support groups for caretakers can be beneficial and help you to better understand what your loved is going through.

Be a good role model. Practice healthy eating habits and be encouraging. 7

Finding Anorexia Treatment for a Friend or Family Member

If you need additional guidance finding help for anorexia, call us today at . We're available 24/7 to assist you.

We provide 100% confidential support by caring advisors who can help you navigate the services and supports available in your area.

Read next: Anorexia Causes, Symptoms, and Effects

Sources

[1]. National Institute of Mental Health. (2016). Eating Disorders.

[2]. U.S. Department of Health and Human Services. (2016). Anorexia Nervosa.

[3]. National Institute of Mental Health. (2014). Eating Disorders: About More than Food.

[4]. U.S. National Library of Medicine. (2016). Anorexia.

[5]. U.S. Department of Health and Human Services. (2012). Anorexia Nervosa Fact Sheet.

[6]. National Eating Disorders Association. (n.d.). What should I say?

[7]. National Eating Disorders Association. (2015). Parental toolkit version 3.0.

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Getting Help with Anorexia | Eating Disorder Treatment Options

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Anorexia nervosa, commonly referred to as anorexia, is a serious eating disorder in which a person has a distorted body image and does not maintain a healthy weight. It can have life-threatening consequences if not treated appropriately. Help for anorexia is available.

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National Institute of Mental Health (NIMH)

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What is schizophrenia?

Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and for their family and friends. The symptoms of schizophrenia can make it difficult to participate in usual, everyday activities, but effective treatments are available. Many people who receive treatment can engage in school or work, achieve independence, and enjoy personal relationships.

What are the signs and symptoms of schizophrenia?

What are the risk factors for schizophrenia?

How is schizophrenia treated?

How can I find help for schizophrenia?

How can I find a clinical trial for schizophrenia?

Where can I learn more about schizophrenia?

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Learn about schizophrenia, including onset & symptoms, risk factors, treatments and therapies, how to help a loved one, & resources for more information.

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This severe mental disorder can result in hallucinations, delusions, and extremely disordered thinking and behavior that interfere with daily living.

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"I won’t let a number on a scale own me."

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https://www.webmd.com/depression/guide/seasonal-affective-disorder#1

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Constantly worrying or complaining about being fat

Having a distorted, excessively negative body image

Repeatedly eating unusually large quantities of food in one sitting, especially foods the person would normally avoid

Strict dieting or fasting after binge eating

Not wanting to eat in public or in front of others

Going to the bathroom right after eating, during meals or for long periods of time

Exercising too much

Having sores, scars or calluses on the knuckles or hands

Having damaged teeth and gums

Changing weight

Swelling in the hands and feet

Facial and cheek swelling from enlarged glands

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"Bulimia statistics tell us that the lifetime prevalence of bulimia nervosa in the United States is 1.5% in women and 0.5% in men. This translates to approximate 4.7 million females and 1.5 million males." Mirror Mirror (2015)

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The exact cause of bulimia is unknown. Many factors could play a role in the development of eating disorders, including genetics, biology, emotional health, societal expectations and other issues.

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Anorexia Recovery Story: How I Survived An Eating Disorder

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WebMD

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How Do I Know If I Have Postpartum Depression?

Despite the fact that postpartum depression has long been known, many experts believe it is not being properly diagnosed. As knowledge about postpartum depression grows, more health care providers are looking for risk factors in their patients as early as their first prenatal care visit. If a woman is at risk, her health care provider can evaluate her moods throughout the pregnancy. After a woman gives birth, she and those close to her should watch for signs and symptoms of depression. Her health care provider should look for such signs at her six-week postpartum visit, as well.

If you experience the symptoms of postpartum depression, your health care provider will evaluate the severity of your symptoms, including asking about whether you have thoughts harming yourself or your baby. Your health care provider will also ask about other mood-related symptoms to determine whether you are suffering from postpartum depression or another condition, such as bipolar disorder or postpartum psychosis.. Your thyroid levels also may be checked to make sure it is functioning normally. Hypothyroidism can cause the same symptoms as postpartum depression.

What Are the Treatments for Postpartum Depression?

Postpartum depression (PPD) sometimes goes away on its own within three months of giving birth. But if it interferes with your normal functioning at any time, or if "the blues" lasts longer than two weeks, you should seek treatment. About 90% of women who have postpartum depression can be treated successfully with medication or a combination of medication and psychotherapy. Participation in a support group may also be helpful. In cases of severe postpartum depression or postpartum psychosis, hospitalization may be necessary. Sometimes, if symptoms are especially severe, electroconvulsive (ECT) therapy may be used to treat severe depressions with hallucinations (false perceptions) or delusions (false beliefs) or overwhelming suicidal thoughts.

It is best to seek treatment as soon as possible. If it's detected late or not at all, the condition may worsen. Also, experts have found that children can be affected by a parent's untreated PPD. Such children may be more prone to sleep disturbances, impaired cognitive development, insecurity, and frequent temper tantrums.

While you are recovering from postpartum depression, you will probably see an improvement from month to month. Be aware that your symptoms may flare up before a menstrual period because of fluctuations in your hormones.

Continued

Medications for Postpartum Depression

The first step in treatment is to resolve immediate problems such as sleep and appetite changes. Antidepressants are usually quite effective for this. You and your doctor will need to make a careful decision about the use and choice of antidepressants if you are breastfeeding. Some antidepressants are secreted in small amounts in breast milk. Other medications, such as lithium, are more controversial in breastfeeding because of concerns that they may cause infant toxicity, although there is debate if lithium poses a real risk. Talk to your health care provider to determine if the benefits of antidepressant therapy outweigh the risk. If you take an antidepressant, you will probably be advised to take it for at least six months to a year to avoid a relapse and then either taper it off or continue it longer depending on your symptoms and history.

Also, if you have had a previous episode of postpartum depression, your health care provider may suggest you take preventive medicine shortly after the baby is born or during pregnancy. Most antidepressants do not pose any major risks to a developing fetus, although all medications have potential risks. Some antidepressants including the selective serotonin reuptake inhibitors Celexa, Paxil, Zoloft, and Prozac have been associated with cardiac and cranial defects when taken early in the pregnancy. Older reports that some tricyclic antidepressants may cause limb deformities have not been confirmed in larger, more modern studies.

Many women who have given birth do not want to become pregnant again right away. However, if you are being treated for postpartum depression, you may want to choose a contraception method other than birth control pills, which may sometimes aggravate the symptoms of depression. Talk with your health care provider to decide which contraception method is best for you.

Psychotherapy and Postpartum Depression

Psychotherapy, or talk therapy, is commonly prescribed alone or with antidepressants to treat PPD. Your health care provider can refer you to a qualified mental health professional who specializes in treating postpartum depression. A therapist can give emotional support and help you understand your feelings and develop realistic goals, which are critical to overcoming postpartum depression.

Continued

Postpartum Depression Support Groups

Support groups may be very helpful if you are experiencing PPD. They may provide useful information and ideas about how to cope better with day-to-day stresses.

Living With Postpartum Depression

While recovering from postpartum depression, try to take time for yourself. Get out of the house every day, even if it's just for a walk around the block. Reach out to supportive family and friends for both emotional and household help. Don't try to do everything yourself. Consider joining a new mothers support group or starting one in your area.

Exercise and Postpartum Depression

Exercise can help lift your spirits. Once you've recovered physically from giving birth, try to get some exercise every day. One study has shown that vigorous exercise after recovering from childbirth is associated with an increased feeling of well-being. Your health care provider can help you plan an exercise program that's right for you.

Sources

SOURCES:

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. 2000.

Stewart, D. Journal of Clinical Psychiatry, 2004.

The Journal of the American Medical Association. "Recommendations for Screening Depression in Adults," Vol. 315, No. 4, January 26, 2016.

Wisner K. et al, New England Journal of Medicine, 2002.

Bérard A, BMJ Open, Jan. 12, 2017.

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Postpartum Depression -- Diagnosis, Medications, and Other Treatments

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Despite the fact that postpartum depression has long been known, many experts believe it is not being properly diagnosed. As knowledge about postpartum depression grows, more health care providers are looking for risk factors in their patients as early as their first prenatal care visit.

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Obsessive compulsive disorder (OCD) - causes, symptoms & pathology

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Andrew Kukes Foundation for Social Anxiety

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Social anxiety can affect multiple areas of a person's life. For some individuals, symptoms are very specific - they may be afraid of speaking in front of a group or eating in public. Other people tend to feel anxiety more broadly, and are uncomfortable with most social situations regardless of context. Social anxiety can be a pervasive and debilitating condition that overtakes a person's entire life. There are many different manifestations of social anxiety, and the problem usually worsens with time.

In its simplest terms, social anxiety disorder - which was previously referred to as social phobia disorder - is an intense fear of being judged by others and is characterized by the emotions of shame, humiliation and embarrassment. While it may seem that we all have this fear to some degree, sufferers of social anxiety are often unable to push past these emotions, causing them to avoid the situations in their lives that trigger these feelings.

Click to enlarge.

Sufferers can experience strong symptoms of anxiety just by anticipating a situation that is weeks or months away. This can lead to obsessive behaviors like memorizing what he or she will say and excessive grooming. If a situation cannot be avoided, a sufferer will often analyze how they were perceived and how they performed long after the situation is over.

"Social anxiety does not discriminate. It affects people of all ages, all races and
all cultures."

Symptoms of social anxiety exist on a continuum. They are more severe in some people, and may affect individuals differently depending on the stage of life they're experiencing. For this reason, social anxiety must be diagnosed by a mental health professional, who can help to provide increased understanding, resources, and approaches for managing anxiety.

Additionally, social anxiety is characterized by symptoms that last for six months or longer. Many times, individuals who have social anxiety may struggle to recognize that their anxiety is more extreme than truly warranted. As such, symptoms of social anxiety may be more easy to recognize by caregivers or clinicians, though only a trained medical professional can provide an accurate diagnosis.

Social anxiety does not discriminate. It affects people of all ages, all races and all cultures. Social and performance anxieties can affect people at all functioning levels, from high achievers to those who struggle across multiple areas of life. Millions of individuals suffer from some form of social anxiety. In fact, it's estimated that one out of every eight people experiences some degree of social anxiety.

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What is social anxiety? - Andrew Kukes Foundation for Social Anxiety

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Social anxiety can affect multiple areas of a person's life. For some individuals, symptoms are very specific - they may be afraid of speaking in front of a group or eating in public. Other people tend to feel anxiety more broadly, and are uncomfortable with most social situations regardless of context.

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Myths about bipolar can perpetuate stigma and unhelpful treatment strategies-so it's important to learn the facts about living with this brain-based disorder.

Hi. This is Karl Shallowhorn with the BPHope.com vlog. In this segment, I'm going to be talking about three of the myths associated with bipolar disorder.

Myth #1

One of the myths associated with bipolar is that mania is fun. While mania can bring about such things as excessive energy, and creativity in some respects, there are also other aspects of mania that aren't so fun. These include things like delusions, irritability and anger. And there's many symptoms that go along with bipolar that really aren't fun whatsoever.

Myth #2

Another myth about bipolar disorder is that people with bipolar are moody. And, while once again, mood is certainly one of the conditions associated with bipolar-those wide mood swings that we often have-there's depression. And while you have depression, that is something that can really be, something that takes a person to a place where it's not very fun, at all. It can be very painful and oftentimes people will lose hope and some cases even feel like they want to take their life which is certainly one of the end results and one of the most difficult things to deal with. I've been through that myself and I know really, really what a dark place that can be.

Myth #3

Finally, another associated myth with bipolar disorder is that medication is the only way to treat bipolar disorder. And while certainly medication is one of the tools that are used, there are other things that are often beneficial to combine with medication that can help a person.

So, it's things like exercise, talk therapies, and I've talked about this before in my previous blogs. Things like Cognitive Behavioral Therapy and other such therapies that can help and also be very beneficial. Things also like getting proper rest and a getting a proper diet and exercise. All those things are really helpful to really keep a person well balanced.

So, certainly medication-while it's very helpful-it can be very beneficial - some people, in fact, choose not to use medication at all and prefer to do it in a more holistic manner. But in the end, it's a very personal decision and it's something that's up to you to and based on your own personal experience. One thing that I would say and I would caution however is that if you are taking medication and you do want to take a break, do that with your doctor's input and make sure that you are following and titrating off the medication, in other words coming off it slowly so you don't have a severe reaction.

There's a lot of things you can do to help yourself when living with bipolar and these are just some of the myths that are associated with it.

If you have any other myths that you know of feel free to leave them in the comments section below.

For the BPHope.com vlog, this is Karl Shallowhorn. Be well.

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How to Combat Myths of Bipolar Disorder: A Survival Guide - bpHope

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Hi. This is Karl Shallowhorn with the BPHope.com vlog. In this segment, I'm going to be talking about three of the myths associated with bipolar disorder. One of the myths associated with bipolar is that mania is fun.

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Treatments include counseling, medications, and nutrition education

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Up to one in seven women experiences postpartum depression, according to the American Psychological Association. Symptoms vary but may include a loss of pleasure in activities that were once enjoyable, anxiety and panic attacks, feelings of guilt or worthlessness, disinterest in or a fear of being left alone with the baby, irritability and mood swings, and more. The APA suggests mothers seek treatment if any of these symptoms go on for longer than two weeks.

In an effort to lessen the stigma surrounding postpartum depression, a handful of famous mothers have used their platforms to share their own experiences. Model Chrissy Teigen most recently wrote about her journey of being diagnosed with postpartum depression, and others including Brooke Shields, Bryce Dallas Howard, Adele, and Princess Diana have been candid about their struggles with postpartum depression in the past. Read on for their stories and advice.
Chrissy Teigen
"Before the holidays I went to my GP for a physical. John sat next to me. I looked at my doctor, and my eyes welled up because I was so tired of being in pain. Of sleeping on the couch. Of waking up throughout the night. Of throwing up. Of taking things out on the wrong people. Of not enjoying life. Of not seeing my friends. Of not having the energy to take my baby for a stroll. My doctor pulled out a book and started listing symptoms. And I was like, 'Yep, yep, yep.' I got my diagnosis: postpartum depression and anxiety. I remember being so exhausted but happy to know that we could finally get on the path of getting better. John had that same excitement. I started taking an antidepressant, which helped. And I started sharing the news with friends and family - I felt like everyone deserved an explanation, and I didn't know how else to say it other than the only way I know: just saying it. It got easier and easier to say it aloud every time. (I still don't really like to say, 'I have postpartum depression,' because the word depression scares a lot of people. I often just call it 'postpartum.' Maybe I should say it, though. Maybe it will lessen the stigma a bit.)" - , April 2017
Bryce Dallas Howard
"I loved being pregnant. Yes, I threw up every day for six months, and yes, the stretch marks were (and still are) obscene. But I treasured every moment I had with this new life growing inside me ... Mostly I recall the moment someone handed my son to me, and I heard shouts of joy, and my father crying, 'Bryce, you're an incredible mother!' And then ... Nothing. I felt nothing ... It is strange for me to recall what I was like at that time. I seemed to be suffering emotional amnesia. I couldn't genuinely cry, or laugh, or be moved by anything. For the sake of those around me, including my son, I pretended, but when I began showering again in the second week, I let loose in the privacy of the bathroom, water flowing over me as I heaved uncontrollable sobs." - Goop, July 2010
Adele
"I had really bad postpartum depression after I had my son, and it frightened me ... But also, I didn't talk to anyone about it. I was very reluctant. ... My boyfriend said I should talk to other women who were pregnant, and I said, 'Fuck that, I ain't hanging around with a fuckin' bunch of mothers.' Then, without realizing it, I was gravitating toward pregnant women and other women with children, because I found they're a bit more patient. You'll be talking to someone, but you're not really listening, because you're so fuckin' tired. My friends who didn't have kids would get annoyed with me, whereas I knew I could just sit there and chat absolute mush with my friends who had children, and we wouldn't judge each other. One day I said to a friend, 'I fuckin' hate this,' and she just burst into tears and said, 'I fuckin' hate this, too.' And it was done. It lifted." - Vanity Fair, December 2016
Gwyneth Paltrow
"I felt like a zombie. I couldn't access my heart. I couldn't access my emotions. I couldn't connect. It was terrible. It was the exact opposite of what had happened when Apple was born. With her, I was on cloud nine. I couldn't believe it wasn't the same [after Moses was born]. I just thought it meant I was a terrible mother and a terrible person ... About four months into it, Chris [Martin] came to me and said, 'Something's wrong. Something's wrong.' I kept saying, 'No, no, I'm fine.' But Chris identified it, and that sort of burst the bubble ... The hardest part for me was acknowledging the problem. I thought postpartum depression meant you were sobbing every single day and incapable of looking after a child. But there are different shades of it and depths of it, which is why I think it's so important for women to talk about. It was a trying time. I felt like a failure." - Good Housekeeping, February 2011
Drew Barrymore
"I didn't have postpartum the first time so I didn't understand it, because I was like, 'I feel great!' The second time, I was like, 'Oh, whoah, I see what people talk about now. I understand.' It's a different type of overwhelming with the second. I really got under the cloud." - , October 2015
Amy Poehler
"It was [hard to deal with postpartum depression while preparing for a new show]. I mean, I look back now and realize that I was unprepared for what my emotions and body and energy level would, you know, consist of. And I had to go to LA and start this show, and, you know, my baby was only a few months old. ... I think I tortured myself a bit in that first year about what kind of mother I was. And could I do this thing well and also kind of, like, give birth to this new show? ... There's not enough, in my opinion, not enough working mothers who kind of talk about who they leaned on and how they got through that difficult time. There's this thing where, you know, nobody likes to talk about how difficult things are. Everybody likes to talk about how easy it is, or can be, if you only do X, Y, and Z. But it's difficult to be away from your baby and to be working hard and also want to be working. And it's difficult to be staying at home after you've been a person who maybe wasn't." - NPR, October 2014
Hayden Panettiere
"When [you're told] about postpartum depression you think it's: 'I feel negative feelings toward my child - I want to injure or hurt my child.' I've never, ever had those feelings. Some women do. But you don't realize how broad of a spectrum you can really experience that on. It's something that needs to be talked about. Women need to know that they're not alone, and that it does heal ... There's a lot of misunderstanding - there are a lot of people out there that think that it's not real, that it's not true, that it's something that's made up in their minds - 'Oh, it's hormones.' They brush it off. It's something that's completely uncontrollable. It's really painful and it's really scary and women need a lot of support." - Live! with Kelly and Michael, September 2015
Marie Osmond
"I had severe postpartum depression. When I got to the point of postpartum depression, there was no reason to get out of bed; I was too overwhelmed to get dressed. It was just so dark. I think that's the only word I can explain. I finally just handed my baby to the babysitter, I gave her my credit cards and cash, and I said, 'Something's wrong with me.' And I just got in the car and drove away ... I think I was trying to drive my car off a cliff probably five times. But, you know what, I was raised a very religious person - I'm Christian, and I knew here [ points to head] that that was the stupidest thing in the world, but I knew here [ points to heart] it felt so right. That I really felt that everybody would be better off without me. That is the biggest lie of depression. There is nothing good in leaving anybody behind. So if you are feeling that, please know that there will be light and get help because that is an absolute lie ... My mother tracked me down. She said, 'When I had your brother, my last child, I did the same thing you did. I got in a car and I drove away.' And she said, 'I made it through it and so will you.' And I never believed that was possible, but I believed my mother." - The Dr. Oz Show, April 2016
Brooke Shields
"I really didn't want to live anymore. [I would think,] 'I just want to leap out of my life,' but then the rational side of me [would say], 'You're only on the fourth floor. You'll get broken to bits and then you will be even worse.' ... [My husband] would say, 'Oh, my God, she's crying,' and I would respond, 'Yeah, baby. She's crying. I wonder what she wants?' It was like this weird alien overtook my body and every appropriate response was answered with the antithesis of what you would assume ... Postpartum depression takes certain truths and turns them into the worst version of the truth. The truth is, your life is changed forever when you have a child, but what you don't factor in is that it might be better and it might be more enriched." - WebMD Magazine, April/May 2005
Alanis Morissette
"The degree and intensity of my [postpartum] depression shocked me. I am predisposed to depression, but what surprised me this time was the physical pain. I hadn't realized the depths to which you can ache: limbs, back, torso, head, everything hurt - and it went on for 15 months. I felt as if I was covered in tar and everything took 50 times more effort than normal. I wished I could have cried but there was no relief during that time; my version of depression is almost below crying, where there is just despondency. Amazingly, it didn't hinder the creative process and I wrote the album [ Havoc and Bright Lights]. I had various therapies and now I feel all light and springy. Thankfully, it didn't interfere with the bond with my son, although I think that has strengthened since I got better in April." - the Daily Mail, August 2012
Kendra Wilkinson
"After giving birth to my son, I had struggled with depression, and there were a lot of the same feelings I had when I was a teenager. I'd never taken care of a baby; I'd never even held a baby or changed a diaper until my son, baby Hank. I never even knew one rule or one thing to do. I really went on instincts. I think it's important to talk about because nobody really talked about it - I didn't know I was going to get that depressed. I would always hear about postpartum, but I never really believed it was true. There were times I couldn't handle what I was going through. I snapped a couple times, I screamed - but I never put my baby in danger. Whenever he would take a nap, I would take it all out and cry. You can't really control what you feel inside after you have a baby." - The Huffington Post, September 2011
Diana, Princess of Wales
"Well, everybody was thrilled to bits. It had been quite a difficult pregnancy - I hadn't been very well throughout it - so by the time William arrived it was a great relief because it was all peaceful again, and I was well for a time. Then I was unwell with [postpartum] depression, which no one ever discusses ... you have to read about it afterwards, and that in itself was a bit of a difficult time. You'd wake up in the morning feeling you didn't want to get out of bed, you felt misunderstood, and just very, very low in yourself ... I never had had a depression in my life. But then when I analyzed it, I could see that the changes I'd made in the last year had all caught up with me, and my body had said: 'We want a rest.'... I received a great deal of treatment, but I knew in myself that actually what I needed was space and time to adapt to all the different roles that had come my way. I knew I could do it, but I needed people to be patient and give me the space to do it." - BBC1, November 1995
Courteney Cox
"I went through a really hard time - not right after the baby, but when [Coco] turned 6 months. I couldn't sleep. My heart was racing. And I got really depressed. I went to the doctor and found out my hormones had been pummeled." - , July 2005
Amanda Peet
"I want to be honest about [postpartum depression] because I think there's still so much shame when you have mixed feelings about being a mom instead of feeling this sort of 'bliss.' I think a lot of people still really struggle with that, but it's hard to find other people who are willing to talk about it." - , August 2008
Lisa Rinna
"After having my first daughter, Delilah, I had severe postpartum depression. I kept it secret. I didn't say a word to anybody in the world. [My husband] thought I was just nuts. He just had no idea what was going on, and I was so hopeless and felt so lost that when I finally, ten months later, opened up to him and told him how worthless I felt - my self-esteem was gone; I didn't want to have sex, obviously that was part of it. But it was opening up something that I felt so much shame about that was the most valuable thing that I could have done ... It was really, really challenging ... But I suffered silently. And I don't want any woman to ever do that again. You have to talk about it. You have to be open to your husband, and you've got to call your doctor, certainly." - HLN, May 2012

25 Famous Women on Bullying

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15 Famous Women on Postpartum Depression

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Up to one in seven women experiences postpartum depression, according to the American Psychological Association. Symptoms vary but may include a loss of pleasure in activities that were once enjoyable, anxiety and panic attacks, feelings of guilt or worthlessness, disinterest in or a fear of being left alone with the baby, irritability and mood swings, and more.

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https://docs.google.com/document/d/1L0GLxapmbUcdt_2Fqy5A2UF-zJvx940s6AS1GS8VWIE/edit?usp=sharing

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Map of treatment centers (psychologists)

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Map of treatment centers (psychologists)

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1. most people believe anxiety is not a real medical illness and 2.most people believe that people with anxiety could snap out of it if they wanted to. 3. Social anxiety isn’t like being shy in social situations and most people believe it just gets better on it's own, but that's not true with social anxiety.

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The Center for Postpartum Support
250 Post Rd E, Westport, CT 06880

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National Institute of Mental Health (NIMH)

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Overview

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks.

There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely "up," elated, irritable, or energized behavior (known as manic episodes) to very "down," sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

Bipolar I Disorder- defined by manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) are also possible.

Bipolar II Disorder- defined by a pattern of depressive episodes and hypomanic episodes, but not the full-blown manic episodes that are typical of Bipolar I Disorder.

Cyclothymic Disorder (also called Cyclothymia)- defined by periods of hypomanic symptoms as well as periods of depressive symptoms lasting for at least 2 years (1 year in children and adolescents). However, the symptoms do not meet the diagnostic requirements for a hypomanic episode and a depressive episode.

Sometimes a person might experience symptoms of bipolar disorder that do not match the three categories listed above, which is referred to as "other specified and unspecified bipolar and related disorders."

Bipolar disorder is typically diagnosed during late adolescence (teen years) or early adulthood. Occasionally, bipolar symptoms can appear in children. Bipolar disorder can also first appear during a woman's pregnancy or following childbirth. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.

Signs and Symptoms

Risk Factors

Treatments and Therapies

Join a Study

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Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental disorder that causes unusual shifts in mood, energy, activity levels, concentration, and the ability to carry out day-to-day tasks. There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels.

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Available online and local services and resources

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Available online and local services and resources

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Contact the NAMI HelpLine at 1-800-950-NAMI (6264) or info@nami.org

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What to expect from health care professionals

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What to expect from health care professionals

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They will probably list various types of treatment such as medication, psychotherapy, and education. A type of medication that a professional would recommend may be antidepressants. The side effects of these may be nausea, fatigue, and drowsiness.

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"Don't brush off that yearly feeling as simply a case of the "winter blues" or a seasonal funk that you have to tough out on your own. Take steps to keep your mood and motivation steady throughout the year" - Mayo Clinic

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What to expect from health care professionals

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What to expect from health care professionals

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There is no prescription for DID, all that is 'prescribed' is talk therapy, so therefore no side effects

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The defining feature of social anxiety disorder, also called social phobia, is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward, or boring. As a result, they often avoid social or performance situations, and when a situation cannot be avoided, they experience significant anxiety and distress. Many people with social anxiety disorder also experience strong physical symptoms, such as a rapid heart rate, nausea, and sweating, and may experience full-blown attacks when confronting a feared situation. Although they recognize that their fear is excessive and unreasonable, people with social anxiety disorder often feel powerless against their anxiety.

Social anxiety disorder affects approximately 15 million American adults and is the second most commonly diagnosed anxiety disorder following specific phobia. The average age of onset for social anxiety disorder is during the teenage years. Although individuals diagnosed with social anxiety disorder commonly report extreme shyness in childhood, it is important to note that this disorder is not simply shyness. Read about the difference.

Social anxiety disorder can wreak havoc on the lives of those who suffer from it. For example, individuals may decline a job opportunity that requires frequent interaction with new people or avoid going out to eat with friends due to a fear that their hands will shake when eating or drinking. Symptoms may be so extreme that they disrupt daily life and can interfere significantly with daily routines, occupational performance, or social life, making it difficult to complete school, interview and get a job, and have friendships and romantic relationships. People with social anxiety disorder are also at an increased risk for developing major depressive disorder and alcohol use disorders.

Despite the availability of effective treatments, fewer than 5% of people of with social anxiety disorder seek treatment in the year following initial onset and more than a third of people report symptoms for 10 or more years before seeking help.

Triumph Over Shyness: Conquering Social Anxiety Disorder,
Second Edition

This ADAA publication is full of practical tips, helpful techniques, and more to help manage anxious thoughts and physical symptoms of social anxiety disorder.

Look inside: Read an excerpt of Triumph Over Shyness: Conquering Social Anxiety Disorder. Using humor, warmth, and language that is easy to understand, authors Murray Stein, MD, MPH, and John Walker, PhD, explain what causes social anxiety disorder, how it impacts social and romantic relationships, and what treatments work. Order your copy today.

Additional Resources
Tips to help stop paranoia and cope with anxiety at BetterHelp.com.

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The defining feature of social anxiety disorder, also called social phobia, is intense anxiety or fear of being judged, negatively evaluated, or rejected in a social or performance situation. People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward, or boring.

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https://docs.google.com/document/d/1ZZZMD2UZOmWEtGXFS6YWG6IgWuMXoc5KVI7QOHD-etQ/edit?usp=sharing

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Talking about socializing: "Chances are the worst outcome that you fear won't happen," says Dr. Busman. "And if it does, you might find you have the skills to handle it."

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All information on Teen Health & Wellness is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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Bipolar disorder is treated with three main classes of medication: mood stabilizers, antipsychotics, and, while their safety and effectiveness for the condition are sometimes controversial, antidepressants.

Typically, treatment entails a combination of at least one mood-stabilizing drug and/or atypical antipsychotic, plus psychotherapy. The most widely used drugs for the treatment of bipolar disorder include lithium carbonate and valproic acid (also known as Depakote or generically as divalproex). Lithium carbonate can be remarkably effective in reducing mania, although doctors still do not know precisely how it works. Lithium may also prevent recurrence of depression, but its value seems greater against mania than depression; therefore, it is often given in conjunction with other medicines known to have greater value for depression symptoms, sometimes including antidepressants.

Valproic acid ( Depakote) is a mood stabilizer that is helpful in treating the manic or mixed phases of bipolar disorder, along with carbamazepine ( Equetro), another antiepileptic drug. These drugs may be used alone or in combination with lithium to control symptoms. In addition, newer drugs are coming into the picture when traditional medications are insufficient. Lamotrigine, another antiepileptic drug, has been shown to have value for preventing depression and, to a lesser degree, manias or hypomanias.

Other antiepileptic drugs, such as gabapentin, oxcarbazepine (), or topiramate (), are regarded as experimental treatments that sometimes have value for symptoms of bipolar disorder or other conditions that often occur with it.

Haloperidol (Haldol Decanoate) or other newer antipsychotic medications, such as aripiprazole ( Abilify), asenapine ( Saphris), olanzapine (Zyprexa, Zyprexa Relprevv, and Zyprexa Zydis) or risperidone( Risperdal), are often given to patients as an alternative to lithium or divalproex. They also may be given to treat acute symptoms of mania -- particularly psychosis -- before lithium or divalproex can take full effect, which may be from one to several weeks. Another antipsychotic, lurasidone (Latuda), is approved for use in bipolar I depression as is the combination of olanzapine plus fluoxetine (called Symbyax). The antipsychotic quetiapine ( Seroquel) is approved to treat bipolar I or II depression. Preliminary studies also suggest that the atypical antipsychotic cariprazine ( Vraylar) also may have value for treating bipolar depression

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Some of these drugs can potentially become toxic if doses get too high. Therefore, they need to be monitored periodically with blood tests and clinical assessments by the prescriber. Because it is often difficult to predict which patient will react to what drug or what the dosage should ultimately be, the psychiatrist will often need to experiment with several different medications when beginning treatment.

While antidepressants remain widely prescribed for bipolar depression, most antidepressants have not been adequately studied in patients with bipolar depression.

In general, your doctor may try to keep the use of antidepressants limited and brief. Long-term treatment with antidepressants in bipolar disorder tends to be recommended only when the initial response is clear-cut and there are no current or emerging signs of mania or hypomania. Some antidepressants -- given alone or in combination with other drugs -- may trigger a manic episode or cause cycles between depression and mania to be more rapid. If an antidepressant is not clearly having a beneficial effect for bipolar depression, there is usually little reason to continue it.

The family or spouse of a patient should be involved with any treatment. Having full information about the disease and its manifestations is important for both the patient and loved ones.

Nondrug Treatments of Depression

While medications are usually the cornerstone of treatment for bipolar disorder, ongoing psychotherapy is important to help patients understand and accept the personal and social disruptions of past episodes and better cope with future ones. Several specific forms of psychotherapy have been shown to help speed recovery and improve functioning in bipolar disorder, including cognitive-behavioral therapy, interpersonal/social rhythm therapy, family therapy, and group therapy. In addition, because denial is often a problem -- sticking with medications can be especially tricky in adolescence -- routine psychotherapy helps patients stay on their medications.

Electroconvulsive therapy (ECT) is sometimes used for severely manic or depressed patients and for those who don't respond to medication or for those women who, while pregnant, experience symptoms. Because it can act quickly, it may be especially helpful for severely ill patients who are at high risk for attempting suicide. ECT fell out of favor in the 1960s partly due to distorted, negative portrayals of its use in the media. But modern procedures have been shown to be both safe and highly effective. The patient is first anesthetized and a muscle relaxant is given. Then, while the patient is asleep, a small electric current is passed through electrodes placed on the scalp to produce a grand mal seizure of short duration -- less than one minute. A course of treatment usually involves 6-12 treatments, typically administered three times per week. During the course of ECT treatments -- usually two to four weeks -- lithium and other mood stabilizers are sometimes discontinued to minimize side effects.They are then resumed after completion of the treatment.

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The newer types of nonpharmocological treatments of depression are:

VNS (Vagus or Vagal Nerve Stimulation) involves implantation of a device that sends electrical signals to the vagus nerve in order to treat depression.

TMS (Transcranial Magnetic Stimulation) is a procedure which involves the use of an electromagnetic coil to create electrical currents and stimulate nerve cells in the mood centers of the brain as a treatment for depression.

Light therapy has proved effective as an additional treatment when bipolar disorder has a connection to seasonal affective disorder. For those people who usually become depressed in winter, sitting for 20 minutes to 30 minutes a day in front of a special light box with a full-spectrum light can help treat depression.

Home Environment and Bipolar Disorder

If someone you live with has bipolar disorder, maintain a calm environment, particularly when that person is in a manic phase. Keep to regular routines for daily activities -- sleeping, eating, and exercise. Adequate sleep is very important in preventing the onset of episodes. Avoid excessive stimulation. Parties, animated conversation, and long periods of watching television or videos can exacerbate manic symptoms. Alcohol or illicit drug use can cause or worsen mood symptoms and make prescription medicines work less effectively.

IMPORTANT! Help and Support

In the manic phase of bipolar disorder, patients may engage in risky activities, such as fast driving or certain risky sports. They should be monitored and prevented from taking chances, especially in a car. Drinks and foods containing caffeine -- tea, coffee, and cola-- should be allowed in moderation. Avoid alcohol at all times. It is very important for a patient experiencing manic symptoms to receive prompt psychiatric assessment. Family members may need to contact the doctor, because oftentimes patients in a manic or hypomanic episode have little insight into their illness and may refuse treatment. But prompt intervention, including possible medication adjustments at an early point in an episode, may prevent further problems and the need for hospitalization.

Sources

SOURCES:

American Psychiatry Association: Diagnostic and Statistical Manual of Mental Disorders 5.

Kupfer, J. (editor). Bipolar Depression The Clinician's Reference Guide., Current Psychiatry, 2004.

Geddes, JR. American Journal of Psychiatry, 2004.

McElroy SL. Journal of Clinical Psychiatry, 2004.

Sunovion Pharmaceuticals, Inc.

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