Dr Mark Agresti, Author at Mental Health Treatment West Palm Beach FL – Page 2 of 7

General anxiety disorder (GAD) is among the most usual types of anxiety disorders, and it is a condition that is defined by continuously worrying, in addition to feeling panicky about nothing worse than ordinary and simple daily occurrences.

The worry, which to a logical person is wholly unjustified is so severe that it will considerably degrade the quality of life of the sufferer. It is essential to understand what general anxiety disorder is, what its symptoms are in both psychological as well as physical terms, and how the condition can be treated.

Common general anxiety disorder symptoms consist of feeling lightheaded and experiencing headaches, as well as observing that the heart has actually begun palpitating, and there is also a particular amount of tiredness felt as well. In addition, the signs of general anxiety disorder include profuse sweating, in addition to becoming an insomniac and the muscles may also begin to twitch uncontrollably.

Doctors will have to first look at the symptoms of general anxiety disorder, and take note of the frequency, and the condition will only be diagnosed as GAD in case specific symptoms continuously happen over a period of six months at the very least. When the medical diagnosis has been made, the doctor will then recommend appropriate general anxiety disorder treatment that commonly involves the taking of anti-anxiety medicine consisting of sedatives, and there is also a need to go through cognitive behavioral therapy. Even yoga, along with various other relaxation methods, can help to get rid of general anxiety disorder.

It is disheartening to note that in the United States alone, an estimated, it is believed, over six million Americans suffer from general anxiety disorder, and the actual figure might in fact be even higher. What’s more, GAD can frequently be misdiagnosed, and even undiagnosed, meaning that in truth, the numbers of Americans affected by this condition could be as high as tens of millions of individuals. Also, GAD affects adults in addition to children in equal numbers.

Though the specific cause of general anxiety disorder is yet to be discovered, it is presumed that the trouble takes place due to hereditary factors, and also because of certain sorts of lifestyles. Thankfully, there are numerous treatment methods available that can help control and minimize the symptoms of GAD.

Anxiety disorder signs generally manifest themselves as behavioral, along with physical indicators that are noticed right away, as well as during an attack of anxiety disorder. They manifest themselves in the form of the inability, along with the fear of being able to interact effectively with others.

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Stress and anxiety helps individuals face threats, along with challenging circumstances, and it also helps individuals to deal with external threats. Nevertheless, some people are not so lucky as you and I, because they have to suffer from anxiety that persists over time, and which is also mostly irrational.

Such individuals are considered to be suffering from a condition known as an anxiety disorder which has a variety of causes, as well as causes that in turn, when studied, helps physicians identify the sort of anxiety disorder an individual is experiencing.

The most common kind of anxiety condition is the one that is described as general anxiety disorder (GAD), which has characteristics such as lengthy durations of anxiety that is unjustified, but still present over a time frame. GAD is a condition in which the person experiencing it is incapable of describing their stress and anxiety, and which is an issue that also seems to affect women more than men. Typically, this form of anxiety disorder lasts for about six months, and it continues and causes the sufferer to experience dizziness, headaches, as well as become insomniacs, and there is also some amount of palpitation of the heart felt also.

Some people establish particular fears, and this type of anxiety disorder is unique in that the sufferer is not able to find a reason for their irrational fear of specific objects or scenarios. It is not the same as regular fears that most people experience, as the fear being felt in this case is intense, and causes nauseous sensations, along with shortness of breath, hand shaking, and a palpitating heart.

Another kind of anxiety disorder is the one described as post-traumatic stress disorder that occurs in individuals that have suffered a severe and emotionally upsetting, traumatic experience such as having undergone a threat to their lives, or even having experienced somebody’s death. Occasionally, such people come into contact with particular stimuli that cause them to link the stimulus with the past distressing activity and this in turn will cause a post-traumatic stress disorder.

Other forms of anxiety disorder consist of obsessive-compulsive disorders, panic disorders, and social fears. Individuals that are affected by obsessive-compulsive disorders will have a continuous fixation and/or compulsion, where undesirable thoughts and images preoccupy their minds, and any attempt to suppress these thoughts will lead to the exacerbation of the thoughts, rather than the suppression of the disturbing thoughts.

Panic disorders have certain traits such as the reappearance of panic attacks that happen suddenly. Social fears cause a person to believe that they are the center of everyone’s attention, even when that is not the case.

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Gender identity disorder (GID) is the formal diagnosis used by psychologists and physicians to describe persons who experience significant gender dysphoria (discontent with their biological sex and/or the gender they were assigned at birth). It describes the symptoms related to transsexualism, as well as less severe manifestations of gender dysphoria.

Gender identity disorder in children is usually reported as “having always been there” since childhood, and is considered clinically distinct from GID that appears in adolescence or adulthood, which has been reported by some as intensifying over time. As gender identity develops in children, so do sex-role stereotypes. Sex-role stereotypes are the beliefs, characteristics and behaviors of individual cultures that are deemed normal and appropriate for boys and girls to possess. These “norms” are influenced by family and friends, the mass-media, community and other socializing agents. Since many cultures strongly disapprove of cross-gender behavior, it often results in significant problems for affected persons and those in close relationships with them. In many cases, transgendered individuals report discomfort stemming from the feeling that their bodies are “wrong” or meant to be different.

Many transgendered people and researchers support the declassification of GID as a mental disorder for several reasons. Recent medical research on the brain structures of transgendered individuals have shown that some transgendered individuals have the physical brain structures that resemble their desired sex even before hormone treatment. In addition, recent studies are indicating more possible causes for gender dysphoria, stemming from genetic reasons and prenatal exposure to hormones, as well as other psychological and behavioral reasons.

One contemporary treatment for this disorder consists primarily of physical modifications to bring the body into harmony with one’s perception of mental (psychological, emotional) gender identity, rather than vice versa.

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Female sexual arousal disorder (FSAD), commonly referred to as frigidity, is a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of a sexual activity, or an adequate lubrication-swelling response that otherwise is present during arousal and sexual activity. The condition should be distinguished from a general loss of interest in sexual activity and from other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time.

Although female sexual dysfunction is currently a contested diagnostic, pharmaceutical companies are beginning to promote products to treat FSD, often involving low doses of testosterone.

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Borderline personality disorder (BPD) is a personality disorder described as a prolonged disturbance of personality function in a person (generally over the age of eighteen years, although it is also found in adolescents), characterized by depth and variability of moods. The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the disorder often manifests itself inidealization and devaluation episodes, as well as chaotic and unstable interpersonal relationships, self-image, identity, and behavior; as well as a disturbance in the individual’s sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation.

BPD splitting includes a switch between idealizing and demonizing others. This, combined with mood disturbances, can undermine relationships with family, friends, and co-workers. BPD disturbances also may include self-harm. Without treatment, symptoms may worsen, leading (in extreme cases) to suicide attempts.

There is an ongoing debate among clinicians and patients worldwide about terminology and the use of the word borderline, and some have suggested that this disorder should be renamed. The ICD-10 manual has an alternative definition and terminology to this disorder, calledEmotionally unstable personality disorder. There is related concern that the diagnosis of BPD stigmatizes people and supports pejorative and discriminatory practices.

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In clinical psychology, voyeurism is the sexual interest in or practice of spying on people engaged in intimate behaviors, such as undressing, sexual activity, or other activity usually considered to be of a private nature.

Voyeurism (from the French voyeur, “one who looks”) can take several forms, but its principal characteristic is that the voyeur does not normally relate directly with the subject of their interest, who is often unaware of being observed. The practice of making a permanent image of an intimate activity has been made easier with modern photographic and video technology, and is considered an invasion of privacy. However, in today’s society the concept of voyeurism has evolved, especially in popular culture. Non-pornographic reality television programs such as Survivor and The Real World, are prime examples of voyeurism, where viewers (the voyeur) are granted an intimate interaction with a subject group or individual. Although not necessarily “voyeurism” in its original definition, as individuals in these given situations are aware of their audience, the concept behind “reality TV” is to allow unscripted social interaction with limited outside interference or influence. As such, the term still maintains its sexual connotations.

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Sexual dysfunction or sexual malfunction refers to a difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including desire, arousal or orgasm.

To maximize the benefits of medications and behavioural techniques in the management of sexual dysfunction it is important to have a comprehensive approach to the problem, A thorough sexual history and assessment of general health and other sexual problems (if any) are very important. Assessing (performance) anxiety, guilt (associated with masturbation in many Indian men), stress and worry are integral to the optimal management of sexual dysfunction. When a sexual problem is managed inappropriately or sub-optimally, it is very likely that the condition will subside immediately but re-emerge after a while. When this cycle continues, it strongly reinforces failure that eventually make clients not to access any help and suffer it all their life. So, it is important to get a thorough assessment from professionals and therapists who are qualified to manage sexual problems. Internet-based information is good for gaining knowledge about sexual functioning and sexual problem but not for self-diagnosis and/or self-management.

Disorders in this Category

Dysfunctions in this Category

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Brief psychotic disorder is a period of psychosis whose duration is generally shorter, non re-occurring, and not better accounted for by another condition.

The disorder is characterized by a sudden onset of psychotic symptoms, which may include delusions, hallucinations, disorganized speech or behavior, or catatonic behavior. The symptoms must not be better accounted for by schizophrenia, schizoaffective disorder, delusional disorderor mania in bipolar disorder. They must also not be caused by a drug (such as amphetamines) or medical condition (such as a brain tumor).

Symptoms generally last at least a day, but not more than a month, and there is an eventual return to full baseline functioning. It may occur in response to a significant stressor in a person’s life, or in other situations where a stressor is not apparent, including in the weeks following birth. In diagnosis, a careful distinction is considered for culturally appropriate behaviors, such as religious beliefs and activities. It is believed to be connected to or synonymous with a variety of culture-specific phenomena such as latah, koro, and amok

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Sexual fetishism, or erotic fetishism, is the sexual arousal a person receives from a physical object, or from a specific situation. The object or situation of interest is called the fetish, the person a fetishist who has a fetish for that object/situation. Sexual fetishism may be regarded, e.g. in psychiatric medicine, as a disorder of sexual preference or as an enhancing element to a relationship causing a better sexual bond between the partners. Arousal from a particular body part is classified as partialism.

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Kleptomania is an irresistible urge to steal items of trivial value. People with this disorder are compelled to steal things, generally, but not limited to, objects of little or no significant value, such as pens, paper clips, paper and tape. Some kleptomaniacs may not even be aware that they have committed the theft.

Kleptomania was first officially recognized in the US as a mental disorder in the 1960s in the case of State of California v. Douglas Jones.

Kleptomania is distinguished from shoplifting or ordinary theft, as shoplifters and thieves generally steal for monetary value, or associated gains and usually display intent or premeditation, while kleptomaniacs are not necessarily contemplating the value of the items they steal or even the theft until they are compelled without motive.

Increasing brain research and clinical work indicate that shoplifting and stealing can become addictive-compulsive disorders. Hence, the terms “shoplifting addiction” or “theft addiction” or “compulsive theft or stealing” have gained popularity and credence recently. There even are books and support groups devoted to recovery from addictive-compulsive shoplifting or stealing. Most “theft addicts” are neither kleptomaniacs nor typical criminals who steal for profit or due to sociopathic or characterological issues.

This disorder usually manifests during puberty and, in some cases, may last throughout the person’s life.

People with this disorder are likely to have a comorbid condition, specifically paranoid, schizoid or borderline personality disorder. Kleptomania can occur after traumatic brain injuryand/or carbon monoxide poisoning.

Kleptomania is usually thought of as part of the obsessive-compulsive disorder spectrum, although emerging evidence suggests that it may be more similar to addictive and mood disorders. In particular, this disorder is frequently co-morbid with substance use disorders, and it is common for individuals with kleptomania to have first-degree relatives who suffer from a substance use disorder.

Relationship to OCD

Kleptomania is frequently thought of as being a part of obsessive-compulsive disorder, since the irresistible and uncontrollable actions are similar to the frequently excessive, unnecessary and unwanted rituals of OCD. Some individuals with kleptomania demonstrate hoarding symptoms that resemble those with OCD.

Prevalence rates between the two disorders do not demonstrate a strong relationship. Studies examining the comorbidity of OCD in subjects with kleptomania have inconsistent results, with some showing a relatively high co-occurrence (45%-60%) while others demonstrate low rates (0%-6.5%). Similarly, when rates of kleptomania have been examined in subjects with OCD, a relatively low co-occurrence was found (2.2%-5.9%).

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A fugue state, formally dissociative fugue or psychogenic fugue (DSM-IV Dissociative Disorders 300.13), is a rare psychiatric disorder characterized by reversible amnesia for personal identity, including the memories, personality and other identifying characteristics of individuality. The state is usually short-lived (hours to days), but can last months or longer. Dissociative fugue usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity. After recovery from fugue, previous memories usually return intact, but there is complete amnesia for the fugue episode. Additionally, an episode is characterized as a fugue if it can be related to the ingestion of psychotropic substances, to physical trauma, to a general medical condition, or to psychiatric conditions such as delirium, dementia, bipolar disorder or depression. Fugues are usually precipitated by a stressful episode, and upon recovery there may be amnesia for the original stressor (Dissociative Amnesia).

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Psychogenic amnesia, also known as functional amnesia or dissociative amnesia, is a memory disorder characterized by extreme memory loss that is caused by extensive psychological stress and that cannot be attributed to a known neurobiological cause. Psychogenic amnesia is defined by (a) the presence of retrograde amnesia (the inability to retrieve stored memories leading up to the onset of amnesia), and (b) an absence of anterograde amnesia (the inability to form new long term memories). Dissociative amnesia is due to psychological rather than physiological causes and can sometimes be helped by therapy.

There are two types of psychogenic amnesia, global and situation-specific. Global amnesia, also known as fugue state, refers to a sudden loss of personal identity that lasts a few hours to days, and is typically preceded by severe stress and/or depressed mood. Fugue state is very rare, and usually resolves over time, often helped by therapy. In most cases, patients lose their autobiographical memory and personal identity even though they are able to learn new information and perform everyday functions normally. Other times, there may be a loss of basic semantic knowledge and procedural skills such as reading and writing. Situation-specific amnesia occurs as a result of a severely stressful event, as in post-traumatic stress disorder, child sex abuse, military combat or witnessing a family member’s murder or suicide, and is somewhat common in cases of severe and/or repeated trauma.

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Agoraphobia Without a History of Panic Disorder is an anxiety disorder characterized by extreme fear of experiencing panic symptoms, of panic attacks.

Agoraphobia typically develops as a result of having panic disorder. In a small minority of cases, however, agoraphobia can develop by itself without being triggered by the onset of panic attacks. Historically, there has been debate over whether Agoraphobia Without Panic genuinely existed, or whether it was simply a manifestation of other disorders such as Panic Disorder, General anxiety disorder, Avoidant personality disorder and Social Phobia. Said one researcher: “out of 41 agoraphobics seen (at a clinic) during a period of 1 year, only 1 fit the diagnosis of agoraphobia without panic attacks, and even this particular classification was questionable…Do not expect to see too many agoraphobics without panic” (Barlow & Waddell, 1985) . In spite of this earlier skepticism, current thinking is that Agoraphobia Without Panic Disorder is indeed a valid, unique illness which has gone largely unnoticed, since its sufferers are far less likely to seek clinical treatment.

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Not to be confused with agraphobia, agoraphobia is a condition where the sufferer becomes anxious in environments that are unfamiliar or where he or she perceives that they have little control. Triggers for this anxiety may include wide open spaces, crowds (social anxiety), or traveling (even short distances). Agoraphobia is often, but not always, compounded by a fear of social embarrassment, as the agoraphobic fears the onset of a panic attack and appearing distraught in public. This is also sometimes called ‘social agoraphobia’ which may be a type of social anxiety disorder also sometimes called “social phobia”.

Not all agoraphobia is social in nature, however. Some agoraphobics have a fear of open spaces. Agoraphobia is also a defined as “a fear, sometimes terrifying, by those who have experienced one or more panic attacks”. In these cases, the sufferer is fearful of a particular place because they have experienced a panic attack at the same location in a previous time. Fearing the onset of another panic attack, the sufferer is fearful or even avoids the location. Some refuse to leave their home even in medical emergencies because the fear of being outside of their comfort area is too great.

The sufferer can sometimes go to great lengths to avoid the locations where they have experienced the onset of a panic attack. Agoraphobia, as described in this manner, is actually a symptom professionals check for when making a diagnosis of panic disorder. Other syndromes like obsessive compulsive disorder or post traumatic stress disorder can also cause agoraphobia, basically any irrational fear that keeps one from going outside can cause the syndrome.

It is not uncommon for agoraphobics to also suffer from temporary separation anxiety disorder when certain other individuals of the household depart from the residence temporarily, such as a parent or spouse, or when the agoraphobic is left home alone. Such temporary conditions can result in an increase in anxiety or a panic attack.

Another common associative disorder of agoraphobia is necrophobia, the fear of death. The anxiety level of agoraphobics often increases when dwelling upon the idea of eventually dying, which they consciously or unconsciously associate with being the ultimate separation from their mortal emotional comfort and safety zones and loved ones, even for those who may otherwise spiritually believe in some form of divine afterlife existence.

Gender differences

Agoraphobia occurs about twice as commonly among women as it does in men. The gender difference may be attributable to several factors: social-cultural traditions that encourage, or permit, the greater expression of avoidant coping strategies by women (including dependent and helpless behaviors); women perhaps being more likely to seek help and therefore be diagnosed; men being more likely to abuse alcohol in reaction to anxiety and be diagnosed as an alcoholic. Research has not yet produced a single clear explanation for the gender difference in agoraphobia.

Causes and contributing factors

Although the exact causes of agoraphobia are currently unknown, some clinicians who have treated or attempted to treat agoraphobia offer plausible hypotheses. The condition has been linked to the presence of other anxiety disorders, a stressful environment or substance abuse. Chronic use of tranquilizers and sleeping pills such as benzodiazepines has been linked to onset of agoraphobia. In 10 patients who had developed agoraphobia during benzodiazepine dependence, symptoms abated within the first year of assisted withdrawal.

Research has uncovered a linkage between agoraphobia and difficulties with spatial orientation. Individuals without agoraphobia are able to maintain balance by combining information from their vestibular system, their visual system and their proprioceptive sense. A disproportionate number of agoraphobics have weak vestibular function and consequently rely more on visual or tactile signals. They may become disoriented when visual cues are sparse (as in wide open spaces) or overwhelming (as in crowds). Likewise, they may be confused by sloping or irregular surfaces. In a virtual reality study, agoraphobics showed impaired processing of changing audiovisual data in comparison with healthy subjects.

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In psychiatry, adjustment disorder (AD) is a psychological response to an identifiable stressor or group of stressors that cause(s) significant emotional or behavioral symptoms that do not meet criteria for anxiety disorder, PTSD, or acute stress disorder. The condition is different from anxiety disorder, which lacks the presence of a stressor, or post-traumatic stress disorder and acute stress disorder, which usually are associated with a more intense stressor. There are nine different types of adjustment disorders listed in the DSM-III-R. In DSM-IV, adjustment disorder was reduced to six types, classified by their clinical features. Adjustment disorder may also be acute or chronic, depending on whether it lasts more or less than six months. Diagnosis of adjustment disorder is quite common; there is an estimated incidence of 5-21% among psychiatric consultation services for adults. Adult women are diagnosed twice as often as are adult men, but among children and adolescents, girls and boys are equally likely to receive this diagnosis. Adjustment disorder was introduced into the psychiatric classification systems almost 30 years ago, but the concept was recognized for many years before that.

Disorders in this Category

Adjustment Disorder Unspecified
Adjustment Disorder with Anxiety
Adjustment Disorder with Depressed Mood
Adjustment Disorder with Disturbance of Conduct
Adjustment Disorder with Mixed Anxiety and Depressed Mood
Adjustment Disorder with Mixed Disturbance of Emotions and Conduct

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Dr. Mark Agresti discusses the importance of keeping the news in perspective. By doing so, one allows themselves to minimize the impact that negative news can have.