Promoting Awareness- Your thoughts and stories welcome.

In the effort to promote awareness, resources and information regarding Reflex Sympathetic Dystrophy Syndrome/Complex Regional Pain Syndrome, aka, RSD, RSDS and CRPS these sites have been created so that understanding might come from them.
RSD Advisory and RSD Advisor are mirror dot.com sites

www.RSDAdvisor.com and www.RSDAdvisory.com

Here at RSD Advisory-WordPress you can leave comments, add your own stories, and tell the world of anything you might like to add. Just add it to the comment area of this post or one of the blogs that best fits you.

Thank you for supporting my passion to promote education, to date there is still no cure.

Best of wishes to you all

~twinkle/ellaj

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Cyclothymic Disorder

Cyclothymic Disorder
http://www.merck.com/mrkshared/mmanual/section15/chapter189/189e.jsp


Less severe hypomanic and mini-depressive periods follow an irregular course, with each period lasting a few days. Cyclothymic disorder is commonly a precursor of bipolar II disorder. But it can also occur as extreme moodiness without being complicated by major mood disorders. In such cases, brief cycles of retarded depression accompanied by low self-confidence and increased sleep alternate with elation or increased enthusiasm and shortened sleep. In another form, low-grade depressive features predominate; the bipolar tendency is shown primarily by how easily elation or irritability is induced by antidepressants. In chronic hypomania, a form rarely seen clinically, elated periods predominate, with habitual reduction of sleep to < 6 h. Persons with this form are constantly overcheerful, self-assured, overenergetic, full of plans, improvident, overinvolved, and meddlesome; they rush off with restless impulses and accost people.

Although cyclothymic and chronic hypomanic dispositions contribute to success in business, leadership, achievement, and artistic creativity in some persons, they more often have serious detrimental interpersonal and social sequelae. Cyclothymic instability is particularly likely to be manifested in an uneven work and schooling history; impulsive, frequent changes of residence; repeated romantic or marital breakups; and an episodic pattern of alcohol and drug abuse.

Treatment
Patients should be taught how to live with the extremes of their temperamental inclinations, although living with cyclothymic disorder is not easy because of the resulting stormy interpersonal relations. Jobs with flexible hours are preferred. Patients with artistic inclinations should be encouraged to pursue such careers because the excesses and fragility of cyclothymia are better tolerated in such circles.

The decision to use a mood stabilizer depends on the balance between the functional impairment produced by unpredictable mood swings and the social benefits or creative spurts the patient may receive from hypomanic swings. Divalproex 500 to 1000 mg/day is better tolerated than equivalent doses of lithium. Antidepressants should be avoided because of the risk of switching and rapid cycling.

Dysthymic Disorder

Dysthymic Disorder
http://www.psychologyinfo.com/depression/dysthymic.htm

Dysthymic Disorder is characterized by chronic depression, but with less severity than a major depression. The essential symptom for dysthymic disorder is an almost daily depressed mood for at least two years, but without the necessary criteria for a major depression. Low energy, sleep or appetite disturbances and low self-esteem are usually part of the clinical picture as well.

People who have dysthymic disorder will often report that they don’t recall ever not feeling depressed, but they may be relatively functional in managing their life, although the symptoms are severe enough to cause distress and interference with important life role responsibilities. It is important to have a complete physical to rule out any physical illnesses that might be causing the depression. Also, if the person has a chronic medical condition that appears to be the cause for the depression (such as any chronic debilitating condition), then the correct diagnosis might be a Mood Disorder due to a general Medical Condition, even if all the criteria for dysthymic disorder are met. The question is whether the medical condition is physically causing the depression, rather than creating chronic psychological distress that is causing the depression.

Despite the long term nature of this type of depression, psychotherapy is effective in reducing the symptoms of depression, and assisting the person in managing his/her life better. Some individuals with dysthymic disorder respond well to antidepressant medication, in addition to psychotherapy, so an evaluation for medication may be appropriate. You should consult your psychologist if you have questions about treatment.

Identifying Dysthymic Disorder
Depression causes changes in thinking, feeling, behavior, and physical well-being.

Changes in Thinking – Many people experience difficulty with concentration and decision making. Some people report problems with short term memory, forgetting things all the time. Negative thoughts and thinking are characteristic of depression. Pessimism, poor self-esteem, excessive guilt, and self-criticism are all common. Some people have self-destructive thoughts during more serious depression.

Changes in Feelings – Many people report feeling sad for no reason. Others report that they no longer enjoy activities that they once found pleasurable. You might lack motivation, becoming more apathetic. You might feel “slowed down” and tired all the time. Sometimes irritability is a problem, and more difficulty controlling your temper. Often, dysthymic disorder leads to feelings of helplessness and hopelessness.

Changes in Behavior – You might act more apathetic, because that’s how you feel. Some people do not feel comfortable with other people, so social withdrawal is common. Some people experience a change in appetite, either eating more or less. Because of the chronic sadness, excessive crying is common. Some people complain about everything, and act out their anger with temper outbursts. Sexual desire may disappear, resulting in lack of sexual activity. In the extreme, people may neglect their personal appearance, even neglecting basic hygiene. Needless to say, someone who is this depressed does not do very much, so work productivity and household responsibilities suffer. Some people have trouble getting out of bed.

Changes in Physical Well-being – We already talked about the negative emotional feelings experienced during depression, but these are coupled with negative physical emotions as well. Chronic fatigue, despite spending more time sleeping is common. Some people can’t sleep, or don’t sleep soundly. These individuals lay awake for hours, or awaken many times during the night, and stare at the ceiling. Others sleep many hours, even most of the day, although they still feel tired. Many people lose their appetite, feel slowed down by depression, and complain of many aches and pains.

Now imagine these symptoms lasting for months. Imagine feeling this way almost all of the time. This may be dysthymic disorder, if several of these symptoms are present most of the time, for the past two years. Remember, all of the symptoms do not need to be present! Of course, it’s not a good idea to diagnose yourself. If you think you might be depressed, talk to a psychologist for a consultation. A licensed psychologist can assess whether you are depressed, and can determine the proper treatment for your depression. Remember, depression is treatable.

Treatment for Dysthymic Disorder
Psychotherapy is the treatment for choice for this psychological problem. Often, antidepressant medication is also recommended because of the chronic nature of the depression in Dysthymia. Psychotherapy is used to treat this depression in several ways. First, supportive counseling can help to ease the pain, and can address the feelings of hopelessness.  Second, cognitive therapy is used to change the pessimistic ideas, unrealistic expectations, and overly critical self-evaluations that create the depression and sustain it. Cognitive therapy can help the depressed person recognize which life problems are critical, and which are minor. It also helps them to learn how to accept the life problems that cannot be changed. Third, problem solving therapy is usually needed to change the areas of the person’s life that are creating significant stress, and contributing to the depression. Behavioral therapy can help you to develop better coping skills, and interpersonal therapy can assist in resolving relationship conflicts.

Facing the Storm- Pain and Mental Illness by twinklev

Facing the Storm
Pain and Mental Illness
by TwinkleEKV
Mental Health, a most fascinating area of study, but are all diagnosis’ correct? A diagnosis relies on symptoms, or should I say, for a doctor to give a diagnosis, he must rely on symptoms and underlying factors before making such a determination. Can a doctors determination of said illness be based simply on assumption? How about a pre conceived idea or notion that the symptoms are obvious to a specific illness or disorder? Perhaps you know someone that experiences mood swings, altered behavior, or sudden changes in personality with bouts of highs and lows without notable warnings and you probably never even see it coming. This seems to be a tell tale sign of a widely known and diagnosed disorder and before I mention it, many of you will already know where I’m heading.

Depression is defined as sadness, gloom, dejection. A condition of feeling sad or despondent. In Psychiatry it is defined as a condition of general emotional dejection and withdrawal; sadness greater and more prolonged than that warranted by any objective reason. A disorder characterized by an inability to concentrate, insomnia, loss of appetite, anhedonia, feelings of extreme sadness, guilt, helplessness and hopelessness, and thoughts of death. Also called clinical depression. In Pathology, a low state of vital powers or functional activity.

Mania is defined as excessive excitement or enthusiasm; craze. An excessively intense enthusiasm, interest, or desire. In Psychiatry, manic disorder. A manifestation of bipolar disorder, characterized by profuse and rapidly changing ideas, exaggerated sexuality, gaiety, or irritability, and decreased sleep. Violent abnormal behavior. Insanity. Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behavior, and elevation of mood; specifically : the manic phase of bipolar disorder. An irrational but irresistible motive for a belief or action. A mood disorder; an affective disorder in which the victim tends to respond excessively and sometimes violently.

Lets take a look at this again. Depression equals low and mania equals high. Common sense would lead us to believe that a “normal” mood would be at the center of both and in studying mental illness and Bipolar disorder, we would be correct. Imagine a pole, any pole, even a telephone pole. At the top is mania, in the middle is an even stabalized mood and at the bottom is depression.

Lets take a peek at hypomania. A mild to moderate level of mania is called hypomania, which generally does not impair a persons daily functioning and includes an enhanced mood and productivity.

A manic depressive is called Bipolar 1, the less severe form of Bipolar 1 is Bipolar 2, who’s characteristics include hypomania, instead of full blown manic episodes and then there is Unipolar, which by definition means that there is a depressive phase only.

Hmm! Wouldn’t that simply be depression? Lets review for a moment.  Bi means two, Uni means 1. Bipolar 1 and 2 move up and down the pole, Unipolar means 1, it stays at the bottom. It’s said that mixed episodes do not exist in Bipolar 2, on the contrary, they do exist. It is but a mixed state of being, fluctuating, deflating and back again.

Have you wondered by chance where I might be going with all this? Let me introduce you to pain.

Pain is defined as physical suffering or distress, as due to injury illness, etc. A distressing sensation in a particular part of the body. Pain and ache usually refer to physical sensations (except heartache); agony and anguish may be physical or mental. Pain suggests a sudden sharp twinge. Agony implies a continuous, excruciating, scarcely endurable pain: in agony from a wound. Anguish suggests not only extreme and long-continued pain, but also a feeling of despair. A pang, twinge, stitch. afflict, torment; trouble, grieve. An unpleasant sensation occurring in varying degrees of severity as a consequence of injury, disease, or emotional disorder. Suffering or distress. A physical discomfort associated with bodily disorder (as disease or injury). A state of physical, emotional, or mental lack of well-being or physical, emotional, or mental uneasiness that ranges from mild discomfort or dull distress to acute often unbearable agony, may be generalized or localized, and is the consequence of being injured or hurt physically or mentally or of some derangement of or lack of equilibrium in the physical or mental functions (as through disease), and that usually produces a reaction of wanting to avoid, escape, or destroy the causative factor and its effects. Basic bodily sensation that is induced by a noxious stimulus, is received by naked nerve endings, is characterized by physical discomfort (as pricking, throbbing, or aching), and typically leads to evasive action. A symptom of some physical hurt or disorder. A somatic sensation of acute discomfort.

Now I’m going to propose a thought for others to think upon. When physical pain developes in a person, at some point emotional distress will take over. This is not an assumption, but fact. I don’t even need to get into information explaining the chemical imbalances that play a part in mental illness. Of course, it’s true. What I want to discuss is that when someone is in pain, acute, severe, mild to extreme, it takes so much energy inside ourselves that mental dilemma’s will develop. This can happen over a short period of time or a longer period of time. It might depend on strength, hope, the will to live, the ability to fight off the discomfort, attitude and a minimal level of stress.  Stress increases pain, pain increases instability, instability creates lack of peace of mind. Thoughts of no longer wanting to live and exist expand and increase, however, there is a difference between suicidal ideation and suicidal intent.

On a good pain day the individual may have their high, creativity, feel happiness, smile and laugh, bounce around in a positive manner, demonstrate self esteem, feel excitement, desire, feel optimistic with the emotion that “no one can hold me back”.  Mania?

On a bad pain day the person may feel hopeless, worthless, no longer have the will to live that they had on their “good pain day”. Lose hope, cry, feel agony, sadness, have no drive to get out of bed because either the physical pain or emotional pain has them beat. It is that the physical and emotional has grabbed them up once again. Depression?

On a so so day, he or she may feel fatigued, but flash a smile, hurt, but want to survive, their mood may be that of feeling “okay” considering what they endure through their day to day lives and hope flows through them. A stabalized mood? The center of that pole!

I am at the belief that pain is misunderstood and since many pain syndromes currently have no cure that many people are mis-diagnosed with a mental illness, namely Bipolar disorder as a means to justify that which cannot be accepted or explained.

I urge you all to think about this, I certainly do.

~twinkle/ellaj

© 2006 twinklev – Unauthorized duplication is prohibited. May be used by permission and with viewable credit to author.