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Disorderly Conduct

Somatoform disorders describe a group of disorders characterized by physical symptoms indicative of a medical disorder. However, somatoform disorders are psychiatric conditions since the physical symptoms present in the disorder cannot be completely explained as a medical disorder, substance use, or another mental disorder. These somatoform disorder physical protests test medical practitioners who must tell apart a physical and psychiatric cause for the patient’s complaints. Frequently, the medical symptoms experienced by patients may be from both psychiatric and medical illnesses. Anxiety disorders and temper disorders often produce physical symptoms. These physical symptoms can radically improve with excellent treatment of anxiety or mood disorder.

The Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) includes a specific category for somatic symptoms related to psychiatric origins called the somatoform disorders. Specific somatoform disorders include

  1. Somatization disorder
  2. Conversion disorder
  3. Pain disorder
  4. Hypochondriasis
  5. Body dysmorphic disorder.

Somatization disorder is a relatively rare disorder that is associated with high medical resource utilization. More common somatization syndromes may not reach the diagnostic threshold for somatization disorder but may be clinically and functionally significant.

As suggested above, somatoform is a psychological disorder whereby an individual experiences severe pain, but when tested by a medical doctor, no signs are found. Such feelings may result in mental distress for the patient. Such conditions may persist for a number of years, and since the symptoms are similar to other diseases one may be treated for the wrong illness. When correctly diagnosed, somatoform disorders can be treated using a combination of psychiatric and medical procedures.

Somatization disorder typically causes pain and brutal neurological symptoms (such as fatigue, headache), digestive symptoms (such as diarrhea, abdominal pain, nausea, constipation, vomiting) or sexual symptoms (such as loss of sexual desire, pain during sexual activity and awfully painful menstruation for women).

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Body dysmorphic disorder is a situation where a person becomes preoccupied with a flaw in his or her physical look that is either a slight flaw or a flaw that is not real. He or she continuously worries about the flaw, which can be any part of the body. Hair loss, wrinkles, size, and weight gain and shape of attribute like the eyes, mouth, nose and breasts, are all widespread concerns for individuals who have body dysmorphic disorder. Such individuals try all kinds of cures for their perceived flaws. It would be no surprise to find body dysmorphic patients under the mercy of a cosmetic surgeon’s scalpels. Even after extreme and numerous surgeries, the patients are never satisfied with their looks and this result in mental distress.

Hypochondriasis comes about when a person supposes that ordinary body functions (such as an irritable stomach) or trivial symptoms (such as a common headache) are symptoms of a very solemn disorder. To a person who has hypochondriasis, an irritable stomach may denote colon cancer and a headache may imply a brain tumor.

Conversion disorder is a situation where physical symptoms that are related to a neurological disorder develop, when no neurological disorder is really present. Vision loss, paralysis of an arm or leg, hearing loss and convulsions are familiar symptoms. Nervous tension may make the symptoms worse.

Somatoform and its psychological symptoms cannot be accurately traced to any particular cause. It is important to understand that somatoform patients do not fake the symptomatic pain that they experience. When a feeling is motivated by psychological conditions, it may become so vivid that the patient actually feels pain. In some rare instances, there may be a hitch with the nerve impulses that transmit signals of extreme pain, strain and other horrible sensations to the brain.

Even though there is no medically acknowledged remedy for somatoform disorders, they can be managed. Treatment concentrates on assisting the patient who has the disorder to live as much of an ordinary life as achievable, even though the patient may still experience a little pain or other symptoms. Fortunately, a somatoform disorder cannot result in death of the patient. In most somatoform cases, doctors usually administer dud pills in order to give the patient psychological appeasement and comfort.

Dissociative disorders are professed this way since they are manifested by a dissociation from or disruption of a person’s basic aspects of waking consciousness (such as one’s personal history, one’s personal identity). Dissociative disorders are experienced in numerous forms, the most well-known being the dissociative identity disorder (previously referred to as multiple personality disorder). All of the dissociative disorders are thought to arise from shock experienced by the patient with this disorder. The dissociative characteristic is assumed to be a coping method. The person factually separates himself from an experience or situation that is too traumatic to incorporate with his conscious self. Indications of dissociative disorders, or even one or more of the disorders themselves, are also seen in several other mental diseases, including panic disorder, post-traumatic stress disorder and obsessive compulsive disorder. As with most somatoform cases, most dissociative cases are difficult to diagnose using standard medical and mental health assessments. This is especially so since most medical professionals are under-trained on dissociative disorders. They may, as a result, fail to consider these conditions when making diagnosing. As a result, most dissociative disorders are under reported, and the present number of patients may be a misrepresentation of the facts. Dissociative disorders are usually misdiagnosed as schizophrenia, bipolar and borderline personality disorder.

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Localized amnesia is evident in an individual who cannot remember detailed events that occurred, frequently traumatic. The loss of memory is limited to a small window of time. For instance, a survivor of an automobile crash who cannot remember the experience until two days after is going through localized amnesia.

Dissociative amnesia: This illness is characterized by a blocking out of important, private information, usually of a distressing or stressful nature. Dissociative amnesia, in contrast to other types of amnesia, is not a consequence of other medical trauma (e.g. a blow to the head).

Selective amnesia occurs when an individual can remember only minute parts of events that took place in a distinct period. For instance, an abuse casualty may only remember several parts of the sequence of proceedings around the abuse.

Systematized amnesia is distinguished by a failure of memory for a precise category of information. A person with this disorder could, for instance, omit all memoirs about one specific family member.

Dissociative fugue is an unusual disorder. A person with dissociative fugue abruptly and unexpectedly takes bodily leave of his or her environment and sets off on a trip of some kind. These trips can continue for hours, or even some days or months. People going through a dissociative fugue could travel over thousands of kilometers. An individual in a fugue condition is oblivious of or confused about his personality, and in a number of cases will presume a new identity.

Dissociative identity disorder (DID), commonly known as multiple personality disorder, is the most prominent of the dissociative disorders. A person going through multiple personality disorder has more than one separate identity or personality state that is exemplified in the individual on a frequently. This disorder is also manifested by disparities in memory which change with the patient’s other personalities.

Depersonalization disorder is manifested by a sentiment of separation or distance from one’s own body, experience or self. These sentiments of depersonalization are intermittent. Of the dissociative disorders, depersonalization is the most easily recognized with by the general public; one can simply recount feeling as if in a reverie, or being “spaced out.” Feeling out of control of one’s deeds and activities is something that people narrate when drunk. A person with depersonalization disarray has this occurrence so regularly and so relentlessly that it interrupts his or her ordinary functions. An individual’s experience with depersonalization can be so rigorous and vivid that he or she believes the outside world is imaginary or vague.

Some of the symptoms experienced by an individual with dissociative disorder include, finding yourself in a bizarre place without knowing how you got there, spaces in memory, loss of feeling in parts of your body, out-of-body experiences, forgetting significant personal information, a sense of detachment from your emotions, indistinct views of your body, feeling detached from the world, inability to make out your image in a mirror, feelings of being unreal, the notion of watching a film of yourself, internal voices and conversation, and being puzzled about your sexuality or gender.

A similar mental illness is the infamous bipolar disorder. This refers to a mental disorder in which patients go back and forth between episodes of a very good or short-tempered mood and depression. The “mood swings” between obsession and depression can be very swift depending on the extent of the disease. Individuals with this disease experience unusual shifts in energy, mood and activity levels. This limits their ability to carry out normal daily tasks. Symptoms of bipolar disorder can result in broken relationships, failed school work, poor job performance and in some extreme cases, suicide. Actually, in the United States, an estimated 3.5% of individuals with bipolar depression commit suicide, and up to 60% of suicides are committed by individuals who had some form of depression.

Bipolar disorder has equal prevalence among both sexes. Most cases are reported to have started between ages 15 – 25. The precise origin is unidentified, but it transpires frequently in relatives of people with bipolar disorder suggesting that it is a genetic disorder. There are several types of bipolar disorder with the most common being type 1, type 2, bipolar disorder not otherwise specified (BP-NOS)  and cyclothymia.

Individuals with type 1 bipolar disarray have had at least one hyper occurrence and periods of serious depression. Previously, bipolar disorder type I was referred to as maniac depression. Patients of type 2 bipolar disorder have never had complete mania. Rather, they go through periods of soaring energy levels and recklessness that are not as intense as mania (called hypomania). These episodes interchange with phases of depression. BP-NOS is diagnosed when an individual has an indication of the illness that do not satisfy the diagnostic standards for either bipolar I or II. The signs may not be prolonged enough, or the patient may have very few symptoms, to be diagnosed with bipolar I or II. Cyclothymia is a mild form of bipolar depression involving less severe mood swings. Patients alternate from mild depression to hypomania.

An interesting fact is that there is no obvious reason for the depressive or manic episodes. Simple and harmless situations may lead to episodes of depression. Some of the most noted symptoms of bipolar depression are easy distraction, poor judgment, little need for sleep, reckless behavior, poor temper control, lack of self control, Binge drinking, drug use, spending sprees, sex with many partners (promiscuity), very involved in activities, elevated mood, excess activity (hyperactivity), augmented energy, increased self-esteem, racing thoughts and very upset (agitated or irritated) during the maniac stage. In the depression episode, the individual has fatigue or lack of energy, loss of self-esteem, feeling worthless, hopeless, or guilty, loss of appetite and weight loss, difficulty concentrating, remembering, or making decisions, thoughts of death and suicide and pulling away from friends or activities that were once enjoyed.

Unipolar depression is also known as major depressive disorder, clinical depression or recurrent depressive disorder. It is a mental disorder that encompasses episodes of extreme depression. Unlike bipolar depression, unipolar depression does not have alternating episodes from mania to depression. The vast majority of patients with unipolar depression has non-melancholic depression while the majority of those with bipolar disorder have melancholic or psychotic depression.

The main reason blamed for melancholia is psychomotor disturbance. This could either be psychomotor retardation or agitation. Psychomotor retardation is characterized by a profound lack of energy in the morning, poor attention and talking slowly. Agitation is the exact opposite and involves rapid movement, fast speech, inability to sit down and pacing around.

Treatment and control of unipolar and bipolar depression mainly involves the same techniques. The main objectives of treatment are to avoid changing from one episode to the other. The individuals should be treated to avoid prolonged stays in hospitals and prevention of self-injury or suicide. Medication to suppress the episodes should also be administered to patients. The most common mood stabilizers are Carbamazepine, Valproate (valproic acid), Lamotrigine and lithium. After administration of mood stabilizers, antipsychotic and antidepressant medications are given to the patient. In cases where the patient does not react to prescription, electroconvulsive remedy may be administered. This treatment involves passing an electric current to create a short convulsion while the patient is under anesthesia.  In addition to the medical treatment and therapy, a patient is encouraged to join a support group.