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Do You Have Postpartum Depression?

This quiz is based in part on the Edinburgh Postpartum Depression Score (EPDS). This quiz evaluates your risk of having postpartum depression symptoms. 

Edinburgh Postnatal Depression Scale (EPDS). Adapted from Cox, J.L., Holden, J.M. and Sagovsky, R. (1987). “Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale.” British Journal of Psychiatry, 150, 782-786.

What is Rumination Disorder?

Rumination Disorder is a rare disorder that occurs mostly in infants and young children but has also been seen in older children and adults with intellectual disabilities.  Because there is not much research being done on this disorder, there seem to be more questions than answers.  This article will take a look at the definition, possible causes, what to look for and treatment for Rumination Disorder.

Rumination Disorder What Does It Mean?

Rumination Disorder is an eating disorder where a person eats their food and regurgitates it back up, often times chewing it again, regurgitating again and spitting it out. Regurgitation will occur within 30 minutes of eating, and usually within 10-20 minutes.  Sometimes will regurgitate and not chew it again.  One thing is clear, however, that this disorder is done without thinking about it or doing anything.  Persons with Rumination Disorder don’t consciously regurgitate their food and its unknown what causes it.

Ruminate Definition

The Merriam-Webster dictionary defines Ruminate as:  to chew again what has been chewed slightly and swallowed.  An example is how cows have to chew their food twice.  They cannot digest it without chewing twice, so, therefore, they chew once, swallow, regurgitate and chew again.  The word “ruminate” comes from the part of the cow called “rumen muscles” that sends the cud back up to a cow’s mouth where they then re-chew and swallow it.

Stats: How Many Suffer from this Disorder?

Rumination Disorder is very uncommon, however, it is not known how many people suffer from this disorder due to possible under-reporting.  This disorder typically occurs in infants between the ages of 3-12 months and is rarer in adults.  Most children that have this disorder outgrow it by adulthood and adults with this disorder tend to have intellectual disorders or do not seek treatment.  It is thought that slightly more boys than girls have this disorder.

What Causes Rumination Disorder?

The cause of Rumination Disorder is unknown.  Some doctors have said that it is a feeding or eating disorder, however, most medical professionals don’t believe it has anything to do with that.  Stress is thought to exasperate the disorder and it is thought that many times the behavior is learned.  Many doctors believe that often times persons with Rumination Disorder didn’t learn how to relax their abdominal muscles and instead constrict them which causes them to regurgitate the food.

Signs and Symptoms of Rumination Disorder

The signs and symptoms of Rumination Disorder are regurgitating food after eating it.  It appears to be more common in infants and young children but should be considered a possible diagnosis when it happens with older children or adults with developmental disabilities.  Many times the person will chew the food again and swallow the food after they have regurgitated it.

What are the Common Behaviors/Characteristics?

Rumination Disorder tends to happen mostly in infants and children, however, it also affects some adults.  Typically it is seen in infants, children and adults with intellectual disabilities.  Some medical professionals think that when a patient is unable to express that they don’t want food, they may develop Rumination Disorder. This, however, is not always the case.  It is not completely known why they develop this disorder, but it appears that it may either be learned behavior or brought on by stress.

Testing: What are the Diagnostic Criteria Per the DSM 5?

Rumination Disorder is often diagnosed after a complete medical examination and often times by observing the patient’s behavior during eating.  It is important to rule out any medical conditions before diagnosing someone with this disorder.

Some doctors may use a test called single-photon emission computerized tomography (SPECT) of the stomach to see how the stomach is functioning.  It can also help the doctors to determine if a medication to relax the stomach muscles can be used.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) identifies the following diagnostic criteria for rumination disorder:

  • Recurrent regurgitation of food for at least a one-month period. Regurgitated food may be spit out, rechewed, or reswallowed.
  • Regurgitation isn’t caused by a medical condition, such as a gastrointestinal disorder.
  • Regurgitation doesn’t always occur in relation to another eating disorder, such as anorexia nervosa, binge-eating disorder, or bulimia nervosa.
  • When regurgitation occurs alongside another intellectual or developmental disorder, symptoms are severe enough to require medical assistance.

This disorder is classified under “eating disorder in infancy” in the DSM 5.

Rumination Disorder and Other Conditions

Rumination Disorder is very different than any other disorder or condition, however, the conditions listed below should be ruled out before a diagnosis of Rumination Disorder is made.

Rumination Disorder vs GERD

In GERD, the acid that is used to break down food in the stomach rises into the esophagus which causes acid reflux, or GERD.  With GERD, food is not often regurgitated and when it is, it has an acidic taste which is not the case with Rumination Disorder. Treatment for GERD also does not help persons with Rumination Disorder.  GERD is usually treated with medication and diet.

Rumination Disorder vs Bulimia or Anorexia

Bulimia is characterized by binge eating then forcing yourself to vomit so that you don’t absorb the calories.  This is very different than Rumination Disorder because the vomiting is self-induced and intentional.  Bulimia is very severe and can be life threatening.  Persons with this disorder are not absorbing vitamins and nutrition and tend to have other problems associated with self induced vomiting.

Anorexia is characterized by a person that purposely restricts their calories in an effort to lose weight or to not gain weight. Persons with this disorder tend to exercise compulsively, self induce vomiting and may even take laxatives to try to get rid of food.  They often have a distorted view of their body image and may see themselves as being fat when they are, at times, underweight.  Again, this disorder is different from Rumination Disorder in that the actions are intentional.  A person with Rumination Disorder does not intentionally vomit or regurgitate their food.

Related Conditions

Rumination Disorder is considered an eating disorder that is unrelated to any other eating disorder.  It is believed that the regurgitation is unintentional, however, it can also be a learned behavior.

Rumination Disorder In Adults/Children

Rumination Disorder can occur in children and adults, however, it typically occurs in infants and young children.  There are cases of Rumination Disorder in older children and adults with intellectual disabilities, and is thought to be the cause of learned behavior or possibly a lack of desire to eat and they are unable to express this.  Its more likely that when Rumination Disorder occurs in infants and young children it is due to stress or tightening of stomach muscles.

Example Case of Rumination Disorder

A 11 year old male patient with complaints of vomiting, for the past 10-15 days.  Mom reports her son regurgitates his food within 15 minutes of swallowing it and sometimes chews it and swallows it again.  Patient has moderate mental retardation and this behavior appears to be new as the mother has never seen him do this before now.  Mom takes her son to a gastroentrologist who performs a variety of tests including looking at the lining of the patient’s stomach.  The doctor determines that the patient has no medical reason to be regurgitating his food and suggests the patient may have Rumination Disorder.  Patient is monitored in the hospital while tests are being completed.  The patient was discharged after five days of admission and was given a psychological consultation. Mother was counseled regarding the feeding techniques and given the name of some licensed therapists that can assist in cognitive behavior therapy to address the behavior aspect of the disorder.  After several months of treatment, the patient no longer exhibits symptoms of Rumination Disorder.

Rumination Disorder

How to Deal/Coping With Rumination Disorder

Rumination can be a difficult disorder to deal with due to the frustration it may cause the caretaker of someone with this disorder.  Often times, care takers don’t understand why the person is regurgitating food and may even feel that they can control it.

Look out for These Complications/Risk Factors

Some of the potential complications associated with Rumination Disorder when it is untreated are:

  • Malnutrition
  • Lowered resistance to infections and diseases
  • Failure to grow and thrive
  • Weight loss
  • Stomach diseases such as ulcers
  • Dehydration
  • Bad breath and tooth decay
  • Aspiration pneumonia and other respiratory problems caused by vomit that is breathed through the lungs
  • Choking
  • Death

Rumination Disorder Treatment

Treatment of rumination disorder focuses on changing the behavior. Several techniques are used, including:

  • Changing the persons posture during eating and right after eating.
  • In children, encouraging more interactions between a child and their mother during feeding; which in turn, gives the child more attention.
  • Reducing outside distractions during feeding.
  • Making the feeding time more relaxing and pleasant.
  • Distracting the person whenever he or she begins the rumination behavior.
  • Placing something sour or bad-tasting on the persons tongue when he or she begins to regurgitate food which is known as aversive training.

One of the most common treatments for Rumination Disorder is diaphragmatic breathing treatment.  During this treatment, the patient is taught how to do deep breathing and relax while eating.  Relaxing the diaphragm makes it impossible for someone to vomit while eating.

Possible Medications for Rumination Disorder

There are no medications to treat Rumination Disorder but they are medications that can treat the various symptoms and sometimes doctors will use medications to relax the stomach muscles if they determine that is the cause of the Rumination Disorder.

Home Remedies to help Rumination Disorder

There are no known home remedies for Rumination Disorder.

Living with Rumination Disorder

important to seek help from a medical professional if you know someone who may possible have Rumination Disorder. Without treatment, people with this disorder can damage their esophagus or cause weight loss that is unwanted.  Most infants and young children with this disorder will outgrow it, however, older children and adults may take longer and need more treatment for these symptoms to go away.

Insurance Coverage for Rumination Disorder

Most insurances will cover the diagnosis and treatment of Rumination Disorder.  To find out more, contact your treating physician or call the number on the back of your insurance card.

How to Find a Therapist

If you suspect you or someone you love has signs of Rumination Disorder, you can find a therapist at www.psychologytoday.com . There you will search for a therapist that specializes in eating disorders and cognitive behavior therapy.  Its important to seek medical attention first to rule out the possibilities of any underlying medical condition.

What Should I be Looking for in an LMHP?

To find a therapist that would have knowledge in working with persons with Rumination Disorder, you will want to make sure the therapist has knowledge of eating disorders and also of cognitive behavior therapy.  This therapy is often used to teach new behaviors.

Questions to Ask a Potential Therapist

Questions you should ask a potential therapist are:

  1. Are you knowledgeable of Rumination Disorder?
  2. Have you ever treated someone with Rumination Disorder and if so, how many people?
  3. What is your preferred treatment of Rumination Disorder?
  4. What is your success rate?

Rumination Disorder Resources and Support Helpline

National Eating Disorders website offers resources as well as a helpline number.  The website is www.nationaleatingdisorders.org.  The number to the helpline is: 800-931-2237.  Their website provides screening tools, support and information on eating disorders including Rumination Disorder.

Although Rumination Disorder is an uncommon disorder, it is highly treatable and the outcome for those who are diagnosed is very favorable.  Getting the diagnosis may be confusing at first, but with the right treatment and support, persons with this disorder can make a 100 percent recovery.  It’s important to gather all your facts and information and seek medical attention first to rule out any medical issues.   Support is out there and getting a good therapist will be helpful in learning how to cope with this disorder.

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Am I Depressed? Quiz

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7 Ways to Start Dealing With Depression Now

Depression is a serious psychological disorder which may impact negatively on an individual’s quality of life and relationships with others. There are, however, a lot of ways of dealing with depression and moving on again in life.

What is Depression?

Depression is a psychological disorder that comes with significant morbidity and mortality. It remains a major cause of suicide, substance abuse, and impaired quality of life. Depression is not the same as the occasional mood fluctuations and transient gloominess everyone has in response to challenges of everyday life. People living with depression experience a long-lasting depressed mood, loss of energy, reduced ability to think or concentrate, reduced interest in activities they once enjoyed, and sleep disturbance. Approximately 80% of adults with depression reported some difficulty with home, work, and social activities as a result of their symptoms.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies depressive disorders into major depressive disorder, premenstrual dysphoric disorder, disruptive mood dysregulation disorder, persistent depressive disorder, and depressive disorder due to a medical condition. However, the hallmarks of all these classes of depression are the presence of irritable mood, difficulty thinking, poor concentration and attention span, difficulty carrying out daily tasks, and a reduced quality of life.

Stats about Depression

Depression is a common issue globally, with more than 300 million people affected worldwide. During 2013-2016, about 8.1% of American adults aged 20 years and more had depression in a given 2-week period and women were found to be twice (10.4%) as likely as men (5.5%) to have had it. From 2007-2008 to 2015-2016, the prevalence of depression among American adults did not change significantly. It was also revealed that the prevalence of depression was lower among non-Hispanic Asian adults than in Hispanic, non-Hispanic white, and non-Hispanic black adults.

7 Tips to Start Dealing with Depression Now

Dealing with depression requires a lot of commitment and action and this may seem exhausting for a depressed person. It’s not just medications that help treat depression, lifestyle changes, and dietary modifications can also contribute to the improvement of your symptoms and a better quality of life. The following practical tips may restore your mood and quality of life:

1. Practice Self Compassion

Depression could take a huge toll on your emotions and mental health. However, the journey to recovery begins by showing yourself some compassion. Developing love and kindness for yourself will, in time, make you feel less moody and irritable and more alive. Self-compassion involves being warm to yourself when you do not achieve the small goals you set for yourself. Instead of being overly critical of yourself in perceived inadequacies or failures, you can talk about your strengths, feel good about them, and accept your weaknesses.

Another way of showing self-compassion is forgiving yourself. Many people develop depression as a result of life events, such as the death of a loved one, divorce, broken relationships, which they perceive were caused by them. In these situations, the first great step to recovery is letting go of that hurt and guilt and forgiving yourself. Not forgiving oneself keeps the guilt in, which will form a focal point of the negative thoughts and emotions, and the depressive symptoms may linger despite treatment.

In addition, you have to do things that energize you in order to overcome depressive symptoms. Depression, on its own, leaves you with no interest or drive to do what you once loved. However, to develop those interests again, you need to push yourself into doing them: engage in a sport, pick up a new hobby, learn a new music, or take a trip to the ballpark or museum. Even if your symptoms do not improve immediately, you will feel slightly better and that feeling would improve as long as you are persistent.

2. Keep a Depression Journal

Journaling your experiences with depression helps to make your thoughts and emotions clearer to you. When your thoughts, fears, and insecurities swirl around, it helps to take control and manage these emotions if you pen them down. Journaling empowers you to take steps that will eliminate those worries and make you feel better.

Also, writing how you feel or what events happen during the day helps you to notice patterns: You can easily identify a potential stressor or trigger when you keep track of your emotions by writing them down. For instance, you may identify that your symptoms become worse during a certain time of the day or when you engage in a certain activity in a day. This helps you to identify the stressor so you can avoid them in the future.

Journaling also gives you insight into how your symptoms are improving over time. If you flip through the pages to look back at older entries, you may notice how better or worse your symptoms have gone over time. You can make your journal private or share it with your therapist. Whichever you do, it helps to keep your worries in the surface so you could take practical steps to resolve them.

3. Challenge Negative Thinking

Depression often comes with the feeling of worthlessness, the feeling of being powerless or weak. These result from negative thinking patterns stemming from past experiences or perceived failures. It is important to know that these feelings and negative attitudes are not realistic and are distortions caused by the disorder. Life is made of the good and the bad experiences, mistakes and successes, however, in depression, the mistakes and failures are exaggerated and the success or strengths of the individual are downplayed or forgotten, draining them of the energy to do or achieve something.

Challenging these negative thinking patterns is a major step in recovering from depression. Some of these patterns include thinking that one shortcoming means one is a total failure, generalizing a single negative event and expecting it to hold true to other aspects of one’s life, and making negative conclusions about a situation without having any evidence. These patterns of thinking foster depression and must be replaced by positive and more rational thought patterns. For example, instead of thinking that a stranger dislikes you without even having a conversation with you, ask yourself if there’s any way a stranger will not like you if they don’t know you and tell yourself that if a stranger does not like you without knowing you, it is no fault of yours.

4. Set up a Routine

Depression robs one of a stable life and one sure way of combatting it is by creating a stable pattern of living, even if you don’t feel like it. In setting up a routine, the following tips may help:

  • Establish the same sleep and wake-up times every day. This ensures you get the right amount of sleep, creating time for other activities during the day. Getting good sleep also helps to improve your mood and brain functions.
  • Set up meal times each day. This prevents excessive eating or poor eating which may be associated with depression.
  • Set time for social activities every daytime to visit a friend, time to go to the cinema, time to read a book, time to hit the gym etc.

Having a stable pattern gradually keeps your mind focused on the day’s activities rather than engaging the depressive thoughts and feelings.

5. Practice Sleep Hygiene

Sleep is an important factor that helps your brain and mind restore itself and feel rejuvenated. Experts recommend that you get 7 -8 hours of sleep every day to keep your mind functioning properly. Having less or way over that may leave you feeling fatigued, tired, worn out, and not well rested. These may exacerbate the depressive symptoms. Sleep hygiene practices include:

  • Limit your daytime nap to 30 minutes
  • Establish a regular bedtime and wake-up schedule
  • Ensure the sleep environment is comfortable – comfortable mattress and pillows, turn off the lights or adjust them at bedtime so you could fall asleep easily, and keep the temperature cool.
  • Avoid stimulants such as nicotine and caffeine close to bedtime
  • Avoid heavy, fatty, spicy, or fried foods at bedtime, as these foods could cause an uncomfortable heartburn which disrupts sleep.
  • Ensure adequate exposure to natural light during the day.

6. Get Some Exercise

Exercise elevates your mood and keeps not just your body but your mind rejuvenated. Research has shown that exercise may be as effective in improving the symptoms of depression as medications. To get the most benefit, you should engage in regular exercises for at least 30 minutes every day. If you are new to exercises, you can start with mild ones for short durations, then gradually increase the intensity and duration.

Starting and sticking to an exercise routine may seem daunting at first, but regular exercise has been found to improve energy levels and mood. You can get the most benefits from rhythmic exercises such as walking, swimming, dancing, martial arts, and cycling in which your arms and legs are in constant motion.

Dealing with Depression

7. Reach Out to Friends and Loved Ones

It helps to reach out and stay connected to other people when you have depression. Depression creates a tendency to isolate yourself and withdraw from other people, but this, in itself, may worsen your symptoms and allow the negative emotions and thoughts to fester.

You may feel exhausted or pessimistic about social activities, but engaging in them keeps you alive and connected to the world. Participating in positive social activities can help improve your mood and change your attitude about life.

In addition, staying connected to people helps you access the needed emotional support which will help reduce your symptoms. Talking to someone about your feelings help you feel better about them, and having someone listen to you will make you feel loved and cared for. In addition to receiving emotional support, staying connected to people provides you with avenues to support others. Providing care and sharing love to others have been found to give an even bigger boost to your mood and emotional wellbeing.

What are the Traditional Treatments for Depression?

There are a number of conventional methods for treating depression including medications and psychotherapy. However, a combination of both antidepressant medications and psychotherapy is effective in relieving the depressive symptoms. Treatment with only one of those methods is usually not as effective.

Therapy for Depression

Therapy for persons with depression is centered on helping the individual deal better with their symptoms by promoting new thinking, emotional, and behavioral patterns. Examples of therapy for depression include interpersonal psychotherapy, emotion-focused therapy, problem-solving therapy, and cognitive behavior therapy. Nowadays, there are even online options to work with.

Medications for Depression

Medicines used for treating depression are called antidepressants and are of many classes. Some of these drugs include Selective serotonin reuptake inhibitors (SSRIs) such as Fluoxetine, Sertraline, and Citalopram and tricyclic antidepressants such as imipramine and Nortriptyline. Your physician will prescribe these drugs, usually starting at the lowest tolerable dosage and adjust it as required.

What are Alternative Methods of Dealing with Depression?

There are other methods of treating depression. These measures may complement conventional methods or may be as applied if the individual does not respond to these methods.

ECT for Depression

Electroconvulsive therapy (ECT) is highly effective for the treatment of depression. It is usually indicated for individuals who do not respond to medications, those who have become suicidal, or if a fast reduction of symptoms is required.

ECT has an onset of action that is more rapid than drug therapies, with improvement in symptoms seen within a few days of commencing therapy. However, ECT is associated with a number of risks including post-treatment confusion, short-term memory loss, and problems caused by the anesthesia.

Ketamine for Depression

Ketamine is a drug used for anesthesia to numb pain sensation during a surgical procedure, however, when misused for recreational purposes, it may cause severe effects such as hallucinations, mood distortions, and losing touch with reality.

New studies, however, has suggested that ketamine may be effective in the treatment of severe depression, especially in individuals who do not respond to other forms of treatment or those who are suicidal. Ketamine may be administered via intravenous routes or through inhalation. Ketamine acts quickly with improvement in symptoms observed within a short time after use.

CBD Oil for Depression

Cannabinoid (CBD) is a naturally occurring chemical substance found in the hemp plant, cannabis. It is one of the most common naturally-occurring compounds in hemp. CBD oil has been found to be effective in the treatment of depression by potentiating the effects of chemical substances in the body which help regulate mood, sleep, and appetite. CBD oil is considered safe for use with minimal risk of side effects and, contrary to popular belief, CBD is not addictive and does not cause the user to get high.

Bottom Line: Dealing with Depression

Depression is a disorder that takes a huge toll on a person’s quality of life and interpersonal relationships. However, it is possible to overcome the symptoms and lead a happier and healthier life. It may be difficult but persistence and commitment in practicing healthy lifestyle habits and professional care will see those symptoms lose their grip on you over time.

Resources

https://www.helpguide.org/articles/depression/coping-with-depression.htm

https://www.huffingtonpost.com/hannah-sentenac/mental-health-news_b_5678778.html

https://www.psychologytoday.com/us/blog/compassion-matters/201110/eight-ways-actively-fight-depression

http://www.who.int/news-room/fact-sheets/detail/depression

https://www.cdc.gov/nchs/products/databriefs/db303.htm

https://www.webmd.com/depression/features/writing-your-way-out-of-depression

https://www.healthyplace.com/blogs/copingwithdepression/2017/02/successful-coping-with-depression-requires-routine

https://sleepfoundation.org/sleep-topics/sleep-hygiene

https://emedicine.medscape.com/article/286759-treatment#d8

https://www.webmd.com/depression/features/what-does-ketamine-do-your-brain#1

 

 

What is Cataplexy?

Many individuals report feeling very weak or even losing control of their muscles and body when they experience strong emotions. This condition is called cataplexy and it is almost always a feature of the sleep disorder called narcolepsy.

Cataplexy: What does it mean?

Cataplexy is a condition characterized by a sudden and transient loss of voluntary muscle tone triggered by strong and, often pleasant emotions such as laughter and happiness. The loss of muscle tone, typically, affects both sides of the body and the attack lasts between a few seconds to less than 2 minutes after which normal muscle tone and function returns.

Cataplexy usually occurs during waking hours and it may range from mild to severe. While laughter is the most common trigger of cataplexy, it may also be triggered by other emotions such as excitement, anger, fear, stress, and surprise. It may also occur after abrupt discontinuation of an antidepressant medication.

Stats: How many People suffer from this Disorder?

Cataplexy is a common feature of Narcolepsy, however, it may be seen in other rare disorders including Wilson’s disease, Prader-Willi syndrome, and Niemann-Pick disease. Additionally, some patients with stroke, multiple sclerosis, traumatic brain injury, and encephalitis may also develop this condition.

Narcolepsy is a neurological disorder characterized by excessive daytime sleepiness and it occurs in 2 in 100 adults worldwide, however, the incidence of cataplexy is a little lower than this as not all persons with narcolepsy have cataplexy. Cataplexy which occurs with narcolepsy typically begins in childhood and early adulthood with an age of onset between 7 and 25 years, although it may begin at any time.

How many episodes of cataplexy people with the condition experience varies from as small as one per year to as many as several attacks in a day. However, on average, a person with cataplexy will experience at least one attack every week.

What Causes Cataplexy?

The exact cause of cataplexy is not clearly understood, however, scientists suggest that it may occur as a result of an inability of the brain to regulate the sleep-wake cycle. The stage of sleep called the rapid eye movement (REM) sleep is characterized by normal loss of muscle tone. In cataplexy, this feature occurs during wake hours, suggesting that there is an overlap between sleep and wake phases.

The cause of this intrusion of sleep into waking hours is unknown, however, a contributing factor is a loss of brain cells which produce a chemical substance called hypocretin (or orexin) which is involved in keeping an individual awake and alert within a sleep-wake cycle. Some studies have suggested that this loss of brain cells that produce hypocretin is caused by an autoimmune process in which antibodies destroy these cells.

Signs and Symptoms of Cataplexy

Symptoms of a cataplectic episode vary widely and may be mild and undetectable or severe. These symptoms include:

 

  • Jaw tremor
  • Nodding of the head, in partial loss of muscle tone.
  • Drooping of the eyelids
  • Difficulty speaking
  • Trembling of the knees
  • Muscle twitching
  • Making unusual tongue movements
  • Facial twitching and grimacing
  • In severe cases, the person may collapse and develop a transient inability to move.

During a cataplectic attack, an individual is usually conscious and able to breathe. These symptoms usually last a few minutes or less and resolve without any intervention. Some persons may fall asleep afterward.

Testing: What are the Diagnostic Criteria per the DSM-5

Cataplexy is the diagnostic feature of narcolepsy and its presence typically suggests that an individual has narcolepsy. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Narcolepsy is defined as recurrent episodes of an irrepressible need to sleep, lapsing into sleep, or napping occurring within the same day. These must have been occurring at least three times per week over the past 3 months. There also must be the presence of at least one of the following: 

  • Episodes of cataplexy occurring at least a few times per month
  • Hypocretin deficiency
  • REM sleep latency ≤15 minutes, or a mean sleep latency ≤8 minutes and two or more sleep-onset REM periods (SOREMPs)

Cataplexy and other Conditions

There are a number of conditions which are characterized by or which presents similarly to cataplexy and which should be distinguished clinically.

Cataplexy vs. Narcolepsy

Narcolepsy is a sleep disorder that is characterized by the tetrad of excessive daytime somnolence, sleep paralysis, hallucinations just before falling asleep, and cataplexy. However, cataplexy is the diagnostic symptom of narcolepsy, such that if an individual develops excessive daytime sleepiness with cataplexy, they likely have narcolepsy. Cataplexy occurring without narcolepsy is rare and its cause is unknown. Narcolepsy is also associated with trouble sleeping at night and nocturnal compulsive behavioral patterns such as sleep-eating and night smoking.

Cataplexy vs. Catatonia

Catatonia is a state of unresponsiveness to external stimuli and it is characterized by an apparent inability to move in a person who is apparently awake. Catatonia often occurs in severely ill individuals with certain psychiatric or medical conditions.

Individuals with catatonia present with mutism, opposition or no response to instructions or external stimuli, agitation that is not influenced by an external trigger, grimacing, mimicking another’s speech, and mimicking another’s movements. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition classifies catatonia into three types: (i) catatonia associated with another mental illness, (ii) catatonia resulting from a medical condition, and (iii) unspecified catatonia.

Cataplexy vs. Stroke

Cataplexy may be distinguished from stroke by the short timeline of the symptoms of the former. While symptoms of muscle paralysis in cataplexy lasts for a few minutes or less and resolve without intervention, symptoms of stroke typically last longer and requires treatment. However, in the case of transient ischemic attacks, symptoms may last for several hours but resolve within 24 hours.

In addition, stroke presents typically with convulsions, sudden severe headache, numbness in one half of the body and face, trouble speaking, transient blindness in one or both eyes, and difficulty walking.

Related Conditions

Sleep paralysis is a condition related to cataplexy but which usually occurs during awakening or when falling asleep. In sleep paralysis, the patient is typically unable to move when they wake, however, unlike in cataplexy, hallucinations are associated with this paralysis.

A severe form of cataplexy may be mistaken for convulsions, however, the difference is that, unlike in convulsions, the individual remains conscious during a cataplectic episode and is able to recount all that happened during the attack.

Cataplexy in Adults and Children

Cataplexy with narcolepsy typically begins in childhood and early adulthood between the ages of 7 and 25. However, children with cataplexy may also manifest some atypical movement disturbances, such as repetitive movement patterns which resolve later in the course of the disease. Also, children with cataplexy develop an unusual facial appearance during each attack, characterized by repetitive mouth opening, drooping of the eyelids, and tongue protrusion. In addition, the emotional triggers of cataplexy, such as laughter or excitement, are not always present in children.

Example Case of Cataplexy

John, a 14-year-old college student is referred to the sleep clinic by his primary care physician on account of his excessive daytime sleepiness which has been occurring on most days of every week for the past three months. John notes that these symptoms began with recurrent episodes of falls to the ground from his seat whenever he laughs or jokes with his classmates. He claims that he remains conscious during each attack and can remember what happens. He notes that each “attack” typically begins with drooping of his eyelids, inability to continue with whatever he was doing at the time before he falls to the ground.

Cataplexy

How to Deal/Coping with Cataplexy

Cataplexy may be a debilitating condition, impairing a person’s daily activities, interpersonal relationships, and productivity at work or school. It is essential to consult a physician or expert before it causes serious complications. Certain lifestyle changes may help to reduce the symptoms and frequency of cataplexy and to reduce the risk of developing serious injuries.

Look out for these Complications/Risk Factors

Complications of Cataplexy include:

  • Since cataplexy can occur without any notice and at any time, an episode may cause injuries and even death if the individual is driving or doing an activity that involves dangerous objects.
  • An individual may avoid both pleasant and unpleasant emotions for fear of an attack.
  • A strain on interpersonal and social relationships
  • Poor work or school performance as a result of the intermittent disruption of activities cataplexy causes.

Although cataplexy has been associated with reduced levels of the chemical substance, hypocretin in the brain, there are other factors which may increase the risk of this disorder. These include:

  • Traumatic brain injuries
  • Brain tumors around the areas of the brain that regulate sleep.
  • Autoimmune conditions – characterized by overactive immune cells which mistake normal cells for foreign objects, destroying them in the process.
  • Viral infections and vaccinations against viral infections.

Cataplexy Treatment

Treatment of cataplexy includes the use of medicines, lifestyle modifications, and dietary changes. People with cataplexy need emotional support at work/school and at home and should be provided with their special academic needs and other social requirements such as insurance and driver’s license.

Possible Medications for Cataplexy

Common medications for treating cataplexy, with or without narcolepsy, include antidepressants such as tricyclic antidepressants such as clomipramine, and selective serotonin reuptake inhibitors including Fluoxetine. Sodium oxybate is another medication commonly used to treat cataplexy. Individuals that have narcolepsy with cataplexy may also be treated with modafinil and stimulant drugs such as Ritalin.

Home Remedies to Help Cataplexy

Lifestyle changes and dietary modifications may help in reducing the frequency and intensity of cataplexy. Sleep hygiene is an important factor which may help reduce the intensity and frequency of cataplexy.

Practicing the following sleep hygiene measures may help reduce the symptom of cataplexy:

  • Keep a regular sleep schedule which ensures that you get up and go to bed at the same time every day.
  • Ensure you aim at getting a minimum of 7 to 8 hours of sleep daily.
  • Make the bedroom quiet and keep the temperature cool to allow for comfortable sleep.
  • Limit your exposure to light in the evening to prevent a delayed sleep onset.

Other lifestyle changes which help reduce these symptoms include:

  • Engage in regular exercise
  • Avoid consuming alcohol
  • Avoid taking caffeine in the afternoon or close to bedtime.
  • Take at least one short nap during the day.
  • Maintain a healthy diet.

Living with Cataplexy

People with cataplexy need to take extra precautions because of the nature of the condition:

  • Inform your friends and loved ones that you have the condition and tell them how to identify the symptoms. This will help them better understand the condition and help you to cope with it.
  • Ensure you drive with a companion or have them drive you as often as possible.
  • Be prepared for situations which may provoke strong emotions and have a friend keep a close eye on you in those situations.
  • Ensure you get as much sleep as possible – a short nap in the afternoon and seven to eight hours of sleep each night.
  • Be aware of potential dangers such as sharp objects, heights, and glass
  • Practice relaxation techniques such as yoga.
  • Avoid driving a car or operating machinery until you have been cleared by a medical professional.

Insurance Coverage for Cataplexy

Check your plan benefits for coverage of sleep therapy or neurological services. You may inquire through your human resources unit for employer-sponsored health coverage for treatment of this condition or you may contact your health insurance company directly. Also, find out about the out-of-pocket costs and deductibles you will pay to access the mental health services under your insurance plan.

How to Find a Therapist

Your primary care physician, after a thorough evaluation of your symptoms, will refer you to a neurologist or a sleep medicine specialist for treatment. You may also check through online resources and directory to find the right therapist for you.

What should I be looking for in a Licensed Mental Health Professional (LMHP)?

Qualities you should look for in an LMHP or sleep specialist include:

  • Good Communication Skills – Your LMHP should be able to effectively communicate their expert ideas and thoughts about your symptoms.
  • Empathy: You do not want a counselor who would rush through medical facts and treatment protocols without considering your emotional needs. You need an LMHP that is considerate, patient, calm, and compassionate with you.
  • Problem-Solving Skills: Your chosen LMHP must be knowledgeable enough to help you through to a satisfactory reduction of your symptoms. While your complete relief is not entirely up to your counselor, they must demonstrate ample ability to help manage your symptoms effectively.
  • Good multicultural Relationship: Your counselor must be able to strike a strong patient-therapist relationship with you regardless of any racial, ethnic, or cultural differences. Therapy must be devoid of such prejudices which may hamper the effectiveness of treatment.

Questions to ask for Potential Therapist

You should ask your therapist the following questions to help you gain more insight into your symptoms and the scope and potential effectiveness of available treatment options.

  • What may be causing these symptoms?
  • Do I have cataplexy?
  • Should I inform my school/employer/colleagues about the condition?
  • What is the treatment approach you recommend?
  • What medications will I be on?
  • What side effects should I expect from those drugs?
  • Are there effective home remedies I can employ?
  • What precautions should I take in living with this condition?
  • How will you monitor my treatment progress?
  • Are there any resources or websites you recommend?

Cataplexy is a brief, sudden loss of muscle control and tone triggered by strong emotions such as laughter, excitement, fear, and anger. Cataplexy is almost exclusively associated with narcolepsy, a sleep disorder characterized by excessive daytime sleepiness. Although cataplexy has no cure, its intensity and symptoms may be reduced with medications, sleep hygiene practices, and dietary changes.

References:

https://sleepfoundation.org/narcolepsy/content/cataplexy

https://www.medicalnewstoday.com/articles/307668.php

https://www.sleepassociation.org/sleep-disorders/narcolepsy/about-narcolepsy-cataplexy-2/

https://www.livestrong.com/article/83013-diet-therapy-narcolepsy/

https://www.researchgate.net/publication/262813425_Cataplexy_-_Clinical_aspects_pathophysiology_and_management_strategy

https://emedicine.medscape.com/article/1188433-overview#a1

https://emedicine.medscape.com/article/1154851-overview#a1

What is Encopresis?

Sometimes, long after potty-training has passed, some children still find themselves having problems with soiling themselves (called encopresis by doctors). While this can be especially frustrating for parents, it’s a common enough problem that there are many solutions. Find out more below.

Encopresis: What Does It Mean?

This disorder, which is also sometimes referred to as fecal intolerance (or soiling) is the involuntary, repeated passing of feces into places other than a traditional toilet (such as clothing or on the floor.) Encopresis usually occurs after the age of four, or when children typically have already learned how to use the bathroom on their own (without the use of a diaper or parental assistance.) Typically, Encopresis occurs when impacted (retained or “stuck”) stools collect in the colon and rectum of a patient – the colon becomes too full and liquid stool leaks around the retained stool and leaks into a patient’s clothing. If this bowel retention continues, it can eventually cause swelling and the loss of bowel movement control.

Stats: How Many Suffer from Encopresis?

Encopresis, which can be caused by constipation or emotional distress, impacts about 1.5% of school-aged children, and the onset of this disorder can happen at any time during a young child’s development, but usually occurs after the age where children are generally potty-trained. Boys who have Encopresis outweigh girls by a ratio of six to one – although this is the case, scientists are unsure why this disparity occurs. Even though Encopresis occurs more in boys, this condition is not related to family size, birth order, age of parents, or socioeconomic class.

What Causes Encopresis?

This condition can occur in children because of a number of causes, including constipation and emotional distress. In most cases of Encopresis, the onset is caused by chronic constipation – in children, hard, painful to pass stools may cause them to avoid going to the bathroom altogether, which can only exasperate the condition further. The longer stools remain in the patient’s colon, the more the colon stretches. As the colon continues to extend, nerves are impacted – nerves that tell a child when to use the bathroom. When these nerves are impacted (and the colon becomes too full,) soft or liquid stool may leak into the child’s clothing. In addition to leakage, patients can also experience the loss of control of bowel movements. Some factors that can lead to constipation include fear of using the bathroom because of pain or being away from home, not eating enough fiber, not drinking enough fluids, and fear of interrupting play or other activities. Aside from constipation, some of the factors that can influence the emotional distress associated with Encopresis include stressful or overly-controlled potty-training, emotional stressors (such as the birth of another child or separation/divorce,) or dietary changes that may make bowel movements painful.

Signs and Symptoms of Encopresis

Many of the symptoms of Encopresis are physical and are easy to spot – but many of the emotional stressors, such as the birth of a sibling or divorce – may not seem as apparent to parents when attempting to diagnose this condition.

What are the Common Behaviors/Characteristics?

Some of the most common side-effects of Encopresis are:

  • Abdominal pain
  • Avoidance of using the bathroom
  • Constipation, or dry, hard stools
  • Lack of appetite
  • Leakage of the stool into underwear, which may be mistaken for diarrhea
  • Repeated infections of the bladder (more common in girls)

Testing: What are the Diagnostic Criteria Per the DSM-5?

The DSM-5, a tool used by mental health professionals to recognize and diagnose mental illnesses and conditions, lays out criteria for the diagnosis of conditions, and Encopresis is no exception. According to the DSM-5,

  • The patient’s chronological age must be at least 4 years;
  • A repeated passage of feces into inappropriate places, e.g., clothing or floor. This can be either intentional or involuntary;
  • At least one such event must occur every month for at least 3 months;
  • The behavior is not attributable to the effects of a substance, e.g., laxative, or another medical condition, with the exception of a mechanism involving constipation.

“In making the diagnosis, it is critical that the clinician, specify which of the following is present:

With constipation and overflow incontinence: through physical examination or medical history, there is evidence of constipation.

Without constipation and overflow incontinence: through physical examination or medical history, there is no evidence of constipation.”

Encopresis and Other Conditions

This condition is referred to as an elimination disorder because it deals with a child’s inability to use the bathroom – whether this is due to chronic constipation or emotional distress. There are, however, some related conditions to Encopresis.

Encopresis vs. Enuresis

Whereas Encopresis deals with a child’s inability to pass fecal matter, Enuresis is the repeated passing of urine in places other than the toilet. The most common form of Enuresis is its nocturnal form, which is referred to as bed-wetting. If a child experiences this during the day, it is referred to as diurnal Enuresis. A child may experience a combination of daytime and nighttime symptoms.

Encopresis vs. Fecal Incontinence

Fecal Incontinence is another way to phrase Encopresis – another phrase commonly used to describe this condition is soiling. Fecal matter builds up in the rectum, which can cause stretching – this stretching can cause loss of control of bowel movements or leakage.

Encopresis in Adults/Children

Although this condition is primarily found in children, it can impact any age group. Senior citizens are especially at risk of Encopresis because the rectum weakens as we become older. Encopresis can impact adults of any age, and reactions to medications such as antidepressants, iron supplements, and antacids can increase the likelihood of Encopresis occurring. In women, pregnancy can also cause Encopresis to occur – the growing womb can press against the bowel and cause discomfort that may exasperate constipation, and hormonal imbalances can also play a role in constipation.

Example Case of Encopresis

Joshua, age 5, has already passed the age where he has been potty-trained. His father notices that he is using the bathroom less (to pass bowel movements,) and while doing the laundry, Joshua’s underwear has fecal matter marks, which he initially mistakes for diarrhea. This pattern continues for about two weeks when he receives a call from Joshua’s teacher saying he passed a bowel movement during recess. Joshua is extremely embarrassed and his father is concerned, so they go to the doctor – after a rectal examination, the doctor finds hard fecal matter lodged in Joshua’s rectum. In order to treat this example of Encopresis, the doctor prescribes a laxative and tells Joshua’s father to keep a log of what his son eats, in order to see if Joshua needs to adjust his diet.

Encopresis

How to Deal/Coping with Encopresis

Living with Encopresis can be quite difficult and frustrating at times – the inability to pass a bowel movement or leakage into clothing can be embarrassing, so it is important to be upfront with family members when discussing your condition. There are a number of medications that can help with Encopresis, so talk to your doctor about these options in addition to dietary changes (if necessary.) If medications are taken as prescribed and you follow the instructions of the doctor, the symptoms of Encopresis will subside with time.

Look out for These Complications/Risk Factors

Although it is unknown if Encopresis is genetic, having a family history of constipation will increase the likelihood that you or your children will suffer from Encopresis. Complications that may occur while suffering from or being treated for Encopresis include vomiting, dry mouth, and pain in the abdomen. Certain side effects of laxatives, such as weakness or dizziness, may become serious – if you experience any of these symptoms, call your doctor right away.

Encopresis Treatment

Although the treatment of Encopresis is more often than not physical, this doesn’t mean there cannot be psychological stressors that cause this condition. Consulting with a doctor or mental health professional will help you or your child get the best care possible.

Possible Medications for Encopresis

Your doctor can recommend a number of medications for Encopresis, including over-the-counter or prescribed laxatives. In older patients with this condition, enema treatment can be used to help evacuate the bowel. Because cramping and abdominal pain can occur during this treatment, it is generally accepted that it should not be administered to children. In addition to medication, therapy can be administered if the fear of using the bathroom comes from emotional trauma.

Home Remedies for Encopresis

In addition to any over-the-counter or prescribed medications or therapy, people suffering from Encopresis may keep a log of what they eat in order to understand their dietary pitfalls such as lack of fiber or in rare cases, over-consumption of cow’s milk. If your child is suffering from Encopresis, try to reassure them and offer to sit by the bathroom when they pass a bowel movement in case any abdominal pain occurs.

Living with Encopresis

Sometimes, children may be anxious about discussing Encopresis with you out of embarrassment or fear. Living with this condition can also be quite painful because of the frequent and uncomfortable constipation that is associated with it. Be sure to talk to your child about this condition and establish that it is okay and you are there to help. Children often outgrow the symptoms of Encopresis with a mixture of therapy, medication, and diet, and these methods can help your child readjust to everyday life.

Insurance Coverage for Encopresis

Because every insurance policy varies, it is best to discuss treatment options with your insurance agent. Explain your child’s condition, and explain the mixture of diet, medication, and therapy you are choosing to use in order to treat your child’s Encopresis. Insurance coverage for therapy can vary from no co-pay to high fees depending on your insurance policy’s mental health coverage, and the same goes for any potential medications your child may take due to Encopresis. Even though navigating insurance can be frustrating at times, clearly explaining your situation to the insurance company will help both you and your child. If you cannot afford therapy or medication, there are a number of state and federally-funded programs you can take advantage of.

How to Find a Therapist

There are many therapists currently practicing today – although it may seem impossible at times to find the perfect therapist for your child, there are a number of steps you can take in order to ensure the right care for your child.

What Should I be Looking for in an LMHP?

When looking for an LMHP (licensed mental health professional) to help your child overcome Encopresis, be sure to ask your potential therapist if they have experience dealing with children. Although many therapists deal with all age groups, Encopresis is a condition that primarily impacts children, so this experience is important. In addition to age specialty, it is important to find out which psychological perspective the therapist adheres to – some psychologists practice Freudian psychology, which focuses on the role of the conscious and subconscious mind, while others practice behavioral-cognitive, which looks at the relationship between thought processes and behaviors. This information can be crucial when determining which therapist your child will visit.

Questions to Ask a Potential Therapist

For the treatment of Encopresis, age experience is one of the most important factors. In addition to age, ask the therapist if they have a history of treating patients with Encopresis, and which methods they used to help treat those children. Also, ask how frequently/for how long your child will be in therapy for.

Encopresis Resources and Support

In addition to a mental health professional and other parents who have had children with Encopresis, there are a number of hotlines you can call to receive help navigating your child’s condition. NAMI, or the National Alliance on Mental Illness, offers a mental health hotline you can call in order to discuss Encopresis and possible treatment options. In addition to this hotline, which can be reached at 1-800-950-NAMI Monday through Friday, 10 a.m.– 6 p.m. ET, there are also a number of blogs featuring parents sharing their stories about the condition and its treatment.

 

Schizophreniform Disorder

Schizophreniform is a psychiatric condition that shares symptoms with its more common cousin, schizophrenia. The difference between them simply comes down to how long the symptoms are present for, and we will discuss this in more detail further down. The symptoms of schizophreniform disorder – which include delusions, hallucinations, and a range of behavioral disturbances – can really interfere with your ability to live a normal life. Luckily, though, these sorts of problems often respond well to treatment. Read on for an overview of everything that you need to know about schizophreniform disorder.

Schizophreniform: What Does It Mean?

Translated literally, ‘schizophreniform’ means ‘split mind’. This has led people to believe that schizophreniform disorder (and the associated condition of schizophrenia) amounts to having a split personality. But this is a misconception. Rather than having multiple personalities, people with schizophreniform disorder are split-off and disconnected from reality.

Signs and Symptoms of Schizophreniform Disorder

People with schizophreniform disorder struggle to differentiate between what is real and what isn’t. Usually, this can be seen in their patterns of thinking, speaking, behaving and interacting with the world.

Clinicians sometimes talk about these in terms of “positive” symptoms and “negative” symptoms. Put simply, positive symptoms are things that shouldn’t be there but are (like hallucinations or delusions) and negative symptoms are things that should be there but are not (like a deep lack of motivation or a lack of ability to display emotions).

Clinicians use these and other special terms to describe some of the more unusual symptoms seen in these kinds of disorders.

What are the Common Behaviors/Characteristics?

Unusual Thoughts

People with schizophreniform disorder often have ideas or beliefs that seem strange or irrational. For example, you may believe that you’re the reincarnation of Jesus, that you can read minds or that a celebrity is stalking you. These beliefs are maintained firmly, despite the existence of any contradictory evidence

Hallucinations

A hallucination involves hearing, seeing or experiencing something that isn’t really there. With schizophreniform disorder, this is most often a case of hearing voices. But you may also see things that aren’t there or experience a physical sensation that doesn’t have any real basis, such as the feeling of bugs crawling under your skin.

Unusual Communication

People with schizophreniform disorder may communicate in a way that is difficult or even impossible to understand. This might involve, for example, jumping erratically from topic to topic and answering questions off-point or in a complicated and roundabout way. Clinicians call this “disorganized speech”. In some cases, people with schizophreniform disorder may also repeat words and phrases over and over (called “clanging”) or make up new words that don’t exist (“neologisms”).

Unusual Physical Movements

People with schizophreniform disorder may perform odd movements, such as grimacing, becoming unusually restless, pacing, fidgeting or rocking. Their movements may also slow down to a point where they maintain a fixed posture for extended periods of time, known as “catatonic behavior”.

Other symptoms

The early stages of schizophreniform disorder may include a mixture of other less obvious characteristics, such as negative symptoms. For example, you may find yourself withdrawing socially and emotionally, avoiding eye contact and speaking monotonously. You may also lose motivation to pursue activities such as working, studying, cleaning, cooking, maintaining your personal hygiene and having fun.

Stats: How Many Suffer from this Disorder?

It has been estimated that 0.07% of the general population has this condition, meaning that you’re 5 times less likely to have schizophreniform disorder than schizophrenia.

What Causes Schizophreniform?

Researchers have yet to pinpoint the exact cause of schizophreniform and other similar disorders. However, it’s clear that genes play a role: if someone in your family has had any form of psychotic episode, you may be predisposed to developing schizophreniform disorder. Evidence also suggests that differences in the brain’s structure and chemicals may contribute to the disorder’s development – as well as being in a social environment that is characterized by ongoing or extreme stress and a lack of social support.

Testing: What are the Diagnostic Criteria Per the DSM 5?

According to the DSM 5, a person needs to experience at least two of the following symptoms to qualify for a diagnosis of schizophreniform disorder. They also need to tick the box for at least one of the symptoms listed under points 1 to 3.

  1. Delusions
  2. Hallucinations
  3. Disorganized and incoherent speech
  4. Disorganized behavior
  5. Negative symptoms

Furthermore, the DSM tells us that these symptoms must be present for between 1 and 6 months; and that schizophreniform disorder can’t be diagnosed when the symptoms have been caused by medications, drugs or other medical conditions such as a stroke, brain injury or epilepsy.

Schizophreniform and Other Conditions

There are several psychotic conditions that present in a similar way to schizophreniform disorder: read on to learn how to tell the difference.

Schizophreniform vs Schizophrenia

These two disorders present with the exact same set of symptoms. The main difference, however, relates to the timing: schizophreniform disorder is diagnosed when symptoms have been occurring for no more than 6 months, whereas schizophrenia requires symptoms to have been present for at least six months.

Schizophreniform vs Schizoaffective Disorder

Schizoaffective disorder differs from schizophreniform due the presence of major depression or a manic episode, which is a period of unusual energy, irritability, enthusiasm or euphoria. These depressive or manic conditions exist alongside the psychotic features, which both disorders share.

Related Conditions

Schizophreniform is a psychotic disorder, sharing symptoms with related conditions such as delusional disorder, brief psychotic disorder, schizophrenia, schizoaffective disorder and psychosis caused by drugs or another medical condition. To know exactly what you’re dealing with, it’s important to have a thorough assessment done by a psychologist and/or psychiatrist. Often, people who are diagnosed with schizophreniform disorder are later diagnosed with another, different psychotic disorder.

Schizophreniform In Adults/Children

Schizophreniform and other psychotic disorders are rare amongst children and young adolescents, although they have been known to occur in people of this age. It’s not unusual for children to have imaginary friends, night terrors or vivid dreams, so it’s important that these are not mistaken for psychotic symptoms.

Example Case of Schizophreniform

Steven (22) was an outgoing student who lived with his parents. He played football and had a healthy social and academic life. Over time, however, things started to change. Steve stopped attending practice and seeing his friends. His grades also started to suffer, as he found it difficult to pay attention and often chose to skip class.

This went on for about two months until one day, his mom came home from work and found Steven pacing about the kitchen. When he saw his mom, Steven started speaking in a strange and jumbled way: “They want me. Want me. Want me. I’m always looking out there but I’m never seeing. Do you know what I mean? The aliens, they’re looking for me. Not being free.”

His mom managed to calm him down enough for him to explain that a group of aliens had been communicating with him. He told his mom that he heard the alien voices many times during the day, and that they were saying that they wanted him to join them as their leader.

At this point, Steven’s mom realized that he needed medical attention. She called Steven’s dad and the three of them met at the nearest emergency room. After undergoing various tests and medical exams – as well as a family interview – Steven was given antipsychotic medication.

Within one week most of his symptoms had cleared and on discharge he was referred for weekly talk therapy to receive emotional support and education about psychosis. When he attended his follow-up appointment at the hospital one month later, Stevens was completely back to his normal old self.

The psychiatrist explained that because Steven’s symptoms had resolved within six months, he qualified for a diagnosis of schizophreniform disorder. The psychiatrist went on to say that it was a good prognostic sign that Steven had recovered so quickly and now that his symptoms were gone he could slowly start to focus on getting his social and academic lives back on track.

Schizophreniform

How to Deal/Coping With Schizophreniform

The best way to cope with your condition is by following the recommendations of the professionals who are treating you, mainly regarding medication and psychotherapy adherence, as well as attending future check-up appointments with your clinician. In addition, it can be incredibly healing to connect with other people who have experienced psychosis: ask your doctor or search online for support groups near you.

Look out for These Complications/Risk Factors

Approximately 60% of people who are initially diagnosed with schizophreniform disorder end up having symptoms that last for more than 6 months. As a result, they end up being diagnosed with other psychotic disorders such as schizophrenia or schizoaffective disorder. Other complications include the fact that antipsychotic use may lead to health problems later down the line.

Finally, schizophreniform disorder may put you at risk of self-harm and suicide. If you or someone you know is experiencing suicidal thoughts or behavior, act quickly by contacting 911 or the National Suicide Prevention Lifeline on 1-800-273-8255.

Schizophreniform Treatment

Schizophreniform disorder should be treated using a three-pronged approach involving medication, talk therapy, and community-level support. Therapy is usually focused on providing education about the disorder, emotional support, and coping skills. However, treatment should also involve the person’s community: immediate family, friends, and neighbors should learn what they can do to provide support and minimize the chances of relapse. At times, it may also be appropriate for the person to have access to assisted work programs.

Possible Medications for Schizophreniform

Up until the 1960s, talk therapy was the main strategy used to treat psychotic disorders. Since then, the invention of antipsychotic medication has enabled health professionals to reduce psychotic symptoms with far more efficiency. Furthermore, medication works faster in improving a person’s level of functioning which makes it easier for them to benefit from therapy, meaning that medication and therapy work well when used together.

Home Remedies to help Schizophreniform

Schizophreniform disorder is a serious condition that warrants professional medical attention and management. There are no safe or effective home remedies that can be used instead of seeing a health professional. However, in consultation with a doctor, therapist or psychiatrist, you’re likely to learn coping skills and strategies which should be used at home. Read on to learn more.

Living with Schizophreniform

  • Avoid using illicit drugs and alcohol, as these may trigger another psychotic episode.
  • Reduce your stress – another risk factor for a psychotic episode. You might do this through yoga, meditation, meeting a friend for a movie or taking a walk in nature. Work with your therapist to find the right stress-busting techniques for you.
  • Eat healthily and exercise regularly. Weight gain is a common side-effect of antipsychotic medications, so try to maintain a healthy lifestyle, which will improve your physical health, mood, self-esteem and stress levels.
  • Get enough good quality sleep. This will help improve your mood and mental functioning during the day, as well as helping you to de-stress. Visit the National Sleep Foundation’s pointers on how to keep good sleep hygiene
  • Look after yourself by making time for activities that relax you and give you pleasure. This may be a new hobby or an old one that you previously enjoyed.
  • Keep in touch with your friends and family. Keeping socially active and connected is beneficial while in recovery.

Insurance Coverage for Schizophreniform

Schizophreniform Disorder is recognized by the American Psychiatric Association as an official psychiatric disorder. For this reason, you’re likely to receive compensation if your insurance policy includes mental health benefits. Speak to your doctor or insurance company to find out exactly what your benefits are.

How to Find a Therapist

Your doctor should be able to recommend an appropriate therapist. Alternatively, search online or ask your health insurance for recommendations. If you know other individuals who have had a psychotic episode, they may also be able to point you in the right direction.

What Should I be Looking for in an LMHP?

Ideally, you would want to be seeing someone who has experience working with psychosis. It’s also important that you feel safe and comfortable talking to them, so don’t hesitate to “trial” one or more therapists before deciding who you would like to see. Finally, Cognitive Behavioral Therapy (CBT) and Supportive Psychotherapy are two therapy techniques which have been shown to be effective in managing psychosis, so if you’re chosen therapist uses these techniques that’s a bonus.

Questions to Ask a Potential Therapist

  • Are you experienced in treating schizophreniform disorder?
  • How would you go about treating this condition?
  • What can I expect from a therapy session?
  • Will you work with my family?
  • What sort of goals would you suggest for therapy?
  • How could treatment help me?
  • How long are the sessions and how often will we meet?
  • Will my insurance cover any of the sessions?

Schizophreniform Resources and Support Helpline

References

  1. https://www.psychologytoday.com/us/conditions/schizophreniform-disorder
  2. https://www.merckmanuals.com/professional/psychiatric-disorders/schizophrenia-and-related-disorders/schizophreniform-disorder
  3. https://my.clevelandclinic.org/health/diseases/9571-schizophreniform-disorder
  4. http://www.cochrane.org/CD004716/SCHIZ_supportive-therapy-schizophrenia
  5. https://www.medscape.com/viewarticle/430529
  6. https://www.ncbi.nlm.nih.gov/pubmed/17199051