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Intermittent Explosive Disorder

Intermittent Explosive Disorder – More Than Just Anger

Intermittent Explosive Disorder (also called IED, that is appropriate as it can go off unexpectedly and cause significant damage)

Intermittent Hulk Explosive DisorderProbably everyone knows that teenage boy (or girl) who punched a hole through the wall.  Perhaps for some, this became a regular pattern of behavior during adolescence but most of those teenagers outgrew it.  In fact, at least one-quarter of teenage boys has done something dumb like punching a wall.

One boy I knew in high school even broke his hand by punching the roof of his car, and some boys were routinely doing stupid stuff.  Despite that, all of it was teenage angst and changes that can be attributed to the massive amounts of testosterone flowing through the male adolescent body – none of them had intermittent explosive disorder.

Intermittent Explosive Disorder is worse than punching a hole through a wall.

It typically is first identified in the early teens – but can be seen much earlier in some cases.    In order to be actually characterized as intermittent explosive disorder, an individual must have had three episodes of explosive behavior that is severely out of proportion to the stressor.

Intermittent Explosive Disorder HulkinsectThey must have broken or smashed something that is monetarily valuable (more than a few dollars), physically attacked or made explicit threats to attack someone with the intent of causing harm.  If these three episodes occur within the space of 12 months, the disorder is considered to be more severe.

Here is the catch.

How do you distinguish between IED, average – though extreme teenage behavior and other psychiatric conditions?  It turns out that IED is probably a diagnosis of “if nothing else fits” as other psychiatric disorders certainly overlap with similar symptoms – and you have to rule out the adolescent hormone issue.

Bipolar disorder may cause outbursts of extreme anger and agitation, Borderline personality disorder may cause outbreaks, ADHD patients can exhibit a severe lack of self-control, and drug abuse is always a potential cause.  Even though those diseases may cause IED-like events, a sustained behavior pattern is something to address.

Intermittent Explosive Disorder WarningA recent study reported by the National Institutes of Health shows that IED can actually affect up to 4 percent of adults and lead to an estimated 43 attacks over a lifespan.  The disorder may also increase that chance of depression, anxiety and substance abuse disorders.  People with IED have an obvious increased risk of legal trouble, financial difficulties, and divorce – that’s a no-brainer.

So the biggest problem for mental health professionals, like many other disorders, is to untangle all of the information leading in and out with a mix of behaviors and a mix of causes.  What came first – the chicken or the egg?  What came first – the drug abuse or the anger?  Which illness is more important – bipolar disorder or the IED?

One of the biggest clues may be in examining (or better, paying attention to) behavior that occurs before puberty.  In other words: What came first – the behavior or puberty?  Clearly if the behavior started before puberty, there was and is an issue.  If the behavior begins during adolescence – you have to wait (and hope) to see if the behavior goes away once the hormones are settled.

IED is not a simple diagnosis.

It requires a careful examination of an entire psychiatric and behavioral history – and the “ruling out” of a lot of other disorders that may be to blame.  Unfortunately, in the end – unless an underlying cause can be found, there is no medicationAnger management and cognitive behavioral therapy are likely the only answer – minimization of harm, not very satisfactory if it was your car window that got smashed in a fit of rage.

Melissa Lind

Depression and Women

Does women suffer from depression more often than men?

Depressed ManBoth men and women suffer from depression, but studies have shown that women suffer from depression twice as much as men do. Over the decades, many things have been blamed on a woman’s biological function, and a great deal of research has been put into this.

While a woman’s biological function does play a role in depression, other factors come into play as well. Several decades ago, women had very little control over their lives. It was standard that the man of the house — whether that was a woman’s father, husband or a grown son — made the decisions and had all of the control.

This lack of control can lead to depression, both in men and women. But since it was women who were the ones without any control, it was more often they that had to deal with the depression that this causes. Today, however, women are more in control. But there are still factors that affect them, as much as men, that lead to depression, such as relationship problems, the loss of a loved one, and financial changes.Depression, sadness and lonelyness

Furthermore, society shows us images of what women are “expected” to be, and these are things that few women in the world can live up to. This in turn affects the self-esteem, which in turn can lead to depression. Women see men’s reactions to those unrealistic images, and think that this is what they are supposed to be.

Women, who were children in the sixties, are in a real quandary today. Then, the world was changing for women. Depressed Woman - All AloneThose women were raised in homes where the old standards still applied, and then tossed into the world where all of the rules, standards, and social expectations had changed. This has contributed to even more self-esteem issues. The question “Who am I, and who am I supposed to be?” becomes very hard to answer.

So, yes, women do suffer from depression more often than men, and while hormones do play a role, there are many other aspects of life that also contribute to depression for women.

Never assume that a female is just suffering from PMS and that everything will be better in a few days!

Differences between male and female depression:
Women tend to: Men tend to:
Blame themselves Blame others
Feel sad, apathetic, and worthless Feel angry, irritable, and ego inflated
Feel anxious and scared Feel suspicious and guarded
Avoid conflicts at all costs Create conflicts
Feel slowed down and nervous Feel restless and agitated
Have trouble setting boundaries Need to feel in control at all costs
Find it easy to talk about self-doubt and despair Find it “weak” to admit self-doubt or despair
Use food, friends, and “love” to self-medicate Use alcohol, TV, sports, and sex to self-medicate
Adapted from: Male Menopause by Jed Diamond

Psychologically and Physiologically Addictive Medications

Are antidepressants psychologically or physiologically addictive? – Kind of – but not in the way that you think!

For many years, most of the medical community have held steadfast to the idea that antidepressants were not “addictive.” But many Prescription Pain Medicationof those, not in the medical community or those with no personal experience of drug abuse or psychiatric illness, were convinced that those happypills were subject to abuse.  In fact, both were wrong.  Antidepressants are not “abusable“, but they are sort of “addiciting“.

To be clear – antidepressants are not subject to abuse.  They do not produce a “high” or anything like intoxication.  There is no immediate reward for taking antidepressants; in fact, one of the most troublesome things about antidepressants is that they take several weeks to actually work.

However, there is a difference between “abusabledrugs and “addictivedrugs.  Addiction is generally thought of as a psychological illness – in the way that marijuana and cocaine are psychologically addictive.  There is little evidence that either drug is physiologically addictive.  The body does not become dependent on the drug… the brain may – but not the body.

On the other hand, some medications are physiologically addictive – without being psychologically addictiveHormones are an example of this.  Once you start taking hormones (such as estrogen replacement), your body will adjust to the presence of the Psychologically Drug Addicted Dreammedication – and if suddenly discontinued, will not function normally.  There are many other examples of this, but you get the point.

Drugs like heroin, alcohol, and tobacco are psychologically addictive – but they are also physiologically addictive.  In addition to the brain “wanting” them, the body “needs” them to function normally.  If you suddenly take away the heroin, a severe withdrawal syndrome will begin.  If you suddenly take away alcohol – you may have seizures and a number of life-threatening conditions.

Prescription pain medications and anti-anxiety agents, when taken inappropriately can also be both psychologically and physiologically addictive – like heroin and alcohol.  When taken as prescribed, they are often still physiologically addictive.

Back to the antidepressants.

Certainly, years ago, sudden withdrawal of prescription antidepressants was known to be dangerous. But, with the development of selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Paxil, and many others, most people have believed that there was no chance of physical addiction, and there would be no withdrawal.

Over the years, I would hear about people who complained of “withdrawal” symptoms which I dismissed – like most people in the medical community.  Many of these patients also had a myriad of complaints – generalized pain, foggy thinking, and other things that were considered to be indicative of a hypochondriac or chronic complainer.  Turns out maybe I was wrong.

SSRIs and other “next generation” antidepressants CAN cause withdrawal symptoms.  Some (not all but some) patients may experience symptoms of withdrawal such as Anxiety.

  • Anxiety
  • Anxiety and irritability
  • Depression and mood swings
  • Light-headedness and dizziness
  • Fatigue, headache and flu-like symptoms
  • Electric shock sensations
  • Loss of coordination, tremors and muscle spasms
  • Nausea and vomiting
  • Nightmares and difficulty sleeping

Most people don’t experience these – or have only a mild reaction.  Unfortunately, even “tapering” down won’t make that much difference as the symptoms may take a long time to go away – but the withdrawal is real and shouldn’t be dismissed!

Melissa Lind

The Biology of Stress

Biology of Stress – Another state of mind – another physical state

Stress has always existed. It is a natural phenomenon that humans and animals have in common. We know for sure that all mammals (hereby also humans) stress. It is the same hormones which are activated for all mammals, and it is driven by the same area of the brain, namely the primitive part of the brain, deep inside the organ.

Humans have this part of the brain in common with all other mammals, but we have an exterior part of the brain, a couple of “layers”, so to speak, which is very developed. Not all mammals have as much brain-material around their primitive brain.

This developed part of our brain is a good thing; this is what gives us a very developed social life. But it is not always good when we speak about stress, because this part of the brain may produce stress, just by the power of thoughts.

Stress has an influence on all our body

When we are stressed, we release a stress hormone, which means that we get into another state. Generally, we get in this situation if we feel we are in danger, and we are getting ready to fight or flee: Adrenalin gets pumped up in our body; our heart beats quicker; our muscles get ready for action (fight or flight) and get tense. Then, another hormone is released: Cortisol. That hormone gives us some extra power by using a significant amount of energy from our body.

All of our senses are sharpened, and this is why, when we are under stress, we are more efficient. We are more attentive to what is happening and, therefore; we can easier do more than one thing at a time, we are more efficient, we can remember better.

So stress isn’t a bad thing, so to speak. It has its justification and a good reason to be here.

StressNow, as you can see the state in which our mind and body go to be an acute state. That means that it is a state of being used for an extreme situation. (Generally dangerous ones.) All these hormones and that heightened state we are in are not meant to be a constant state. It is supposed to be used in acute situations.

Dangerous stress situations arises

Stress hormones get pumped up – Your “machine” is getting boosted – You can take care of the situation (or flee from it) – Hormones stop pumping up, and you need rest, so the whole machine is getting back to its usual state. It takes a few minutes before the level of stress hormones is going down, and it will take hours before your body is back in “normal-mode”.

It is no surprise that if you are constantly in “high awareness mode” with Adrenaline and Cortisol almost constantly pumping in your system, this will not do you good.

It is a state supposed to be used on rare occasions, not a state you are supposed to be in for a long period of time. Your body wasn’t built for that.

Biology of Stress

Vitamins for Your Mental Health

Vitamins help you body in a number of different ways.

First published on http://bipolarmentalhealth.com

Many people do not realize that vitamins are also crucial for helping the health of your mind. Depression is one of the many mental illnesses that can really help to ruin a person’s life if left untreated. If you are hoping to deal with your depression in a way that is healthy to your body but does not include the use of drugs, you might want to gain a better understand of just how vitamins can work for your depression.

Vitamin supplements can help you fight your depression.

Norwegian Salmon - Vitamin B12 FoodFirst and foremost, study the B vitamins.

B-complex vitamins are essential to your well-being, including your mental and emotional health. They are water-soluble, which means that they cannot be stored in the body over time to be used at a later date, and so you must eat foods rich in B vitamins every day or take vitamin supplements.

B-vitamins that could cause or add to your depression, include thiamin, which provides energy to your brain, and pantothenic acid, which is crucial in the formation of certain hormones that suppress depression.

Most other B vitamins affect your mental and emotional state as well, and because they are broken down in the body by alcohol and sugar, many people find it a struggle to eat enough food rich in the B vitamins. You should talk to your doctor about vitamin supplements in these areas in order to treat your depression.

Vitamin C is also extremely important in the fight against depression.

Normal levels are usually easy to achieve in the body, but you might find that you need a boost from vitamin supplements if you have recently had surgery or an inflammatory illness. Lack of vitamin C is common if you are stressed or pregnant, so be particularly observant of your depression during these times of life.

A variety of minerals, like magnesium, calcium, and zinc can also help you to fight your depression. The bottom line is that it is important for you to talk to a doctor if you believe that you are depressed.

Vitamin supplements and medical care can help you to fight depression in many cases. You doctor will be able to recommend brands that are of high quality and instruct you on how to take the vitamin supplements so that your body can get all of the nutrients it needs to stay happy and healthy, both physically and mentally.