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Major depressive disorder (MDD) (also known as clinical depression, major depression, unipolar depression, or unipolar disorder; or as recurrent depression in the case of repeated episodes) is a mental disorder characterized by a pervasive and persistent low mood that is accompanied by low self-esteem and by a loss of interest or pleasure in normally enjoyable activities. This cluster of symptoms (syndrome) was named, described and classified as one of the mood disorders in the 1980 edition of the American Psychiatric Association‘s diagnostic manual. The term “depression” is ambiguous. It is often used to denote this syndrome but may refer to other mood disorders or to lower mood states lacking clinical significance. Major depressive disorder is a disabling condition that adversely affects a person’s family, work or school life, sleeping and eating habits, and general health. In the United States, around 3.4% of people with major depression commit suicide, and up to 60% of people who commit suicide had depression or another mood disorder.
The diagnosis of major depressive disorder is based on the patient’s self-reported experiences, behavior reported by relatives or friends, and a mental status examination. There is no laboratory test for major depression, although physicians generally request tests for physical conditions that may cause similar symptoms. The most common time of onset is between the ages of 20 and 30 years, with a later peak between 30 and 40 years.
Typically, patients are treated with antidepressantmedication and, in many cases, also receive psychotherapy or counseling, although the effectiveness of medication for mild or moderate cases is questionable. Hospitalization may be necessary in cases with associated self-neglect or a significant risk of harm to self or others. A minority are treated with electroconvulsive therapy (ECT). The course of the disorder varies widely, from one episode lasting weeks to a lifelong disorder with recurrent major depressive episodes. Depressed individuals have shorter life expectancies than those without depression, in part because of greater susceptibility to medical illnesses and suicide. It is unclear whether or not medications affect the risk of suicide. Current and former patients may be stigmatized.
Anxiety is an unpleasant state of inner turmoil, often accompanied by nervous behavior, such as pacing back and forth, somatic complaints and rumination. It is the subjectively unpleasant feelings of dread over something unlikely to happen, such as the feeling of imminent death. Anxiety is not the same as fear, which is felt about something realistically intimidating or dangerous and is an appropriate response to a perceived threat; anxiety is a feeling of fear, worry, and uneasiness, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing. It is often accompanied by restlessness, fatigue, problems in concentration, and muscular tension. Anxiety is not considered to be a normal reaction to a perceived stressor although many feel it occasionally.
Anxiety is a mental disorder, that is, characterized by excessive, uncontrollable and often irrational worry about everyday things that is disproportionate to the actual source of worry, it is diagnosed as generalized anxiety disorder (GAD). GAD occurs without an identifiable triggering stimulus. It is called generalized because the remorseless worries are not focused on any specific threat; they are, in fact, often exaggerated and irrational. It is distinguished from fear, which is an appropriate cognitive and emotional response to a perceived threat and is related to the specific behaviors of fight-or-flight responses, defensive behavior or escape. Anxiety occurs in situations only perceived as uncontrollable or unavoidable, but not realistically so. David Barlow defines anxiety as “a future-oriented mood state in which one is ready or prepared to attempt to cope with upcoming negative events,” and that it is a distinction between future and present dangers which divides anxiety and fear. In a 2011 review of the literature, fear and anxiety were said to be differentiated in four domains: (1) duration of emotional experience, (2) temporal focus, (3) specificity of the threat, and (4) motivated direction. Fear is defined as short lived, present focused, geared towards a specific threat, and facilitating escape from threat; while anxiety is defined as long acting, future focused, broadly focused towards a diffuse threat, and promoting excessive caution while approaching a potential threat and interferes with constructive coping. While almost everyone has experienced anxiety at some point in their lives, most do not develop long-term problems with anxiety. If long term or severe problems with anxiety develop, such problems are classified as an Anxiety disorder. Symptoms of anxiety can range in number, intensity, and frequency, depending on the person.
Although panic attacks are not experienced by every person who suffers from anxiety, they are a common symptom. Panic attacks usually come without warning and although the fear is generally irrational, the subjective perception of danger is very real. A person experiencing a panic attack will often feel as if he or she is about to die or lose consciousness. Between panic attacks, people with panic disorder tend to suffer from anticipated anxiety- a fear of having a panic attack may lead to the development of phobias. Such a phobia is called agoraphobia, this is a fear of having a panic attack in a public place or new environment and experiencing judgement from strangers or failing to attain help. Anxiety is the most common mental illness in America as approximately 40 million adults are affected by it. Not only is anxiety common in adults, but it has also been found to be more common in females rather than males.
The behavioral effects of anxiety may include withdrawal from situations which have provoked anxiety in the past. Anxiety can also be experienced in ways which include changes in sleeping patterns, nervous habits, and increased motor tension like foot tapping.
The emotional effects of anxiety may include “feelings of apprehension or dread, trouble concentrating, feeling tense or jumpy, anticipating the worst, irritability, restlessness, watching (and waiting) for signs (and occurrences) of danger, and, feeling like your mind’s gone blank” as well as “nightmares/bad dreams, obsessions about sensations, deja vu, a trapped in your mind feeling, and feeling like everything is scary.”
The cognitive effects of anxiety may include thoughts about suspected dangers, such as fear of dying. “You may … fear that the chest pains are a deadly heart attack or that the shooting pains in your head are the result of a tumor or aneurysm. You feel an intense fear when you think of dying, or you may think of it more often than normal, or can’t get it out of your mind.”
Self-esteem is a term used in psychology to reflect a person‘s overall emotional evaluation of his or her own worth. It is a judgment of oneself as well as an attitude toward the self. Self-esteem encompasses beliefs (for example, “I am competent,” “I am worthy”) and emotions such as triumph, despair, pride and shame. Smith and Mackie define it by saying “The self-concept is what we think about the self; self-esteem, is the positive or negative evaluations of the self, as in how we feel about it.”:107 Self-esteem is also known as the evaluative dimension of the self that includes feelings of worthiness, prides and discouragement. One’s self-esteem is also closely associated with self-consciousness.
Self-esteem is a disposition that a person has which represents their judgments of their own worthiness. In the mid-1960s, Morris Rosenberg and social-learning theorists defined self-esteem as a personal worth or worthiness.Nathaniel Branden in 1969 defined self-esteem as “the experience of being competent to cope with the basic challenges of life and being worthy of happiness.” According to Branden, self-esteem is the sum of self-confidence (a feeling of personal capacity) and self-respect (a feeling of personal worth). It exists as a consequence of the implicit judgment that every person has of their ability to face life’s challenges, to understand and solve problems, and their right to achieve happiness, and be given respect.
As a social psychological construct, self-esteem is attractive because researchers have conceptualized it as an influential predictor of relevant outcomes, such as academic achievement or exercise behavior (Hagger et al. 1998)[full citation needed]. In addition, self-esteem has also been treated as an important outcome due to its close relation with psychological well-being (Marsh 1989)[full citation needed]. Self-esteem can apply specifically to a particular dimension (for example, “I believe I am a good writer and I feel happy about that”) or a global extent (for example, “I believe I am a bad person, and feel bad about myself in general”). Psychologists usually regard self-esteem as an enduring personality characteristic (“trait” self-esteem), though normal, short-term variations (“state” self-esteem) also exist. Synonyms or near-synonyms of self-esteem include: self-worth, self-regard, self-respect, and self-integrity.
An adjustment disorder (AD) occurs when an individual is unable to adjust to or cope with a particular stressor, like a major life event. Since people with this disorder normally have symptoms that depressed people do, such as general loss of interest, feelings of hopelessness and crying, this disorder is sometimes known as situational depression. Unlike major depression the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. One hypothesis for adjustment disorder is that it may represent a sub-threshold clinical syndrome.
Its common characteristics include mild depressive symptoms, anxiety symptoms, and traumatic stress symptoms or a combination of the three. There are nine types of adjustment disorders listed in the DSM-III-R. According to the DSM-IV-TR, there are six types of adjustment disorders, which are characterized by the following predominant symptoms: depressed mood, anxiety, mixed depression and anxiety, disturbance of conduct, mixed disturbance of emotions and conduct, and unspecified. However, the criteria for these symptoms are not specified in greater detail. Adjustment disorder may be acute or chronic, depending on whether it lasts more or less than six months. According to the DSM-IV-TR, if the adjustment disorder lasts less than 6 months, then it may be considered acute. If it lasts more than six months, it may be considered chronic. Moreover, the symptoms cannot last longer than six months after the stressor(s), or its consequences, have terminated. 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. 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.
Anger is an emotional response related to one’s psychological interpretation of having been threatened. Often it indicates when one’s basic boundaries are violated. Some have a learned tendency to react to anger through retaliation. Anger may be utilized effectively when utilized to set boundaries or escape from dangerous situations. Sheila Videbeck describes anger as a normal emotion that involves a strong uncomfortable and emotional response to a perceived provocation. Raymond Novaco of UC Irvine, who since 1975 has published a plethora of literature on the subject, stratified anger into three modalities: cognitive (appraisals), somatic–affective (tension and agitations), and behavioral (withdrawal and antagonism). William DeFoore, an anger-management writer, described anger as a pressure cooker: we can only apply pressure against our anger for a certain amount of time until it explodes.
Anger may have physical correlates such as increased heart rate, blood pressure, and levels of adrenaline and noradrenaline. Some view anger as an emotion which triggers part of the fight or flight brain response. Anger becomes the predominant feeling behaviorally, cognitively, and physiologically when a person makes the conscious choice to take action to immediately stop the threatening behavior of another outside force. The English term originally comes from the term anger of Old Norse language. Anger can have many physical and mental consequences.
The external expression of anger can be found in facial expressions, body language, physiological responses, and at times in public acts of aggression. Humans and animals, for example, make loud sounds, attempt to look physically larger, bare their teeth, and stare. The behaviors associated with anger are designed to warn aggressors to stop their threatening behavior. Rarely does a physical altercation occur without the prior expression of anger by at least one of the participants. While most of those who experience anger explain its arousal as a result of “what has happened to them,” psychologists point out that an angry person can very well be mistaken because anger causes a loss in self-monitoring capacity and objective observability.
Modern psychologists view anger as a primary, natural, and mature emotion experienced by virtually all humans at times, and as something that has functional value for survival. Anger can mobilize psychological resources for corrective action. Uncontrolled anger can, however, negatively affect personal or social well-being. While many philosophers and writers have warned against the spontaneous and uncontrolled fits of anger, there has been disagreement over the intrinsic value of anger. The issue of dealing with anger has been written about since the times of the earliest philosophers, but modern psychologists, in contrast to earlier writers, have also pointed out the possible harmful effects of suppressing anger.Displays of anger can be used as a manipulation strategy for social influence.
Psychological trauma is a type of damage to the psyche that occurs as a result of a severely distressing event.
A traumatic event involves a single experience, or an enduring or repeating event or events, that completely overwhelm the individual’s ability to cope or integrate the ideas and emotions involved with that experience. The sense of being overwhelmed can be delayed by weeks, years or even decades, as the person struggles to cope with the immediate circumstances. Psychological trauma can lead to serious long-term negative consequences that are often overlooked even by mental health professionals: “If clinicians fail to look through a trauma lens and to conceptualize client problems as related possibly to current or past trauma, they may fail to see that trauma victims, young and old, organize much of their lives around repetitive patterns of reliving and warding off traumatic memories, reminders, and affects.”
Trauma can be caused by a wide variety of events, but there are a few common aspects. There is frequently a violation of the person’s familiar ideas about the world and of their human rights, putting the person in a state of extreme confusion and insecurity. This is also seen when people or institutions, depended on for survival, violate or betray or disillusion the person in some unforeseen way.
However, different people will react to similar events in different ways. One person may experience an event as traumatic while another person might not. In other words, not all people who experience a potentially traumatic event will actually become psychologically traumatized.
Some theories suggest childhood trauma can lead to violent behavior, possibly as extreme as serial murder. For example, Hickey’s Trauma-Control Model suggests that “childhood trauma for serial murderers may serve as a triggering mechanism resulting in an individual’s inability to cope with the stress of certain events.”
Posttraumatic stress disorder[note 1] (PTSD) may develop after a person is exposed to one or more traumatic events, such as sexual assault, serious injury, or the threat of death. The diagnosis may be given when a group of symptoms, such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal continue for more than a month after the traumatic event.
Most people having experienced a traumatizing event will not develop PTSD. Women are more likely to experience higher impact events, and are also more likely to develop PTSD than men. Children are less likely to experience PTSD after trauma than adults, especially if they are under ten years of age.
PTSD is believed to be caused by the experience of a wide range of traumatic events and, in particular if the trauma is extreme, can occur in persons with no predisposing conditions.
Persons considered at risk include combat military personnel, victims of natural disasters, concentration camp survivors, and victims of violent crime. Individuals not infrequently experience “survivor’s guilt” for remaining alive while others died. Causes of the symptoms of PTSD are the experiencing or witnessing of a stressor event involving death, serious injury or such threat to the self or others in a situation in which the individual felt intense fear, horror, or powerlessness. Persons employed in occupations that expose them to violence (such as soldiers) or disasters (such as emergency service workers) are also at risk.
Children or adults may develop PTSD symptoms by experiencing bullying or mobbing.
Despite being the most commonly studied and diagnosed psychiatric disorder in children and adolescents, the cause in the majority of cases is unknown. It affects about 6–7% of children when diagnosed via the DSM-IV criteria and 1–2% when diagnosed via the ICD-10 criteria. Rates are similar between countries and depend mostly on how it is diagnosed. ADHD is diagnosed approximately three times more in boys than in girls. About 30–50% of people diagnosed in childhood continue to have symptoms into adulthood and between 2–5% of adults have the condition. The condition can be difficult to tell apart from other disorders as well as that of high normal activity.
ADHD management usually involves some combination of counseling, lifestyle changes, and medications. Medications are only recommended as a first-line treatment in children who have severe symptoms and may be considered for those with moderate symptoms who either refuse or fail to improve with counseling.:p.317 Long term effects of medications are not clear and they are not recommended in preschool-aged children. Adolescents and adults tend to develop coping skills which make up for some or all of their impairments.
ADHD and its diagnosis and treatment have been considered controversial since the 1970s. The controversies have involved clinicians, teachers, policymakers, parents and the media. Topics include ADHD’s causes, and the use of stimulant medications in its treatment. Most healthcare providers accept ADHD as a genuine disorder with debate in the scientific community mainly around how it is diagnosed and treated.
Loneliness is a complex and usually unpleasant emotional response to isolation or lack of companionship. Loneliness typically includes anxious feelings about a lack of connectedness or communality with other beings, both in the present and extending into the future. As such, loneliness can be felt even when surrounded by other people. The causes of loneliness are varied and include social, mental or emotional factors.
Research has shown that loneliness is widely prevalent throughout society among people in marriages, relationships, families and successful careers. It has been a long explored theme in the literature of human beings since classical antiquity. Loneliness has also been described as social pain — a psychological mechanism meant to alert an individual of isolation and motivate him/her to seek social connections.
Healing In Progress offers a wide range of services. We have over 10 years experience assisting
individuals, couples, families, and children, in reaching their objectives.
Please browse the services on your left for more details, we have compiled informative articles from various sources on the web to help guide you.
If you have any questions, comments, or concerns, please don’t hesitate to ask.