Clinical Psychology

Transcript

JAI MAHARISHI! MAGILVUDAN VAZHGA! HITRO INSTITUTE OF MEDICAL SCIENCES – KANCHIPURAM. Psychology: Psychology evolved out of both philosophy and biology. Such discussions of the two subjects date as far back as the early Greek thinkers such as Aristotle and Socrates. The word psychology is derived from the Greek word psyche, meaning 'soul' or 'mind.' A Separate Science. Freud - Father Of Psychology Known as the father of psychology, Freud developed many of the first theories of modern physiology. His ideas and concepts will continue to be studied through the years. He put forth many new concepts about sexuality, consciousness, unconsciousness and instincts. He spent his whole life devoted to discovering the secrets of the human nature. Clinical Psychology: Clinical psychology is one field of psychology that deals with the understanding and treatment of abnormal behaviour. It is broad field that includes both practice and research. A clinical psychologist diagnoses and treats patients with psychological problems. 1 Developmental Psychology: 1 Developmental psychology, also known as human development, is the scientific study of systematic psychological changes that occur in human beings over the course of their life span. Originally concerned with infants and children, the field has expanded to include adolescence, adult development, aging, and the entire life span. This field examines change across a broad range of topics including motor skills and other psycho-physiological processes; cognitive development involving areas such as problem solving, moral understanding, and conceptual understanding; language acquisition; social, personality, and emotional development; and selfconcept and identity formation. Social Psychology: Social psychology is the study of the relations between people and groups; or how situational factors affect the thoughts, feelings, and/or behavior of an individual. Scholars in this interdisciplinary area are typically either psychologists or sociologists, though all social psychologists employ both the individual and the group as their units of analysis. Schizophrenia: Schizophrenia is a severe mental disorder characterized by delusions, hallucinations, incoherence and physical agitation; it is classified as a "thought" disorder while Bipolar Disorder is a "mood" disorder. Schizophrenia is a mental disorder that makes it difficult to tell the difference between real and unreal experiences, to think logically, to have normal emotional responses, and to behave normally in social situations. Causes, incidence, and risk factors Schizophrenia is a complex illness. Even experts in the field are not sure what causes it. 2 Genetic factors appear to play a role. People who have family members with schizophrenia may be more likely to get the illness themselves. Some researchers believe that environmental events may trigger schizophrenia in people who are already genetically at risk for the disorder. For example, infection during development in the mother's womb or stressful psychological experiences may increase the risk for developing schizophrenia later in life. Social and family support appears to improve the illness. Schizophrenia affects about 1% of people worldwide. It occurs equally among men and women, but in women it tends to begin later and be milder. For this reason, males tend to account for more than half of patients in services with high numbers of young adults. Although schizophrenia usually begins in young adulthood, there are cases in which the disorder begins later (over age 45). Childhood-onset schizophrenia begins after age 5 and, in most cases, after normal development. Childhood schizophrenia is rare and can be difficult to tell apart from other developmental disorders of childhood, such as autism. Symptoms Schizophrenia may have a variety of symptoms. Usually the illness develops slowly over months or years. Like other chronic illnesses, schizophrenia cycles between periods of fewer symptoms and periods of more symptoms. At first, you may feel tense, or have trouble sleeping or concentrating. You can become isolated and withdrawn, and have trouble making or keeping friends. As the illness continues, psychotic symptoms develop: • • • • Appearance or mood that shows no emotion (flat affect) Bizarre movements that show less of a reaction to the environment (catatonic behavior) False beliefs or thoughts that are not based in reality (delusions) Hearing, seeing, or feeling things that are not there (hallucinations) Problems paying attention Thoughts "jump" between unrelated topics (disordered thinking) Paranoid types often feel anxious, are more often angry or argumentative, and falsely believe that others are trying to harm them or their loved ones. Disorganized types have problems thinking and expressing their ideas clearly, often exhibit childlike behavior, and frequently show little emotion. Catatonic types may be in a constant state of unrest, or they may not move or be underactive. Their muscles and posture may be rigid. They may grimace or have other odd facial expressions, and they may be less responsive to others. Problems with thinking often occur: • • Symptoms can be different depending on the type of schizophrenia: • • • 3 • Undifferentiated types may have symptoms of more than one other type of schizophrenia. Residual types experience some symptoms, but not as many as those who are in a fullblown episode of schizophrenia. • People with any type of schizophrenia may have difficulty keeping friends and working. They may also have problems with anxiety, depression, and suicidal thoughts or behaviors. Signs and tests A psychiatrist should perform an evaluation to make the diagnosis. The diagnosis is made based on a thorough interview of the person and family members. No medical tests for schizophrenia exist. The following factors may suggest a schizophrenia diagnosis, but do not confirm it: • • • • • Course of illness and how long symptoms have lasted Changes from level of function before illness Developmental background Genetic and family history Response to medication CT scans of the head and other imaging techniques may find some changes that occur with schizophrenia and may rule out other disorders. Treatment During an episode of schizophrenia, you may need to stay in the hospital for safety reasons, and to receive basic needs such as food, rest, and hygiene. MEDICATIONS Antipsychotic medications are the most effective treatment for schizophrenia. They change the balance of chemicals in the brain and can help control the symptoms of the illness. These medications are helpful, but they can have side effects. However, many of these side effects can be addressed, and should not prevent people from seeking treatment for this serious condition. Common side effects from antipsychotics may include: • • Sleepiness (sedation) or dizziness Weight gain and increased chance of diabetes and high cholesterol Feelings of restlessness or "jitters" Problems of movement and gait Muscle contractions or spasms Tremor Less common side effects include: • • • • 4 Long-term risks of antipsychotic medications include a movement disorder called tardive dyskinesia. In this condition, people develop movements that they cannot control, especially around the mouth. Anyone who believes they are having this problem should check with their doctor right away. For people who try and do not improve with several antipsychotics, the medication clozapine can be helpful. Clozapine is the most effective medication for reducing schizophrenia symptoms, but it also tends to cause more side effects than other antipsychotics. Because schizophrenia is a chronic illness, most people with this condition need to stay on antipsychotic medication for life. SUPPORT PROGRAMS AND THERAPIES Supportive and problem-focused forms of therapy may be helpful for many people. Behavioral techniques, such as social skills training, can be used during therapy or at home to improve function socially and at work. Family treatments that combine support and education about schizophrenia (psychoeducation) appear to help families cope and reduce the odds of symptoms returning. Programs that emphasize outreach and community support services can help people who lack family and social support. Important skills for a person with schizophrenia include: • • Learning to take medications correctly and how to manage side effects Learning to watch for early signs of a relapse and knowing how to react when they occur Coping with symptoms that are present even while taking medications. A therapist can help persons with schizophrenia test the reality of thoughts and perceptions. Learning life skills, such as job training, money management, use of public transportation, relationship building, and practical communication • • Family members and caregivers are often encouraged to help people with schizophrenia stick to their treatment. Expectations (prognosis) The outlook for a person with schizophrenia is difficult to predict. Most people with schizophrenia find that their symptoms improve with medication, and some can get good control of their symptoms over time. However, others have functional disability and are at risk for repeated episodes, especially during the early stages of the illness. To live in the community, people with schizophrenia may need supported housing, work rehabilitation, and other community support programs. People with the most severe forms of this disorder may be too disabled to live alone, and may need group homes or other long-term, structured places to live. Some people with milder forms of schizophrenia are able to have satisfying relationships and work experiences. Complications 5 • People with schizophrenia have a high risk of developing a substance abuse problem. Use of alcohol or other drugs increases the risk of relapse, and should be treated by a professional. Physical illness is common among people with schizophrenia due to an inactive lifestyle and side effects from medication. Physical illness may not be detected because of poor access to medical care and difficulties talking to health care providers. Not taking medication will often cause symptoms to return. • • Calling your health care provider Call your health care provider if: • • • • • • Voices are telling you to hurt yourself or others. You feel the urge to hurt yourself or others. You are feeling hopeless and overwhelmed. You are seeing things that aren't really there. You feel like you cannot leave the house. You are unable to care for yourself. Prevention There is no known way to prevent schizophrenia. If you do have the condition, the best ways to prevent symptoms from coming back are to take the medication your doctor prescribed, and see your doctor or therapist regularly. Always talk to your doctor if you are thinking about changing or stopping your medications. The Neurosis Neurosis is a mental disorder characterized by incomplete insight into the nature of difficulties or conflicts. The Nine (9) General Characteristics of Neurosis 1. 2. 3. 4. 5. 6. 6 Presence of Anxiety – there is a feeling of dread, fearful anticipation and apprehensiveness in most routine circumstances. Inability to function at capacity. The neurotic fails to realize his potentials and frequency fails miserably in his achievements efforts. Rigid or repetitive behavior – incapable of learning new means of adjusting the life’s problems. Egocentricity – self-preoccupied and fails to distinguish that there are other people in his environment. He tends to exortanly selfish. Hypersensitivity – inability to tolerate criticism Immaturity – failure to develop mature emotions and motivational pattern. 7. 8. 9. Somatic Complaints – physical ailment which is psychogenically oriented and has therefore no organic or psychogenic basic. Unhappiness – feelings of loneliness of being hurt, of missing the good things in life. Unconscious motivation – awareness of reality is colored by unconsciousness, fears and hostilities. Types of Neurotic Reactions A) Anxiety Neurosis – this manifests itself principally in feelings for which there seems to be no specific basis on reality. B) Hysterical Neurosis – this is a kind of adjustment through conversion of illness. C) Dissociative Neurosis – the patient’s flight is into the awareness rather than into sickness 1. 2. 3. 4. 1. 2. 3. 4. Amnesia – forgetting Fugue – leaves his original environment and takes a new one. Multiple Personality – two or more personality Somnambulism – sleepwalking or any activity that takes place while asleep. Agoraphobia – fear of open places Claustrophobia – fear of closed places Acrophobia – fear of heights Germophobia – fear of germs Hematophobia – fear of blood Zoophobia – fear of animals Xenophobia – fear of strangers Pathophobia – fear of disease Tapophobia – fear of being buried alive D) Phobic Reaction – irrational fear or dread of person, objects, acts or situation. 5. 6. 7. 8. 9. 10. Cheimophobia – fear of cold 11. Electrophobia – fear of electricity 12. Astrophobia – fear of lightning / thunder E) Obsessive / Compulsive 1. Obsession – irrational thought which persistently forces into consciousness. 2. Compulsion – irrational act, which a person is compelled to carry out F) Depressive / Neurotic Depression nor Reactive Depression – is precipitated by saddening stress situation or bereavement 7 G) Hypochindrial Reaction – pre-occupation with bodily processes. Branches of Psychology: There are a number of unique and distinctive branches of psychology. Each branch looks at questions and problems from a different perspective. While each branch has its own focus on psychological problems or concerns, all areas share a common goal of studying and explaining human thought and behavior. The following are some of the major branches of psychology within the field today. 1. Abnormal Psychology Abnormal psychology is the area that looks at psychopathology and abnormal behavior. The term covers a broad range of disorders, from depression to obsession-compulsion to sexual deviation and many more. Counselors, clinical psychologists and psychotherapists often work directly in this field. • • What is Abnormal Psychology? Mental Disorders 2. Behavioral Psychology Behavioral psychology, also known as behaviorism, is a theory of learning based upon the idea that all behaviors are acquired through conditioning. While this branch of psychology dominated the field during the first part of the twentieth century, it became less prominent during the 1950s. However, behavioral techniques remain a mainstay in therapy, education and many other areas. What is Behaviorism? • Classical Conditioning • Operant Conditioning • Reinforcement Schedules • Behavioral Analysis 3. Biopsychology The branch of psychology focused on the study of how the brain influences behavior is often known as biopsychology, although it has also been called physiological psychology, behavioral neuroscience and psychobiology. • What is Biopsychology? • Neuron Basics • Nervous & Endocrine Systems • Structure of a Neuron 4. Cognitive Psychology Cognitive psychology is the branch of psychology that focuses on internal states, such as motivation, problem solving, decision-making, thinking and attention. This area of psychology has continued to grow since it emerged in the 1960s. • 8 What is Cognitive Psychology? • Careers in Cognitive Psychology • Memory • Intelligence 5. Comparative Psychology Comparative psychology is the branch of psychology concerned with the study of animal behavior. The study of animal behavior can lead to a deeper and broader understanding of human psychology. • • What is Comparative Psychology? 6. Cross-Cultural Psychology Cross-cultural psychology is a branch of psychology that looks at how cultural factors influence human behavior. The International Association of Cross-Cultural Psychology (IACCP) was established in 1972, and this branch of psychology has continued to grow and develop since that time. Today, increasing numbers of psychologists investigate how behavior differs among various cultures throughout the world. 7. Developmental Psychology This branch of psychology looks at development throughout the lifespan, from childhood to adulthood. The scientific study of human development seeks to understand and explain how and why people change throughout life. This includes all aspects of human growth, including physical, emotional, intellectual, social, perceptual and personality development. Topics studied in this field include everything from prenatal development to Alzheimer's disease. • • • • What is Development? How is Development Studied? Issues in Developmental Psychology Child Development Theories 8. Educational Psychology Educational psychology is the branch of psychology concerned with schools, teaching psychology, educational issues and student concerns. Educational psychologists often study how students learn or work directly with students, parents, teachers and administrators to improve student outcomes. • • • Careers in School Psychology Jung and Learning Styles Multiple Intelligences 9. Experimental Psychology 9 Experimental psychology is the branch of psychology that utilizes scientific methods to research the brain and behavior. Many of these techniques are also used by other areas in psychology to conduct research on everything from childhood development to social issues. • • • • Introduction to Research Methods Steps in Psychology Research The Simple Experiment Correlational Studies 10. Forensic Psychology Forensic psychology is a specialty area that deals with issues related to psychology and the law. Forensic psychologists perform a wide variety of duties, including providing testimony in court cases, assessing children in suspected child abuse cases, preparing children to give testimony and evaluating the mental competence of criminal suspects. The Causes of Mental Illness? Although the exact cause of most mental illnesses is not known, it is becoming clear through research that many of these conditions are caused by a combination of biological, psychological and environmental factors. What Biological Factors Are Involved in Mental Illness? Some mental illnesses have been linked to an abnormal balance of special chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain communicate with each other. If these chemicals are out of balance or are not working properly, messages may not make it through the brain correctly, leading to symptoms of mental illness. In addition, defects in or injury to certain areas of the brain have also been linked to some mental conditions. Other biological factors that may be involved in the development of mental illness include: • Genetics (heredity): Many mental illnesses run in families, suggesting that people who have a family member with a mental illness are more susceptible (have a greater likelihood of being affected) to developing a mental illness. Susceptibility is passed on in families through genes. Experts believe many mental illnesses are linked to abnormalities in many genes, not just one. That is why a person inherits a susceptibility to a mental illness and doesn't necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors such as stress, abuse, or a traumatic event, which can influence, or trigger, an illness in a person who has an inherited susceptibility to it. • Infections: Certain infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms. For example, a condition known as pediatric autoimmune neuropsychiatric disorder (PANDA) associated with the Streptococcus bacteria has been linked to the development of obsessive-compulsive disorder and other mental illnesses in children. • Brain defects or injury: Defects in or injury to certain areas of the brain have also been linked to some mental illnesses. 10 • • Prenatal damage: Some evidence suggests that a disruption of early fetal brain development or trauma that occurs at the time of birth, for example, loss of oxygen to the brain, may be a factor in the development of certain conditions, such as autism. Other factors: Poor nutrition and exposure to toxins, such as lead, may play a role in the development of mental illnesses. What Psychological Factors Contribute to Mental Illness? Psychological factors that may contribute to mental illness include: • Severe psychological trauma suffered as a child, such as emotional, physical, or sexual abuse • An important early loss, such as the loss of a parent • Neglect • Poor ability to relate to others What Environmental Factors Contribute to Mental Illness? Certain stressors can trigger an illness in a person who is susceptible to mental illness. These stressors include: • Death or divorce • A dysfunctional family life • Living in poverty • Feelings of inadequacy, low self-esteem, anxiety, anger or loneliness • Changing jobs or schools • Social or cultural expectations (For example, a society that associates beauty with thinness can be a factor in the development of eating disorders.) • Substance abuse by the person or the person's parents Counselling Counseling is a scientific process which is largely accepted by many of us. Whether its vocation guidance or coping with personal trauma counseling surely makes it easy for us to seek professional guidance. There are many subjects that require counseling.With changing times our lifestyle offers us so many advantages that make life easy but at the same time it is important to acknowledge the side effects of a routine fast paced life. In a changing world people are more open with their views. Academic institutions also appoint counselors to guide and coach children so as help them with their goings on in the field of academics. Counseling courses are undertaken as a diploma which is useful for freelance and trainee jobs or post graduate ones that are of a more specialized category. Overcoming fear or risking exposure is another way to look at approaching a counseling centre. This can be a therapy session or a generally programmed technique to overcome the problem. The philosophy about life stays simple as all problems have solutions. Many a times we have obligations and priorities that are in a higher order than the current situation in hand. During this phase the ignored problem grows and causes damage. The problem can be simple like over medication, coping with loss or grief owing to personal trauma. The therapy may be recommended and regular visits would be required so that the root cause is identified in case of grief therapy. Counseling kids is another professional medium to 11 understand the caliber, financial background and support system for the child to excel in their chosen academic path. Whether it is post partum trauma or dealing with a financial loss, counseling help can be sought in reputed centers to deal with the problem and explore multidimensional options. Mood disorders: Introduction A mental disorder characterized by a disturbance of mood. The mood disturbance may be mild or severe and may include depression, mania or hypomania or any combination of these. Bipolar disorders and depressive disorders are the two main categories of mood disorders.  Depression (629 causes)  Anxiety (895 causes)  Mania (102 causes)  Irritability (783 causes)  Mood symptoms (763 causes)  Emotional symptoms (2080 causes)  Emotional problems (2080 causes)  Normal teenage behavior  Premenstrual syndrome (17 causes)  Depressive syndromes different kinds of mood disorders? Basically, there are quite a few known disorders ranging from anxiety, to depression, to mania, to agitation, the list just keeps going on! Most disorders can be traced back to a chemical imbalance in the brain, which can occur naturally, or though the abuse of various substances. When this invasion into the conscience happens, it manifests as your loss of control of your behaviour. The anti-conscience wishes to completely destroy your conscience, so that it may control your behaviour completely and transform you into a crazy and violent creature. Therefore, when this poisonous content invades your human conscience, you start feeling annoyed, irritated and nothing can satisfy you. This is why your mood suddenly changes and you feel desperate, you lose your courage, become too nervous and nothing can give you the peace you need. Its shocking to note that mood disorders these days are not uncommon. In the United States alone it is estimated that between 15 and 20 million people suffer from depressive disorders. Most symptoms of depression would be characterized as overwhelming sadness and loss of joy and pleasure in daily activities. There are two categories of mood disorders recognized by the psychiatric community: unipolar and bipolar disorder. Both are a type of depression with the difference being those who suffer bipolar disorder, also known as manic depression, also experience extreme mood swings between depression and episodes of extreme mania or high energy. Depression is mainly because of the consequences of life such as the death of kin etc. Most of these kinds of depression (bipolar) fade away with the time and as one takes the new situation in his/her stride. It is not for nothing that they say time is the best healer. The chronic mood disorders (unipolar), in some cases genetic, require medical attention as they can be life 12 threatening (suicides). The unipolar mood disorders are major types and clinical attention is necessary. Treatment of mood disorders such as depression is a complex process and may involve psychotherapy and drug treatment. Drugs which have antidepressant effects usually alter levels of neurotransmitters, serotonin and noradrenaline, which are involved in the transmission of nerve impulses in the brain. There are several types and they have slightly different effects in the body. People respond differently to the various types of antidepressant drugs; and a person's symptoms, age, whether or not they have a physical illness, suicide risk, and response to previous medication may help to play a role in deciding what drugs are given. Mood disorders are also called affective disorders. Mood disorders have a major economic impact through associated health care costs as well as lost work productivity. A mood is an emotion or feeling that lasts a long time. Moods affect how we act. Your mood also affects how you feel about yourself and life in general. Mood disorder problems may be caused by changes in your life. Chemical changes in your body can also cause a mood disorder Symptoms of Depression: Introduction The severity and types of symptoms of depression vary from person to person. Typical symptoms include feelings of sadness, anxiety, and/or despair that do not go away. Other feelings may include hopelessness, guilt, worthlessness, helplessness, and anger and irritability. Medical articles People with depression may also experience a loss in interest in activities they once enjoyed, chronic fatigue, trouble focusing, and difficulties with memory or in making decisions. Sleep abnormalities may also occur, such as insomnia or a desire to sleep all the time. Suicidal thoughts or attempts at committing suicidal may also be experienced. Chronic pain is also associated with depression. The two conditions are connected closely because the mood and pain perception centers are both located in the same areas of the brain. Bothchronic pain and depression can deplete the body's stores of endorphins and other neurochemicals that regulate mood and sensation and result in an exacerbation of the other condition. Seventy-five percent of patients with depression have complaints of physical symptoms, especially chronic pain. In addition, depression occurs in about 30% of patients with chronic pain, and anyone in pain can experience some level of mood change, according to the National Pain Foundation....more about Depression » Depression symptoms: The severity and types of symptoms of depression vary from person to person. Typical symptoms include feelings of sadness, anxiety, and despair that do not go away. Other feelings may include hopelessness, guilt, worthlessness, helplessness, and anger and irritability. People with depression may also experience a loss in interest in activities they once enjoyed, chronic fatigue, trouble focusing, and difficulties with memory or in making decisions. Sleep abnormalities may also occur, such as insomnia or a desire to sleep all the time. Suicidal thoughts or attempts at committing suicidal may also be experienced. Chronic pain is also associated with depression. The two are connected closely because the mood and pain perception centers are both located in the same areas of the brain. Both chronic pain and depression can deplete the body's sores of endorphins and other neurochemical that regulate 13 mood and sensation and result in an exacerbation of the other condition. Seventy-five percent of patients with depression have complaints of physical symptoms, especially chronic pain. In addition, depression occurs in about 30% of patients with chronic pain, and anyone in pain can experience some level of mood change, according to the National Pain Foundation. Not all of the above symptoms are always related to depression. They and other symptoms can be related to many other conditions. At the same time, depression can accompany other conditions. For example, chronic body aches and fatigue may be due to fibromyalgia, which may or may not accompany depression. Depression also often goes hand in hand with other conditions, such as anxiety disorder and post traumatic stress disorder (PTSD). Only a thorough evaluation by a qualified health care professional can determine what is causing your particular symptoms and make a diagnosis of depression. Symptoms of depression, especially suicidal thoughts, should be reported immediately to your health care provider, and 911should be called immediately for any attempt at suicide, even if it does not appear serious. Anxiety effects the body: The word “anxiety” has been taken from Greek which means œto constrict, grab the sensation of tightness physically. We are living in the age of uncertainty, quick life and technology which leads us to anxiety, fear and depression. To get rid of these feelings people start taking drugs, alcohol etc. In scientific language anxiety is known as “fight/flight” response. Many times anxiety is normal and a part of human living but if it is more than the normal level it affects our daily activities and then it becomes a disorder. Normal anxiety is a protective response. Anxiety affects the body both physically and mentally. Effects of anxiety on nervous system Whenever the body perceives some danger our brain give signals to the nerves of autonomic nervous system that consists of two parts i.e. sympathetic nervous system and parasympathetic nervous system. The first one gives out the energy for “primed† action of body. Anxiety sometimes immediately shifts the attention to the environment and surroundings because of which a person cannot think about the daily routine and work. The other one helps the body to come back in normal state. Severe anxiety can cause depression, disturbance in relationships, tension and the person may remain in the constant state of worry. Effects of anxiety on cardiovascular system Adrenaline is released into the blood which compells the sympathetic nervous system to heighten the rate of heart beat which further increases the flow of blood and the transportation of oxygen to the different parts of body. The increased rate of blood flow strengthens the muscles of biceps and thighs for the quick action. And if the heart rate decreases you may feel alarming but there is not much to worry about because your heart won’t stop beating. 14 Effects of anxiety on chest When the body experiences anxiety it heightens the breathing rate and the action of body quickens. This can even cause choking, breathlessness, pain in the chest, gastric problem etc. when the breathing rate increases and body performs no quick action then the supply of blood to the brain decreases which cause dizziness, confusion, blurred vision etc. Throat lump and difficulty to swallow This symptom is known as globus hystericus. In this case throat muscle contract because of anxiety. It makes you feel that you are not able to swallow food properly. It will not cause any harm to you and with the anxiety it will also go. Effects on sweat glands Because of anxiety body sweats more making the skin slippery so that it cannot be grabbed easily and also cools the body as it gets heated. Skin As the flow of blood is more in the muscles it decreases in the fine blood vessels which cause a slight change in the color of your skin from pinkish to white. When your body comes to normal state the skin regains its color. Effects on respiratory system During anxiety the rate of blood flow is increased in the muscles whereas blood is needed in the digestive system so as to absorb nutrients from the food. When required amount of blood does not reach to the digestive system then the rate of digestion is slowed down causing diarrhea, heartburn, constipation, indigestion etc. Dryness in mouth and sore eyes Because most of the body fluids and blood is sent to the muscles for quick action so your mouth feels dry during anxiety. The best way to get rid of it is to drink water or take some sweets so that your mouth gets lubricated. The dryness will pass away with the anxiety and causes no harm. Anxiety also decreases the lubrication of eyes which make them feel sore and dry. Insomnia Sometimes anxiety causes sleeplessness or excess of sleep which is called insomnia. Anxiety and stress also causes bad dreams which may disturb us but have no direct affect on the body. Depression and suicidal attempt Severe anxiety may lead to depression and compels the person even to commit suicide. Effects on endocrine system The work of this system is to release hormones for the different parts of the body. Its work is only to secrete hormones but cannot control the amount of hormones to be released. This work is done by brain. During anxiety the signals from the brain get distracted and effects slightly on the secretion of these hormones. When the body comes back to normal state the secretion also returns to its normal rate. 15 Effects on behavior Anxiety makes the body to act quickly like: – to talk, move or respond in a quick manner. Many times you behave in confused and irrational way. This may also make you to do things which you usually avoid. If no action is performed then the body responses in shivering, tension, stress, guilty, foot tapping, improper speaking etc. These things help the body to give away the feeling of anxiety. Nurosis: Neurosis refers to a variety of psychological problems involving persistent experiences of negative affect including anxiety, sadness or depression, anger, irritability, mental confusion, low sense of self-worth, etc., behavioral symptoms such as phobic avoidance, vigilance, impulsive and compulsive acts, lethargy, etc., cognitive problems such as unpleasant or disturbing thoughts, repetition of thoughts and obsession, habitual fantasizing, negativity and cynicism, etc. Interpersonally, neurosis involves dependency, aggressiveness, perfectionism, schizoid isolation, socio-culturally inappropriate behaviors, etc. Generally, neurosis means poor ability to adapt to ones environment, an inability to change one’s life patterns, and the inability to develop a richer, more complex, more satisfying personality. The first point to note is that there are predisposing physiological conditions, for the most part hereditary. Most obvious is the temperament trait (or traits) referred to as neuroticism or emotional instability. Other traits may also contribute, such as extremely high or low conscientiousness. It may be that any inherited trait, when present in the extreme, makes the person more liable to develop neurotic problems. The second point is that one’s culture, upbringing, education, and learning in general may prepare one to deal with the stresses of life, or not. These factors may also serve to override any predisposing physiological conditions, or to exacerbate them. The third point concerns the triggering stressors in people’s lives which lead to the various emotional, behavioral, and cognitive symptoms of neurosis. These stressors can be understood as consisting of situations of uncertainly and confusion, usually involving interpersonal relationships, that overwhelm the person’s capacities, learned and/or inherited, to cope with those situations. Basically, we deal with the world by using our previously acquired knowledge of the world, in coordination with our inherited capacities, to solve the problems presented to us as efficiently as possible. When we are up to the task, our emotional responses are kept to within tolerable limits. When we are not up to the task, we experience anxiety. This anxiety may develop into other emotional responses as well, depending on the details of the problem, our inherited traits, and our learned patterns of response to problematic situations. When we experience repeated occasions of stress and anxiety, we begin to develop patterns of behavior and cognition designed to avoid or otherwise mitigate the problem, such as vigilance, 16 escape behaviors, and defensive thinking. These may develop into an array of attitudes which themselves produce anxiety, anger, sadness, etc. The family is often the focus in discussing the origins of neurosis. First, any genetic predispositions towards neurosis may be inherited. Secondly, the family may have provided little in the way of preparation for a child to deal with the stresses of life. And thirdly, the family may itself be a source of the stress and confusion which the child may be unable to cope with. It may often be the case that a parent is him- or herself troubled by neuroses, and thereby provides the genetics, the poor parenting skills, and the stresses that lead children to develop neuroses. A child is still in the process of learning the skills required to survive and thrive in the social world, and is thereby more susceptible to stress. He or she needs both parental guidance and a degree of security. The child needs to know that the parent will be there for him or her. This reliability is communicated by means of the love a parent expresses to the child. If the child fails to perceive that love (even if it does actually exist), he or she will be left with considerable and very general anxiety, as well as feelings of incompetence and unlovableness. On the other hand, we should not jump to conclusions in this regard: Not all neurotics raise neurotic children, and not all neurotics were themselves raised by neurotic parents. There are many stressful events which can overwhelm even fairly emotionally stable and well educated children, adolescents, and even adults. Among these, we can mention the death of parents, their divorce and remarriage, foster homes, institutionalization, ill health of the child or the parents, war time experiences, immigration, poverty and homelessness, assault, sexual abuse, bigotry, and so on. Many people develop neuroses during adolescence. The sometimes dramatic physical and emotional changes can by themselves overwhelm some adolescents. Even more likely, these changes, combined with the need to demonstrate social competence and to gain peer approval, can lead to great stress and overwhelm the adolescent’s emotional capacities. Teenagers rejected by their peers, due to weight problems, physical appearance, weakness, retardation and learning problems, social shyness or awkwardness, sexual orientation, race, ethnicity, national origin, etc., are especially vulnerable. Many, if they have the resources and especially if they have support from family and friends, recover in early adulthood. Others do not. Just like the child, the adolescent is still in a stage of development, and has the added burden of requiring the social skills involved in sexual competition. These are usually learned by imitating other adolescents, especially those that are admired for their skills and successes. The learning is then supported by gaining validation from other adolescents in the form of acceptance and approval. Without that approval, the adolescent feels no confidence in his or her social skills and again lives with the anxiety of never quite knowing how to act. The adolescent is left with feelings of isolation and self-loathing. Many of these issues continue to apply in young adulthood and even later. Young adults typically feel the need for a partner in life, for a network of friends, for a sense of competence as evidenced by success in college or in the workplace, and so on. Later, the desire for children, for financial security, and for social respect add to the stress. And later still, coming to terms with the prospect of ill health, the death of friends and family, and one’s own mortality provide 17 the older adult with new challenges for their emotional strength. The better the foundation in childhood and adolescence, however, the better the chances that the adult will be able to cope. Hysteria Definition The term "hysteria" has been in use for over 2,000 years and its definition has become broader and more diffuse over time. In modern psychology and psychiatry, hysteria is a feature of hysterical disorders in which a patient experiences physical symptoms that have a psychological, rather than an organic, cause; and histrionic personality disorder characterized by excessive emotions, dramatics, and attention-seeking behavior. Symptoms Of Hysteria Heaviness in the limbsSymptoms Of Hysteria • • • • • • • • • • • • • • Heaviness in the limbs Severe cramps Strong feeling of ascending abdominal constriction Continual sighing Difficulty in breathing Constriction in the chest Palpitations Feeling of a foreign body lodged in the throat Swelling of the neck Suffocation Headache Clenched teeth Generalized and voluntary tensing of muscles of locomotion Loss of consciousness 18 • • • • Violent and tumultuous heartbeats Weakness No willpower Tendency towards emotional instability Clinical psychology is the branch of psychology concerned with the assessment and treatment of mental illness, abnormal behavior and psychiatric problems. This field integrates the science of psychology with the treatment of complex human problems, making it an exciting career choice for people who are looking for a challenging and rewarding field. clinical applications to the treatment of various mental health disorders. The word clinic derives from the Latin clinicus, a bed-ridden person or a physician who attends patients sick in bed. A clinic, therefore, is a place where sick patients are treated. So, in the literal sense, Clinical Psychology is concerned with the work of treating “sick” patients. In the broader, contemporary sense, however, clinical psychology involves teaching about, research about, or treatment of persons with any of the common mental health disorders. (Today, we understand that someone with a phobia, for example, is not literally “sick in bed.”) As clinical psychology grew, it became strongly influenced by the treatment principles of psychoanalysis which place a large emphasis on unconscious functioning. Although the whole story is quite complicated, the various forms of clinical treatment that emerged in the mid-20th century through the associations with, and reactions against, psychoanalysis resulted in what we now collectively call psychotherapy. The most recent Diagnostic and Statistical Manual of Mental Disorders defines a delusion as: A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture. Types Delusions are categorized into four different groups:   Bizarre delusion: A delusion that is very strange and completely implausible; an example of a bizarre delusion would be that aliens have removed the affected person's brain. Non-bizarre delusion: A delusion that, though false, is at least possible, e.g., the affected person mistakenly believes that he is under constant police surveillance. 19  Mood-congruent delusion: Any delusion with content consistent with either a depressive or manic state, e.g., a depressed person believes that news anchors on television highly disapprove of him, or a person in a manic state might believe he is a powerful deity. Mood-neutral delusion: A delusion that does not relate to the sufferer's emotional state; for example, a belief that an extra limb is growing out of the back of one's head is neutral to either depression or mania.[5  An illusion is a distortion of the senses, revealing how the brain normally organizes and interprets sensory stimulation. While illusions distort reality, they are generally shared by most people.[1] Illusions may occur with more of the human senses than vision, but visual illusions, optical illusions, are the most well known and understood. The emphasis on visual illusions occurs because vision often dominates the other senses. For example, individuals watching a ventriloquist will perceive the voice is coming from the dummy since they are able to see the dummy mouth the words.[2] Some illusions are based on general assumptions the brain makes during perception. These assumptions are made using organizational principles, like Gestalt, an individual's ability of depth perception and motion perception, and perceptual constancy. Other illusions occur because of biological sensory structures within the human body or conditions outside of the body within one’s physical environment. The term illusion refers to a specific form of sensory distortion. Unlike a hallucination, which is a distortion in the absence of a stimulus, an illusion describes a misinterpretation of a true sensation. For example, hearing voices regardless of the environment would be a hallucination, whereas hearing voices in the sound of running water (or other auditory source) would be an illusion. Mimes are known for a repertoire of illusions that are created by physical means. The mime artist creates an illusion of acting upon or being acted upon by an unseen object. These illusions exploit the audience's assumptions about the physical world. Well known examples include "walls", "climbing stairs", "leaning", "descending ladders", "pulling and pushing" etc. hallucination Non-specific concepts of madness have been around for several thousand years, the psychiatrist and philosopher Karl Jaspers was the first to define the three main criteria for a belief to be considered delusional in his 1917 book General Psychopathology. These criteria are:    certainty (held with absolute conviction) incorrigibility (not changeable by compelling counterargument or proof to the contrary) impossibility or falsity of content (implausible, bizarre or patently untrue) 20 These criteria still continue in modern psychiatric diagnosis. The most recent Diagnostic and Statistical Manual of Mental Disorders defines a delusion as: A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture. Obsessive-compulsive disorder: A psychiatric disorder characterized by obsessive thoughts and compulsive actions, such as cleaning, checking, counting, or hoarding. Obsessivecompulsive disorder (OCD), one of the anxiety disorders, is a potentially disabling condition that can persist throughout a person's life. The individual who suffers from OCD becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. OCD occurs in a spectrum from mild to severe, but if severe and left untreated, can destroy a person's capacity to function at work, at school, or even in the home. Behavioural Therapy:A form of psychological treatment based on the premise that emotional problems are learned responses to the environment, and that these maladaptive behaviors can be unlearned. From the perspective of behavioral therapists, the reasons behind behaviors are not as important as the fact that the behaviors can be changed. Some examples of behavioral therapy techniques include systematic desensitization and operant conditioning. Reasons For Sucide: They're depressed. They're psychotic They're impulsive They're crying out for help, They have a philosophical desire to die They've made a mistake. Definition: Schizophrenia is a severe mental disorder characterized by delusions, hallucinations, incoherence and physical agitation; it is classified as a "thought" disorder while Bipolar Disorder is a "mood" disorder. It is estimated that 1 percent of the world's population has schizophrenia. While there is 21 evidence that genetic factors have a role in developing schizophrenia, other unknown causes play a significant part as well. Psychotherapy: The treatment of a behavior disorder, mental illness, or any other condition by psychological means. Psychotherapy may utilize insight, persuasion, suggestion, reassurance, and instruction so that patients may see themselves and their problems more realistically and have the desire to cope effectively with them. Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components.[2] The root meaning of the word anxiety is 'to vex or trouble'; in either the absence or presence of psychological stress, anxiety can create feelings of fear, worry, uneasiness and dread. [3] Anxiety is considered to be a normal reaction to a stressor. It may help a person to deal with a difficult situation by prompting one to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder.[4] The intensity and reasoning behind anxiety determines whether it is considered a normal or abnormal reaction. [5] Anxiety: Anxiety, panic attack and fear are daily issues many people face. Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either the absence or presence of psychological stress, anxiety can create feelings of fear, worry, uneasiness and dread. Anxiety is considered to be a normal reaction to stress. It may help a person to deal with a difficult situation by prompting one to cope with it. When anxiety becomes excessive, it may fall under the classification of an anxiety disorder. They Do excessive repeated activities. Anxiety disorders present a variety of physical symptoms in addition to non-physical symptoms that characterize the disorders such as excessive, unrealistic worrying. Many of these symptoms are similar to those exhibited by a person suffering general illness, heart attack, or stroke, and this tends to further increase anxiety. 22 Generalized anxiety disorder (GAD) - The main characteristic of GAD is chronic, exaggerated worry, tension, and Extreame irritability that appear to have no cause or are more intense than the situation warrants. Physical signs that can accompany psychological symptoms. B-Polar Disorder: Bipolar disorder or manic-depressive disorder, also referred to as bipolar affective disorder or manic depression, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or more depressive episodes. The elevated moods are clinically referred to as mania or, if milder, hypomania. Individuals who experience manic episodes also commonly experience depressive episodes, or symptoms, or mixed episodes in which features of both mania and depression are present at the same time. Disorders-IV-TR, and the International Classification of Diseases. Class Profound mental retardation Severe mental retardation Moderate mental retardation 23 IQ Below 20 20–34 35–49 Mild mental retardation Borderline intellectual functioning 50–69 70–84 Carl Rogers Theory and his Client Centered Approach Person centered therapy makes the same impact today as it did 25 years ago. Like others in the field of humanistic psychology, I believe Roger's theory goes to the core of who we are as human beings - afterall we are social animals. His client centered approach relies upon attunement in the therapeutic relationship as a means to change. And as we know, the crucial importance of attunement has been borne out by extensive neuroscience research in recent years. Behaviour therapy, or behavior therapy (behavior modification) is an approach to psychotherapy based on learning theory which aims to treat psychopathology through techniques designed to reinforce desired and eliminate undesired behaviors. The water-soluble vitamins, excluding vitamin C, popularly are termed the B-complex vitamins. There are eight of them, namely; B1 (thiamine), B2 (riboflavin), B6 (pyridoxine), niacin (nicotinic acid), B12, folic acid, pantothenic acid, and biotin. The watersoluble vitamins, inactive in their so-called free states, must be activated to their coenzyme forms. B-complex vitamins and vitamin C are water-soluble vitamins that are not stored in the 24 body and must be replaced each day, preferably through a highquality liquid multivitamin.. The water-soluble vitamins are absorbed in our intestine, pass directly to the blood, and are carried to the tissues in which they will be utilized. Vitamin B12 requires a substance known as "intrinsic factor for absorption". Psychoanalytic theory refers to the definition and dynamics of personality development which underlie and guide psychoanalytic and psychodynamic psychotherapy. Introduction to the Humanistic Approach The Humanistic Approach began in response to concerns by therapists against perceived limitations of Psychodynamic theories, especially psychoanalysis. Individuals like Carl Rogers and Abraham Maslow felt existing (psychodynamic) theories failed to adequately address issues like the meaning of behavior, and the nature of healthy growth. However, the result was not simply new variations on psychodynamic theory, but rather a fundamentally new approach. There are several factors which distinguish the Humanistic Approach from other approaches within psychology, including the emphasis on subjective meaning, a rejection of determinism, and a concern for positive growth rather than pathology. While one might argue that some psychodynamic theories provide a vision of healthy growth (including Jung's concept of individuation), the other characteristics distinguish the Humanistic Approach from every other approach within psychology (and sometimes lead theorists from other approaches to say the Humanistic Approach is not a science at all). Most psychologists believe that behavior can only be understood objectively (by an impartial observer), but the humanists argue that this results in concluding that an individual is incapable of understanding their own behavior--a view which they see as both paradoxical and dangerous to well-being. Instead, humanists like Rogers 25 argue that the meaning of behavior is essentially personal and subjective; they further argue that accepting this idea is not unscientific, because ultimately all individuals are subjective: what makes science reliable is not that scientists are purely objective, but that the nature of observed events can be agreed upon by different observers (a process Rogers calls intersubjective verification). 26