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June 17 2021

Delusional Disorder

Delusional disorder (Paranoid disorder) is characterized by having continuous delusions where the person cannot tell what is real versus what is just part of their self-assumed delusion/fantasy. Delusions may also occur with other types of mental health issues such as paranoid delusion, schizophrenia, bipolar disorder, and certain personality disorders.

Overview

Delusions are persistent beliefs in something that is not real or factual, but they are also not completely unrealistic. Delusional Disorder involves delusions that are not necessarily bizarre delusional or strange and usually include false perceptions or practices. However, in reality, these beliefs are either not true or are highly overstated. Conversely, a bizarre delusion is something that could never take place in real life such as flying high in the sky without being in an airplane or traveling to Mars, etc.

People with Delusional Disorder (Paranoid disorder) can usually continue to connect with people and function normally. They do not behave in an odd or disturbing manner but in some circumstances, they may become so entrenched with their delusions that their lives are disturbed. Delusional Disorder Delusional Disorder itself is not as common as seeing it occur because of psychological disorders. Delusional Disorder often occurs during middle age to late in life and is more common in women than men.

Girl is depressed with Delusional Disorder

Symptoms of Delusional Disorder (Paranoid disorder)

Non-bizarre delusions which are the most evident symptoms
Being short-tempered
Aggression
Poor mood
Hallucinations such as feeling, hearing, or seeing things that are not real

Causes and Risk Factors of Delusional Disorder:

The causes of Delusional Disorders are unknown but there is a role of genetics, environmental, or psychological factors that make them t more likely to occur.

Genetic factors

Like with some mental health disorders, there is a thought that a person is predisposed to having a Delusional Disorder which would have been passed on to the individual from their parents. When parts of the brain that regulate perception and thought patterns do not function properly, it can cause symptoms of a Delusional Disorder.

Environmental/psychological factors

Studies support that stress can give rise to the symptoms of Delusional Disorder. Intake of alcohol and illicit drugs may also add to it. People who are alone are more at risk to develop a Delusional Disorder.

Types of Delusions with Delusional Disorder (Paranoid disorder)

There are 6 Different types of Delusional Disorders like Erotomanic Delusional Disorder, Grandiose Delusional Disorder, Jealous Delusional Disorder, Persecutory Delusional Disorder, Somatic Delusional Disorder, and Mixed Delusional Disorder. Details are mentioned below.

Erotomanic Delusions: The person believes that someone is in love with him, and he may try to connect with that person. Usually, Erotomanic Delusional Disorder centers around a famous personality. It may lead to stalking behaviors.
Grandiose Delusions: This is a magnified sense of self-obsession, supremacy, acquaintance, or personality delusion. The person in Grandiose Delusional Disorder believes that he is exceptional and that he has a significant influence.
Jealous Delusions: The person thinks that his partner is disloyal and, the person may believe that a particular person has better attributes. This is the Delusional disorder jealous type in the list of delusional disorders.
Persecutory Delusions: The person in Persecutory Delusional Disorder leads its victim to believe that they are not being treated well by others or that someone is out to harm them in any way.
Somatic Delusions: Somatic Delusional Disorders are focused on perceived physical impairments or medical issues.
Mixed Delusions: Persons with Mixed Delusional Disorders have two or more of the types of delusions listed above.

Common Complications of Delusional Disorder (Paranoid disorder)

Individuals that suffer from Delusional Disorder (Paranoid disorder) may develop depression because of the consequences that occur related to their delusions. Reacting to the delusions also can evoke feelings of fear or they can lead to legal problems. For example, an individual with erotomanic delusions stalks or bothers the object of their delusion and their actions (e.g., stalking) can lead to an arrest. The individual can also be socially isolated and especially if their delusions interfere or harm their relations with others.

Diagnosis of Delusional Disorder:

There currently is no lab or medical tests available to determine a diagnosis of Delusional Disorder. If medical tests are done, it is to rule out any physical cause for the symptoms of Delusional Disorder. These include:

Obsessive-compulsive disorder
Epilepsy
Alzheimer’s disease
Hallucination
Delirium
Schizophrenia or other mental health problems

If medical reasons for the symptoms are ruled out, the individual may be referred to a psychiatrist to collaborate on the diagnosis and for potential psychotropic medications.

To meet the diagnostic criteria for Delusional Disorder (Paranoid disorder) the person must have one or more delusions that last for one month or longer. The delusions have to affect the person’s life. The presence of mania or major depression should not accompany the delusions, and another mental health issue, medical condition. or medications are not suspected as the causative factors for symptoms.

Treatment of Delusional Disorder (Paranoid disorder)

Psychotherapy and medications together can help manage Delusional Disorder (Paranoid disorder). The therapeutic approaches best used are:

Individual psychotherapy helps the individual to identify and correct thinking patterns.
Cognitive-behavioral therapy helps to recognize and transform the thoughts and behaviors that lead to delusions.
Family therapy helps families to deal with the loved one that has Delusional Disorder.

Medications: Usually an antipsychotic will be prescribed such as: :

- Conventional antipsychotics work by blocking dopamine receptors in the brain, which are involved in the development of delusions. Conventional antipsychotics include Fluphenazine (Prolixin) and Loxapine (Oxilapine) etc.
- Atypical antipsychotics work by blocking dopamine and serotonin receptors in the brain which are both somewhat involved in causing delusional disorder. These drugs include Clozapine (Clozaril) and Iloperidone (Fanapt) etc.
- Other medicines: Anti-depressants, sedatives, tranquilizers, and anti-anxiety drugs might help with depression, anxiety, or mood swings

June 11 2021

Attention Deficit Hyperactivity Disorder

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Attention Deficit Hyperactivity Disorder (ADHD) | Symptoms, Causes & Treatment

Attention Deficit Hyperactivity Disorder (ADHD) is a type of neurodevelopmental disorder that is characterized by poor concentration and attention, being disorganized, forgetting information, impulsivity, and can also include hyperactivity, restlessness, and inability to sit still.

Overview

ADHD has become one of the most common neurodevelopmental disorders in children and adolescence. It is mostly diagnosed in childhood when the child is struggling academically or has hyperactive behaviors. The disorder is caused by a chemical imbalance in the brain and lasts into adulthood. Signs of ADHD are more prominent in males than females. Although ADHD treatment cannot provide a 100% cure for ADHD, it can help to minimize attention deficit hyperactivity disorder symptoms. Early attention deficit hyperactivity disorder diagnosis and management of ADHD can help in dealing with the severity and later complications of the disorder.

Many people with ADHD enjoy successful lives. People with ADHD are usually artistic, work well with their hands or at a job they enjoy. If ADHD treatment for adults and children is not done timely, it can have a serious impact on their day-to-day functioning and can lead to difficulties with relationships, academics, and work-related tasks. Additionally, untreated ADHD in adults can present as depression or anxiety.

Following Topics of This Blog Have Been Discussed Below:

Symptoms

Types

Causes

Diagnosis

Treatment

Triggers of Attention Deficit Hyperactivity Disorder Symptoms – ADHD Symptoms

Common triggers:

Overstimulation
Stress
Poor sleep cycle
Some specific foods additives

Once the triggers for Attention Deficit Hyperactivity Disorder symptoms are recognized, some lifestyle changes can help to minimize attention deficit disorder symptoms.

(ADHD) Symptoms

The Attention Deficit Hyperactivity Disorder Symptoms in children and teenagers include:

Inattentiveness

Short attention span and is distracted easily
Carelessness
Forgetfulness or losing things
Inability to stick to time-consuming tasks
Inability to focus on instructions
Difficulty with organizational skills

Hyperactivity and impulsivity

Inability to sit still
Fidgeting
Inability to concentrate on tasks
Unnecessary physical movement
Too much talking
Inability to wait for their turn
Impulsive actions and reactions
Interrupting conversations

Attention Deficit Hyperactivity Disorder Symptoms in adults may include:

Lack of attention
Carelessness
Starting new tasks before finishing old ones
Poor organizational skills
Inability to focus
Losing things
Forgetfulness
Restlessness and agitation
Difficulty staying quiet, and interrupting conversations
Impulsivity
Irritability and aggression
Too much stress and inability to deal with it
Impatient behavior
Risky behaviors
Poor money management
Depression and/or anxiety

Chart of Attention Deficit Hyperactivity Disorder

(ADHD)Types – ADHD Types

There are three subtypes of ADHD:

Inattentive subtype: The person suffers from the inability to focus, maintain attention, is distracted, forgetful, and exhibits impulsive decision-making skills.
Hyperactive-Impulsive subtype: This is the least common type of ADHD and it is characterized by hyperactive behaviors without the problems of inattention. The person cannot sit still and may easily interrupt others.
Combined subtype: This type of ADHD involves the attention deficit disorder symptoms of both types of ADHD mentioned above.

(ADHD)Causes

The specific Attention Deficit Hyperactivity Disorder causes and risk factors are not known, but research shows that genetics play an important role in the incidence of ADHD.

Other risk factors for ADHD include:

Brain injury
Exposure to environmental toxins during pregnancy or at a young age
Alcohol and tobacco use during pregnancy
Premature delivery
Low birth weight

According to research, ADHD is NOT caused by too much sugar intake, excessive screen time, bad parenting, environmental and societal factors, and family problems. In some people, such factors might aggravate the ADHD symptoms, but they are not the ADHD causes.

Conditions related to ADHD

One of the most common conditions that come with ADHD is depression.
Personality disorders which occur as a complication of ADHD
Bipolar disorder might be comorbid with ADHD depending on the severity of mood changes
Obsessive-Compulsive Disorder (OCD) is a disorder that causes obsessive thoughts and compulsive behaviors and responses to conditions
The behavioral disorders associated with ADHD can also cause problems such as difficulties in social interaction and relationships.
An anxiety disorder, development of phobias, or panic attacks

ADHD Diagnosis

There is no single test to evaluate if a child or an adult has ADHD. The disorder is thought to affect the chemical balance in the right frontal lobe of the brain. Testing conducted by a neurologist or neuropsychologist can help determine how the brain is functioning when performing different tasks on testing measures. A psychiatrist can also consider the history and evaluate all active symptoms.

ADHD Treatment

Attention Deficit Hyperactivity Disorder treatment usually includes medication, behavior modification or cognitive behavioral therapy, or both.

ADHD Medication

ADHD Medication work by influencing the chemical imbalance of the brain. This results in the ability to focus, maintain attention, decrease impulsivity, and reduce hyperactivity. The medications to treat ADHD are stimulants and non-stimulants. Central nervous system stimulants are commonly prescribed medicines for ADHD. These medicines increase the production of dopamine and norepinephrine and are amphetamine-based stimulants (e.g., Adderall, Concerta, Ritalin, Vyvanse)

If an individual has negative side effects from stimulant Attention Deficit Hyperactivity Disorder medications, a non-stimulant can be prescribed such as Strattera. If depression is present, a psychiatrist may prescribe bupropion (Wellbutrin) because there is a chemical compound in the drug that also helps to minimize ADHD symptoms.

Behavioral / Psychotherapy for ADHD:

Individuals with ADHD often benefit from mental health counseling. Some individuals with ADHD might also have other conditions such as depression or anxiety. In this case, counseling can help with both ADHD and comorbidities.

Types of psychological therapy for ADHD include:

Behavioral therapy: Parents or partners of the individual can learn multiple strategies to help with modifying the individuals’ behaviors through using positive and negative reinforcement.
Social skills training: This training can help the individual to learn appropriate social behaviors and coping skills.
Parenting skills training: Helps parents to learn different ways to understand their child with ADHD and how to apply structure and help follow through with behavior modification.
Psychotherapy: Helps the individual learn better ways to cope with frustration, impulsivity, and vacillating emotions. It can help to improve self-esteem.

February 21 2021

Managing The “New Normal” During COVID-19

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Normalizing the “new normal”

As many of us are learning to manage this “new normal” during the COVID-19 crisis, we have had to redefine many aspects of our lives. Some has gone from the traditional 9 am to 5 pm job to remote offices-coffee and computer on hand at the dining room or kitchen tables. Others are suddenly thrust into a new life of remote learning with their children. Here in New York, car parades have replaced milestone achievements such as birthdays, anniversaries, and visits from teachers who miss their students. First responders and healthcare workers are waking up every day knowingly putting themselves at risk to save others. What amazing resiliency to observe around my neighborhood, New York, the United States, and the world.

Managing The “New Normal” During COVID-19

The question I ask is, what about the resiliency of our thoughts and emotions as well? How do people tap into those same skills that made them say “Hey Coronavirus! You won’t ruin my daughter’s graduation” and apply them in a way they can combat the thoughts that fuel anxiety, depression, loneliness, and worry? The truth is, we as humans are amazing at adapting. We just need to have confidence that we can.

Below I have outlined some strategies that can help tap into this idea of mental and emotional adaption. It is important to remember; this does not mean to ignore any worrisome thoughts but rather, identify them, experience them, and adapt them to be more effective in your daily life.

Give your day purpose

It may feel like you are stuck on repeat, new day, same boring routine, and no place to go because of Covid-19. For some, that can elicit thoughts of depression and isolation. Setting simple goals during the day can help combat these thoughts. It will make you feel productive in a situation that sometimes feels overwhelmingly unproductive.

Focus on what you CAN control

You may not be able to visit your family or loved one in person before Covid-19, friends, however, the sky is the limit on finding ways to tell them how much you cherish and love them. You CAN carve out time to call them just to say hi. You CAN send them a beautiful handwritten letter. You CAN apply this thinking in any area that is a cause of anxiety or depression.

Gratitude

While the days may feel long and overwhelming, adapt your thinking to find something you are grateful for. Focus on some positives. Maybe you are grateful for not having a 2-hour commute each morning. How wonderful, you now can stay in bed late and catch up on all those missing hours of regenerative sleep. Others might be grateful for the opportunity to be able to sit down and have breakfast with their family without the anxiety of being late for something for the first time in years because of Covid-19.

Lastly, remember, with every negative there is a positive. They cannot exist without each other. Many of us have experienced great loss during this time. However, maybe that loss gave you the ability and courage to contact a fading friendship you had been wanting to reach out to. Maybe, it allowed you to cherish those who are around you even more. Perhaps it made you increasingly mindful of your experiences, making each moment count.

Stay well,

Christina

Committed to helping
people who want to help themselves

1-800-403-4360

February 21 2021

Regulating Your Emotions Through COVID-19

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COVID-19 Pandemic and Its Emotional Consequences

None of us will forget the year 2020 and all the different emotions we have experienced. So many people still suffer from feeling some form of depression, anxiety, fear, or paranoia. Then there is the other side where some people are rebelling against the COVID-19 restrictions put on us. Many of us have been overwhelmed and stressed by trying to keep our families financially and physically afloat. Believe it or not, a lot of the stress we feel is silent. Just imagine how much more stress is underneath if you are feeling stressed, to begin with.

Here is an exercise for you. Take 10 minutes to step back, clear your mind, and reflect on certain experiences you had in 2020. Then ask yourself, “If life was what we used to know as normal, would I have been less irritable, less edgy, more flexible, or reacted differently to something this year?” I bet you will find yourself saying, “Yes, I would have reacted differently and probably better than I did.”

With the second wave of COVID upon us, no one knows what to expect. Depending on what television station you watch or article you read on the Internet, you are going to get different or conflicting information. It is sad because we do not know what is factual anymore. Sometimes I think what is reported goes with the way the political wind is blowing for the week. The influence of media is entirely another subject to address at some other time.

For those working from home, it was great for maybe a month but now it is another way that many of us feel trapped and socially isolated. We do not think about how much our work environment is a form of socializing. When you add a household that is typically busy and you have family members around all the time or children who are remote learning, stress levels go even higher, especially if your residence is not big enough for everyone to have their own private space to retreat to.

With winter approaching fast, the feeling of being trapped is going to get worse. People tend to become more depressed during the winter months because the cold weather leaves outside activities to be non-existent for some, and for others that typically go skiing or engage in another winter outside activities, with COVID they are thinking twice about traveling to enjoy these activities.

COVID has had devasting emotional effects. As a clinician, I am witnessing firsthand the emotional toll this has taken on many clients. Sadly, COVID and the restrictions it brings are not over by any stretch of the imagination. It will be one day, but not soon. As those infected continue to rise right now and more restrictions are put into place, any emotional issues or negative reactions you have been experiencing in 2020 that you are aware, or unaware of, are about to get worse. There are things that you can do to help yourself through the upcoming months. Here are some ideas:

Limit your information intake from any form of media, including social media, to 30 minutes a day. When listening or reading, try to keep objective and realize that what you might be hearing or seeing be skewed.
Start and keep a regularly scheduled routine for self-care. The mindset that you are not showering or getting dressed daily because no one sees you are one of the worst thought patterns. You are falling into a trap that can easily lead to or enhance, depression.
If you are working from home, it is important to keep yourself to a routine. Work your typical workday and do not fall into a cycle of working all different hours. Treat working at home as if you went into your place of employment and when you are done for the day, you are done for the day. Now it is time for you and/or your family.
Whether living alone or with family, take 30 to 60 minutes a day to turn your mind off and relax. This could be exercising, going for a walk, going for a drive if it is cold out, or becoming involved in a hobby or activity that you enjoy. Try an online class for something you always wanted to learn or do. If living with other adults, encourage them to do the same. Healthy outlets reduce tension in the household.
Take the time each evening to keep a journal or just type into a document what you are feeling and experiencing. The thoughts don’t have to be organized because this is just for you. Even getting emotions out in this way helps. It is also something you can look back on one day and say, “wow, I didn’t realize how bad I was feeling at the time.”
If you feel very stressed and catch yourself being irritable or angry, walk away from a situation or at the minimum count to 20 before you react. This takes practice but you can do it! It will save the heartache from potential arguments with others and is a way to keep you grounded.
For consistent mental grounding here is an exercise that my clients tell me works. I give it to them because it has worked well for me. Imagine yourself looking at a field of windmills. You notice that each windmill stops from time to time. Now imagine you take every one of the issues you are handling that cause stress and assign each one of them to their windmill. As you do this you are taking each issue and putting it in front of you where you can see it, rather than keeping it inside of yourself. Once you are done you now have your personal space around you and vow to keep this space. When a windmill stops it means that a particular issue needs your attention. You address it only to the point the windmill is ok for now and starts up again, but now you leave it until the next time it stops and needs your attention. Treat each windmill the same.
Seek therapy sessions. Talking to a non-judgmental clinician can be very helpful. All of the answers are inside of you, but sometimes we need someone to guide us to find them.

One of our staff is developing a webinar on regulating emotional reactions when overwhelmed or stressed. It will be airing in February. In the meantime, check out our webinar page to see if any current topics can help with a particular issue you are having.

Theresa DeSantis, Ph.D.

Committed to helping
people who want to help themselves

1-800-403-4360