Tuesday 15 December 2009

Depression in Pregnancy

Pregnancy is supposed to be one of the happiest times of a woman's life, but for many women this is a time of confusion, fear, sadness, stress, and even depression.

About 10-20% of women will struggle with some symptoms of depression during pregnancy, and a quarter to half of these will suffer from major depression.

Depression is a mood disorder that affects 1 in 4 women at some point during their lifetime, so it should be no surprise that this illness would also touch women who are pregnant. But all too often, depression is not diagnosed properly during pregnancy because people think it is just another type of hormonal imbalance. This assumption can be dangerous for the mother and the unborn baby.

Depression is an illness that can be treated and managed during pregnancy, but the first step, seeking out help and support, is the most important.

What is depression during pregnancy?

Depression during pregnancy, or antepartum depression, is a mood disorder just like clinical depression. Mood disorders are biological illnesses that involve changes in brain chemistry. During pregnancy, hormone changes can affect brain chemicals, which are directly related to depression and anxiety. These can be exacerbated by difficult life situations, which can result in depression during pregnancy.

What are the signs of depression during pregnancy?

Women with depression usually experience some of the following symptoms for 2 weeks or more:

• Persistent sadness

• Difficulty concentrating

• Sleeping too little or too much

• Loss of interest in activities that you usually enjoy

• Recurring thoughts of death, suicide, or hopelessness

• Anxiety

• Feelings of guilt or worthlessness

• Change in eating habits

What are possible triggers of depression during pregnancy?

• Relationship problems

• Family or personal history of depression

• Infertility treatments

• Previous pregnancy loss

• Stressful life events

• Complications in pregnancy

• History of abuse or trauma

Can depression during pregnancy cause harm to my baby?

Depression that is not treated can have potential dangerous risks to the mother and baby. Untreated depression can lead to poor nutrition, drinking, smoking, and suicidal behavior, which can then cause premature birth, low birth weight, and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby.

What is the treatment for depression during pregnancy?

If you feel you may be struggling with depression, the most important thing is to seek help. Talk with your health care provider about your symptoms and struggles. Your health care provider wants the healthiest choice for you and your baby and may discuss options with you for treatment. Treatment options for women who are pregnant can include:

• Support groups

• Private psychotherapy

• Medication

• Light therapy

If your symptoms are severe, your health care provider may want to prescribe medication immediately. There are medications that have been used during pregnancy without adverse affects. Discuss with your health care provider what he/she feels is safest for your baby but still beneficial to you.

If you do not feel comfortable talking with your health care provider about your feelings of depression, find someone else to talk with. The most important thing is that someone knows what you are dealing with and can try to help you. Never try to face depression alone. Your baby needs you to seek help and get treatment.

source :
http://www.americanpregnancy.org/pregnancyhealth/depressionduringpregnancy.html

Monday 14 December 2009

Vaginismus

Case scenario:

a young lady - recently married (a few months) - love marriage -  unable to have intimate relationship with husband - develop severe panic attacks and vaginismus everytime they were together - tried various medications and treatment but without much success


Source:

http://www.minddisorders.com/Py-Z/Vaginismus.html


Definition

Vaginismus occurs when the muscles around the outer third of the vagina contract involuntarily when vaginal penetration is attempted during sexual intercourse.

Description

Vaginismus is a sexual disorder that is characterized by the outer third of the vaginal muscles tightening, often painfully. A woman with vaginismus does not willfully or intentionally contract her vaginal muscles. However, when the vagina is going to be penetrated, the muscles tighten spontaneously due to psychological or other reasons.

Vaginismus can occur under different circumstances. It can begin the first time vaginal penetration is attempted. This is known as "lifelong vaginismus." Alternately, vaginismus can begin after a period of normal sexual functioning. This is known as "acquired-type vaginismus." For some women, vaginal tightening occurs in all situations where vaginal penetration is attempted (generalized type). For other women, it occurs in only one or a few situations, such as during a gynecological examination at the doctor's office, or with a specific sex partner (situational type). According to the professional's handbook, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) , in order for a condition to be diagnosed as vaginismus, the response must be due to psychological factors or a combination of psychological and medical factors, but not to medical factors alone. Because of this DSM-IV-TR criterion, this entry focuses on the psychological causes and treatments of vaginismus.

Causes and symptoms

Causes

There are many possible causes of vaginismus. One example is an upbringing in which sex was considered wrong or sinful—as in the case of some strict religious backgrounds. This is common among women with this disorder. Concern that penetration is going to be painful, such as during a first sexual experience, is another possible cause. It is also thought that women who feel threatened or powerless in their relationship may subconsciously use this tightening of the vaginal muscles as a defense or silent objection to the relationship. A traumatic childhood experience, such as sexual molestation, is thought to be a possible cause of vaginismus. Acquired-type vaginismus is often the result of sexual assault or rape.

Symptoms

Vaginismus can occur when any kind of penetration of the vagina is attempted. This includes attempted penetration by a penis, speculum, tampon, or other objects. The outer third of the vaginal muscles contract severely. This either prevents penetration completely, or makes it difficult and painful. The woman may truly believe that she wants to have sexual intercourse or allow the penetration. She may find that her subconscious desires or decisions do not allow her to relax the vaginal muscles.

Diagnosis

Diagnosing sexual disorders, including vaginismus, can often be very difficult. This is mainly due to lack of comfort many people feel in discussing sexual relations, even with their physicians. Often, cultural norms and taboos deter women from seeking assistance when they are experiencing such problems. When a physician or gynecologist is consulted, involuntary spasm during pelvic examination can confirm the diagnosis of vaginismus, and the physician will rule out any physiological causes for the condition. When psychological causes are suspected, referral should be made to a psychologist or psychiatrist .

According to the DSM-IV-TR , the first criterion for the diagnosis of vaginismus is the spasm of the muscles in the outer third of the vagina that are involuntary and recurring or persistent. The symptoms must cause physical or emotional distress, or, in particular, problems with relationships. The symptoms cannot occur during the course of another mental disorder that can account for them— they must exist on their own. As mentioned, the muscle spasm cannot be the direct result of any sort of physical or medical condition for vaginismus to be diagnosed.

Demographics

Although many women experience sexual disorders, it is hard to gather accurate data regarding the frequency of specific problems. Many cases go unreported. Vaginismus is thought to occur most often in women who are highly educated and of high socioeconomic status.

Treatment

There are many different treatments of vaginismus, as there is a multitude of ways to treat most sexual disorders. Therapists can use behavioral, hypnotic, psychological, educational, or group therapy techniques. Multiple techniques are often used simultaneously for the same patient. Much treatment is aimed at reducing the anxiety associated with penetration.

Psychotherapy

There are three settings in which psychological treatment can occur. These are in individual, couple, or group settings. During individual therapy, the treatment focuses on identifying and resolving any underlying psychological problems that could be causing the disorder. Problems stemming from issues such as childhood trauma or rape are often resolved this way. Revealing insecurities or fears about sex resulting from such things as parents' attitudes about it, or a religious upbringing, can often be discussed successfully if the affected woman can trust her therapist.

Couples therapy has been referred to as "dual-sex therapy." The idea behind couples therapy is that any sexual problem should be treated as a problem for the couple as a whole, and not just addressed as a problem for one person. Because this view is taken, the therapist interacts with the patients both separately and as a couple. The therapist addresses both the couple's sexual history and any other problems that may be occurring in the relationship. Confronting these problems may help to resolve the cause of the vaginismus. Working with a therapist on relationship problems can be very effective— perhaps especially so if the vaginismus is caused by a subconscious use of vaginal muscle spasms as a nonverbal form of protest about one or more aspects of the relationship. The couple is educated about vaginismus disorder and given advice on the kind of activities that can be engaged in at home that may be helpful in overcoming the disorder.

Group therapy, which can be very effective, is another form of therapy for vaginismus. In this form of therapy, couples or individuals who have the same or similar sexual disorders are brought together. For people who are embarrassed or ashamed of their disorder, this setting can provide comfort and strength. It is often very beneficial to witness another person discussing sex and sexual problems in an open and honest forum. It can also help to inspire patients to become more open and honest themselves.

Another positive feature of group therapy is that it provides a certain amount of pressure. Pressure to open up can help to provide a needed "push." Also the group's expectations for each other can provide positive pressure and encouragement for the group members. For example, the therapist may recommend "homework" outside the therapy sessions, including masturbation or certain kinds of foreplay. The group members will expect each other to complete the homework, and that expectation may help individual couples overcome their aversions to completing the activities.

Hypnotherapy

Hypnotherapy is also effective for some patients. In general, hypnotherapy tends to focus on overcoming the vaginismus itself, as opposed to resolving any causes or conflicts behind it. The therapist will determine if hypnotherapy is appropriate for a particular patient. There are often a number of sessions, during which the patient and therapist work to define the goals of the hypnotherapy. When the actual hypnosis occurs, the suggestions made are intended to resolve underlying fears or concerns, and to alleviate symptoms. For example, the patient may be told that she can have coitus without it being a painful experience, and that she will be able to overcome the muscle spasm.

During hypnosis, the problems causing the vaginismus may be explored, or an attempt may even be made to reverse feelings or fears that could be causing the disorder. Exploring causal relationships, as well as suggesting to the woman she can overcome her vaginal muscle spasms, can be very effective for certain patients.

Other treatments

Behavioral therapy is also used to treat vaginismus. When behavioral therapy is chosen, it is assumed that the vaginismus is a learned behavior that can be unlearned. Behavioral therapy generally involves desensitization. Patients are exposed to situations that they find create a mild sense of psychological discomfort or anxiety. Once these situations are conquered, the patient is exposed to sexual situations that they find more threatening, until coitus is eventually achieved without difficulty.

Another type of treatment for vaginismus involves desensitization over a period of time using systematic vaginal dilation. In the beginning of the treatment, the woman inserts a small object into her vagina. Over time, she inserts larger and larger vaginal dilators. Eventually, a dilator the size of a penis can be inserted comfortably and sexual intercourse can be achieved. There is some debate about this procedure, as it treats the symptoms and not the underlying causes of the vaginismus disorder.

Prognosis

Vaginismus is generally considered to be the most treatable sexual disorder. Successful treatment has been reported to be 63% or higher. For different people, the possibility of success using different treatments varies, because different cases of vaginismus disorder have varying causes. Generally, a treatment plan combining two or more therapeutic techniques is recommended.

Prevention

There is no known way to successfully prevent vaginismus; however, maintaining open marital communication may help to prevent the disorder, or to encourage seeking help if it does arise.

See also Cognitive-behavioral therapy ; Systematic desensitization

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., text revised. Washington DC: American Psychiatric Association, 2000.

Sadock, Benjamin J. and Virginia A. Sadock, eds. Comprehensive Textbook of Psychiatry. 7th ed. Philadelphia: Lippincott Williams and Wilkins, 2000.

PERIODICALS

Kleinplatz, Peggy J. "Sex Therapy for Vaginismus: a Review, Critique, and Humanistic Alternative." The Journal of Humanistic Psychology 38 no. 2 (Spring 1998): 51- 82.

Sadovsky, Richard. "Management of Dyspareunia and Vaginismus." American Family Physician 61 no. 8 (April 15, 2000): 2511.

ORGANIZATIONS

American Psychological Association. 750 First Street NE, Washington, D.C. 20002-4242, 800-374-2721;

Friday 11 December 2009

What Is 'Paranoia' ?

par·a·noi·a (pr-noi)
n.
1. A psychotic disorder characterized by delusions of persecution with or without grandeur, often strenuously defended with apparent logic and reason.
2. Extreme, irrational distrust of others.
[Greek, madness, from paranoos, demented : para-, beyond; see para-1 + nous, noos, mind.]

The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.

paranoia [ˌpærəˈnɔɪə]
n
1. (Psychiatry) a form of schizophrenia characterized by a slowly progressive deterioration of the personality, involving delusions and often hallucinations
2. (Psychiatry) a mental disorder characterized by any of several types of delusions, in which the personality otherwise remains relatively intact
3. (Psychology) Informal intense fear or suspicion, esp when unfounded
[via New Latin from Greek: frenzy, from paranoos distraught, from para-1 + noos mind]
paranoiac [ˌpærəˈnɔɪɪk], paranoic [ˌpærəˈnəʊɪk] adj & n

Collins English Dictionary – Complete and Unabridged 6th Edition 2003. © William Collins Sons & Co. Ltd 1979, 1986 © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003


paranoia
Psychiatry. a slowly progressive personality disorder marked by delusions, especially of persecution and grandeur. — paranoid, paranoiac, adj.
See also: Grandeur
a mental disorder characterized by behavior that stems from an elaborately constructed system of delusions of persecution and grandeur. — paranoiac, n. — paranoid, adj.
See also: Insanity
-Ologies & -Isms. Copyright 2008 The Gale Group, Inc. All rights reserved.


ThesaurusLegend: Synonyms Related Words Antonyms

Noun 1. paranoia - a psychological disorder characterized by delusions of persecution or grandeur
psychosis - any severe mental disorder in which contact with reality is lost or highly distorted
paranoia definition - medical


par·a·noi·a (părˌə-noiˈə)
noun
A psychotic disorder characterized by systematized delusions, especially of persecution or grandeur, in the absence of other personality disorders.
Extreme, irrational distrust of others.
The American Heritage® Medical Dictionary Copyright © 2009 by Houghton Mifflin Harcourt Publishing Company. Published by Houghton Mifflin Harcourt Publishing Company. All rights reserved.

Tuesday 1 December 2009

What is Personality ?





Persona literally means "mask ", although it does not usually refer to a literal mask but to the "social masks" all humans supposedly wear.

Definition

The English term personality is derived from the Greek word persona, which refers to the masks worn by the actors in ancient Greek dramas.

In psychology, the persona is the personality that we project to the world (i.e., the self we want other people to see). As a public self, the persona is a means of facilitating social interaction and should not be viewed negatively as a "false" self.

One of the most influential formulations of the notion of persona was put forward by the Swiss psychiatrist Carl Jung. In Jung's personality theory, the persona is one among several selves: the ego represents what we might call the self-image (the self we imagine ourselves to be); the shadow (which is a kind of alter-ego) embodies the traits that have been rejected as "not-self"; the anima or animus is the subconscious counter-self composed of the characteristics our particular culture identifies as belonging to the opposite sex; and the self is an archetype from the collective unconscious that provides the subconscious pattern for the ego (for the sense of selfhood).

Each of these aspects of the self can appear in dreams in various forms. In the case of the persona, dream images include everything from clothing that we put on or take off in dreams to the roles we assume. In Jungian therapy, the persona is viewed as a means whereby new characteristics can be integrated into the patient's ego structure. In other words, the subject can draw on previously rejected personality traits from the shadow and the anima or animus by acting them out in certain social situations and later identifying with them as part of a new ego concept.


Components of Personality

While there are many different theories of personality, the first step is to understand exactly what is meant by the term personality. A brief definition would be that personality is made up of the characteristic patterns of thoughts, feelings, and behaviors that make a person unique. In addition to this, personality arises from within the individual and remains fairly consistent throughout life.

Some of the fundamental characteristics of personality include:

  1. Consistency - There is generally a recognizable order and regularity to behaviors. Essentially, people act in the same ways or similar ways in a variety of situations.
  2. Psychological and physiological - Personality is a psychological construct, but research suggests that it is also influenced by biological processes and needs.
  3. Impact behaviors and actions - Personality does not just influence how we move and respond in our environment; it also causes us to act in certain ways.
  4. Multiple expressions - Personality is displayed in more than just behavior. It can also be seen in out thoughts, feelings, close relationships, and other social interactions.

Theories of Personality

There are a number of different theories about how personality develops. Different schools of thought in psychology influence many of these theories. Some of these major perspectives on personality include:

  1. Type theories are the early perspectives on personality. These theories suggested that there are a limited number of "personality types" which are related to biological influences.
  2. Trait theories viewed personality as the result of internal characteristics that are genetically based.
  3. Psychodynamic theories of personality are heavily influenced by the work of Sigmund Freud, and emphasize the influence of the unconscious on personality. Psychodynamic theories include Sigmund Freud’s psychosexual stage theory and Erik Erikson’s stages of psychosocial development.
  4. Behavioral theories suggest that personality is a result of interaction between the individual and the environment. Behavioral theorists study observable and measurable behaviors, rejecting theories that take internal thoughts and feelings into account. Behavioral theorists include B. F. Skinner and John Watson.
  5. Humanist theories emphasize the importance of free will and individual experience in the development of personality. Humanist theorists include Carl Rogers and Abraham Maslow.
 
source:
http://psychology.about.com/od/overviewofpersonality/a/persondef.htm
http://www.answers.com/topic/persona#In_psychology